Michael Docktor, MD, is a pediatric gastroenterologist, director of clinical mobile solutions at Boston Children’s Hospital and a co-founder of Hacking Pediatrics. Above: The Hacking Pediatrics executive team: Judy Wang, MS; Michael Docktor, MD; Alex Pelletier, MBA; Margaret McCabe, PhD, RN, PNP; Kate Donovan, PhDc, MBA, BS, from Boston Children’s Hospital. (Photos: K.C. Cohen)
A hackathon is most easily explained by relating it to the crowd-sourced, time-crunched challenges that we see every day in pop culture. From “Top Chef” to “The Apprentice” to “Extreme Makeover,” television is teeming with passionate individuals trying to solve a difficult task with incredibly constrained resources and time. What results is often remarkable by any standard and speaks to the power of concentrated, collaborative problem solving.
When the challenge involves children and their health, the results can be magical, as witnessed by the weekend-long Hacking Pediatrics in late October, the first event of its kind. More than 150 “hackers,” including engineers, designers, software developers, entrepreneurs and roughly 40 clinicians gathered to create ground-breaking solutions for children and their families. Full story »
The Affordable Care Act (ACA)’s health insurance exchanges opened for business on Oct. 1, and, despite website glitches and non-stop political fighting, citizens across the U.S. can now comparison shop and pick an insurance plan. Time will tell how well the exchanges will work out for consumers, employers and insurers—as well as what effect they will have on pediatricians and hospitals.
According to Wendy Warring, senior vice president, network development and strategic partnerships at Boston Children’s Hospital, the exchanges may force medical professionals to face changes in patient volume, adjustments in reimbursement rates and shifts in how employers provide benefits to insurers. Right now, she says, “people are very confused about public exchanges versus state exchanges versus private exchanges,” and opinions vary on what impact these changes will have on medical professionals. Full story »
(Diane Campbell Payne, used with permission)
Naomi Fried, PhD, is chief innovation officer at Boston Children’s Hospital. This post is adapted from her remarks at the Connected Health Symposium on October 24, 2013. She tweets @NaomiFried.
In the health care industry, we rely heavily on regulations to ensure the safety of our patients, procedures and drugs. New national health care regulations can even spur innovation in care delivery, but in the case of telehealth, they can be an impediment.
Telehealth, the remote delivery of care via computers, mobile devices, videoconferencing and other technologies, has great potential to improve the patient experience and reduce health care costs by removing the barriers of brick and mortar. At Boston Children’s Hospital, the Innovation Acceleration Program’s pilot telehealth programs have focused on both direct patient care and virtual clinician-to-clinician consultations.
Unfortunately, most states’ regulations are limiting providers’ ability to broadly offer telehealth services. Full story »
Because unplanned hospital readmissions put patients at risk, burden families and add to the cost of health care, many medical professionals are taking steps to reduce them. To push the effort, new Centers for Medicare & Medicaid Services (CMS) rules impose escalating penalties that decrease a hospital’s Medicare payments if patients are readmitted within 30 days of discharge.
Last week on Vector, we reported research suggesting that some readmissions may be incorrectly classified as preventable (and thereby penalized), particularly at pediatric hospitals. But what steps can be taken to reduce the number of truly preventable readmissions?
One step, highlighted here last week, is making post-discharge communications much simpler with texts and emails. But how can hospitals make sure their patients are ready to go home? A new study published in the International Journal for Quality in Health Care finds that in pediatric settings, the answers may be found in parents’ perceptions, which turn out to be good predictors of an unplanned readmission. Full story »
One-size-fits-all metrics don't appear to fit children's hospitals.
Government agencies in charge of determining what constitutes efficient, quality health care have taken to looking at hospital readmission rates. On the surface, this makes perfect sense: If patients are continually being readmitted to a hospital, that hospital must not be doing enough to treat patients appropriately on the first go-round. But new research indicates that relying too heavily on readmissions as an efficiency metric may wrongly put some health care institutions—particularly pediatric hospitals—at a disadvantage.
At the American Academy of Pediatrics (AAP) meeting this week, a team led by James Gay, MD, medical director of Utilization and Case Management at Monroe Carell Jr. Children’s Hospital at Vanderbilt, presented research involving more than 1 million patients cared for at children’s hospitals across the country. The team, which also included Boston Children’s Mark Neuman, MD, MPH, posed this question: If hospital ratings are going to be tied so strongly to readmission rates, shouldn’t that rating system recognize the difference between potentially preventable readmissions (PPRs) and those that are unavoidable?
Currently, some state Medicaid programs use software such as 3M PPR, developed for this exact purpose. Like the basic idea that inspired it, the 3M PPR system works well on principle. However, according to Gay and colleagues, it doesn’t capture all the nuances of what makes a readmission preventable or not. Full story »
Hackathons are quickly growing beyond Red Bull- and Dorito-fueled code-fests into fertile grounds for new technologies and products that potentially could improve medicine and health care.
But beyond individual events, could hackathons signal the beginnings of a new ecosystem for medical innovation?
That’s what groups like MIT’s H@cking Medicine, Brigham and Women’s Hospital (BWH)’s new iHub and the New Media Medicine group at the MIT Media Lab are betting on. By tapping the same creative entrepreneurial energy that hackathon culture has brought to the technology industry, they believe they can fundamentally reimagine health care, one device, app and system at a time.
“The Boston area is the most fertile ground for medical innovation you could ever imagine,” says Michael Docktor, MD, a gastroenterologist at Boston Children’s and one of the organizers, with the H@cking Medicine team, of this weekend’s Hacking Pediatrics hackathon. “We need to make the case with the local medical and technology community that hackathons are a viable way of innovating in this day and age, that this is the way we ought to be innovating.” Full story »
The Human Genome Project’s push to completely sequence the human genome ran a tab of roughly $2.7 billion and required the efforts of 20 research centers around the world using rooms full of equipment.
But that was using technology from the 1990s to early-2000s. As by a panel of genomics experts from industry and academia pointed out at last week’s National Pediatric Innovation Summit + Awards, a scientist in a single laboratory today can sequence a genome for as little as $1,000, making sequencing almost a medical commodity.
Now what? How do we go about making clinical genomics an everyday thing? The discussion left the answer to that question—and the other questions it raises—unclear. While the panelists expressed excitement about what’s possible, they cited great uncertainty among doctors, scientists, patients, payers, companies and regulators about how to make clinical genomics work. Full story »
At the start of today’s National Pediatric Innovation Summit + Awards 2013 panel on patient engagement, healthcare journalist Carey Goldberg offered up a personal anecdote about engagement— or the lack of it—in medical care:
“I was having a minor dermatological procedure, and right before it started, I said to the doctor, ‘This really is a good idea to get this done, right?’ And she said, ‘No, actually, you don’t really need to get it done.’ And I didn’t stop the procedure. And I realized that I embodied the problem of patient engagement. It is a piece of [the health care] puzzle.”
Goldberg’s story framed a discussion that ranged from outcomes measurement to data access, from healthcare incentives to care coordination—all centered on one overriding question: How do we encourage patients to become more engaged in their own medical care?
And given the number of topics that were covered, it’s clear how complex a question that is. It’s one that engages multiple stakeholders—patients and their doctors for starters, but also insurers, policymakers and regulators, health care systems and more. Full story »
There’s been an explosion of scientific research in autism—from mouse models of genetic syndromes involving autism to culturing neurons from stem cells derived from patients’ skin to tracking EEG patterns in infants whose brothers or sisters have autism.
So I expected yesterday’s panel on Piecing Together the Autism Puzzle, part of Boston Children’s National Pediatric Innovation Summit, to be about the science. I changed my seat just before it started, so I could better view the slides.
Instead, the conversation turned to the insurance, public health and social justice aspects of autism. Take, for example, the rising incidence of autism, which the CDC places at 1 in 88 (and 1 in 54 in boys). Panelist Ami Klin, PhD, director of the Marcus Autism Center at Children’s Healthcare of Atlanta, noted that between the CDC’s 2002 and 2008 reports on autism, there was close to a 101 percent increase in autism prevalence in Hispanics and a 96 percent increase in blacks.
Thousands of children didn’t suddenly develop autism in a six-year span; rather, more were diagnosed with autism as awareness of the disease increased. Even so, diagnoses often don’t occur until a child is 3 to 5 year old, and only 2.5 percent of diagnostic assessments of autism are using the field’s best standardized tools. While multiple diagnostic tests are being researched—like EEGs or blood tests looking at gene expression—they’re still experimental. Full story »