Stories about: health care

Advanced computing meets healthcare: Disruptive changes to come

(alikins/Flickr)

The recent Bio-IT World meeting featured some exciting forecasts about disruptive healthcare advances from advanced computing technology. We’re closer than ever to process streamlining, artificial intelligence and combining the best ideas from other industries. Many themes I like to blog about — clinical decision support, data visualization, patient-entered health data — were addressed provocatively in the talks. Here are some trends I’m watching.

•    New data visualization systems will increase scientific productivity. Keynote speaker Bryn Roberts of Hoffmann-La Roche demoed a futuristic, multi-touch tool for reviewing and designing compound molecules,

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Using health-records technology to bring value

The shelves that used to hold Children's Hospital Boston's paper medical records now stand empty.

What does paperlessness mean? It’s about helping patients, says Daniel Nigrin, Chief Information Officer at Children’s Hospital Boston. This approach helps explain why he was named one of the InformationWeek Healthcare 25, a short list of leaders driving the healthcare IT revolution.

“The integration of a patient’s data has to be one of the topmost national priorities,” Nigrin says. “It will eventually lead to better care, and hopefully a reduction in cost.”

This need is becoming critical as healthcare reform rolls out and primary-care practices become patients’ medical homes, integrating information from

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Keeping frequent flyers safe at home – with good detective work

Photo: PhylB/Flickr

Jay Berry is a pediatrician and hospitalist within the Complex Care Service at Children’s Hospital Boston. He leads the multi-institutional Complex Care Quality Improvement Research Collaborative (CC-QIRC). This is the final post in a 3-part series.

Imagine a child and family going through four hospital readmissions in a row — one right after the other — and how disruptive those hospitalizations are to their lives. I recently was involved in a study that demonstrated that patients experiencing frequent, potentially avoidable readmissions – so-called “frequent flyers” — are a major driver of pediatric healthcare costs. These children often have very complex, chronic health conditions.  It’s now our duty to take action on these findings.

So how can we help prevent these repeated readmissions?

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Gauging the impact of pediatric “frequent flyers”

Jay Berry, MD, MPH, is a pediatrician and hospitalist in the Complex Care Service at Children’s Hospital Boston. He leads the multi-institutional Complex Care Quality Improvement Research Collaborative. This post is second of a three-part series.

Emerging evidence suggests that small groups of adult patients who are frequently readmitted to the hospital are responsible for a large proportion of health care costs. Is this also true in pediatrics? What impact do our young “frequent flyers” have on the inpatient health care system?

I’m fortunate to be part of a multi-state collaborative, supported by the Child Health Corporation of America, that is trying understand how to best deliver care to the neediest children. These patients have complex medical needs, who are fragile and predisposed to getting very, very sick. Often, they have multiple, chronic health conditions, neurodevelopmental/intellectual disabilities and impaired functional status, requiring feeding tubes, breathing tubes and other technology to maintain their health.

Many of them, like Jim, seem to be falling through the cracks.

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My first “frequent flyer”

Photo: Lars Plougmann/Flickr

Jay Berry, MD, MPH, is a pediatrician and hospitalist in the Complex Care Service at Children’s Hospital Boston. He leads the multi-institutional Complex Care Quality Improvement Research Collaborative (CC-QIRC). This post is first of a three-part series.

Everywhere you turn these days, there’s an airline, grocery store or coffee shop pushing a “frequent flyer” or “rewards” program. You know the gist – the more money you give these businesses, the more discounts they give back to you and the more money you “save.” In theory, these programs are win-win: customers like frequenting the same business; businesses love holding onto satisfied customers.

But when I was a medical student, and overheard a nurse call my patient a “frequent flyer,” I wondered, “Who gets the ‘reward’ in that frequent flyer deal?” I hoped this child, a 4-year-old boy with cerebral palsy, was benefiting from being admitted over and over again.

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New universal pneumococcal vaccine advances in early tests

Streptococcus pneumoniae in spinal fluid
Streptococcus pneumoniae in spinal fluid

Serious pneumococcal infections – pneumonia, bacteremia, meningitis – are responsible for up to 11 percent of child deaths on the planet. Vaccines exist, such as Prevnar, but they have two big shortcomings.

First, they’re designed to help people build antibodies against specific strains of pneumococcus. But new strains keep emerging, and most of those circulating in the developing world aren’t covered.

Second, they’re too expensive for most developing countries.

Six years ago, Richard Malley, of the Division of Infectious Diseases at Children’s Hospital Boston, and Marc Lipsitch of the Harvard School of Public Health, showed that there is another defense against pneumococcus that doesn’t care what strain it’s encountering. And, despite what textbooks were saying, it has nothing to do with antibodies.

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How good are social networking sites for patients?

A teenager with type I diabetes has general admission tickets to a U2 concert. She’ll have to stand in a crowd all day to get a decent spot, and wonders how to make sure her blood sugar doesn’t hit a dangerous low.

A grandpa with type II diabetes is tired of people thinking he can’t ever have any sweets. And a new mom with diabetes is too overwhelmed with her baby and work to manage her illness.

All three, from different nations and continents, recently shared their stories on a social networking site for diabetics – part of an increasing trend for patients to turn to online social networks for healthcare. I came across their stories, along with some identifying information, without even having to register as a member of the site I was on.

But is this a bad thing?

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Disruptive innovation in healthcare IT: Spreading it to the masses

Photo: Paul Anderson/Creative Commons

The term disruptive innovation – introduced by Harvard Business School’s Clayton Christensen in a 1995 article  — has been used by technology-development stakeholders to describe radical innovations and their implications for market entry strategies. Christensen describes the term on his website:

“An innovation that is disruptive allows a whole new population of consumers access to a product or service that was historically only accessible to consumers with a lot of money or a lot of skill.”

Last week I heard Christensen speak at an event hosted by Vodafone,

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Licensing: It’s not just the money

(Photo: iChaz/Flickr)

An article popped up in my Google alerts that gave me some excitement.  A survey from the Association of University Technology Managers, reported in Mass High Tech, placed Children’s Hospital Boston fifth in licensing income among all U.S. hospitals. We were ranked just below the Mayo Clinic, which has more than double the research funding of Children’s. Massachusetts General Hospital was second on the list and Brigham and Women’s was eighth.*

I don’t often get to see quick financial results from my work (I’m the marketing and communications specialist in Children’s Technology and Innovation Development Office (TIDO), which licenses the Hospital’s technologies). But what I do get to see regularly is just as important to our mission: small advances that barely impact the hospital’s bottom line but have a large significance to our patients.

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Fragmented care: a hospitalist’s dilemma

Without records, every patient is a black box (Image: Pedro Vera/Flickr)

Recently, I was admitting a patient to the general pediatrics service who was followed by several specialists from different hospitals, required a number of medications and was quite ill. We were obliged to start treatment immediately given the severity of his illness, but unfortunately, this was his first visit to Children’s Hospital Boston and none of his records were available to us.

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