Online Diagnosis and Treatment App – Zipnosis

I was recently introduced to an online diagnosis and treatment app called Zipnosis. The video embedded below does a pretty good job describing how the app works and what they’re trying to do with the company.

In some ways, this technology reminds me of Vinod Khosla’s famous quote that “technology will replace 80 percent of doctors.” In the case of Zipnosis, it seems that the technology isn’t quite replacing the doctor, but it’s one step closer to being able to do so. I’m not sure if that’s their vision, but you can see how this could be the start of a very interesting algorithm that could treat patients.

I’m sure many people reading this are wondering how a doctor can treat someone who they’ve never talked to, met, touched, etc. In fact, it seems that with Zipnosis the doctors is treating and prescribing for a patient who has just filled out what amounts to an online form (in the form of a mobile app). Lest you get too concerned, here’s the list of conditions they treat:
Zipnosis Online Diagnosis Treatment Options

I’ll be interested to see how this list expands and contracts. No doubt, there are a lot of situations where a form on a mobile phone is probably more than enough to treat the patient. Add in pictures and you have a bunch more things you can treat. Add in other external devices and you can treat even more. I’ll be interested to watch Zipnosis and see how they expand and how the market responds to what they’re offering.

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The Sullivan Institute for Healthcare Innovation Announces Release of Guiding Principles for Patient Experience-Centered Care

The Sullivan Institute for Healthcare Innovation’s Patient Experience Council expandsInstitute of Medicine’s definition for patient-centered care with six guiding principles

RESTON, Va. — October 22, 2014 The  Louis W. Sullivan Institute for Healthcare Innovation, which is dedicated to distribute health information technology innovation to transform quality and efficiency of healthcare delivery worldwide announced the development of six key guiding principles of patient-centered card in which patients expect when receiving healthcare. These are an expansion of the Institute of Medicine’s definition for patient-centered care: “providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.”

The full document of guiding principles is available online, which details the six main principles:

  1. Clearly Defined Roles
  2. Assessment of Patient and Clinical Care Team Competencies
  3. Patient-Centered Decision-Making
  4. Information Access and Exchange
  5. Information Accuracy
  6. Privacy and Security

“I am incredibly proud of the work our Patient Experience Council is doing to make strides in reshaping the way we look at healthcare from the patient’s perspective and experience of their own care,” said Kym Martin, MBA, CNC, CFT, Co-Chair of The Sullivan Institute’s Patient Experience Council. “As healthcare stakeholders explore strategies to deliver more patient-centric care, products and services, we see these Guiding Principles serving as the next step to ensuring that the patient engagement strategies being considered result inpatient-experience centered outcomes.”

The Patient Experience Council represents a collective body of ePatients and eAdvocates committed to transforming healthcare from the patient perspective. They are charged with the implementation of the Patient Engagement recommendations set forth in the 2013 WEDI Report, a roadmap for the future of healthcare information exchange that was launched December of 2013.

“The 2013 WEDI Report envisioned the future of healthcare information exchange with the patient in the middle. I believe that the principles being released today by our Patient Experience Council will help provide a framework for how organizations should orient their efforts in order to prepare for the future landscape of healthcare,” said Devin Jopp, Ed.D, President and CEO, WEDI.

About the Sullivan Institute

The Louis W. Sullivan Institute for Healthcare Innovation is a 501(c)(3) non-profit organization, named in honor of The Honorable Louis W. Sullivan, M.D.  Its mission is to bring healthcare leaders together to share knowledge needed to transform the quality and efficiency of healthcare delivery through education, cooperation, communication and innovation. To learn more, visit www.sullivaninstitute.org.

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Insightful Healthcare Factoids from Health Catalyst

Who doesn’t like a good set of healthcare IT stats and facts? Obviously, you have to be careful looking at the context of the statistic and how it was collected. However, when done right, you can learn a lot from what Health Catalyst is calling a Healthcare Factoid. They shared a bunch of Factoids during their Healthcare Analytics Summit and then packaged them into a nice slide presentation below.

Which healthcare factoids stand out for you?

Posted in Healthcare Analytics, Healthcare Big Data, Hospital Electronic Health Record, Hospital Electronic Medical Record, Hospital EMR, Hospital Healthcare IT | Tagged , , , | Comments Off

Podcast: Scot Silverstein talks health IT safety risks

In a sidebar to the September cover story I did for Healthcare IT News, I reviewed some of the work of Scot Silverstein, M.D., who has long been chronicling problems with EHRs and other health IT systems. Unfortunately, he wasn’t available for an interview in time for that report, but he was last week, so I got him for a new podcast.

Silverstein, a professor of health informatics at Drexel University in Philadelphia, considers EHRs to be experimental and, sometimes, less safe than paper records and would like to see health IT subjected to the same kind of quality controls as aerospace software or medical devices. “Suboptimal system design could lead even careful users to make mistakes,” Silverstein said in this interview.

During this podcast, we refer to a couple of pages that I promise links to, so here they are. Silverstein writes regularly for the Health Care Renewal blog, a site founded by Roy Poses, M.D., a Brown University internist who runs the Foundation for Integrity and Responsibility in Medicine. His definitions of good health IT and bad health IT appear on his Drexel Web page.

Podcast details: Scot Silverstein, M.D., on health IT safety risks. MP3, mono, 128 kbps, 33.8 MB. running time 36:59.

1:10 How this interest came about
3:05 His blogging
3:45 His 11 points demonstrating why he believes the FDA should be concerned about health IT risks
5:00 IOM, FDA and ECRI Institute statements on health IT safety
5:50 Comparing EHRs to medical devices and pharmaceuticals
8:35 Lack of safety testing in health IT
9:25 Issues with EHR certification
10:00 Safety validation of software
10:35 EHR’s role in Texas Health Presbyterian Hospital’s initial discharge of Ebola patient
11:50 EHR failure causing medical harm to a close relative
13:10 Poor design vs. poor implementation
14:35 Who should regulate?
15:55 Billions already spent on EHRs
16:45 Threat of litigation
17:40 “Postmarket surveillance” of “medical meta-devices”
18:50 EHRs now more like “command and control” systems
19:30 Movement to slow down Meaningful Use
20:17 Safety issues with interoperability
21:40 Importance of usability
22:30 His role at Drexel
24:18 “Critical thinking always, or your patient’s dead”
25:05 Lack of health/medical experience among “disruptors”
29:30 Training informatics professionals and leaders
31:15 Concept vs. reality of “experimental” technology
32:50 Advice for evaluating health IT
33:55 Guardians of the status quo
35:10 Health IT “bubble”
36:10 Good health IT vs. bad health IT

 

Posted in ARRA, blogging, EMR/EHR, health it, Health IT workforce, Healthcare IT, informatics, interoperability, jurisprudence, Meaningful Use, medical errors, medical informatics, patient safety, physicians, podcast, quality, regulations | Tagged , , , , , , , , , , , , , , , | Comments Off

How Do You Change the HIPAA Culture of Your Hospital?

Over on EMR and HIPAA, I wrote an article about the “Just Enough” culture of HIPAA compliance. I’m sure that many of you reading this post will be very familiar with this culture. Unfortunately, it’s rampant in so many hospitals across the nation. Even when a few people in the organization are hyper focused on doing more about HIPAA compliance, they’re often stifled by others who want to do just enough.

In response to this post, Christopher Gebhardt, offered these suggestions on when a hospital’s culture has a “funny” way of changing:
– Through the genuine interest of senior executives leading the charge.
– After being slapped with a violation.
– When OCR shows up at your door. The latter defeats the “it can’t happen here” mentality.
– When OCR takes action, repeatedly, for known violations against your competitors.

I think you could define Christopher’s description as a reactionary approach to HIPAA compliance. I think it’s fair to say that along with being a “just enough” culture of HIPAA compliance, healthcare is also very reactionary. There are some notable exceptions to this, but HIPAA and security compliance are very reactionary in most hospitals.

Culture is a hard thing to change at any organization. However, I think we’re entering a new era where a culture of security and compliance is going to be very important to every healthcare organization. With social media, there’s no where to hide any more. An investment in the right hospital security and privacy culture will likely pay off greatly in the long term.

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The State of Hand Hygiene Compliance Infographic

DebMed recently announced the results of the Hospital Hand Hygiene report. They also put out this infographic which summarizes some of the findings:
The State of Hand Hygiene Compliance Infographic

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3-D Printed Facial Prosthesis Offers New Hope for Eye Cancer Patients Following Surgery

Made to cover hollow eye sockets, flexible custom masks provide more affordable, fast- production alternative to traditional prosthetics

CHICAGO – Researchers have developed a fast and inexpensive way to make facial prostheses for eye cancer patients using facial scanning software and 3-D printing, according to findings released today at AAO 2014, the 118th annual meeting of the American Academy of Ophthalmology. Their novel process can create more affordable prosthetics for any patients who have hollow sockets resulting from eye surgery following cancer or congenital deformities.

In the United States, more than 2,700 new cases of eye cancer are diagnosed each year, according to the American Cancer Society, and the mortality rate is high for the disease. Some patients undergo a life-saving surgery known as exenteration that involves removing the contents of the eye socket and other tissue. The research team hopes to bring these patients relief by providing a more affordable facial prosthesis that will allow them to live their lives more fully and with less stigma.

Conventional facial prostheses can cost $10,000 to $15,000 and take weeks to produce. Each one is created by an ocularist, an artisan who makes a mold of the face, casts it using rubber and then adds the final touches such as skin color and individual eyelashes. Patients and their families often have to pay out-of-pocket for facial prostheses because health insurance oftentimes will not cover the cost.

University of Miami researchers developed a process to manufacture facial prostheses in a matter of hours at a fraction of the cost of a traditional prosthesis using topographical scanning and 3-D printing technology. Patients are scanned on the undamaged side of their face using a mobile scanner. The software then creates a mirror image. Along with a scan of the side of the face with the orbital defect, the program can mesh the two scans together to create a 3-D image of the face. The topographical information then goes to a 3-D printer, which translates the data into a mask formed out of injection-molded rubber suffused with colored pigments matching the patient’s skin tone.

The project started as the brainchild of David Tse, M.D., professor of ophthalmology at the Bascom Palmer Eye Institute in Florida and the Nasser Ibrahim Al-Rashid chair in ophthalmic plastic, orbital surgery and oncology. Dr. Tse was treating a child with eye cancer who had both eyelids removed and underwent exenteration. The family could not afford an ocularist, so Dr. Tse raised donations to help pay for her first prosthesis. Now a teenager, she has grown out of the prosthesis and must instead wear an eye patch.

“Hopefully, using this quick and less expensive 3-D printing process, we can make an affordable facial prosthesis for her and also help thousands of other people like her who lack the resources to obtain one through an ocularist,” said Dr. Tse.

Designed and developed in partnership with Dr. Tse and a team at the Composite Materials Lab at the University of Miami, the 3-D printed prosthesis possesses several advantages over the conventional type created by an ocularist. The material involves a proprietary mix of nanoparticles that provides extra reinforcement and makes it possible to match many shades of skin. Over time, conventional facial prostheses can discolor and fray at the edges, but nanoclay protects the material from breaking down and changing color when exposed to moisture and light. It also prevents dirt from depositing. If the prosthesis ever needs to be replaced, reproduction can happen with the press of a button.

“Once we have a patient scanned, we have the mold, so we can create a new prosthesis in no time,” said Landon Grace, Ph.D., director of the lab and an assistant professor of mechanical and aerospace engineering. “Our long-term goal is to help patients anywhere in the world. We could get a mobile scan, download the data in Miami, print out the prosthesis and ship it back to the patient the next day.”

Rapid and cost-effective orbital prosthesis fabrication via automated non-contact facial topography mapping and 3-D printing (PO467) was presented at AAO 2014, the 118th annual meeting of the American Academy of Ophthalmology in conjunction with the European Society of Ophthalmology, which is in session October 18-21 at McCormick Place in Chicago. More than 25,000 attendees and 620 companies from 123 countries gather each year to showcase the latest in ophthalmic education, research and technology. To learn more about the event Where All of Ophthalmology Meets, visit http://www.aao.org/2014.

More 3-D Printing Technology Research

Additional 3-D printing technology results will be presented at AAO 2014 by ophthalmologist David Myung, M.D., Ph.D., of the Byers Eye Institute at Stanford University. His work centers on a 3-D-printed lens adapter system that enables high quality images of the eye using smartphones, which may help increase access to more affordable eye care. The poster is titled “Design and Rapid Prototyping of a Novel 3-D Printed Smartphone Lens Adapter System” (PO328).

About the American Academy of Ophthalmology
The American Academy of Ophthalmology, headquartered in San Francisco, is the world’s largest association of eye physicians and surgeons, serving more than 32,000 members worldwide.  The Academy’s mission is to advance the lifelong learning and professional interests of ophthalmologists to ensure that the public can obtain the best possible eye care. For more information, visit www.aao.org.

The Academy is also a leading provider of eye care information to the public. The Academy’s EyeSmart® program educates the public about the importance of eye health and empowers them to preserve healthy vision. EyeSmart provides the most trusted and medically accurate information about eye diseases, conditions and injuries. OjosSanos™ is the Spanish-language version of the program. Visit www.geteyesmart.org or www.ojossanos.org to learn more.

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Video on Building Accountability and Consistency Into Your Workflow

What do you think of this video?

I found this video really interesting. Vishal Gandhi, CEO of ClinicSpectrum took his post Building Accountability and Consistency Into Your Healthcare Practice on EMR and HIPAA and turned it into video format. He did it quickly, so I think it could benefit from a little polish, but I love the idea. Video can capture people’s imagination in a way that text can not.

Going to the topic of the video, I’ve seen a lot of practices that can benefit from the idea of accountability in their practice. In many respects, Vishal is just describing how to implement some best business practices into your clinic. Many practices could benefit from these simple ideas.

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Fine Thinking Friday

I just posted a tweet summary of today’s #HITsm chat about meaningful use. It was full of amazing insights on what’s happening with EHR, meaningful use and healthcare IT. There were so many insights that it got really long, but go and read it anyway. It’s still just a bunch of easily digestible tweets.

Since the post was getting too long, I didn’t want to make it longer by including some of the off topic tweets that were sent during the #HITsm chat. I guess that’s where it’s an advantage to have a full network of EHR and Healthcare IT blogs. I decided that I’d share the really interesting off topic tweets from today’s Twitter chat here.


What a great discussion between Keith and Stephanie. I think we’d all like to see a “little less talk…a lot more action!” (sorry to get that song in your head, but I had to do it)


Gregg Masters response to this tweet was spot on: “Bingo! you nailed the problem. ‘complexity’.” It is super complex and Mandi’s right that no doctor is going to go through the trouble. Bernadette also replied to the tweet and said that “Experts like you are precious.” Very true!


This is the challenge that we’ll be dealing with for a while to come. The shift will not be easy.

I love when a Twitter chat goes off topic. These tweets are great examples of why I like it. Definitely worthy of a Fine Thinking Friday post!

Posted in EHR, Electronic Health Record, Electronic Medical Record, EMR, Healthcare IT, HITECH, Meaningful Use | Tagged , , , , | Comments Off

Hospitals and Ebola

It seems like you can’t turn your head anywhere without hearing something about Ebola these days. I heard one TV station in Dallas being called the Ebola news. It’s probably pretty accurate considering it’s been the epicenter of the news coverage. Although, the coverage has seemed to be a little all over the place. In fact, the coverage for Ebola has hit so many places, that I’ve basically avoided almost all of the coverage. I’ve only gotten a little bit of coverage from the sources that I ready regularly. I guess I’ve also seen a few headlines on social media.

With that said, I have dug a little deeper on what’s happened with the EHR and Ebola discussions. Although, that story seems to be even more convoluted and misunderstood than the larger Ebola story. If you want something really valuable (notice the sarcasm font), check out this just released joint statement from the AMA, AHA, and ANA that basically says “We’re working together on it.” If I were a member of any of these organizations, I’d have to consider quitting.

Here’s my short synopsis on what we should know about Ebola:

1. Be thoughtful in how you avoid any communicable disease (Ebola included). That doesn’t mean you have to lock yourself in your house and never go out.
2. We need to get Ebola under control in Africa. If we don’t, then we could have Ebola become a real issue in the US.
3. EHR software can help healthcare professionals identify and track Ebola if configured properly.

There are a number of groups and organizations trying to come together to spread the EHR best practices when it comes to Ebola. I’ll be interested to hear what they find.

Those are my general thoughts on what’s happening. As I said, I’m not an all encompassing expert on the topic. Let’s all share what we know and what we’re doing in the comments.

Posted in Hospital EHR, Hospital Electronic Health Record, Hospital Electronic Medical Record, Hospital EMR, Hospital Healthcare IT | Tagged , | Comments Off