healthcare technology

Panelists from a hospital forum have agreed that there is still progress needed before the devices can be integrated.

According to a panel at the Hospital Cloud Forum from the Information Management Network last week, doctors still need to be able to find a way to integrate mhealth and the data available through those systems into clinical care.

The devices that would be used would be connected to the cloud and would bring physicians and patient data together.

Mhealth could provide a very important way to bring the data regarding a patient’s current health and medical history to the fingertips of a doctor, according to the Maimonides Medical Center senior vice president and chief medical informatics officer, Dr. Steven J. Davidson, from Brooklyn, New York. He said that “I’d like to offer a vision as a longtime clinician that has talked to lots of patients over the years that the cloud is where patients and physicians are going to meet.”

Many panel members saw the value of giving doctors access to virtualized services through mhealth technology.

According to senior information and communications technology strategist and architect at Intel, Matthew Taylor, giving physicians direct access to mhealth services by way of mobile devices would give the entire healthcare industry a way to shrink the number of readmissions, and avoid unnecessary admissions from the very start.

 

Researchers found that patients saw physicians who use CDS as somehow less capable than those who don't. They saw the IT tools as impersonal, and thought the systems were a barrier between them and their caregivers.

That's the wrong way to think about it, says John Hoyt, executive vice president, HIMSS Analytics.

 

"They just need to understand it's not taking the place of their physician," he says. "It's an aid and reminder of the latest peer-reviewed advice and best practice alerts, etc."

It can "touchy," says Hoyt, because it may suggest, "subconsciously, that your physician is flawed, that he has a human brain – that may be a shock to some people."

But far from being a cheat, or a crutch to be leaned upon, decision support is an essential tool in the clinician's arsenal. Especially nowadays.

"Things get complex," he says. "A good physician will go out and search the literature. In days of old, they used to spend time in the medical library. But now we can bring it to their faces, at the moment."

But there's a fine line between that and "in your face," as it were.

Designing CDS to supply relevant information – at the right time and place – without risking physician alert fatigue, "is an art," said Hoyt. "We don't want to remind the physician, 'Hey, we've got a patient with high cholesterol, order a lipid test.' For God's sake, they know that."

 

It's even worse in the pharmacy: "Every minute, today, in these hospitals, the pharmacists are getting alerts that are far more detailed and hypnotic than the physicians get."

 

But clinical and business intelligence technology is changing, evolving – and getting smarter.

 

Sometimes, too much of a substance that's supposed to help can cause serious harm.

 

Drug overdose death rates in the United States have more than tripled since 1990, according to the Centers for Disease Control and Prevention (CDC). Just in 2008, for example, the CDC says there were 14,800 deaths in the U.S. caused by prescription painkillers.

 

Considering this problem, a group of Brigham Young University (BYU) students reimagined the prescription drug bottle and have developed a high-tech regulator.

 

Their invention, called Med Vault, basically lets a pharmacist give instructions to the bottle, which then dispenses painkillers accordingly to the patient. Via a USB connection, a pharmacist can use special software to load the pills and program how many can be dispensed per day.

 

"They can dispense one pill every four hours or two pills every 24 hours or whatever the doctor prescribes," said BYU senior Madison Clark, the team's electrical engineer.

 

It's a pretty complex design that the team claims is tamper-resistant and break-resistant. The Med Vault requires users to put in an access code to get a pill, making it harder for the drugs to get into the wrong hands (e.g., a small child).

 

"The physical requirements of the shell and of the material properties are such that you can't take a hammer to it and break it open," Clark told Mashable.

Computer scientists and electrical engineers are devising algorithms that look for useful new patterns in data produced by medical sensors.

 

Medical radiography is basically a species of photography. Historically, the patient’s limb would be positioned between an x-ray source and a photographic plate. The plate would be exposed and developed, and the result was an image of the limb’s interior.

Today, most larger x-ray machines use digital sensors rather than photographic film, but otherwise, little has changed. The raw data captured by the sensors is easily interpretable as a visual image. 

That’s not true of more recent imaging technologies, however. In magnetic resonance imaging (MRI), for instance, different types of electromagnetic signals are individually analyzed and then stitched into a composite image. The algorithms that produce MRI scans are just as remarkable as the hardware.

Interpretation of the data produced by medical sensors remains one of the most fruitful applications of computer-science and signal-processing techniques in medicine, and it’s one that MIT researchers are pursuing down a number of different avenues.

Mobile health (mHealth) applications are rapidly evolving to take advantage of new image support capabilities in mobile networks and devices, according to a new report from Strategy Analytics M2M Strategies service, “Remote Healthcare Imaging Has Growth Potential in Both Developed and Developing Markets.” mHealth image-based applications range from remote interpretation of blood samples taken in a remote jungle clinic to sending fetal sonograms to the smartphones of friends and relatives.

Remote diagnostics has seen significant growth in recent years, as it is a way to get around shortages or poor distribution of specialists. In Egypt, for example, a partnership of Qualcomm, Mobinil, Click Diagnostics and the Ministry of Health allowed remote health clinics to send smartphone-captured images of skin conditions for diagnosis, by some of the country’s few dermatologists. “Smartphones and tablets have improved so much as image capture and display devices that they permit remote diagnosis with accuracy rates that approach in-person examination,” says Tom Elliott , Director of Emerging Markets at Strategy Analytics and the report’s author. In late 2011, for example, MIM Software received FDA 510(k) clearance for the use of its iOS viewing application for diagnostic x-ray and ultrasound viewing.

 

A richer clinical interaction between patients and practitioners is now supported by videoconferencing, taking advantage of a combination of more capable mobile devices, more pervasive high bandwidth networks, and improved image handling software. Management of the vastly increased volume of clinical imaging data is inviting the attention of mobile operators like AT&T, whose cloud-based image access and management service supports service delivery over multiple platforms and wide geographic areas.

 

Treato, a startup based in Israel, uses big data analytics to unearth patient insights about drugs and medical conditions from thousands of online health communities.

 

On thousands of message boards, community forums and health sites across the web, patients and caregivers leave detailed descriptions of their battles with disease, their experiences with drugs and their paths to recovery.

 

But those online notes don’t just provide catharsis and comfort. For big data startup Treato, they’re a rich source of data for uncovering health insights that could help patients, health care providers, pharmaceutical companies and other health organizations.

 

Plenty of other social media monitoring tools “listen” to digital chatter by keyword to help companies track the sentiment of online conversations about their brand.  But Treato CEO Ido Hadari said his company goes further. Over four years and with $7.5 million in venture funding, Treato developed technology that collects and processes billions of natural language patient conversation in real-time, as well as qualifies the sources of those conversations.

 

“What Treato is doing is the next-generation of patient intelligence,” he said. “It’s about an in-depth understanding of patients and caregivers and their real-life personal experiences.”

 

To start, it analyzes health-oriented web sites to make sure that they include quality health content and personal experiences.

 

To date, Treato has qualified 2,000 sites, including Topix.com, Drugs.com and smaller condition-specific health sites. Interestingly, while it includes public posts from Facebook, Hadari said, Treato does not include comments on Twitter because they found that 90 percent of its data is spam.

 

Once the company aggregates the commentary, it runs an analysis with its own medical ontology that organizes the unstructured social data into knowledge about patients’ personal experiences. To date, Hadari said, it’s analyzed 1.3 billion conversations from millions of patients about 11,000 drugs and 13,000 conditions.

 

Many physicians are going through the EHR paradigm shift and have lost tremendous amount of money and time. Numerous patients have given poor feedback to their doctors after the practice moved to an EHR.

 

Decade long relationships with their doctor slowly dissipates as patients become frustrated with their doctors lack of care because more attention is focused on computers.

 

Financially speaking, physicians have spent tens of hundreds of thousands of dollars on hardware, consulting services, and EHR software costs and usually spend just as much time figuring out what should have been discovered during a workflow assessment.

 

Technical doctor believes that continuing billing during the implementation, training physicians and staff members properly, and utilizing technology to assist in patient care is key to a successful EHR for every practice.

 

These beliefs are what keep Technical Doctor ahead of all other IT companies.

 

We bring you this e-book series as an attempt to simplify technology for you and your staff, to help you appreciate technology and what it can do for you and practice.

Dr. Data is IN...

 

The technology that’s already increased retail revenues and made law enforcement more effective could enhance healthcare providers’ business, by improving patient outcomes and lowering costs.

 

What’s the future of big data in healthcare?

 

According to the McKinsey Global Institute, using data to better predict the healthcare needs of the U.S. population could save between $300 and $450 billion.

 

1. The Patient Data Warehouse
By 2015, the average hospital will have two-thirds of a petabyte (665 terabytes) of patient data, 80% of which will be unstructured data like CT scans and X-rays.

2. Predictive Medicine
Our grandchildren will view personalized medicine the way we view antibiotics. It’ll be impossible—terrifying even—to imagine a time when patients were treated with a “one size fits all” drug for cancer, diabetes or heart disease because we didn’t know the risks from our genes and lifestyle.

3. Wellness Maintenance
It doesn’t end there. Big data can unlock the patterns of risk factors—both genetic and behavioral—that lead to higher rates of some diseases in some people, and guide them to make the lifestyle and medication changes that will keep them well.

4. Just-In-Time Medicine
Obviously, treating patients at the wrong time and in the wrong place is costly. Scheduled care is much cheaper than unscheduled care. Today, the industry works hard to “maximize production,” but improved big-data analytics across the industry can help optimize it further.

 

The Bottom Line
A hundred-billion here, a hundred-billion there: Pretty soon, you’re talking serious money.

With possible savings of 10% of the entire U.S. medical bill, insights from big data could be the prescription for better care, lower costs and higher productivity.

No matter how much technology we throw at it, the diabetes epidemic just won’t budge. Today, 8.3% of the U.S. population has the disease--a problem that cost the country $245 billion in 2012 alone.

 

For the past few years, drugmaker Sanofi US has run the $100,000 Data Design Diabeteschallenge, a call for entrants to design data-driven diabetes solutions. This isn’t a challenge for flash in the pan ideas that disappear soon after winning. Past competitions have yielded successful initiatives like Ginger.io, a behavioral health analytics startup that recently raised $6.5 million.

 

The finalists for this year’s competition (theme: using open data to make the right diabetes decisions at the right time) are below.

GOCAP

The GoCap is perhaps the simplest concept of the bunch: it’s a high-tech replacement cap for pre-filled insulin pens that can read dose amounts and time, and then wirelessly communicate that information to cell phones and glucometers. The resulting data can be used by both patients and large organizations for analysis.

CONNECT & COACH TM

A product of software development firm PHRQL, Connect & Coach TM calls itself the first clinical and consumer application to let dietitians and diabetes educators perform Diabetes Self-Management Education and Medical Nutrition Therapy in local communities. The product is designed for supermarket and pharmacy use.

ALLAZOENGINE

Created by healthcare analytics company Allazo Health, the AllazoEngine attempts to solve the niggling problem of medication non-adherence by using existing data from its members to predict who will neglect to take their pills--and the best way to get them back on track.

NUDURO

Like many products breaking into the market today, Nuduro provides healthy meal recommendations that match customer lifestyle, taste, and nutritional requirements. Unlike the other products out there, however, Nuduro presumably focuses specifically on diabetes patients.

MEDISAPIEN DIABETIC CLINICAL DATA REPOSITORY

This product, created by ZyDoc, is an enterprise healthcare analytics platform that lets users deposit all sorts of unstructured data--dictation, legacy data, transcribed text, and more--and transforms it all into fully-coded structured data. The platform is obviously relevant outside of the diabetes world as well.

Have you ever Googled a medical symptom? Posted in an online forum before visiting your general practitioner? Used social media to voice an opinion about a healthcare provider or speak about your personal experiences? For many people, turning to the Internet (especially social media) has become a natural way to seek quick answers and discuss medical matters, and the increasing reliance on “Dr. Google” has altered the way that people engage with clinicians.

 

In addition to changes in Internet usage and communication patterns within patient groups, a large number of clinicians have developed their own digital cultures and communities. In fact, medical communities are extremely active, and tend to make use of a large variety of communication channels. Through personal blogs, Twitter chats (e.g., MD Chat and #hcsm), and professional social media networks likeBMJ’s doc2doc, clinicians are increasingly talking online.

 

Nearly everyone has experienced the tedium and frustration of sitting on hold with customer service, trying to resolve a pressing issue, but being passed around from representative to representative just to find someone with the expertise to handle your problem.  It’s hard enough when it’s a malfunctioning television or an erroneous credit card charge, but it’s even worse when a physician is trying to document a patient’s life-threatening allergy before a surgery, and she can’t get access to the file she needs – or to anyone at the helpdesk with the clinical and technical skill to talk her through the solution. Poor customer support is one of the top reasons that providers consider replacing their EHR systems, and with good reason.  Minimal training and a lack of ongoing guidance can turn a major investment into a major mistake, as an increasing number of physicians are finding out.  “Our first EHR was not very user friendly, and customer service was really lacking.  We just couldn’t get answers.  We were at the point of hiring a consultant just to help us navigate the EHR,” said Dr. Waseem Khan of Cancer Care of North Florida.  “It was really anxiety-ridden.  I think we had one or two days of support from our vendor, and then we were on our own, so that was really difficult.” 

A new report estimates the market for sensors and mobile health apps will grow to $5.6 million by 2017. But how can that be if the adoption rate has been flat?

 

Consumers now are increasingly being incentivized by their employers to adopt healthy behaviors. Meanwhile, their healthcare providers are being pushed to do more in the way of preventive health and disease management (the focus of many of these sensors and apps), as reimbursement becomes value-based and ACOs continue forming. Since many people seem to think that physicians are the driving force in overhauling how care is delivered, perhaps those two forces will encourage growth in adoption of mobile products.

 

The cloud computing market in health care is expected to reach $5.4 billion by 2017 according to a recent study. In the past, the healthcare industry has been extremely resistant to embracing the cloud; however, today more healthcare organizations are rapidly moving their infrastructure and data to the cloud. 

Despite the accelerated move towards cloud adoption, it is important for pharma, biotech, SaaS providers, and other healthcare organizations to tread lightly regarding sensitive and HIPAA related information in the cloud.

Applying security best practices is vital to protecting data that rests in the cloud.

 

The benefits of the cloud are too big to ignore

– About 300% Global health care cloud computing revenue is expected to increase from $1.8 billion in 2001 to $5.4 billion by 2017

Easy to spin resources up and downAccessible and portable dataReduce CAPEX spendHigh Performance/capacityShift IT focus process to innovationIdeal for big data compute jobsStill, sensitive Personally Identifiable Information is at risk.Patient NamesDiagnosesMedicationsHospital RecordsInsurance IDsSocial Security NumbersBilling InformationGenetic History 

The Smartphone Physical project, which uses a set of devices that connect to an iPhone, allows doctors and patients to conduct a comprehensive physical examination. The devices can collect both quantitative and qualitative data, ranging from simple readings of weight and blood pressure to more complex readings such as heart rhythm analysis and visualization of the back of the eye. Here's why the project could change doctor's visits. 

 

Physical exams are falling out of favor, but the Smartphone Physical project wants to change that.

 

The  project, which uses a set of devices that connect to an iPhone, allows doctors and patients to conduct a comprehensive physical examination. The devices can collect both quantitative and qualitative data, ranging from simple readings of weight and blood pressure to more complex readings such as heart rhythm analysis and visualization of the back of the eye.

 

Most of the devices are now widely available. The project hopes to create the best black bag of devices for the next generation of doctors and modernize medical education with mobile technology.

 

Here’s why the project matters:

 

The use of ‘small data” such as the smartphone-enabled devices and medical apps can enhance patient engagement. Being able to meaningfully trend blood pressure data at home with plug-and-play devices reduces the mundane by using the smartphone device as a repository for personal health information.

 

Patients can look at their own point-of-care images including middle ear and back of the eye. For 100 percent of patients I screened, this was the first time they’d seen their own eardrum. Most hadn’t seen their own retina.

 

Use of a smartphone Electrocardiogram (e.g. AliveCor) allows patients to connect symptoms to objective data.Often times patients experience chest pains or heart palpitations that land them in the ER. By the time the ambulance arrives and brings the patient to the ER, the patient may feel better and not have a findable medical issue. Now, patients can grab a smartphone-enabled ECG right when they’re having symptoms at home and beam results to a doctor who can help decide whether the patient needs immediate medical attention. This can be quite validating and reassuring for the patient

 

Baselining: collecting objective imaging, numerical and/or tracing data allows clinicians to create a patient’s baseline health so that future data can be compared to baseline for more personalized diagnosis

 

Some of these devices can be used at home, but others do not necessarily replace the physician. They make the physical exam more reliable and enhance its quality.

 

The Smartphone Physical can improve medical by:

 

enhancing visual learning and the ability to deal with more data at the point of care to make better patient care decisions.

 

allowing students to see the optic disk/retina while learning how to do the exam in real time. I didn’t reliably see the optic disk until I started using the [Smartphone Physical] ophthalmoscope.

The future of health care could be found in a tiny, paper-thin skin patch that collects vital information. The Bio-patch sensor developed by researchers at Stockholm's KTH Royal Institute of Technology is inexpensive, versatile and, best of all, comfortable to wear.

 

"On the chest it provides electrocardiography (ECG), on the skull it measures brainwaves (EEC), and on the forearm it can measure muscle response to stimulation from the nervous system (EMG)," he says. It also has a built-in sensor that constantly monitors body temperature.

 

With a wireless connection, the patient can analyse the readings in their smartphone, or send the data via internet to a healthcare professional for diagnosis.

 

The thinking behind Bio-patch is that health care can be moved out of the hospitals and into the home, Yang says. "Bio-patch is a step towards what is known as self-care, which is valuable especially for patients discharged after an operation, or for the elderly living unassisted," he says.

 

While the technology is versatile, interest has focused on the heart. "Heart diseases account for the majority of all deaths in the EU," he says.

 

The Internet offers more than WebMD searches to find out what that headache really means. But how should we - and doctors - navigate this tricky space?

 

You wake up feeling a slight tickle in your throat. You try and shake it off and drink lots of water. After a few hours, it’s still there. Instead of calling your mom or making a doctor appointment, you head to the Internet. 

 

Today, anyone with a computer and a connection can get online and find a variety of results, ranging from simple sore throat to the more serious, like bronchitis and asthma.

 

But just because we can doesn’t mean we should. In a world where almost everyone is online and can easily find and provide medical solace, is it really, truly a good idea to consider social media and the Web a reliable source of healthcare?

Doctors and hospitals are on the social media bandwagon

Today, more and more members of the medical profession are embracing social media for sharing helpful medical information and providing patient care.

 

A Pricewaterhouse Cooper conducted survey asked over a thousand patients and over a hundred healthcare executives what they thought of the way many healthcare companies are utilizing social media and the Web, and results show the most trusted resources online are those posted by doctors (60 percent), followed by nurses (56 percent), and hospitals (55 percent).

 

Entrepreneurs in any industry need to start with a big idea – and a big tolerance for risk. But in health care, startups often need to take on a unique set of regulatory hurdles, complex systems and entrenched ways of getting things done to successfully build and scale.

 

1. Let your experience inspire, but don’t just build for yourself.

 

“There are a lot of entrepreneurs that may have experienced their own situation or the situation of someone close to them. And they’re developing a solution for that without actually going out and talking to enough people to make sure they’re not solving the need for one institution… and that they’re building something that has the ability to scale,” she said. “You can’t just sit behind your computer and code in health care, you have to be out in the trenches.”

 

2. Nuance over need.

“It’s important for entrepreneurs to understand the complexities of the industry and that’s not always easy because entrepreneurs and industry aren’t always speaking the same language,” she said. “Entrepreneurs really need to put their solutions in context.”

 

3. Build to build, not to sell.

But he also said that startups should get to know the top 10 companies that could be potential acquirers years in advance: “There are a lot of people working for you and counting on you to make the right decision. You’re not flipping the business to cash out, [you’re] putting it in a place that has greater leverage and impact potential,” he added.

  

4. Ask yourself the hard questions.

 

“There’s a point in the life of the company [when] the entrepreneur has to ask himself and the management team the hard question: ‘Can we build the company to last or are we better off as a feature of a bigger product?’ You have to be really honest with yourself,” he said. And even before that point, he added, it’s critical to find investors and a management team that will hold you accountable and force you to think.

Mobile technology is experiencing a surge of advances in relation to the medical industry.

 

Technological advances once merely imagined in Sci-Fi flicks (think of Star Trek’s communicator, Bluetooth technologies, and even a quasi version of touch enabled computer screens) are being realized and even superseded thanks to modern innovation.

 

Mobile technology, in particular, is experiencing a surge of advances in relation to the medical industry. Research breakthroughs, advances in supporting technology infrastructure, and even substantial allocations of resources from private investors are realizing far reaching technological dreams, and then some.

 

Several weeks ago, Mike Lazaridis’ Research In Motion’s Blackberry Vice Chairman, (the maker of those once ubiquitous handheld wireless devices), launched a $97 million dollar Quantum Valley Investments fund to support innovation and entrepreneurs focused on creating non-invasive medical diagnostic equipment. The idea is simply to make “Star Trek’s” medical tricorder device for diagnosis a reality.

 

The push to go mobile has been years in the making and has, in many respects, been assisted by underlying communications technology and the utilization of what many in Silicon Valley have termed the social, mobile, web trifecta. Smartphones, applications, and social media have helped to drive mobile advancements in relation to consumer technology adoption, and impactful breakthroughs in medical technologies have been evolving as well.

The adoption of electronic health records (EHRs) has ushered in a new era in medicine.Family physicians say there are both benefits and drawbacks to EHRs.Analysts insist, however, that EHRs are a necessary component of the emerging health care system.

 

Chris Tashjian, M.D., has been a family physician for the past 25 years and has spent most of his career practicing in a paper-driven medical environment.

 

"In the paper world, we reacted -- we waited for the patient to get sick and then reacted to it," said Tashjian in an interview with AAFP News Now. "In the electronic world, we can practice proactive medicine. We can actually try and reach out to patients before they get sick and before they have bad sequelae that come with diabetes, high blood pressure and heart disease.

"It changes the way we look at the patient," he added. Tashjian's experience is an example of how technology is transforming the practice of medicine. In 2009, the federal government enacted the American Recovery and Reinvestment Act (ARRA), which made major investments in health information technology and created financial incentives for physicians and other health care providers in the Medicare and Medicaid programs who achieve meaningful use of EHRs.  

Patient participation is essential in developing high-quality guidelines but faces practical challenges. Evidence on timing, methods, evaluations, and outcomes of methodologies for patient participation in guideline development is lacking.

 

Objective: To assess the feasibility of a wiki as a participatory tool for patients in the development of a guideline on infertility determined by (1) use of the wiki (number of page views and visitors), (2) benefits of the wiki (ie, number, content, and eligibility of the recommendations to be integrated into the guideline), and (3) patients’ facilitators of and barriers to adoption, and the potential challenges to be overcome in improving this wiki.

Results: The wiki attracted 298 unique visitors, yielding 289 recommendations. We assessed the 21 recommendations ranked as the top 5 or top 3 for their eligibility for being integrated into the clinical practice guideline. The evaluation identified some challenges needed to be met to improve the wiki tool, concerning its ease of use, website content and layout, and characteristics of the wiki tool.

Conclusions: The wiki is a promising and feasible participatory tool for patients in guideline development. A modified version of this tool including new modalities (eg, automatically limiting the number and length of recommendations, using a fixed format for recommendations, including a motivation page, and adding a continuous prioritization system) should be developed and evaluated in a patient-centered design.