Doctors debate email

With health information technology rapidly changing and growing - there are 40,000 health and wellness phone applications pending with the U.S. government, according to the National Institutes of Health - are the feds ready to move health care into the future when it's still living in the past? This was the question in Washington last month when Politico convened a panel of health policy and technology experts for "Tech intersection: Health care of the future."

Practicing primary care physician Dr. Jordan Shlain of San Francisco said the first place to start is email. "Where's the connective tissue between doctor's visits?" he asked during the April 30 discussion at Microsoft's D.C. office. "Go to where they are - email. They aren't going to go elsewhere," he continued, referring to other ideas like sending patients to a website or online portal for contact with their doctor.

Shlain added that 100% of patients in his practice were willing to "sign away playing by the rules" in order to receive emails from the doctor, which are of course governed by HIPAA. Audie Atienza, senior program director of science of research and technology at the National Cancer Institute, part of the NIH, agreed with Shlain on that regard. "It's about the problems you can solve with technology," he said, but cautioned that different populations will need to be reached through varying mediums.

Atienza explained that for teens and young adults, text messages are a better way to reach out. "NCI provided smoking cessation programs via text and at post-test [had] a 17% quit rate," Atienza explained.

Dr. Joe Smith, chief medical and science officer at West Health, said email might be a dead end. "Most people still don't have email," he said. "How do we shove email out to the rest of the world?"

Shlain couched his own proposal that email is the way of the future for doctor-patient communication, describing a situation where one of his patients wrongly interpreted his email as a sexual advance.

 

 

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The panel also discussed the number of apps that are emerging in health and are pending approval by the Food and Drug Administration. "There's a perception out there that it's impossible to get FDA approval," said Joel White, executive director of Health IT Now Coalition. White said this needs to be fixed and Christi Foreman, director of the FDA Office of Device Evaluation, who was also on the panel, assured the audience that the mobile medical guidance is on the priority list for the fall.

Sridhar Iyengar, founder and CTO of AgaMatrix, created the first app for diabetes that was regulated and approved by the FDA, and was also present at the panel. He said he's seen the future of health IT by watching his company's success.

People with Type 2 diabetes don't know how much insulin to use or what do with their numbers. "The user experience of putting life into the context of blood glucose," changes lives, he said about his app.

The panel agreed that there is a gap between the number of apps being conceived and those that are actually effective. The FDA's Foreman left off with a question, "What will the educated consumer do with all this information?"

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