Microsoft and Consumer eHealth

I have written many times in the past (on this blog and through other channels) on the potential of Microsoft to play a key role in consumer eHealth.  In addition to Microsoft HealthVault, the company has released information about other ideas currently in their labs:

http://www.pcworld.com/businesscenter/article/188848/microsoft_ehealth_research_taps_xbox_mobile_phones.html

Ideas include:

• smartphone apps that use sensors such accelerometers, camera, and microphone to help people keep daily logs of their activities.  I am considering employing a personal trainer to get into better shape and they have suggested that keeping such a log is an important part of a wellness and fitness program.
• Use of xbox 360 platform in hospital rooms to “to feed information from electronic medical records onto in-room display screens for patients”
• Computers built into tabletops that would instruct patients on how to care for themselves when outsidemthe hospital. “The computers could be used to pull content like X-ray images from personal records, or other pictures from the Internet, and to save them for the patient to view later.”

While some of these ideas might seem far fetched, I find it interesting to watch how a large consumer electronics and software company like Microsoft is exploring health applications for their products.

Mike

Local perspective on “hospitals of the future”

In conjunction with its new exhibit, “Our Body: The Universe Within”, the Children’s Museum in Kitchener, Ontario, is presenting a series of Sunday afternoon presentations entitled “The Future Health Care”

http://www.thechildrensmuseum.ca/ourbody/speakers.html

The first presentation in the series explored what “hospitals of the future” might look like.  According to an article posted on the TheRecord.com (http://news.therecord.com/News/Local/article/661578), highlights from presentations by Moira Taylor (President of St. Mary’s Hospital in Kitchener / Waterloo), Patrick Gaskin (CEO of Cambridge Memorial Hospital), and Malcolm Maxwell (CEO of Grand River Hospital in Kitchener / Waterloo) included:

• “…hospitals could learn a lot from corporations such as Toyota, which put a priority on finding efficiencies within their operations”
• “Another solution, the CEOs said, is more alternative methods of care, such as getting medically stable people out of expensive acute care beds and into more cost-effective community-based services, such as in-home nursing care. It’s also things like more nurse practitioners, anesthesia assistants and physician assistants.”
• “One of the biggest advances, they said, would be electronic health records, which can cut unnecessary surgeries, ambulance trips and adverse drug reactions that should have been preventable.”
• “…hospital of the future also needs to become more responsive to patients’ needs and schedules …. offering such things as elective surgery on Friday nights or Saturday mornings”
• “Patients need to be more involved in the whole process, with access to their own digital medical records and their own test results.”

I was pleased to see recognition at the most senior levels of hospital adminstration of the need for electronic records and greater patient engagement in the healthcare delivery process (enabled by IT).

Mike

iPad in Healthcare

I continue to be amazed at the attention that the iPad is receiving, both in the mainstream press and in the blogosphere.  As the three main focus areas of my consulting practice are eHealth, mobility, and social media, I am tracking iPad discussions quite closely.  In the health sector there is active debate as to whether the iPad will a suitable platform for physician practices.  Dr. Alan Brookstone explores this topic today in his CanadianEMR blog (http://blog.canadianemr.ca/).  He notes that a recent survey by health IT software vendor ePocrates found that 59% of physicians are considering purchase of iPad, with 21% indicated that they will buy one sometime this year.

In related iPad news, two FCC officials have voiced their concerns about the impact of the iPad on mobile network congestion.

http://www.fiercebroadbandwireless.com/story/fcc-argues-more-spectrum-apples-ipad-makes-appearance/2010-02-07?utm_medium=nl&utm_source=internal

The story notes that these officials are concerned that potential network capacity problems “are reminiscent of congestion problems AOL experienced in the 1990s when it decided to allow unlimited Internet use.” The two officials are quoted as saying that “”..wireless network congestion today reveals intense demand for wireless broadband. Widespread use of smartphones, 3G-enabled netbooks, and now, perhaps, the iPad and its competitors demonstrate that wireless broadband will be a hugely important part of the broadband ecosystem as we move ahead.“

I think believe that we will see a renewed and intense interest in “tablet” computing with the debut of the iPad and other similar devices from vendors such as HP (which announced their “slate” computer at CES earlier this year).  I think that Apple’s decision to use the iPhone OS instead of MacOS will encourage active development of iPad applications, a key driver for tablet use.  The immediate availability of 140,000+ iPhone applications plus near daily announcements by software vendors of plans to release new applications designed specifically for the iPad bode well for widespread iPad adoption.

Mike

Increased gov’t funding for eHealth in the US

The Obama administration is requesting additional funds for federal eHealth programs in their current budget submission:

http://www.healthdatamanagement.com/news/hhs_budget_onc_ahrq_ocr-39734-1.html?zkPrintable=true

The silence re: additional eHealth funding in Canada is deafening.  The federal gov’t is still sitting on the promised $500M for Infoway though there are signs that it may be released in the spring after the Auditor General’s office releases a report on provincial eHealth programs.  Wouldn’t it be great if this funding could be released prior to the eHealth conference in Vancouver at the end of May?

Mike

Canadian eHealth success stories

Dr. Alan Brookstone pointed on his blog today (www.canadianemr.ca) that HIMSS and the American Society for Quality (ASQ) are publishing case studies on hospital use of healthcare IT (geez, I finding myself avoiding use of the word “eHealth”).  Check them out:

http://himss.org/storiesofsuccess/caseStudies.asp

I am interested in hearing similar success stories in Canada. As I find them I will post them on the blog and, if I can gather enough of them, I will create a special area on the site for these stories.  So, those of you responsible for PR in their healthcare organization looking to promote local success stories, please point them out to me!

Mike

Ray Hession’s testimony to Standing Committee on Government Agencies

The transcripts for the 30 min interview with the Standing Committee on Government Agencies was posted yesterday.

http://www.ontla.on.ca/web/committee-proceedings/committee_transcripts_details.do?locale=en&Date=2010-02-01&ParlCommID=8859&BillID=&Business=Intended+appointments&DocumentID=24632#P83_4416

Some comments that I found interesting:

• In this opening speech, Mr. Hession concluded with the following statement of intent: “Mr. Chair, if your committee supports my nomination by the government as chair of the board of directors of eHealth Ontario, we, the board, will move quickly to establish strengthened governance and, in particular, become a disciplined and collaborative integrator, emphasizing the public value-led, importantly, by a seasoned new chief executive officer. Secondly, we will build an image and reputation based on the quality of our solutions and of the services we provide. Finally, and importantly, we will achieve the outcomes stipulated in the eHealth strategy.”
• When asked about his past experience regarding compliance with procurement rules, Mr. Hession stated that “… in an earlier life, was the deputy minister federally responsible for procurement, so, without any bravado here, I have a considerable amount of experience in the subject matter …  But more recently, I’ve served as fairness commissioner on two major capital projects involving the government of Ontario“
• With regard to his approach for ensuring that the auditor’s recommendations are in place, Mr Hession stated that “I find his findings, conclusions and recommendations compelling” and “…given all the moving parts, given a new CEO, a new chairman, a number of new board members, I believe that an executive committee of the board is a necessity, an absolute necessity, such that that tight coupling can occur and that there is an information flow between the two parties that enables proper accountability on the one hand but also maintains a pace of activity that goes with a lot of moving parts.“
• When asked “How are we going to restore the public’s confidence?” and “How are you going to ensure that electronic health records are going to be made available to all Ontarians?”, Mr. Hession suggested that “The strategy needs to be translated, in the context of the work to be done, into an architecture …. the fact of the matter is, unless you know quite specifically what it is you’re going to build, you run reasonably high risks of failure. So we need that architecture.” He also noted that “My hope and expectation is that with the architecture, clearly defined, flowing from that strategy, we will begin to see real product, good quality, results, and that’s what will begin to reinvigorate the image and reputation of the organization.
• When asked by the opposition whether he would be able to “stand up to” the Premier or the Minister of Health, Mr. Hession replied, “From my point of view, I did not want to be, nor was I seen to be, anybody’s toady. I spoke for the council, and the council spoke on behalf of Ontarians with respect to the performance of the health system. A large part of that speaking had to do with the very subject we’re here to talk about today.

I was hoping that the committee members would ask a question about the process of finding a new CEO.  I have heard a rumour that eHealth Ontario offered the job to someone and the person turned it down.  I am hopeful that with Mr. Hession at the helm qualified candidates will feel more comfortable considering the position.

Mike

IBM buys Initiate Systems

One of the most successful small companies (Initiate) to ever sell software into the Canadian healthcare IT market is being swallowed by Big Blue. I remember watching these guys sew up the provincial client registry market back in 2006. This looks like a good deal for both parties.  IBM gets a very good specialist health-IT company to strengthen their product pipeline, and Initiate gets the reach of IBM.

The impact for the Canadian eHealth market appears to me to be more strategic. IBM will now have a very important seat at the table when it comes to provincial eHealth infrastructure and strategy. I expect to see IBM winning more follow on work at a provincial level…not because of new products from Initiate, but because they are IBM and they now have the seat at the table and the ear of the powers that be.

Mark

Ontario LHINs using the Internet to inform and engage

I have noted several Ontario LHINs are actively using the Internet to inform and engage their communities.  The SouthEast LHIN, for example, provides a tool for registering your interest in various topics so that they can send an email notification when there is a new announcement regarding these topics. Check out:

http://southeastlhin.on.ca/mypage.aspx

One of the topic areas for which you can register to get news is board meetings.  A complete agenda, supporting documentation, and board minutes are provided.  There is some very interesting reading in the board meeting minutes.  I applaud their efforts to be open and transparent.

Another initiative comes from the SouthWest LHIN (hmmmmm …. LHINs with the South in their name seem to be reaching out).  Julie White (Twitter handle – GET_ENGAGED), Director of Communications & Customer Service,  is actively using Twitter to post announcement regarding events and other items of interest.

If you are aware of any other similar LHIN initiatives please let me know and I’ll post information about them on this blog.

Mike

First, do no harm

Just came across an interesting announcement from the US Department of Health and Human Services regarding an upcoming contract to “create and support a panel of experts and related work groups to identify and explore potentially undesirable or harmful “unintended consequences”" arising from US healthcare IT funding initiatives.  According to the contract award notice (https://www.fbo.gov/index?s=opportunity&mode=form&id=22633354ce0c9b300b832ff16c2658a7&tab=core&_cview=0&cck=1&au=&ck=):

“While we expect for these programs to help achieve the many desirable outcomes envisioned by Congress, a sense of responsibility for activities we support, historical experience, as well as mounting evidence of unexpected problems, demand that we consider potential downsides.”

“While some unintended consequences are desirable, the purpose of this contract is to identify and address those that are undesirable and potentially harmful.”

The contract notice defines “unintended consequences” as

“… outcomes that are not intended, even though, upon investigation and reflection, they are, at least in part, a natural consequence of the activities.”

I was intrigued by HHS’s decision to explore unintended consequences.  What do you think of their decision to do so? Any thoughts on unintended consequences arising from the application of IT in healthcare?

Mike

Reflections on the iPad

I have been eagerly following the discussion leading up to and following the iPad annoucement.  I have envisioned just such a device since held my first iPOD Touch (since replaced by an iPhone).  At the time I thought “great device but Iwish that it had a larger screen”.

I think that the iPad is a new category of device meant for people who already have a computer (either desktop or laptop) and a mobile device (smartphone or otherwise) and is looking for a lightweight device for basic functions (email, web browsing, light work processing). The iPad will be what netbook tried to be … an inexpensive, lightweight, light duty computer. It will NOT replace either an iPhone or a laptop and, hence, doesn’t need some of the same functionality.

My plan is to buy a Wi-Fi only iPad and tether to my iPhone when not in Wi-Fi range. I think that Apple will need to think about better integration between iPhone and iPad. I will always carry my iPhone but won’t always take my iPad. Hence, some means of easily sharing data and connections is required.

Mike