Amazon Echo for healthcare

61cnyft6IlL._SY355_

Alexa, what can you do for healthcare?

I bought an Amazon Echo this week and have been enjoying using it in the kitchen. I can ask, “Alexa, what time is it in Germany?” and it will tell me. Or I can say, “Alexa, play music by the Beatles,” or ask, “Alexa, how many ounces in a cup?” and it will let me know. It’s remarkably easy –and not at all frustrating– to use. The whole family is enjoying it.

Naturally I started almost immediately to think of healthcare uses, so I wasn’t at all surprised to pick up the Boston Globe yesterday and see that my friends from Boston Children’s Hospital are a step or two ahead. Chief Innovation Officer John Brownstein, PhD and clinical innovation director Michael Docktor, MD have launched a KidsMD app for the platform and are testing out uses for Echo in the OR, ICU and bedroom.

Although the article lays out some of the potential for Echo, overall I find it too dismissive, highlighting a software glitch, voice recognition problem, and asserting that “another layer of technology might frustrate staff.” The article ends with a quote from a Children’s engineer whose own kids aren’t interested in speaking with Alexa. None of this reflects my family’s experience.

What the article misses is that Echo represents the latest example of physicians bringing cutting edge consumer technology into the hospital and running circles around the standard tools offered by the IT department. In the real world, physicians are early and enthusiastic adopters of tools like the iPad and iPhone, and through the bring your own device (BYOD) movement they have upended the traditional, clunky hospital IT environment.

Here are some thoughts about what could make Echo so useful for healthcare:

  • It’s the rare tool that can be used equally well by doctors and patients
  • It’s a handsfree device, which makes it easy to use when one’s hands are occupied, dirty, or injured
  • The voice recognition is really good, and works just fine in a noisy environment
  • It enables continuity of care because a patient could use the same device at home that was used at the hospital
  • It gets smarter all the time as new intelligence and apps are added to the cloud
  • It can entertain as well as inform

I can foresee apps that help patients remember their customized care instructions, “Alexa, how often am I supposed to change my dressing?” or “Alexa, am I supposed to take my medication with food?”

I also think it will be useful for hospitalized patients who are trying to remember questions they want answered the next time their doctor or nurse comes around. There is a built in ability to say, “Alexa, add butter to my shopping list.” So there’s no reason it couldn’t compile a list of doctor questions as well.

These are the veritable tip of the iceberg, and I look forward to seeing a thousand (or more) flowers bloom as the healthcare field embraces Echo. “Alexa, I love you.”

By healthcare business consultant David E. Williams, president of Health Business Group.

 

Will Zika help or hurt health plans?

ID-100393375

Health insurers are starting to think about the impact of the Zika virus, which may arrive in force in the US over the coming months. Actuaries are looking for analogous examples for their models, such as other mosquito born illnesses including dengue fever.

Some insurers aren’t too concerned, according to Healthcare Finance News. Others are looking at reinsurance opportunities and considering premium increases.

Most Zika infections cause only mild illness, so the costs of treatment will be modest or zero much of the time. The real impact is likely to come from the cost of lifelong care for babies born with microcephaly or other problems, which could be millions of dollars per case.

But does that mean Zika will hurt health plans financially? Not necessarily.

For commercial health plans, maternal and newborn care is one of the largest categories of expenses. If a Zika epidemic looms, I would expect women to stop having babies, at least for a while. After all, in El Salvador the government has suggested women not become pregnant for the next two years.

If that happens, insurers will enjoy a windfall from avoided expenses that will show up right away. Meanwhile, the costs of Zika babies will be spread over many years and no doubt much of the cost will be shifted to Medicaid one way or the other.

Zika is a huge threat and we should be doing much more about it as a society. But health plans may not suffer as much as people assume.

Image courtesy of duntaro at FreeDigitalPhotos.net

By healthcare business consultant David E. Williams, president of Health Business Group.

 

Trouble ahead: Obese, diabetic 50 somethings heading for bleak senior years

ID-100314466

It’s not too late

Today’s middle-aged adults (50-64) are much fatter and more likely to have diabetes than their predecessors from 15 years ago. Obesity is up 25 percent, diabetes 55 percent and the percentage reporting being in very good or excellent health declined by 9 percent, according to the latest America’s Health Rankings Senior Report from the United Health Foundation.

At the state level, some of the changes were far more dramatic. Prevalence of diabetes among middle-aged Coloradans is up 138 percent, while obesity rates in Arizona are up by 96 percent.

The report warns that today’s middle-aged cohort is on track for an expensive and unhealthy experience when they hit the ranks of seniors by 2030.

The news isn’t all bleak. My home state of Massachusetts is rated the healthiest for seniors in the latest report (overtaking Vermont). Seniors here have become more physically active; many have stopped smoking. On the negative side the rate of flu vaccination dropped in Massachusetts. (Maybe it has something to do with the vaccine’s recent lack of effectiveness — I got the flu vaccine and the flu this past season.)

As usual, this year’s report is chock full of statistics and insights, with a variety of national indicators and state-by-state comparisons. And no surprise, the Southern states remain the unhealthiest –with Louisiana, Oklahoma, Mississippi, Arkansas and West Virginia bringing up the rear.

It’s not too late for middle-aged Americans to improve their health and well-being. Reports like this may spur individuals, governments and private sector players into action. For the sake of seniors-to-be and the country as a whole, I sure hope it happens.

Image courtesy of Stuart Miles at FreeDigitalPhotos.net

By healthcare business consultant David E. Williams, president of Health Business Group.

 

 

Canada is looking better and better

ID-100184412

O Canada!

In almost every election cycle people talk about moving to Canada if a presidential candidate they despise takes office. In practice few make the move. Things could be a little different this time around if a certain nationalist strongman comes to power.

There’s something else to fear this year: the Zika virus. According to NIH director Tony Fauci, mosquitoes with Zika are likely to arrive in the US mainland within the next month or two. One species will be all over the South, another will come up the East Coast as far as New England. Already, close to 300 pregnant women in the US are infected.

Congress is dithering with the President’s request for funds to combat Zika’s spread and is toying with the idea of canceling Ebola funds to partially support the Zika fight. It’s pretty irresponsible.

In the past I would have assumed that Congress would get it’s act together and do the right thing. But after seeing some members unconcerned about preventing a default I no longer take good intentions and common sense for granted.

Zika is serious and its spread could have a big impact on economic growth. In El Salvador, the government has advised women not to get pregnant for the next two years, lest they give birth to babies with severe birth defects. Can you imagine the impact such an advisory would have in the US?

Image courtesy of Vlado at FreeDigitalPhotos.net

By healthcare business consultant David E. Williams, president of Health Business Group.

Health Wonk Review is up at Boston Health News

Check out the latest edition of the Health Wonk Review over at Boston Health News. Tinker Ready has a great collection of posts about insurance, HIT, report cards, LGBT health and cancer.

And you won’t want to miss the beautiful collection of photos of the Sant Rafael Pavilion in Barcelona.

The false link between mental illness and gun violence

It would be nice if we could eliminate mass shootings by improving the mental health system, coaxing (or forcing) potential shooters into treatment before they have a chance to wreak havoc.  As the Washington Post (Most mass shooters aren’t mentally ill. So why push better treatment as the answer?) reports:

“It would be ridiculous to hope that doing something about the mental-health system will stop these mass murders,” said Michael Stone, a forensic psychiatrist at the Columbia College of Physicians and Surgeons and author of “The Anatomy of Evil,” which examines the personalities of brutal killers. “It’s really folly.”

This seems pretty obvious, and yet Republican and Democratic leaders, along with the general public and the media seem to think mental illness is the root cause of shooting sprees and that improving the mental health system can fix the problem.

After mass shootings, reporters often jump quickly to mental illness as the cause. Remember after the Sandy Hook shooting when there was speculation that the shooter’s Asperger’s diagnosis was to blame?

Asperger’s? Are you kidding me?

The danger of our fixation on mental illness as the root cause of violence is that we end up stigmatizing people with mental illness –and developmental disorders– while ignoring more direct causes of gun violence, such as ready access to guns.

Mass shootings are rare outside the US. Is there someone who can tell me with a straight face that the difference is due to better mental health systems abroad?

Meanwhile, Australia has seen a major decrease in gun violence over the past 20 years since adopting strong gun control after a mass murder. That seems like a more evidence and logic based response than what we’ve tried here.

By healthcare business consultant David E. Williams, president of Health Business Group.