10 May

Reality check when stepping in to a panel on health IT. This is not House, scripted to get all things wrong made right this is BLAH BLAH BLAH. That is the opening words of the Politico correspondent mediating the early morning panel of TECH INTERSECTION Health Care Of The Future. Tip off from the get go is the Count of the Panel – four pictured in the flyer and 5 in the hot seat. The same morning early morning report was that earnings were done with several medical

There are over 40k apps out there without FDA oversight that flood the at home consumer seeking to monitor illness and such. To date the product entities wanted to get into hands, user initiated, are not integrating with Electronic Records. The inventor wanted the product into user hands before FDA review and oversight. The app is free to consumers. It is funded by private interest.

Jordan Shlain compares the art of medicine to the art of movie making. Shlain says the doctor gets put in charge of the script of patient care. Shlain says meet patients when they are, which is their email Inbox. Doctors know the algorithm of medicine that on X day something will go wrong. Shlain says the boat has been missed on workflow. Go to a doctors office. Watch the receptionist and staff constantly in reactive mode to overwhelmed office staff. Shlain wants doctor authored medical care. Shlain is reactive to the crisis situation of lifeline now. Email is expeditious but it won’t show the doctor what the patient won’t know to describe and how. Give a patient a physician connected PDA and patients will overwhelm the system. Fear and liability overwhelm doctors as led by the case of a woman in Utah who accused her doctor of sexual misconduct then sued him. Malpractice is a very real fear as is privacy. Shlain asked patients to sign a Hippa waiver in order to send him emails 100% signed the waiver. Fact is the emails are not secure since they are being archived by google, Aol, Microsoft etc. there is no privacy that will protect patient in the event of a suit.

Shlain acknowledges that patients will type novels the doctor then must read at the end of the day after they come home from work. Artie Artienza of  NIH found teens prefer for text. Audie says grants are used to expand research which is what NIH does. Studies show phones are a tool that can be used to track people then later to be hooked up to genome research. Audie says medication and adherence are huge issues. Email contact will make doctor a daddy nanny checking in on patients. Shlain says wants to prevent admission not read admission . Reality from NIH says more people get medical reports from friends than from doctors. Thanks to Webmd.

The FDA rep said trying note to impede in innovation process. Says they have a mobile app guide but are working slower than hope for. When asked if it is time to start streamlining government oversights agencies days trying to respond to issues to position well. Regulatory duplication does not hold innovation back. Reality is the speed of an idea is a Omer. Ideas are cheap and free. Bradley Thompson says has seen 15 plus warning letters. Says cant tell anyone what the rules in thenFDA are because he sees no activity and commerce needs to move. No transparency. Christy said not often asked to do more enforcement action. Guidance process isn’t slow. Innovation is too fast. FDA said wont tread on to enforcement area since guidelines are ready .there are items on itunes that are clearly FDA oversight but not adressed in FDA. Technology is accelerating long needed shift in medicine how patients communicate, etc. liberating data is a new oxygen to medicine. Sridhar Iyengar said New innovation is good but must be careful

 New regulatory oversight must be designed to keep pace. Discrete technologies with bedside monitors were networked into one. There are over 90k apps on the medical App Store. What about patient privacy.

Patients reality is they will party all weekend then go to doctor Monday morning. Get paid up front and pay the cost of the mistake or lack of oversight. Reality is patient can lie. Medical entrepreneurs don’t make time to understand the rules as written. Incubators give that insight to medical entrepreneurs. The perception is FDA is the problem where in fact is not the problem. FDA wants the standard which by default becomes the rite rica according to Christyn Foreman.

Joel White says FTC, FCC, White House, etc.

Farzad is a White House wonk with his media man in tow. Whoever said that Press Officers respect the law didnt watch the PIO drive off with Handicapped Plates of his wife. Where is a death panel when you wish there was one. Farzad says that patients now have control over their medical file. Presumption is data inputs correct. Often is not. Says companies that make it simple for patient will make a ton of money human nature won’t change. What if a doctor prescribes oxycodone to a patient who doesn’t need all the pills. What about the patient who gets multiple prescriptions under different names from different doctors. Need connectivity, operability. Moremilhones in the US than ever.fact is as Bradley says there pockets who won’t adopt it. Caregivers play role to. Need to operate from pov of those who won’t not those who will.
Hackers can hijack insulin pumps. Bradley says all products have some risk to them electronic or otherwise. Hard to forecast what a device risk will be.
Fancy words- device ecosystems

A lot of bad info out there.broader issue isn’t just security is correct inform from the doctor. Encrypted by default can never happen since data is breached by being paved by FB, google etc.
Working with civil rights, boots on the ground, etc

Foreman says standards should be out by October.

joe smith looking at jailbreak of healthcare as bandwidth increases.

The headline a year from now, apps will be moving from regulatory to cloud based, challenges that arise with progress ie greatermpatientnengagement with their healthcare- conflicting data from three doctors, Bradley telecommunications and wellness and doctor oversight convergence- how is the line drawn between healthcare and healthy living and won’t benadressedwithnFDA guidance, Christy- what willthencnsumer do with all the data and how will the cnsumer act with this data. How is the data used appropriately so patient doesn’t drive up cost on what is normal variation

So that is the predicted way of the future- No Patient privacy- Patients self diagnose-Yelp reviews of doctors that doctors will be able to erase- and more lead ins to events with supposedly bright moderators starting with BLAH BLAH BLAH

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