iMedicalApps, a leading blog for mobile applications for physicians, pharmacists, and other healthcare providers, has graciously taken me on as a guest writer for their site. I’m grateful to Satish Misra, a partner, editor, and an internal medicine resident doc at Johns Hopkins, for the opportunity!

You can read some of my articles already up on their site:

• A quick and easy process for healthcare professionals interested in designing an app, which covers how to create paper prototypes for medical apps. Not only that, but how to scan them into a PDF to simulate them onto mobile devices. This allows healthcare professionals to try out different workflows and layouts for their app ideas without knowing how to program or use complex expensive tools.
• Mood Watch is a cumbersome app that tracks limited psychiatric symptoms, my first app review that covers a mood-tracking app on iPhone and Android devices.

This week, I’m covering the Health 2.0 Health:Refactored developer conference, which focuses on the development and design of health applications, including medical records, mobile apps, and more. It’s a much smaller conference than Health 2.0, but so far the energy has been very high!

I’ll post the articles onto iMedicalApps with Satish’s help, and tweet from both my @StevenChanMD account and the @iMedicalApps Twitter account. See you there!

I just finished USMLE (the United States Medical Licensing Exam) Step 3, a 2-day-long ordeal spent answering questions about patient care.

500 multiple-choice questions pelted at me like paddles at a frat hazing party, each with clinical scenarios. I tore through several hours of 12 simulated patient cases, placing orders and doing virtual “exams” within the emergency department, the outpatient clinic, and in the inpatient wards. These were questions from nearly all of the specialties: a bit of opthalmology, dermatology, pediatrics, OB/GYN, lots of psychiatry, neurology, gastroenterology…suffice it to say, psychiatrists (like me) know quite a bit about the entire body and not just psychiatry cases. :-P

Telehealth involves incorporating care beyond traditional clinics and hospitals, and into two more domains: (1) at home, (2) in the community. Thomas Nesbitt, MD MPH, at the University of California, Davis, spoke at UC Davis’s most recent monthly Health IT seminar covering the future of telehealth. I covered some of the questions concerning telehealth in my earlier post; here, I’ll cover some of the challenges he touched upon during his talk.

At home, telehealth can potentially manage chronic diseases better. We are used to seeing health professionals during sporadic one-time episodes. Care management models are migrating towards more frequent patient contact and regular physiologic management.

This can make things like managing hypertension more accurate. Some patients might forget to take their meds for awhile, so they “spiff themselves up” beforehand to make it appear as if they were more compliant before a doctor’s visit. Or perhaps they get “white coat hypertension,” becoming more nervous while in the doctor’s office.

Telehealth can instead monitor blood pressure on a more frequent basis to have a more accurate picture of a patient’s day-to-day blood pressure.

Sensors like this SecuraPatch Sensor can help track heart rate, respiration rate, falls, stress, skin temperature, activity, caloric burn, and even body posture. It’s nearly the size of a Band-Aid but does a whole lot more!

Projects from the VA in the mid-2000’s, dedicated medical devices and peripherals for iPhones (and, I hope, Android devices), and even pills with embedded chips (as previously covered by Stephen Colbert in Cheating Death) demonstrate how telehealth can work at home.

Numerous industry and economic changes are causing healthcare to incorporate telehealth and mobile health technologies. Thomas Nesbitt, MD MPH, at the University of California, Davis, spoke at our most recent monthly Health IT seminar covering the future of telehealth. He declared that the shortage of physicians, President Obama’s Affordable Care Act with its consequent increased demand for health services, and the Institute of Medicine’s focus on increasing healthcare quality.

As a result, there will be numerous transformations over the next few years: a focus on population health, treatment at home (versus institutions), integration of services, and increased usage of technology.

Last Wednesday, we hosted the Health 2.0 Sacramento’s inaugural kick-off to a crowd.

I couldn’t believe the energy in the room.

A few of my new friends in Sacramento and I put together a new group, Health 2.0 Sacramento, to bring together people interested in mobile devices, Internet technologies, and healthcare. With some generous financial support from Health 2.0’s Jennifer Lee, two amazingly talented speakers, one Costco run later with my sweetie, and the Hacker Lab co-working space, we put together the inaugural kick-off event in a few short weeks.

read more→

Ron Jimenez, MD, FAAP, one of Stanford Medicine’s medical informatics directors, brought together the concepts of usability, technology, and medicine at the monthly UC Davis Health Informatics Seminar. His goal: make Epic, one of the leading electronic medical record (EMR) system providers, usable for Stanford’s numerous clinics and hospitals.

Why is usability in medical records important?

Saw this on Victoria Flores’s Facebook post and thought this was a great visual infograph of antibiotic toxicities. Medical school is so much more than bulleted lists in review books and dry Powerpoint slides!

Ramit Sethi, a New York Times-bestselling author and productivity/finance/entrepreneur expert, talks about the 5 productivity mistakes that people make in his latest blog post. Here are my thoughts on how this applies to physicians, along with notes from the video itself since it doesn’t come with a transcript.

Productivity mistake #1: Trying to do it all ourselves

Which to-do items will change your life (e.g. learn how to invest), and which just needs to get done (e.g. empty the dishwasher)? If you rank them all at the same level, you set them up for failure because you can’t do them all. Top performers in the same 24 hours are very clear about where their time deserves to be spent. As you earn more and more, you can trade money for time. e.g. hire someone else to do laundry.

What is one thing you can you outsource today? Each week, pick one thing you can do to save one hour a week.

For me, I can get all my groceries delivered at Safeway.com. Or as a physician, delegating tasks properly to other members of the team. I remember one family physician at UC Irvine saying she was overwhelmed with trying to raise her family, be a wife, take care of her patients, and also clean the house — she’s always been the one to clean her house — when she finally yielded & hired a housekeeper.

This is a continuation of my thoughts on “Manage Your Energy, Not Your Time,” by Tony Schwartz and Catherine McCarthy, as published in the Harvard Business Review. The first series in the post dealt with physical energy, the second, on emotional energy.

Mental Energy

• Reduce interruptions by performing high-concentration tasks away from phones and emails.
• Respond to voice mails and emails at designated times during the day.
• Every night, identify the most important challenge for the next day. Then make it your first priority when you arrive at work in the morning.

This is nearly impossible on the wards since so many people want to page you. I did, at one point, try using a Bluetooth headset on my cell phone so that I could answer phone calls more efficiently. I noticed that the more efficient residents would enter in orders, write notes, and present cases (i.e. multitask) during rounds. The point that the authors try to make is to emphasize how important it is to reduce clutter, and it relates to a condition one psychiatrist, Dr. Edward Hallowell, has labeled attention deficit trait.

This is a continuation of my thoughts on “Manage Your Energy, Not Your Time,” by Tony Schwartz and Catherine McCarthy, as published in the Harvard Business Review. The first series in the post dealt with physical energy.

• Defuse negative emotions — irritability, impatience, anxiety, insecurity — through deep abdominal breathing.
• Fuel positive emotions in yourself and others by regularly expressing appreciation to others in detailed, specific terms through notes, emails, calls, or conversations.
• Look at upsetting situations through new lenses. Adopt a “reverse lens” to ask, “What would the other person in this conflict say, and how might he be right?” Use a “long lens” to ask, “How will I likely view this situation in six months? ” Employ a “wide lens” to ask, “How can I grow and learn from this situation?”

Renewing emotional energy is harder to accomplish when on a high-stress high-stakes service like internal medicine or surgery. read more→