Harvard Medical School

Boston, MA, USA

The Department of Continuing Education of Harvard Medical School has organized a course on "Patient-Centered Computing and eHealth". The course presented the best practices for using eHealth applications (e.g., electronic health records, personal health records, secure messaging, web visits, etc.). It was a mix of plenary presentations, panel discussions, and workshops.

LECTURE ON THE WEBSITE THAT HELPS YOU QUIT SMOKING

The first keynote address blew my mind. It was possibly the best lecture I attended on eHealth in my life. It was delivered by Brent James, MD, MStat, and dissected the contemporary US debt and how healthcare is pulling the US down. If nothing is done to prevent the rise in healthcare spending, the US is bound to bankrupt in several decades, and Medicare will run out of money by 2017. Dr. James was not only an authority on the issue, as a Director for Innovation and Research at the Intermountain Healthcare system, but was an inspirational speaker too.

The keynote that followed, delivered by Victor Strecher, Ph.D., MPH, Director of innovation and Social Entrepreneurship at the University of Michigan, Centre for Health Communications Research, struck a different cord. The need to tailor information to personal preferences, ethnic background, and gender is an important tool in public health (and telehealth for that matter). He demonstrated how this tailoring can lead to better outcomes in health.

The course had two arms: one discussing electronic health records and related legislation and the other telehealth in general. The concerns raised about the privacy of data overshadowed the need to move forward in the implementation of EHRs. My gut feeling is that no one knows how the implementation process in small to medium practices will be conducted as the training and loss of productivity will burden those, on average, from 6 to 18 months after the adoption of EHRs, as demonstrated by some studies. Major vendors, as EPIC and Cerner, have no incentives to work together and make their records interoperable. Currently, the Government has no directive that demands interoperability, which will burden patient mobility and proper coordination of care.

I engaged Blackford Middleton, MD, MPH, MSc, Corporate Director of Clinical Informatics Research and Development, at Partners Healthcare and professor at Harvard - the organizer of the course in a conversation. I know Blackford from Techniche University of Munchen, where I was awarded a Ph.D. position. Blackford was a visiting professor. If I had accepted the position, Blackford would be on my faculty. The World is a small place, after all.

DELICIOUS SNACKS IN THE HALL

The course was delivered at the Boston Sheraton Hotel, which went through a $20M refurbishment with some impressive results. Funnily so, Internet access was not provided for a course dealing with eHealth. The rationale was that the attention would be taken away from the curse by doing so. That seems fair, but why put the curriculum online if you can't access it during the course? The syllabus was 'green' - meaning that all the material was provided online and available for download. I believe that this is how education should be provided to allow for ubiquitous access and knowledge sharing. Many of the attendees possessed an iPad which was seen as a platform of choice for healthcare providers. Maybe there is a lecture here for us all.