Mar 06

Meeting Dr Don Murphy #2 – Physical therapy as part of an integrated spine program

By admin | Clinical Pathways , Cultural Authority , Disruptive Innovation , Low Back Pain , Primary Spine Provider , Spine Care , Spine Pathway , Spine Related Disorders , Value-Based Healthcare , Videos

Following on from part 1 introduction to Dr Don Murphy’s Rhode Island Spine Centre, here is #2 where Dr Murphy takes us through to the larger room used for more extensive exercises and discusses the role of physical therapists in an integrated spine pathway. Sign up to take our PSP course online which covers these topics fully:

Meeting Dr Don Murphy #2 – Physical therapy as part of an integrated spine program

Following on from yesterday's intro video to Dr Don Murphy's Rhode Island Spine Centre, here is #2 where Dr Murphy takes us through to the larger room used for more extensive exercises and discusses the role of physical therapists in an integrated spine pathway. Sign up to take our PSP course online which covers these topics fully: https://www.spinecloud.org/courses/Some key questions that are answered here:What hi-tech equipment is used in the facility?What is the most important aspect (i.e.” the one thing”) of any PSP & pathway facility & services?Is there any animosity between Chiros and Physios in the program?How do they work together in this program? What is the baseline authority?

Posted by Spine Cloud International on Tuesday, March 6, 2018

Some key questions that are answered here:

  • What hi-tech equipment is used in the facility?
  • What is the most important aspect (i.e.” the one thing”) of any PSP & pathway facility & services?
  • Is there any animosity between Chiros and Physios in the program?
  • How do they work together in this program? What is the baseline authority?
Mar 05

Meeting Dr Don Murphy #1 – A private practice as part of an integrated spine program

By admin | Clinical Pathways , Cultural Authority , Disruptive Innovation , Low Back Pain , Primary Spine Provider , Spine Care , Spine Pathway , Spine Related Disorders , Value-Based Healthcare

In January, I met with Dr Don Murphy at his practice (Rhode Island Spine Centre) in Rhode Island.  His practice began as a chiropractic practice, grew in size and reputation, and at Care New England‘s invitation,  was embedded into a fully integrated, interdisciplinary spine care pathway/program, with Dr Murphy as Director of the Program.  He took me on a tour of his facilities, and I asked him a bunch of questions – see video below.  We expect to have Dr Murphy on upcoming webinars and mentorship sessions. Sign up for exclusive access!  Dr David Peyton, DC, South Africa.

Meeting Dr Don Murphy #1 – A private practice as part of an integrated spine program

In January, I met with Dr Don Murphy at his practice (Rhode Island Spine Centre) in Rhode Island. Rhode Island Spine Centre began as a chiropractic practice, grew in size and reputation, and at Care New England's invitation, was embedded into a fully integrated, interdisciplinary spine care pathway/program, with Dr Murphy as Director of the Program. He took me on a tour of his facilities, and I asked him a bunch of questions – see video below. We expect to have Dr Murphy on upcoming webinars and mentorship sessions. Sign up for exclusive access! https://www.spinecloud.org/membership –Dr David Peyton, DC, South Africa.

Posted by Spine Cloud International on Monday, March 5, 2018

  • What are the fundamentals of this approach?
  • Why have an integrated pathway- i.e. what is it that patients really want?
  • How does the patient flow work at this facility?
  • Who manages the patients?
  • What modalities does the primary spine practitioner use?
  • How much space is needed?

 

Mar 01

Spine & Health Info Platter (1 March ’18)

By Kanwal Sood | Artificial Intelligence , Disruptive Innovation , Spine Cloud Platter , Value-Based Healthcare

In this week’s platter we look at how AI looks at the eye to predict heart disease risk, then we pay attention to an interesting statistic related to EHR, we consider 3 insightful takeaways from the Healthcare Costs Innovation Summit, and we probe the true health risks related to the Brexit negotiations. Sign up for our newsletter on the left. Enjoy!

——————————————————————————————————————————————————————-

The eye is no longer just the window to the soul, as it may actually now save your life

A new study by Google and its health-focused Alphabet-sibling, Verily Life Sciences, has shown that deep-learning algorithms can accurately predict heart disease by analyzing photographs of an individual’s retina.

Given that the algorithm could accurately predict risk factors, the scientists also trained the algorithm to predict the onset of a major cardiovascular event, such as a heart attack within five years.  The technical journal is found here 

——————————————————————————————————————————–

Study: In Family Practice Visits, EHR Time Exceeds Face-to-Face Patient Time

A Time-Motion Study reveals that primary care physicians in the US spent more time working in the electronic health record (EHR) than they spent in face-to-face time with patients in clinic visits.  This is in contrast to a recent study in the UK which found the inverse to be true.  There is a need for serious introspection here (read disruption…).

——————————————————————————————————————————————————————-

3 thoughts that emerged from the Healthcare Costs Innovation Summit

The recent Healthcare Costs Innovation Summit sought to bring money to the forefront of the conversation by asking a central question: Why does healthcare cost so much and what can we do about it?

Here are three takeaways that came out of the summit.

  1. There’s a lot of unnecessary care that’s amping up costs
  2. Implementing value-based care is still a work in progress
  3. America’s broken political system is a threat to the future of healthcare

Simple yet insightful.

——————————————————————————————————————————————————————-

When elephants fight, it is the grass that suffers – the case of Brexit as a healthcare risk…

Public health leaders have warned that health risks are being forgotten in Brexit negotiations, potentially delaying the availability of new medicines and imposing large costs on manufacturers.  According to this article, a ‘hard Brexit’ would pose the greatest disruption for the European healthcare sector and patients, particularly if there is no mutual recognition agreement on clinical trials, batch testing and diagnostics.

It is said that history repeats itself, but this unfortunately does not have the “undo” button.  This is definitely a development worth following closely….

Image Credit: Google

Feb 23

Spine & Health Info Platter (23 Feb ’18)

By Kanwal Sood | Artificial Intelligence , Big Data in Healthcare , Blockchain , Disruptive Innovation , Value-Based Healthcare

In this week’s platter, we consider some of the issues related to the migration towards value-based programmes; we look at an executive’s guide to AI; we learn about the FDA approval for AI-enabled stroke alert app; we learn about the deployment of DNA nanorobots in the fight against cancer; and, finally, a treatise of blockchain technology and what it means for healthcare and pharma. Enjoy…

Most healthcare execs say value-based programs led to positive financial results

HFMA and AAFP reports found that nearly three-quarters of executives surveyed said their organizations achieved positive financial results, including return on investment, from value-based payment programs. Despite the benefits associated with the fee-for-value payment models, the report found that barriers to value-based payments persist: such as lack of resources, inconsistencies among payers, lack of physician alignment and support, lack of staff time, lack of standardization of performance measures and uniform performance reports from payers.
The move into value-based payments is just beginning…

——————————————————————————————————————————————————————-

An executive’s guide to AI

With the accelerating artificial-intelligence race, executives have to make nimble, informed decisions about where and how to employ AI in their business. Management consultant McKinsey & Co. present AI essentials for executives in this interactive guide.

——————————————————————————————————————————————————————-

FDA OKs marketing of AI-enabled stroke alert for providers

We’ve seen the FDA approve prescription apps for substance abuse and digital pills that track when patients take it, and now we learn of the approval of clinical decision support software which analyzes brain scans and alerts clinicians if a patient is at risk of a stroke. During the FDA review, real world evidence was used to show that the app could alert a neurovascular specialist sooner than a clinician in cases where a large vessel blockage was seen. Incremental improvement, but improvement nonetheless…

——————————————————————————————————————————————————————-

Power Source Inspired by Electric Eels to Energize Medical Implants

Last week we learnt about the development of spine-like battery to power flexible electronics. Here we learn of a power source inspired by electric eels to energize medical implants. This is a significant development as the power source would overcome the limitations of batteries: it will remain inside the body (no need to remove/replace), no need for the introduction of toxic materials into the body, and – stating the obvious – completely alleviate the need to use batteries for implants.

——————————————————————————————————————————————————————-

Nanomachines Create Clots Inside Vessels Feeding Cancer Tumors

Researchers from Arizona State University and National Center for Nanoscience and Technology of the Chinese Academy of Sciences have developed a remarkable new way of killing tumors. They’ve developed robot-like nanoscale devices that cling to the walls of tumor vessels, release a clotting agent, and block the tumor from receiving nutrients. This article reports that the technology was applied to mice with a variety of tumors, including breast cancer, ovarian, melanoma, and lung cancer. It worked in all the tumor types, to different degrees, but quite well. Inasmuch as there is a lot of work still to be done even before clinical trials can begin, the expanding of the possibilities of this new technology is exciting…

——————————————————————————————————————————————————————-

What Is Blockchain And What Does It Mean For Healthcare And Pharma?

This article presents a treatise on blockchain technology; and argues the immense potential in both healthcare and pharma.

Feb 18

Spine & Health Info Platter (18 Feb ’18)

By Kanwal Sood | Big Data in Healthcare , Blockchain , Disruptive Innovation , Wearable Tech

In this week’s platter, we look at how the earth’s most customer-centric company (…Amazon) could disrupt healthcare; we learn how FitBit is enabling providers to better support patients beyond the walls of the clinical environment; we pay attention to an application of blockchain technology that promises to lower drug costs; we consider the importance of cybersecurity given the advent of EHRs; we look at how technology imitates nature; and finally, we pay attention to the application of machine vision for spinal navigation. Enjoy!

——————————————————————————————————————————————————————-

What could Amazon’s approach to healthcare look like?

It is clear from some of its recent moves that Amazon sees the 18% of U.S. GDP dedicated to health care as fertile ground for expansion. The challenge is formidable. As many critics have noted, employers have banded together before to address health care costs and failed to make much of a dent in health care spending. How will this effort be different? If Amazon succeeds in changing health care, how might it do so? This article presents four key strengths that Amazon will have to exploit to bank this opportunity.
Suffice to say that for existing health care companies, the operative words in their mandates have been “health care”; for Amazon, the operative words likely are “service that needs to be delivered to a customer.” Is this the disruption that the healthcare industry has been waiting for?

____________________________________________________________________

Fitbit digs into healthcare industry with acquisition of personal coaching platform Twine Health

On Tuesday, the wearables manufacturer announced plans to purchase Twine Health, a Boston-based company that combines artificial intelligence with personalized coaching to assist patients with diseases like diabetes and hypertension. This is in pursuit of helping healthcare providers to better support patients beyond the walls of the clinical environment, which can lead to better health outcomes and ultimately, lower medical costs.

______________________________________________________________________________________________

Cambridge Consultants creates blockchain-based platform to help manage drug costs

Development firm Cambridge Consultants has designed an open market trading platform for drug price negotiation that’s based on a public blockchain. The company says it’s an effort to help fix the lack of transparency around how drug prices are set – that by creating a set of so-called smart contracts on the Ethereum blockchain, it will enable a trust-based mechanism for the trading of drug products as if they were commodities. By moving to an open market that creates price competition and improves access, one can expect that drug prices will taper and could eventually decline.

______________________________________________________________________________________________

Tennessee Hospital’s EHR Hacked by Cryptocurrency Malware

Decatur County General Hospital, a 40-bed hospital located in Parsons, Tennessee, has informed its patients about a security incident in which is electronic medical record (EMR) system was hacked, impacting 24,000 patients’ records.
As per classic PR, the hospital alleges that, at this time, there is no evidence that patient information was actually acquired or viewed by an unauthorized individual and officials investigating the incident do not believe that patient health information was targeted. Nonetheless, this incident highlights the risk associated with digital EHRs on a network

______________________________________________________________________________________________

Lithium-ion battery shaped like spine could power flexible electronics

Scientists are developing a lithium-ion battery shaped like the human spine to power wearable electronics in the future. Researchers from Columbia University in the US were inspired by the suppleness of the human spine, and used the spine model to design a battery with a similar structure as that of the spine. The battery allows remarkable flexibility, high energy density and stable voltage no matter how it is flexed or twisted, researchers said. The solution to some of our problems is found in paying attention to what has already been created…

______________________________________________________________________________________________

Machine-Vision Image Guided Surgery: Cost-Effective & Radiation-Free (YouTube)

The 7D Surgical System is an impressive Machine-vision Image Guided Surgery (MvIGS) platform. The system delivers on the promise of image guided surgery (IGS) and allows surgeons to perform fast, cost-effective, radiation-free IGS. Unlike conventional IGS systems that rely on time-consuming intra-operative radiation emitting devices or laborious point matching techniques, MvIGS uses only visible light to easily register patients in less than 20 seconds. Have a look…

Feb 14

The Strategy That Will Fix Healthcare: Part III- The Model

By Kanwal Sood | Clinical Pathways , Disruptive Innovation , Primary Spine Provider , Spine Pathway , Value-Based Healthcare

Our review of Porter & Lee’s publication continues. This week we outline the model that defines the ‘value agenda’- the model that will transform healthcare. It’s six distinct, mutually reinforcing components are briefly described below:

1) Organise into integrated practice units (IPUs). In an IPU, a dedicated team made up of both clinical & non-clinical personnel provides the full care cycle for a patient’s condition. IPU’s treat not only a disease but also the related conditions, complications and circumstances that commonly occur along with it e.g. kidney disorders for diabetics. They also assume responsibility for engaging patients and their families in care e.g. by providing education and counselling, encouraging adherence to treatment & prevention protocols, and supporting needed behavioural changes  such as smoking cessation or weight loss

2) Measure outcomes and costs for every patient. Wherever we see systematic measurement of results in health care – no matter what the country – we see the results improve. The key is to measure outcomes that matter to patients i.e. key functional measures/functional status. Outcomes should cover the full cycle of care for the condition and track the patient’s health status after care is completed.

3) Move to bundled payments for care cycles. These cover the full cycle care for acute medical conditions, the overall care for chronic conditions for a defined period (usually a year), or primary and preventative care for a defined patient population (e.g. healthy kids). Well designed bundled payments directly encourage teamwork & high-value care.

4) Integrate care delivery systems. This eliminates the fragmentation & duplication of care and  optimizes the type of care delivered in each location. To achieve this, organizations must grapple with four related sets of choices: defining the scope of services, concentrating volume in fewer locations, choosing the right location for each service line, and integrating care for patients across locations.

5) Expand geographic reach– this takes two principle forms. The first is a hub-and spoke model- for each IPU, satellite facilities are established and staffed partly by clinicians & other personnel employed by the parent organization. The second model is clinical affiliation, in which an IPU partners with community providers or other local organizations, using their facilities rather than adding capacity.

6) Build an enabling IT platform– this powerfully enables the preceding five components. The right kind of system can help the parts of an IPU work with one another, enable measurement and new reimbursement approaches, and tie the parts of a well-structured delivery system together.

Implementing the value agenda is not a one-shot effort; it is an open-ended commitment that requires strong leadership. For most providers, creating IPUs and measuring outcomes and costs should take the lead. Superior IPUs will be sought out as partners of choice, enabling them to expand across their local regions and beyond.

Feb 09

Spine & Health Info Platter (9 Feb ’18)

By Kanwal Sood | Big Data in Healthcare , Blockchain , Disruptive Innovation , Spine Cloud Platter

In this week’s platter, we look at curing disease through big data; then we pay attention to the early applications of virtual reality technology in healthcare; we look at how a simple tweet about your cough could help reduce the impact of a pandemic; we consider the rise of ‘digiceuticals’; and finally, and frankly ironically, we turn our attention to the lobby against digital addiction.            Sign up for our newsletter on the left. Enjoy!

———————————————————————

Medichain – saving lives with blockchain

MediChain is a Medical Big-Data Platform that allows patients to control all their medical data with complete privacy and at no cost to themselves, the doctors, or hospitals using the system. The platform is unique in that it that stores the anonymised data in such a way that patients can opt to let researchers use it in developing cures for every possible disease or illness that occurs in the population. So your data can actually be used to save the life of others. This is a fine example of curing disease through big data.
———————————————————————

Where is the business case for medical VR?

Proponents of virtual reality (VR) technology believe VR offers a valuable new addition to the clinical toolkit, with potential applications ranging from education and training to rehabilitation, pain reduction and even treating anxiety and depression. But is there evidence supporting the use of VR in the treatment of medical conditions? This article answers in the affirmative, and suggests that VR could even find application in cognitive behavioral therapies.

———————————————————————

Fighting the flu with code

Early detection and prediction of disease outbreak is critical because it can provide more time to prepare a response and significantly reduce the impact caused by a pandemic. Multiple researchers are harvesting data from social media platforms to estimate current (real-time) influenza activity and determine hot spots of transmission.
This represents a big leap because such predictions provide actionable insights for public health that can be used for planning, resource allocation, treatments and prevention. So, the next time you tweet ‘Oh, I’m coughing,’ you may just be helping the authorities determine to where to focus their resources. Was that a cough I just heard…?

———————————————————————

Don’t worry, be appy

LUANN STOTTLEMYER has had diabetes for 23 years, but it was only in 2016 that her doctor prescribed a treatment that changed her life. It has allowed her to bring her blood-sugar levels under control and lose weight. Yet this miracle of modern science is not a new pill. It was a smartphone app (a “digiceutical” for those who are into the lingo).

———————————————————————

Social media pioneers will now fight what they helped build

With the advent of digital solutions/apps for just about anything, a lobby group has been formed to highlight the dangers of excessive smartphone use has on the mental health of the users. Ironically, the lobby group is spearheaded by the very same people who helped create these ubiquitous social media platforms. What was once a solution is now becoming a massive problem…

Feb 05

The Strategy That Will Fix Healthcare: Part II- The Goal

By Kanwal Sood | Disruptive Innovation , Primary Spine Provider , Spine Care , Value-Based Healthcare

We continue our review of Porter & Lee’s ‘The Strategy that will fix Healthcare’.

As discussed last week in Part I, in the existing approach, patients most often receive portions of their care from a variety of types of clinicians, usually in several different locations, who function more like a spontaneously assembled “pickup team” than an integrated unit. They might undergo special testing e.g. radiology at any point- even before seeing a physician. Essentially, no one:

– measures patient outcomes
– measures how long the process takes
– measures how much the care costs

Thus, the VALUE of care never improves.

This problem has been reinforced by payment structures- however, all this is now changing. With massive pressure to contain costs, payors are aggressively reducing reimbursements and finally moving away from fee-for service and toward performance-based reimbursement. We are entering a period during which providers will work under multiple payment models with varying risk exposure. The days of charging higher fees for routine services in high-cost settings (e.g. hospitals) are quickly coming to an end.

In this environment, providers need a strategy that transcends traditional cost reduction and responds to new payment models. Providers that improve the efficiency of providing excellent care will:
– grow their market share
– be more competitive
– enter any contracting discussion from a position of strength

Let’s move away from a supply-driven health care system organized around what physicians do and towards a patient-centered system organized around what patients need. Let’s shift the focus from the volume & profitability of services provided- physician visits, hospitalizations, procedures and tests- to the patient outcomes achieved. And let’s replace today’s fragmented system, in which every local provider offers a full range of services, with a system in which services for particular medical conditions are concentrated in health delivery organizations and in the right locations to deliver high-value care

So, let us all agree on the overarching core goal of Value for health care systems – improving outcomes that matter to patients relative to the cost of achieving those outcomes- so that we can begin to make progress. How does that sound?

This ‘value agenda’ will require a restructuring of how health care delivery is organised, measured and reimbursed. The revolution is well under way- organisations such as the Cleveland clinic and Germany’s Schὅn Klinik have undertaken large-scale changes involving multiple components of the value agenda- leading to striking improvements in outcomes & efficiency, as well as growth in market share.

In Part III next week we’ll analyse the model for change that defines this ‘value agenda’, with its six interdependent components. The model for transformation of healthcare delivery.

Feb 04

Spine & Health Info Platter (4 Feb ’18)

By Kanwal Sood | Artificial Intelligence , Big Data in Healthcare , Disruptive Innovation , Spine Care , Spine Cloud Platter , Value-Based Healthcare , Videos , Wearable Tech

In this week’s platter we consider whether remote patient monitoring technologies translate into improved patient health; we look at the 3 industry tycoons who want to fix health care in the US; we study the application of artificial intelligence in big pharma; we look at Apple’s lesson for healthcare innovation; and finally, we get introduced to DNA portraits. Enjoy!
——————————–

Remote patient monitoring: From hype to reality

Enthusiasm for remote patient monitoring (RPM) is growing, and it’s no wonder. The latest wave in health data collection uses non-invasive devices (think smart watches, smart phones, and other wearables) to automatically transmit data to a web portal or mobile app for patient self-monitoring and/or health provider assessment and clinical decision-making. Could the use of these exciting technologies actually translate into improved patient health? Researchers found that RPM could be impactful—so long as it was coupled with interventions that integrated new experiences, such as personalized health coaching, into the care model. While that’s good news, we should ask ourselves: why wasn’t the technology alone enough to move the needle?

Jeff Bezos, Warren Buffett and Jamie Dimon want to fix health care

On Monday, Jeff Bezos, Warren Buffett and Jamie Dimon announced that their three companies -Amazon, Berkshire Hathaway and JPMorgan Chase- would create a new company to develop a better health care solution for their U.S. employees. Given the resources of the companies, and their history of concentrating on the long-term rather than just the near-term, they have a chance to make significant changes in the way health care is provided. Still, it won’t be an easy industry to change.

India’s Growing Healthcare Burden has a Solution at ‘Home’

As India marches ahead, the nation still struggles with substantial issues and worrying gaps in it’s healthcare system. An imminent solution which can have an immediate impact on improving India’s health status, without the additional economic burden of increased expenditure on healthcare infrastructure, is home healthcare. Increasing penetration of internet and technological improvements in healthcare will act as strong enablers in delivery of services at a patient’s home. This article posits that it is time for India to proactively consider home healthcare as a solution for the multiple challenges faced by it’s healthcare industry.

Precision medicine allows accurate disease prevention and treatment tailored to an individual by combining knowledge of a person’s environment, their genetic make-up and protein levels.

Big pharma turns to AI to speed drug discovery

The world’s leading drug companies are turning to artificial intelligence to improve the hit-and-miss business of finding new medicines. The aim is to harness modern supercomputers and machine learning systems to predict how molecules will behave and how likely they are to make a useful drug, thereby saving time and money on unnecessary tests. In fact, experts believe that AI systems could deliver drug candidates in roughly one-quarter of the time and at one-quarter of the cost of traditional approaches. Let’s hope that this contributes to a net reduction of health-care costs

Apple’s surprising lesson for healthcare innovators: it’s not about the product

In this video, Rebecca Fogg explains what the iPhone can teach us about Disruptive Innovation in healthcare to audiences at the Imperial College London Business School’s 2017 innovation conference

And finally,

Order Your DNA Portrait!

You can get your own DNA portrait!!! In the era of personalized genetics, it’s a perfect example of how industry will use these methods to explore all the financial possibilities. DNA Portraits are the world’s most unique and personalized form of art. No two prints will ever be alike (but for those who cannot read DNA, the portrait remains beautiful, even if it is not unique).

>