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Hacking Health in Hamilton Ontario - Let's hear that pitch!

What compelled me to register for a weekend Health Hackathon? Anyway, I could soon be up to my ears in it. A pubmed search on Health Hack...

Friday, February 24, 2017

The myUHN Patient Portal - Infoway Award Winner


The myUHN patient portal has won a second place award from a Canada Health Infoway contest. Here is the presentation they gave:
 http://imaginenationchallenge.ca/wp-content/uploads/2017/02/myUHN-Patient-Portal.pdf

Their infographic on the uptake of the portal is very impressive by the numbers - numbers which have been suggested as viable in research on patient portals (They didn't mention concern for the security of personal health information):
 http://www.uhn.ca/corporate/News/Documents/myUHN_infographic.pdf

The pilot study is over and a full launch began January 30, 2017. It is expected that 250,000 patients will register for it in 2017! Very, very interesting that the portal is integrated into all stages of the clinical experience and by all personnel.

Based on my research on patient portals this looks to be the very promising. Sunnybrook Hospital myChart was also a great pioneer in this area and they have taken a page from their book. It also appears to be an ideal integration solution that I think would work best for a healthcare system.

But what about primary care? Is there an API for that? And why are family docs still so worried about liability or whatever for using a PHR?

Looking closer at myUHN it is very much just a portal or window on the hospital EHR, with a limited but very useful and important set of interaction tools. It is not a personal health record where one can self-report and journal one's health, as is the one developed by McMaster Family Medicine, now called KindredPHR.

If I get sick, I am going to Toronto and the UHN:
 http://www.uhn.ca/PatientsFamilies/myUHN







Thursday, February 16, 2017

mbant2 clinical trial - a super duper fitbit?

I noticed on the Journal of Medical Internet Research that the mbant2 clinical trial is starting.
 http://www.researchprotocols.org/2016/3/e174/

This is an ehealth cornerstone - evaluating the effectiveness of ehealth applications. mbant2 is a University of Toronto study, where Frederick Banting appropriately enough was one of the discovers of insulin.  I almost think the fitibt could help self-manage type 2 diabetes if there was also a way to measure glucose A1c levels. Apparently Medtronic is looking into exactly that.
 https://www.medtronicdiabetes.com/blog/partnering-with-fitbit-for-type-2-diabetes/

No google contact lens yet for tears to detect blood sugar insulin. Guess they are still working on it. The email alerts I have been getting about always make it sound it is off in the future somewhere. It would be great to have pin-prickless procedures and devices. The research is very hard to make that work well.




Saturday, February 11, 2017

Pushing Drugs - American Style: Watching the news makes people sick.

This is a post from the blog of Professor emeritus Dr. Richard Hayes, who taught Buddhism and Sanskrit at McGill University, and is now back home in the 4 corners area of the United States. Dayamati Hayes is also a Quaker, peace activist, vegan, and a conscientious objector from the Viet Nam war. As a friend who I have known on internet lists and now on social media for more than several decades, Dr. Hayes is well known and respected for his wit, wisdom, and insight into our human condition. In fact, there are too many excellent posts one could share from Richard, but this one is only a sample, and one that has some relevance to digital health:

http://dayamati.blogspot.ca/2017/02/pushing-drugs-american-style.html

Watching the news makes people sick

At the outset I must confess to being addicted to watching the news on television. Although my favorite televised news sources are on PBS, on most nights I supplement the PBS News Hour with the news on one of the traditional network stations or a cable news channel. Something that has repeatedly struck me in watching the evening news on traditional network stations is that advertisers have obviously learned that the vast majority of people who watch the evening news are suffering from indigestion, irritable bowel syndrome, erectile dysfunction, atrial fibrillation not caused by a heart-valve problem, moderate to severe psoriasis, rheumatoid arthritis, osteoporosis, depression, insomnia, restless leg syndrome or dry eye disease. If not afflicted by one of those conditions, they are being assaulted by meatballs or chicken wings.

Not all the commercials are pushing drugs, of course. Interspersed with all the pharmaceutical products are commercials featuring lawyers who are prepared to sue pharmaceutical companies for offering products that have life-changing side effects, and health insurance plans that complement Medicare to provide coverage to pay for all those pharmaceuticals that TV viewers are urged to ask their doctors about. Given the evidence of television commercials, remarkably few of the people who watch the televised news are under the age of sixty-five and have sound minds in sound bodies.
An often-heard claim of those who are convinced that the Affordable Care and Patient Protection Act has all but destroyed the health-care system in the United States is that the ACA (which they persist in calling Obamacare) has driven insurance premiums through the ceiling, thus bringing financial ruin to small businesses and confronting hard-working Americans with having to choose between health insurance and sending their children to overpriced universities. What is missed in this analysis, of course, is that health insurance is expensive because medical care and pharmaceuticals are expensive. Also left out of consideration is that almost every pharmaceutical product sold in the United States is available in Canada for a fraction of the cost.

Why don’t Canadians pay their share of the cost of drugs?

A claim I have heard many American make, clearly a claim that they have learned from the pharmaceutical companies themselves, is that the prices of pharmaceutical products are so high in the United States because it costs pharmaceutical companies a great deal of money to do the research necessary to develop new products. Some American friends have even showed indignation that Americans are subsidizing Canadians, who derive all the benefits of expensive medical research but pay none of the cost. Once, when I was still living in Canada, I received an email from a (former) friend in the United States who accused me, in language unsuitable for anyone not in either the navy or a motorcycle gang, of being a freeloader who was enjoying good health at the expense of poor Americans. That claim was false for two reasons. First, I have almost never been prescribed a pharmaceutical product and tend to avoid over-the-counter medical products. Second, there are better explanations for why pharmaceutical prices are outrageously high in the United States. So the answer to the question “Why don’t Canadians pay their share of the cost of drugs?” is that they in fact do pay their fair share. Americans pay more, not because they are subsidizing freeloading Canadians, but because Americans pay far more for products than it costs to develop and manufacture those products.

Why do Americans pay for overpriced pharmaceuticals?

The pharmaceutical companies typically claim that they must charge high prices for their products because of the high cost of developing them. It cannot be denied that running controlled tests on new products and making sure the products meet safety standards is costly. It should also be pointed out, however, that advertising the products once they are developed is also costly. To that can be added that pharmaceutical companies also tend to pay shareholders rather high dividends. When health care products are manufactured by for-profit corporations that have investors to reward with high dividends, then costs naturally rise. While the claim of many advocates of free-market capitalism is that competition keeps costs down, the opposite is often the case. If two companies are competing for a share of the market, the cost of the competition—the advertising of products to potential consumers of the products and to potential prescribers of those products—can be quite high.

Neither of those kinds of advertising is necessary. There is no justification whatsoever for running expensive advertisements on television that end with the line “As you doctor whether…is right for you.” There is no need to make the patient into a sales representative for a product that the patient may end up buying. If someone has, say, osteoporosis, then it should be sufficient for the physician to suggest a range of possible treatments, and to tell the patient the desired effects and the likely side effects of each of the possible treatments. And that information should be given directly to the physician in the form of the results of clinical trials, not in the form of slick presentations delivered in the context of work-vacations at expensive resorts. The cost of disseminating objective information is relatively low, whereas the cost of trying to persuade a physician to prescribe product A rather than the almost-identical product B is much higher.

One way to bring medical costs down is to make advertising of medical products illegal, as it is in some countries that have lower costs for pharmaceuticals and hands-on medical care. Another way is to have government-imposed limits on the amount of profit a company can make on a product, as is also the case in some countries that have reasonable consumer-costs for health-related products. A third way is to have a government-run insurance plan that negotiates prices with pharmaceutical companies and imposes a cap on how much a pharmaceutical company can receive for its products. There is no need for a government-run plan to be managed by the central government. In Canada each province has its own plan, and no two provinces have exactly the same setup.

Health care is far too important to be left to the vagaries of markets in a for-profit corporate scheme. The good health of the entire citizenry is far more important than the bank accounts of capitalist shareholders. There are plenty of other markets in which investors can make or lose their money. Pharmaceutical companies, manufacturers of medical devices, clinics, hospitals and retirement homes for the elderly should not be in the private investment sector of the economy. (Neither should correctional facilities, but that is a matter for another day.)

Americans desiring affordable health insurance should first advocate for more affordable treatments, and that is best achieved by a not-for-profit health-care system. They should be asking for, in fact demanding, more government involvement and less private-sector investment in products designed for health. Such a change in outlook would, however, require that Americans first seek a cure for their addiction to free-market capitalism and the delusion that the best way to keep costs down is to let the market determine prices. That strategy has been tried again and again, and it has failed again and again. It is time for Americans to considered an alternative system (not to be confused with “alternative facts”).

Next time you see a television commercial for an expensive treatment that you have seen a hundred times before, instead of simply reaching for the mute button on the remote control, ask your doctor whether socialized medicine is right for you. If you doctor says No, then consider seeking a second opinion. 

Wednesday, February 8, 2017

COACH is recuiting health informatics student for MacKenzie Health Epic HIS



FOR IMMEDIATE RELEASE: COACH supports Mackenzie Health with large-scale digital health/health informatics undergraduate and post-graduate students recruitment initiative

Toronto, ON - February 8, 2017 - Today COACH: Canada's Health Informatics Association announced the roll-out of a major recruitment initiative with the goal of hiring more than 75 emerging professionals/ students/ HI graduates to fill full-time contract, co-op, and summer positions at Mackenzie Health, the regional health service provider for Ontario's Southwest York Region.

Mackenzie Health has embarked on a full implementation of the Epic hospital information system (HIS) as part of its drive to achieve Level 7 in the HIMSS EMRAM scale within three years. The hospital also has plans to open a second major site in 2020, and will become the first hospital in Canada to implement the full suite of Epic systems.

To facilitate adoption of the new HIS, the hospital will need 75 Super Users and 15 Credentialed Trainers to be drawn largely from COACH membership and academic contacts.

"We need to cast a wide net, and quickly," said Diane Salois-Swallow, chief information officer at Mackenzie Health. "The COACH membership community is simply the best place to find this many applicants with a basic understand of HIS implementation complexities."

75 Super Users/15 Credentialed Trainers
Super Users will provide direct end-user support and assistance during implementation training sessions. Customer service skills and knowledge of the new system will ensure hospital users are comfortable during the go-live process. The Super User position is a paid position, and is defined as a placement or summer term opportunity starting May 1, 2017 and ending August 21, 2017. For more information about the Super User role, visit http://bit.ly/2kF4AWK.

Credentialed Trainers will train end-users (using existing training materials) and provide go-live support. Credentialed Trainers will be required to commit to a longer term, from March 30, 2017 until August 21, 2017. This is a paid position. For more information about the Credentialed Trainer role, visit http://bit.ly/2kiRy00.

"We are happy to be supporting Mackenzie Health in this important initiative," said Mark Casselman, COACH CEO. "This benefits everyone. The hospital benefits by being able to tap into a group of engaged, motivated young digital health professionals, trained for Canadian HIS delivery. And our Academic and Student Members will have the opportunity to put their education to practical use in a major health service delivery transformation. COACH is growing, and this is the first in a wave of new partnerships that will connect, inspire, and educate the digital health professionals who are contributing to the future of healthcare in Canada."
Applicants who require training in HIS delivery best-practices will participate in a COACH education session. Funding partners interested in reaching and investing in the next generation of the Canadian digital health workforce are welcome to participate in this education initiative.

About COACH
COACH: Canada's Health Informatics Association has a history of fostering professionalism and refining the expertise of its 2,000+ member population, with an emphasis on continuing education and shared knowledge. COACH is Canada's largest digital health community, representing professionals working to advance healthcare delivery through information technology. As the voice of Health Informatics (HI) In Canada, COACH promotes the adoption, practice and professionalism of HI. HI is at the intersection of clinical practice, Information Management/Information Technology and healthcare management. Visit www.coachorg.com for more information.

CONTACT
Mark Casselman at 416.358.0567 or ceo@coachorg.com