Collaborative Family Healthcare Association

Researchers at M.D. Anderson Cancer Center are using mobile apps to help understand nicotine addiction

by Iltifat Husain

There are plenty of apps in the Apple Store and the Android Marketplace that try to help patients quit smoking. Some of them even have integration with social media networks such as Facebook and Twitter. However, these same genre of apps are helping researchers study addition in a new way.

SmartPlanet has a great interview with Dr. David Wetter, who is leading a team of researchers using real-time smart phone data from those trying to quit smoking in order to better understand addiction.

These M.D. Anderson Cancer Center researchers are finding some interesting trends in the data they are collecting.

"We use smart phones to collect data during critical events that happen when people try to quit. For example, when they have a craving to smoke or when they actually smoke a cigarette, we’ll collect data. [We'll find out]: Who else is in the environment with them? What else is going on? Are cigarettes available? Are they drinking? Are they eating? Are they at work, at home, in the car?"

"The smart phone will also beep at random times throughout the day and evening to collect the same kinds of information. We can compare that information across different situations. For example, when someone is craving we may find that they’re in situation characterized by negative emotions, like anxiety and stress, much more so than when you beep them at random times."

From the data collected so far, Dr. Wetter’s group has found that volatility of emotions and intensity of cravings is predictive of relapse. People who have a roller coaster of emotions – volatility – are at a much higher risk of relapse. He credits these findings to the ability of collecting real time data via smart phones.

Source Article

10 Revolutionary iPad Apps to Help Autistic Children

by JEFFRY MCDOWELL on AUGUST 15, 2010

via GadgetsDNA.com

Source Article

Teachers and doctors are using iPads as a tool to reach out to children with Autism or Asperger Syndrome and the results are remarkably great. Autistic children are showing tremendous improvement after playing fun-filled exercises on iPad which is less stressful and more fun for both the teachers and the students. Below is the list of 10 best iPad applications to give Autism a voice.

Those who don’t know, Autism is a lifelong disability that affects the way a person communicates and relates to other people and the world around them. Those affected typically display major impairments in three areas: social interaction, communication and behavior (restricted interests and repetitive behaviors). 1 in 160 children have autism in some form, making it twice as common as cystic fibrosis, cerebral palsy, childhood deafness or blindness and ten times more common than childhood leukemia.

View list of apps at source article on GadgetsDNA.com

AHRQ Launches Website with Resources for Integrated Care in the Patient-Centered Medical Home

The Federal Agency for Healthcare Research and Quality announces the launch of a new website devoted to providing objective information to policymakers and researchers on the patient centered medical home, www.pcmh.ahrq.gov. The site also provides users with searchable access to a rich database of publications and other resources on the medical home including Integrating Mental Health Treatment Into the Patient Centered Medical Home. The paper examines the conceptual similarities in and differences between the PCMH and current strategies used to deliver mental health treatment in primary care, presenting programmatic and policy actions needed to facilitate the integration of high-quality mental health treatment within a PCMH.

Where are the innovators in health care delivery?

Almost everyone believes there is an enormous amount of waste and inefficiency in health care. But why is that? In a normal market, wherever there is waste, entrepreneurs are likely to be in hot pursuit — figuring out ways to profit from its elimination by cost-reducing, quality-enhancing innovations. Why isn’t this happening in health care? As it turns out, there is a lot of innovation here. But all too often, it’s the wrong kind.

Effectiveness of Web-based Interventions on Patient Empowerment: A Systematic Review and Meta-analysis

via Journal of Medical Internet Research

Source Article

ABSTRACT

Background: Patient empowerment is growing in popularity and application. Due to the increasing possibilities of the Internet and eHealth, many initiatives that are aimed at empowering patients are delivered online.
Objective: Our objective was to evaluate whether Web-based interventions are effective in increasing patient empowerment compared with usual care or face-to-face interventions.
Methods: We performed a systematic review by searching the MEDLINE, EMBASE, and PsycINFO databases from January 1985 to January 2009 for relevant citations. From the 7096 unique citations retrieved from the search strategy, we included 14 randomized controlled trials (RCTs) that met all inclusion criteria. Pairs of review authors assessed the methodological quality of the obtained studies using the Downs and Black checklist. A meta-analysis was performed on studies that measured comparable outcomes. The GRADE approach was used to determine the level of evidence for each outcome.
Results: In comparison with usual care or no care, Web-based interventions had a significant positive effect on empowerment measured with the Diabetes Empowerment Scale (2 studies, standardized mean difference [SMD] = 0.61, 95% confidence interval [CI] 0.29 - 0.94]), on self-efficacy measured with disease-specific self-efficacy scales (9 studies, SMD = 0.23, 95% CI 0.12 - 0.33), and on mastery measured with the Pearlin Mastery Scale (1 study, mean difference [MD] = 2.95, 95% CI 1.66 - 4.24). No effects were found for self-efficacy measured with general self-efficacy scales (3 studies, SMD = 0.05, 95% CI -0.25 to 0.35) or for self-esteem measured with the Rosenberg Self-Esteem Scale (1 study, MD = -0.38, 95% CI -2.45 to 1.69). Furthermore, when comparing Web-based interventions with face-to-face deliveries of the same interventions, no significant (beneficial or harmful) effects were found for mastery (1 study, MD = 1.20, 95% CI -1.73 to 4.13) and self-esteem (1 study, MD = -0.10, 95% CI -0.45 to 0.25).
Conclusions: Web-based interventions showed positive effects on empowerment measured with the Diabetes Empowerment Scale, disease-specific self-efficacy scales and the Pearlin Mastery Scale. Because of the low quality of evidence we found, the results should be interpreted with caution. The clinical relevance of the findings can be questioned because the significant effects we found were, in general, small.

(J Med Internet Res 2010;12(2):e23)
doi:10.2196/jmir.1286

KEYWORDS

Patient empowerment; Internet; eHealth

Healthcare's New Face

What You Need to Know about the Government's New Health Insurance Website

KHN

Consumers shopping for health insurance coverage get a boost today with the launch of a new federal website, www.healthcare.gov.

The health law that Congress passed in March called for the creation of the site, which advocates say will make it easier to shop for a plan. Consumers will be able to see all options available where they live, compare costs and determine if they qualify for a government program.

Federal health officials say the website will work as a bridge to help consumers until 2014 when much of the new law takes effect, including provisions that bar insurers from discriminating against people with pre-existing conditions and establishing new health insurance exchanges, the marketplaces that make it easier for consumers and small business to buy insurance.

VA mobile health apps empower vets, improve outcomes

via Government HealthIT

By Mary Mosquera

Source Article

The Veterans Affairs Department is exploring a number of applications of wireless technologies to improve the health outcomes of veterans, especially those in rural areas that may be hundreds of miles from the closest VA clinic or hospital.

Wireless technologies can link veterans with their providers through personal cell phones and enable them to manage their health, said Gail Graham, deputy chief officer in health information management in the Veterans Health Administration.

For many veterans, “geographical distance from VA’s physical healthcare assets often presents a challenge to receiving care,” she said at a hearing of the House Veterans Affairs Committee health subcommittee June 24.

Among its projects, VA is building a prototype of a mobile version of MyHealtheVet, VA’s online personal health record, to deploy on mobile phones and test for usability and functionality. Through MyHealtheVet, veterans can receive patient education, wellness reminders and refill prescriptions.

VA sought the suggestions of veterans in five rural communities about the features they desired in a mobile version of MyHealtheVet, Graham said.

It’s already installed very small aperture terminals (VSATs) on its 50 mobile vet centers to provide satellite communications. The agency uses the centers to provide readjustment counseling services.

VA’s wireless efforts are also part of changes it is making in the way it delivers care, by designing its systems around the needs of patients and to improve care coordination and online access through secure messaging, social networking tools and telehealth, Graham said.

VA will use these capabilities, among other things, to support a home-care model to help veterans manage their chronic diseases, and for a preventative care program for telephone-based health counseling to reduce risky behaviors, such as smoking and physical inactivity.

VA has demonstrated that it can realize cost savings and improve care with its deployment of promising technologies, said Dr. Joseph Smith, chief medical and science office at West Wireless Health Institute.

For example, through the use of its care coordination and home telehealth program VA reported a 25 percent reduction in bed days of care, and a 19 percent reduction in hospital admissions by linking chronically ill veterans with healthcare providers and care managers through videoconferencing, messaging and biometric devices and other tele-monitoring equipment, he said.

Through the program, which involved 43,000 veterans, one nurse could “touch” 150 patients remotely on a daily basis.

VA’s program “offers substantive proof that wireless health technology can dramatically increase the efficiency of already overstretched health professionals to help patients no matter where they are or when they need care,” Smith said.

The U.S. Army also is also using mobile phone technology for patients with mild traumatic brain injury, said Col. Ronald Poropatich, deputy director of the telemedicine and advanced technology research center, U.S. Army Medical Research and Materiel Command.

These patients, who are receiving outpatient care in their home communities, receive health tips, appointment reminders and general announcements from a secure central Web site where healthcare providers can enter and control message content and review delivery confirmations, he said.

The mobile messages provide additional communications between face-to-face office visits. Currently, the service is available to soldiers in five selected sites in Alabama, Florida, Illinois, Massachusetts and Virginia.

Similarly, VA will also test the use of videoconferencing with a mobile device for a small number of recently diagnosed patients with post traumatic stress disorder (PTSD) in San Diego, according to Smith, whose health institute is working with VA on the project.

SAIC's OLIVE And InWorld To Treat Veterans With PTSD

via Virtual Worlds News

Source Article

Science Application International Corporation (SAIC)'s Online Interactive Virtual Environment (OLIVE) will be used in conjunction with the InWorld online cognitive behavioral health care system to treat military veterans suffering from mild traumatic brain injuries, post-traumatic stress disorder (PTSD), and other psychological health issues. The technology was first demonstrated at the grand opening of the National Intrepid Center of Excellence in Bethesda, Maryland.

The National Intrepid Center for Excellence is a new military hospital facility devoted to the research and treatment of veterans suffering from traumatic brain injuries and PTSD. The Center plans to use OLIVE's 3D virtual world technology in conjunction with InWorld to deliver clinical behavioral therapy. The virtual world solution will be used to rapidly engage clients, maintain their active participation, overcome emotional barriers to therapy, accelerate the therapeutic process, and work remotely with clients.

"InWorld is designed to manage a wide range of disorders," said Les Paschall, InWorld Solutions co-founder and CEO of CFG Health Systems, in a press statement. "We’re seeing unprecedented levels of engagement and participation with clients who suffer from oppositional defiance disorder, attention deficit hyperactivity disorder, and post-traumatic stress disorder, as well as patients dealing with issues of anger management and substance abuse."

A virtual world environment also offers an ideal way to engage group therapy sessions and provide multiple perspectives on a particular behavior. Therapists will be able to "playback" behaviors and use that to encourage discussion and refine coping techniques more quickly than is sometimes possible with purely real-world therapy. OLIVE and InWorld will also be able to deliver therapy to clients at a lower cost than prior solutions.

OLIVE was initially developed by Forterra Systems, who wanted an open, standard platform that would be suitable for government and military use. The virtual world has been used to enable joint training experiments involving the US and UK militaries, by the education-oriented Serious Games Institute, and as party of therapy in the Kids in Trouble initiative. Forterra sold OLIVE to SAIC earlier this year, following rumored financial difficulties.

DSM-V

DSM-V Revised in Response to Comments; Clinicians Prepare to Field Test

AMED News

The fifth edition of the Diagnostic and Statistical Manual of Disorders is ready to be field-tested after an unprecedented call for public comment that drew about 8,600 responses from health professionals, patients, professional societies and researchers during a 2½ month period.

The DSM-5 is undergoing revisions because of those comments, with changes made to entries including those covering eating disorders and sexual disorders. One particularly contentious issue was left untouched: the grouping of the current four classifications of autism spectrum disorders into one.

Medical Home

Medical Home Demos Report Some Positive Outcomes - With Caveats

AMED News

Moving to a patient-centered medical home model of care can present significant challenges for physician practices, but given the necessary resources and guidance, some early adopters have found that the move can be worth the effort. That's according to a new report commissioned by the American Academy of Family Physicians and its for-profit subsidiary, TransforMED.

Most of the medical practices that participated in the organizations' two-year national demonstration project from June 2006 to May 2008 achieved positive results in quality of care, chronic disease care and prevention outcomes, stated the report published in a special supplement to the May/June 2010 Annals of Family Medicine.