Evidence and Technology – Page 3

February 7, 2010August 18, 2022

Integrating Tablet Computers Into Your Practice

iPad in use — Photo Courtesy Tom Raftery via flickr

With Mac releasing the iPad last week, it is time to think about how these new tablet computers that are flooding the market can become a valuable member of your PT team. But to many, abandoning your traditional pen and paper for a sleek touch-screen tablet computer seems overwhelming.

The potential for these devices to make your office more efficient is almost limitless. Combining tablets with electronic documentation (you are using electronic documentation, right?) could give you the opportunity to integrate information from multiple levels. Imagine having diagnostic images, the patient’s medical history, the PT chart, physician’s orders, and functional outcome measures all easily accessible on one, ½ inch thick screen. But, the benefits go beyond working in a paperless environment. Having the internet in your hands during treatment sessions allows you to browse special tests, diagnostic information, drug information, and more importantly patient education materials like instructional videos. You can also search for detox center in Orlando to overcome drug addiction as it has numerous negative impacts. Some tablets also feature 3G capabilities, allowing PTs in home healthcare the ability to access the same information available on a WiFi network. Ideally, this would result in the opportunity to be more efficient and spend more time treating and educating patients, not writing SOAP notes by hand, scheduling, or billing.

But, introducing these devices into your clinical practice is not for everyone. It is important to remember that no single device (not yet anyway!) is appropriate for all clinics or settings. The potential is great for integrating these devices into PT practice, but is there an app for that? Since this technology is so new, the documentation software you prefer or the features you want may not be available yet. Cost may be another barrier to integration, ranging from $499 to $829, the iPad can be expensive, especially if you are integrating into a large clinic or hospital setting. Apple is not the only company on the tablet front, HP-Compaq, Dell, and Panasonic ToughBook all offer competing models. Compared to laptops, the current trend, tablets are easier to disinfect, less cumbersome, touch-screen, feature a longer battery life, and easier to operate overall.

These platforms also open the door for PT specific apps and programs to be developed. At an average of $1.99 per download, the apps for the iPad are more expensive than their iPhone counterparts. As PTs and the general public catch the app downloading bug, there is profit to be made in every sector, not just healthcare. The question then becomes, should PT specific apps be limited to PTs? And, if so, how do we regulate who downloads them?

February 4, 2010February 4, 2010

UK Sends Data to The Cloud

One of the big barriers to both performing and consuming research is the issue of closed doors and ownership of data. Researchers struggle with gaining access to information. Readers of research struggle with gaining access to manuscripts locked away behind expensive subscription fees. Thus, the move to open access publishing is useful on multiple levels. The ability to have access to the best recent research findings is a critical component of best care.

The United Kingdom has taken a postive step with data from the public sector and goverment commisioned research by moving away from proprietary copyright laws and adopting the very popular Creative Commons licenses. They recently launched a new website, data.gov.uk as a resource for gaining access to this information. People developing the information will also have an easier time securing the protection of their data using the easy stardards of the Creative Commons rules. This certainly seems like a win-win for everyone.

By the way, this is really about opening data up to “the cloud” and I think we’ll see more and more opportunities to connect and free up data. To that end, you have to love the presence of the “Semantic Web” definition on the landing page for the UK’s new site.

What kind of data is available?

Here’s a data set to chew on: “The patient journey post hip fracture: What constitutes rehabilitation?“

October 14, 2009

A Simple Solution: Posterous.com

Eric's Posterous I get asked by quite a few physical therapists about the best way to establish some sort of online identity for themselves or, more often, their business. While my gut reaction is to suggest a WordPress, this does take at least some footwork to get off the ground and to look nice. Another option which, due to the insanely simple process of setting it up, maybe more palatable to some folks is Posterous.com

Posterous allows everyone to make a blog on the fly, and they take care of images, hosting, posting, etc. All the user has to do is to remember the email address to post something (post.posterous.com), find something of value on the web worth sharing, or write down some thoughts, and click send. That’s it!

This article by Guy Kawasaki does a great job explaining how one can use Posterous to it’s full potential, including simultaneously posting to several social media sites and blogs.

June 15, 2009

I'm back and so here's a link

General apologies and regrets for the long delay between posts. One of the things I was up to was presenting at the annual APTA Conference in Baltimore with Tim Noteboom. I thought it might be nice to direct all those folks who I coerced into subscribing to my blog by way of a how-to demo to the slides from the presentation.

Here they are posted on my Physiopedia Page.

PT HACKER – APTA 2009

February 20, 2009

Physiopedia vs. Medpedia

Many of you may already know about Physiopedia, but perhaps some of you do not. Physio-pedia.com is a project, orginially conceived by Rachael Lowe, that she and I, with the help of her technologically gifted husband, Tony Lowe, have been working on for the better part of the last year. Our aim is to create a world-wide, open access encyclopedia written by, and targeted to physical therapist and physiotherapists around the globe. This is a growing, long-term project, but has recently been gaining some good momentum.

This week, a new public wiki site, Medpedia launched publically. I first started following Medpedia in December during their beta phase and was recently approved as an editor for the site. Medpedia has huge finanical backers (Harvard, for example), and is primed to be an excellent resource. It begs the question, is there room for both Physiopedia and Medpedia is this wiki healthcare world?

The following post orginally appeared on Rachael's Physiospot blog:

A new wiki for health care was launched this week called Medpedia, take a look, it's incredibly impressive and comprehensive, and is likely to become the key reference for the public on medical matters.

You may be wondering why we need Physiopedia when Medpedia is available? Well these are my thoughts in this regard. With Medpedia being driven by doctors it will not truly represent our profession. It is primarily focused on educating the general public with good quality information about conditions that affect them, also providing a place for professionals to publish their work and create a profile. Physiopedia also offers the opportunity for therapy professionals to publish their work and create a profile, however Physiopedia is also an educational resource aimed specifically at the physio/physical therapy profession. It will provide evidence based information for physiotherapists relating to common conditions, interventions and management options that we come across in our daily practice. With Physiopedia we aim to truly represent, promote, educate and develop the physio/physical therapy profession. So the emphasis of Physiopedia is on developing the profession which is significantly different to Medpedias' emphasis on informing the public.

So, while Medpedia may be getting all the press right now, Physiopedia maintains its awesome potential to be a great resource for physiotherapists. But, just as the Medpedia sites grows as more contributions by authors are made, Physiopedia needs your content. Come on physios! If the medical community can do it, then so can we. Let's show them just how valuable our profession is.

Join in the Physiopedia efforts.

Come collaborate with us!! www.physio-pedia.com

January 16, 2009

2009 Healthcare Trends: Are PT's Behind the Times?

From CNN Health we are given this list of upcoming trends in healthcare for 2009:

Online House Calls
Virtual Clinics
Ask-a-doc websites
Getting your test results online
Twittering Doctors

I'm going to go way out on a limb here and suggest that 99% of physical therapists don't know what Twitter is, and just about the same percentage are prepared for the other items on this list. Perhaps it's our love affair with third-party reimbursement, perhaps it's something else that causes physical therapists to be slow adopters of technology. Afterall, most of these trends also include directly charging patients for things not covered by insurance. The bottom line is that patient-provider relationships are evolving and physical therapists will need to evolve with them.

Get ready!

ERIC

p.s. Follow me on Twitter.

January 12, 2009

Google Reader for Beginners

I get a lot of follow-up questions about using Google Reader from audience members when I present on using feeds to enhance evidence gathering for clinical practice. The official Google Reader Blog has made some new videos which may prove a helpful resource. Check them out!

ERIC

January 7, 2009

Patient-centered Marketing Beats Fringe

I have a Google News search feed (you can copy and paste this url into your reader, fyi) for "Physical Therapy" set up in my reader program to help me keep up with what's going on. Sometimes there's some interesting items, sometimes not so much. But sometimes, the thing that captures my interest lies not so much in the individual news items, but in the patterns of groups of news items.

This was the case today as I scrolled through the various entries. There were a few job postings, one or two clinic opening announcements, and a whole lot of articles devoted to Wiihab, hippotherapy, and physical therapy for pets.

Not once in any of the hundred or so entries that I read did I discover news about physical therapists doing anything related to the core of the profession: enabling function, reducing pain. Sure, those things are briefly implied in the fringe type articles, but why doesn't good old fashioned physical therapist practice garner news headlines?

Perhaps because it's boring. From a news perspective, there's nothing too exciting about going to physical therapy and getting a good treatment. Just like it's boring to hear about someone going to a primary care doctor and getting a new prescription for pain relievers. We don't see news items about that either.

News headlines are about things that touch our humanity. Things that are new and different. Human stories. Perhaps the stories of our patients need to play a larger role in the profession's marketing efforts. Perhaps then the story might be more about what we can do to help, what good physical therapy is, and less about the random fringe-type aspects of physical therapy. I'm routinely fascinated by the stories of my patients and the efforts they put forth to improve their lives. Now that's good news!

I propose Patient-centered Marketing, which by the way, will be ripe for social media efforts as well.

ERIC

Image courtesy pawpaw67 via Flickr.

December 2, 2008

Cyberchondria

Just about everyone I know has experienced some form of this condition. I'm particularly susceptible to the pet version of this. Basically, doing a web search for a health condition can leave you feeling anxious and sure you are facing a serious crisis. Have a headache? It must be a brain tumor, right? After all, that's what all the results are about!

This is a serious issue that, as a health professional, I deal with frequently as patients come in to the clinic with many questions, often concerned about the serious complications they are facing. A patient with back pain may come into the clinic well-versed about spine surgery, but not so aware of the fact that most back pain gets better on its own! Microsoft has published a research paper on this issue that is extremely useful in understanding how and why cyberchondria happens.

The table I pulled from the article lists probabilities of certain conditions occurring during web searches. If we stick with our headache example, a common benign condition, we see that we have a probability of seeing "brain tumor" 0.03 of the time. In actuality, the probability of your headache being a brain tumor is more along the lines of 0.000116, or 1:10,000.

The bottom line is that web searches are weighted unequally toward serious conditions. You are more likely to read about serious things than common things. Web searches currently do not allow you to make judgments about the frequency or likelihood of a certain condition…pretty important parameters in making a diagnosis!

Beware the web search next time your head is pounding, your dog has a fever, or your back is sore!!

November 30, 2008

Clinically Proven?

One of the things I struggle with in relation to improving consumers' ability to make informed health care decisions is the constant assault of information from advertisers and special interest groups. It can be very difficult to sort through the haze and determine what the best course of action might be in response to a specific issue.

This might be responding to a serious health crisis like cancer, or it could be responding to something more minor, but no less confusing. For example, chronic "tennis elbow" or lateral elbow pain has as many proposed solutions as proposed causes of the condition itself. For the average consumer, there is no way to determine what the right course of action might be aside from relying on the perspective of their health care provider…whomever that might be.

Andrew Pollack from the Evidence Gap series does an excellent job of portraying how, even in the face of strong evidence, certain treatments don't catch on through the example of diuretics, hypertension, and the Allhat study: The Minimal Impact of a Big Hypertension Study. Placing the blame solely on the pharmaceutical reps may not be appreciating all the factors that come into play when evidence-based practice is examined at the level of a health system.

However, placing the blame of the pharmaceutical companies sure is fun, especially as I sit through advertisement after advertisement on TV touting each drug to be "clinically proven." Nonsense!

Afterall, we know that in science, there is no such thing as proof. It's a moving target.

Photo by Diana Lili M via Flickr