Post Author: Joseph Kvedar, MD

Digital tools should not adversely affect the doctor-patient relationship

Tech
March 27, 2017

I did a second stint on a talk radio a few weeks ago which I really enjoyed.  The callers represent a genuine, down-to-earth view of the reality of connected health adoption.  The first time around, most callers were cautionary, raising concerns about data security and wondering about physician endorsement.  This time the theme that spontaneously emerged was one of people telling stories from the heart, about loved ones who have …

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5 obstacles to texting patients

Tech
November 1, 2016

The business value of medication adherence tools is coming into focus.  For years, I remarked that, while we could create a case for why adherence was the right thing to do, we had great difficulty creating the right financial incentives to move these programs from curiosity to scale.  That is changing now with the collision in the marketplace of new payment models and exorbitantly priced pharmaceutical products.

The poster child for …

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Here are the limitations of virtual doctor visits

Tech
May 21, 2016

Virtual visits are increasingly the rage amongst forward-thinking healthcare providers that want to jump on the telehealth band wagon.  Extending the office visit across distance, using the same technology we use to keep in touch with loved ones (videoconferencing such as Skype and FaceTime), is a safe and logical way for providers to venture into a new tech-enabled world that may still be scary for some.

One way to think of …

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Connected health: It’s time to write a different headline

Tech
April 16, 2016

We live in a headline/hyperlinked world.  A couple of years back, I learned through happenstance that my most popular blog posts all had catchy titles.  I’m pretty confident that people who read my blog do more than scan the titles, but there is so much information coming at us these days, it’s often difficult to get much beyond the headline.  Another phenomenon of information overload is that we naturally apply heuristics or …

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What’s preventing telemedicine from taking off?

Tech
November 18, 2015

Health care remains one of the few services that require people to have a face-to-face interaction to obtain access. But more and more consumers are questioning that reality, and change is on the way. In January 2015, the Centers for Medicare & Medicaid Services (CMS) issued a new provider reimbursement code for non–face-to-face health care services for patients who have chronic medical conditions. A new CMS code …

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The challenge of helping patients with chronic illness with mobile health

Tech
June 2, 2015

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In the seven or so years I’ve been blogging, I’ve only written a few posts that prompted controversy in the comments section. Looking back, I notice that these posts have involved chronic illness management, motivation, adherence and/or engagement. In fact, a commentator recently felt my writing was that of an old-fashioned doctor who believes that paternalistic messaging is key to engaging …

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Paying patients for their engagement

Physician
May 20, 2015

A couple of years ago, my clinical practice (Dermatology Associates at Massachusetts General Hospital) began sending patients a bill when they did not show up for an appointment. Dentists do this with some frequency, but it’s unusual for a physician practice to do it. Our reasoning was that we have many folks who insist they need to be seen right away and, despite a large, busy practice (we see more …

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Can connected health improve the lifestyle challenges patients face?

Tech
December 9, 2014

My dad was a wonderful guy who could fill the room with his personality.  He grew up during the Great Depression and was a World War II veteran.  I was thinking of him recently while considering how much health care delivery has changed in the last 100 years.

When asked about his health, my dad would always say, “I feel great.  I don’t have any aches or pains.”  This is telling. …

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The tension between mobile apps and health care

Tech
October 9, 2014

I saw another exciting news story on a mobile health intervention the other day.  I honestly don’t remember the company or product, but what stuck with me was the declaration of success based on 10 patients using the product for three months.  Success was touted in terms of cost reduction and resource utilization reduction in a before/after analysis.  This inspired me to collect some thoughts on some of the challenges …

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Will 2015 be the year mHealth takes off?

Tech
September 29, 2014

I’ve been toiling in the field of connected health for 20 years now, watching for signs of adoption that will move us into the steep part of the curve.  I have to wonder, with announcements from several huge consumer companies recently, if that time is coming.

By now you’ve heard about Apple’s HealthKit announcement, which involved not only Apple, but Mayo Clinic and Epic.

Samsung is not sitting still, having released increasingly …

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A wish list for Apple’s HealthKit

Tech
July 7, 2014

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Apple has been making headlines again, which is not unusual for a company that sets trends and moves markets. Recently, they announced that iOS 8 would have a built-in app to collect all of your health info in one place. Then there was the announcement of the partnership with Mayo Clinic and Epic Systems. This generated even more headlines.  I saw all …

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Momentum for telehealth is accelerating

Tech
June 24, 2014

The nation’s ongoing battle to strike a delicate balance between increasing access to quality health care for all Americans and reducing overall health care spending just scored one of its most substantial victories.  In late April, after several months of thoughtful and robust collaboration, the Federation of State Medical Boards (FSMB) ratified a new model national policy: the Appropriate Use of Telemedicine in the Practice of Medicine.  This marks the first …

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Can the pharmaceutical industry move beyond the pill?

Meds
March 11, 2014

What an amazing time to be a champion of new health care delivery models.  Three megatrends are driving change at a pace that I only wished for 20 years ago. Back then, I first had the insight that care could be improved, in some instances, if we separate doctor and patient in time and space.

The first trend is provider reimbursement reform.For provider organizations going at risk with their payers, these are nerve-wracking …

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Why our personal health data will become less private

Tech
November 14, 2013

I have been following  the news about the National Security Agency (NSA) access to our phone records with great interest.  If we as a society don’t sort some of this out, we’ll see a repeat in the health sector a few years from now.

These discussions seem to pivot on issues of population-level safety vs. personal liberty, and on trust vs. suspicion re: how much of the process is driven by …

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Is there a place for personalized medicine in clinical guidelines?

Physician
November 6, 2013

As we grapple with provider shortages, the surge in chronic illness and the quality to price (QPR as they say in the wine business) challenge in US healthcare delivery, it’s hard to imagine a future that does not include some sort of guideline or algorithm-driven care.  As providers take on more financial risk, one common strategy involves team-based care, and the attendant increase in decision-making and care delivery by non-physician …

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Patient care appears to be catching up with mobile technology

Tech
October 18, 2013

The hype over mobile health is deafening on most days and downright annoying on some.  So it is with some reluctance that I admit that mobile has the potential to be a gamechanger in health.  I’ve professed enthusiasm before, but that was largely around the use of wireless sensors to measure physiologic signals and SMS text as a way to deliver messages to patients and consumers.  For several years, the …

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Using Skype for patient visits: A doctor is sanctioned

Tech
September 29, 2013

The medical board of the state of Oklahoma recently sanctioned a physician for using Skype to conduct patient visits.  A number of other factors add color to the board’s action, including that the physician was prescribing controlled substances as a result of these visits and that one of his patients died.  This situation brings up several challenges of telehealth — that is, using technology to care for patients when doctor …

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