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If We Can't Get Genome Accuracy Right, Personalized Medicine Is a Pipe Dream

If We Can't Get Genome Accuracy Right, Personalized Medicine Is a Pipe Dream | healthcare technology |

If genomes are going to revolutionize personalized medicine, the first step will be sequencing the genome accurately.

It bears repeating just how far this tech has come: the price of sequencing a genome is rapidly coming down, as is the time it takes to do a sequence. It’s getting so easy that the price point is already well within the means of many middle class Americans, and the technology might soon prove useful enough to save lives. Proponents say that, in the future, personalized medicine will allow doctors to determine the specific genetic variants that predispose their patients to certain diseases, which will then help doctors to devise individualized—and more effective—treatments.

But with roughly six billion base pairs in the human genome, creating a truly accurate gene sequence is no easy task. Even the best sequencing techniques can have an error rate around 1 percent, which adds up to hundreds of thousands of errors. When diseases depend on single nucleotide insertions or changes, those errors can mean the difference between a misdiagnosis and an accurate one.

A group of researchers with the US government’s National Institute of Standards and Technology is trying to solve that problem with a program called Genome in a Bottle. With academic and commercial partners, the group is trying to create what is essentially one “perfect” human genome that can be a reference for sequencing labs. Though every genome is different, the places where sequencing errors most commonly happen are fairly well understood, and by comparing one sequence with a reference genome, doctors and researchers would be able to tell if they’ve made a mistake.

“We’re sitting here with billions of data pairs—it boggles the mind try to get that much information accurately determined,” said Marc Salit of NIST’s Genome Scale Measurements Group. “Even when we think we’re getting it right, a few missing bases or additional ones can make a huge difference.”

Salit and his colleague, Justin Zook, recently published a study in Nature Biotechnologydiscussing their solution to the problem. According to Salit, by sequencing the same genome many times and comparing the base pairs, they can create a reference that is much more accurate than what we already have.

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As 3D printing trend in healthcare continues, pediatricians form "think tank"

As 3D printing trend in healthcare continues, pediatricians form "think tank" | healthcare technology |

Now that kids are using 3D printers to build their own new limbs, a group of Philadelphia doctors is exploring how to use the technology to build kid-sized devices.

A group of pediatric specialists at Children’s Hospital of Philadelphia want to find out how 3D printing can be used to create customized devices for the complex needs of its pediatric patient populations.

One frustration of pediatrics is that it tends to be an area overlooked by medical device companies. Children represent a relatively small market that doesn’t lend itself to mass production. Adapting adult medical devices for children can be problematic. But when you factor in subtle developmental differences, that can make it more complicated to find the best medical device for children.

Dr. Jorge Galvez, an anesthesiologist at CHOP and a professor of anesthesiology and critical care at the Perelman School of Medicine at the University of Pennsylvania, talked about the group at the kickoff of DreamIt Venture’s new program with CHOP. It began collaborating with University of Pennsylvania engineering students Nicholas McGill and Michael Rivera after they won a challenge by the Society for Technology in Anesthesia.

The annual contest this year turned its attention to 3D printing applications. It sought ideas for applying the technology to developing a Williams intubating airway that could be adjusted based on measurements from a CT or MRI scan. That particular technology is especially useful for a pediatric hospital because there’s a need for specialized devices for children with variations in the shapes of their airways.

Galvez said the idea is that the 3D printing think tank would develop applications for the technology across different pediatric specialties. Among the specialties represented in the group are cardiology; anesthesiology; ear, nose and throat; and orthopedics. “There’s a lot of low-hanging fruit in this area, such as customized prosthetics,” said Galvez. “The challenge is not about using the printer, but having the knowledge and expertise to know what the needs of each specialty are.”

The idea is that as the practice of 3D printing becomes more mature, customized devices could be developed more rapidly.

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Hospitals Use Tablets as Extension of EHRs

Hospitals Use Tablets as Extension of EHRs | healthcare technology |

Some leading hospitals are increasingly turning to tablets -- iPads and iPad-like devices -- as a way to improve access to patient health records for providers walking the hospital halls.

Such devices are seen as a way to work around clunky desktops and make greater use of an electronic medical record's (EMR) capabilities.

"Tablets, in our experience, are very effective if you need not the entire EMR, but a slice of information," Will Morris, MD, associate chief medical information officer at the Cleveland Clinic, told MedPage Today.

The hospital is piloting the use of tablets with a few sectors of its workforce, such as its rapid response teams. Clinicians can look up patient information on their way to a patient who is crashing and better know how to treat the patient when they arrive at their room.

Other hospital staff use them on rounds; data entered is synced with the hospital's full EMR.

"The more we can assist our providers in being more efficient, the better the value proposition," Morris said.

Hospitals are increasingly turning to mobile devices as a cost-effective extension of their EMRs, making them more usable and friendly, David Collins, senior director of mHIMSS, the mobile wing of the Healthcare Information and Management Systems Society (HIMSS), in Chicago, said.

"You spend millions of dollars for EHR [electronic health record] implementation," Collins toldMedPage Today in a phone interview. "But if you can spend $300 on a tablet and issue these to providers so they're more mobile, it's really a minimal cost for the payoff."

At the Cleveland Clinic, officials don't have data on quality improvement just yet, but Morris said they have seen an improvement in how long it takes nurses to enter vital signs.

"It's not going to be the tablet that transforms practice," he said. "It's going to be 'How do you use the data coming out of your EMR, applied with clinical rules, to empower the clinical practice?' "

Inforth Technologies's curator insight, February 19, 2014 8:13 AM

We have had great success using the Microsoft Surface Tablets to access the EHR.

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Turn Your Smartphone Into a Digital Microscope! This video shows to convert your smartphone into a digital microscope capable...
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Left Atrial Pressure Monitoring To Optimize Heart Failure (Trial)

Left Atrial Pressure Monitoring To Optimize Heart Failure (Trial) | healthcare technology |
LAPTOP-HF is designed to investigate a new way to help treat heart failure. Since many heart failure patients are frequently hospitalized and often feel poorly, the hope is that this system may help your doctor adjust your medications before you develop symptoms or require hospitalization.

This is accomplished by measuring pressure in the heart and then each day providing you with your physician’s updated recommended medications and dosages. These may change daily depending on your condition. This is very similar to how diabetics manage their glucose levels. -

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Apple vs. Google: An mHealth Face-Off

Apple vs. Google: An mHealth Face-Off | healthcare technology |

Industry observers like myself have often painted the competitive mHealth landscape with a brush that wages computer manufacturer Dell and software behemoth Microsoft versus Apple--the reigning mobile healthcare champion. However, the real battle for the heart, mind and soul of the still-emerging mHealth market places Apple and search engine giant Google squarely in the commercial trenches.

Apple's iPhone and iPad have set the standard for other mobile devices in healthcare. Doctors, in particular, simply love their iPhones and iPads. But, now, the mHealth war between Apple and Google appears to be entering a new battlefield, namely wearable devices. 

At the center of Apple's efforts in this area is its long-awaited iWatch, a wristwatch-like computing device with smartphone/tablet and health/activity tracking capabilities. Reportedly, iWatch includes a pedometer for counting steps and sensors for monitoring health-related data such as heart rate.

Apple is growing its team of medical sensor specialists by hiring some of the world's premiere experts in mobile medical technologies. Presumably, this expertise will be heavily leveraged by Apple in their development of the iWatch or some other device.    

Simultaneously, Google has been working on its much-heralded Google Glass, high-tech glasses which contain a heads-up display, camera and a microphone, and can ostensibly support mobile health apps directly on the device. Google Glass, developed by the company's secretive Google X lab, has strong potential for healthcare, particularly in the ER where physicians could use the glasses to scroll through lab and radiology results and in the OR providing surgeons with hands-free access to critical clinical information.

In addition, earlier this month, Google unveiled its contact lenses, which use a tiny sensor and wireless transmitter, to monitor and measure glucose levels in tears, potentially replacing the self-administered blood tests from finger pricks that diabetics must endure on a daily basis. Not surprisingly, Google employees recently met with U.S. Food and Drug Administration officials at FDA headquarters who regulate eye devices. 

Who will be first to market with these wearable devices--Apple or Google--remains to be seen. What is certain, however, is that the two technology leaders with track records for building strong brands will no doubt dazzle the marketplace with innovative, leading-edge products that put sensor-based devices in the hands of consumers and medical professionals. That kind of competition in mHealth can only serve to benefit us all as this nascent industry moves forward

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Ricardo Rocha's curator insight, February 16, 2014 7:53 PM

"wearable devices"  .... Estamos falando apenas do começo, as possibilidades e benefícios são incontáveis!!!! Imagine não ter que tomar uma agulhada por dia para medir a glicose?

Jay Gadani's curator insight, August 6, 2014 11:44 PM

Competition is always great! 

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Trends and Drivers of Primary Care Physicians' Use of #HealthIT

Trends and Drivers of Primary Care Physicians' Use of #HealthIT | healthcare technology |

Commonwealth Fund researchers analyzed data from surveys of primary care physicians conducted in 2009 and 2012 to check on the progress of health IT adoption.

Adoption of health information technology (HIT) by physician practices rose considerably from 2009 to 2012, yet solo physicians lag practices of 20 or more and certain functions—like electronically exchanging information with other physicians—have been adopted by only a minority of providers. Physicians who are part of an integrated delivery system, share resources with other practices, and are eligible for financial incentives, have higher rates of HIT adoption.

Doctors are using HIT in greater numbers, spurred on in part by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, which provided billions to help build a national HIT infrastructure. Commonwealth Fund researchers analyzed data from surveys of primary care physicians conducted in 2009 and 2012 to check on the progress of HIT adoption and to see how certain factors—like being part of an integrated health system or using shared technical assistance programs—can influence technology take-up.

Key Findings
  • From 2009 to 2012, the rate of adoption of electronic medical records (EMRs) by U.S. primary care physicians increased by half, from 46 percent to 69 percent. HIT use rose particularly in order entry management: the proportion of physicians able to send prescriptions electronically to pharmacies nearly doubled, from 34 percent to 66 percent; electronic prescribing increased from 40 percent to 64 percent; and electronic ordering of lab tests grew from 38 percent to 54 percent.
  • In 2012, 33 percent of primary care physicians could exchange clinical summaries with other doctors, and 35 percent could share lab or diagnostic tests with doctors outside their practice.
  • As of 2012, a minority of physicians provided electronic access for patients. Roughly one-third or fewer allowed patients to electronically view test results, make appointments, or request prescription refills.
  • Practice size is a major determinant of HIT adoption. Half of physicians in solo practices use EMRs, compared with 90 percent of those in practices of 20 or more physicians.
  • Physicians who are part of an integrated delivery system (like Kaiser Permanente or the Veterans Administration), those who have arrangements with other practices to share resources (technical assistance programs for clinical information systems or quality improvement), and those who are eligible for financial incentives, have higher rates of HIT adoption.

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U.S., U.K. collaborate on health IT sharing initiative

U.S., U.K. collaborate on health IT sharing initiative | healthcare technology |

With an eye on improving healthcare quality and efficiency, the U.S. Department of Health & Human Services and the U.K.'s National Health Service will share health IT information and tools with one another after signing an agreement Thursday at the Office of the National Coordinator for Health IT's annual meeting in Washington, D.C.

HHS Secretary Kathleen Sebelius and her British counterpart Jeremy Hunt signed the memorandum of understanding, the latter of whom was broadcast via a live feed from the U.K. The agreement focuses on four key areas, according to an HHS announcement, including:

  • Sharing quality indicators: The collaboration now is identifying alignments across existing British and American repositories to identify best practices in the design and use of quality indicators. Future work will include mutually leveraging technical experts and data, and working on a standardized approach to quality indicator development.
  • Liberating data and putting it to work: HHS and NHS will discuss and find areas of collaboration around open data and safe and secure data transparency of secondary stored data, as well as interoperability standards for improvement of data sharing and clinical care with a focus on patients accessing and sharing data.
  • Adopting digital health record systems: Both organizations will work to maximize successful adoption of digital records across the health care spectrum and support the development of a robust health IT workforce.
  • Priming the health IT market: Both organizations will work to support the Health IT Marketplace by identifying barriers to innovation, sharing individual certification approaches for patients and clinician-facing applications, and strategies to support small and medium enterprises/start-ups

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How does patient engagement transform into useful EHR data?

How does patient engagement transform into useful EHR data? | healthcare technology |

Patient engagement represents the next aim of healthcare reform through the adoption of health IT systems and services. It just received a boost from PCORI which awarded $93.5 million for the creation of 29 clinical research data networks that will combine to form its National Patient-Centered Clinical Research Network (PCORnet).

A major aim of establishing these networks is to enable the patient population to play an active role in how their care is delivered. “One of the reasons people think we should be engaging patients more actively is to make sure that as we do research we’re measuring and assessing the kinds of things they want to know when they’re making medical decisions,” says Elizabeth McGlynn, PhD, Director of the Center for Effectiveness & Safety Research at Kaiser Permanente.

“While we appreciate that more traditional biometric information may be important,” she continues, “there are a number of other things that any of us who have had to make decisions about whether or not to have a surgical procedure or take a particular drug would like to know beyond some of that information.”
McGlynn and her team of researchers will rely on its network, Partners Patient Outcomes Research To Advance Learning (PORTAL), to change how a healthcare organization learns from its patients, namely in bridging the gap between the latter and researchers. “The whole area of engaging patients more actively and comprehensively in research is an evolving one. 

At a high level, the challenges for the project are two-fold. On the one hand, researchers need to be able to understand how patients want to be engaged:

We know that patients aren’t homogenous; we know that there’s a range of opinion. These kinds of tools give us the chance to continue to appreciate the diversity of ideas and opinions and avoid trying to just get to the one or the two leading ideas but really to think. As people are exploring the notion of what personalized medicine means, how do we make sure that we’re eliciting information from people about what’s important to them personally?

On the other hand, they must tackle the challenge of making this feedback available to clinicians in a meaningful way:

One of our big challenges is finding ways to effectively integrate that information into the electronic health record. We have some work underway right now that’s given us some early insights into what patients are willing to provide if their doctors are going to see it and use it but if it’s just a hypothetical exercise, not so interested.

Mike Vassel's curator insight, January 15, 2014 1:54 PM

Interesting article.  I believe that a healthy patient is engaged and proactive in their own wellbeing. 

Renzogracie academy's curator insight, January 17, 2014 6:03 AM
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Top health industry issues of 2014

Implications of integrating technology:

Under increasing pressure to keep costs down, providers should promote technologies that help manage patients’ health outside of costly care settings.

Shouldering more of their medical costs, health-conscious consumers may be more willing to pay for mobile and other technologies to help manage their health.

Drug and device companies must understand consumer behavior and satisfaction in the social media era.

Reimbursing non-traditional, mobile-enabled therapies may allow insurers to reduce medical costs.

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Consumer electronics industry is heading toward world of wearables and sensors

Consumer electronics industry is heading toward world of wearables and sensors | healthcare technology |

The consumer electronics industry is expanding beyond its traditional borders as consumers start to adopt technologies that make use of ubiquitous computing power, sensors, and wearable product designs.

Shawn Dubravac, chief economist of the Consumer Electronics Association, made this observation of the industry at the first press event at the 2014 International CES, the big tech trade show in Las Vegas this week.

Among the trends he sees taking hold are mass customization, thanks to technologies like 3D printing. The 3D printing companies like Maker Bot have their own space at the show now, 7,000 square feet of exhibits, and it’s sold out. He believes about 99,000 3D printers will ship in 2014.

Consumers are also embracing lots of new screens in their lives. As an example, tablets didn’t exist as a big market in 2009. But now, in the U.S., Dubravac said that tablet ownership is expected to exceed 50 percent of households once the numbers from the holiday season are tallied up.

He also said that wearables and the spread of mobile devices are making more new technologies possible. And many of these new devices are autonomous, or able to do smart things on their via robotics or artificial intelligence.

Dubravac said that mobile devices are expected to outnumber computing devices sold to date sometime in 2014 or 2015.

BandKids13-14's curator insight, January 7, 2014 10:19 AM

The electronics industry is advancing very quickly. The future is coming and its coming fast. Its crazy that people waste their money on these acessories. Thers really no need or use for them. You can function in the world without them. People have have before and they still will.


shamlabeth's curator insight, January 7, 2014 7:26 PM

To me the new and improved technology is a real eye opener. As the years go by many things are coming and going. In this article Dubravac is right about old technology we do begin to waste. What scares me the most is we will soon be able to operate things with our eyes.~Amanda

Emma Baker's curator insight, November 16, 2014 2:20 PM

Wearable technologies are making new technologies a possibility and are inspiring new gadgets and ideas. It seems that with every new wearable gadget there are updates. 

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Credit Card-Sized Chip Diagnoses HIV and Provides T Cell Counts on the Spot

Credit Card-Sized Chip Diagnoses HIV and Provides T Cell Counts on the Spot | healthcare technology |

A credit card-sized chip can diagnose HIV infection and provide T cell counts to guide treatment, according to a recent paper in Science Translational Medicine.

The fluid-processing chip provides accurate test results in less than 20 minutes using a single drop of blood that goes directly into the testing chamber and does not require trained handling.

The chip is designed to work in a battery-powered handheld device that would “deliver simple HIV diagnostics to patients anywhere in the world, regardless of geography or socioeconomic status,” the researchers say in the paper.

Nearly 7 in 10 HIV-infected people live in poor parts of the world. Many have to travel long distances to get to a clinic, making coming back for test results a major ordeal.

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Rx for patient engagement: Provider-prescribed apps

Rx for patient engagement: Provider-prescribed apps | healthcare technology |

While much is made of the mHealth app market for consumers, a growing segment is being tailored for clinicians. Doctors are becoming as mobile as their patients, and they need the tools to access medical information as well.

Vendors are already moving in that direction, too. Take Orca Health, for instance, which has developed a platform of iOS 7 apps designed to help clinicians educate patients about certain conditions or medical procedures. The Patient Education for Healthcare Professionals platform, which currently features 10 apps, allows physicians to choose and edit medical content, capture photos and videos and securely send that information to the patient — in essence, enabling the physician to prescribe an app.

"Patient education is a monster, monster problem," said Matt Berry, Orca Health's founder and CEO, in an interview with mHealth News.

Berry said the Orca Health apps (the company also has a line of iBooks through a partnership with Harvard Medical School) enable clinicians to personalize patient education, rather than relying on generic handouts. The physician sends the patient an e-mail with a link to a HIPAA-compliant web portal, where the patient can create a secure account and view that information. Subsequent prescriptions — videos, photos, links to information, histories of medical encounters and resolutions — can be added to the patient profile by the physician.

Apps currently available in the Apple App Store are Spine Decide, Knee Decide, Heart Decide, Eye Decide, Shoulder Decide, Foot Decide, Hand Decide, Dental Decide and Ear, Nose and Throat Decide (a Kids dental app is available for the Apple iPad).

Company officials said physicians using the Orca Health platform have improved patient retention rates by as much as 15 percent.

"Physicians are asking for these tools," Berry said. "They want to be able to prescribe that content for their patients."

nrip's insight:

Physicians are asking more every week for mobile apps which they can use for their practice as well as recommend to patients. In the last quarter alone, I received over 400 requests from Physicians for certain types of Apps for Android and Windows Phones. . The fragmented mobile ecosystem does present challenges for vendors, but look at the opportunity.

Thybo Lingier's curator insight, December 31, 2013 10:27 AM

Company name: Orca Health
Economic activity segment: Healthcare

Use of ICT: Designing mobile apps to controle your health


Objectives: Welfare of the people 

Nmsu HC's curator insight, June 9, 2014 1:18 PM

Health education is expanding in many ways! 

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Apple Patents Fitness-Tracking Earbuds That Can Read Your Heartbeat

Apple Patents Fitness-Tracking Earbuds That Can Read Your Heartbeat | healthcare technology |

The U.S. Patent and Trademark Office just granted Apple a patent for a new kind of biometric sensor that, unlike other wearables we've seen so far, connects to you via your ear. The patent applies to a sensor that can be embedded in a pair of earbuds or headphones, which then hoovers up wearer data like heartbeat, body temperature, or even how much you're perspiring when you hit the gym.

How the sensor intends to do that, however, isn't explicitly outlined in the filing. AsAppleInsider first pointed out, U.S. patent #8,655,004 concerns a "sports monitoring system for headphones, earbuds and/or headsets" to be used "during exercise or sporting activities." Originally filed in 2007, the patent suggests Apple has apparently been experimenting with new ways to cull together biometric data for quite some time now.

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How can HIE patient queries save millions in repeat tests?

How can HIE patient queries save millions in repeat tests? | healthcare technology |

How can health information exchange lead to savings? A case study by Western New York’s clinical information exchange HEALTHeLINK claims more than a million dollars could have been saved by avoiding unnecessary CT scans. And patients stand to benefit as well.

“These findings demonstrate the value an HIE provides by reducing the number of unnecessary tests which saves time, money and radiation exposure to our patients,” HEALTHeLINK chairman Dr. David Scamurra said in a public statement.

Using a sample of patients having received more than one CT scan during six-month period — sometime between July 1 , 2011 and Dec. 31, 2014) — the study broke duplicate scans into three categories: known (3,361), inconclusive (1,878), and unknown (885). Known studies were removed and the remaining 2,763 CT scans deemed to potentially unnecessary duplicative tests.

Based on the findings, an overwhelming majority of duplicative CT scans (90%) were the result of orders made by physicians who either never (0 queries) or infrequently (1-499 queries) used the HEALTHeLINK patient query function, the virtual health record (VHR).

What’s more, the use of VHR could have prevented 48.2 percent of duplicate CT scans from being performed based on the patients having consented to their information being available for HIE and their data being searchable by HEALTHeLINK users.

The study also shows that hospital-based physicians were the most frequent users of CT scans and the greatest source of duplicate scans, representing more than 95 percent of those deemed potentially unnecessary.

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3D Printing: The Future is Now

3D Printing: The Future is Now | healthcare technology |

Who knew the loud dot matrix printers of the 1980s, complete with their perforated-edge paper, would give way to sleek 3D printers that can create items ranging from weapons to medical equipment? Let’s take a look at how 3D printing works and how far the technology has come since its recent inception.

malek's comment, February 18, 2014 7:14 AM
@nrip appreciate If you can deliver more on using 3D printing to create organs, build new human skin.
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Better RNA interference, inspired by nature

Better RNA interference, inspired by nature | healthcare technology |

Inspired by tiny particles that carry cholesterol through the body, MIT chemical engineers have designed nanoparticles that can deliver snippets of genetic material that turn off disease-causing genes.

This approach, known as RNA interference (RNAi), holds great promise for treating cancer and other diseases. However, delivering enough RNA to treat the diseased tissue, while avoiding side effects in the rest of the body, has proven difficult.

The new MIT particles, which encase short strands of RNA within a sphere of fatty molecules and proteins, silence target genes in the liver more efficiently than any previous delivery system, the researchers found in a study of mice.

"What we're excited about is how it only takes a very small amount of RNA to cause gene knockdown in the whole liver. The effect is specific to the liver - we get no effect in other tissues where you don't want it," says Daniel Anderson, the Samuel A. Goldblith Associate Professor of Chemical Engineering and a member of MIT's Koch Institute for Integrative Cancer Research.

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APIs Boost Health Information Exchange

APIs Boost Health Information Exchange | healthcare technology |

No matter how innovative the personal health records (PHRs) or electronic health records (EHRs) become, given the highly fragmented and specialized US healthcare system they still need to exchange data in a secure way that preserves privacy and trust. That is the goal of health information exchange (HIE).

The key HIE technical challenges are easily understood. Parts of a patient's clinical data will often be stored in many EHRs. For a patient with four, five, or more chronic diseases (these drive half of all Medicare costs) research shows that this will typically exceed 10 EHR implementations from multiple vendors! A conscientious provider seeing such a patient would want a comprehensive view of all of this care in order to save time collecting information that already exists, avoid duplicating tests and procedures that have already been done, and prevent mistakes from lack of information.

Historically, there have been two attempted solutions: 1) store everything centrally and, in essence, create a community record, or 2) keep the data at the source but build central indexes to patients and their medical documents and provide some kind of translation service to bridge differences in the way clinical data is represented across EHRs. This is the so-called hybrid exchange.

More recently there is Fast Healthcare Interoperability Resources (FHIR), which is essentially based on the idea that healthcare information can be exchanged the same way that other information is shared on the Internet. If you've used Amazon to look for goods to purchase, you might have noticed that, up there in the URL, text appears when you click the search button that specifies what you want. Although it might be a bit cryptic, even a non-technical person can usually figure out most of what it says.

What's really going on here? You're at your computer (which, of course, these days might be a mobile device such as a smartphone), and the information you want is securely stored in, for example, Amazon's cloud. You specify what you want, and your browser creates a query and sends it to the cloud, where it might be routed to any one of thousands of Amazon servers that will interpret it, query a database, and return the information you requested. This ability to route requests to any server in the cloud that is available is another key technical property that lowers costs and is exploited in FHIR.

As with Direct, there is more to the story than I've described (technically inclined readers should read the FHIR Summary, which is also available as a two-page PDF). But this should suffice to give you the basic idea of what is increasingly termed "API-based HIE."

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Craig Allen Keefner's curator insight, January 29, 2014 11:20 AM

HL7 ccda ruling standard

Stephen Greengrass's curator insight, January 31, 2014 4:56 AM

APIs are the way forward for so many aspects of digital content.  Combine these with patient info and it's a powerful opportunity for real innovation in care.

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51% of physicians regularly use tablets as mHealth tools

51% of physicians regularly use tablets as mHealth tools | healthcare technology |

While smartphones still beat tablets in numbers and frequency of use, physicians generally prefer to do their reading and research on the bigger screen.

Tablets are taking over as a tool of choice for physicians, says a survey by Kantar Media, with just over half of medical professionals using the hand-held computers to read up on the latest journal articles, conduct research on patient care, and email with colleagues.

51% of physicians say they use a tablet during their daily work, while nearly the same amount also use the device for personal tasks. 

The survey of more than 3000 physicians found that nearly a third of respondents use tablets to read up on medical publications and 16% watch webcasts or listen to podcasts on professional topics using their tablets which have been making their way into hospitals and offices at a steady pace, through patient-oriented telehealth pilots and monitoring programs intended to engage patients and give providers an edge over chronic diseases

“As physicians continue to shift their work-related tasks to mobile devices, they must overcome technological hurdles challenging them from completing some of their most important tasks, namely interacting with EHRs and recording clinical notes.”  An unrelated CDW survey adds that physicians can gain more than an hour of productivity by using tablets to help them multitask, with 84% of physicians saying that the devices make them more efficient and happier doing necessary paperwork.

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Can sharing patient records among hospitals eliminate duplicate tests and cut costs?

Can sharing patient records among hospitals eliminate duplicate tests and cut costs? | healthcare technology |

A recent analysis of the impact of health information exchanges, which allow health-care providers to share patient records electronically and securely, shows the systems hold promise for reducing health costs and unnecessary care in emergency departments.

For the study (subscription required), University of Michigan researchers examined information on hospital health information exchange participation and affiliation from the Health Information Management Systems Society’s annual survey as well as data the  California and Florida state emergency department databases from 2007 through 2010. Both states were early adopters of health information exchanges. According to a university release:

The findings show that the use of repeat CT scans, chest X-rays and ultrasound scans was significantly lower when patients had both their emergency visits at two unaffiliated hospitals that took part in a [health information exchange]. The data come from two large states that were among the early adopters of [health information exchanges]: California and Florida.

Patients were 59 percent less likely to have a redundant CT scan, 44 percent less likely to get a duplicate ultrasound, and 67 percent less likely to have a repeated chest X-ray when both their emergency visits were at hospitals that shared information across an [health information exchange].

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Google testing contact lens that can monitor glucose levels

Google testing contact lens that can monitor glucose levels | healthcare technology |

Finger pricks and careful eating are an important part of the daily routine for most people with diabetes. While automated glucose meters are a growing option, they can still create discomfort and other inconveniences.

Google wants to go in a totally different direction with a project announced today:smart contact lenses that can detect glucose levels via the wearer’s tears and alert them when levels dip or rise.

This isn’t the first smart contact lens, and several options already exist for people interested in monitoring glaucoma. But Babak Parviz, who also leads the Google Glass team, is a smart contact pioneer and Google which is a secretive division of Google dedicated to difficult, future-looking projects, has a reputation for ably pursuing projects like this.

The lens works via a small wireless chip and glucose sensor embedded between two pieces of soft material. The current prototype puts out a reading once a second. Google is also interested in integrating an LED light, which could light up to alert the wearer of dangerous glucose levels.

The lab is now looking for parters to help bring the lens to market. It would also like to develop an app that would help wearers read and manage the data the lens takes in.

The lens could help people with diabetes monitor their daily health and recognize dangerous situations.

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Beth Faulkner's curator insight, January 22, 2014 7:27 AM

Google's smart contact lens could ease the pain of diabetes monitoring.

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Sensors that want to your smartphone to be your doctor is a big trend at CES

Sensors that want to your smartphone to be your doctor is a big trend at CES | healthcare technology |
Sensors that want to your smartphone to be your doctor is a big trend at CES

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Lets Get Industrial Engineers to Design EHRs

Lets Get Industrial Engineers to Design EHRs | healthcare technology |

Many EMR designers are seduced by the idea that since users are already familiar with paper forms that the paper form metaphor is a good user interface. It is not.EMRs that try to mimic traditional paper medical records are not well designed for high-usability, high-productivity data and order entry.

An EMR designed and implemented using industrial engineering principles and techniques is a fundamentally different EMR that the traditional EMR. Instead of starting with a user interface that looks like a paper form, the user interface is essentially derived, using scientific and engineering principles, from the human body’s response to physical, physiological, and cognitive workload.

Perception, attention, cognition, motor control, memory storage and retrieval all interact with work environment and job demands to result in a body of knowledge about mental workload, vigilance, decision making, skilled performance, human error, human-computer interaction, and training. (This is not dissimilar to the way in which medical knowledge is derived using scientific methods from the structure and function of the human body.)

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DNA sequencer raises doctors' hopes for personalized medicine

DNA sequencer raises doctors' hopes for personalized medicine | healthcare technology |

Among the many stents, surgical clamps, pumps and other medical devices that have recently come before the Food and Drug Administration for clearance, none has excited the widespread hopes of physicians and researchers like a machine called the Illumina MiSeqDx.

This compact DNA sequencer has the potential to change the way doctors care for patients by making personalized medicine a reality, experts say.

"It's about time," said Michael Snyder, director of the Stanford Center for Genomics and Personalized Medicine.

Physicians who rely on genetic tests to guide their patients' treatment have had to order scans that reveal only small parts of a patient's genome, as if peeking through a keyhole, Snyder said: "Why would you study just a few genes when you can see the whole thing?"

Back in 2000, when the Human Genome Project completed its first draft of the 3 billion base pairs that make up a person's DNA, the effort took a full decade and cost close to $100 million. The Illumina MiSeqDx can pull off the same feat in about a day for less than $5,000 — and the results will be more accurate, two of the nation's top physicians gushed in the New England Journal of Medicine.

That confluence of "faster, cheaper and better" is likely to accelerate the use of genetic information in everyday medical care, Dr. Francis Collins, director of the National Institutes of Health, and Dr. Margaret Hamburg, commissioner of the FDA, wrote last month. DNA sequencing should guide physicians in choosing the best drug to treat a specific patient for a specific disease while risking the fewest side effects.

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How medical augmented reality will seamlessly save your life

How medical augmented reality will seamlessly save your life | healthcare technology |

You walk in to the doctor’s office – nervous – thinking of the last time you received the injection of your monthly medication, remembering how painful and aggravating it was when the nurse couldn’t find your vein and poked you five different times to insert the IV.

This time, however, something is different. When the nurse shows up he is wearing a special pair of glasses, something you wouldn’t expect to see during such a standard procedure. The device uses advanced technology and shows the nurse a perfect highlighted image of your veins so he can insert the IV in one painless attempt.

Sounds like science fiction right? Wrong. This is a real device and is just one early example of how Augmented Reality (AR) technology is changing the healthcare landscape.

Research shows that up to 40 percent of IV sessions require multiple attempts to locate and access the vein. Augmented reality comes to the rescue in a standard procedure that still causes so much discomfort and dissatisfaction.

Typically, when people think of AR, they imagine glasses and screens that present new layers of content on top of real world images. This traditional model will still play a significant role in the future. However, there’s another aspect to AR that will be important, specifically in the healthcare industry and that is the ability to instantly display relevant information to people who need it most.

Imagine a doctor who is able to view a patient’s medical history displayed over the latest medical scan, and even over the patient himself. We are already beginning to see wearable medical devices that provide critical health information during relevant points of the day.

In the near future, the next time you want to bite into your hamburger, you might get a friendly reminder that your cholesterol level won’t like it.

Overcoming roadblocks with the help of the crowd

We are still facing significant barriers before we will be able to see AR’s full potential in action. Some of these barriers are practical, such as problems with Wi-Fi connectivity and battery life. Several of the barriers are conceptual, but we do see a huge shift in people’s mindsets.

Wearables will play a major role in this. For example, there have been several crowd-sourced campaigns to develop wearables that could sense your heart rate and blood oxygen levels and send you real-time notifications. In another case, there was an abdominal surgery that took place on one side of a city, and in parallel was live-streamed via glasses to a medical school class.

The right information to save lives

Medicine is one of the industries that provides tangible real-world benefits to help people live better lives, and AR can help immensely. When you’re dealing with life and death decisions, immediate access to necessary and relevant information is of the utmost importance.

This is where AR has the most potential to disrupt the industry – putting the information doctors and healthcare providers need in front of their eyes, when they need it. Beyond that, this same experience can be tailored for the needs of patients and everyday users unlocking the potential for a real revolution in health and in the way people think about maintaining their health.

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