Yesterday, Google released a sneak peak of their upcoming Android 3.0 platform, Honeycomb. This rendition of Android has a primary focus on the tablet experience through designing the UI on a larger screen interface. After having played with platforms 2.0 and 2.2 enabled android tablets, the collective experiences have come up short for me.
While both Android platforms were built around the mobile phone experience (which are brilliant in their own right), they just don't seem to shine versus the iPad experience for me. With that said, the gap in this fluid UI experience isn’t much between the two big players, and I have good reason to believe this release will even the playing field.
Among the promised improvements in the Honeycomb platform:
Refined multi-tasking.
Home screen customization with a new 3D experience and redesigned widgets that are richer and more interactive.
Upgrades to the web browser (including tabbed browsing, form auto-fill, syncing with your Google Chrome bookmarks, and incognito mode for private browsing.)
The latest Google Mobile innovations including Google Maps 5 with 3D interactions and offline reliability.
Access to over 3 million Google eBooks, and Google Talk, which now allows you to video and voice chat with any other Google Talk enabled device (PC, tablet, etc.)
Alivecor has developed an iPhone ECG system that utilizes its ECG app in conjunction with its proprietary iPhone case. The remarkable case has two electrode leads implanted within it. The inventor Dr. David Albert has stated that the device will reliably detect, analyze and produce clinical quality single lead ECGs. In coordination with the ECG app, the system has a QRS wave detector that will help identify any beat. Furthermore, the app has the capability to store and transmit a given rhythm wirelessly.
The ECG iPhone device and app will debut at this weekend's annual Consumer Electronic Show in Las Vegas. Currently the company is seeking approval for sale as a medical device in the United States and is not immediately available for purchase. Word is the iPhone ECG case and app will be priced right around $100.
New year, new rules. Medicare has broadened its coverage of preventive services. As of January 1st, the new legislation allows for reimbursement of annual wellness visits that include advanced care planning. Also dubbed as end-of-life counseling, this legislation reimburses physicians to open the dialogue with Medicare patients about issues such as life sustaining treatments (living wills), surrogate decision makers (durable power of attorney), and palliative care.
Many believe this could not come at a better time. A recent New England Journal of Medicine study stated that only 70% of community living elderly have advanced directives. The study went on to suggest that more than 25% of adults greater than 60 years old may need surrogate decision making before death.
Several reasons can account for this low adoption of advanced care planning from both the patient's and the physician's side. On the patient end, he or she may have certain cultural views on death that prevent such discussion, a fear of death itself (thanatophobia), or any number of other emotional psychological or social hindrances that prevent for such planning.
On the physician's end, monetary reimbursement for the care provider's time can be viewed as one of the main inhibitors towards opening this dialogue. Much like any other medical plan, physicians must tailor their approach in evaluating each individual patient’s needs (medical, financial, emotional, etc.) and delivering substantive advanced care options. Such planning takes time.
Armed with this added reimbursable incentive, physicians can bridge the gap towards a more informed patient population in regards to palliative care, living wills, durable power of attorney, and other end of life provisions.
Armed with relevant articles (here, here, and here) to inform your patients and guide them to increased well-being, you’ve done most of the heavy lifting in yours aims to educate and guide your patient population. The final hurdle is broadcasting this information.
Recently Google Reader has enabled the ability to share a given article with a number of social networks. Because we are focusing on the most widely available social network, Facebook, you will need to get an account (here) or sign into your account.
Note: I prefer to use a business page (previously known as a fan page) in Facebook as it will send you weekly analytical data such as the number of visits, posts, new subscribers, etc. All are good measurables as to the productivity and reach of your page.
Google Reader integration:
Having signed into your Facebook business page, here is the easy 3 step process:
Sign into your Google account and visit your Google Reader site.
Click on the Settings link.
Click on the ‘Send To’ tab, then check the ‘Facebook’ box. You may want to share with other social network options.
A facebook page will pop up with the article title, link, and the first few sentences. Here you have the opportunity to write your thoughts, include any included thumbnail picture, and post by clicking ‘Share’ much like you would any Facebook post.
It is as simple as that. The article posts to your Facebook from Google Reader, your patients will receive this post in real time, and most of your work is nearly done. Your final responsibility is promoting the site with your patients. This is the easiest of tasks.
Nearly half of all Americans have a Facebook account (and this number is growing). All they have to do is ‘Fan’ your page to receive the feed of articles and thoughts into their own Facebook feeds. Telling a patient that you have a previous relevant posts to their condition is reason enough to ‘fan’ your page. Patients can search your page for prior posts, interact through commenting and e-mailing, and post to your fan page.
Scanning through your Google Reader feed every day should take no more than 5-minutes per day. Sharing those relevant pieces with a sentence or two should take a minimal amount of additional time. Seamlessly you will have opened up the dialogue towards wellness with your patient through this powerful toolset.
The advantages in delivering info to your patients with regularity are compelling. Among them include: increasing compliance, decreasing redundancy, boosting one’s brand while marginalizing threats to your brand, and staying ahead of the public opinion curve. Our tactic is a two pronged approach that will require a set up for data collection and a second set up for data distribution. We will focus this article on data collection through the use of Google Reader.
For those of you not familiar with Google Reader and RSS, let me give you a quick primer. RSS stands for ‘Real Simple Syndication.” In a nutshell, this platform allows a web surfer to receive published articles as they are released for a given web site in near real time. There are different formats to receive these feeds (in browser, atom, etc.) but I want to focus on one RSS feed reader, Google Reader.
Google created an easily accessible and useable RSS feed reader in Google Reader in 2005. This reader platform effectively manages 98% of the sites that have regular updates, and will format these feeds into one uniform look and feel. The end user is left with the responsibility of simply visiting Google Reader to peruse all the blogs, web sites, etc. that one is interested in.
I chose Google Reader because it is free, it is extremely easy and quick to use, it conveys to our mobile world nicely, and it will sync with our data distribution arm, Facebook, seamlessly.
SET UP
1. Create a Google account if you don’t already have one.
2. Go to Google Reader.
3. To use this platform to add and read RSS feeds, the folks at Google have an awesome 1-minute instructional video:
SUBSTANCE
Once you have a feel for adding and viewing feeds, I would like to focus your attention on the feeds themselves. As we said earlier, there is a lot of noise out there in the area of consumer health news. You will spend 5-10 minutes a day in Google Reader perusing these articles and hand picking the ones with relevance to your patient population and broadcasting those (along with any thoughts you may have) on Facebook.
Choosing such feeds requires a specific focus. You will need to look for web sites that publish articles that are relevant to your patient population, in a language that your patients can understand, and relevant to your own clinical values. The web sites do not have to be a 100% perfect fit, with all articles having relevance. You will be choosing only those articles that you want to broadcast. A site that regularly puts up articles that meet your criteria for posting should be included in your RSS feed.
With that said, I will highlight a few web sites and blogs that have shown to have great value in this realm:
• KevinMD.com: has been previously voted best medical blog on the web. If you only read the daily piece, “Top stories in health and medicine this morning,” you will have a good idea of what noise your patients encounter on a day-to-day basis.
• CelebrityDiagnosis.com: claims to provide teachable moments in medicine through celebrity health ailments. Remember this is about staying ahead of the curve. Solid plain English explanations on the diseases themselves are given, great for resolving those patient questions.
• Health.yahoo.net: has a pretty wide breadth of health news bombarding our patients.
• Google news feed: set up your own RSS news feed for any given health movement, disease, condition or ailment:
1. Run a Google search for the desired item.
2. On your results page, click on the “news” link on the left.
3. Scroll to the bottom of list of articles and click on RSS.
4. Select Google Reader as the RSS reader and click “Subscribe now.” You will now have this specific feed into your Google Reader.
While these sites are a great start, do not limit yourself to these few feed options as there are a limitless number of available out there. Now that we have established where we will derive relevant articles, let’s harness the awesome ability of a linked Google Reader and Facebook account to broadcast to our patient population.
You've read about the old paradigm of information delivery to patients. What reasons do I have to set up an efficient system to transmit time-sensitive medically relevant information?
1. Compliance
I am going to take a massive leap and say, awareness of one’s condition in itself leads to positive clinical outcomes as a whole, versus lack of awareness of one’s condition. If you’ve followed me in this ‘leap’, you would probably agree that delivering disease info to patients is paramount. Doing this with some regularity can only multiply the positive outcomes.
2. 80:20 rule
It has been postulated that 20% of patients use 80% of healthcare resources. While I can’t say for certain this is accurate, we could postulate the theorist was in the ballpark. Having said this, the take home for me and the 80:20 rule: there’s a magnificent amount of redundancy in medicine.
Why not use this to our advantage? In the area of information delivery, let’s reduce those redundant tasks into a one time, one place event. Let’s commit to designing an efficient central information collection and distribution center.
In your arsenal of articles you’ve found some gems for a given disease; let’s use Chrohn’s disease as an example. Amongst those articles include: a fantastic article explaining what exactly Chrohn’s Disease is and what can be anticipated; a recent article that dispels the rumors of Chrohn’s Disease; and an article on new treatment options that you endorse in Chrohn’s Disease.
Copying a packet or e-mailing the pdf or links to every patient that walks into your office with Chrohn’s, takes time and compromises valuable resources. Time that should be spent on the other 39 patients, labs, hospital visits, etc. Why not post to one area where your patients have the freedom to read at their leisure without time restrictions, comment and interact with you or other patients with the same diseases or interests, and allow your patients to take more responsibility for their condition? This forum that I am alluding to is an area that the great majority of your patient population already has familiarity and command.
3. Branding: whether you care or not about your medical or non-medical worth, branding plays a significant piece to the valuation formula. If someone hops onto a given physician (or other professional) review web repository, and completely trashes your good name and good practices, they effectively trash your brand. In the eyes of your current colleagues, patients, and non-patients, you’ve taken a real hit.
In sports (and life), a good offense can serve as a strong defense. Having said this, every physician has the power to marginalize any given negative onslaught with an overwhelming number of positive posts that reflect the true good will and servitude of that individual. Every time you post an article or opinion on an article, it gets logged into search engines/spiders and helps formulate your working perception as internet users search your name and practice. The more posts you pump out, the greater chance your consensus opinion is drawn from these. Furthermore, the less likely a given negative post will have deleterious effects. Like anything else, this isn’t full proof. Gross neglect will garner the attention of other bloggers and news media to a point that you can never compete with.
4. Public interest pulse:
Identify and answer the questions before they come up. Back in 2008, the great Oprah did a show pointing the finger of blame of obesity on thyroid hormone levels. Needless to say, the number of useless and costly thyroid panels went through the roof. Shortly thereafter, a few clinicians logically wrote articles criticizing Oprah’s ‘medicine’ and reported the real main sources of American obesity. These articles proved to be an invaluable resource for physicians hoping to guide their patients into “the know.”
To make the aforementioned happen you need two tools: Google Reader and Facebook. I don’t see either one of these multibillion dollar players going anywhere soon. Thus you’ve got security that you can lean onto these tools for the foreseeable future. Let’s roll up our sleeves with the upcoming posts and focus on our purpose here: data collection (through Google Reader) and data distribution (through Facebook.) Click here to continue.
Mary Joe walks into your offices with a myriad of problems that all stem from her morbid obesity. Fed up with it all, Mary Joe has had enough and seeks good advice, treatment, and direction from you. Mary Joe sincerely wants to get more information on her condition, the obesity epidemic and weight management.
Old Paradigm: Clinical treatment options aside, Doc/Nurse/Secretary finds the pamphlet(s) or internet print outs dedicated to this and hands them over. If the clinical team is lucky, patient reads them and files them away in a place never to return to the patient consciousness. Fail.
Information is abound on the web. It’s a good place to send Mary Joe. After all, if you Google the word, “obesity,” an astounding 26 million articles pops up in .25 seconds. It’s all there for the patient to sift through: the good; the bad; & the ugly. Unfortunately, for the majority of us, the common denominator to filter the vast amount of information becomes the responsibility of the clinician.
Moreover, with 40 patients on the books today (many with similar requests), labs that need to be reviewed, and a "quick" late afternoon set of rounds at the local hospital, the question becomes how do I set up an efficient system to get the latest up-to-date information to Mary Joe and to the rest of my patient population for their given ailments?
The answer: sound digital information resourcing and broadcasting. Click here for part 2.
