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The fascinating future of technology in healthcare

(TECH NEWS) Technology in the world of healthcare has been lagging but things are changing, and quickly.

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Tech in healthcare has been lagging

It’s undeniable that technology is playing a huge role in how we get around, how we interact with each other, and how we do business. But what about how healthcare is delivered and managed?

For many patients, interactions with the healthcare world can feel jarringly slow and disconnected, especially when it comes to communication between doctors and patients or between different healthcare providers.

Doctors and tech entrepreneurs acknowledge that in many ways, technology in healthcare has been lagging – but that’s about to change, and quickly. From the way hospitals are built to the way we visit doctors, get ready for some huge technology disruptions in the world of healthcare.

How patient data is shared

It may not seem like the sexiest part of the healthcare world, but it’s a critical aspect of how care is delivered: patient data.

“If you’re a patient, it’s difficult to track down your medical records,” says Kevin Grassi, MD, Chief Medical Officer and Co-Founder of PatientBank. “95% of medical info is exchanged by fax or by hand. In 2016 it’s ridiculous for faxing to be the main communication method, but faxing is HIPAA compliant, and it’s been the backbone of medical information exchange.”

Today, online fax services are the only easy way for patients to receive digital copies of their medical records.

There are health information exchanges in certain geographic areas, but they are limited to information like immunizations and prescriptions, Grassi says, and systems in different parts of the country aren’t set up to communicate with each other.

So if you’re a resident of New York who is seeing an oncologist in Texas, you’re on your own finding and conveying all the pertinent medical details, and you will likely have to navigate through several isolated patient portals.

That’s where Grassi hopes PatientBank will change things. PatientBank is a HIPAA-compliant service that can request medical records for you from multiple providers, and combines the information you choose to store into a summary that can be shared with doctors and family members.

Grassi hopes the technology will not only make it easier to safely share information, it will also increase patient engagement. That’s a crucial issue for doctors as well, since reimbursement models for physicians will change in 2017, from a fee-for-care model to a value-based system.

In an effort to improve patient outcomes, doctors will be required to do much more follow up care than they currently do.

“If a patient can give medical record access to their doctor, they’re empowered to look at that information, maybe even see where it isn’t correct – which is a big issue particularly in medication records,” Grassi says. “Engaged patients are healthier patients.”

It’s not just transmitting patient data that is difficult – sometimes just getting it in the first place is nearly impossible. That’s something Fahad Aziz, Co-Founder and CTO of CareMerge, learned firsthand when he got into a bicycle accident. He was treated in Seattle, then went back to San Francisco, where his doctor wanted to learn what had happened and how he’d been treated in order to give Aziz follow up care.

“I couldn’t get my medical records from the operation in Seattle. They put me in an endless loop of trying to get my records, and after two weeks I just gave up,” Aziz says. “That started me thinking differently about my company, and what we are doing.”

CareMerge builds coordination and communications technology specific to geriatric care that lets doctors share information with nursing homes and assisted living facilities.

If a doctor sends a patient from a hospital to a nursing care facility, for instance, that physician can use CareMerge to keep tabs on the patient’s progress and get alerts if there’s a change so that a doctor can visit at the nursing home.

That cuts down on patients being readmitted to hospitals, and improves patient outcomes, Aziz says. That’s a direction he sees a lot of healthcare technology going.

“There are close to 100,000 apps that area healthcare-related, but they are all isolated, none of them talk to each other,” Aziz says. “There’s been a lot of talk around building care coordination systems that talk to each other, but there wasn’t a driver to really make that take off until the shift to value-based reimbursements was finalized. All the entities responsible for providing patient care will have to talk to each other, and for the first time these systems are starting to get traction.”

Make way for AI

Aziz predicts that artificial intelligence (AI) is also going to lead to major changes in the healthcare industry.

“A lot of startups are working on technology that will read notes from your doctors, and based on intelligence like your own labs, or viral incidents in the area, will give you recommendations,” Aziz says. “That’s where the future is going to be. Five years from now, there is no doubt you and I will have an app that will give information about an episode happening to me, and what it means not just for me but for my whole family.”

That kind of machine learning will eventually replace many routine doctor’s visits, Aziz predicts.

AI will be able to coordinate data in a way that is currently not possible, he says, which could mean better, more coordinated treatment plans for complex health problems.

Smarter hospitals

That same unified coordination will also become a factor in the new hospitals being built.

Auron Priestley, MD, says that hospitals are under duress trying to solve the issues around patient handoff.

“Physicians today have no secure and efficient collaborative tool to share information at the end of shift changes,” Priestley says. “Believe it or not, they use Word documents to share information between each other at the end of shifts. Often written in short code and when physicians are exhausted, some information may be missed. Miscommunication in hospitals currently results in 80% of preventable patient deaths in the U.S. 250,000 preventable patient deaths occur each year.”

To combat this, Priestley worked with the American College of Surgeons (ACS) to create Kolkin SOS, a HIPAA-compliant app that makes it easy for doctors to collaborate on clinical workflow in real-time. It can work with or without Internet connectivity, and allows physicians to share clinical protocols and best practices. The ACS is working on getting the app integrated into hospital IT systems.

Grassi also thinks that technology in hospitals will change around the customer experience: remote checking in that can eliminate waiting rooms, or kiosks that will help shorten wait time.

In Austin, Texas, the new Dell Seton Medical Center is under construction, and will include smart screens in each patient room so that healthcare teams can access patients’ medical history and monitor their condition in real time. Because it is a teaching hospital, there will also be cameras in operating rooms, which will allow medical students to observe procedures from offsite.

Whether it’s sharing notes between doctors or more efficiently monitoring patients, technology in hospitals will streamline communications, something physicians hope will save time and improve safety and patient outcomes.

Conclusion:

Cutting edge technology has already led to huge advances in how our health care is delivered, from robotic surgery to advances in prosthetics. Now physicians and tech entrepreneurs are making inroads in how medical data is shared, both between patients and their providers and between physicians.

For physicians involved in piloting new technology, the hope is that those innovations could mean more efficient doctor’s visits, fewer medical errors, and greater patient satisfaction. With evolving challenges in the U.S. like aging and disease, that’s certainly welcome news to healthcare providers and patients alike.

#MedTech

Leo Welder is the founder of ChooseWhat.com, which guides entrepreneurs through the process of starting a business. Using How-To's, Comparisons, "STARTicles," and a community forum, the site gives people a detailed road map to support them through their entrepreneurial journeys.

Business Finance

Personal finance steps every freelancer must take to avoid ruin

(FINANCE) The government shutdown showcased financial instability, but what do people that have no paycheck guarantee need to do to be secure?

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personal finance

In light of the recent government shutdown, there has been a lot of attention in regards to how missing paychecks impacts the average American. Most Americans don’t have a regular savings account and could not handle a $1,000 emergency, let alone miss practically a month of pay.

While things look positive for the backpay of those government workers, we all could benefit from some careful reflection about the precarious nature of our personal finances.

Particularly those of us who don’t receive a regular paycheck.

Entrepreneurs and those invested in the gig economy have volatile incomes, and literally no promise of a paycheck ever – that can impact your personal finances in a number of ways.

Variable incomes are normal for this group and can impact entrepreneurs in ways as simple as handling debt.

If this is you – here a few things to keep in mind that can help you deal with the volatility of living on a variable income and handling your personal finances.  

  • Set up an emergency fund. Start with 500 if you have too, and remember this an emergency fund for your personal expenses, not your business. If you have an emergency fund, make sure you identify what an emergency is and also be prepared to put money back when it comes out. If you have a hard time not spending money in front of you, put your money in a local bank or CU that you don’t have immediate access too.
  • Stick to a budget. when you can’t forecast your income appropriately, controlling expenses is so critical it’s the few things that are in your control.
  • Don’t mix business with personal. While you may be pouring your personal energy and time into your start up or gig, be careful about mixing expenses for two reasons: First, it messes up your budget. You need to have separate budgets for personal and business. Second, there could be tax challenges – consult a tax professional for more information. Here’s a little primer to get you started.
  • Save for retirement. There are tax benefits and come on, don’t wait till you can’t work anymore. Also, an IRA IS NOT AN EMERGENCY FUND.
  • Practice good financial behaviors. Automate bill pay. Online statements. Digital receipt tracking. The more you can automate your life, the better you are. You already have so many demands on your time, reduce that so you can spend more time doing what you love and what matters.
  • Consider diversifying your income. Either ensure you have multiple strings or a backup gig (even if it’s just uber driving); or be prepared to do temporary or contract labor during your slow seasons.

The path to entrepreneurship is rough. What we can learn from the very struggles of the federal employees and the government shutdown is that if the government can be unstable, those of you who work in the world of startups, gigs, and entrepreneurship, need to be even more on our toes. The “normal recommendation” for saving is 10% of your income, but normal may not be enough for you. Be prepared and save (more).

Disclaimer: I am neither a tax or investment professional. This is personal financial advice and I encourage you to visit a professional if you need more specific plans of action.

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Business Finance

Delivery startups skim customer tips to pay employees #wth

(FINANCE) Grocery delivery startups are flourishing, but stealing from employees isn’t a sustainable move…

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theft delivery startups

Popular grocery app Instacart has been using customers’ tips to pay its guaranteed $10/hour rate to employees, rather than using the tips as, you know, bonus money paid to workers on top of their normal pay. The way that you’d expect something called a “tip” to work.

According to the report, “Instacart confirmed that when its payment algorithm determines a driver should be paid below that guaranteed $10, the company uses the customer’s predelivery, ‘up front’ tip to cover the difference. The ‘up front’ tip is automatically set to 5% on the Instacart app; if the customer removes the tip, and the payout would be below $10, Instacart itself covers the cost.”

In this system, the customer’s tip for the deliverer subsidizes the company’s commitment to its employees. Once the change to the tipping policy was announced in workers began complaining about how it affected their earnings in 2017.

Even though the app’s customers have taken to social media to compare the policy to wage theft, the practice is actually legal. Because Instacart and other apps in the gig economy classify their workers as contractors instead of employees, they do technically still get 100 percent of the tips in their wages (even if the company doesn’t supply the same percentage of the wage they’d give the worker without the customer throwing in).

This kind of payment structure may be familiar to you if you’ve ever working in restaurants, bars, or another establishment that uses subminimum wages.

Sadly, Instacart is not the only grocery app that uses a dodgy tipping system. Shipt, DoorDash, and others have similar tipping policies. And they aren’t interested in changing them after all this week’s backlash.

If you’re concerned about making sure that you’re supporting the contractors for these grocery delivery services, some of the contracted workers have requested that you provide the tip in cash instead of tipping through the app and activating its algorithm.

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Tech News

How blockchain has the power to improve democracies

(TECH) Blockchain is changing the face of democracy with a magical fix to basically all the problems.

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blockchain

Despite our best intentions to be active, informed citizens in democratic practices, not everyone has time, figuring out how to be engaged can be confusing, and reps don’t always vote how you want. Plus, confidence in Congress is hilariously/depressingly low with all the scandals and thinly veiled corporate interests.

Well hooray for the future, because now we have blockchain technology to propel us out of the murky waters of representative democracy and into a more efficient liquid democracy.

A liquid democracy platform, also referred to as delegative democracy, has voters select a personal representative as a proxy for their vote. In our current set up, elected representatives vote for things on your behalf, and the best you can do other than running for office yourself is call in and ask them to vote your way.

With a liquid democracy, everyone votes on each piece of legislation.

You can assign a delegate to vote on your behalf by proxy when you’re not available. Personal representatives can be removed and reassigned at any time unlike set terms for elected officials.

The delegate can even select a proxy for their votes, creating a directed network graph, where voters and politicians are connected on a publicly verified blockchain. Anyone can be selected as a delegate as long as they’re a legal resident of your jurisdiction registered to vote.

Quick refresher course: Blockchain is essentially a decentralized digital list of records with timestamps and transaction data information. Each individual record is considered a block, which is cryptographically secured and resistant to modification.

Blocks contain a cryptographic hash of the previous block, creating a chain. Once recorded, data cannot be altered without network majority consent. As an open, peer-to-peer distributed ledger, blockchain is a permanent and efficient way to record transactions.

Used by Satoshi Nakamoto in 2008 for cryptocurrency exchange to create Bitcoin, blockchain has now expanded to the healthcare industry, banking, and now potentially democratic practices.

David Ernst, one of the leaders of the liquid democracy movement, founded United.vote, a platform established to get the ball rolling. The site helps connect voters to personal representatives, and provides a scorecard that tracks how elected politicians’ votes compare to constituents wishes.

“What if instead centralizing authority into the hands of a few strong men, we expanded political power to many, many more voices,” Ernst suggested at the 2017 CyFy conference.

His plan to expand power is liquid democracy via the United.vote platform, which he notes is backwards-compatible with our current system. Ernst is also running as an independent candidate for California Assembly District 19.

He was partially inspired by the Flux Party’s 2016 campaign in Australia, who tried to implement an issue-based direct democracy similar to liquid democracy. Although the party only got 0.15 percent of the vote nationwide, Ernst stands by the idea.

A liquid democracy via blockchain would theoretically increase accountability, participation, and representation.

Through direct participation and personal representation, elections would no longer be necessary.

Instead, voters simply choose someone to represent them, and can select a different person for individual issues. Delegation can be changed at any time, so you’re not stuck with someone if they end up being a total weasel.

So far, only a little over one thousand people have signed up for United.vote, but Ernst stated, “If I got elected, but only 20 people were actually using [the platform], I would still follow those people.”

Although the concept may be ahead of its time (and possibly a wishful Utopian dream), Ernst is confident that these changes can fix democracy.

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