Posts tagged » health care
November 14, 2007 at 12:07 pm · Filed under Online Health Care + Politics
Interesting completely different approach that this internet mobile based doctor, Jay Parkinson MD, is taking to online healthcare.
Nice site too though a bit too trendy web2.0 looking for my tastes – it would look professional for a techno DJ, but for a doctor it just feels fake. Interestingly, this doctor designed and built the site himself. It’s a fine example of someone with a spot of web design talent and no branding or identity knowhow.
He’s acting as a sole practitioner “country doctor” that doesn’t take insurance. However, he is available 24/7 by email, IM, or phone and makes housecalls but conducts most consults as eVisits. Also, he acts as a middle man of sorts to find the best healthcare specialist deals.
His whole practice is based on the fact that there is a whole swath of uninsured people out there looking for inexpensive healthcare. His practice and his offer to find good health deals brings up a several interesting points about the state of health care in America:
- There are so many uninsured patients that they now constitute a market in themselves.
- This market of uninsured patients is not having it’s needs met, as most health care targets insured patients. (Note they do not target medicare/medicaid since doctors don’t get enough money from those programs to justify the extensive paperwork that comes with treating patients on medicare/medicaid).
- The actual cost of health care is hidden because of the insurance industry and the ubiquitous $15 co-pay
- Competition for services between doctors is stifled because of the fact that costs are hidden and because patients are locked into choosing a preferred provider in a select doctor network
- Jay Parkinson’s entire business strategy would be out the window if universal health care became a reality
It’s funny how much the republicans cry and whine about the horrors of socialized medicine when our own health care industry stifles their beloved “capitalist competition.” If there was truly a open market for health care the needs of the uninsured would be getting met better. I’m not arguing that this is a good idea mind you since a truly open health care market may also lead to hospitals becoming more like car mechanic shops — where 9 out of 10 are trying to rip you off.
Personally, I’m in favor of some form of universal health care for several reasons; however I think Jay Parkinson is doing a good service that is needed right now. Until a universal health care system is created, we need more solutions for uninsured patients rather then just having them go the emergency room for treatment. And if the market can figure out a way to service these people where our government has floundered, that’s great.
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June 25, 2007 at 11:19 am · Filed under Life, Meaning, & Selfhood + Politics
Caught a story through Digg about the ‘Most severly wounded’ soldier.
TAMPA, Florida: He lies flat, unseeing eyes fixed on the ceiling, tubes and machines feeding him, breathing for him, keeping him alive. He cannot walk or talk, but he can grimace and cry. And he is fully aware of what has happened to him.
Four years ago almost to this day, Joseph Briseno Jr. was shot in the back of the head at point-blank range in a Baghdad marketplace. His spinal cord was shattered, and cardiac arrests stole his vision and damaged his brain.
If he had just died, this story would have never made Digg. Many commenters are using it as a case against war or the state of medical coverage in our country. However, the real tragedy here is not the war or the inadequacy of veterans medical insurance. It’s more complicated.
He is no more a case against the war as the several who have died. Because of enhanced armor and field medicine we are saving more of our troops than ever before. This of course leaves many with horrible injuries yet still alive (the amount of brain trauma from this war is a big issue here). It’s really not surprising that this has happened.
If a lesson is here to be learned it is that our medical technology has advanced further than our ethics. We can keep people alive and even bring them back from death, but often leaving the patient even worse off because of oxygen deprivation. In this case, the soldier is not only paralyzed but blind and has brain damage because of the cardiac arrests that they saved him from.
Resuscitation has a success rate anywhere from 1-30% depending on the celerity and skillfulness of the response. Though even when people do survive many die shortly afterwards or suffer permanent damage to their brain and body. Until we can protect against oxygen deprivation or fuse spinal cords we need to rethink emergency resuscitation and our attitude of “save at all costs.”
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March 21, 2007 at 2:47 pm · Filed under Blogging about blogging + Fetal & Pediatric Medicine + Online Health Care
Patient blogs are a way for patients to communicate to their friends and family and journaling can help them get through what may be a difficult experience. It can also benefit the hospital by offering self-generating patient stories that potential new patients can be directed towards.
From the Fetal Treatment Center’s website statistics, I know that we already have fetal treatment patients that blog about their experiences using various free blogging resources like blogger (I know because we get links from their blogs).
Caring Bridge - pros and cons
At the NACHRI conference, I talked with some people from Caring Bridge, which is a non-profit that offers blogging services for patients. Caring Bridge is a good service, but they have one fatal flaw: all the patient’s pages are automatically locked private. They can choose to give friends and family a password to see their posts, but they can’t choose to make any of their posts public.
Personally, I’d rather see the service offer the possibility for patients to choose make some of their story public. Without this feature, there is nothing for potential patients to read. Caring Bridge has a sponsorship package so that hospitals can pay to put their logo on their patient sites, but this is useless from a marketing perspective if the pages are all locked private. Supposedly, public post functionality is on the table, but it won’t be ready this year. Frankly, the ability to set a post to private or public is a common feature to most blogging services, so it really makes no sense for me to encourage patients to use Caring Bridge—as much as I’d like to support a non-profit like them.
The problems with hosting our own
I’d like to have a nice single solution to direct patients towards. We could host our own but that would require time and effort. Also, having it hosted here creates a rather strange legal situation. As the patient tells their story, they are also potentially letting out patient data. On any other blogging site this is fine, but if it is under our banner it creates a weird legal gray area in regards to HIPAA Compliance.
I will have to do some additional research to see if what the best solution is: a single interconnected solution that is easy for patients would be ideal. If anyone out there has any ideas let me know.
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March 21, 2007 at 2:11 pm · Filed under Blogging about blogging + Fetal & Pediatric Medicine + Online Health Care
After hearing the session on blogging at the NACHRI conference, I did some research into pediatric blogging. I found that there aren’t nearly the number of pediatric bloggers as there are neuroscience bloggers, but there are still some interesting sites out there:
Blogs targeted at patients
Blogs targeted at pediatricians or anyone who will listen
- Pediatric Grand Rounds - the archive of past editions of the Pediatric Grand Rounds, a bi-weekly collection of the best posts pertaining to the health of children.
- Blog, MD - a blog written by a third year fellow in a combined pediatric hematology/oncology and pediatric neuro-oncology program in the Northeast.
- Consider the Evidence: Med/Peds Journal Roundup - a blog written by a 5th year medical student (aka intern) about recent interesting medical journal articles
It’s a fascinating assortment of blogs, and there are more out there. PediaCast/PediaScribe seems like it is definitely a great resource for parents. I like Dr Raley’s personal touch and how he uses it to reach out directly to the patients he serves. For doctors, the Pediatric Grand Rounds seems like the best resource for recent news and research related to pediatric care.
It would be an interesting endeavor to have a blog written by a member of our staff at the Fetal Treatment Center or the Bay Area Pediatric Surgeons. However, that requires a measure of focus and time in their already busy schedules, so I don’t know how realistic that is. As a result, my main interest here at UCSF is working to facilitate patient blogging. I have a lot of thoughts surrounding that topic, which I will leave for my next post.
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March 21, 2007 at 2:04 pm · Filed under Blogging about blogging + Fetal & Pediatric Medicine + Online Health Care
As a medium, blogging lays somewhere between a newspaper article and Hamlet’s egocentric soliloquy. Over the past year or two, the wild interwebtube has become overrun blogs like some sort of bunny warren with burrows reaching to infinity. The variety of topics range from politics to cute puppys & kittens to science to “oh my gawd, you wouldn’t believe who I saw sally holding hands with!”
With the popular explosion of blogging, it’s not surprising that corporations and institutions have began to take interest in the phenomenon. Everyone wants to get on the bandwagon, but few know how to use this new medium, which is why most corporate blogs are just thinly disguised press releases.
Akron Children’s Foray Into Blogging
The medical industry has only just begun to experiment with blogging. At the NACHRI Conference, the Akron Children’s Hospital presented their two blogging experiments. Their first foray into blogging followed Ellen Kempf, M.D., director of the Oak Adoptive Health Center, on her educational journey to a Chinese orphanage. Their second blogging project followed 11 year old Meghan Frantz as she traveled to Washington, D.C. to talk with members of Congress about the challenges imposed on her younger brother Zack because he has cerebral palsy.
These projects were crafted to gain media attention for Akron Children’s and support political health advocacy efforts. Meghan’s blog was the most interesting, as it was a younger blogger and it was so targeted. It wasn’t an easy project: while Meghan wrote all the content she needed a lot of hand-holding for uploading the content and photos; also, the family required a lot of help traveling with Zack.
Blogging doesn’t always have to require so much extra support. In fact, the medium usually prides itself for being something anyone can do with a minimum of fuss. I still think their approach was good, but I was curious as to what else was out there. I did some research into other examples of pediatric blogging which I will detail in my next post.
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March 17, 2007 at 5:17 pm · Filed under Fetal & Pediatric Medicine + Online Health Care
I went to several sessions involving online health care and promotion at the NACHRI conference. It was really interesting to see what other hospitals are doing. As I have a lot to say, I’m going to break this up into multiple parts. Part one here is about Akron Children’s efforts with ORLive webcasting from the operating room. Other sessions will deal with the other sessions I went to including: incorporating blogging into your hospital site, hospital bedside interactive technology for education and entertainment, and ethnic media.
ORLive - webcasting from the operating room
Akron Children’s Hospital had a session on the live surgery video webcasts. Actually, they have a new webcast coming up on March 28th at 12:30pm entitled Horizontal Tenotomy: A Treatment for Congenital Nystagmus and if you miss it you can check their archives.
Their purpose behind the webcasts was to increase the image of Akron Children’s as a high tech institution and increase media exposure. Being so close to Rainbow Children’s. At $38k per webcast it seems like a high price to pay, but they have indications that they are getting results. They had a fairly high number of visitors, and more importantly they showed a large increase in ablation surgeries after they had a webcast ablation surgery. Of course it’s hard to disentangle these results from their other PR efforts. Still they seem to have accomplished what they wanted to get out of it, and it sure looks good on the front-page of their website. Speaking of which, they have a nicely redesigned site—I wish UCSF Children’s Hospital site was that nice looking and clear.
I don’t really see us at the Fetal Treatment Center doing webcasts. Personally, I think our short targeted educational videos are more effective since they are directly and quickly answering the questions that patient’s tend to ask. In contrast, their one hour long webcasts are more like tv programs that you have to set time aside to watch with no table of contents for skipping around. Supposedly they average a watch time of 20min, which I find amazing and a bit suspect with your typical new media short attention span. This feeling of television pervades the webcast medium as once it gets tossed in archives it feels old and sorta no longer useful.
Still webcasts and other longer videos have their place on the web. It might make sense to include some of our longer video productions online, which is something I should put some thought into.
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