Earlier on this blog we had profiled a bunch of innovative health care solutions that associated with web applications that facilitate interactive information sharing, and collaboration on the World Wide Web.We had even cutely called it Health 2.0.
But now we think there is another quantum leap in technology and hence we decided to take the lead and coin the term Health 3.0.

Smart Pills
Want an example of a Health 3.0 product? Try Smart pills. U.S.-based Proteus Biomedical is working to create “smart pills” that can transmit data from inside the body to monitor patients’ vital signs and check they have taken medicines as prescribed.

We think in the not so distant future, your nurse or doctor might not be asking you if you took your pills(although your mom might). Instead they are most likely to be looking up data on their mobile phones, tablets or desktops.

Stay tuned for more on our Health 3.0 series.

When Steve Jobs got on stage Wednesday, to release Apple’s latest creation the iPad, he described the iPad as a magical and revolutionary device. Whether it is truly revolutionary from a technology standpoint or not, is a debate best reserved for the tech pundits like Endgadget. But we are are more interested how it can revolutionize health care. So here is how we think the iPad can do this.

1. Accelerate electronic medical records adoption in hospitals- eMR and eHR have been talked about for a while but there is still a lot of resistance and inertia in the healthcare community. We think the popularity of the iPad can help change that in a way tablet pcs never could.

2. Apps for health care- There’s an app for that. Imagine what web 2.0 did to the airline and restaurant business. Reviews, reservations, social networking. We think iPad will serve as a platform for all those innovative app developers (App developers are you reading this ?).
Everything from scheduling a doctor’s visit to viewing your x-ray (yes on that gorgeous AMOLED 9.7 inch screen ).

3. Paperless for real – Remove clutter and Free up space in Emergency departments and urgent care clinics- There is no need for a registration desk with a big clunky desktop. No paper work to deal with for Reg and insurance staff.

4. More time at bedside and with the patient – If you have ever been to an Emergency department or urgent care, the word waiting has new meaning for you. We think that the iPad adoption in hospitals can reduce the time doctors and nurses spend walking to a nurse’s station or desk to wait for results or write orders and spend more time at bed side. Which means that they can focus more on taking care of you working on the iPad. Research has shown that this can improve outcomes and improve quality of care.

5. Improve communication and entertainment options – Remember the last time you were at your Dentist or Doctor’s office. What did you do in the waiting room? Now imagine reading that Cosmopolitan, the Healthcare Management blog or whatever else you like to read. And while you are reading that your screen flashes with an update on your wait time, test result or even a prompt with some information on your illness. Same if you are in the waiting room of a surgery center eager to hear about your loved one. The possibilities are endless.

Magical or not, the more popular the iPad gets we believe it can revolutionize health care delivery and, without the tedious debates on Capitol Hill.

In an earlier post we examined how health care organizations are increasingly investing in clinical information systems( aka EMR) and, the benefits from such a system. As these systems have evolved, vendors(like with other application software) are increasingly migrating to a web based or online EMR systems. For as little as $500/month some vendors offer a full featured EMR system for physician offices, providing advanced features such as charting, drug interactions,  etc.

While some  physician offices and provider groups have bought into this (partly because they require considerably lower investment than  desktop based EMR software), there is still a lot of skepticism. Just as with any other new technology questions are being directed at the security of data on such systems. This is amplified due to sensitive patient data and, payment information residing in such systems.

Houston Neal at SoftwareAdvice, recently told us about his article on the double standards that exist in healthcare when it comes to evaluating the security of web based Electronic Medical Records (EMR) systems. He notes that vendors of such web based EMR software put in considerable resources and efforts to secure data exchange, data storage and, data integrity.

How Vendors secure medical data in web based EMR

To protect data transmitted between a physician office and the server, vendors use HIPAA-compliant data encryption technologies, the standard being 128-bit secure socket layer (SSL) encryption. The servers are powered with firewalls to block illegitimate traffic, and intrusion detection systems to monitor when someone tries to hack the system. In addition, vendors safeguard the data center where the server exists, storing the server in a highly secure compartment with un-interruptible power, air filtration and advanced fire suppression systems. At the physician’s office, software will have permission settings for each user, allowing them to access the EMR only during specified hours and days of the week.

While there are definitely some valid unanswered questions about security and HIPAA compliance of such systems, it does look like many of the questions are being answered by the top quality software vendors.

Now, we wonder how many exisiting health care providers or even large acute care hospitals currently have such sophisticated secure data centers ?  We will leave that question as food for thought.

Sermo, the largest online physician social networking site founded by Dr. Daniel Palestrant, recently launched FluMonitor to help track the spread of Influenza in the US.  FluMonitor(see pic above) lets physicians submit flu cases they might encounter with a few clicks.

HealthCare Management spoke with Sermo’s chief medical officer Adam Sharp. According to Dr. Sharp, the FluMonitor provides near real-time access to physicians on the spread of influenza across the United States.

This is definitely the first of its kind in tracking the spread of disease in real time exclusively through an online social networking platform for physicians. FluMonitor can give doctors the ability to track and predict outbreaks and, share notes on treatment and trends. Specifically, it can provide granular details such as, Patient breakdown for vaccinated vs. not vaccinated Age distribution- which age is most affected Symptom breakdown- which symptoms are presenting more than others voracity of outbreak- how many per day/week/month, etc.

If doctors know the flu is coming, it helps them to know that flu likelihood is much higher so they can be confident to base a diagnosis solely on observations in patients vs. having to use a Rapid Flu test- which is quite expensive. This will also help them avoid taking other, expensive, tests in order to rule out other ailments/diseases because they know it’s likely to be the flu.

HealthCare Management was recently informed of a product launch that could potentially, help hospitals lower their inventory costs, improve tracking of medical devices, and positively impact patient care.

The new RFID technology enabled system is being launched jointly by Wavemark: a market leader in real-time inventory management (RTIM) solutions for the healthcare supply chain, and Lumedx, the market leader in developing end–to-end cardiovascular information and imaging systems.

Florida Hospital Pilot

A strategic customer to WaveMark and LUMEDX, Florida Hospital Orlando facilitated the development of this interface by becoming the pilot site. The  goal was to achieve accurate and timely inventory data that would enable the department to reduce its device and equipment inventory by $30,000 to $40,000. According to the RFID journal, the system allowed the department to post a savings of $65,000 at the end of the pilot.

From a patient care standpoint the system is expected to enhance the level of care and, the accuracy of their medical records while at the same time improving the billing process.

HealthCare Management plans to talk to WaveMark-Lumedx and, Florida hospital to bring you more details on the technology in future posts. Stay tuned!.

We had previously featured an article on this site on the Smart patient room innovation at the Univ. of Pittsburgh Medical Center. Since, then we have talked to David Sharbaugh(DS), the leader of the smart room project and,  a senior director at UPMC’s center for quality improvement and innovation and, Lucy Thompson(LT) one of the team members.

Today we bring you this exclusive interview.

What is the vision behind the smart room project ?

DS:  We believe this technology will enhance patient safety, allow clinicians to spend more time at the bedside, simplify the jobs of health care workers and improve overall patient satisfaction

Who are the people behind the smart room?

DS: The core development team consisted of 5 people. Working anywhere from part time to full time to complete most of the development. In addition, over the past six months a team of clinicians and medical technologists have worked on this.

Where does the ultrasound technology for Smart Rooms come from ?

DS: the system uses ultrasound tracking devices to identify the numerous caregivers whom a patient might encounter on any given day. UPMC used Sonitor technologies, as the vendor for buying the ultrasound tracking devices.

How much did it cost to build the smart room system?

DS/LT: Since it was internally developed, it mainly cost UPMC man-hours (or FTEs in health care parlance). But,  the total cost to the system would be approximately $2 per patient/day.

What clincal metrics does smart room system impact?

DS/LT: We are currently still compiling the metrics and observing the impact, but it is estimated that this system has reduced the time spent searching for allergies, demographics, since there is a visual cue provided to the care giver on the items that need to be completed. Medication safety is expected to impacted and patient safety, and, fall rate are some other metrics that are expected to improve. Currently, smart rooms are in the medical surgical floor.

How long did it take to train staff on this system?

LT/DS: There was minimal training for this, since the screen interfaces that staff and, physicians need to use are very intuitive.

Future enhancements to the Smart patient rooms system.

The Smart Room went live in early October and is being tested in six patient rooms at the UPMC Shadyside campus .They, told us that they are currently working on releasing the second version. The new version would include code information that will automatically display to the relevant care giver when a code is called.

In addition patient will be able schedule tests, get test results, and other information. Another possible enhancement is informative emails to patients!

We think this is innovative and will keep bringing you more information on future enhancements. So keep watching this space.

Star Trek at Bedside

Imagine a hospital room, which recognizes doctors and nurses as they enter. Their name flashes on a flat panel screen for the patient and family to see. At the same time, a second monitor, shows the clinician exactly what they need to know at that moment to care for the patient. Information displayed includes: medication due, patient’s vital signs, and allergies. Does this sound like futuristic technology too good to be true? Well, it is not.

The smart room idea has already been developed and tested at the University of Pittsburgh Medical Center(UPMC). They have been testing this since early October at their Shadyside campus. The idea for the Smart Room came about two years ago when a UPMC nurse wearing latex gloves unknowingly went to place an IV in a patient with a latex allergy, causing an allergic reaction

Effective Technology

According to the UPMC , the system uses ultrasound tracking to identify the clinicians that might come to advance the care process for a patient. Each worker is assigned a unique tag—smaller than a pager—that emits ultrasonic sound waves, when the person wearing the tag first enters the Smart Room. The ultrasound detector in the room reads the tag and identifies the caregiver by name and job title, displaying the information on a flat-screen monitor at the foot of the patient’s bed. When a caregiver leaves the room, the information disappears from the screen. In this pilot phase, tags have been assigned to doctors, nurses, nursing assistants, phlebotomists and dietary hosts and hostesses.

Benefits

The biggest benefit of this innovation is in helping improve patient safety. Patient identification is a key factor in the care process and numerous errors can result from not verifying patient id. Smart rooms can help minimize that. In addition medication errors can be greatly reduced. Less obvious benefits can include, improving workflow and minimizing redundancy. The amount of time wasted in communication between care givers to gather information can also be impacted with this system.

**Picture courtesy UPMC media kit