Every time we interact with a public service we leave a record—a medical report, perhaps, or an exam result. Those records should be the lifeblood our public services. If shared and analysed—securely—they can help services to improve the quality of their performance. They can also help to prevent problems: identifying, for instance, those at risk from diabetes or even child abuse. And the economic downturn brings new urgency: if public services don’t improve productivity they will soon be unaffordable. (…)

If we want to have good public services, we are going to have to trust them with our data; and if our public services want us to pay for them, they will have to show us that they are using our data effectively and securely. But armed with the type of data created by Brian Jarman, and the tools built by Richard Webber, we can build safer, cheaper public services that know their users better.

Leaders and stakeholders all throughout the world should realize that data sharing and analyzing is the next step for the healthcare systems survival and sustainability, from global to local settings. More than never, we need an effective, statistical, secure and responsible interpretation of the information that is being collected by healthcare providers.

In summary, only knowledgeable healthcare systems are capable of becoming true complex adaptive systems. Only then, they will face effectively the increasing needs and demands of the future.

Delta Exchange is a social networking for primary care physicians created by TransforMED, an American Academy of Family Physicians subsidiary. Its main goal is to enhance the family physicians knowledge in the patient centered medical home model.

Transform to a medical home — with a little help from your friends

We learned from the National Demonstration Project (NDP) that transforming to a patient-centered medical home (PCMH) isn’t easy — it actually IS rocket science — and it requires meaningful change throughout all aspects of a practice.

We also learned that medical practices can be lonely places: physicians and staff often feel isolated. What they want and need are opportunities to communicate, collaborate, and learn with other practices in order to maintain the momentum of change.

And lastly, we also learned that some practice leaders have a DIY attitude (Do-It-Yourself). They were not interested in having a consultant or practice coach in the practice; they just wanted useful information, some accountability, and connections with other practices to learn best practices.

TransforMED’s Delta-Exchange provides all of that in an online, social networking platform.

With the cost of 30$/month per user, this is an interesting solution for knowledge sharing and collaborative virtual work among family physicians.

Jay Parkinson, @jayparkinson, author of the jay parkinson + md + mph blog and a health 2.0 revolutionizer, presented hellohealth in June 2008, a social network between patients and doctors that steps aside from the US healthcare insurance companies and their dense billing system. Although a little focused on an economist point of view, this video from Jay presents the way that primary care should be on the 21st century: personalized and citizen centered healthcare based on a high usage of the communication technologies.

Is this is the doctor-patient relationship 2.0 ? Probably yes.

Ladies and gentlemen, Jay Parkinson.

More information:

Scienceroll: Jay Parkinson and Hello Health

Jay Parkinson MD website

The recently published “Virtual Doctor Visit Report”, conducted by Prophis eResearch on 1600 online US adults, proves that patients perceive online consultation as being positive, and even more if one is consultated by a personally known physician.

How should GP practices prepare themselves for this upcoming reality? Should Instant Messaging services and virtual reality consultations be as common as a telephone consultation?

In my humble opinion, yes they should.

The “Virtual Doctor Visit Report” results – via imarketinsights

Further information:

• Scienceroll: Call Your Doctor Online: The Future of Medicine

• Innovation Playground: The Coming Healthcare Innovation – Doctors Need to Go Virtual… and Social

• Prophis eResearch: Virtual Doctor Visit Report – Perceptions, Projected Use and Users of Internet-based Doctor-Patient Interaction

I think it could be useful to list all the family physicians/GPs or GP trainees that are on Twitter.

If you want to add someone, please write your comment below or send me a tweet.

• @amargaridaz – GP trainee

• @amcunningham / www – GP and Clinical Lecturer… interested in everything:)

• @brownleader / www – inner city primary care doctor

• @doc_rob / www – Primary Care Doc, Goofball, Daddy, Hubby

• @doctoranonymous / www – Family Physician, MedBlogger, Internet radio show host, all around nice guy

• @drbonis / www

• @DrHubbard / www – Family physician and publisher of James Hubbard’s My Family Doctor, which is medical information for the general public written by health-care professionals.

• @drottematic / www – Final year med student at UBC, Vancouver. Canadian Family Practice Resident, starting July 1, 2009

• @Dr_Paige / www – Family Practice doc for Family Practice West in Columbus, Ohio

• @GPforhire – Family Doctor, husband, father, geek, gardener, old skool Jedi, um, and loads of other interesting things…

• @holmspun / www – A Family Doc and a Medical Student musing about medicine in the Midwest.

• @japrados

• @jmbhan / www – I am a Family Physician and tech junky, trying to change the world

• @kevinmd / www – Primary care doctor Kevin Pho, M.D. provides commentary on physicians, patients, hospitals, medicine and health care.

• @KittKlaiss –  Small Town Doc, mom of 2, knitter, scifi junkie

• @meducate / www – Global, strategic medical education professional. Interested in clinical practice gaps and outcomes measures. Also humorous speaker/writer globally.

- @mgfamiliarnet / www – MGFamiliar.net

• @rqgb / www – Spanish GP trainee in Madrid

• @ruraldoctoring / www – Rural family doctor, hospitalist, baby catcher, restlessly creative.

• @tedeytan / www – Health Informatics. Patient Empowerment. Washington, DC, Oh, I’m a doctor too.

• @tiagoMGF / www – GP trainee/Family Medicine resident and Freelance Writer

Join the Primary Care Twitter Group, launched by @amcunningham.

Check the full list of medical Twitterers created by @medicalstudent here and take a look at the Twitter Top 100 Health and Medicine rank.

On 16 January, Prof. Lawrence Green from the Department of Epidemiology and Biostatistics – University of California, will be in Lisbon to present a conference entitled  “If we want more evidence-based practice, we need more practice-based evidence”. His article “Making research relevant: if it is an evidence-based practice, where’s the practice-based evidence?”, published in the journal Family Practice, promotes a needed change in research priorities and knowledge itself, by stating that the actual research is based on methods and patients that are far away from the reality of the daily practices.

I found this Medscape video that focus the same subject:

Making research relevant: if it is an evidence-based practice, where’s the practice-based evidence?

abstract

The usual search for explanations and solutions for the research-practice gap tends to analyze ways to communicate evidence-based practice guidelines to practitioners more efficiently and effectively from the end of a scientific pipeline. This examination of the pipeline looks upstream for ways in which the research itself is rendered increasingly irrelevant to the circumstances of practice by the process of vetting the research before it can qualify for inclusion in systematic reviews and the practice guidelines derived from them. It suggests a ‘fallacy of the pipeline’ implicit in one-way conceptualizations of translation, dissemination and delivery of research to practitioners. Secondly, it identifies a ‘fallacy of the empty vessel’ implicit in the assumptions underlying common characterizations of the practitioner as a recipient of evidence-based guidelines. Remedies are proposed that put emphasis on participatory approaches and more practice-based production of the research and more attention to external validity in the peer review, funding, publication and systematic reviews of research in producing evidence-based guidelines.

Keywords. External validity, evidence-based practice, dissemination, generalizability.

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Green LW. Making research relevant: if it is an evidence-based practice, where’s the practice-based evidence? Family Practice 2008; 25: i20–i24.

Read the post by clicking the image:

More information about Personal Health Records:

• Wikipedia: Personal Health Record

• Personal Health Records 2.0 by Gunther Eysenbach

• Microsoft Health Vault

• Google Health

In 2008, the World Health Organization had a double celebration: its 60th anniversary and the 30th birthday of the Declaration of Alma-Ata on Primary Health Care, signed in 1978.

The World Health Report of 2008 was called “Primary Health Care: Now More Than Ever” and settled  4 “avenues” to be crossed in order to globalize and develop qualified and sustainable health systems: universal coverage reforms, service delivery reforms, public policy reforms and leadership reforms. 

After such an important year as this, WHO has published a photo essay with the key public health issues to remark and to keep fostering the global consciousness regarding healthcare inequalities.

See this video regarding the Declaration of Alma-Ata: