Revisiting Health Social Networking and Communities with http://www.inspire.com/brian

I got to revisit this topic with the person behind (or in front of the easy-to-remember) URL, Brian Loew, the CEO of Inspire.com. I visited this the first time in May, 2008, when Brian and VP for Partnerships Amir Lewkowicz and I went for a short walk to talk about Inspire. And I have to …

Patient Online Access in the Safety Net: Adam Szerencsy, MD and Neil Calman, MD’s slides

Patient Online Access in the Safety Net: Adam Szerencsy, MD and Neil Calman, MD's slides

These are Adam Szerencsy, MD and Neil Calman’s slides from the recent discussion in Oakland, “Patient Online Access in the Safety Net,” hosted by the California Healthcare Foundation. Adam and Neil are from the Institute for Family Health, and as you can tell, have learned a lot in providing online access to their patients in …

Patient Online Access in the Safety Net: James Kahn, MD’s slides

Patient Online Access in the Safety Net: James Kahn, MD's slides

Continuing on, in the publication of the stories of some of our nation’s leading edge safety net organizations in the area of patient online access, these are the slides shared by James Kahn, MD, from the University of California, San Francisco Positive Health Program. I had previously blogged about their myHERO patient portal, which is …

Stepping Through a Patient’s Experience with Hypertension: Maintaining control (yearly recheck)

Stepping Through a Patient's Experience with Hypertension: Maintaining control (yearly recheck)

This is fifth of a multi-part series on a patient’s experience managing a chronic condition, in this case hypertension. A diagnosis has been made, and our patient has hopefully followed up and has hopefully been maintained on appropriate therapy (there is a 1 in 3 chance that this is happening). We are now in the …

Patient Online Access in the Safety Net: Hilary Worthen, MD’s Slides

Patient Online Access in the Safety Net: Hilary Worthen, MD's Slides

“If you don’t like the news, go out and make some of your own” – this was the theme of the presentations given by safety net organizations who are innovating by providing patient online access to their personal health information. It’s now possible to talk to safety net providers who have the technology and the …

Patient Online Access in the Safety Net: Ted’s Slides

Patient Online Access in the Safety Net: Ted's Slides

I am attaching the opening remarks that I made, alongside Veenu Aulakh, at the Patient Online Access in the Safety Net discussion, hosted by the California Healthcare Foundation. It describes the “why?” in the context of my journey of discovery. Click on any image to see full size, and comments are welcome. Update: Incidentally, depending …

Sheraton Palace Picketing — Palace Hotel and Hall of Justice

Sheraton Palace Picketing — Palace Hotel and Hall of Justice – As I sit here working to design a pilot for connecting Californians with chronic illness to their personal health information. It's incredible to walk these halls and think about what happened here 44 years ago. Now, we're doing the same work, in the digital …

Now Reading: Pew Hispanic Center’s Hispanics and Health Care in the United States

Now Reading: Pew Hispanic Center's Hispanics and Health Care in the United States

Livingston, Gretchen, Susan Minushkin, and D’Vera Cohn. Pew Hispanic Center Report: Hispanics and Health Care in the United States: Access, Information and Knowledge. Pew Hispanic Center. Tomorrow I will be in Oakland, California, along with health care leaders from the California Heatlhcare Foundation, California Safety Net Organizations, National Leaders in Patient Online Access in the …

Stepping Through a Patient’s Experience with Hypertension: Setting Rates and Negotiating Benefits

Stepping Through a Patient's Experience with Hypertension: Setting Rates and Negotiating Benefits

This is fourth of a multi-part series on a patient’s experience managing a chronic condition, in this case hypertension. A diagnosis has been made, and our patient has hopefully followed up and has hopefully been maintained on appropriate therapy (there is a 1 in 3 chance that this is happening). Now it is time for …

Stepping Through a Patient’s Experience with Hypertension: Adjusting Therapy

Stepping Through a Patient's Experience with Hypertension: Adjusting Therapy

Many patients already self-monitor (55 %, do it, 64 % own a monitor) – many have not been trained how to monitor correctly, and may over monitor; the most accurate way to monitor is twice per day, once in the morning, once in the evening, for 7 days. … The estimates of “masked hypertension,” or high blood pressure that appears normal in the doctor’s office are probably much greater than the 10 % reported; many patients restart medications in advance of coming to see their physicians (“similar to flossing your teeth a week before the dentist appointment”).

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Stepping Through a Patient’s Experience with Hypertension: Making the Diagnosis

Stepping Through a Patient's Experience with Hypertension: Making the Diagnosis

This is second of a multi-part series on a patient’s experience managing a chronic condition, in this case hypertension. We’re now past the discovery that something may be wrong, and at follow up with a personal physician. Recall that 1/3 of patients do not make it this far. Click on the image to see it …

Stepping Through a Patient’s Experience with Hypertension: Initial Discovery

Stepping Through a Patient's Experience with Hypertension: Initial Discovery

This is first of a multi-part series on a patient’s experience managing a chronic condition, in this case hypertension. Click on the image to see it larger size We’ll start with the patient story, told by Gilles Frydman, followed by clinical and public health commentary by Nancy Houston-Miller, RN, BSN, FSHA. At the bottom of …

Stepping Through a Patient’s Experience with Hypertension: Should It Continue This Way? (Intro)

Stepping Through a Patient's Experience with Hypertension: Should It Continue This Way? (Intro)

We recently facilitated an exercise involving a patient, a clinical expert, and interested stakeholders at the California Healthcare Foundation, to look at the way a chronic condition (in this case, high blood pressure) is managed. Over the next several days on this blog, I will step through our patient’s real story, along with clinical and …

Now Reading: A Few Peer-Reviewed Articles About Patient Willingness to Self-Monitor

Now Reading: A Few Peer-Reviewed Articles About Patient Willingness to Self-Monitor

Rickerby, J, and J Woodward. “Patients’ experiences and opinions of home blood pressure measurement.” J Hum Hypertens 17, no. 7 (0): 495-503. Pare, Guy, Mirou Jaana, and Claude Sicotte. “Systematic Review of Home Telemonitoring for Chronic Diseases: The Evidence Base.” J Am Med Inform Assoc 14, no. 3 (May 1, 2007): 269-277 Little, Paul, Jane …

Latest Project Plan: Connectivity for California Consumers (c-cubed)

Latest Project Plan: Connectivity for California Consumers (c-cubed)

Click on the image to see a much larger version…just 1 page. Issue & Focus The California Healthcare Foundation is dedicated to the improvement of the lives of Californians managing chronic illnesses. There are many community stakeholders involved in supporting this goal; their work could be improved by making connections to each other that are …

“If people are given the tools and techniques (to manage blood pressure), they can get better control,” – A Conversation With Nancy Houston-Miller, RN, BSN, FAHA

I was able to speak with Nancy Houston-Miller, RN, BSN, FAHA, about the future of blood pressure management today. She’s a national expert in the field, and has a research career spanning 30 years which has supported innovative ways to improve health. In the 1970’s her team established that patients could exercise to rehabilitate their …

High Blood Pressure as a Foundation for Connectivity: Telling The Story Via Cartoon

High Blood Pressure as a Foundation for Connectivity: Telling The Story Via Cartoon

I am experimenting with storyboarding using cartoons to help people visualize how to connect Californians to better management of a chronic condition. The goal is for potential partners and patients to see the value of a program like this, and add their input based on technical and clinical knowledge. Full storyline coming…working on getting patient …

How Does Chronic Illness Impact You In the Workplace?

How Does Chronic Illness Impact You In the Workplace?

I am here at the WIxRed Conference in Washington, DC, the annual conference of the Center for Information Therapy and in my comments, decided to include some information about the work I am doing with California Healthcare Foundation to connect Californians to good chronic illness management. I mentioned that this is the first time I …

Project Plan: Connectivity for Californians

Project Plan: Connectivity for Californians

Defining of the target condition for multiple audiences – a “general” target, which is overall infrastructure and connectivity for all chronic illnesses, a “specific” one for the Foundation, which is a target condition, hypertension, to stay focused on one thing. Addition of another milestone, a partner summit, this summer, to go over workflows and technology feasibility Rapid management of follow-up / countermeasures, including defending the “presenteeism” hypothesis (which I believe I can), and the “patient engagement” challenge (see this post for discussion on this).

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Aetna Clinical Policy: Automated Ambulatory Blood Pressure Monitoring

Aetna Clinical Policy: Automated Ambulatory Blood Pressure Monitoring – Rules for ambulatory blood pressure monitoring, which is different from "home" blood pressure monitoring. Useful to know when thinking of connectivity in the California Healthcare Foundation project work. Because health plans and CMS already pay for this type of monitoring, there’s precedent for looking at home …

Consumer acceptance of self-monitoring devices

More information about connecting California’s Consumers, tip from Larry Leisure, President of iMetrikus: This is from the 2008 Deloitte Survey of Health Care Consumers, page 14 of the report: 13 indicate prior use of one or more medical devices for monitoring a condition for themselves or a family member. 7% of consumers report expressing a …

Spending some time with iMetrikus in California

Spending some time with iMetrikus in California

When in California last week, I went to visit Larry Leisure, President, North America, and Deryk Van Brunt, DrPH, Senior VP of Business Development for iMetrikus. images: click on any to see larger size iMetrikus is part of the Continua Alliance, and has expertise in collecting and processing patient derived biometric data using FDA-cleared gateways, …

Now Reading: Call to Action on Use and Reimbursement for Home Blood Pressure Monitoring

Now Reading: Call to Action on Use and Reimbursement for Home Blood Pressure Monitoring

Pickering, Thomas G., Nancy Houston Miller, Gbenga Ogedegbe, Lawrence R. Krakoff, Nancy T. Artinian, and David Goff. “Call to Action on Use and Reimbursement for Home Blood Pressure Monitoring. A Joint Scientific Statement From the American Heart Association, American Society of Hypertension, and Preventive Cardiovascular Nurses Association.” Hypertension (May 22, 2008). As we have been …

Wireless Messaging System Has No Impact on Blood Glucose Levels, but Patients Believe It Improves Quality of Care (…and their blood pressure was reduced)

Wireless Messaging System Has No Impact on Blood Glucose Levels, but Patients Believe It Improves Quality of Care – From the AHRQ Innovations Exchange. I thought the title of the Exchange article was interestingly different than the actual title of the study that it references, so I pulled the actual paper and read it. There …

Monitors urged for all with high blood pressure – Yahoo! News

Monitors urged for all with high blood pressure – Yahoo! News – American Heart Association urges patients to monitor their blood pressure – nice coincidence for the work we're doing in California. Note the concern about conflict of interest, however – it comes up multiple times in the article. People are interested in information free …

Flip this A3 : Project Plan for Connectivity for California Consumers

Flip this A3 : Project Plan for Connectivity for California Consumers

A3 (Project Plan). Click here to learn more about what an A3 is This post contains the A3 Document, or the Project Plan, for Connectivity for California Consumers. I have been posting some of the data that supports this plan on this blog (click here to see them all). In addition, I have been working …