HealthBlog

On Super Bowl Sunday, I received an e-mail from one of my physician colleagues, Dr. Thomas Gumprecht.  I’ve provided information on HealthBlog before about Dr. Gumprecht and his ENT practice in Redmond, Washington.  Tom and I share a passion for the use of contemporary communication and collaboration technologies in healthcare delivery.  We both understand how a medical practice can be transformed when physicians use every means available to them in the care of their patients.  That means phone, fax, messaging, e-mail, web visits and tele-health applications in addition to traditional face to face visits with patients in the office. Even more so, Tom and I share a strong conviction that physicians must be paid for delivering services to patients when using any of these modalities.

Here in Washington state, Dr. Gumprecht has been successful in getting many insurance companies to go along with this.  No, I don’t mean that private insurance will necessarily pay for services rendered using technology (although some do).  But they will allow physicians to bill patients for these services provided that the physician has written, signed documentation in the patient’s chart that she or he understands and agrees to the fact of being charged when such services are provided.  According to Dr. Gumprecht, even CMS allows for private billing when patients have been so informed and the documentation is in the chart.

Dr. Gumprecht e-mailed me to vent his frustration that so many docs are still unaware of this opportunity to deconstruct their practices and transform the way they deliver medical services.  He wrote:

There is a huge universe of need for medical services of every type and variety. Medical offices should reconfigure themselves into "call centers/communication centers (phone, fax, email, texting etc.)" wherein the patient is contacting the office for some sort of service. With this new policy the secretaries/nurses are not incentivized to channel every request for service into an office appointment. Especially with an EMR data base, the requests for service can be fielded, sorted through by the secretary/nurse as to what seems to be the most appropriate way to provide the service, format it for doctor review and response and the service provided---by phone call, fax, email, or in office visit whatever is proper. And an appropriate bill generated and sent to the patient. The office revenue would not be limited to just what can be seen in office. If the doctor fields 5 phone calls, 5 prescription refills, and 5 emails in a day in addition to his office visits, the doctor would have a better paycheck to show for the genuine work he/she has done. It would reward true "medical homes". It would help rectify pay inequities in medicine.

If you look through the comments the last time I vetted this on HealthBlog, you’ll see we hit a nerve.  One doctor wrote:

As a Family Doctor, I spend a significant portion of my clinical time on purely cognitive services (counseling and education). These are currently reimbursable only when conducted face-to-face in the office. Requiring a patient to leave work and drive to the office for a 15-30 minute discussion seems unfair. But it is equally unreasonable that a physician couldn't collect for that time if the same services are provided telephonically or electronically.

We lose the subtle clinical cues: body language, gross neurologic inspection, skin color, etc. But much of the time, even these are not needed.

Do I need the patient sitting across from me to counsel on travel vaccines? Motion sickness medications?

Is there anything negligent about following up with a stable depression patient by telephone or video-conference?

I always feel a little guilty requiring office visits for these types of services, but it is my only option right now if I am to stay in business.

These are services I would love to provide remotely, but there are some obstacles:

1) Insurance contracts still won't pay for "virtual" visits

2) Most of my patients, for reasons I can't grasp, expect that telephone services and consultations should be free.

Even over the phone, I still spend the same amount of my professional time. I still accumulate the same liability (maybe even more). And I require the same level of cognitive work.

The potential downside of expanding access to tele-health is that patients will begin to expect more services in this fashion.

Yes, patients appreciate not having to make appointments and come into the office for every little thing they need.  Time is money on both sides of the equation.  Especially when an office visit co-pay is already involved, how many patients would trade convenience over the hassle factor if you charged a similar amount for services by phone, e-mail or on the web?

The longer physicians hold on to the notion that only office visits generate revenue, and the longer they continue to give away their cognitive services when using any other modality (or steer patients to expensive office visits that they really don’t need) the misery will continue.  Dr. Gumprecht and I believe that our professional societies need to step up, and start training physicians how to deconstruct their practices and avail themselves of the contemporary communication and collaboration technologies at their disposal.  In any other professional services industry this happened long ago.  Just ask your tax preparer, attorney, or accountant.

Bill Crounse, MD  Senior Director, Worldwide Health   Microsoft

In Today’s Healthcare IT News, Jeffery Daigrepont, senior vice president for healthcare IT consulting company the Coker Group, offers some sage advice on “Five Healthcare IT Decisions to Avoid”.  They are:

1. Buying defective software
2. Buying non-compliant software
3. Not seeing the writing on the wall (buying software that is being discontinued)
4. Buying or developing “one-offs”
5. Going live with an incomplete system

As a former hospital CIO and CMIO I learned some of those lessons the hard way.  If you hold a similar position in a hospital or clinic, I’ll bet you’ve “been there, done that” too. We all get wiser from our mistakes.  Either that, or we get fired.

Along the way I learned that no matter what company serves as your enterprise core clinical system vendor, and no matter how comprehensive their solution, there’s always a whole bunch of things that system won’t do and was never designed to do.  In other words, no single system will provide everything you need in order to run today’s typical, and very complex, health delivery system organization.  And that is why I wanted to add one thing that you should embrace in addition to Jeffery’s five things you should avoid.  Embrace  innovation!

I’ve noted as I have traveled the world for Microsoft, and visited health facilities large and small, that the most successful organizations are the one’s that nurture innovation.  And when I say innovation, I don’t mean that you have to live on the bleeding edge. I simply mean that you should look for opportunities where you can apply readily available, widely-used, highly flexible and proven commodity software to solve the most pressing needs of your organization that are not being addressed by your core clinical or administrative systems.  Whether you need powerful analytic tools and scorecards for business and clinical decision making; solutions to enable and enhance caregiver communication and collaboration; a way to publish and manage organizational policies and procedures; strategies to streamline your IT infrastructure and run greener; or solutions to improve patient satisfaction….you can do this!  In fact, you may be able to do it with software you already own but just haven’t implemented.

I’ve seen so many success stories over the years.  I’ve shared many of them right here on HealthBlog--examples of hospitals and clinics embracing innovation and creatively using what, in many cases they already have at hand, to solve for what they need.  You might be surprised what you can do.  Let us help you “innovate”!

Bill Crounse, MD  Senior Director, Worldwide Health    Microsoft

While the media will be focused today on Apple’s Tablet announcement,  I’d like to remind HealthBlog readers that there’s nothing new about Tablet devices.  I have been evangelizing the use of Tablet PCs in health for nearly a decade.  And over the last several years, particularly with the release of Windows Vista and now Windows 7, the Tablet PC value proposition for healthcare providers just gets better and better.

First of all, the devices themselves are better.  And, healthcare providers have more choices than ever before (I have four Tablet PCs on my desk right now).  There are excellent Tablets available from most major manufacturers including ones made expressly for clinicians such as the devices offered by Motion Computing, Panasonic, Tablet Kiosk and other vendors.

Of course, it’s not really so much about the device as it is what you can do with it.  First and foremost, these are full-function computing and productivity solutions (unlike that shiny new Apple).  Tablet PCs more closely mimic the familiar patient chart.  They can be used, digital pen in hand, without feeling intrusive in the physician-patient encounter.  They accommodate multi-modal data input including keyboard (when docked), digital inking, point and click, voice and even touch including multi-touch with Windows 7.  The inherent speech engine in Windows Vista and Windows 7 is so good, it is even possible to do excellent speech recognition dictation if you are willing to put in a little effort up front.  When connected wirelessly to a corporate network or the Internet, Tablet PCs provide instant access to the information you need, when and where you need it.  They can also run all of the other applications you might want to use in your office or home.

All of this functionality hasn’t been lost on clinicians.  Just  yesterday I was contacted by Dr. Alan Rosenbach.  Dr. Rosenbach runs a very successful solo dermatology practice in the Los Angeles area.  He called me because he wanted to share his enthusiasm for his Tablet PC running Microsoft Office OneNote.  He said for the last three years, he has been using OneNote as the official EMR for his office.  He does all of his chart notes and tracks all of his patients with OneNote.  He uses a Tablet PC from Fujitsu. He makes extensive use of digital inking for both data entry and illustrations on clinical findings.  He also embeds photos in his patients’ “charts” and attaches transcriptions and other documents to each patient’s record.  Most remarkably, he says, OneNote has never gone “down” for even a second.  And of course, he loves the low, low price.

What Dr. Rosenbach didn’t know until I told him, was that there is actually a company that has for many years been selling an EMR solution based on Microsoft Office OneNote for the Tablet PC.  That company is the Ablet Factory.  I received an update from company founder, Fritz Switzer, in this morning’s mail.  I had asked him to tell me what medical specialties where particularly drawn to his company’s solution.  He replied:

“With regard to the mix of specialties we see using our OneNote EMR products, a large number of psychiatrists and podiatrists lead the specialty roster. I have referred to this fact as “we provide a head to toe solution”. Chiropractors and pain management specialists are also recurring practice types. We have seen a common thread with this usage mix. The practices have a large number of “graphically oriented” forms/templates. The digital inking of a Tablet with drawing capabilities of OneNote provide a platform where a conventional EMR falls short”.

The Ablet Factory also offers a medical vocabulary plug-in for their EMR solution called WordMgr 2010.  It takes care of spell check, digital inking recognition and improved speech recognition for more than 100,000 medical terms and abbreviations.

If there is a downside here, it is that this EMR solution isn’t “certified” by ONCHIT.  It also may not meet “meaningful use” criteria.  So, if you are looking for a government handout to pay for your EMR, you are likely out of luck.  On the other hand, thousands of docs in solo or small group practices have found an easy pathway to digitizing patient records that is simply “good enough”, at least for now.  And this solution will only set you back about $700 for software.  Add another $250 if you want the medical vocabulary plug-in.  At those prices, who needs a bailout from the government anyway?

Bill Crounse, MD  Senior Director, Worldwide Health   Microsoft

Yesterday I provided the opening keynote address and participated on an expert panel for the BayCare Health System’s annual Innovation Day retreat.  The retreat was held just outside of Tampa, Florida, at the Safety Harbor Resort.

BayCare is a community based health system consisting of 10 hospitals and 31 ambulatory care facilities.  Like other very large health systems, BayCare is focused on continuous improvement in the scope and quality of services it provides to its communities.  Part of their quest is planning for future growth and anticipating what kinds of health services will be needed a decade from now.  That was the focus of the Innovation Day retreat.

One of the themes we explored was how to apply new communication and collaboration technologies to better serve citizens in the region.  This included how to utilize cellular networks and mobile devices, messaging, e-mail, and video conferencing.  We also examined the growing interest in “medical gaming” using platforms like the Nintendo Wii or Microsoft Xbox.  There are already video games that can help people lose weight, learn how to exercise, rehab from an injury, and recuperate from cancer treatment.  With new 3D motion camera controllers and hands-free technology like project Natal from Xbox, the opportunities to develop health and wellness video game applications will only grow.  Hospitals and health systems should be thinking now how they will incorporate these and other technologies, like Microsoft Surface and Windows 7 multi-touch, into patient care and patient education applications. 

There is also interest in using electronic data to more accurately manage population health, and individualize care.  Genetic screening information when coupled with the vast amounts of information in our health system data bases will reveal things we’ve never been able to analyze before in real time.  Social networking sites and platforms like Microsoft HealthVault will become vast repositories of health and wellness information that can be utilized by citizens and clinicians around the world.

Although a great deal of focus and investment is currently around electronic records systems and HIS interoperability, my message to hospitals and health systems is that there is much they can do now with lower cost, commodity technology to solve some of today’s most pressing needs and put themselves in great position for the opportunities that will arise tomorrow.  It’s really that adage of going after the low hanging fruit.

That thought was reinforced as I took a long walk around Safety Harbor after the Innovation Day event.  I couldn’t help but notice the Southern Oaks hung heavy with glistening clusters of Spanish moss.  For me, each tree represented a health system firmly planted in the soil of a community.  And the low hanging moss on each tree offered a plethora of untapped opportunities to improve health and wellness.  OK maybe that’s a bit of a stretch, but it did cross my mind.

Bill Crounse, MD  Senior Director, Worldwide Health    Microsoft 

I just returned from an overnight trip to Toronto, Canada.  If you plan on making the trip yourself, let me warn you.  Flying back to the States is a major hassle these days.  I spent more than 2 hours waiting in four different lines of check-in, customs and security checks before arriving at my gate.

The reason for my quick trip to Toronto was to provide a  breakfast keynote to healthcare executives, public health officials and clinicians at the invitation of eHealth Ontario.  Later the same morning I was invited to speak at the launch of eHealth Ontario’s Physician’s Task Force.  There I was joined by clinical leaders from across Ontario who will help chart the course of eHealth initiatives in the region.

Just as what is dominating discussion in America these days, an important component of eHealth Ontario’s work is increasing the adoption and use of electronic medical records systems by Ontario physicians.  According to speakers at the gathering, about 35 percent of physicians in Ontario are currently using EMRs.  Clearly, digitizing clinical information is an important goal.  But as I’ve pointed on this Blog and in my discussions with eHealth Ontario and other groups, this is just the beginning of the journey to improve patient care and citizen health.  In fact, it is not the EMR that will deliver the value but rather what we do next with the health information that is digitized.  I summarized my thinking with the following recommendations to eHealth Ontario.

• Focus on projects and initiatives that reduce complexity.   Technology only adds real value when it reduces complexity.
• Focus on projects to improve care team communication and collaboration. (Unified Communications).
• Focus on projects that engage consumers/patients and provide transactional value; again reducing complexity in how consumers engage with the health system.
• Look for opportunities to use technology to facilitate patient referrals, reduce errors, and improve patient flow and through-put.
• Look for ways to meet consumer's needs with exactly the most appropriate level of service, at the most appropriate time and place (messaging, e-mail, phone, web, and in-office visits).
• Where possible, apply commodity, flexible, adaptive technology when building industry solutions.
• Remember, so many of today’s solutions are not as dependent on the technology (we can solve for that) as they are on human behaviors, regulations, and business models that reward innovation with properly placed incentives. 

Time and time again, I have seen healthcare organizations adhere to these common sense principles and succeed where others have failed.  The opportunity to use technology to solve some of our most pressing issues in health and healthcare is immense.  And, that opportunity is in all kinds of areas in clinical practice and public health that have nothing to do with EMRs.  In fact, some of the biggest and fastest returns on investment will come from these other areas.  Now, if only we could figure out how to make flying fun again.

Bill Crounse, MD    Senior Director, Worldwide Health     Microsoft 

On January 13th we will launch the third program in our monthly, on-line video series “Health Tech Today”.  The show features two entirely new segments and two encore segments from earlier programs (yes, not only did HealthBlog take a break over the Holidays, but Health Tech Today as well).

New program segments in our January 13th episode include:

Jeff Goldsmith: Future Prescriptions

Leading health care futurist, Jeff Goldsmith, analyzes the future of IT in health care. He asks the big question; Why has IT adoption been so painfully slow in health care?” Can IT transform health care to improve quality, productivity and health worker morale at the same time? Health Talk Today hears the insights of Jeff Goldsmith, the president of Health Futures Incorporated.

Joel French, VP Motion Computing

He says in many cases technology solutions have been oversold, over-hyped and are not living up to their promises. Health Tech Today meets the vice-president of Motion Computing, Joel French, to learn tips on how to insure the success of health IT implementations. He also shares information about some of the latest advances in his company’s products.

In addition to these new program segments, we have an encore appearance from Dr. Cornelia Ruland, the nurse/inventor of a video game that is giving clinicians better insights in caring for chronically ill children.  We also revisit Halo Monitoring CEO, Chris Otto, who demonstrates his company’s unique solution to help keep tabs on the well being of aging seniors in their homes.

I hope you will join us January 13th for our new Health Tech Today program.  Remember that you can view past shows as well as individual program segments from each show on-demand.  Stay tuned for an all-new episode of Health Tech Today in mid February.  I think you’ll be blown away by the special guests and cool technologies featured in upcoming shows.  Health Tech Today also has a fan page on Facebook. Please become a fan!

Here is the Health Tech Today promo for our January program:

Bill Crounse, MD     Senior Director, Worldwide Health     Microsoft

After two weeks away from the office, I’m back in the saddle in Redmond.  As much as I tried to pull the plug over the Holidays it was pretty hard to avoid the Christmas Eve health (insurance)  reform antics gong on in Congress.  If that wasn’t bad enough, the Office of the National Coordinator (ONC) on December 30th released a 556-page document providing interim final rules on meaningful use and qualified electronic health records.  Reading even a summary of of the rules gave me a hangover greater than anything I’ve experienced on New Years Day.  Is it just me, or are we only making everything about health, healthcare and the practice of medicine in America even more complicated and confounding than it is already?

I mean no disrespect to the politicians, industry executives, thought leaders and others who are doing this important work.  But has anybody really stepped back and asked, “What is it exactly that we are trying to improve and how can we make getting and giving healthcare less complicated,  more affordable, and more satisfying”?

I see glimmers of hope in some of the proposed rules.  For instance, as a consumer I like the idea of being able to get a copy of my medical record in a timely manner.  I applaud directives that take a more proactive, preventive approach to health.  I really, really want my medical information to be stored electronically and shared (by my permission) with anyone who needs it.  I want my doctor to be focused on providing safe and effective treatments when I’m ill and recommending things I can do to stay healthy when I’m not.  But 556 pages of rules defining meaningful use of electronic records!

I think I have a far better than average grasp of contemporary  information technology, electronic health record solutions, and hospital IT systems than your average Joe.  Yet even I cannot help but feel overwhelmed when reading the ONC rules.  As an average doctor in America, how many additional full-time staffers would I need to implement, let alone keep track of all this stuff.  Would I be incented by an additional forty to sixty thousand dollars to my cumulative Medicare or Medicaid reimbursements to even bother with any of this?  It might be easier to just withdraw from those programs as so many doctors have already done.  Then who will care for our seniors and the medically underserved?

I can’t answer for my medical colleagues.  I’m not in practice anymore.  But if I was still in practice, I’m pretty sure these new rules would push me over the edge.  And that’s coming from someone who actually enjoys using technology!  And while we in America mire ourselves in all these new regulations and directives, will the rest of the world continue to innovate with much simpler, more pragmatic approaches to health IT?  That has been my observation as I’ve traveled the world.  Sometimes we are our own worst enemies. 

Bill Crounse, MD    Senior Director, Worldwide Health     Microsoft

What a year this has been!  Market meltdown, mortgage defaults, bank failures, bankruptcies, joblessness, and outright fraud.  Surely 2010 will be a better year.  Who knows, for better or worse we might even get healthcare reform done.  For certain, more clinicians will be going digital and more hospitals will be seeking solutions to improve operational efficiency, care quality, and patient safety.  And, no doubt, everyone will be looking for ways to do all of that while lowering costs. 

Healthcare has always been a challenging industry. In my 30 year career as a physician, hospital executive and technology pundit, my observation is that the business of medicine isn’t getting any easier.  A number of my colleagues have simply packed up and left healthcare for retirement or new careers in other industries.  Those left behind are likely to face increasing scrutiny, lower incomes, and greater pressure to do even more with fewer resources.

Of course, before we start feeling too sorry for each other, I should point out that all of this is happening in other industries as well.  Welcome to a much flatter world.  It really doesn’t matter if you work in manufacturing, real estate, banking, retailing, broadcasting, publishing, or any other industry; it seems doing business and making a decent living is more challenging than ever before.  So perhaps we should all just suck it up, stop complaining, and get on with it.

Maybe I’ve become a bit jaded by all the technology that surrounds me working at Microsoft, but I genuinely believe that technology holds the key to addressing many of our current challenges.  Yes, it requires new training and skills.  Yes, it forces us to change the way we’ve always done things before, and change is never easy. But technology provides a way to automate so many of the mundane tasks and processes that hold us back and take up our time.  Technology offers a way for us to communicate and collaborate on a global scale.  It can help us manage our business, improve our efficiency, and gain deeper insight to the overwhelming amount of data that surrounds us.  Technology can transform the way we deliver health information and certain kinds of medical services.  It can augment and assist our decision making processes to improve care that is both safer and more satisfying.

So dust yourself off and climb aboard the change train.  Better times are ahead, but only if each of us is willing to become a part of the solution.

Like many of you, I’ll be taking some much needed time off over the Holidays to refresh and recharge.  To my loyal readers, thanks for all that you do to improve health and wellness around the world.  Thanks for sharing your thoughts and comments.  And thanks for making HealthBlog, a top 100 industry forum.  If you have time over the Holidays, please check out our new on-line show, Health Tech Today as well as all the other useful resources you’ll find on our Health Industry web site.

Happy Holidays!

Bill Crounse, MD    Senior Director, Worldwide Health      Microsoft

Yesterday, I had the honor of delivering a luncheon keynote address at the LifeScience Alley annual conference and exhibition in Minneapolis.  Despite the major snowstorm that swept the Midwest this week, more than 1200 people showed up for this annual gathering of movers and shakes in the life sciences industries. 

On my way through the Minneapolis airport, I came across the ad  you see to the right.  I couldn’t decide if it was brilliant marketing tied to recent events, or pure serendipity.  In either case, it made me chuckle.  It also aligned quite well with something I’ve been advocating for some time. 

The entire nation has its eyes on Washington these days where Congress is debating the future of healthcare.  No matter what you think about the debate or its likely outcome, one thing is clear.  The days of practicing medicine on paper are rapidly coming to a close.  Like it or not, physician practices and hospitals will need to go digital, or they will take a serious hit in how much they are paid.  I’m sure some of my colleagues feel they will take a serious hit either way, and they may be right.  The ROI on electronic records doesn’t come from the digital information itself, it comes from what you do with that information.  In other words…… it’s what you do next.

Digital health information enables a different kind of practice.  It lays the groundwork for a practice that is proactive and preventive rather than one that is reactive and only focused on disease after it occurs.  It helps us achieve and measure benchmarks for best practices.  It provides the data that measures quality and patient safety.  It helps us reach out to our community and patients in ways previously not possible.  It paves for the way for business models that are better aligned to control the spiraling cost of care while maintaining high quality.  These are the rewards now being realized by some of America’s best healthcare organizations; hospitals and clinics (many of them profiled right here on HealthBlog) that have been digital for some time.  Hospitals and clinics that are already using and mining their digital health data to deliver better care.   Like I said, it’s not about the EMR….. it’s what you do next that counts.

Bill Crounse, MD  Senior Director, Worldwide Health   Microsoft

I want to draw your attention to the next episode of Microsoft Health Tech Today.  The second show in our monthly series will premier December 10th. 

This time around, we catch up with my friend and colleague Dr. Jay Parkinson.  Jay and I are a full generation apart in age, but we are cut from the same cloth when it comes to our enthusiasm for how software and information technology will transform health and healthcare delivery.  Like  most young physicians setting up practice today, Jay grew up with technology.  Everywhere he looked, he saw opportunities to use that technology in new and innovative ways.  It started with his own practice and soon morphed into a new kind of business and delivery model called Hello Health.  He describes it as the EMR meeting Facebook. 

Our second guest is the CIO of New York Presbyterian Hospital, Aurelia Boyer.  Not only does NYP enjoy the advantage of having the famous Dr. Oz on its staff (where he does patient care when not on TV) but they have also teamed up with Microsoft HealthVault and Microsoft Amalga to deploy a new kind of patient portal that is facilitating care team communication and collaboration, improving care quality and safety, and delighting patients.

Also on the program is Dr. Sayave Gnoumou, Founder and CEO  of Nazounki Global Medical Network.  Nazounki is an international network of doctors who share information about their patients in order to help each other provide better treatments and better services. They are very active in Africa working to bring western medical advancements to patients who would otherwise not have access to those treatments. Their primary challenge was that in many African countries telephone lines are expensive and unreliable, internet access is sporadic, and bandwidth is often too low to send large image files such as X-rays, CT scans, and MRI results. The doctors often found themselves waiting for days to receive information via long distance courier services. But now Nazounki has been able to overcome many of these obstacles. By using Windows Mobile® and Waves image compression software they are able to exchange information and images via cell phone, and provide real time solutions to patients for whom every moment counts.

Finally, due to popular demand we bring back my interview with the 31 year-old founder of Remote Medical International as he explains why his company and the services it provides are growing, year over year, by several hundred percent.  And why technology is playing a huge role in that success.

If you would like to view the show trailer for our December 10th edition of Health Tech Today, click on the player below.

Bill Crounse, MD    Senior Director, Worldwide Health      Microsoft

If I was commenting on Facebook or Twitter about today’s topic on HealthBlog, I would have to give this one a very strong “like”.  I’m referring to some new work from an organization in the United Kingdom known as the Digital Access Provision Forum.  The Forum exists “to support a step-change in levels of installation and application of integrated digital communication technologies within the UK built environment in support of public and private policy objectives for building performance including energy conservation, education, health services, quality of life and an information driven, more productive, more competitive economy”.  Now that is a mouthful, but hold on, because what this group is doing is really cool.

  One of Forum’s specific areas of research is to “demonstrate a new approach to exercising informed customer choice for those needing assisted living support in the management of chronic health conditions”.  You’ll recall that in my last post on HealthBlog, I shared information about a company, Halo Monitoring, that is doing some very good work on peace of mind home monitoring solutions.  Typically, these solutions are for seniors and other individuals with chronic disease or disabilities who are trying to maintain a degree of independence in their own homes.

I think it is helpful to be able to envision a possible road map for this kind of technology in the years ahead.  That is exactly what the Digital Access Provision Forum has accomplished with an on-line interactive service called the Assistive Demonstrator Tool. The Tool shows how over the next few years people living with long term chronic health conditions will have more choice and better products to support the management of their conditions.  And, they will be able to do this from the comfort and convenience of their own homes.

The Tool is a collaborative effort involving the Kent City Council, the Foundation for Assistive Technology, the Buildings Research Establishment, and Microsoft UK.  It takes viewers through some well crafted scenarios that help us understand exactly how new consumer technologies might be applied to help us live longer and better, independently.  In one scenario, we see how technology might be used to help patients with dementia and help family members who care for them.

In another scenario, ICT helps connect an ailing senior with her family members and community medical resources.  These are scenarios that anyone who has ever cared for an aging parent or other loved one will understand all too well.

The scenarios are dramatic and engaging.  The user interface for the Tool is stunningly elegant.  Furthermore, the vision for how technology can play a role in helping people and families manage chronic conditions and stay connected is spot on.

If you are a developer, medical professional, home care provider, or just someone with a keen interest in technology, I highly recommend a visit to the Digital Access Provision Forum’s Assistive Demonstrator Tool.  You’ll be glad you did.

Access the Assistive Demonstrator Tool by CLICKING HERE

(Be patient.  The Tool takes time to load and requires Microsoft Silverlight).

Bill Crounse, MD Senior Director, Worldwide Health   Microsoft

As I travel the world meeting with public health officials, healthcare executives and providers, a common theme is the concern about aging populations and the growing incidence of chronic disease.  This, coupled with the skyrocketing cost of care for aging seniors, has become top of mind for government leaders and tax-paying citizens in most countries of the developed world.

However, the real burden and angst about this is far more personal.  Today’s families are all too often separated by great distances.  It’s only natural that we worry about the well being of aging parents or other loved ones and often feel helpless in our situation.  Fortunately, technology is now stepping in to relieve some of our anxiety.

A recent example of this was profiled on our new on-line video series, Health Tech Today.  I was joined in the studio by Chris Otto, CEO of Halo Monitoring.  Chris was prompted to start his company from a personal need in his own family.  His mother was looking for a better way to keep tabs on her frail elderly mother who lived many miles away.  Not finding the solution they were looking for, Chris set out to develop one.  The result is the MyHalo monitor.

As demonstrated on our program, this wearable device can track both pulse and body temperature.  It also has an accelerometer and the necessary algorithms to accurately detect when a person has taken a fall or is at growing risk for falling.  Information collected by the wearable device is transmitted to a central hub in the home.  The hub is connected through the Internet or dail-up phone line to a central monitoring center.  When an adverse event occurs, it is reported both to the central monitoring center so help can be summoned and to family members who subscribe to the service. Notifications can be received via phone, e-mail, or SMS text message.  Family members can also sign on to a secure web site where they can receive regular reports on their loved one’s activity and well being.  According to Chris Otto, the MyHalo monitoring service costs about $50 a month, about what many people pay for cell phone or cable television.  For peace of mind, it seems to me that’s a small price to pay.

This is but one example of a growing list of health devices and  services that are becoming available to aid people in their homes.  Many of these devices, both those for monitoring chronic disease issues as well as those for tracking personal health and well being, can be connected to web platforms and personal heath record solutions such as Microsoft HealthVault.  In fact, the market for these kinds of solutions is expanding so fast that giant electronics retailers such as Best Buy are now featuring personal health and well being devices in stores around the country.  Perhaps one of these is a great Christmas gift for someone you know.

Technology certainly can’t solve all of the problems associated with growing old or dealing with infirmities, but it will play a very important role in helping people maintain a better quality of life while staying longer in their own homes.  And that is something I suspect most of us will welcome.

Bill Crounse, MD  Senior Director, Worldwide Health   Microsoft

Click Here to Watch “Health Tech Today”

The first program in our monthly video series at the intersection of health and information technology, Health Tech Today, is now live on the web.  A show like this takes a village to produce.  Special thanks to my colleagues at Microsoft, our production team at Pirhana Productions, and most especially thanks to all of YOU for your encouragement and support.  We plan to bring you a new show each month.  We welcome your ideas for future programs: thought-leaders you would like us to interview; people and organizations doing great work to improve the cost, quality and safety of care; and anything else that illustrates how software innovation is improving health around the world.  I hope you enjoy the show.  Comments welcome at drbill@microsoft.com.

Bill Crounse, MD    Senior Director, Worldwide Health    Microsoft

Health Tech Today is a monthly, online video series providing cutting-edge stories at the intersection of health and information technology.  The show features informative interviews with some of the world's top health leaders; compelling health-related personal stories; and the latest new technologies and IT innovations.

Watch Program Trailer Here

 
Program guests for launch show on November 10th 

ARCHBISHOP DESMOND TUTU: eHealth Initiative

He’s a recognized name around the globe; A lifelong defender of human rights and advocate for vulnerable peoples around the world. Archbishop Desmond Tutu joins Health Tech Today from South Africa to discuss how eHealth--the use of information & communication technologies in medicine--may be the key to improving access and solving chronic problems in global health care.

ANDREW CULL: Digital Paramedic

This 31-year old paramedic-turned-chief executive is breaking the mold dispensing emergency medical services around the globe—all coordinated by handheld devices, cell phones, and online software. Whether it’s rescuing a fallen climber in Nepal or evacuating a research scientist in the South Pacific, Remote Medical International delivers 24-hour service around the globe.  Health Tech Today reveals how information technology is helping this company experience triple-digit annual growth.

CORNELIA RULAND, Ph.D: Video Game Diagnosis

Doctors are receiving new insights into the symptoms of their young chronically ill patients—courtesy of an interactive video game. SiSom gives ailing children a voice in their treatment and helps their doctors care for them. Health Tech Today talks with the creator of the new technology, Cornelia Ruland, from her office in Oslo, Norway.

KIM PITTENGER, MD: Technology Transformation

He believes that much of the cost of medical care involves clogs in the flow of information—so his team turned to the lessons learned from the efficient production line system of automaker Toyota. The Medical Director of Kirkland, Washington’s Virginia Mason Medical Center, Dr. Kim Pittenger shows Health Tech Today how this production line revelation is transforming the patient’s experience.

DON DETMER, MD: Putting ‘Communication’ Into ICT

He says ‘communication’ is what is vitally missing at the intersection of health and information technology today. Health Tech Today hears why nationally recognized thought leader Dr. Don Detmer is advocating for stronger communication and collaboration solutions in clinical workflow.

CHRIS OTTO: Peace Of Mind Monitoring

It’s a dynamic personal health monitoring and alert system that is giving peace of mind to those who worry about their aging loved ones. MyHalo offers around-the-clock vital sign & activity monitoring by using body sensor technology combined with the Internet. Company CEO, Chris Otto demonstrates Halo’s technology on the set of Health Talk Today.

BILL CROUNSE, MD: Program Host, Executive Producer

HealthTech Today is hosted Bill Crounse, MD, who is also executive producer and creator of the show.  Dr. Crounse is a local and network TV physician journalist with more than two decades of experience. The program is produced by Emmy-award winning producer, Mark Stendal. Health Tech Today is taped at Microsoft Studios in Redmond, WA.  The show premiers November 10th.

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You can watch the entire program or individual segments of Health Tech Today starting November 10th, 2009, at www.healthtech2day.com.

Bill Crounse, MD    Senior Director, Worldwide Health    Microsoft

Health Tech Today—a new monthly, on-line video series at the intersection of health and information technology.  The show premiers November 10th, but you can see a video trailer of our first show right now (click on the link or program logo above, or watch it in the embedded player below).  Please help us spread the word.  Blog about it.  Tweet your friends.  Post information about Health Tech Today on Facebook.  Health IT has a new voice.  I think you’ll like what you see.

Bill Crounse, MD   Senior Director, Worldwide Health       Microsoft