Past data is sketchy at best.

No one is likely to save everything forever, especially when they think something will not be needed by them.  They expect everyone to look out for themselves.  The hospital where I was born went bankrupt and was liquidated.  Most of my doctors have retired, gone out of business or are no longer living.  I have been treated in different parts of the world.  Many of my records are gone forever or incomplete and difficult to read.  Consequently, I cannot answer all the questions I get from my current healthcare providers.  Usually people believe that old paper records do not need to be scanned and digitized.  They are thrown in a box and saved “just in case.”  This is especially true when the big picture is missed or changes.

Information can now have unforeseen relevance and value for everyone.

The science of Data Mining has brought predictive analytics and modeling to many industries.  It has allowed relationships to be discovered that people did not know about or expect to be beneficial.  Benefits of Data Mining have proven to be enormous.   (See http://outcome-improvement.rockwood.com/?p=21.)  Healthcare is lagging because of its legacy of paper.  Those in the know are struggling to catch up.  Soon, the power of our own individual information will be extended by mining everyone’s anonymous data to uncover causes of diseases and the best possible treatments.  This intelligence coupled with more timely diagnosis and testing will help each one of us to attain longer, higher quality lives.

The full potential will not be realized immediately.

It will take time, but there will be a growing stream of benefits as progress is made.   Many standalone capabilities will bring partial value, but need to be integrated and automated to reach full potential.  Until this happens, gaps can be bridged by manual interfaces and processes.  Benefits will also grow as data becomes more complete and accurate and can be mined to enable real-time applications that anticipate and solve more complex tasks.

Future Outlook

We expect many new jobs to be required to bring everyone up to speed and make all the infrastructure changes.  We are expanding our roles in planning, developing and implementing these efforts.  We look forward to discussion and participation with you.

When I think of improvements being made to personal health and fitness, I think of an ultimate extreme makeover on steroids.   Since it is our bodies that are affected, there is no escaping to Walt Disney World for a week of fun while groups of perfect strangers demolish and rebuild them.  We must live through the pain and turmoil firsthand.  Fortunately, managing pain and health in general are aspects of healthcare that technology is changing dramatically as it becomes proactive and consumer focused.

There is a growing emphasis on self-help throughout the entire economy.  Healthcare is especially right for such applications since so much costly, manual effort has been required.  Networks that share information and digital tools that facilitate its collection and analysis are poised to empower more knowledgeable patients to participate in their decisionmaking and care.   Patients are urged to work with their healthcare professionals to adopt new capabilities and improve processes for working together.  Using a Lifelong Personal Health Record will assure that what patients do for themselves is communicated to providers and enable everyone to be on the same page.

As we look at things from this perspective, we see parallels with how we take care of all the other things around us.  There either needs to be a fine (not filing tax returns or getting a car inspected), an obvious problem (leaking roof, something that does not work, grass that needs to be cut) or an incentive (easier to do, looking better, feeling better, saving money, having fun).  When we can find multiple benefits, so much the better, but they must be concrete and specific, not vague and abstract.  Otherwise, we are off looking for satisfaction somewhere else.

With healthcare, we see the impact of bad habits and the role that diet and exercise can play in improving our prospects.  Yet, without immediate incentives, we all procrastinate and still fail to get the job done.   The timing needs to be right.  It cannot be difficult and complicated (KISS).  We need the added push to get motivated.  Whether we don’t get a job because we are a smoker, are given rewards for losing weight, have others to help us, or receive pressure from our families, something needs to set us in motion.  Then it takes a continuing stream of  positive reinforcement to keep us going.  Otherwise, it is easy to get distracted and fall back into the same bad habits.  It becomes a constant battle, but even talking to the person in the mirror can be helpful to stay focused on the target.

Continuous improvement is essential.  It is bad for something to take too long before there are signs of progress.  Without something tangible, it can easily appear that what is being done is not working or worth the effort.  This is why we are firm believers in managing what is being done and measuring the impact.  This can be as simple as controlling portions of food and getting weighed every day.  However, it is essential to maintain a daily log that shows the numbers.  Then it becomes easy to see progress (again, motivation).

The more we do these things for ourselves and share results with others, the more positive reinforcement we get.  We need to believe in what we are doing and get the approval of others.  Wellness programs are a big help, but we can also do a lot on our own with the help of our friends and families.  Over time, small steps can take all of us a long way.  I feel good about myself when I see how much weight I have been losing.  I think that I may live a longer and more productive life with my family.  It also helps my self esteem when I look in the mirror and my clothes fit better.

We all have something that we would like to improve about our health.  Some things require help; others we can do ourselves. Remember KISS – Keep It Simple Stupid and use Lifelong PHR to keep track of what is accomplished and any issues along the way.  Be sure to print summaries to share with your doctors so you can keep them on board.  They will appreciate your conscientiousness and interest in helping, and do a better job focusing on what is important for them to address.

Like the rest of us, pets get sick and have pain, but can suffer in silence.  It is important to constantly look for warning signs and take them to their doctors (veterinarians) for regular checkups, vaccinations, tests, allergies, injuries, diseases, operations, prescriptions and more.  We need to keep track of these things for our pets just like we do for ourselves and our children.

Creating a Lifelong Pet Record using Lifelong PHR is easy.   For example, to keep track of your pet’s weight, enter weight measurements regularly in the Vital Signs tab of their health record.  You can also include the frequency and amount of time that they exercise.  If you already have a copy of Lifelong PHR for yourself, you have everything you need.  Simply create an additional record for your pet by clicking “NEW” on the General Information screen.  Otherwise, go to www.LifelongPHR.com/order.php to download a free evaluation copy and get started.  When you are ready, simply pay for a license and receive a license key to unlock the software for unrestricted use.  Anything you have already entered will be saved, and you can create a record for yourself, too.

People spend thousands of dollars to feed and care for their pets.  Taking along a report from your software will make visits to your pet’s veterinarian more productive and help to avoid missing anything important.   It is also a good idea to store their record on a chip in their collar or a tag hanging from it.  That way someone can find out how to contact you if your pet becomes lost and learn whether they had their shots.

Fortunately for me, I do not drink these beverages regularly, but I love chips, restaurant meals and many other things that are also high in sodium.  Recently, Matt Lauer compared salt content for an assortment of them on NBC’s Today Show.  What I found on the plane was minor in comparison with many of his examples.  The lesson I learned is to watch what I eat, pick more fruits and vegetables and diversify.   The body needs salt in moderation, but in excess, it can lead to high blood pressure, heart disease, stroke, heart failure, and kidney disease.

I read about a conspiracy by food producers to get people addicted to unhealthy foods and keep them that way to generate sales.  Supposedly this is done using food additives such as salt (sodium chloride) that make food taste better.  Personally, the conspiracy part sounds a bit extreme, but blindly reaching into a super-sized bag can easily become a bad habit.  The same is true about reaching for the salt shaker before tasting food.  Personally I try to use pepper to enhance the taste of my foods.  It also contains antioxidants that reduce the impact of aging.

We record and track sodium levels when we get blood tests using our Lifelong Personal Health Record.  It helps to spot adverse trends.  We encourage you to consider doing it, too.  Also, check the Internet to learn more about the affects of salt and be sure to discuss your blood test results with your doctor.

Since that time, I have been given chest x-rays in school to look for tuberculosis; the dentist used them for checkups and I had x-rays when I was hospitalized after an accident.  Back then, no one knew enough to be concerned even though early x-ray machines used higher doses of radiation than newer ones.  Now when x-rays are taken, doses are not only lower, but lead aprons are also used in an attempt to reduce collateral damage.  Also, technicians stay behind the scenes in shielded rooms.  Nevertheless, exposures continue to grow as CT scans have become more popular than simple x-rays.  Each CT scan is typically equivalent to several hundred  x-rays.  When you consider that it sometimes takes multiple scans to get a good one, and specialists may want to have ones from different angles, radiation can really add up.

Since it typically takes time for cancer to develop, it is difficult to predict the impact of these exposures.  Couple this with cell phones, high tension power lines, airport scanners, microwave ovens, and a growing amount of other electromagnetic radiation, and the outlook for risk does not look good.  My recommendation is to keep a log that itemizes scans and other exposures.  If possible, try to obtain an estimate of the incremental exposure from each one of them.  Then, put the results in a Lifelong Personal Health Record and share concerns with providers before getting additional scans.  Although CT scans certainly help to diagnose problems, minimizing exposure to any type of radiation is a good idea especially when there is so much that we do not know about their danger.

Manufacturers abhor commodities and seek to differentiate their products so they stand out in the marketplace.  Trademarked brands are designed to be distinctive.  Consumers expect them to provide exceptional value; manufacturers expect them to command premium prices.  It is easy to see why there are so many foods, drugs and supplements that have ingredients combined into special, branded formulations.

Unfortunately, confused consumers lack time to navigate the myriad choices and select the best possible combinations.  Their goal is simply good health and longevity.  They think that everything from reputable sources is safe.  Yet for someone seeking a simple cold remedy, it can be easy to overdose by mistaking products that duplicate ingredients in other products they are taking.  Similarly, fortified foods duplicate vitamins that are found in other foods and supplements.  Studying labels is time consuming, but well advised.

Recent problems with fungicides in imported orange juice is indicative of how the products we buy have changed.  It is a lot more than the shrinking size of containers!!  I drink orange juice every day and have done so since I was a child.  Back then, the best orange juice was pure and hand-squeezed by my grandmother.  It was a standard that could not be surpassed.  Normally, we had juice that we mixed from water and frozen concentrate that likely came from the same place.  Commercial juices are now packaged ready to drink and typically contain juice that is blended from different sources.  It is mixed with  additives, some is from concentrates, and its consistency differs between “no pulp” and “most pulp.”

All the processing that foods undergo make me wonder about their nutritional value and uniformity.  I suspect that differences in soil and growing conditions cause a lot of variation.  I take supplements with my food, just in case.  Some day I hope to  make better selections by basing  decisions on better scientific research.  I expect that to be possible in the not too distant future.

In the meantime, if you get sick, keep a record of foods, drugs and supplements that could have contributed to your problem, and stay tuned for a planned post about tomatoes.

We have come a long way from when our ancestors roamed the earth on foot, hunted
for roots, berries, fish and game, and drank from streams and lakes.  Hunger and thirst were factors, but an uncertain food supply made it necessary for them to eat whenever and whatever they could.  Diet was not a consideration.  Foods were eaten near their source when nutritional value was at its peak.  How different things are today for those of us with abundant supplies and thousands of choices.  However, there is a downside.  Our foods are sprayed and mixed with preservatives, shipped hundreds or thousands of miles, stored for
weeks, months and even years, and subjected to degrading heat during processing.  All this gives cause for concern since, with the varied quality, no one knows for sure what their best choices really are, and whether vitamins and other food supplements are needed.  Despite years of research, results remain inconclusive leaving us to make arbitrary decisions.  This leaves keeping track of weight and other health indicators to decide whether or not they were satisfactory and reasonable.

Similarly for an increasingly sedentary populace, lack of exercise has become an
increasing challenge.  Eons ago people typically lived to their teens and twenties and were constantly running to catch or evade wild animals.  Lack of exercise was not
an issue.  Now people live long enough to grow old and for their bodies to wear out from exercise.  There are tradeoffs between obesity, diabetes, cancer, cardiovascular disease, and hip and knee replacements.  Records are a good place to keep track of the amount and type of exercise.

Diabetes and heart disease run in my family.  When I started to see things in myself that I had seen in my relatives, I decided that it was time to take action.  Weight gain had been virtually imperceptible over many years.  Periodically, I went on diets, but they never lasted.  Now with a personal health record, I have a place to log and track my progress.
Seeing results has given me the incentive to set objectives and stay with the program.  I have been practicing portion control and eating a healthier and greater variety of foods.  I have also been adding supplements when I learn about deficiencies that people like me typically have, but am careful not to overdo them.

Doing more things for myself makes it important to manage what I am doing, keep records and inform doctors and other providers about things they may need to know.

People are beginning to keep health records for themselves.  Results are getting better and easier.  Some people are buying scales, blood pressure and glucose monitors, and exercise tracking devices that feed results to their computers.  Capabilities will grow as systems become interoperable and interconnected.  This will enable data to be collected and results to be sent automatically to those who need it.

Recipients can even be computers.  After they digest data, computers can explain options and risks and suggest a top choice which might indeed be to visit a doctor.  The final decision, however, will be the patient’s.   This is not a departure since patients do not always do what they are told, and they often start with their own diagnosis and treatment before trying something else.  Surprisingly, in some states, patients can already order their own blood tests on the Internet.

Just as there is a hierarchy of support for computer systems, the division of healthcare
services will become more organized and efficient.  Already, people are finding that they can do many things for themselves with help from their computers.  This provides Tier 1 support.  Mini-clinics and urgent care centers are springing up in such places as pharmacies and grocery stores (Tier 2); and Tier 3 is reserved to handle the most difficult cases using higher trained professionals and specialists.  Improvements in the Internet will make it easier to escalate a case to the right place for the best possible outcomes.  Likely this will lower costs, too.

Also, we found a very informative article about AIDS on MSNBC.com.  http://www.msnbc.msn.com/id/45478404/ns/health-aids/?GT1=43001   You are encouraged to read it.