HOW HEALTH 2.0 IS RESHAPING MEDICAL PRACTICE AND RESEARCH

Reshape 2009, Nijmegen, 12 Oct 2009John Sharp, MSSA, PMP@JohnSharp

CONTACT ME

Blog: ehealth.johnwsharp.com Twitter: @JohnSharp Links:

delicious.com/johnsharp/ClevelandClinic

www.linkedin.com/in/JohnSharp Department:

lerner.ccf.org/qhs/informatics Email: sharpj@ccf.org

HOW HEALTH 2.0 IS RESHAPING MEDICAL PRACTICE AND RESEARCH

Key Points Cleveland Clinic – EMR and eHealth Engagement of patients through Health 2.0

and social media Google Health and Microsoft HealthVault as

enabling platforms Reshaping Medical Research The Future of Medical Care through new

technologies

CLEVELAND CLINIC

CLEVELAND CLINIC 1000 bed hospital and medical center 1800 physician group practice 3.3 million total visits and more than

50,000 hospital admissions Locations: Cleveland, Ohio; Fort

Lauderdale, FL; Toronto, CA; Abu Dhabi, UAE; Las Vegas, NV

ELECTRONIC MEDICAL RECORD Epic Systems 2,000,000 patients In hospital, outpatient clinics and

suburban health centers CPOE implemented Now being used for

quality reporting and research

EHEALTH INITIATIVES Personal Health

Record – tethered to EMR

Online Second Opinion

Google Health partnership

Microsoft HealthVault – remote monitoring

LEADERSHIP IN HEALTHCARE REFORM Outcomes Booklets – reported annually Cited as model of care efficiency President Obama’s visit to discuss

reform Physicians on salary – remove

motivation for fee for service

INNOVATION AT THE CORE OF HEALTHCARE Need to innovate to stay competitive Innovation and Process Improvement

encouraged on all levels Commercialization of innovations Bench to beside – translational science Transparency - conflict of interest

ENGAGEMENT OF PATIENTS THROUGH HEALTH 2.0

ELECTRONIC MEDICAL RECORD Foundation for eHealth initiatives Provides personalized medical

knowledge base Updated based on medical visits Basis for future medical research Need to network with other providers –

IHE – Integrated Health data Exchanges

CULTURE SHIFTEHEALTH – INVITING PARTICIPATION

Personal Health Records (PHRs) Best practice – tethered

to EMR Calculators Health reminders Engage patients in

health management

EHEALTH AND WELLNESS Beyond acute medical model of

treatment PHR as a platform to provide wellness

education and reminders Future – personalized medicine –

reduce your risk of disease based on family history, genetic profile

SOCIAL MEDIA AND PATIENT ENGAGMENT

SOCIAL MEDIA – ENGAGEMENT Interactive with others with similar

conditions Talk to hospital – complaints, service

recovery Interact with providers real time Interactive health talks

SOCIAL MEDIA FOR EMPLOYEES www.ShapeUpandGo.com Teams of employees compete for most

steps Pedometer provided Team leader encourages participation Anyone in team can send a message

SOCIAL MEDIA PRESCRIBED Newly diagnosed with a chronic

condition Prescribe a well respected social media

site which focuses on this Educate the patient on the appropriate

role of social media and how to protect against misinformation

Ask the patient what they have been learning

TWITTER AND FACEBOOK HEALTH ALERTS

MOBILE HEALTH AND MORE

365 is a Wellness ventureBy the Cleveland Clinic

MOBILE HEALTH

MOST DESIRED MOBILE HEALTH APPS

GOOGLE HEALTH AND MICROSOFT HEALTHVAULT

PLATFORMS FOR HEALTH

IMPACT ON PATIENT CAREGOOGLE HEALTH

Combine all informationfrom all providers

Special tools – health Calculators, integration with Google Maps for doctors office locations

Add scanned documents including Living Wills

HOME MONITORING & VIRTUAL VISITS

Microsoft HealthVault – recording home monitoring directly to a PHR

HOME MONITORING - GOALS Improved outcomes for patients --patients may be

more apt to track and measure their health, improving compliance and data integrity and allowing physicians to more efficiently view, track and measure their data.

Improved clinician efficiency -- By receiving reliable, consistent and automatic patient data, physicians can improve the quality of office visits and reduce the length of appointment times. 

Consumer Empowerment -- This type of web-enabled, consumer-driven approach will provide patients with increased control of their medical information and an important part to play in the management of their chronic disease.

HELLO HEALTH MODEL

WHICH PLATFORM? Available platforms enable rapid

development – Facebook, Twitter, Blogger, Google Health

But are they reliable for health care? Gmail down for 2 hours

Alternative – host and install own tools Control reliability, data

Private cloud versus public cloud

HEALTH 2.0 RESHAPING MEDICAL RESEARCH

IMPACT ON CLINICAL RESEARCH

Clinical Trial recruitment Collecting research data through

patient diaries, patient social networking

Data mashups – research implications Data sharing – OrphanData.org Social networking for collaborative

research – case study – National Comprehensive Cancer Network

MEDICAL REFERENCE Will Wikis replace standard reference

works? Weaknesses of Wikipedia Growth of Medpedia Open Source versus vetted medical

content Who are the contributors? How accurate is

the source? How current is

the information?

MEDICAL PUBLISHING Enhanced search tools

- Google Scholar and PubMed enhancements

More online only journals – gaining impact scores (JMIR, Open Medicine)

Accelerated review processingThe Lethal Lag Time

INVOLVING PATIENTS IN RESEARCH Secondary use of medical data in social

networking sites Assistance in identifying post marking

side effects Early pilot data on off label treatments Clinical trial alerts

HOW TO USE EXISTING TECHNOLOGIES WHILE REDUCING RISKS

Good project management – Risk Mitigation planning

Develop policies, educate employees Have an owner of each application Monitor content Address problems quickly

THE FUTURE OF MEDICAL CARE THROUGH NEW TECHNOLOGIES

PROTECTING AND ENABLING HEALTH INFORMATON

Facebook

Google Health

Twitter

PHR

EMR

Research Data

HealthMaps

FUTURE

Innovation through academic and entrepreneur partnerships

Health 2.0 Accelerator as a model Feasible business models Government role – funding, awarding

innovation

HEALTH 2.0 ACCELERATOR

EHEALTH AS THE PLATFORM FOR HEALTH 2.0Health 2.0

PHR

EMR

FUTURE Convergence of eHealth and Health 2.0

How to integrate provider ehealth tools and PHRs with social media?

Cloud computing SaaS – Software as a Service PaaS – Platform as a Service Data.gov, Apps.gov

CONTACT ME

Blog: ehealth.johnwsharp.com Twitter: @JohnSharp Links:

delicious.com/johnsharp/ClevelandClinic

Department: lerner.ccf.org/qhs/informatics

Email: sharpj@ccf.org