July 20, 2005
Cyberchondriacs
Wall Street Journal columnist Dr. Benjamin Brewer yesterday looked at how the increase in health information online has led to more patients taking responsibility for their health. Brewer writes that what "troubles" him is the "proliferation of the partially informed patients and ... the misinformed patients - the patient who crosses the line from Internet-educated patient to cyberchondriac."
It seems that "self-directed online medical investigations" can result in similar symptoms that can be attributed to several diseases, and most patients do not have the background and experience to effectively narrow down the possibilities. It also seems that rare and serious diseases seem more common and prominent online, while mundane and nonthreatening illnesses are less popular
California Healthcare Foundation Report
Wall St. Journal
WSJ article (time limited link)
July 17, 2005
Virtual Cure
Psychologists are using virtual reality in combination with cognitive-behavioral therapy as a tool to help people overcome phobias.
An article in the July/August Monitor on Psychology highlights the use of traditional cognitive-behavioral therapy methods, but with a high-tech twist. The psychologists use virtual reality--3-D computer graphics that simulate environments in the real world--to help their patients confront their fears.
The article discusses the use of virtual reality therapy as a tool utilizing exposure therapy which introduces patients to controlled amounts of the thing they fear. It is a key component of most cognitive-behavioral therapy.
Along with an interesting history of VR therapy, the article highlights Virtually Better. Ken Grapp, CEO of Virtually Better was one of the invited speakers at our recent AATP annual meeting in Atlanta.
The article points out that the therapy does not work for everyone--and it works better for some people than for others. Some studies have found, for example, that people who are more hypnotizable or more easily able to block out distraction and be absorbed in an activity like reading are also more likely to benefit from virtual reality exposure therapy. One of the keys to effective virtual reality treatment is "presence," or making the user feel completely immersed in the virtual world. According to Brenda Wiederhold, a psychologist and the executive director of the Virtual Reality Medical Center in California, "we're always looking at how we can improve presence." The improvements don't have to be high-tech: "Some studies have shown that thousands of dollars worth of better graphics don't help, but things like a $10 fan blowing on your face do."
Virtual Reality Medical Center, San Diego
July 14, 2005
Spyware Gets Users to Change Online Habits
Over 90 percent of internet users in the United States have altered their online behavior significantly to counter the threat of spyware programs, according to a study released by the Pew Internet & American Life Project.
Spyware and the threat of unwanted programs being secretly loaded onto computers are becoming serious threats online. Tens of millions of Americans have been affected in the past year by software intrusions and many more have begun to take precautions by changing the way they use the internet. Overall, 91% of internet users say they have made at least one change in their online behavior to avoid unwanted software programs.
Among the changes:
- 81% of internet users say they have stopped opening email attachments unless they are sure these documents are safe.
- 48% of internet users say they have stopped visiting particular Web sites that they fear might deposit unwanted programs on their computers.
- 25% of internet users say they have stopped downloading music or video files from peer-to-peer networks to avoid getting unwanted software programs on their computers.
- 18% of internet users say they have started using a different Web browser to avoid software intrusions.
July 08, 2005
Telemedicine In Treating Chronic Illnesses
A project with two large health centers in Oregon and Washington will give 2,000 patients Internet-connected equipment to collect vital signs that nurses and doctors can monitor remotely. Centers for Medicare and Medicaid Services will be evaluating an early intervention program and learn where it works best, with a new home-health-monitoring telemedicine project that will launch in January 2006.
The patients chosen by the centers for the project are under care for conditions such as congestive heart failure, chronic obstructive pulmonary disease, or diabetes.
The hope is that with earlier intervention for chronically ill patients experiencing health problems, serious complications and expensive trips to the hospital can be avoided. A goal for each of the two medical groups is to cut by 5% the total Medicare costs for the patients assigned to them. Often, patients don't realize they're having symptoms that indicate an impending, but preventable, health crisis until they actually get very sick,
The Technology
For the project, the patients will use home-monitoring devices, such as glucose tests or blood-pressure cuffs, to collect readings. The readings are collected by "Health Buddy," which is an appliance from vendor Health Hero Networks that provides an interface between the patient's home and the care provider. Depending upon the device, readings can be either electronically collected and transmitted to Health Hero, or keyed in to Health Hero by the patient.
Health Hero includes monitoring technologies, clinical databases, Web-based decision-support tools, health-management programs, and content-development tools. The home-health-monitoring medical devices that hook up to the Health Buddy, such as blood glucose testing devices, are available in many pharmacies and other retailers.
Those devices feed data into the Health Buddy, which plugs into a home phone line and dials-up to send data and information about patient symptoms to a secure remote database. The Health Buddy serves as a "home hub for health."
Individualized health information and programs also can be downloaded to the Health Buddy.
Health Buddy features four large keys that automatically get labeled electronically, based on text questions the patient is asked to answer about his or her symptoms and behavior.
The Health Buddy screen can display several lines of text, and is programmed to ask specific questions based on the individual patient's responses. So, for instance, if a blood-pressure reading is high for a heart patient, the Health Buddy could ask a series of questions to help determine the cause, such as whether the patient recently has eaten foods with high sodium content.
The data is sent to remote clinical information databases. At the provider's end, authorized doctors and nurses can access the data via the Internet. Decision-support tools are provided to review a patient's status to detect problems earlier. The system also gives health-care providers a list of patients having symptoms or other problems, and can rank the list based on the severity or type of problems, so that nurses or doctors can intervene by calling the patient or changing treatment.
The system also can be programmed to provide emergency alerts to nurses or doctors, so that ambulances can be called in serious situations. The goal of the three-year project -- called "Advancing Chronic Care Through E-Health Networks And Technologies" project, or Accent -- is to determine whether a project involving 2,000 patients is beneficial and can be scaled to a much larger population.
July 01, 2005
Positive Outcome from SPAM
A steady diet of e-mails that promote healthy behavior can change a person's outlook and behavior regarding healthier eating and increased physical activity, says a new study from the University of Alberta, Centre for Health Promotion Studies
People who were frequently emailed about healthy eating and keeping active, tended to exercise and lose weight, according to the researchers at the University of Alberta.
For 12 weeks, Dr. Ron Plotnikoff and colleagues sent weekly e-mail reminders to some volunteers at five large Canadian workplaces who were taking part in a larger study about exercise and health. More than 1,600 completed the full study.
Writing in the American Journal of Health Promotion, Plotnikoff said those who received the e-mail reminders exercised more and knew more about the benefits than those who did not.
They also reduced their mean body mass index, or BMI, a measure of body fat based on height and weight.
Those who did not get the e-mails actually gained some weight over the three-month study.
Other studies by Dr. Plotnikoff