Creative Health Labs

SecondOpinions.com is offering telemedicine-based second opinions to patients looking for more reassurance or an alternate opinion of their medical condition or their radiological studies. What's really innovative is the ability to upload your radiology films (digital copies of x-rays, CTs, MRIs, or ultrasound) to their HIPAA secure server and then get a second opinion of your images. This is fascinating and awesome. There's currently no easy or affordable way to get a second radiologist to review your films with such a fast turn-around (as far as I know).

The future of medicine is in standardizing medical decision pathways for both diagnosis and therapeutics. Some resources that are valuable for helping find evidence-based medical guidelines include the National Guideline Clearinghouse from US Department of Health and Human Resources  and OpenClinical . The American College of Physicians also has a great list of Clinical Practice Guidelines . Tobacco cessation guidelines can be find here . AHRQ has a fabulous list of Clinical Preventive Services guideline s, which includes recommendations for all sorts of screening exams, including diabetes, cancer (lung, breast, ovarian, prostate...), depression, and AAA.

The telemedicine industry is expanding very rapidly and it's hard to keep up with all the new products out there. One very interesting service is CloudVisit  that provides a nearly turn-key solution for doctors to be able to easily set up their own telemedicine service. CloudVisit provides a SAAS solution for physicians to be able to easily set up HIPAA compliant video-based telemedicine with appointment scheduling, billing, notes, and secure session recording all built in.

Great article on Venturebeat  talks about the loss of efficiency (and therefore money) associated with certain EHRs. As I've said before, interface matters.  Here's some quotes: "EHRs are one of the main issues that make doctors worry about their profitability."  " EHRs are currently slowing doctors down ...  20 to 25 percent of doctors will be back in the market for better solutions surrounding EHRs." Venturebeat goes on with a fantastic second article titled " Nurses will never adopt your tech if the usability sucks ," which reinforces the same idea, interface matters .  “User experience it’s really critically important. Because of the consumer experience now is pretty slick, when you get into the walls of the hospital [consumer-grade experiences are] beginning to be the expectation, and we so don’t deliver it right now.” http://venturebeat.com/2013/05/21/carecloud-ppi/

The average adult spends $30-150 every 3 months to maintain their car, but what do they do to maintain their body, which presumably is more important? When's the last time you checked your cholesterol? (compare that with your last oil change) Blood pressure? blood sugar? triglycerides? percent body fat? Think about this: jiffy lube took the really cumbersome and long task of car maintenance and made it  routine, focused, and fast. Maybe the same could be done with health maintenance? Just like with cars, if there's something actively wrong, you have to go the standard route (see a mechanic/doctor/hospital), but if you're just doing routine maintenance, you don't need all that.  What if regular health maintenance check-ups raise your health awareness and end up motivating you to eat/act healthier? What if insurance companies offer cheaper insurance rates if you show a record of regular maintenance and good numbers?

The Center for Public Integrity  has a piece titled " Cracking the Codes " which is making waves in the medical world over the last several weeks, as it has revealed data indicating a massive increase in Medicare billing by hospitals and physicians ever since the federal government began incentivizing physicians and hospitals to start using Electronic Medical Records (EMRs). The immediate (and understandable) fear is that doctors are abusing the built-in efficiencies of EMRs to over-document and/or over-bill. For novice readers unfamiliar with ER billing, here is a quick primer: ER charts are coded into 5 separate categories (plus a sixth for critical care), based on the complexity and risk of the case. The complexity and risk is derived from the ultimate diagnoses, the number of history (the patient's version of his complaints) elements involved, number of physical exam elements (number of body systems examined) examined, and the medical decision making (MDM). MDM is co...

Om Malek, posting on GigaOM, has an interesting article on a startup which time shifts power consumption of appliances attached to its smart grid system from peak hours to off-peak hours. Unused energy is sold back to a local grid operator, creating revenue, which is shared with the customer. Managing Emergency Department volume is surprisingly similar to managing electricity demand. There are massive fluctuations in demand at different hours of the day. Both require massive amounts of infrastructure in order to manage peak demand. Both systems have a potential for life threatening consequences if peak demand is not met. Peak demand is affected by weather and day of the week (well documented in ED literature). In addition to the obvious similarities listed above, what is most important is that total demand is determined by the sum of independent events, which are often convenience choices by consumers: "turn on dishwasher now or in an hour", "go to the ER now for my...

The Health Datapalooza in Washington DC showcased a number of innovative companies, technologies, and people who are leading the healthcare innovation revolution. These innovators are the tip of the iceberg of disruptive innovation piercing the titanic healthcare system, overladen with the burden of poor access, asymmetric information, lack of interoperability, and misaligned incentives. These innovations may transform the future of emergency medicine, often considered the eye of the storm of wasted health care dollars. Symcat , the winner of the conference's $100,000 Robert Wood Johnson Foundation Aligning Forces Challenge, directly addresses the bane of the emergency medicine physician, what co-founder Craig Monsen called the "cyberchondriac" patient - the patient who is convinced he has a spinal cord tumor because he strained his back this morning and "on Google it said... and I want my MRI now!" Symcat is more than a beautifully designed interface - it...

Techcrunch has a great piece on Stanford medical school flipping its didactic model so that students listen to lectures at home and collaborate on problem solving projects in the classroom. Techcrunch posits that this is more innovative than Harvard and MIT posting their lectures online; I agree. Having sat through hundreds of laborious hours of monotone recitations at the University of Maryland Medical School, I can attest that lectures are not an efficient nor effective method for transferring information to students like me. Watching videos at home allows each student to play, pause, and repeat any portion at any time without any embarrassment or guilt. If there is a word or an idea that isn't clear, the student can pause and research something immediately on the web, and gain the appropriate contextual understanding that allows for real learning - this isn't possible in a live lecture. Using classroom time learning to work with other students on complicated medical is...

Having just flown out of Washington Dulles Airport, I was stunned to see the TSA personnel manning the whole body X-ray scanners not wearing radiation dosimeters. Having worked in research labs with nuclear isotopes and in many hospitals, I know that each institution REQUIRES staff who have exposure to non-background radiation to wear radiation dosimeters. It's ridiculous not to - if you care about your staff. Dosimeters are cheap (less than $50), can be easily worn as a badge, and are easy to administer ($69 for the whole year from this vendor ). Although a dosimeter does not itself protect against the cancer risks of radiation, which are well documented , it can notify you if your cumulative dose is reaching dangerous levels, something you wouldn't be able to know or feel otherwise.  I asked my screener whether she was offered a dosimeter, and she had no idea what I was talking about. I got the very a uncomfortable feeling that this young female was not properly educated ...

This article from MIT Technology Review explains how a hospital experimenting with cartoon nurses on a computer screen providing discharge instructions were received better by patients than real nurses. Patients not only liked the virtual nurses more than real nurses, they also bonded more with the virtual nurse! Click on the link to see the video . For an hour long video explanation, click here . What this experiment underscores is the difficulty that health professionals, such as nurses and physicians, have in communicating effectively with patients. Not only is there a vast knowledge and experience gap, but there's also the issue of patient embarrassment and provider impatience. A patient robot is better than an inpatient medical provider, in the patient's eyes.

After first starting a healthcare innovation startup challenge in Chicago earlier this year, according to a post in Innovation Daily , Healthbox will be launching at additional healthcare innovation program in the Boston/Cambridge area. Healthbox offers not only seed capital ($50,000 in exchange for 7% equity), but also provides the networking, contacts, and collaborative work environment that entrepreneurs need to flourish. Applications to the Boston program close "mid-June", and the program will run from August through October, 2012. Click here for more details.