These are the slides from my talk at the 4th Annual Putting Patients First Conference in Mumbai.
If god were to manifest the world using technology, he would first create something like social media. Conceptually provide technology with the ability to understand the thoughts of a population
SocMed leaves behind the old model of 1-to-1 communication – “talking to someone over the phone” Enables one-to-many communication (via blogs or microblogging) or many-to-many communication (discussion forums, social walls). Now anyone can setup an online community site/portal to represent a small or big offline community.
Further, anyone can setup an online site related to a treatment, a disease, a doctor, a drug , a concept or anything and see it grow into a popular site which in effect is simply the manifestation of a community which exists/ed but which no one ever knew of.
The Role of Facebook in Crush the Crave, a Mobile- and Social Media-Based Smoking Cessation Intervention: Qualitative Framework Analysis of Posts
Background: Social networking sites, particularly Facebook, are increasingly included in contemporary smoking cessation interventions directed toward young adults. Little is known about the role of Facebook in smoking cessation interventions directed toward this age demographic.
Objective: The aim of this study was to characterize the content of posts on the Facebook page of Crush the Crave, an evidence-informed smoking cessation intervention directed toward young adults aged 19 to 29 years.
Results: We found that the original Crush the Crave Facebook posts served two main purposes: to support smoking cessation and to market Crush the Crave.
Most of the original posts (86/121, 71.1%) conveyed support of smoking cessation through the following 7 subthemes: encouraging cessation, group stimulation, management of cravings, promoting social support, denormalizing smoking, providing health information, and exposing tobacco industry tactics. The remaining original posts (35/121, 28.9%) aimed to market Crush the Crave through 2 subthemes: Crush the Crave promotion and iPhone 5 contest promotion.
Most of the reply posts (214/278, 77.0%) were in response to the supporting smoking cessation posts and the remaining 64 (23.0%) were in response to the marketing Crush the Crave posts.
The most common response to both the supporting smoking cessation and marketing Crush the Crave posts was user engagement with the images associated with each post at 40.2% (86/214) and 45% (29/64), respectively.
The second most common response consisted of users sharing their smoking-related experiences. More users shared their smoking-related experiences in response to the supporting smoking cessation posts (81/214, 37.9%) compared to the marketing Crush the Crave posts (11/64, 17%).
With the exception of 4 posts, a moderator posted all the original posts. In addition, although 56.00% (18,937/33,815) of Crush the Crave Facebook page users were men, only 19.8% (55/278) of the reply posts were made by men.
Finally, men were found to be more likely to express sarcasm or make strong assertions about quitting smoking and Crush the Crave than women.
Conclusions: The CTC Facebook page presents as a unique platform for supporting young adult smoking cessation at all stages of the cessation process. The findings of this study indicate that social networking sites, especially Facebook, warrant inclusion in tobacco control efforts directed towards young adults. Research on effectiveness of the Facebook page for quitting smoking is needed.
The FDA is looking into a new way to regulate drugs and medical devices—by using social media. The agency has drafted social media guidelines that would urge drug companies to use platforms such as Facebook, Twitter, and YouTube, to educate the public about the risks of their prescription drug or medical device.
The draft guidelines, which are currently under review by the agency, propose that companies be required to use the “character space constraints” on social media platforms such as Twitter to tweet the risks, along with the benefits, of a product. The guidelines also recommend that manufacturers include a link that takes readers to more information about the product. In the case of Twitter, that information should all be included in a single tweet.
If a firm concludes that adequate benefit and risk information, as well as other required information, cannot all be communicated within the same character-space-limited communication, then the firm should reconsider using that platform for the intended promotional message.
If approved, the guidelines will become the first formal recommendation by the agency regarding manufacturers’ use of social media.
iPatientCare announced the update of the miGlasss, the first wearable EHR App for the Google Glass, by adding options healthcare professionals will be able to exploit in their day-to-day activities by addressing the new demands a connected working environment presents.
According to iPatientCare, its goal was to give care givers the ability to interact with their patients by accessing the right information whenever they need it to deliver better care.
The new version extends functionality available on the iPad, Android and web to Google Glass. This gives physicians and other practitioners access to patient information while in mid-care, without having to go to their desktop computers, laptops, or tablets to retrieve it. Whether it is X-Rays or MRIs, physicians will now be able to see what they need in real-time.
"We constantly work to explore how doctors can achieve better access to the right information at the right time so they can focus on providing better care to the patients. Physicians are looking for ways to spending quality time with patients rather than spending it on bureaucratic tasks such as entering data into a computer. The ease of use on both ends, namely, the Glass and the EHR, makes the difference,"said Kedar Mehta, CTO, iPatientCare.
The technology available on the miGlass includes:
Web browser based EHR and PM System
Microsoft .net Technology
Services Oriented Architecture
HL7 CCD and ASTM CCR for Interoperability
HL7 Integration with leading Lab
SureScripts/RxHUB Certified ePrescribing
Reporting & Analytics using Cognos and Business Objects
Available on iPhone and iPad
The miGlass app can also be used by patients to provide medication reminders, appointments, alerts, and patient education. Engaging patients with a device they have with them at all times means they will be less likely to make mistakes with their medication, or miss any other kind of therapy, by delivering real-time information.
Researchers from Intermountain Healthcare have developed a smartphone-based test for measuring salivary cortisol, which can help care providers understand the patient’s stress levels. The test can be performed at the point of care in just five minutes.
When someone feels stress, their body’s natural response is to release hormones, including adrenaline and cortisol, to help them deal with the “threat”. When cortisol is released, it increases glucose in the system, but also curbs nonessential functions including the digestive system, the reproductive system and growth processes.
When people feel stress throughout the day, thus releasing too much cortisol, it can lead to anxiety, depression, digestive problems, heart disease, sleep problems, weight gain, and memory and concentration impairment.
To perform the test, care providers use a smartphone’s camera to take a picture using the flash. From there, the image analysis app can identify the user’s cortisol levels.
“When cortisol levels are overlooked too many people suffer and die because of excess or insufficient cortisol,” lead researcher and Intermountain Medical Center Director of Diabetes and Endocrinology Dr. Joel Ehrenkranz said in a statement.
Ehrenkranz also believes this test will be especially helpful for people with diabetes.
The path to unlocking the secrets of the brain is a tough one, but Numenta is making progress with apps like Grok.
Jeff Hawkins and Donna Dubinsky started Numenta nine years ago to create software that was modeled after the way the human brain processes information. It has taken longer than expected, but the Redwood City, Calif.-based startup recently held an open house to show how much progress it has made.
Hawkins and Dubinsky are tenacious troopers for sticking with it. Hawkins, the creator of the original Palm Pilot, is the brain expert and co-author of the 2004 book “On Intelligence.” Dubinsky and Hawkins had previously started Handspring, but when that ran its course, they pulled together again in 2005 with researcher Dileep George to start Numenta.
The company is dedicated to reproducing the processing power of the human brain, and it shipped its first product, Grok, earlier this year to detect unusual patterns in information technology systems. Those anomalies may signal a problem in a computer server, and detecting the problems early could save time.
While that seems like an odd first commercial application, it fits into what the brain is good at: pattern recognition. Numenta built its architecture on Hawkins’ theory of Hierarchical Temporal Memory, about how the brain has layers of memory that store data in time sequences, which explains why we easily remember the words and music of a song. That theory became the underlying foundation for Numenta’s code base, dubbed the Cortical Learning Algorithm (CLA). And that CLA has become the common code that drives all of Numenta’s applications, including Grok.
Hawkins and Dubinsky said at the company’s recent open house that they are more excited than ever about new applications, and they are starting to have deeper conversations with potential partners about how to use Numenta’s technology. We attended the open house and interviewed both Hawkins and Dubinsky afterward. Here’s an edited transcript of our conversations.
Big data analytics technology has been able to find patterns and pinpoint disease states more accurately than even the most highly-trained physicians.
The human brain may be nature’s finest computer, but artificial intelligences fed on big data are making a convincing challenge for the crown. In the realm of healthcare, natural language processing, associative intelligence, and machine learning are revolutionizing the way physicians make decisions and diagnose complex patients, significantly improving accuracy and catching deadly issues before symptoms even present themselves.
In this case study examining the impact of big data analytics on clinical decision making, Dr. Partho Sengupta, Director of Cardiac Ultrasound Research and Associate Professor of Medicine in Cardiology at the Mount Sinai Hospital, has used an associative memory engine from Saffron Technology to crunch enormous datasets for more accurate diagnoses.
Using 10,000 attributes collected from 90 metrics in six different locations of the heart, all produced by a single, one-second heartbeat, the analytics technology has been able to find patterns and pinpoint disease states more quickly and accurately than even the most highly-trained physicians.
Researchers at the American Chestnut Research and Restoration Project, led by William Powell and Charles Maynard of New York University in Syracuse, have created a genetically modified version of the American chestnut that is completely fungus-resistant.
Known as “Darling4,” these homebrewed trees contain the wheat gene OxO, which produces an enzyme that blocks the acid the fungus uses to attack the trees. Even better, after long years of work, the trait appears heritable.
This is a huge step forward. It will hopefully move ecology beyond its too often far-Luddite position and put it in line with current thinking about agriculture—thinking UC Davis plant pathologist Pamela Ronald well-summarized in the Economist:
A premise basic to almost every agricultural system (conventional, organic, and everything in between) is that seed can only take us so far. The farming practices used to cultivate the seed are equally important. GE crops alone will not provide all the changes needed in agriculture. Ecologically based farming systems and other technological changes, as well as modified government policies, undoubtedly are also required. Yet. . . there is now a clear scientific consensus that GE crops and ecological farming practices can coexist, and if we are serious about building a future sustainable agriculture, they must.
This co-existence is critical to the future of the environment as well. And the chestnut is bringing this issue to the fore. Since 2006, scientists have been growing over 1000 of these GE-trees in contained plots, but now they are applying to the US government for permission to move them into the wild. No question about it, the approval process could be sticky.
Not only does the EPA and the Department of Agriculture have to approve this wild-release tree, but because the chestnuts are edible—and because there’s no way for wild chestnut trees to come with the kind of ‘Contains GMO’ labeling that states like Vermont now demand—the FDA will also get to weigh in as well.
The latest beta version of iOS 8 adds a pair of new health-tracking data points to the Health app and one of them won’t even need manual data entry or a wearable device if you have a newer iPhone.
Apple’s iOS 8 Health app can track dozens of health stats through other apps and devices, providing a full picture of your well-being. Now, it can track two more things and one of them can be measured by the iPhone itself.
AppleInsider installed the latest beta version of iOS 8, which was made available on Monday, and found two new functions for Health. First is a step counter card that works directly with the M7 co-processor inside the iPhone 5s — and presumably the next iPhones as well. Second is a new caffeine intake card. Since the M7 chip can’t track that, you’ll likely have to manually enter your caffeine data or use a third-party app such as Jawbone’s UP Coffee.
New software could give people greater control over how their personal health information is shared between doctors and medical institutions—provided that enough health providers decide to use the system.
Today a patient’s data typically stays within a hospital group or doctor’s practice. If you get care elsewhere you are essentially a blank slate unless a special request for your data is made, in which case the entire record becomes accessible. But many patients may not want their entire medical history to be accessible by everyone they see, so there is pressure to develop tools that can be used to limit access. One tricky issue is that redacting details of a diagnosis may not remove all the clues as to that condition, such as prescribed drugs or lab tests.
A new tool developed by computer scientists at the University of Illinois can figure out which parts of a record may inadvertently reveal aspects of a patient’s medical history. The idea is that as data-sharing proposals advance, the patient would decide what parts of his or her record to keep private. A clinician would get advice from the technology on how to amend the record to ensure that this occurs.
The software bases its recommendations on a machine-learning analysis of many other medical records. This reveals what details could be associated with things like mental health episodes, past drug abuse, or a diagnosis of a sexually transmitted disease when the record is shared with another hospital or doctor. The tool could eventually automatically remove those additional details to keep that information confidential.
When it comes to designing, developing and building new mobile healthcare tools, many of the most successful ventures typically have one factor in common: accredited healthcare expertise.
Proof is evident in the foray the Mayo Clinic has made with mHealth technology, as well as other pilots and deployments led by the healthcare institution and providers.
"Our culture of learning, innovation, and the desire to find answers has allowed Mayo to remain at the forefront of health and wellness, and we want to extend this expertise to people anywhere," Paul Limburg, M.D., medical director of Mayo Clinic Global Business Solutions, said in an announcement. "We collaborated with and invested in Better to create a powerful way for people to connect with Mayo Clinic in their homes and communities, wherever they are."
Other top medical institutions are also finding success with mHealth initiatives. For instance, Steven J. Hardy, Ph.D., a pediatric psychologist at Children's National Health System in the District of Columbia, wants to engage families and patients in conversations about how they're managing illness and use mobile gaming as the tool to do so.
Speaking with FierceMobileHealthcarein an exclusive interview, Hardy discussed a pilot the hospital is conducting for children with sickle cell disease. The kids play a game on a mobile platform (in this case, an iPad) that helps them with an often-overlooked symptom of sickle cell disease--memory loss.
And a Harvard Innovation Lab startup aims to bolster patient treatment by enhancing coordination and communication among caregivers with an mHealth app that lets healthcare teams text, share images and videos and always have a patient list within reach.
Considering the pace of technological growth in recent decades, the convergence of humans and machines seems a foregone conclusion. Yet, unlike most machines, the body is far too flexible and squishy for modern advanced materials. So it falls on researchers to develop new stretchable technologies that are easily manufactured and relatively inexpensive.
Recently, a biomedical engineering team at Purdue University developed a methodology to generate zigzag patterns out of conventional wire that can extend up to five times in length. The wires can be utilized as conductive interconnects between sensors, allowing for flexible networks or meshes to be embedded or wrapped around 3D objects.
“This compares to only a few percent for an ordinary metal connection,” said Professor Barak Ziaie, leading the research in the press release. “The structures are also highly robust, capable of withstanding thousands of repeated stretch-and-release cycles.”
Even more intriguing, the approach utilizes a standard sewing machine to fabricate the system.
Using water-soluble thread, the technique involves stitching wire in zigzags onto standard transparencies used with overhead projectors.
A commercially available elastomer called Ecoflex is poured over the sheet and allowed to solidify. The thread is dissolved with warm water, allowing the flexible polymer with the embedded wires to be separated from the transparencies.
To demonstrate how their approach could be used for medical devices, the team generated a sensor system that wraps around a urinary catheter balloon - as the balloon inflates, the sensor gauges the strain.
This flexible system can measure much greater expansion than conventional approaches that employ rigid metal films that permit only small percentages of stretching before breaking.
Many recent headlines regarding DNA and genetic science have been complex and hard for the average person to relate to. When the technology saves a young person's life, such as what happened recently at the University of California, San Francisco, the science takes on human qualities, and as a public, we can truly grasp just how important and revolutionary this combination of biology and technology really is.
Dr. James Gern, a professor of pediatrics and medicine at the University of Wisconsin School of Medicine and Public Health in Madison, contacted Joseph DeRisi for help after his patient, a 14-year-old boy, was hospitalized with encephalitis. The prognosis was so severe that the young man had been hospitalized for six weeks and put into a medically induced coma, according to a press release.
None of the tests and procedures run so far had managed to point out the cause of the boy’s illness. Gern contacted DeRisi, chair of biochemistry and biophysics at UCSF, due to his expertise in new genomic techniques. These techniques involved identifying pathogens that were previously unknown, such as that which caused the young man's illness. According to DeRisi, with this new technology, essentially any pathogen can now be detected with a single test. Once the cause was found, correct treatment could be administered.
The case study can be found published online in the New England Journal of Medicine.
Using SURPI, a tool used in “next generation-sequencing,” a team of researchers quickly and efficiently found the cause of the young man’s illness.
With the help of the technology, the team compared samples of the boy’s DNA to the GenBank databases maintained by the National Center for Biotechnology Information with awe-inspiring speed, doing in 96 minutes what before took at least a day.
Researchers determined that 475 distinct DNA sequences among the three million DNA sequences obtained in the patient’s cereospinal fluid came from a type of bacteria called Leptospira.
The team was even able to pinpoint the exact strain of Leptospira that they boy had been contaminated with: one native to the Caribbean and warmer climates.
Based on these findings, researchers decided to treat the boy using penicillin without having the diagnosis validated with a clinically approved test.
The antibiotics treatment was successful in ridding the boy’s body of infection, and he was discharged and sent home shortly afterward.
Validation by a clinically approved test could have taken upward of five months to confirm, and by this time the boy may not have survived.
Advertisers aren't the only ones interested in your spending habits — hospitals and insurance companies are taking note as well. Carolinas HealthCare, which operates hundreds of healthcare facilities from hospitals to nursing homes and care centers throughout North and South Carolina, is purchasing transaction data and other information on its patients to try and get ahead of any medical problems, according toBloomberg Businessweek.
The data, including purchase history and information like car loans, is put through an algorithm that gives a risk score to patients. That score can then be shared with doctors. A representative from Carolinas HealthCare tells the magazine that it plans to start routinely giving those scores to health-care professionals in two years' time, and it hopes to do more with the data.
It currently can't pass along detailed information — like what its patients are purchasing — to doctors, but the company hopes it can renegotiate with its (undisclosed) data provider to give professionals access to that as well. Nevertheless, under the current system, data like whether patients have open gym memberships or how often they purchase cigarettes is used in the score calculation.
Both insurance companies and hospitals are interested in using consumer data in this way to help cut costs. While insurance companies are no longer allowed to increase premiums or deny coverage under Obamacare based on preexisting health conditions, companies can save money by trying to proactively prevent health conditions based on the data. Alternatively, hospitals can identify patients who are likely to heavily lean on emergency room visits instead of regular check-ups, and proactively provide resources to help cut down costly ER trips.
A recent international survey by the McKinsey & Company consulting firm addresses some myths about consumer use of digital healthcare services.
Many healthcare executives believe that, due to the sensitive nature of medical care, patients don’t want to use digital services except in a few specific situations. Decision makers often cite relatively low usage of digital healthcare services. Results of this survey however reveal something quite different.
The 5 myths debunked by this survey are as follows
Myth 1: People don’t want to use digital services for healthcareMyth 2: Only young people want to use digital services
Myth 3: Mobile health is the game changer
Myth 4: Patients want innovative features and apps
Myth 5: A comprehensive platform of service offerings is a prerequisite for creating value
Wearables, devices used to sense data and process it into information, are generating quite the buzz in healthcare these days. But down the line, does that buzz come with a sting?
In Wearable Tech News, Tony Rizzo reports wearable technology spending predictions of $50 billion by 2018. He also reports on a ground-breaking, glucose-sensing contact lens for diabetics that will be a “true solution for a very real medical problem that affects hundreds of millions of people.”
By 2016, wearable wireless medical device sales will reach more than 100 million devices, according to a Cisco blog on the future of mobility in healthcare. The importance of these devices is that healthcare professionals can access critical data via mobile apps before, during and after a patient’s hospitalization, thus boosting the speed and accuracy of patient care, the blog says.
The Age of Wearables has a few caveats, though – note that a doctor “can,” “could,” “may” or “potentially” be able to monitor a patient from a wearable, as the products are still under development. One product cites unpublished research as support, and another uses a modality, thermography, that the National Cancer Institute states has no additional benefit for breast cancer screening.
The new, intense focus on wearables is the engagement of the general public, both the ill and the well, and how they collect and transmit patient information to physicians and EHRs. This presents two challenges:
1. Are physicians prepared for this tidal wave of data and information?
2. What is the true cost of the data surge versus its benefits?
Like all healthcare information technology, wearables have huge potential – married to massive challenges.
On December 5, 2011, Andrew Meas wiggled his toes for the first time since a motorcycle accident four years earlier paralyzed him from the chest down. Within a week, he was beginning to stand. Meas’s remarkable (albeit partial) recovery comes courtesy of a groundbreaking use of an electrode array implanted over his spinal cord.
For decades, researchers have been seeking ways to help the millions of people with spinal cord injuries regain control of their limbs, with frustratingly little success. The new device provides a rare glimmer of hope. Scientists at the University of Louisville’s Kentucky Spinal Cord Injury Research Center, where Meas and three other patients received their implants, speculate that the stimulation may be reawakening connections between the brain and the body. “There’s residual circuitry that we can recover that no one realized was possible to do,” says Reggie Edgerton, director of the Neuromuscular Research Laboratory at the University of California, Los Angeles. “We were shocked.”
Some of the benefits, such as better bowel and bladder control and improved blood pressure, remain even when the device is switched off. Electrical stimulation isn’t a cure, of course. The patients still can’t walk. And the stimulation must be customized for each individual, a time-consuming process. But it’s an enormous advance nonetheless. Says Edgerton, “It opens up a whole new mechanism of recovery.”
The U.S. military has chosen two universities to lead a program to develop brain implants to restore memory to veterans who have suffered brain injuries, officials said at a news conference Tuesday.
The Restoring Active Memory (RAM) program is a project of the Defense Advanced Research Projects Agency (DARPA), the branch of the U.S. Department of Defense charged with developing next-generation technologies for the military. The initiative aims to develop wireless, fully implantable "neuroprosthetics" for service members suffering from traumatic brain injury or illness, DARPA Program Manager Justin Sanchez said at the news conference.
DARPA has selected two teams of researchers to develop the implants: The University of California, Los Angeles (UCLA) and the University of Pennsylvania, in Philadelphia.
Currently, few treatments for TBI-related memory loss exist, but DARPA is trying to change that, Sanchez said. Deep brain stimulation, the use of implanted electrodes to deliver electrical signals to specific parts of the brain, has already demonstrated success in treating Parkinson's disease and other chronic brain conditions. Building on these advances, "we're developing new neuroprosthetics to bridge the gap in an injured brain to restore memory function," Sanchez said.
The UCLA team will focus on studying memory processes in the entorhinal cortex, an area of the brain known as the gateway of memory formation. Researchers will stimulate and record from neurons in patients with epilepsy who already have brain implants as part of their monitoring and treatment. The researchers will also develop computer models of how to stimulate the brain to re-establish memory function.
The University of Pennsylvania team will focus more on modeling how brain circuits work together more broadly, especially those in the brain's frontal cortex, an area involved in the formation of long-term memories. The university is collaborating with Minneapolis-based biomedical device company Medtronic to develop a memory prosthesis system.
In 2011, a 52-year-old runner and yoga enthusiast walked into the office of Monica Loghin, a neuro-oncologist at MD Anderson Cancer Center in Houston, complaining of numbness and weakness in her lower limbs and difficulty controlling her bladder.
The symptoms were of grave concern, as the patient had previously undergone surgery for breast cancer that had spread to her brain. If such a cancer returns post-surgery, that is often a sign the patient doesn’t have much time left.
An MRI confirmed that the breast cancer had again spread to the woman’s cerebrospinal fluid. Loghin ordered testing of that fluid to see if the patient might have certain biomarkers that could be targeted by existing drugs. (A biomarker is a DNA sequence or protein associated with the disease; different biomarkers can suggest specific treatments, depending on the disease and other factors.) She asked for tests that could detect tumor cells circulating in the blood.
The cancer cells in the fluid bathing the woman’s spinal cord and brain chambers did, in fact, have a lot of the protein that controls a glucose (sugar) transporter that drives cancer cells. The cancer cells in the fluid also had a lot of HER2, a protein associated with aggressive breast cancers but also treatable with a drug called Herceptin (trastuzumab). The drug is usually taken intravenously, but Loghin had heard of a couple of cases in which Herceptin was delivered directly into the cerebrospinal fluid via a flexible tube, or catheter. The patient agreed to this experimental treatment.
It took only a week for the news to improve. After the first infusion of Herceptin, the patient’s cancer numbers were down. Within a few weeks, her cancer cell numbers had fallen so low that her immune system had begun to take over, clearing out the remaining cancer cells. Nearly two and a half years later, the patient is still alive and well enough to do yoga. Another MD Anderson patient who had a similar disease profile and therapy is also alive and well one year after treatment.
This case outlines the dream of personalized medicine: A disease is analyzed at the molecular level. The analysis identifies a drug target. The drug gets delivered where it needs to go. The patient gets better. And while this hopeful scenario has yet to become commonplace, it is becoming more and more the norm for many breast cancer patients.
Depression is one of the hardest disorders to diagnose, yet it affects 14 percent of the world’s population. Researchers have found factors in EHRs may be key to predicting a diagnosis of depression.
While depression comes at a high cost to those who suffer from it, the actual price tag in the United States reaches over $44 billion annually. This takes into account, among other things, lost productivity and direct expenses. Depression is a diagnosis that is often missed by primary care physicians, despite the fact that it is the second most common chronic disorder they treat.
According to EHR Intelligence, researchers from Stanford University have worked to use EHR systems as a tool to help predict depression diagnoses. In the study, published by the Journal of the American Medical Informatics Association, researchers say valuable information already stored in the EHR can be used to predict depression up to a year in advance.
“Depression is a prevalent disorder difficult to diagnose and treat. In particular, depressed patients exhibit largely unpredictable responses to treatment,” explain researchers. “Many depressed patients are not even diagnosed … primary care physicians, who deliver the majority of care for depression, only identify about 50 percent of true depression cases.”
The Stanford team used EHR data including demographic data, ICD-9, RxNorm, CPT codes, progress notes, and pathology, radiology, and transcription reports. From these, they used a model which factored in three criteria: the ICD-9 code, the presence of a depression disorder term in the clinical text, and the presence of an anti-depressive drug ingredient term in the clinical text.
These factors were then compared to predict a diagnosis of depression, response to treatment, and determine the severity of the condition.
If you believe that Population Health Management is about reporting and analytics then you only know half the story. Yes, having the right Population Health Management tools eases the pain associated with delivering performance or compliance reports, demonstrating Meaningful Use and meeting Patient Centered Medical Home requirements. The right tools will also allow you to view and analyze data from targeted populations and compare your organization’s performance against others in your peer group.
The next evolution of Population Health Management, what I refer to as Population Health 2.0, will demand a greater focus on these three key truths:
A University of Pennsylvania-developed personalized immunotherapy has been awarded the U.S. Food and Drug Administration’s Breakthrough Therapy designation for the treatment of relapsed and refractory adult and pediatric acute lymphoblastic leukemia (ALL). The investigational therapy, known as CTL019, is the first personalized cellular therapy for the treatment of cancer to receive this important classification.
In early-stage clinical trials at the Hospital of the University of Pennsylvania and the Children’s Hospital of Philadelphia, 89% of ALL patients who were not responding to conventional therapies went into complete remission after receiving CTL019.
The investigational treatment pioneered by the Penn team begins by removing patients' T cells via an apheresis process similar to blood donation, then genetically reprogramming them in Penn’s Clinical Cell and Vaccine Production Facility. After being infused back into patients’ bodies, these newly built “hunter” cells both multiply and attack, targeting tumor cells that express a protein called CD19. Tests reveal that the army of hunter cells can grow to more than 10,000 new cells for each single engineered cell patients receive.
Researchers say European commission-funded initiative to simulate human brain suffers from 'substantial failures'
The world's largest project to unravel the mysteries of the human brain has been thrown into crisis with more than 100 leading researchers threatening to boycott the effort amid accusations of mismanagement and fears that it is doomed to failure.
More than 80 European and international research institutions signed up to the 10-year project.
But it proved controversial from the start. Many researchers refused to join on the grounds that it was far too premature to attempt a simulation of the entire human brain in a computer. Now some claim the project is taking the wrong approach, wastes money and risks a backlash against neuroscience if it fails to deliver.
In an open letter to the European commission on Monday, more than 130 leaders of scientific groups around the world, including researchers at Oxford, Cambridge, Edinburgh and UCL, warn they will boycott the project and urge others to join them unless major changes are made to the initiative.
The researchers urge EC officials who are now reviewing the plans to take a hard look at the science and management before deciding on whether to renew its funding. They believe the review, which is due to conclude at the end of the summer, will find "substantial failures" in the project's governance, flexibility and openness.
Central to the latest controversy are recent changes which sidelined cognitive scientists who study high-level brain functions, such as thought and behaviour. Without them, the brain simulation will be built from the bottom up, drawing on more fundamental science, such as studies of individual neurons. The brain, the most complex object known, has some 86bn neurons and 100tn connections.
Sir Colin Blakemore, professor of neuroscience at the University of London, who is not one of the signatories to the letter, said: "It's important that the review should be thorough and, if necessary, critical. But it would be unfortunate if this high-profile project were to be abandoned. There's enough flexibility in the plans to allow the project to be refocused and re-energised.
"The most important thing is that the goals should be realistic. If they promise the politicians cures for dementia or miraculous breakthroughs in artificial intelligence, but don't really deliver them, it might have a negative impact on the whole funding of neuroscience in the future – and that would be a disaster.".
Coordinated care for chronic diseases in kids is now part of the school nurse's terrain. In some states, nurses are getting access to EHR data.
Although the school nurse is a familiar figure, school-based health care is unfamiliar territory to many medical professionals, operating in a largely separate health care universe from other community-based medical services.
Now, as both schools and health care systems seek to ensure that children coping with chronic conditions such as diabetes and asthma get the comprehensive, coordinated care the students need, the schools and health systems are forming partnerships to better integrate their services. In these projects, some funded by the health law, school health professionals gain access to students' electronic health records and/or specialists and other health system resources. Such initiatives currently exist or are on the drawing board in Delaware, Miami and Beaverton, Ore., among other locations.
School nurses today do a lot more than bandage skinned knees. They administer vaccines and medications, help diabetic students monitor their blood sugar, and prepare teachers to handle a student’s seizure or asthma attack, among many other things.
A 2007 study found that 45 percent of public schools have a full-time nurse on site, while 30 percent have one who works part time. In addition to school nurses, 12.5 percent of school districts have at least one school-based health center that offers both health services and mental health or social services, according to the federal Centers for Disease Control and Prevention’s 2012 Schools Health Policies and Practices Study. School nurses often work closely with school-based health centers, referring students there as needed.
So far the internet of things hasn’t made much headway into patient care in the medical setting, but consumers are buying wellness devices for a variety of reasons. Will the medical world embrace that data?
The intersection of healthcare and connected devices was thrown into high relief these last few weeks as both Apple and Samsung unveiled ecosystems to take consumer health data and turn it into actionable intelligence.
But this week’s guests at the Weekly podacst at GigaOm are confident that as advanced as consumer-grade consumer grade health devices get, they won’t become something doctors are hot on for years to come — if ever.
In this week’s podcast Stacey Higginbotham discusses medical connected devices and where it may meet the consumer with Rick Valencia from Qualcomm Life. Will doctor’s prescribe our apps or devices?
Information that may offer medical insights has been locked away in the filing cabinets of doctors' offices.
Researchers at IBM, Berg Pharma, Memorial Sloan Kettering, UC Berkeley and other institutions are exploring how artificial intelligence and big data can be used to develop better treatments for diseases
But one of the biggest challenges for making full use of these computational tools in medicine is that vast amounts of data have been locked away — or never digitized in the first place.
The results of earlier research efforts or the experiences of individual patients are often trapped in the archives of pharmaceutical companies or the paper filing cabinets of doctors’ offices.
Patient privacy issues, competitive interests and the sheer lack of electronic records have prevented information sharing that could potentially reveal broader patterns in what appeared to any single doctor like an isolated incident.
When you can analyze clinical trials, genomic data and electronic medical records for 100,000 patients, “you see patterns that you don’t notice in a couple,” said Michael Keiser, an instructor at the UC San Francisco School of Medicine.
Given that promise, a number of organizations are beginning to pull together medical data sources.