Friday, September 28, 2012

Introducing GeriTech

Hello and welcome to GeriTech. I’m Leslie Kernisan, practicing geriatrician in San Francisco.

I’ve always been interested in how technology can:

  1. Help me with my day-to-day doctoring work, practicing outpatient geriatrics
  2. Help other people – families, caregivers, other health professionals --  provide good health care to frail and vulnerable elders
  3. Help solve the big problem of how to provide high quality care for an aging population at a price we can all afford.
For the past several years, I practiced primary care geriatrics first at the San Francisco VA, and then for almost two years at a community clinic in Berkeley. In both cases, the technology I used was given to me by the institutions I worked with. This left me with relatively little opportunity to explore or use some newer technologies, such as patient portals, home-based medical monitoring devices, or any of the new-fangled mHealth applications that all the venture capitalists get excited about.

Now, I’m launching a solo geriatric housecalls practice. Here’s what I’ve found myself thinking:

Are there any devices and apps that I should recommend to patients?
More and more gadgets, gizmos, apps, and home monitoring devices are being designed for health care. Every now and then patients ask me about some of them, but I’ve never felt confident even advising them on which home BP cuff to use. Or medication management program to use. Time to change that.

Which devices will work not only for the consumer, but for the provider?
Have you ever received a long string of printed blood pressure readings, courtesy of a home BP cuff? What the doctor probably needs is a good summary showing minimum, maximum, and average, preferably in a format that can be added to the patient’s EHR. The ideal devices should be designed for easy use by patients and families, and by providers expected to act on the information.

Which devices will work for *my* patients?
How well does it work for a patient who has multiple chronic problems, cognitive impairment? Can it help the caregiver provide care?
Can it help coordinate among multiple providers and care settings?

Which electronic health record systems work well for geriatrics?
Which EHR will facilitate the kind of care I want to provide to patients and families? What do we geriatricians need from an EHR in order to maximize our ability to help patients?

These are some of the questions I’d like to explore over the coming months.

Through this blog, I’m hoping to bring together a community of people interested in how technology can support geriatrics, which is to say: the health care of frail or vulnerable older people. Found something that is really helping you provide geriatric care? Tell us about it in the comments, or better yet, email me and maybe we can turn it into a guest post. All are welcome – healthcare providers, patients, caregivers, technology experts – but I hope to especially hear from other geriatricians and clinicians providing primary care to older Americans.