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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
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.
Background: Mobile text messages are a widely recognized communication method in societies, as the global penetration of the technology approaches 100% worldwide. Systematic knowledge is still lacking on how the mobile telephone text messaging (short message service, SMS) has been used in health care services.
Objective: This study aims to review the literature on the use of mobile phone text message reminders in health care.
Conclusions: We can conclude that although SMS reminders are used with different patient groups in health care, SMS is less systematically studied with randomized controlled trial study design. Although the amount of evidence for SMS application recommendations is still limited, having 77% (46/60) of the studies showing improved outcomes may indicate its use in health care settings. However, more well-conducted SMS studies are still needed.
more at : http://www.jmir.org/2014/10/e222/
An object in your pocket could help diagnose rare diseases like Ebola, finds David Robson – and one day it might even replace the doctor’s surgery too.
As fear of the Ebola virus escalates, Eric Topol thinks that we’re missing an important weapon. And you just need to reach into your pocket to find it. “Most communicable diseases can be diagnosed with a smartphone,” he says. “Rather than putting people into quarantine for three weeks – how about seeing if they harbour it in their blood?” A quicker response could also help prevent mistakes, such as the patient in Dallas who was sent home from hospital with a high fever, only to later die from the infection.
It’s a provocative claim, but Topol is not shy about calling for a revolution in the way we deal with Ebola – or any other health issue for that matter. A professor of genomics at the Scripps Research Institute in California, his last book heralded “the creative destruction of medicine” through new technology. Smartphones are already helping to do away with many of the least pleasant aspects of sickness – including the long hospital visits and agonising wait for treatment. An easier way to diagnose Ebola is just one example of these sweeping changes.
So far, however, few doctors have embraced these possibilities. “The medical cocoon has not allowed a digital invasion,” says Topol, “while the rest of the world has already assimilated the digital revolution into its day-to-day life.” That’s not due to lack of demand: many patients are already monitoring their health through their phone, with apps that check your skin for cancer from a selfie, for example. These programs are not alwaysdesigned with the accuracy most doctors would require, however – and some fear that by missing a diagnosis and offering a false sense of security, they could cost lives. “The slower the healthcare system is in exploring these things, the more people are at risk by doing the exploration on their own,” says Estrin.
My associates and I have built a mobile Ebola diagnosis and data collection prototype. If interested in exploring possible uses of the same for your organization, please drop me a message.
The big hairy audacious goal of most every data scientist I know in healthcare is what you might call the Integrated Medical Record, or IMR, a dataset that combines detailed genetic data and rich phenotypic information, including both clinical and “real-world” (or, perhaps, “dynamic”) phenotypic data (the sort you might get from wearables).
The gold standard for clinical phenotyping are academic clinical studies (like ALLHAT and the Dallas Heart Study). These studies are typically focused on a disease category (e.g. cardiovascular), and the clinical phenotyping on these subjects – at least around the areas of scientific interest — is generally superb. The studies themselves can be enormous, are often multi-institutional, and typically create a database that’s independent of the hospital’s medical record.
Inevitably, large, prospective studies can take many years to complete. In addition, there’s generally not much real world/dynamic measurement.
The other obvious source for phenotypic data is the electronic medical record (EMR). The logic is simple: every patient has a medical record, and increasingly, especially in hospital systems, this is electronic – i.e. an EMR. EMRs (examples include Epic and Cerner) generally contain lab values, test reports, provider notes, and medication and problem lists. In theory, this should offer a broad, rich, and immediately available source of data for medical discovery.
DIY (enabled by companies such as PatientsLikeMe) represents another approach to phenotyping, and allows patients to share data with other members of the community. The obvious advantages here include the breadth and richness of data associated with what can be an unfiltered patient perspective – to say nothing of the benefit of patient empowerment. An important limitation is that the quality and consistency of the data is obviously highly dependent upon the individuals posting the information.
Pharma clinical trials would seem to represent another useful opportunity for phenotyping, given the focus on specific conditions and the rigorous attention to process and detail characteristic of pharmaceutical studies. However, pharma studies tend to be extremely focused, and companies are typically reluctant to expand protocols to pursue exploratory endpoints if there’s any chance this will diminish recruitment or adversely impact the development of the drug.
The performance of an electronic health record (EHR) system can mean the difference between a thriving practice and a struggling one. These systems impact every aspect of medical care, from the car
As Ebola continues to ravish Sierra Leone, Guinea and Liberia, people from all around the world are working together to stop the disease. In addition to the life saving work of medical staff, logisticians and community organizers, information and communication technology (ICT) is also playing a vital part in supporting their work. Below are six examples showing how ICT is already making a difference in the current Ebola crisis.
1. Tracing outbreaks with mapping and geolocation
2. Gathering Ebola information with digital data collection forms
3. Connecting the sick with their relatives using local Wi-Fi networks
4. Sharing and receiving Ebola information via SMS text messages
5. Mythbusting for diaspora communities via social media
6. Supporting translations of Ebola information remotely online
Adding to this list, my associates and I have built a mobile Ebola diagnosis and data collection prototype. If interested in exploring possible uses of the same for your organization, please drop me a message.
The world of medicine could become a lot cheaper, thanks to a team of researchers at Michigan Technological University (MTU).
Engineer Joshua Pearce and his team of researchers at MTU created an entire digital library of open source designs for a particular medical device, a syringe pump. Each design comes in the form of a printable file that can be 3D printed with aRepRap 3D printer, and each file can be customized by doctors according to their needs. The team posted their findings in a research paper titled Open-Source Syringe Pump Library.
Professional medical syringe pumps, which are frequently used by doctors for drug delivery to administer precise amounts of medicine, can cost between hundreds to thousands of dollars. By creating an open library of customizable printable syringe pump files, the team at MTU have enabled anyone with access to a 3D printer to attain a pump for a fraction of the cost. Whereas syringe pumps would previously cost thousands of dollars, doctors can now print them for nothing more than the cost of filament.
“Not only have we designed a single syringe pump, we’ve designed all future syringe pumps,” said Pearce. “Scientists can customize the design of a pump for exactly what they are doing, just by changing a couple of numbers in the software.”
Pearce and his team tested out the library for themselves, using a 3D printer to print various pump designs. They decided to expand their idea even further and incorporate a Raspberry Pi as a wireless controller. With the Raspberry Pi, they could control the syringe pump remotely. This breakthrough could allow doctors to control medical devices even while not physically present.
More at :
At the Food and Drug Administration, a small team of scientists is investigating how 3-D imaging — the technology used to create more realistic animations in video games and movies — could transform medical screening devices.
The scientists are focused on early breast cancer detection; in a process known as tomosynthesis, new screening machines take low-dose X-rays from various angles, overlaying them to produce a 3-D rendering of a patient’s breast. Traditional mammograms create a 2-D image, and cannot show cancers hidden by overlapping tissue, according to the FDA, which last week released a consumer update on the new technology to coincide with the start of Breast Cancer Awareness month.
Though 3-D screening machines are years from becoming commonplace in hospitals, FDA researchers say they are trying to keep up with an industry-wide transition from two- to three-dimensional imaging.
“Other industries are developing displays and fast computers that can be incorporated or utilized in [medical] images,” said Mary Pastel, deputy director for radiological health in the FDA’s office of in vitro diagnostics and radiological health. “The challenge for the FDA and industry is, at what point are those kinds of devices effective enough for the unique challenge of displaying medical images? Certainly Pixar images in movies can be moving toward quite realistic rendering, but there are substantial challenges displaying medical images with a very high pixel [rate].”
First, check your pulse, then, open this app.
If it were that easy, we could all be stars of the Japanese TV drama as referenced in the Code Blue series. However, real life codes are usually all too hectic and stress inducing especially for the new graduating medical class that just started their intern year. Here, imedicalapps.com is reviewing the top iPhone “code” apps available on the market.
We should mention the obvious caveat — you should know how to handle code blue / ACLS scenarios without having to use an app or even without having to use the commonly used pamphlets people carry with them.
That said — these apps can often times help you control the adrenaline that is flooding your veins in these high acuity settings.Medirate
Conclusion: Simple, effective
Price: Free on iPhone app store
Rating: 4 Stars ( User Interface: 4, Multimedia: 4, Price: 5, Real World Applicability: 4)
Conclusion: Do not download
Rating: 0.5 Stars ( User Interface: 1, Multimedia: 1, Price: 0, Real World Applicability: 0)
Conclusion: A great app in the making but it has not been updated since 2011. As an “orphaned” app it is useless. While I was excited about the previous medical app, it is now dead and unless we find a functional option, so will our patient!
The Code Runner Lite
Conclusion: Great app with two main features: 1) Protocol is that helps with prompts but does not allow editing and 2) thorough differential section for PEA protocol. This app is another orphaned app, so I recommend only the lite version and limit use to the differentials section for early learning (as those have not changed much with time).
Rating: 4 Stars ( User Interface: 4, Multimedia: 3, Price: 4, Real World Applicability: 4) The ability to work through a differential of Pulseless Electrical Activity makes The Code Runner Lite a good backup option for new interns, but with the timer for epinephrine at every four minutes and the app orphaned since 2010, users are still limited in their ability to run a full code without running into limitations of the medical apps. Unless we find a workable app soon, we are going to have to call an end to it.
Conclusion: Sometimes you need to keep to the basics.
Rating: 4 Stars ( User Interface: 4, Multimedia: 2, Price: 5, Real World Applicability: 4) At least we now have good CPR going, we now have the luxury of time to keep searching.
Conclusion: Still PDF format for code protocols, but it has a nice quizzes for learning.
Rating: 3 Stars ( User Interface: 4, Multimedia: 2, Price: 5, Real World Applicability: 2) Although still limited to PDF style format for the code protocols, this application does have the added features of including a timer, code quiz, and rhythm quiz. It still suffers from lack of medical input in its creation.
Conclusion: The style is great for editing but it does not offer the user much information, only a template that can be edited. This, however, is actually a plus in my mind.
Recommendations: Add easily accessible resources like The Code Runner Lite has offered
Price: $ 2.99
Rating: 4.5 Stars ( User Interface: 4, Multimedia: 5, Price: 4, Real World Applicability: 4)
Full Code Pro
Conclusion: Simple and effective
Recommendations: Add either audible or vibrating reminders as it is easy to miss the timers if you are not actively looking at the screen.
Price: $ 2.99
Rating: 4 Stars ( User Interface: 4, Multimedia: 3, Price: 4, Real World Applicability: 5)
Much of the chatter around electronic health records (EHRs) revolves around efficiency and cost cutting in clinical practice. There is even a bit of discussion about the use of EHRS to improve population health. But is there more benefit to be found in individual patient health?
Perhaps the greatest potential of the EHR, (and the concept applied to a broader application, the EMR) lies in the role it can play in predicting clinical outcomes around a range of diseases and conditions.
This application is still very much in its fledgling stage, but here are just a few examples of how data analytics, when applied to EHRs in mindful ways, can bring about positive changes in patient health.
One of the most recent examples we saw came out of UC Davis. Researchers there found that, by compiling and analyzing routine information — blood pressure, respiratory rate, temperature, and white blood cell count — as pulled from EHRs, they were able to predict early stages of sepsis, a condition that is a leading cause of hospitalization and death in the U.S. It took them only three measures — lactate level, blood pressure, and respiratory rate — to calculate the likelihood that a patient would die from the condition.
Progressing Kidney Disease
Data from EHRs has also played a key role in predicting the need for dialysis after a patient with chronic kidney disease progresses into kidney failure.
The Journal Of The American Medical Association in 2011 studied patients who were referred to nephrologists between April 1, 2001, and December 31, 2008, in an effort to develop and validate predictive models for the progression of chronic kidney disease.
According to the study, “Our models use laboratory data that are obtained routinely in patients with CKD and could be easily integrated into a laboratory information system or a clinic EHR.” It also notes that emerging literature suggests that the methods lead to “improved patient outcomes with individualized risk prediction and with advances in information technology that allow for easy implementation of risk prediction models as components of EHRs.”
All data for the study where pulled from nephrology clinic EHRs.
EHRs have also been used to improve cardiovascular risk prediction. A study (available from the National Institutes Of Health), analyzed whether internal EHR data (using flexible, adaptive statistical methods) could improve clinical risk prediction. The study used the fact that EHRs have been extensively implemented in the VA system as an opportunity for exploration.
It found that, “despite the EHR lacking some risk factors and its imperfect data quality, health care systems may be able to substantially improve risk prediction for their patients by using internally developed EHR-derived models and flexible statistical methodology.”
Another prevalent health issue in the U.S., hypertension, has seen researchers apply predictive analytics using EHR data to gain more insight into the disease. This study, from the Journal Of Informatics In Health And Biomedicine, sought to identify transition points at which hypertension is brought in, as well as pushed out of, control, through the use of EHR data.
The study of 1294 patients with hypertension (who were enrolled in a chronic disease management program at the Vanderbilt University Medical Center) found that accurate prediction of transition points from a control status could be achieved
Janssen Research and Development, a Johnson & Johnson pharmaceutical company, is looking into 3D printing living tissue for drug research, according to a document filed with the SEC Thursday. The company will partner with Organovo, an expert in bioprinting.
Organovo has 3D-printed everything from blood vessels to thyroid tissue, and has long-term plans to print entire organs. Later this year it will begin offering liver tissue to drug companies for testing the toxicity of drugs — its first commercial product.
Janssen is more interested in using 3D-printed tissue to discover drugs. By exposing many different 3D-printed cells to many different early-stage drugs, it can determine which are the most effective. Janssen and Organovo did not disclose further details about the agreement.
“Researchers who develop new therapies for patients are too often hampered by animal models and traditional cell culture models that are poor predictors of drug efficacy and toxicity in human beings,” Organovo CEO Keith Murphy said in a January release. “Our 3D printer creates living human tissues that more closely reproduce in vivo human tissues.”
QNX OS for Medical 1.1 is important because it has been built to comply with the International Electrotechnical Commission (IEC) 62304 medical device standard.
This is significant because the same standard is accepted in both the United States and the European Union. The fact that the OS has been certified for IEC 62304 saves medical device manufacturers a lot of time and money, because they do not have to recertify that part of their product design. QNZ has done the hazard and risk analysis, and has security features built into the OS. The system also supports graphic displays, touch screen input, and video capture.
QNX also understands the problems of mobile computing technology, so the company is in a good position to support a wide variety of medical monitoring and diagnostic devices.
The perioperative environment is commonly acknowledged as one of the hospital’s most complex.
This condensed and complex environment is precisely why complete command and control of the OR is imperative – and why mobile technology is an optimal path for helping achieve it.
In particular, mobility offers three distinct advantages that support command and control and help ensure all parties have the information they need to keep workflow and patient flow moving:
1. A near real-time, patient-centric OR perspective
During this highly compressed episode of care, a patient is treated by a team of clinicians who are often from different departments. In addition, supporting staff such as surgical scrubs and radiology play an important part in efficient patient movement. Having a single, shared view of patient milestones – for instance, when prophylactic antibiotics are administered, anesthesia is induced and the incision is made, or surgery is complete and the patient is on his way to PACU – allows the entire care team to know exactly what is happening which supports the delivery of more coordinated care. Giving everyone this same view on a mobile device can further synchronize care among disparate care providers.
As a result, the patient is more likely to move efficiently between care events, and clinicians are less likely to miss specific timing for milestones such as medication administration.
2. A comprehensive OR view supports better decisions with fewer interruptions
A patient-centric view enables the OR team to keep one patient on the most efficient, highest quality care path. Sometimes, however, this path requires an adjustment that can impact the entire OR.
The BBC has launched an Ebola public health information service on WhatsApp, aimed at users of the service in West Africa.
The service will provide audio, text message alerts and images to help people get the latest public health information to combat the spread of Ebola in the region.
Content will be limited to three items a day, and the service will be in English and French.
To subscribe, send 'JOIN' via WhatsApp to +44 7702 348 651
To unsubscribe, send 'STOP' via WhatsApp to the same number.
Due to the volume of requests, it may take a little time to be added or removed from the service.
As the biggest "chat app" in use in Africa, the platform is being used as a means of reaching people in the region directly through their mobile phones.
The response to Ebola is now the BBC World Service's biggest health information drive since its reporting on HIV/Aids in the 1980s and 1990s. In addition to the WhatsApp service, the BBC is offering a range of content on radio, online and TV, including special Ebola bulletins in several languages.
This is an excellent example how we can help spread information and awareness to help contain epidemics using simple , everyday use tools. For the many who like the over use of popular keywords - well this is mobile health (#mHealth) being applied effectively :)
The face of medical care is rapidly changing thanks to major advancements in the capture, proliferation, and analysis of medical data. Technologies like the electronic health records (EHRs) and personal health records (PHRs) are drastically improving the way data is aggregated and shared.
Now the hope is that big data analytics will help to make sense of seemingly endless streams of medical information.
These big data analytics applications can also be relevant for the FDA, which may want to see how drugs perform in a non-test environment to ensure the appropriate patient populations are receiving the drug. I also expect pharmaceutical companies to actively scour this data to track drug efficacy post-release or identify markets that could “benefit” from increased penetration.
I am eager to see how the data evolution improves outcomes for doctors and patients.
Searching the web for symptoms of illness can be dangerous -- you could identify a real condition, but you also risk scaring yourself for no reason through a misdiagnosis.
Google might have a solution that puts your mind at ease, though.
The company has confirmed to Engadget that it's testing a Helpouts-style feature which offers video chats with doctors when you search for symptoms. While there aren't many details of how this works in practice, the search card mentions that Google is covering the costs of any chats during the trial phase.
You'll likely have to pay for virtual appointments if and when the service is ever ready for prime time, then. That's not ideal, but it could be much cheaper than seeing a physician in person.
Physicians continue to express dissatisfaction with the usability and the workflow features of electronic health records (EHRs), yet these information systems don’t seem to improve.
One reason, experts say, is that vendors have poured most of their research and development budgets into meeting the requirements for meaningful use (MU) and the International Classification of Diseases-10th revision (ICD-10).
Despite all of this, however, some innovations are starting to enhance the usability of EHRs.
- See more at:
An app which enables healthcare professionals to share photos is to be rolled out across western Europe by the end of the year.
The app was designed to enable doctors to share pictures of their patients, both with each other and with medical students.
So far, more than 150,000 doctors have uploaded case photos with the patient's identity obscured.
However, some experts have expressed concern about patient confidentiality.
Patients' faces are automatically obscured by the app but users must manually block identifying marks like tattoos.
Each photo is reviewed by moderators before it is added to the database.
Late last month, TechnologyAdvice released an interesting study looking at whether most people want to use health wearables such as fitness trackers and other tools for health purposes.
Here are the top-line results of this study:
- 75 percent of U.S. adults do not track their weight, diet, or exercise using a health tracking apps or devices
- 43.7 percent had no specific reason for not tracking their fitness
- 27.2 percent won’t use these devices due to lack of interest
- 25.1 percent of adults are currently using either a fitness tracker or a smartphone app to monitor their health, weight, or exercise.
This sounds like pretty bad news for those who believe the era of health wearables is here. But, this study also raises another question: Are health wearables evangelists fools?
Fard Johnmar, Founder of Enspektos explains why relevancy is the key to boosting the adoption of health wearables.
While healthcare stakeholders naturally focus on the medical reliability of data recorded in EHRs, there's another question worth asking: Would the information EHRs contain stand up in a court of law?
According to a new analysis published in the Ave Maria Law Review, the answer is a pretty clear "No."
There has been no shortage of debate among healthcare stakeholders concerning whether EHRs are reliable and, if not, how to make them so. But the three authors of the Ave Maria piece take, not surprisingly, a lawyer's view on the question of reliability. And almost from the beginning they point to some significant problems.
For example, they cited the fact that the data in EHRs are used, naturally, to determine payments to providers. Consequently, "there is a substantial financial incentive to attuning (sic) the record systems' functional priorities to assure that the resulting record artifact leverages the maximum payment, dissociated from its accuracy and reliability as a business record of patient care events."
Currently, healthcare doesn't have a similarly stringent approach to its own record — but if it did, it seems clear that both doctors and patients would benefit.
Link to the Analysis : http://www.avemarialaw.edu/lr/Content/articles/v12i2.Gelzer.pdf
Link to the rest of this article: http://www.govhealthit.com/news/will-ehr-data-stand-court
When an imaging run generates 1 terabyte of data, analysis becomes the problem
Today's neuroscientists have some magnificent tools at their disposal. They can, for example, examine the entire brain of a live zebrafish larva and record the activation patterns of nearly all of its 100,000 neurons in a process that takes only 1.5 seconds.
The only problem: One such imaging run yields about 1 terabyte of data, making analysis the real bottleneck as researchers seek to understand the brain.
To address this issue, scientists at Janelia Farm Research Campus have come up with a set of analytical tools designed for neuroscience and built on a distributed computing platform called Apache Spark. In their paper in Nature Methods, they demonstrate their system's capabilities by making sense of several enormous data sets. (The image above shows the whole-brain neural activity of a zebrafish larva when it was exposed to a moving visual stimulus; the different colors indicate which neurons activated in response to a movement to the left or right.)
The researchers argue that the Apache Spark platform offers an improvement over a more popular distributed computing model known as Hadoop MapReduce, which was originally based on Google's search engine technology.
The researchers have made their library of analytic tools, which they call Thunder, available to the neuroscience community at large. With U.S. government money pouring into neuroscience research for the new BRAIN Initiative, which emphasizes recording from the brain in unprecedented detail, this computing advance comes just in the nick of time.
Your smartphone is not only your best friend, it's also become your personal trainer, coach, medical lab and maybe even your doctor.
"Digital health" has become a key focus for the technology industry, from modest startups' focus on apps to the biggest companies in the sector seeking to find ways to address key issues of health and wellness.
Apps that measure heart rate, blood pressure, glucose and other bodily functions are multiplying, while Google, Apple and Samsung have launched platforms that make it easier to integrate medical and health services.
"We've gotten to a point where with sensors either in the phone or wearables gather information that we couldn't do in the past without going to a medical center," says Gerry Purdy, analyst at Compass Intelligence.
"You can do the heart rate, mobile EKGs (electrocardiograms). Costs are coming down, and these sensors are becoming more socially acceptable."
The consultancy Rock Health estimates 143 digital health companies raised $2.3 billion in the first six months of 2014, already topping last year's amount.
Recent studies suggest that people who use connected devices to monitor health and fitness often do a better job of managing and preventing health problems.
A study led by the Center for Connected Health found that people who use mobile devices did a better job of lowering dangerous blood pressure and blood sugar levels.
A separate study published in the July 2014 issue of Health Affairs found that data collected by devices is not only useful for patients but can help doctors find better treatments.
"When linked to the rest of the available electronic data, patient-generated health data completes the big data picture of real people's needs, life beyond the health care system," said Amy Abernethy, a Duke University professor of medicine lead author of the study.
Some firms have even more ambitious plans for health technology.
Google, for example, is developing a connecting contract lens which can help monitor diabetics and has set up a new company called Calico to focus on health and well-being, hinting at cooperation with rivals such as Apple. And IBM is using its Watson supercomputer for medical purposes including finding the right cancer treatment.
Called Baseline Study, Google's project will gather anonymous genetic and molecular information to create a full picture of what a healthy human is.
The early-stage project is run by Andrew Conrad, a 50-year-old molecular biologist who pioneered cheap, high-volume tests for HIV in blood-plasma donations.
Dr. Conrad joined Google X—thecompany's research arm—in March 2013, and he has built a team of about 70-to-100 experts from fields including physiology, biochemistry, optics, imaging and molecular biology.
Other mass medical and genomics studies exist. But Baseline will amass a much larger and broader set of new data. The hope is that this will help researchers detect killers such as heart disease and cancer far earlier, pushing medicine more toward prevention rather than the treatment of illness.
"With any complex system, the notion has always been there to proactively address problems," Dr. Conrad said. "That's not revolutionary. We are just asking the question: If we really wanted to be proactive, what would we need to know? You need to know what the fixed, well-running thing should look like."
The project won't be restricted to specific diseases, and it will collect hundreds of different samples using a wide variety of new diagnostic tools. Then Google will use its massive computing power to find patterns, or "biomarkers," buried in the information. The hope is that these biomarkers can be used by medical researchers to detect any disease a lot earlier.
The study may, for instance, reveal a biomarker that helps some people break down fatty foods efficiently, helping them live a long time without high cholesterol and heart disease. Others may lack this trait and succumb to early heart attacks. Once Baseline has identified the biomarker, researchers could check if other people lack it and help them modify their behavior or develop a new treatment to help them break down fatty foods better, Dr. Conrad said.
Google has already built one of the world's largest networks of computers and data centers to serve online-search results quickly and run other data-hungry services like the video website YouTube. This computing muscle can now be used to store and crunch medical information and let other researchers access it more easily.
Duke University Medicine is using geographical information to turn electronic health records (EHRs) into population health predictors. By integrating its EHR data with its geographic information system, Duke can enable clinicians to predict patients' diagnoses.
According to Health Data Management, Sohayla Pruitt was hired by Duke to run this project; “I thought, wow, if we could automate some of this, pre select some of the data, preprocess a lot and then sort of wait for an event to happen, we could pass it through our models, let them plow through thousands of geospatial variables and [let the system] tell us the actual statistical significance,” Pruitt says. “Then, once you know how geography is influencing events and what they have in common, you can project that to other places where you should be paying attention because they have similar probability.”
iHealth Beat explains that the system works by using an automated geocoding system to verify addresses with a U.S. Postal Service database. These addresses are then passed through a commercial mapping database to geocode them. Finally, the system imports all U.S. Census Bureau data with a block group ID. This results in an assessment of socioeconomic indicators for each group of patients.
“When we visually map a population and a health issue, we want to give an understanding about why something is happening in a neighborhood,” says Pruitt. “Are there certain socioeconomic factors that are contributing? Do they not have access to certain things? Do they have too much access to certain things like fast food restaurants?”
Duke is working to develop a proof of concept and algorithms that would map locations and patients. They are also working on a system to track food-borne illnesses.
Mike Dittenber had always wanted to go skydiving. There was only one problem: “At my heaviest I clocked in around 330 pounds,” says Dittenber, a technical writer from Michigan. “That’s above the weight restriction for a tandem jump.” During a doctor’s visit last spring, he got some more bad news. “I had delayed getting a physical for a while, but eventually I had to. Turned out I was borderline diabetic and right on the cusp of hypertension.” His doctor warned him that if he didn’t get his weight under control quickly he would need to begin taking medication. “It was a wake-up call.”
Dittenber had previously tried Weight Watchers, which worked for a time, but didn’t last for long. This time he decided to take matters into his own hands withMyFitnessPal, a mobile app that helps users track their calorie intake and exercise. The app became a gateway to a universe of digital health products. “I ended up buying a Fitbit, because that pairs with MyFitnessPal,” he says. “Turns out I don’t hate running. I don’t love it, but I can take it.” He added the Runkeeper app to log his distance and purchased a Garmin Forerunner 220 to help him maintain the right pace. Since he began using the tracking his health data in June of 2013, Dittenber has lost 110 pounds.
Using a smartphone as the central hub for tracking, analyzing, and motivating exercise has become a phenomenon. MyFitnessPal, which now claims over 65 million registered users, is one of the most popular digital health apps. But its success is part of a much broader trend. Venture funding for startups in the sector reaching $2.3 billion in the first half of 2014, more than was invested in all of 2013. More importantly, three of the biggest players in tech — Apple, Google, and Samsung — have all thrown their weight behind platform plays aiming to aggregate and simplify the universe of devices and apps available to consumers.
“We could be at a real tipping point,” says Harry Wang, an analyst who leads health and mobile research for Park Associates. “Fitness devices and apps have been a fast-growing but still relatively niche market. These new ecosystems, if they gain traction, could finally push the industry into the mainstream.” Success isn’t guaranteed, but Wang says it makes sense for the fragmented digital health industry to rally behind powerful companies. Apple's Healthkit and Google Fit can help reach a broader audience and forge partnerships with the traditional health care industry that would be hard for startups to accomplish alone. “It would be a transformation, with a lot of big winners, and losers as well.”Hardware gets the squeeze
For many years the digital health industry has been driven by wearable devices like the Fitbit, Nike’s Fuelband, and Jawbone’s Up. But if the titans of the smartphone industry succeed in creating a dominant platform for health and fitness data, this business could be in trouble. "A lot of the basic functions we have seen in fitness wearables — tracking your steps, taking your heart rate — those functions will become basic features on a smartphone or smartwatch," says Wang.Software’s turn to shine
While some big hardware players may get squeezed by the rise of mainstream smartphone platforms for digital health, app developers stand to make huge gains. "Devices like Fitbit and Jawbone have been essential to driving the industry forward, but they never got above 2 or 3 percent penetration with the general population," says Malay Gandhi, a managing partner at the venture capital firm Rock Health. "With smartphones as the central device powering this ecosystem, software companies will suddenly have access to tens of millions of new customers."
Gandhi believes this change will broaden the demographics in the digital health market. "Right now most of the people using this stuff are early adopter types, techies who are into the quantified lifestyle, or younger people who want to optimize their athletic performance." With just your smartphone as the baseline, he sees a chance to get older and less tech savvy people involved. "Your average consumer isn’t going to learn about pairing a wristband or managing a dozen different apps. But he or she might use the software that comes standard on their iPhone."
Here are three lessons we can learn from Chopped:
More doesn’t necessarily mean better, the details are what matter. Any chef can tell you that one can cook a delicious spread, but over/under season the dish, and he or she will be doing the walk of shame. Those of us in health IT also know the importance of applying a discerning eye to data. We have seen the dangers of things such as note bloat and copy forward, and we need ensure that those who are accessing the health data are able to immediately find what they need. Just as you shouldn’t have to eat an entire bowl of spaghetti to find a meatball, you shouldn’t have to manually parse through a patient’s entire medical record to find a glucose level from last week.
Presentation is everything. My wife says, and she is always right, “you eat with your eyes first.” A good chef knows the importance of combining and arranging the ingredients of a dish in a way that is appetizing to the foodie. The same goes for personal health data. We can be tracking every heartbeat and measuring every level in our body, however, if it is not organized and presented in a meaningful way, it will not be accepted by physicians or health consumers.
Vision needs to become reality. Chefs who do not thoroughly think through the elements of their recipes often find themselves out of time or presenting a dish that differs from what they had envisioned. Similarly, while it is great to imagine the future of health IT, what we need right now are well-thought out, logical, and achievable solutions that transform even the most challenging ingredients into a delicacy (Remember the monkey brains served during the dinner scene in Indiana Jones and the Temple of Doom?).