October 6th and 7th was the 2009 Health 2.0 “User-generated” Healthcare conference in San Francisco, CA spent a great deal of time discussing the emergence of clinical groupware and the next generation of online clinician-patient interaction tools. There was lively debate on whether these technologies were ready to be adopted, whether our healthcare system would make a way to pay for the solutions, and whether doctors would use clinical groupware. A three doctor panel following demos of the five clinical groupware web applications were skeptical of wide spread use.

On day one of the conference five senior executives from emerging clinical groupware companies spoke about and demonstrated their own technologies. The speakers included Paul Abramson of Health, Roy Schoenberg, the CEO of American Well, Martin Pellinate, the CEO of VisionTree Software, Steve Adams, CEO of RMD Networks, and Arien Malec, the VP of Product Management for Relay Health.

Who pays for these clinical groupware applications?
How do you get the physicians to adopt the technology?

The Moderator of the discussion, David Kibbe, Senior Advisor for AAFP, started the conversation by indicating that the rise of clinical groupware would require changes in how our healthcare system works. He commented, “We have not see the large changes in payment structures that would allow for adoption by healthcare providers of online and remote telehealth solutions that the clinical groupware providers offer.” One big stumbling block to adoption of clinical groupware is the lack of Medicare reimbursement for remote patient-physician interactions.

All five vendors of demonstrated their web portals for patient-physician interaction. Most notable were:

Martin Pellinate from VisionTree discussed a mobile component of their application for patients to have mobile access to medical information.
Roy Schoenberg from American Well demonstrated an online payment system that physicians can share for remote telehealth visits that is already in production in the state of Hawaii. American Well also demonstrated two-way video conferencing.
• Steve Adams at RMD Networks focused on the creation of coordinated care plans for patients.

In day two of the conference Dr. Roni Zeiger from Google Health also presented a clinical groupware application in collaboration with a partner MDLiveCare, which was just integrated with Google Health and launched. This application also showed similar features to the other applications and the ability to offer two-way video conferencing for patients and physicians.

After the five vendor clinical groupware panel on day one of the Health 2.0 conference, a second panel of physicians discussed Adoption of Health 2.0 platforms by Physicians on Main Street‚Äù. We will go into their comments in part 2 of this article, but, all three physicians poured cold water on the new technology. Amy Berlin, a practicing psychiatrist remarks, “There is no technology that can replace interaction between two people and there is nothing that can replace physician to physician discussion.” She remarks that we should “reconsider the premise that more information will change patient behavior.”

Acne

Acid Reflux

ADD & ADHD

Allergies

Anemia

Anxiety Disorders

Arthritis

Asthma

Autism

Bipolar Disorder

Blood Disorders

Breast Cancer

Cancer

Depression

Diabetes

Eczema

Headaches

Heart Disease

High Blood Pressure

High Cholesterol or High Blood Cholesterol

HIV and AIDS

Insomnia

Lung Cancer

Lung Disease

Migraines

Pregnancy

Prostate Cancer

Sexually Transmitted Disease

Shingles

Skin Cancer

Sleeping Disorders

“This new approach is an exciting advance that will speed our efforts to identify functional elements in the genome, which is one of the major challenges facing genomic researchers today,” said NHGRI Scientific Director Eric Green, M.D., Ph.D. “Coupled with continued innovations in DNA sequencing, this topography-informed approach will expand our ongoing efforts to use genomic information to improve human health.”

This new approach combines chemical and computer analysis and offers a promising new way of accelerating our understanding for the human genome.¬† According to a press announcement at the NIH, there are “grooves, bumps and turns of the DNA that make up the human genome and then comparing those structural features to those seen in the genomes of other animal species. Structural features that have been preserved across many species are likely to play important roles in how the human body functions, while those that have changed over the course of evolution may play a less central role or no role at all.”

How important is this new approach?

Given the over 3 billion DNA base pairs that make up the human genome and the fact that our understanding of how these really function is still primitive, any advancement in how to interpret our genes in critical. With new understanding of which genes contribute to which human functions and which genes are the root cause of specific diseases, creating new treatments becomes dramatically easier.

For More Information:

http://www.nih.gov/news/health/mar2009/nhgri-12.htm

There reality is that there are over 150 categorized types of headache. Some headaches require immediate medical attention.  Some may even be associated with aneurisms.

According to dictionary.com, a headache is a “pain in the head, caused by stimulation of or pressure to any of various structures of the head, such as tissue covering the cranium, cranial nerves, or blood vessels. Headache can be a primary disorder, as in migraine or cluster headaches, or a common symptom associated with head injury or many illnesses such as acute infection, brain tumor or abscess, eye disorders such as glaucoma, dental disease, and hypertension.”

When you feel a sudden head pain with no apparent cause you might ask yourself several questions: Have I been sleeping well? How much stress you am I under? Am I congested? Is this a warning sign of the onset a cold or flu or some other illness?  Did I take coffee today? (some people will get headaches when they become used to daily caffeine). Is the weather changing? (weather changes can cause headaches). Is there some environmental factor that is different? (environmental factors like smoke, pollution, neon lights, and even traffic lights cause headaches). For women, you should also ask yourself if you are experiencing hormonal changes.

Tension headache

A tension headache manifests differently than other headaches. You may not only feel head pain mild pain in¬†you neck, shoulders, or other areas where the body is stressed. The “headache” may often the result of pain in other areas. Fore tension headaches, finding a way to relax may be your first remedy. Over-the-counter medications work well for tension headaches. If you experience chronic pain, you should consult a doctor. Tension headaches are often mistaken for migraines.

Sinus Headache

Sinus headaches are caused by pressure of draining nasal passages. You can often experience other symptoms like, watering eyes, fever, eye strain, and excessive coughing. Sinus headaches can be symptom of other issues like allergies. You should not be having recurring sinus headaches. If you are, you should consult a doctor. Over-the-counter medications are good for these types of headaches. Many medications have both pain medication and medication to help with your sinus congestion.

Migraines

Migraines are also a common type of headache and more serious. Many people with tension headaches mistake them for migraines. Migraines are most common in tanagers and adults. If you are experiencing a migraine you have a¬†severe headache on one or both sides of the head and you may be experiencing an¬†upset stomach, nausea, sensitivity to light and sound, and/or moodiness. Many people experiencing migraines report “seeing stars”.

Injuries and headaches

Injuries will often cause headaches and this is where online help becomes more difficult. Never take a head injury lightly. Concussions, for example, can cause continued headaches and many other symptoms. A doctor’s advice is needed when an injury is causing a persistent headache or the headache is part of other issues like blurred vision, loss of consciousness, ringing of ears, loss of balance, or incoherence.

Hormonal Changes

Hormonal changes also cause for headaches. Women are especially prone to this type of headache. Puberty, monthly menstrual cycle, pregnancy, and menopause all cause hormonal changes in women and can result in headaches.

Insomnia manifests differently depending who you are. For one person you may have difficulty falling asleep, but you stays asleep once you get there. For another person, you have easily fall to sleep, but can’t stay sleeping. Chronic insomnia is not regarded as serious by many, but the reality is that it often affects work, health, and how you relate to your friends and family.

The good news is that for most people insomnia only lasts a short period of time. It could be for a few days or a week at most. Unfortunately, some people continue to suffer from insomnia. If the condition lasts for more than six months, it is considered a chronic condition. At this point, you should consult a doctor and potentially look for medication. You should know that many people with insomnia are also depressed and may or may not know it. One common medication for insomnia is an antidepressant that also makes you drowsy.

Take the first steps

Here are several suggestions for those who suffer from insomnia:

• A regular sleeping schedule makes a big difference
• Exercise regularly, but exercising right before bed should be avoided
• When you are sleepy, take a nap
• Don’t drink alcohol. If you do drink alcohol, avoid drinking close to bedtime.
• Avoid caffeine and nicotine
• Work on relaxation. Stress makes it harder to sleep.
• Try to do something you enjoy before bed
• Eat a smaller evening meal .. this helps with dieting too!
• If you are having trouble getting to sleep, if can help to get up for a while. You then go back to bed when you are sleepy
• Look at any medications you are taking and ask your doctor or pharmacist check your medications for stimulating drugs

Over-The-Counter Sleeping Pills

There are too many brands to recommend, but many brands contain diphenhydramine. Buying a cheap, generic, store brand of diphenhydramine is a good way to start. Diphenhydramine is the active ingredient in Benadryl that makes you drowsy, along with helping with allergies. Diphenhydramine is used in Tylenol PM, Excedrin PM, Nytol, and many other brands. There are other alternatives, but ask for advice if you are confused by the choices.

When nothing else works, see a doctor.

A doctor may or may not prescribe a sleeping pill, but it can help to know some of the alternatives. While there are many heavily advertised sleeping pills, one medication that has been prescribed for years is trazodone, which is an antidepressant which makes you drowsy. Trazodone is not advertised much because it is very cheap.

Another medication that is used by doctors is temazepam, which is in same family as Xanax and Valium. A group of medications in the same family is also called benzodiazepines. These medications last about eight hours. The drugs have some addictive properties, but not to the extent of more addictive pain killers. These medications have been around longer and are less expensive.

The newer alternatives are expensive brands like Ambien, Ambien CR, Sonata, or Lunesta. .All of these medications have positives, but, there is not real good real reason to jump to them unless you enjoy paying for the most advertised brands.