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Social and mobile continue to converge in healthcare

I’ve been somewhat off the grid for yet another family health crisis lately, but I thought I’d at least surface to update this blog with something quick and easy. Healthcare Web and software designer Geonetric has recently come out with an infographic about how healthcare consumers engage online. It’s long been believed that the majority of Internet users will search online for health information, and Geonetric cites data showing that some 80 percent actually do so.

The real surprising numbers are in the realms of social media and mobility, two areas that are increasingly overlapping. While it’s not shocking to hear that 20 percent of health consumers use mobile devices to search for health information, take a look at how many people now have mobile phones: an estimated 4.8 billion worldwide, according to Geonetric. By comparison, the chart says only 4.2 billion people own toothbrushes.

And despite all the worries in the provider community that patient will write bad things about them on rating sites like Yelp, Geonetric says just 5 percent of mentions of companies and organizations on social media are negative. It’s not clear if that figure pertains only to healthcare, but if you’ve ever seen what so many trolls post as comments on YouTube, Facebook and news sites across the Internet, you might find that hard to believe. I sure did.

Note also that the graphic says 23 percent of people follow health experiences of friends on social media. That I believe, because I’ve been sending out updates to friends and family the last several days on Facebook, and I’ve gotten updates the same way for a friend in another state who has multiple sclerosis. I’ve written most of the updates from my phone.

November 26, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Health reform is so much more than insurance

The headline above shouldn’t surprise regular readers or anyone who knows me. I’ve been saying for a couple of years to anyone who asks me about “Obamacare” or any other aspect of healthcare reform—and many people who haven’t asked—that the public debate and media coverage have been about insurance reform, not care reform, and health insurance is not the same thing as healthcare. I’ve publicly chided the national media, too.

Maybe that is changing. Last month, attorney Philip K. Howard, chairman of advocacy group Common Good (an organization working to “fill the substance void in the 2012 election by offering new solutions to fix broken government”), wrote in The Atlantic that no matter what the Supreme Court does with the Patient Protection and Affordable Care Act, healthcare still will remain inefficient and expensive. “The Affordable Care Act, aka Obamacare, strives for universal coverage. While it encourages pilots for more efficient delivery systems, the overall effect is to exacerbate the unaffordability of American health care. In this sense, the upcoming Supreme Court decision on constitutionality is just a side skirmish,” Howard said.

In other words, as I’ve been arguing for two years, the insurance expansion of this supposed comprehensive “healthcare reform” legislation is simply throwing more money at the same problem. Having insurance doesn’t assure you good care, nor will it by itself even reduce overall costs. It just shifts costs. There was more reform in the HITECH section of the 2009 American Recovery and Reinvestment Act, in the form of the $27 billion incentive program for “meaningful use” of electronic health records than there is in the part of the ACA being widely debated in this election year.

That’s why, as I pointed out Friday, I was happy to see that investigative journalism organization ProPublica has started a Facebook community for people to share stories of patient harm. And today, the New York Times discussed actual healthcare quality in one of its Sunday editorials (h/t Jane Sarasohn-Kahn). The Times highlighted efforts at Virginia Mason Medical Center in Seattle, Cincinnati Children’s Hospital Medical Center and hospital alliance Premier, saying, “It is a measure of how dysfunctional the system has become that these successful experiments — based on medical sense, sound research and efficiencies — seem so revolutionary.” Indeed.

By the way, my recent, controversial post arguing that faxing should be considered malpractice isn’t a new thought I’ve had. I just rediscovered my January 2011 commentary in Columbia Journalism Review about media coverage of telephone-based “telemedicine.” I ended the piece by advising fellow journalists to “start asking the health-care organizations you cover why they still rely on old-fashioned telephones and fax machines.” Malpractice or not, legal or not, it’s more than a decade into the 21st century, yet we still view healthcare through a 20th-century lens.

Or, as I also like to say, it’s quality, stupid.

June 3, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Facebook community for reporting patient harm

Kudos to investigative journalism organization ProPublica (yes, some journalists still have integrity today) — and a hat tip to HealthLeaders for bringing it to my attention — for setting up a Facebook community for people to report stories of patient harm. I’ve just shared the story of my dad’s torturous final month. I’m glad that a news organization with wide reach beyond the healthcare and technology industries cares about real stories, not distractions related to insurance coverage and partisan politics.

The group now has 661 members. There really should be 1,000 times as many. Please join and share your own stories, then help get the word out about the poor state of U.S. hospital care. (Note that I only accept Facebook friend requests from people I know personally.)

June 1, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Faxing should be malpractice

As you undoubtedly know by now, I am now officially all about patient safety. (Thanks, by the way, for all the support in the wake of my father’s untimely death.) That’s why I was so upset to read a friend’s recent Facebook status update: “So I discovered the real reason why I was in the hospital last week (and not generally feeling well for the past 4.5 months). My doctor’s office faxed a prescription to my mail order pharmacy that was 2x the dose I was expecting.”

In case anyone has forgotten, fax is technology from the late 1980s and early ’90s. It is now 2012. I cannot remember the last time someone asked me if I had a fax number. Yet, inexplicably, this obsolete means of transmitting low-res images—images, not computable data—remains perfectly acceptable in healthcare.

Here’s a radical proposal: medical societies and state medical pharmacy boards should prohibit the use of faxes. Medical errors related to faxed documents should be considered malpractice. Period.

May 20, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Video: ‘Meet the Bloggers’ panel from HIMSS12

As promised,  there is some video from the “Meet the Bloggers” panel I appeared on, and it comes to us from Dr. Chuck Webster of EHR Workflow Inc. and the EHR.BZ Report. (You may know him from his previous job as CMIO of EHR vendor EncounterPro, formerly known as JMJ Technologies.) Webster was there in the front row capturing parts of the session with a Bluetooth camera strapped to his hat.

The moderator is Brian Ahier and the panelist are, from left to right: Healthcare Scene boss and full-time healthcare blogger John Lynn; fellow Healthcare Scene contributor Jennifer Dennard (real job:  social marketing director at Billian’s HealthDATA/Porter Research/; myself; and Carissa Caramanis O’Brien of Aetna.

Here are the results, hopefully in chronological order:

For the record, I do not use Google+. I have an account, and some readers have added me to their circles, but I have not posted a single word there. Google’s terms of service—both old and new—essentially gives the Don’t Be Evil company the right to use my content in any way it sees fit. From “Your Content in our Services”:

Some of our Services allow you to submit content. You retain ownership of any intellectual property rights that you hold in that content. In short, what belongs to you stays yours.

When you upload or otherwise submit content to our Services, you give Google (and those we work with) a worldwide license to use, host, store, reproduce, modify, create derivative works (such as those resulting from translations, adaptations or other changes we make so that your content works better with our Services), communicate, publish, publicly perform, publicly display and distribute such content. The rights you grant in this license are for the limited purpose of operating, promoting, and improving our Services, and to develop new ones. This license continues even if you stop using our Services (for example, for a business listing you have added to Google Maps). Some Services may offer you ways to access and remove content that has been provided to that Service. Also, in some of our Services, there are terms or settings that narrow the scope of our use of the content submitted in those Services. Make sure you have the necessary rights to grant us this license for any content that you submit to our Services.

You can find more information about how Google uses and stores content in the privacy policy or additional terms for particular Services. If you submit feedback or suggestions about our Services, we may use your feedback or suggestions without obligation to you.

As someone who makes a living creating content, this scares me. Google effectively can steal and modify my content without compensation. No, thanks.

I also should give a belated shout-out to Joe Paduda of Managed Care Matters, who hosted last week’s Health Wonk Review. My HIMSS12 wrap made the review of healthcare news from the blogosphere.


March 6, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Let’s get Biz Stone to attend New Media Meetup at HIMSS12

As I first mentioned in August, John Lynn and I had the thought that it would be great if Twitter co-founder and HIMSS12 keynote speaker Biz Stone would show up at John’s 3rd annual New Media Meetup. Stone didn’t respond to our halfhearted attempt back then, but now the conference is less than two months away, and I have to imagine he will be making his plans soon, if he hasn’t done so already.

HIMSS social media guru Cari McLean also would love for Stone to meet and greet conference attendees at the HIMSS Social Media Center after his keynote on the morning of Tuesday, Feb. 21, per her tweet in response to one of mine:

[blackbirdpie url=”!/HIMSS/status/152809159644020737″]

That means that now is the time to put social media to work to get Stone to make a couple of appearances. Stone’s Twitter handle is @Biz. Tweet away, using the hashtag #BizatHIMSS12 and perhaps add #hcsm (for healthcare social media). Blog about this effort. Post on LinkedIn, Facebook and Google Plus. I may even make a YouTube video. Let’s impress Stone with the power of social media and get him to mingle with the masses in Las Vegas.


December 30, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Facebook + health data = all sorts of HIPAA questions

“Time’s Person of the Year is Mark Zuckerberg. Sorry, Julian Assange, I guess you didn’t violate enough people’s privacy.” — Stephen Colbert, Dec. 15, 2010.

Yes, Facebook has issues with privacy. Just Monday, the Electronic Privacy Information Center, the Center for Digital Democracy, Consumer Watchdog and the Privacy Rights Clearinghouse formally asked the Federal Trade Commission to stop Facebook from launching a facial-recognition feature. Last week, European regulators said they would investigate Facebook after it came out that Facebook’s 500 million to 700 million users were automatically opted in to facial recognition.

And now we hear that Microsoft is adding Facebook authentication to its HealthVault health information platform.

Let me repeat: You can now sign in via Facebook to a HealthVault personal health record.

Though I’m not a lawyer, I’m wondering if Microsoft might not be treading in some dangerous territory. What if it’s possible to link HealthVault updates to Facebook so your entire social network knows that you just got a lab test result back? What if the Facebook location tagger indicates that you’ve just visited an STD clinic? Yeah, sometimes discretion is in order, and Facebook generally isn’t the place to be discreet.

According to Healthcare IT News’ MobileHealthWatch blog, Microsoft’s Sean Nolan was practically giddy about this arrangement helping HealthVault go mobile. I think mobility will help make PHRs a bit more attractive to patients, but I still think PHRs are DOA if they don’t link to EHRs.

I just don’t see a lot of medical practices being willing to send electronic data back and forth to HealthVault accounts if Facebook is handling the security, making MobileHealthWatch’s claim that, in wake of the supposed demise or at least de-emphasis of Google Health, HealthVault is now “more or less unchallenged as the PHR of record” a joke. There’s no such thing as a PHR of record, and there won’t be as long as authentication passes through Facebook.


June 13, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Networking, socially

You may have noticed, since the Digital HealthCare & Productivity gig dried up for me a few weeks ago, I’ve been posting more often to this blog. The posts also have been reasonably short. I’m kind of experimenting to see what kind of traffic I get with regular posts.

Now here’s something to get people talking: A collection of Facebook groups for HIT and healthcare quality that I’ve come across recently. All these are open groups; I can’t get into the invitation-only ones anyway. This is by no means exhaustive.

In no particular order:

AMIA – American Medical Informatics Association
American Medical Informatics Association (AMIA) 10×10
Asia Pacific Association for Medical Informatics (APAMI)
IMIA (International Medical Informatics Association)
Canadian Health Information Management Association (CHIMA)
Health Informatics
Health2.0–User Generated Healthcare
Health 2.0
Medicine 2.0
Evidence-based medicine
La Télémédecine mérite mieux. Telemedicine deserves a future.
Medical Informatics
Empower Patients
Institute for Healthcare Improvement
Bioinformatica en Español

And because Dr. Bill Hersh of Oregon Health and Science University asked nicely, here’s the fan page for the OHSU-AMIA 10×10 Program.

Dr. Hersh also had a letter to the editor published in The Oregonian on Sunday, in which he promoted health IT as a job-creation engine for any economic stimulus that the new Congress might consider in 2009.

December 16, 2008 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Global health 2.0

I don’t want to jump on any bandwagons just yet, since plenty of what I’ve seen in health 2.0 so far is bluster. Sure, there are some interesting ideas, but whether they actually help in the provision of care remains to be proven. I am a big fan of disclosure, however, and I am becoming a big fan of social networking. The latter has helped me reconnect with several people I’d lost touch with.

On that note, here are a couple of interesting links I picked up recently:

A hospital rating site in Ireland called seems to be attracting a lot of activity. As of this writing, the counter indicates that 9,896 surveys have been completed. I’m not sure when the site started, but we’re talking about a country with just 4.2 million people.

RateMyHospital is part of a privately run site called, which looks to have all the trappings of a WebMD or Revolution Health, from consumer health information to personal health records. I don’t know the PHR usage rate, but let’s assume it’s low.

As Facebook continues to explode in popularity, so does the number of groups related to health IT. The latest one I’ve come across is the IMIA group. So far, it only has 23 members, including a high school student from Egypt and a healthy contingent from Argentina.

January 4, 2008 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

More health 2.0: Healia on Facebook

Ah, to be unburied from a mound of stuff from my recent travels and a virtual mound of e-mails!

While I was still in Australia last month, the folks at health search engine Healia put up an application on Facebook to test people’s knowledge of health-related issues. (You have to be a member of Facebook to use it, but c’mon, everyone’s doing it! Even me.)

I actually wrote a blurb about this application as part of a project on telehealth (OK, so it was broadly defined) for a client in the UK. Here it is:

Studies have shown that informed patients are better patients and that healthcare in the future increasingly will depend on individuals learning about and taking more control over their own health conditions. Meanwhile, social networking sites have become popular homes on the Internet for interpersonal communication and exchange of ideas. With these trends in mind, Healia, a US developer of a health-specific Internet search engine, has created a game on social networking site Facebook to test consumer knowledge of health issues.

Those who accept the Healia Health Challenge pick multiple-choice and true-false responses to a series of health questions. Players start as pre-medical students and work their way up toward being chief of medicine, scoring points based on how quickly they can come up with correct answers. (The point value of each question declines from 10 as a 30-second timer counts down.)

After answering each question, players see the correct answer and an explanation, as well as a link for further information on the subject. For example: “Some people falsely believe that coffee, cold showers and other remedies can hasten the process of sobering up. To learn more, search: alcohol sobering up.”

As with other Facebook applications, users can share the game with friends and challenge members of their personal Facebook networks.

This application runs through Facebook, a popular social networking site, and questions are based on Healia research.

“Check out Healia’s new Facebook health application.” 30 August 2007. The Healia Health Blog, Accessed 3 September 2007.

Detmer, DE, et al. “The Informed Patient: Study Report.” University of Cambridge, Judge Institute of Management. March 2003. Viewed at Accessed 3 September 2007.

September 25, 2007 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.