Category: Digital Health

Trouble Online

Check this out. What you will see will not shock you in terms of substance. Sure, hacking can be done. No surprise there. 

BUT. This piece may surprise you in terms of the order of magnitude of the problems encountered with patient data platforms. One login permits access to 4 million patient records. Cybercriminals scoring $21B with ransomware in 2020. Etc.

Bottom Line. Hidden between the lines here seems to be an interesting, if not surprising, piece of information. The more standardization and interoperability that gets built into systems, the more they are vulnerable to being hacked. Which is unfortunate since standardization is generally seen as a good thing in platform development.

Another realization underscored here is that the more companies yield to patient demand to have access to their own data, the more vulnerable patient information becomes to security breaches.  Translated, if a platform is set up to make it easy for patients to use, it’s likely going to be easy for hackers to use as well. 

AND. Wrapped around all of this is the message that this situation is likely to keep getting worse in the foreseeable future unless somebody wearing a white hat has an epiphany on how cybersecurity related to healthcare records really needs to be handled.

Fingers crossed!

The Ethics of Telemedicine

In my On Doctors’ MindsSM research that tracks the adaptations that office-based physicians have made to the COVID-19 pandemic, I have been fascinated to learn about how quickly clinicians were able to adapt to telemedicine, and some of the hurdles they encountered going up the learning curve involved in using this new technology.

But check this out. What you will see is a discussion of whether it is ethical for a physician to limit the treatment of unvaccinated patients to telemedicine visits. Survey results revealed that 69% of doctors thought this was ethical given the risk such patients pose to medical staff. A medical ethicist weighing in on the same topic agreed, but put in the caveat that if a patient’s condition requires personal contact for good treatment, e.g., in the management of a movement disorder, it was incumbent upon the practitioner to either allow personal visits or refer the patient to an HCP that would provide such service.

Bottom Line. Think about it. The COVID-19 pandemic brought with it, among many other things, a slew of new and important ethical questions with which healthcare providers must wrestle daily. As with so many aspects of the pandemic, I am thinking that the results of these wrestling matches will substantially modify thinking in the field of medical ethics for years to come.

If not forever!

Digital Therapeutics

Check this out. What you will see is the announcement of the launch of the first FDA-approved video game designed for the treatment of ADHD. Being marketed through, you guessed it, digital media. 

Go to their website and watch the trailer

One wonders how many more videogames will come onto the market, FDA approved, requiring an Rx and costing $100 per month, to compete with this initial offering. Or will this be a monopoly? 

Lots of other questions come to mind. What will the receptivity of healthcare practitioners be for this offering in particular, digital therapies in general? Will parents pony up the $100 a month for three months of initial therapy? How effective will the therapy be? Will parents reup after the initial trial? 

Bottom Line. Don’t you just love it when something genuinely new like this comes along? All the new research avenues that one gets to pursue! 

Should Doctors Give Patients Their Cell Phone Numbers???

Check this out. What you will see is a well-reasoned discussion of the above thought question. The result? The recommendation that doctors’ cell phone numbers should not be distributed under most circumstances. Why? Optimal medical care cannot be delivered spontaneously. You call the doc after he has had two glasses of wine. What happens then? You call a doctor who has 2,500 patients of which you are one, and you have not seen her in over a year. Not surprisingly, her first thought is “Who the heck are you?” Etc.  

Bottom Line. In the age of social media, we have learned to expect instant two way communications. Likely, a doctor’s cell phone should not be a part of this networking. OR. Maybe we need to rethink the overall premise that spontaneous communication is good communication!

Top 10 Dangers Of Digital Health

Check this out. What you will see, as the above title suggests, are some of the reasons why, even though it is a bright shiny new thing that lots of people are talking about, you might not want to be so quick to rush into digital health.

What are these reasons? Pretty much what you would expect. With varying words and emphases, for example, several of them focus on the risks to your privacy that inherently result from having your health data entered into an electronic database.  

Bottom Line. Digital health is inevitable. Database experts had best start figuring out how to reduce these risks!

Healthcare Practice “Waiting Rooms” In 2020

Check this out. Fascinating website, actually. What you will see is a company dedicated to improving the “waiting room” experience, whether it be live or virtual.

Why? Three reasons. First, study findings indicate that issues with the waiting room experience, rather than issues with the actual delivery of the medical care that they received, constitute the most frequent reasons for patients leaving a medical practice.  

Second, the COVID-19 pandemic has made it totally unsafe and unsatisfactory to “store” multiple patients in one closed room while awaiting in-person medical care. The new approach, having patients wait in their car until the practitioner is ready for them, requires some significant adaptations. Screening for Covid symptoms, filling out registration forms, etc. all are now getting handled from the patient’s phone.

A final consideration, but far from the least significant, is the realization that  even telemedicine requires a “waiting room.” The virtual space where medical histories, insurance information, etc. are gathered before the practitioner logs on.  

Bottom Line. All of this leaves me, as usual, pondering. Pondering whether there is an opportunity for those of us in the pharmaceutical vertical to get involved in filling the dead air that characterizes waiting rooms with messages that we want to get across to patients. There aren’t any old magazines lying around in a patient’s car or a virtual waiting room, so it would be a great opportunity to keep a patient amused while telling her something important. 

“Richard, Take Your Medication,” Says Alexa

Check this out. What you will see is a fascinating little piece of technology. WebMD “Med Reminders,” delivered by audio through Alexa, that will/should/might increase patient drug adherence.  

Why the equivocation? Simple. Patients’ lack of adherence to drug regimens is only partly the result of forgetting to take the medication. Inconvenience, cost, side effects and myriad other factors weigh in here. Nonetheless, Alexa’s reducing the impact of patients’ forgetfulness seems like a good idea and worthy of pursuit.  

Bottom Line. When I look at this new service that Amazon is offering, the word “integration” comes to mind. The excitement in the next few years won’t be isolated parlor tricks like Alexa telling me to take my meds. It will be found in enhanced functionality and connectivity of various devices. Huh? For example, my Apple Watch senses an irregular heart beat and Alexa asks, “Richard, are you okay?” and calls 911 if she doesn’t get an answer.

Lots of possibilities!  

Thinking About Algorithms

Take 7 minutes of your day and read this “primer”  on algorithms. Models that underlie Wall Street investing, Amazon advertising, disease diagnosis and even park our cars. Their role in our lives is getting bigger and bigger, so it is important to spend a couple of minutes to think about their strengths and their weaknesses.

Their primary strength is efficiency. They operate quickly, with little or no human effort involved in making them sing and dance. They can incorporate huge quantities of information seamlessly and eliminate the systematic “biases” to which Behavioral Economics introduced us.

BUT. Garbage in, garbage out! Many algorithms, for example, are programmed for men, leaving women by the wayside. As the author points out, algorithms can actually teach social biases by automating  disparity.  

Bottom Line. The message of this little piece is clear. The best outcomes are produced not by unchecked human behavior or by algorithms running thoughtlessly, but rather through a thoughtful combination of Artificial Intelligence and human judgement.

Think about it!

Healthcare IT Podcasts

I can remember when the only people that had to keep up with “new developments in IT” were the guys who fixed our computers. Not anymore. Put the word “Healthcare” in front of IT and you get a brand new ballgame that all of us in the pharmaceutical vertical need to keep track of.

Check this out. A good example of a podcast on the topic of using machine learning to “augment” physician insights. It’s a podcast, so just give it a listen. You will hear things like cloud-based computing is part of the new and bigger scale that is permitting AI to have a greater role in the treatment room. You will hear concepts like “virtual scribes” being used to permit the physician to pay more attention to the patient and less to the keyboard. Relatedly, you will also hear panel participants comment that patients might have a hard time in terms of the privacy implications of speaking into a microphone.

Bottom Line. When you are done listening to this episode, check out some of the titles of the other episodes. Fascinating topics like using AI to smooth the process of prior authorization.  

Little doubt about it. It’s now not just the computer geek that has to keep track of IT. Look for healthcare IT to play an ever-increasing role in medicine, and to become increasingly important for those of us involved in healthcare marketing to understand.  

Using Wearables to Detect Covid

Here’s one I never would have thought of. Check this out. What you will see is an article describing research currently underway to determine if “wearables” can predict who is going to come down with COVID-19. How? By detecting small increases in temperature and heart rate, and by examining changes in the ratio of activity to sleep. 

The big challenge here? Figuring out which changes are the result of COVID-19 vs. other causes.  

Up to 1 million patients will be enrolled in the trials, and the analytics aren’t simple, so don’t expect results anytime soon. 

Bottom Line. MOREOVER. The article goes on to conclude that, as usual, there is no such thing as a free lunch. Issues of data quality and legal liability, among others, make this approach riskier than it might seem at first glance. 

Interesting stuff!