Interoperability is expanding in many hospitals, but one can’t clearly know exactly where to look to observe it in each stage of development as it matures, says James P.
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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.
It's been tough to identify the problems that only turn up after medicines are on the market. An experimental project is now combing through data to get earlier, more accurate warnings.
No one likes it when a new drug in people's medicine cabinets turns out to have problems — just remember the Vioxx debacle a decade ago, when the painkiller was removed from the market over concerns that it increased the risk of heart attack and stroke.
To do a better job of spotting unforeseen risks and side effects, the Food and Drug Administration is trying something new — and there's a decent chance that it involves your medical records.
It's called Mini-Sentinel, and it's a $116 million government project to actively go out and look for adverse events linked to marketed drugs. This pilot program is able to mine huge databases of medical records for signs that drugs may be linked to problems.
The usual system for monitoring the safety of marketed drugs has real shortcomings. It largely relies on voluntary reports from doctors, pharmacists, and just plain folks who took a drug and got a bad outcome.
"We get about a million reports a year that way," says Janet Woodcock, the director of the FDA's Center for Drug Evaluation and Research. "But those are random. They are whatever people choose to send us."
After decades as a technological laggard, medicine has entered its data age. Mobile technologies, sensors, genome sequencing, and advances in analytic software now make it possible to capture vast amounts of information about our individual makeup and the environment around us. The sum of this information could transform medicine, turning a field aimed at treating the average patient into one that’s customized to each person while shifting more control and responsibility from doctors to patients.
The question is: can big data make health care better?
“There is a lot of data being gathered. That’s not enough,” says Ed Martin, interim director of the Information Services Unit at the University of California San Francisco School of Medicine. “It’s really about coming up with applications that make data actionable.”
The business opportunity in making sense of that data—potentially $300 billion to $450 billion a year, according to consultants McKinsey & Company—is driving well-established companies like Apple, Qualcomm, and IBM to invest in technologies from data-capturing smartphone apps to billion-dollar analytical systems. It’s feeding the rising enthusiasm for startups as well.
Venture capital firms like Greylock Partners and Kleiner Perkins Caufield & Byers, as well as the corporate venture funds of Google, Samsung, Merck, and others, have invested more than $3 billion in health-care information technology since the beginning of 2013—a rapid acceleration from previous years, according to data from Mercom Capital Group.
Wearable technologies are set to transform health and wellness experiences and massively increase our expectations of health and wellness services.
This customer shift will transform the health and wellness industry as a whole, dragging regulation and governance kicking and screaming into the 21st century.
Because there’s nothing quite like a vast, shouting mob (of wealthy voters) to drive change.
But first, a little background.The smartphone IS the killer wearable
Most of us have a smartphone. Comscore reports 69% of US citizens and 62% of Canadians own one. Every day more of us are connecting them to our daily activities, homes, cars and communities.
The expanding universe of “wearable” sensors and peripherals are often simply data inputs for a smartphone-based experience. We expect to see few devices succeed without this symbiotic relationship. Those that try, usually offer an experience that’s inferior to simply pulling out your phone.
The major smartphone manufacturers are heavily invested in developing wearable “ecosystems” around their devices. Through close-range sensing technologies like BLE (iBeacon), NFC and RFID, plus increased availability of mobile web access through Wi-Fi hotspots and cheaper data plans, there’s every reason to expect this trend to continue.
The smartphone already is a wearable. And it’s the hub – a “life tracker” with a growing entourage of sensory peripherals on our bodies, in our homes and all around us.We’ll share our lives in return for transformative wellness experiences
A paradigm shift is coming to the world of health and wellness. With the devices on our bodies and in our pockets gathering useful data about our movements, behaviours, preferences and wellbeing, more informed decisions become available.
So what happens next?1. The value we receive from sharing our wellness data will erode our privacy fears.2. Augmented reality will eventually become the new normal for healthcare professionals.3. Personal healthcare innovations will be swiftly subsumed into the major ecosystems. (Apple and Google)4. Healthcare providers need to embed digital capabilities, fast
Cardiologists in Los Angeles have developed a gene-therapy technique that allows them to transform working heart-muscle cells into cells that regulate a pigs’ heartbeat. This procedure, described today in the Science Translational Medicine, restored normal heart rates for two weeks in pigs that usually rely on mechanical pacemakers. The experiment, researchers say, could lead to lifesaving therapies for people who suffer infections following the implantation of a mechanical pacemaker.
"We have been able for the first time to create a biological pacemaker using minimally invasive methods and to show that the new pacemaker suffices to support the demands of daily life," Eduardo Marbán, a cardiologist at the Cedars-Sinai Heart Institute and lead author of the study, told the press yesterday. The approach is practical, added Eugenio Cingolani, a cardiogeneticist also at Cedars-Sinai and a co-author of the study, because "no open-heart surgery is required to inject this gene."
In the study, researchers injected a gene called Tbx18 into the pigs’ hearts. This gene, which is also found in humans, reprogrammed a small number of heart-muscle cells into cells that emit electrical impulses and drive the beating of the heart. The area in which this change occurred — about the size of a peppercorn — doesn't normally initiate heartbeats.
"We were able to get the biological pacemaker to turn on within 48 hours," Marbán said. To get the gene to the heart, the researchers sent a modified virus into the right ventricle through a catheter. The viral vector isn’t harmful, the researchers said, because the virus they employed was engineered to be "replication deficient" — meaning that it will not reproduce and spread beyond the heart.
While portal technology has been available in other industries for some years, access to health information and records via a secure login is only now becoming common place in healthcare by the end of the year.
Patient portal are excellent opportunities for providers to expand the way they engage with their patients. Here are a some best practices for using portals in your practice.
Patients with full-time jobs don’t always have the flexibility to communicate or interact with you during your traditional office hours. By offering a robust patient portal system, ideally tied into your cloud-based EHR, you provide patients with the opportunity to learn more about your practice and their health at their convenience, whether that’s late in the evening or on a weekend. This type of access provides patients a sense of comfort because they know their records are always within reach, even when your office isn’t open or you’re not on call. Including some personally written content or material for patients to view and reference online will go a long way towards creating a helpful presence, while also reducing the amount of time you have to spend explaining that information.
Similarly, many portals offer secure communication channels so patients can ask questions of you or your team. Have a plan in place to respond to these questions. Try to be as prompt as possible – within reason of course.
Some patient portals also allow for the ability to schedule – or at minimum request – appointments. By taking advantage of this feature, you can help eliminate lengthy wait times on the phone, which helps both your patients and your staff.
In return, you also have the ability to easily send patients appointment reminders or contact information when a patient needs their information for a referral.
Allowing the patient to fill out forms in advance of appointments or update their own address and billing information and emergency contact list not only helps the patient get through the intake process more quickly, it helps your team become more efficient. In addition, many portals also offer patients the ability to pay outstanding balances through a secure payment system. In more complex patient portals, patients can update their prescription information and problem list to help physicians reduce the likelihood of adverse events.
Explaining esoteric health information like lab results over the phone, or even in person, can be an inefficient method for educating patients. Since the information is often unfamiliar, the chance they’ll forget the information or misplace their printed instructions can be high.
Through a patient portal, you can not only deliver test results that can be read at any time, you also have the opportunity to educate the patient and his family about what those results mean. Having a library of fact-based information regarding specific conditions or upcoming tests can help alleviate stress or confusion – and maybe even prevent the patient from conducting random searches online, finding inaccurate information, and arriving at ill-founded conclusions.
It’s also a great way to educate a patient about specialists or other doctors that you may be referring him to. While the patient portal system can be very disparate – different offices may or may not be using the same portal – you still have the ability to give a patient a basic fact sheet and office contact information for the referred doctor. This is yet another way to put a patient’s mind at ease.
PHRs/Patient portals must look beyond MU. Patient Portals should go beyond being enterprise portals and become mediums for patient engagement, health tracking and a tool towards personalized health. They must include inputs from the patient and as such should be a bidirectional application rather than being a customized gorgeous front end to an EHR database.
I believe if done right PHR's will be a very useful tool to improving diagnostics, lowering care costs and also in prevention.
If you'd like to take a look at an inclusive bi-directional PHR system which goes beyond MU and is always evolving, contact me on twitter at @nrip or use the form on the right to setup a call.
In oncology, the notion of personalized medicine—in which genetic tools can be used precisely to characterize a patient's cancer and tailor treatment to a genetic profile—is now all but standard practice.
Though personalized treatments for diseases like amyotrophic lateral sclerosis (ALS), epilepsy, and bipolar disorders have remained frustratingly out of reach for neurologists, Harvard scientists say that could soon change.
A new technique for observing neural activity, developed by Adam Cohen, professor of chemistry and chemical biology and of physics, and colleagues including Venkatesh Murthy, professor of molecular and cellular biology, and Bernardo Sabatini, the Takeda Professor of Neurobiology at Harvard Medical School, will allow scientists to stimulate neurons and observe their firing pattern in real time.
Tracing those neural pathways can help researchers answer questions about how neural signals propagate, and could one day allow doctors to design individualized treatments for a host of disorders. The study is described in a paper in Nature Methods.
"This is a tool for looking in great detail at how signals flow through neurons, and how the signal flows through circuits of neurons," Cohen said. "You can think of this as a complete neuro-electronic interface, where you can stimulate any piece of the circuit, or any subcellular region, in any pattern of space and time you can dream of. And you can then record absolutely everything that's going on in that circuit."
In addition to offering invaluable insight into how healthy neural circuits work, the system can be used to probe how disease might cause those circuits to go awry.
It’s one of those thoughts many mHealth insiders and observers have at some point had: What if one could put the power of Watson analytics into a smartphone and interact with it like Apple’s Siri at the point of care?
Well, that specific dream moved closer to reality on Tuesday when Apple and IBM joined forces to create a mobile platform christened IBM Mobile First for iOS.
“For the first time ever we’re putting IBM’s renowned big data analytics at iOS users’ fingertips,” Apple CEO Tim Cook said in a prepared statement. “This is a radical step for enterprise and something that only Apple and IBM can deliver.”
IBM CEO Ginni Rometty added that the intention is to bring the same “innovations [that] have transformed our lives,” into the ways that people work, thereby “allowing people to re-imagine work, industries, and professions.”
To that end, the companies hope that IBM Mobile First for iOS will “transform enterprise mobility through a new class of business apps,” they explained.
It’s not all that often technology giants align and rattle off healthcare as one of their target verticals, much less that Apple joins forces with any of the IT old guard — which gives the partnership a booster shot of luster. And in an mHealth industry currently going like gangbusters with too many startups to count, the sheer scale that Apple and IBM bring at the very least has the potential for significant market-shaping.
What would a medical device suite from Apple look like? More importantly, how would it feel?
When we think about the “why” of how we design products and services, our best work usually makes this planet a better place for all of us to live. Of course, not every product can make that claim, but with the design of medical products it’s almost built in. That said, especially with the constraints imposed by regulations, it’s to claim that our hands are tied and settle for a design compromise instead of looking for the best possible and most poetic answer. One day a hospital room will need to have the equivalently delightful experience of shopping in an Apple store.
It’s coming soon.
Hard to picture? Maybe so in the short term, but as we progress, patients no longer will be willing to accept a care system or the products within it that view them as passive recipients of treatment. Patient loyalty can mean the difference between success and failure for healthcare organizations. Gaining patient loyalty comes down to one core factor: the ability of healthcare organizations to consistently deliver positive patient experiences. Organizations that can do so will own the future of healthcare.
The adoption of a patient-centered care model is becoming the main focus of innovative healthcare organizations as accountability for clinical patient satisfaction continues to grow. Positive patient experiences are no longer a nicety for healthcare systems; they are an absolute necessity. We are seeing an industry wide consciousness shift of this understanding with the steady increase of CXOs (customer experience officers) being appointed to C-suite positions across major healthcare organizations.
The future of healthcare will be won by those who put patients first, who think about patients as customers of healthcare. Again, this core value— always put your users first—is long understood in the design community.
A good way to think about it is to design these experiences looking through three lenses: beauty, ingenuity and charisma.
While we may not often think of medical products as beautiful, there is no reason not to; their expression in form and detail have the power to inspire and comfort.Ingenuity solves for problems of use and manufacture, and charisma draws people to a product because of a true understanding of need.
The trick is an uncompromising commitment to all three lenses in every solution and product designed.
With the widespread consciousness shift seen in healthcare organizations toward understanding the importance of focusing on positive patient experience, I believe that this is incredibly exciting time for design leadership to be brought to the table.
Let me pose a final question, hinted at in the first paragraph: Suppose instead of computers, Apple decided to make medical devices. What would a medical device suite from Apple look like?
Google is developing a smart contact lens, with pharmaceutical giant Novartis, to help patients manage diabetes – in one of a number of moves focused squarely on billions of dollars of potential revenue available across the total digital healthcare market.
As technology moves further into treatment with remote consultations, monitoring and operations, robotic treatments, and advanced digital diagnosis, Google has seen the opportunity to apply its own eyewear technology (up until now limited as glasses called Google Glass) to the healthcare field.
Google’s 3D mobile technology and its offering around health record digitization form potential other strands of its expansion in the health market. Last month, it released the Google Fit platform to track exercise and sleep, among other health factors – but it is far from alone, as Apple and Samsung offer similar systems in that area.
Today, under a new development and licensing deal between Google and the Alcon eyewear division at Novartis, the two companies said they will create a smart contact lens that contains a low power microchip and an almost invisible, hair-thin electronic circuit. The lens can measure diabetics’ blood sugar levels directly from tear fluid on the surface of the eyeball. The system sends data to a mobile device to keep the individual informed.
Google co-founder Sergey Brin said the company wanted to use “the latest technology in ‘minituarisation’ of electronics” in order to improve people’s “quality of life”.
When most people leave the hospital after a lengthy stay, they probably assume they won’t be coming back again soon to deal with the same problem. Unfortunately, that’s often just wishful thinking. In fact, re-admissions — sometimes within just a couple weeks — are such a big problem that the Affordable Care Act (aka Obamacare) includes measures to address the problem.
Put simply, the law provides financial incentives for hospitals to improve readmission rates and financial sticks with which to punish hospitals where the problem persists. Improve the problem, get more funding. Keep readmitting patients within short windows after discharge, don’t get paid for treatment. The latter scenario is bad for patients and bad for hospitals.
According to studies, about a quarter of Medicare patients treated for heart failure are readmitted within 30 days, and heart-failure re-admissions alone cost Medicare about $15 billion a year. Predictions about how many of those are preventable range from less than 20 percent up the the Department of Health and Human Services estimate of 75 percent.
“If you can predict that, that’s a huge, huge cost saving for the hospitals,” said Ankur Teredesai, who manages the Center for Data Science at the University of Washington, Tacoma.
However, help might be on the way thanks to a research project by Teredesai and his Center for Data Science colleagues. It’s called the Risk-O-Meter, and it’s already being used by one hospital system in the Seattle area. Now, the researchers who created it are looking to commercialize it, either by licensing the access to the cloud-based service or by starting their own company.
Under the hood of the web and mobile applications that allow doctors to enter patient information and receive a risk score is a machine learning system that analyzes more than 100 attributes about each patient. These range from standard stuff such as vital signs, lab results and medical history to more-personal stuff such as a patient’s demographic information and living conditions.
However, the Risk-O-Meter has much more utility than simply as a one-off risk-scoring app, Teredesai explained. Risk scores change as patients progress through treatment, helping doctors to evaluate treatment options on an ongoing basis. Even after patients leave the hospital, hospital staff can benefit from alerts indicating it’s a good time to check up on a patient, or to call with reminders about taking medication.
Doctors can also drill down into the data in order to figure out what factors are causing a score to spike. This type of analysis is important because a high score could be caused by a non-medical factor that’s easy enough to account for once a patient is discharged. For example, Teredesai said, “The chances of then getting readmitted are higher — much higher — if [patients] live alone. … The models actually show that.”
What might be most appealing about the Risk-O-Meter is that it’s a broadly deployable cloud service that promises better patient outcomes while also helping hospitals where it matters most to them — their bottom lines. Hospital CIOs and administrators know they need to do both, and anything that can plausibly deliver has to at least get a serious look.
Background: To date, health research literature has focused on social network sites (SNS) either as tools to deliver health care, to study the effect of these networks on behavior, or to analyze Web health content. Less is known about the effectiveness of these sites as a method for collecting data for health research and the means to use such powerful tools in health research.
(1) SNS have been used as a data collection tool by health researchers; all but 1 of the included studies were cross-sectional and quantitative.
(2) Data quality indicators that were reported include response rate, cost, timeliness, missing data/completion rate, and validity. However, comparison was carried out only for response rate and cost as it was unclear how other reported indicators were measured.
(3)The most targeted population were females and younger people.
(4) All studies stated that SNS is an effective recruitment method but that it may introduce a sampling bias.
Conclusions: SNS has a role in health research, but we need to ascertain how to use it effectively without affecting the quality of research. The field of SNS is growing rapidly, and it is necessary to take advantage of the strengths of this tool and to avoid its limitations by effective research design. This review provides an important insight for scholars who plan to conduct research using SNS.
more at http://www.jmir.org/2014/7/e171/
Background: The recent convergence between technology and medicine is offering innovative methods and tools for behavioral health care. Among these, an emerging approach is the use of virtual reality (VR) within exposure-based protocols for anxiety disorders, and in particular posttraumatic stress disorder. However, no systematically tested VR protocols are available for the management of psychological stress.
Results: Although both treatments were able to significantly reduce perceived stress better than WL, only EG participants reported a significant reduction (EG=12% vs CG=0.5%) in chronic “trait” anxiety. A similar pattern was found for coping skills: both treatments were able to significantly increase most coping skills, but only EG participants reported a significant increase (EG=14% vs CG=0.3%) in the Emotional Support skill.
more at http://www.jmir.org/2014/7/e167/
The NHS is starting to test a sticking-plaster-sized patient-monitoring patch.
Placed on the chest, it wirelessly transmits data on heart rate, breathing and body-temperature while the patient is free to move around.
Independent experts say the system, developed in Britain, could ease pressure on wards and has the potential to monitor patients in their own home.
But the Royal College of Nursing says there is no substitute for having enough staff.
Routine checks for vital signs - including temperature, blood pressure and heart rate - are a key part of care and safety in hospitals.
Typically they may be carried out every four hours, depending on the patient's condition.
But patients can deteriorate between checks, putting them at risk.
A hospital in Brighton run by the private healthcare firm Spire has been testing the battery-powered patch, which updates information on some of the vital signs every couple of minutes.
The wireless device, developed by the Oxford-based firm Sensium Healthcare, then issues an alert if the readings fall outside pre-set levels, indicating a potential problem.
The patch is placed on the chest just above the heart when the patient is admitted. There are no cables to any monitors. Instead, readings are recorded and transmitted to a box in each room that works like a wi-fi router, passing on data to the hospital IT system.
As tech giants like Apple, Google and Samsung compete over dominance in the healthcare market, with their latest platforms and apps, the question remains will any or all of these innovations truly tap into the greater realm of consumer health? Aside from the buzz now emanating from consumers’ pockets, is there a real signal being sent out here about how to change healthcare, or will these latest consumer-concentric technologies add nothing more than noise?
Welltok's Scott Rotermund explains that what we really need from Google Fit and HealthKit is an integrated approach that not only collects data, but also meshes with the current healthcare ecosystem.
What lessons learned from the disappointments associated with the consumer use of FitBit and others tell us about behavior change?
We’ve learned two things:
1. A cool gadget is not enough – The novelty will wear off along with the use of the wearable. In my experience, most people lose interest in their tracking device after a month – they learn their sleep patterns, know average steps, etc. To maintain usage, we’ve tied tracking devices to challenges, participatory incentives and personalized action plans with defined goals.
2. Relying on the consumers to take action – With the startling statistics associated to preventable diseases like obesity and diabetes, it’s safe to say that we cannot expect consumers to take action on their own. These big tech giants are treating health activities as they would consumer electronics – the same rules don’t apply. To move beyond early adopters, they need to tie into programs that provide personalized guidance on how to use the trackers and the resulting data, and align those defined actions with the right incentives to get people moving.
The Food and Drug Administration (FDA), which regulates everything from heart monitors to horse vaccines, will soon have its hands full with consumer health apps and devices.
The vast majority of the health apps you’ll find in Apple’s or Google’s app stores are harmless, like step counters and heart beat monitors. They’re non-clinical, non-actionable, and informational or motivational in nature.
But the next wave of biometric devices and apps might go further, measuring things like real-time blood pressure, blood glucose, and oxygen levels.
More clinical apps
The FDA is charged with keeping watch on the safety and efficacy of consumer health products. Lately, that includes more clinical apps as well as devices you might buy at the drugstore, like a home glucose testing kit.
“It’s these apps that the FDA says it will regulate,” David Bates of Brigham and Women’s Hospital and Physicians Organization told VentureBeat in June. These apps will have to go through the full 510(k) process,” he said.
Dr. Bates chaired a group to advise the FDA on how to review health apps for approval, and on how the FDA should advise developers.
“It was intended to help them think through the risk factors involved with these products and then give guidance on how to stay within the guidelines,” he said.
“The device makers were asking from some guidance from The FDA on what types of things would be accepted and what wouldn’t,” Bates said.
Bates believes the FDA wants to use a light regulatory touch when looking at new medical devices. “The FDA definitely wants innovation to continue in clinical devices,” he said. “In general the FDA knows that the vast majority of apps are just informational.”
The FDA’s final guidance focuses on a small subset of mobile apps that present a greater risk to patients if they do not work as intended.
Health apps go mainstream
The big software companies (Apple, Google, and Samsung) have brought attention to, and lent credibility to, apps and devices that do more than count steps. These companies are building large cloud platforms designed to collect health data from all sorts of health apps and devices.
As I see it, mobile-savvy physicians have half-a-dozen distinct advantages over their office-bound brethren:
Mobile physicians can provide better care. I follow my patients everywhere, from my office to the hospital and their homes. In fact, I’ve made more that 10,000 house calls since 1984. Many of my patients have diabetes-related disabilities, so it’s not unusual that trips across town to my office would be next to impossible for them. But I know that I can often keep a patient out of the hospital by providing timely care. That simple fact alone - that I can better serve my patients - keeps me going to their homes as needed.
Mobile health requires less equipment. I started making house calls long before I started using technology. Today’s devices and software are catching up with the way I practice. I now carry only two instruments as I move from location to location: a stethoscope and an iPad.
Mobile physicians can stay connected. Being mobile means I can pull up information I need anytime through a secure Internet connection. Log-in is almost instantaneous with the iPad and I can switch easily from screen to screen, so I can stay focused on the patient. Because I’m always connected, I can take care of many tasks right away - before, during or after seeing a patient. At the end of the day, I’m not chained to the office. I can take my device home with me and finish the day’s “paperwork” after spending time with my family.
Mobile health improves continuity of care. Traditionally, care falters anytime a patient goes from one stage of care to the next. Mobile health is closing some of those gaps. I recently visited a patient with bedsores, for instance. In the past, I would have written a paragraph describing the wound. With the iPad, I can take a picture of the wound, send it to my team and tell them what I did to treat it and how I want them to follow up. They don’t have to interpret my words; they can see the wound for themselves.
Mobile technologies speed workflow. The system I use from Greenway Health enables me to complete and manage most tasks on the iPad. Dictating notes through Siri saves me hours of manual documentation. I still need to use the office computer to integrate unstructured data into the patient’s record, but each release provides more mobile functionality. I fully expect that someday I will be able to do everything from a single portable device.
Mobile physicians are poised for interoperability. My practice in Brooklyn is a completely integrated electronic practice. Within my office, we maintain a complete record of every patient, no matter where that patient was seen. We attested to Stage 1 meaningful use in 2011 and - thanks to all of our work to integrate knowledge across our practice - I’m confident we’re ready for the subsequent stages of meaningful use. Most importantly, our records are more complete, we have access to important details about our patients, and that helps us deliver better care.
ProTransport-1, a Northern California based medical transport provider has announced a software partnership with CrowdOptic, maker of mobile and wearable broadcasting solutions to deploy the CrowdOptic Google Glass broadcasting solution in its ambulances and mobile medicine units.
ProTransport-1 will use CrowdOptic’s software solution that will allow paramedics and nurses to broadcast through Google Glass a live view of complex cases from the ambulance to medical teams at the receiving hospital during transport. According to the press release, the companies aim to “improve documentation and expand medical consultative opportunities for patients en route.
“CrowdOptic’s see-what-I-see technology allows paramedics and nurses on our ambulances to broadcast the live view of complex cases to medical teams at the hospital”, said Glenn Leland, Chief Strategy Officer for ProTransport-1.
Additionally, ProTransport-1 envisions multiple opportunities to utilize CrowdOptic’s software particularly in the mobile medical setting by enabling a two-way educational forum between a patient in their home and providers. “We additionally envision a variety of dispatch, navigation, documentation and operational processes will migrate to CrowdOptic and Google Glass over time” said Glenn Leland, Chief Strategy Officer for ProTransport-1.
For breast cancer patients, the era of personalized medicine may be just around the corner, thanks to recent advances by USC Stem Cell researcher Min Yu and scientists at Massachusetts General Hospital and Harvard Medical School.
In a July 11 study in Science, Yu and hercolleagues report how they isolated breastcancer cells circulating through the blood streams of six patients. Some of these deadly cancer cells are the "seeds" of metastasis, which travel to and establish secondary tumors in vital organs such as the bone, lungs, liver and brain.
Yu and her colleagues managed to expand this small number of cancer cells in the laboratory over a period of more than six months, enabling the identification of new mutations and the evaluation of drug susceptibility.
If perfected, this technique could eventually allow doctors to do the same: use cancer cells isolated from patients' blood to monitor the progression of their diseases, pre-test drugs and personalize treatment plans accordingly.
Big data offers breakthrough possibilities for new research and discoveries, better patient care, and greater efficiency in health and health care, as detailed in the July issue of Health Affairs. As with any new tool or technique, there is a learning curve.
Here are some guidelines to help take full advantage of big data's potential:
Acquire the “right” data for the project, even if it might be difficult to obtain.
Many organizations – both inside and outside of health care – tend to stick with the data that’s easily accessible and that they’re comfortable with, even if it provides only a partial picture and doesn’t successfully unlock the value big data analytics may offer. But we have found that when organizations develop a “weighted data wish list” and allocate their resources towards acquiring high-impact data sources as well as easy-to-acquire sources, they discover greater returns on their big data investment.
Ensure that initial pilots have wide applicability.
Health organizations will get the most from big data when everyone sees the value and participates. Too often, though, initial analytics projects may be so self-contained that it is hard to see how any of the results might apply elsewhere in the organization.
Before using new data, make sure you know its provenance (where it came from) and its lineage (what’s been done to it).
Often in the excitement of big data, decision-makers and project staff forget this basic advice. They are often in a hurry to immediately start data mining efforts to search for unknown patterns and anomalies. We’ve seen many cases where such new data wasn’t properly scrutinized – and where supposed patterns and anomalies later turned out to be irrelevant or grossly misleading.
Don’t start with a solution; introduce a problem and consult with a data scientist.
Unlike conventional analytics platforms, big data platforms can easily allow subject-matter experts direct access to the data, without the need for database administrators or others to serve as intermediaries in making queries. This provides health researchers with an unprecedented ability to explore the data – to pursue promising leads, search for patterns and follow hunches, all in real time. We have found, however, that many organizations don’t take advantage of this capability.
Health organizations often build a big data platform, but fail to take full advantage of it. They continue to use the small-data approaches they’re accustomed to, or they rush headlong into big data, forgetting best practices in analytics.
It’s important to aim for initial pilots with wide applicability, a clear understanding of where one’s data comes from, and an approach that starts with a problem, not a solution. Perhaps the hardest task is finding the right balance.
more at http://healthaffairs.org/blog/2014/07/14/lessons-learned-bringing-big-data-analytics-to-health-care/
With the unveiling of a new clinical operating system for medical devices, BlackBerry is once again making a play for mHealth.
QNX Software Systems, which was acquired by BlackBerry in 2010, has released a new operating system that's billed as being IEC 62304-compliant. With its sights set on alleviating the regulatory and financial burden for device manufacturers, the operating system supports both single- and multicore devices based on ARMv7 and Intel x86 processors. The OS also features an application programming interface to make it compatible with other QNX operating systems, officials said.
"When it comes to medical device software, the OS sets the tone: Unless it provides the architecture to enable reliable operation and a clear audit trail to substantiate claims about its dependability, the entire process of device approval can be put in jeopardy," said Grant Courville, QNX's director of product management, in a July 15 press statement. "By providing an OS that has been independently verified to comply with the IEC 62304 standard, we are helping manufacturers reduce the cost and effort of developing devices that require regulatory approval from agencies such as the FDA, MDD and MHRA."
This is far from BlackBerry's first big move into the healthcare space. In April, the telecommunications behemoth lent financial support to cloud-based health IT company NantHealth, a startup spearheaded by billionaire healthcare mogul Patrick Soon-Shiong, MD.
"We've built supercomputers that can do the genomic analysis in real-time; we've built super computers that can actually take feeds of CT scans from EMRs and feed it directly to mobile devices. All of that, regardless of where it comes from, regardless of the EMR, regardless of the device, whether it be via ventilator, or IV tube, we're agnostic to, and it speaks to this operating system," said Soon-Shiong.
The use of electronic health records to identify the best treatment option for patients is more efficient and less costly than the current clinical trial process, according to a study published in the journal Health Technology Assessment
For the study, which was funded in part by the National Institute for Health Research and the Welcome Trust, researchers from several universities in the United Kingdom, used a new computer program in 23 approved general practitioners across England and Scotland.
The first part of the study used 300 patients' electronic health records, which are stored in the Clinical Practice Research Datalink and updated during routine medical visits, to monitor the effects of their prescribed treatments.
A second part of the study, which involved 31 participants, looked at the use of antibiotics among patients with chronic obstructive pulmonary disease.
The researchers determined that they were able to understand health patterns related to specific prescribed medications and determine which treatments were more effective by analyzing EHRs.
They added that the EHR analysis offers a larger and more diverse overview of the general population than current clinical trial methods.
The researchers also noted that using EHRs allows the analysis to be conducted with minimal effects on the lives of the patients, whose involvement in the process stops after their initial consent.
According to the researchers, 26 out of 27 general practitioners who participated in the study expressed strong support for the use of patients' EHRs for research purposes. In addition, 10 patients who were interviewed by the researchers all said that their involvement in trial was an acceptable practice
A life-sciences-as-a-service startup called Transcriptic has opened its APIs to the general public, allowing researchers around the world offload tedious lab work to robots so researchers can spend more of their time analyzing the results.
Using a set of APIs, researchers can now command Transcriptic’s purpose-built robots to process, analyze, and store their genetic or biological samples, and receive results in days.
The high concept idea, says Founder and CEO Max Hodak, is cloud computing for life sciences — only with “robotic work cells” instead of servers on the other end. “We see the lab in terms of the devices that make it up,” he said, meaning stuff like incubators, freezers, liquid handlers and robotic arms to replace human arms.
And although Transcriptic’s technology is complex, the process for getting work done is actually pretty simple. Researchers write code to tell the robots exactly what to do with the samples (right now, the company focuses on molecular cloning, genotyping, bacteria-growing and bio-banking), and then they send their samples to the Transcriptic lab.
Alternatively, Transcriptic’s robotic infrastructure can also synthesize samples for users.
And although Transcriptic’s technology is complex, the process for getting work done is actually pretty simple.
Researchers write code to tell the robots exactly what to do with the samples (right now, the company focuses on molecular cloning, genotyping, bacteria-growing and bio-banking), and then they send their samples to the Transcriptic lab. Alternatively, Transcriptic’s robotic infrastructure can also synthesize samples for users.
New numbers from the Office of the National Coordinator for Health IT show that far more doctors are filing prescriptions electronically than in 2008.
As of the end of April, 70 percent of doctors say that they are using the e-prescribing function common in electronic health record (EHR) software to send prescriptions to pharmacies.
The prescription pad, the phone, and the fax machine have been the dominant means of writing prescriptions for most of medicine’s modern age.
Just 4 percent of new prescriptions and refills were filed electronically in 2008. By 2013, that number had risen to 57 percent.
“We believe that financial incentives can drive providers’ adoption and use of health information technology, such as e-prescribing, and that health information networks can be a powerful tool in tracking incentives’ progress,” the authors said.
A new study led by Jenine K. Harris, PhD, examined the use of the hashtag #childhoodobesity in tweets to track Twitter conversations about the issue of overweight kids.
The study noted that conversations involving childhood obesity on Twitter don't often include comments from representatives of government and public health organizations that likely have evidence relating to how best to approach this issue. The authors think maybe they should.
Twitter use is growing nationwide. In its 2014 Twitter update, the Pew Research Center found that Twitter is used more by those in lower-income groups, which traditionally are more difficult to reach with health information.
While younger Americans also are more likely to use Twitter, it is used equally across education groups and is used more by non-white Americans than whites.
This, Harris said, is one of the reasons Twitter is an avenue that the academic and government sources with accurate health information should consider taking advantage of in order to reach a wide variety of people.
"I think public health so far doesn't have a great game plan for using social media, we're still laying the foundation for that," she said. "We're still learning what works.
"Public health communities, politicians, and government sources -- people who really know what works -- should join in the conversation. Then we might be able to make an impact," she said.
America’s medical records systems are flirting with disaster, say the experts who monitor crime in cyberspace. A hack that exposes the medical and financial records of hundreds of thousands of patients is coming, they say — it’s only a matter of when.
As health data become increasingly digital and the use of electronic health records booms, thieves see patient records in a vulnerable health care system as attractive bait, according to experts interviewed by POLITICO. On the black market, a full identity profile contained in a single record can bring as much as $500.
“What I think it’s going to lead to, if it hasn’t already, is an arms race between the criminal element and the people trying to protect health data,” said Robert Wah, president of the American Medical Association and chief medical officer at the health technology firm CSC. “I think the health data stewards are probably a little behind in the race. The criminal elements are incredibly sophisticated.”
The infamous Target breach occurred last year when hackers stole login information through the retailer’s heating and air system. Although experts aren’t sure what a major health care hack would look like, previous data breaches have resulted in identity and financial theft, and health care fraud.
Significant breaches are already occurring. Over the course of three days, hackers using a Chinese IP address infiltrated the St. Joseph Health System in Bryan, Texas, and exposed the information of 405,000 individuals, gaining names, address, Social Security numbers, dates of birth and other information.
It was the third-largest health data breach tracked by the federal government.
The L.A. Gay & Lesbian Center reported late last year that hackers attacked its computer systems over a course of two months trying to steal credit card, Social Security and other financial information. About 59,000 clients and former clients were left vulnerable.
While a stolen credit card or Social Security number fetches $1 or less on the black market, a person’s medical information can yield hundreds of times more, according to the World Privacy Forum. Thieves want to hack the data to gain access to health insurance, prescription drugs or just a person’s financial information
The Identify Theft Resource Center — which has identified 353 breaches in 2014 across industries it tracks, says almost half occurred in the health sector. Criminal attacks on health data have doubled since 2000, according to the Ponemon Institute, an industry leader in data security.
Health care is the industry sector least prepared for a cyberattack, according to security ratings firm BitSight Technologies. The industry had the highest volume of threats and the slowest response time, leading the FBI in April to issue a warning to health care providers.