Grand Rounds

Welcome to Grand Rounds.

As a blog dedicated to “engaging conversations on healthcare and technology,” this week’s edition of Grand Rounds is dedicated to posts discussing the relationship between health care and technology. Technology in health care has received more than a notable amount of press over the last few years and more than a few people have something to say about it.

In response to Grand Rounds, we received a number of great submissions by health care bloggers, some positive and others negative, about the impact technology has had on how health care is perceived and understood, delivered and received.

Let it be known: Health care has changed.

Young adults are now officially seeking health information via the internet. This month, Pew Research Center announced the findings from a December 2010 study that confirmed that individuals are seeking online source for the answers to their health care questions. Over the last decade, the trend is projected to continue on its current path as well. Elaine Schattner, M.D., discusses the findings in a post titled, “Internet Surpasses TV as Prime News Source for Young Adults.”

Now, young adults certainly do not represent the general population; however, young adults will not be labeled as “young” forever. Examining trends in younger generations provides great insight on the future of health care and society as a whole, and it seems clear that information sharing via the Internet will only be emphasized in the years to come.

Add mobile health to the mix, and there is a whole new element of complexity. According to a blogger at The Happy Hospitalist, mobile technology and the iPad Touch Screen Technology In the Hospital Changed Everything Overnight. And the recent inclusion of smart tablets on the market, and in health care settings, is only the beginning…

So, is this a good thing?

Well, a number of people agree that technology has had, and will continue to have, a positive influence on the healthcare industry. From simply an information perspective, the benefits and opportunity from information sharing using technology are endless.

Rita Jablonski, an assistant professor of nursing at Penn State University, discusses one example of the growing wealth of information available on the Internet in a post titled, “A Growing Repository of Knowledge.” POGOe (or Portal of Online Education), is a public repository for education materials, lectures and presentations among other resources. Considering the growing number of older adults, ensuring that doctors and nurses have sufficient training in the care of older adults, as well as access to key resources, is particularly important for the future of our health care system.

Not only is a “repository of knowledge” growing online, but the ability to make connections between those bits of information has improved. In a post by Dan Ferber titled, “ResearchGATE: Social Media for Scientists,” Dan explores how scientists are teaming up to utilize social media networks as a medium to make connections, solve problems and communicate with one another.

This all sounds good to me, but are there any actual health improvements from technology?

According to a physician blogger named, Dr. Charles, there are. The same resources that are available to providers to improve care are equally accessible to patients seeking health information. Dr. Charles outlines this occurrence in a post titled, “Respond, Don’t React, Live Longer?” As a result of being plugged in to medical blogging and the vast online wealth of medical information, patients are now using this health information to expose non-traditional forms of treatment that ask critical questions of the health care process.

Additionally, because of access to alternative forms of treatment, patients are exposed to completely new treatments that can be superior to those traditionally offered. Being engaged with their own health, facilitated by the online world, is a “boon to health.” Patients and providers are then in an environment where they can work together to achieve health, instead of placing the entirety of responsibility on one individual.

Are there any downsides to technology in health care?

As with any dramatic social change or industry restructuring, there are negative consequences. For some, the negative consequences are notable and should be considered as progress ensues.

One hot topic, as outlined by psychology student, Erin, in a post titled, “Values of Communication,” is the impact of technology on communication methods. Erin suggests that social media and other online communication may have caused physicians and other providers to lose sight of what brought their conversations online in the first place.

Louise, a blogger on the Colorado Health Insurance Insider, agrees with Erin on a few points that overindulging and relying on technology can be a tendency because of its attractive characteristics. Louise adds to this perspective in a post titled, “Overdoing Technology,” by suggesting there are additional costs associated with technological advancements in health care. For some, the cost is justified by the information network available. For others, it is not:

[…] when it comes to medical technology, not only are we always striving for newer and better, but as Maggie pointed out “we often use the technology on a broad swathe of patients when only a few, who fit a very specific profile, actually benefit from it.”  And of course someone has to pay for all of that technology.  We love to blame health insurance companies for the rising cost of health care, but we should also look at our own demand for the latest and greatest in medical technology.

With an over-indulgence of technological “toys,” there are additional risks of excessive dependency. That dependency can manifest itself physically, emotionally and psychologically. Julie Rosen, the Executive Director of the Schwartz Center for Compassionate Healthcare, explains this risk in a post titled, “Practicing minimally disruptive medicine.” Julie concluded that ultimately, the balance between clinical benefits and burdens will be achieved through good communication and a strong partnership between patients and clinicians, not an overreliance on medical technology.

Are there examples of technology currently used in health care?

For starters, health care information (specifically patient information) cannot be shared without considerations of privacy and security, as outlined by HIPAA laws. To communicate this information in a safe way, there are a number of standards messaging types used between information systems. The most prevalent of those messaging types is HL7. Nate Osit, a medical transcription analyst in health information management describes the HL7 Basics. (You can find additional information on HL7 prevalent throughout our site as well.)

In order to optimize the sharing of patient information, the Office of the National Coordinator has encouraged the adoption of electronic health record (EHR) technology with monetary incentives for health care providers demonstrating the Meaningful Use of the electronic medical record (EMR) technology.

For providers, fishing through the content of Meaningful Use can be a daunting task. Lucky for those individuals, as well as others simply looking for an overview of the requirements, Margo Williams of the American college of Physicians has organized an easy-to-follow guide written to explain how an office practice can more easily understand the issues about EHR certification.

Selecting an EHR system for a practice involves sorting through vendors touting the certification of their products. While certification is extremely important, it does not guarantee that you will get a system that will qualify you for meaningful use incentive dollars, or even that the system will do exactly what it needs to. Thoroughly understanding the requirements of an EHR can help you make the best decision for your needs.

As a patient, what does this mean for me?

As a patient, it is important to understand what personal health information you have access to. Moreover, it is important to take responsibility for your health information and work with your physician as a “partner in health.” HL7 expert, Keith Boone, creatively describes how that conversation could go between the patient and provider.

For many providers, these changes are dramatically different from how things may have traditionally been done. If you haven’t seen your physician in a while (let’s hope this is the case!), things may have changed since your last visit.

How has healthcare technology affected you as a patient and/or as a healthcare professional?

Thank you to all who contributed to this week’s edition of Grand Rounds. Your participation in this event is greatly appreciated. Stay tuned to Suture for a Living for next week’s edition!

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Erica Olenski

Erica V. Olenski currently serves as an account executive at Corepoint Health. She has focused her research and professional experience in healthcare communications and new media opportunities within the healthcare IT industry. Erica is a leader in the health IT social media community, serving as the VP of Communications for the HIMSS DFW Board of Directors for 2011-2012, and was the founder of the #HITsm (healthcare IT social media) tweet chat held each Friday at 11 a.m. CT. (For more information on the #HITsm chat, visit: For updates on healthcare IT and social media, follow her on Twitter: @TheGr8Chalupa.

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  • Elaine Schattner, MD

    Thanks for hosting, Erica. You’ve put together a terrific collection of posts of differing perspectives on technology in medicine. Thanks!

  • Nateosit

    Excellent snapshot of the HIT landscape. Thanks for including me! I look forward to more great discussions!

  • Maria Gifford

    Thanks for hosting for us this week, Erica. Great job!

    Our best,
    Maria & Dr. Val
    Better Health

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  • happyhospitalist

    What a great presentation of Grand Rounds. Thanks!

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