Navigating Healthcare – Patient Safety and Personal Healthcare Management

Men’s Health Week

Posted in Aging, Blood Pressure, Cancer, Personal Health, Suicide by drnic on June 29, 2016

Having a “Y” is No Excuse

It was Men’s Health week Jun 13 – 19 and I had the pleasure of talking to the Talk Ten Tuesday host Chuck Buck last week (Tuesday Jun 21)  to offer some thoughts and insights for their listeners and in particular for women thinking about any men in their lives


Most women know about their own health but not so much about men yet most women have men in their lives – sons, brothers, fathers, partners. Here are some of the highlights of the challenges in men’s Health

More men are born than women but that lead disappears quickly – in 1920 women outlived men by 1 year that’s now up to 5 years women outlive men. Having a “Y” Chromosome is not the reason for the poorer health of men.
Men “lead” in the top 15 causes death with the exception of Alzheimer’s (and that’s because men don’t live as long and as a result experience less Alzheimer’s).

Mars and Venus

This is the Mars vs Venus Gender gap in health. Men, like women have some diseases that are specific to them – prostate disease for example, but despite 1 in 6 being diagnosed with prostate cancer only 1 in 35 die from the disease. But most diseases are a shared problems – they strike both men and women. The leading issues for both gender’s are:

Heart Disease

  • Cardiovascular – men lead in heart un healthiness – but ladies are catching up
  • Heart disease and stroke – leading cause of death
  • Men develop atherosclerosis ~5 years earlier than women
  • Diet, Exercise, and fitness – don’t forget sleep
  • Cholesterol, blood pressure

If you want to explore the gender differences and causes of death head over to World Life Expectancy


Lung cancer remains a threat – tobacco causes 90% of lung cancer and is causing ~158,000 deaths each year but there are gender differences; ~85,000 in men and ~72,000 in women (that’s more than enough to fill the Superdome every year)

Mental Health

But when it comes to Mental Health, Depression and Suicide we thought this affected men more than women but this may just be that men hide their feelings better and men also tend to seek help less for depression and while women attempt suicide more than men, more men die of suicide as they are more “successful”:

That’s about 100 people per day who commit suicide


“The high sugar of diabetes is anything but sweet”

The sugar is a slow poison inducing:

  • Heart attacks
  • strokes
  • blindness
  • kidney failure, and
  • amputations

If you were born after the year 2000 as a boy your chances of developing Diabetes is 1 in 3

“The combination of diabetes and obesity may be erasing some of the reductions in heart disease risk we’ve had over the last few decades”

So what should women do – as they should for themselves, encourage exercise (30 minutes per day reduces the chances of diabetes by 50% for men)  and a balanced and healthy diet. Not ignoring problems and focusing on prevention helping men seek medical help, but above all give them a hug and help them share and talk about their feelings



Men’s Health Week was originally published on Dr Nick van Terheyden, MD

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The Digital ‘Back Door’ #security vs Sur

Posted in Uncategorized by drnic on May 25, 2016

The Digital ‘Back Door’ #security vs Surveillance #Privacy

AI doctors will become ‘as ubiquitous a

Posted in Uncategorized by drnic on May 3, 2016

AI doctors will become ‘as ubiquitous as stethoscopes’ #DigitalHealth

Revealed: Google AI has access to huge h

Posted in Uncategorized by drnic on May 2, 2016

Revealed: Google AI has access to huge haul of NHS patient data <– Surprised!? #privacy

Hospital discharge: It’s one of the most

Posted in Uncategorized by drnic on May 2, 2016

Hospital discharge: It’s one of the most dangerous periods for patients #safety

The identity Problem

Posted in Healthcare Technology by drnic on April 26, 2016

I struggle to keep my contacts in order and synchronized, not just across devices but across ecosystems and channels. How do you keep your old style digitized version of the rolodex in sync with your twitter followers and LinkedIn connections? How do you know when your friends join a new social media channel that you are member of so you can connect there?

I’ve tried many tools and techniques and had been using Brewster which recently was acquired by FullContact and the transition offered me 3 months of premium access to their service. The free version offers backup and some syncing across limited accounts – the premium version expands to multiple accounts and includes business card scanning.

The early results were surprising – in my contact database the system was offering me updates to over 40% of my contacts. I was suspicious but as I investigated I discovered that using some clever back end algorithms it was revealing updates to many of my connections including some I validated manually that good friends revealed were early forays into social media including a blog on Ice Cream and a corresponding Pinterest account.

So in social media and the commercial world we can link data and people – in fact the commercial organizations do this very effectively that Target collected enough information on individuals linked through a unique identifier to identify a high school student was pregnant and mail her maternity adverts before the “news” had leaker to her father

“Target assigns every customer a Guest ID number, tied to their credit card, name, or email address that becomes a bucket that stores a history of everything they’ve bought and any demographic information Target has collected from them or bought from other sources”

The healthcare system is rife with enough challenges – why is it we have one that is of our own making. Why is there so much resistance to the idea of uniquely identifying a patient so we can attach the correct medical data to the correct person and deliver the correct medical treatment to that same individual?

In 1996 the Health Insurance Portability and Accountability Act (HIPAA) was signed into law and it specifically called for

“a standard unique health identifier for each individual”

But in 1998, Congress eliminated that requirement and even prohibited the use of federal funds to develop a unique identifier. Anyone who knows me will know my passion for privacy and individual rights but in this instance the harm and cost foisted on the system, providers, payers and ultimately the patients is gargantuan!

Figure: The Percentage of Waste by country spent on Healthcare Administrative and Insurance

The Social Security number has become the de facto universal (and most valued) US national identifier. Created in 1935 for the purposes of tracking social security benefits it has been hijacked and subsumed into multiple other uses. The gathering and use of this placed a large target on the back of healthcare data and as of the end of last year over 112 Million healthcare records were breached.

As far back as 2009 HIMSS issued a Patient Identity Integrity White Paper making the case for identity management and in 2010 the recently retired Gartner Analyst and Research Director Barry Hieb and now Chief Scientist at Global Patient Identifiers wrote this piece in e-Journal of Health Informatics: A Cost Effective Method to Create a Universal Healthcare Identifier System (full pdf here) advocating the need and a path to the creation of a universal patient identifier

The prohibitive cost associated with creating a universal healthcare identifier has been one of the primary barriers to the creation of such a system. The Voluntary Universal Healthcare Identifier (VUHID) project takes a radically different approach to solving this problem compared to previous proposals. This article examines the economic impact of this approach and discusses why the unique VUHID approach permits implementation of the system at a small fraction of previously estimated costs.

Despite a rational approach that enabled individualized control and security it has not taken off. We continue to waste resources, duplicate tests, decrease the overall safety and increase errors in our healthcare system that according to the RAND study: Identity Crisis; An Examination of the Costs and Benefits of a Unique Patient Identifier for the U.S. Health Care System could offer a saving of $77 billion per year if implemented with sufficient penetration – they cite 90% level of adoption.

Have a I raised your heckles advocating for a unique identifier – is it as Adrian Gropper chief technology officer for Patient Privacy Rights stated

Implementing a unique patient identifier would add nothing to our health care system beyond coercive surveillance

Or as Twila Brase, RN, is cofounder and president of Citizens’ Council for Health Freedom, says its important not to have it to prevent the creation of a “nationalized” healthcare system (I’d interpret this as a single payer system like the VA and Medicare?)

The most important reason is our opposition to building a national health care system. Without a national identification card for patients, it would be difficult to nationalize health care


Or do you side with Douglas Fridsma, MD, PhD, is president and CEO of the American Medical Informatics Association who says people care a lot about the privacy and security of their medical data but want immediate access and transferability with control over who can see and use their medical data and believes that

Giving every American a unique patient ID could help address all of those issues.


Join me Thursday April 28 at 7pm for #CMIOChat: The Identity Problem. We will be covering the following questions


  1. Why does the US not have a Unique Patient Identifier?
  2. Is it possible we can come up with agree and use a Unique National Patient Identifier and if so how?
  3. What alternatives are practical and cost effective to a Unique patient identifier
  4. How do we protect patient confidentiality and privacy in a world with a unique patient identifier?


The identity Problem was originally published on Dr Nick van Terheyden, MD

Reviewing the World’s Best Voice Recogni

Posted in Uncategorized by drnic on April 22, 2016

Reviewing the World’s Best Voice Recognition Software #speechrecognition

The Dell World DoMoreHIT Panel

Posted in #DoMoreHIT, Dell, Healthcare Technology, HealthIT, HIT, Innovation, social media, Technology by drnic on April 1, 2016

On Tuesday March 15th, 2016 a the Dell Lounge at South by Southwest (SXSW) we hosted the #DoMoreHIT Thinktank event.

This was Dell’s 5th’s annual healthcare Think Tank. Together with my good friend and colleague Mandi Bishop – Healthcare Analytics Innovations & Consulting Practice Lead, Dell, #HIT100 influencer, @MandiBPro we were joined by a veritable who’s who of thought leaders from healthcare and related industries for an outstanding set of panelists:

  • Claudia Williams, Sr. Advisor, Health Innovation and Technology at White House Office of Science and Technology Policy




We divided the session up into three segments –  Data explosion in Healthcare, Embracing New Technology and How to be Future Ready


The Data Explosion in Healthcare

  • Physicians, patients and health systems are over whelmed with data – is there too much noise to discern the signal of relevance?
  • Is there any focus area for gathering or managing data that healthcare should target over others (wearables vs genomics vs population health vs clinical data vs lab values vs imaging for example)? And are there data sources outside those traditionally considered “health” that you’d consider particularly relevant?
  • What can patients – and clinicians – do to get ready for the deluge of data and information that they will be receiving and become increasingly responsible for managing?
  • How can we, as an industry, and our individual organizations help make the vast quantities of diverse data into meaningful information that can be readily understood?
  • How much do you trust the quality of the data sources your organization is using for BI and analytics? And how do you address it if/when you don’t trust the data quality?
  • If your organization is collecting data about your patients/consumers, do you offer that data – and any health insights derived from it – back to those patients/consumers? If so, how? And if not, why not?



Embracing New Technology

  • How do we embrace technology while keeping the focus on patient and compassion?
  • Is there any new technology that stands out as delivering value that patients, clinicians and health systems can jump on, now?
  • Do you think there’s a fear amongst healthcare providers that digital health technology, in conjunction with advanced analytics, will change – perhaps reduce – the role of the clinician in healthcare delivery?
  • What do you see as ripe opportunities for emerging technology to disrupt healthcare? What’s already been done that’s working, and what do you think is on the horizon that’s about to break?
  • How do we make wearable technology and remote monitoring accessible to the underserved populations who may best benefit?
  • What do you think are the biggest obstacles to tech adoption (for consumers and for providers/industry)?



Future Ready Healthcare

  • What does being “future-ready” mean to you and your organization? How can you be future ready in the age of constant and increasingly rapid change?
  • What one thing do you think will change the future of healthcare this year, in 3 years and in 10 years?
  • Increasingly people want personalized health and wellness care – how do we deliver that with the current system that does not readily enable personalization (both from a technology perspective and from an incentives perspective)?
  • Do you believe precision medicine principles – genomics informing personalized clinical pathways – are sustainable across vast numbers of people? Or are they perhaps best narrowly applied to complex disease states with limited number of affected persons? And how will incentives have to change to align?
  • When was the last time your doctor asked you how you’d like to be engaged? And if they’ve asked you, have they done what you suggested?
  • Do you have a formal patient/member advisory board/council? If so, how does it work? And if not, why not?


The event was a great success and despite the global LiveStream issues at the time we managed to trend #2 on Twitter just behind #IndianaJones



As of writing there have been over 20M #DoMoreHIT impressions and the material continues to provide additional utility and is in use in other forums. The venue itself was packed and there have to date been 2,500+ Livestream views and ongoing On-Demand promotion and use. In house attendees and online described it as the “best panel yet!”

The 3 sessions from LiveStream can be viewed here

The Highlight Reel from the Dell Lounge Week Long Activities

Dell lounge Photos here

The Dell World DoMoreHIT Panel was originally published on Dr Nick van Terheyden, MD

National Doctors Day

Posted in Compassion, HealthIT, HIT by drnic on March 30, 2016

8Ton Orca jumping out of Ocean

On February 21, 1991 President George Bush declared in Proclamation 6253 March 30 would be National Doctors Day:

There is no greater reward in our profession than the knowledge that God has entrusted us with the physical care of His people. The Almighty has reserved for Himself the power to create life, but He has assigned to a few of us the responsibility of keeping in good repair the bodies in which this life is sustained

In honor of my colleagues and the countless others who make up the healthcare service and who struggle daily with the delivery of healthcare and the challenges of a system that is broken but still delivers outstanding care:

Always Believe in Yourself

For me:

Every Smart Person is Working in Healthcare small

Its an exciting and challenging time and the healthcare service is dependent on the clinical skills and dedication of Doctors to deliver excellent healthcare – take a moment to thank your clinical professional for all they do on a daily basis. The glass is full – 1/2 full of water and 1/2 full of air and I’m excited about the future and what’s coming and hope my friends and colleagues are too:

Excited - Winnie-the-Pooh

National Doctors Day was originally published on Dr Nick van Terheyden, MD

Exciting Progress with CRISPR

Posted in Genetics by drnic on March 28, 2016

This is an exciting and positive development in Genomics using the CRISPR technology – here source scientists have removed the HIV-1 genome from the genome of human immune cells
Gene editing could now be added to the armament of clinicians to fight diseases including infections

Exciting Progress with CRISPR was originally published on Dr Nick van Terheyden, MD


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