Forrest Duncan's Radio Weblog

	10 February 2003

Forrest Duncan/Mysterian: And a reference to a Frost and sullivan report at last. Hospitals Sold on Digital X-Rays [1]. X-rays and CT scan results on film are slowly going the way of other long-discontinued medical practices, thanks in part to a new system that allows health-care workers to view high-resolution images on a regular PC. [1] http://www.wired.com/news/medtech/0,1286,57601,00.html 4:27:00 PM

	09 February 2003

Forrest Duncan/Mysterian: http://searchwin2000.techtarget.com/originalContent/0,289142,sid1_gci878380,00.html 12:41:00 PM

	07 February 2003

KC Bolton and I are in synch with a lot of our thinking about future Healthcare and how technology is going to play a role in this, especially p2p.  I make no apologies for repeating his telemedicine Letterman list below.  It's all good stuff from someone who actually spends his own time THINKING about this stuff and how to make it better. I would like to throw in another point here that is probably worth discussing. I think that one of the potential benefits of telemedicine is in PREVENTATIVE medicine.  If people had the ability to monitor their own conditions with some of the simple devices that are appearing - home ECG, blood pressure etc - then these results could be monitored by their medical practitioners and perhaps some conditions could be spotted earlier than they currently are.  We could then help people BEFORE they get ill. However - and here is the big problem.  In the UK we are extremely lucky to have the NHS (although there are plenty of discussions to be had about how it is working).  In the rest of the world people pay lots for healthcare.  As far as I know, no physician gets paid for preventing disease.  It is in their (financial) interest to treat the illness, not to prevent it.  This is Very Sad (TM). Am I wrong? Why isn't Telemedicine more widely adopted? (Part Deux) This is an enigma.  As several of my family and friends know, I am delving into telemedicine due to my graduate studies and pending new job.  Here are some more thoughts in addition to a previous posting.  Top Ten list Letterman style.   Top Ten Reasons Telemedicine has not been embraced by the medical industry #10: Telemedicine is not a direct healthcare technology (e.g., an MRI machine) so its importance is seen as auxilliary to clinicians. #9: Telemedicine has been promoted as the panacea that will fix all of medicine's woes.  When it didn't produce as promised (no surprise based on the hype) people lost interest. #8: Consultants jumped on this hype-wagon and inundated providers and practices with how they can fix things just by hiring them and implementing their proprietary telemedicine setup.  If you want to be annoyed, call a medical consultant regarding HIPAA and you will see what I mean. #7: Telemedince lacks real standards. (this is a biggie). #6: The benefits of telemedicine are not always passed on to the user.  Example: if a department saves an organization by reducing patient evacuation costs to a different facility (this is our case) the savings are not dropped back into that department's budget.  Not too many altruistic folks out there in this scenario like there is for, say, recycling.  "Save Mother Earth" is a better rallying cry than "Use telemedicine so another department can bust their budget." #5 (A slight variation on a few above): Telemedicine needs to be viewed with a little 't' and not a big 'T'.  It is a technology enabler, pure and simple. #4: Sustained adoption of telemedicine and embedding it into daily practices requires a 'true believer' in the organization. (sounds like Groove!).  #3: Technology whiz kids mystify telemedicine into an arcane thing.  Protecting telemedicine's 'secret inner workings' ensures IT job security.  C'mon!  Using the telephone for consults is a form of telemedicine.  Email is too.  And the fax machine.  #2: Telemedicine does not attempt to augment current practice procedures and adds to them.  I know of zero clinicians who want to take more steps while treating patients. #1: Telemedicine adoption requires a need so unless you are geographically isolated there isn't a sense of urgency to use it. Lots of other reasons, equally valid like: licensure issues, reimbursement for telemedicine-delivered services, and efficacy (perceived and real) of telemedicine interventions.  Am I a believer in telemedicine?  By default, graduate project and position, I certainly am.  But I am not the one who has to use it in lieu of other work-arounds.  People take the path of least resistance on this sort of thing and clinicians are no different.  The challenge is to make the telemedicine path as wide as possible. One last point: telemedicine is a fact of life in many other countries than the U.S.   Hmmm, are we the most advanced country technology wise or aren't we??   [K.C.'s Weblog] 10:09:24 AM

Forrest Duncan/Mysterian: Well, that was easy-peasy lemon squeezy. Well done Tim. Now to get my head round what it means. :-) 9:56:00 AM

Forrest Duncan/Mysterian: Lets see how easy this puppy is. 9:53:00 AM

	04 February 2003

This is an interesting piece from http://blog.mathemagenic.com/  I think I agree with it, but if truth be told, I am sticking it in here until I get more time to go through it later.  Interestingly, the source tells me that 'Diffusion of innovations' is academia speak for Change Management.  Hmmm... I want to have your attention for two pieces. The first one (source) refers to Rogers' Diffusion of innovations book that describes the characteristics of innovations that are more likely to be adopted: Relative advantage - potential adopters need to see an advantage for adopting the innovation Compatibility - innovations need to fit in with potential adopters' current practices and values Complexity - innovations' ease of use will lead to more rapid adoption Trialability - potential adopters want the availability of "testing" before adopting Observability - potential adopters want to see observable results of an innovation The second one is by Diane Dormant (1997, p.144). She writes about different stages of acceptance of innovation and suggests that strategies for each of them: If the person is in the stage of… Then the strategy to use is to… Awareness Passive regarding the change Little/no information about change Little/no opinion about change Advertise Be an ad agent Be credible and positive Appeal to his or her needs and wants Curiosity More active regarding change Expresses personal job concerns Asks questions about own work and change Inform Identify specific concerns Provide clear info about concerns Emphasize pluses, acknowledge minuses Envisioning Active regarding change Expresses work-related job concerns Asks questions about how change works Demonstrate Give success images Provide demonstrations Connect with peer users Tryout Active regarding change Has opinions about change Interested in learning how-to Train Provide effective training Provide job aids, check lists Promise technical follow-up Use Active regarding change Uses change on the job Asks detailed questions about use Support Provide necessary technical help Provide reinforcement Provide recognition 5:19:00 PM

Also from Jon Udell..  more cool stuff. One day there will be many circles around Stornoway... newsQuakes. ... [Jon's Radio] 5:04:04 PM

From Jon Udell.  Hey Neil, how many times do you need to see RISE again, albeit five years later?  :-) BuddySpace. Now that the notion of presence is beginning to infuse our electronic communication, an inevitable next question is: presence where? Marc Eisenstadt, chief scientist at the Knowledge Media Institute of the Open University in the UK, wrote to show me a Jabber-based system called BuddySpace that locates presence indicators on maps. In the map shown here, Marc (top row, third photo from right) is present in the office, but idle. Martin Dzbor (bottom row, far right), KMI's "chief presence architect," is present and active. And that little dot on the US map, in New England, is me, present and active. ... [Jon's Radio] 4:59:49 PM

Haven't a clue what this is about, but is well cool.  Play with the controls. http://dogfeathers.com/java/hyperstar.html 4:56:08 PM

© This work is licensed under a Creative Commons License. Forrest Duncan Weblog 2002-12-26 Occassional weblog entries Forrest Duncan Forrest Duncan --> . Last update: 03/03/2003; 15:02:52.