healthcare technology

No matter how innovative the personal health records (PHRs) or electronic health records (EHRs) become, given the highly fragmented and specialized US healthcare system they still need to exchange data in a secure way that preserves privacy and trust. That is the goal of health information exchange (HIE).

The key HIE technical challenges are easily understood. Parts of a patient's clinical data will often be stored in many EHRs. For a patient with four, five, or more chronic diseases (these drive half of all Medicare costs) research shows that this will typically exceed 10 EHR implementations from multiple vendors! A conscientious provider seeing such a patient would want a comprehensive view of all of this care in order to save time collecting information that already exists, avoid duplicating tests and procedures that have already been done, and prevent mistakes from lack of information.

More recently there is Fast Healthcare Interoperability Resources (FHIR), which is essentially based on the idea that healthcare information can be exchanged the same way that other information is shared on the Internet. If you've used Amazon to look for goods to purchase, you might have noticed that, up there in the URL, text appears when you click the search button that specifies what you want. Although it might be a bit cryptic, even a non-technical person can usually figure out most of what it says.

What's really going on here? You're at your computer (which, of course, these days might be a mobile device such as a smartphone), and the information you want is securely stored in, for example, Amazon's cloud. You specify what you want, and your browser creates a query and sends it to the cloud, where it might be routed to any one of thousands of Amazon servers that will interpret it, query a database, and return the information you requested. This ability to route requests to any server in the cloud that is available is another key technical property that lowers costs and is exploited in FHIR.

As with Direct, there is more to the story than I've described (technically inclined readers should read the FHIR Summary, which is also available as a two-page PDF). But this should suffice to give you the basic idea of what is increasingly termed "API-based HIE."

more at http://www.informationweek.com/healthcare/electronic-health-records/free-the-data-apis-boost-health-information-exchange/d/d-id/1113579

Sustained engagement is emerging as the key challenge for companies developing wearable devices and complementary services. What these companies may not be aware of is the importance of habit formation, social motivation, and goal reinforcement. These three factors, drawn from behavioral science, contain the secrets to successful wearable products and related services that get used and deliver real value.

A failure to engage

A surprising percentage of devices in the market fail to achieve even short-term engagement for many users because they suffer from one or more fatal user experience flaws.

Product design teams typically work toward nine baseline criteria that must be met to drive initial adoption and use: selectability, design, out-of-box experience, fit/comfort, quality, user experience, integration ability, lifestyle compatibility, and overall utility.

Many current devices fail on one or more of these criteria by breaking, failing after a shower, pulling the hairs off your arm, running down quickly, or being a pain to sync with your smartphone. Sadly, the growing number value-added services designed to exploit the data these wearables provide and their open APIs also suffer from similar problems with user experience.

Beyond traditional design criteria

However, even if these criteria are satisfied, they are not sufficient to drive long-term use. Traditional product design criteria are only part of the key to developing successful wearable products and services.

Devices and services that help wearers change their habits also promote sustained behavior change and lead to long-term health. Behavioral science offers three other critical factors that can lead to the development of successful wearable products and related services.

Key factor #1: habit formation

Sustained engagement with a wearable device or complementary service depends on its ability to help the user form and stick with new habits. Psychologists define habits as automatic behaviors or routines that are triggered by situational cues, which are then followed by some form of reward. Habits have three key components: cues, routines, and rewards. The best wearable devices have the potential to make the process of habit formation more effective and efficient than ever before.

Key factor #2: social motivation

Sustained engagement beyond initial habit formation with a wearable device or complementary service depends on its ability to motivate users effectively. Social connections are a particularly powerful source of motivation that can be leveraged in many creative ways. In addition to using social connections to influence behavior, social media and networking sites can be exploited to alter habits for positive outcomes. This includes the communication of social norms through “postings” or “sharing” of thoughts, pictures, and comments with one another.

Key factor #3: goal reinforcement

To achieve sustained engagement, a user needs to build on these habits and social motivation to experience a feeling of progress toward defined goals. Research shows that achieving several smaller goals provides the positive momentum necessary for achieving bigger goals. Wearable products and services that help people experience continuous progress can do so, for example, through real-time updates that are powered by big data and insights. Facilitating personal progress in this way leads to improved health, user satisfaction, and long-term, sustained engagement.

Read more: http://medcitynews.com/2014/03/create-long-term-value-wearables-inspire-behavior-change/#ixzz2utQe7O1q