Archive for 2012

Conference Season Approaching – Prepare for Landing

August 7, 2012

While it may not be as exciting as landing on Mars, there are several conferences this Fall worth noting:

  • Medicine 2.0 Boston with over 300 presenters and a wide range of topics from mobile and social media to education and personal monitoring devices from every continent.  I attended last year at Stanford but will not this year. Will miss the colleagues I have met over the years. Good to see ePatient Dave doing a followup on “Give Me My Damn Data”
  • Health 2.0 San Francisco – the ultimate showcase for health startups will including preconference workshops on Patients 2.0,Health  Law 2.0, Employers 2.0 and Doctorrs 2.0. Would like to see Clinical Trials 2.0 some year as well.
  • StrataRx conference by O’Reilly on health data. Looks like an excellent line up of speakers and topics although light on providers and EMR vendors.
  • AMIA 2012 Symposium in Chicago - Mayor Rahm Emanuel Declares October 30 to November 7, 2012 Informatics Week in Chicago. I will be attending and speaking at a preconfence workshop on Clinical Research Informatics Infrastructure.

I am sure there are many more, this is just a highlight of the Fall schedule.

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Everyone is Talking about Big Data

July 20, 2012

Several new publications about Big Data in healthcare are showing up with good analysis of this emerging field.

First, an article from PharmExec called “Super-Size Me: Optimizing the Information Explosion” which came out in May.  They note new sources of information including:

  • Electronic Medical Records
  • Social Media
  • Real world evidence
  • Personalized medicine
  • Track and trace systems

They see significant potential value in big data:

» Uncover unmet needs
» Assess the feasibility of clinical trial designs and recruit trial subjects
» Demonstrate product value
» Conduct pharmacovigilance
» React more quickly to market changes via real-time market measurement and sophisticated KPIs
» Enhance commercial activities and enable more personalized messaging
» Deploy predictive capabilities rather than retrospective analytics

And next they note the layers of technology required:

  • Collection, Aggregation, and Storage
  • Analytics
  • Reporting.
The starting point for healthcare organizations is “setting the company’s technology strategy and designing the architecture for internal systems” among other tasks.
A more recent article is by Pew Internet titled, The Future of Big Data, focusing on the year 2020.
It notes that, “An equivalent amount of data is generated by people simply going about their lives, creating what the McKinsey Global Institute calls “digital exhaust”—data given off as a byproduct of other activities….”  It is not only human generated data that is cause for this growth but even more so data from sensors as computing and data generation becomes pervasive.  Citing a McKinsey report on some important points -” that big data is  ” replacing/supporting human decision making with automated algorithms and innovating new business models, products, and services.”
The survey results include opinions one the positive but also negative consequences of the future of big data.
  • “Nowcasting,” real-time data analysis, and pattern recognition will surely get better.
  • The good of Big Data will outweigh the bad. User innovation could lead the way, with “do-it-yourself analytics.”
  • Open access to tools and data “transparency” are necessary for people to provide information checks and balances. A re they enough?
  • The Internet of Things will diffuse intelligence, but lots of technical hurdles must be overcome.
  • Humans, rather than machines, will still be the most capable of extracting insight and making judgments using Big Data. Statistics can still lie.
  • Respondents are concerned about the motives of governments and corporations, the entities that have the most data and the incentive to analyze it. Manipulation and surveillance are at the heart of their Big Data agendas.
A good summary addresses some of these varied opinions: “Overall, the growth of the ‘Internet of Things’ and ‘Big Data’ will feed the development of new capabilities in sensing, understanding, and manipulating the world. However, the underlying analytic machinery (like Bruce Sterling’s Engines of Meaning) will still require human cognition and curation to connect dots and see the big picture.”
It is good to see a strong interest in Big Data in healthcare. What is missing is technical approaches to big data in health care. Particularly, there is a need for more organizations to be exploring technologies like NOSQL, Hadoop database architecture in healthcare including the development of interest groups and conferences on specific technical approaches like this.
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Virtual Presentation in Bilbao, Spain at Salud 2.0

July 9, 2012

Salud 2.0 is simply Health 2.0 in Spanish. This conference brings together speakers to discuss Web 2.0 technologies in health care. My presentation was Social Media in Health Care: A Reasoned Approach.

I received several questions and will repeat them here to give more complete answers:

  1. What to you mean about the risk of conflict of interest?
    Because social media is largely brief communication, a physician or other healthcare professional could promote a product or service without a disclaimer that they have a financial interest in this product. To be transparent about potential conflicts of interest in social media, one must add a link to a webpage with full disclosure. Drug and device companies must be clear about any claims they make on social media and should link to more complete information.
  2. There are so many social media outlets, how do you choose where to start?
    Find the best tool for what you need. It is not necessary to use multiple social media tools. For instance, if you are a physician or healthcare professional and want to communicate with colleagues, use Twitter if you are comfortable with more open communications, use a private social network for your group only if you would rather keep private. If you are a hospital and want to interact with patients, consider Facebook because it is an open, widely used platform which allows comments from patients.
  3. In Spain there is a publicly supported healthcare system, unlike the US. How should the approach to social media be different?
    I would think hospitals would still want to hear from patients but would not use social media as a means to attract new patients unless there was a specialty service that more patients should be made aware of. A good example of this is http://www.guiametabolica.org/ which is also being presented at the conference.  Social media could also have more of a public health approach – how to keep the population healthier and identify diseases earlier for intervention.

Here are the slides from the presentation. And the video is below:

 

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Eleven Chronic Disease Technologies to Watch

June 28, 2012

This significant report by NEHI (New England Health Policy Institute) reviews current tech trends which will impact the future of chronic disease management. The report categorizes these technologies into 4 classes based on the significant evidence supporting clinical and financial benefits. The technologies reviewed are:

  • Extended Care eVisits
  • Home Telehealth
  • In-Car Telehealth
  • Medication Adherence Tools
  • Mobile Asthma Management Tools
  • Mobile Cardiovascular Tools
  • Mobile Clinical Decision Support
  • Mobile Diabetes Management Tools
  • Social Media Promoting Health
  • Tele-Stroke Care
  • Virtual Visits

Social media for promoting health was put in class IV. They note that some “their goal is to give simple daily challenges or “micro-actions” that add up to significant health improvements over time.”  They report that their is a lack of evidence of effectiveness because they are so new and reports of success are mostly anecdotal by the vendors themselves. The exception are some studies of smoking cessation. While there may be a limited number of randomized clinical trials in the use of social media, there is a growing evidence of the effectiveness of social media in healthcare. Also, social media in healthcare is much broader than promoting health.  Online communities, apps, and Twitter are powerful tools capable of having a significant impact on managing and coping with illness. Also, increasing evidence is being published weekly in journals like Journal of Medical Internet Research and the Journal of Participatory Medicine.

Conclusion: this report has excellent analysis on several underutilized technologies in medicine but the evidence for the effectiveness of social media is stronger in my opinion.

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New Technology Now Brief on Mobile Apps in Healthcare

June 15, 2012

I authored this tech brief with the American Association of Medical Colleges. These tech briefs are one page, high level documents which “summarize the latest technologies, trends and issues facing our community. They are designed to make it easier for Information Resources professionals to communicate with stakeholders (Deans, students, colleagues) and help in the decision-making process. ” The challenge in producing these is summarize a huge trend into one page. The result is more questions than answers but we did include examples of some apps.

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Presentation at H2.0 Hospital Liquido Barcelona, June 12

June 14, 2012

Electronic Medical Records: From Clinical Decision Support to Precision Medicine

With an emphasis on lethal lag time and how EMRs can be used to bring new discoveries to medical practice more quickly.

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Presenting at H2.0 Hospital Liquido Barcelona, June 11-12

June 7, 2012

The themes of this conference, lead by Jorge Juan Fernández García, are:

  • H ealthcare / Medicine
  • I nnovation
  • T echnology
  • E ntrepreneurship
Looks like a great lineup of speakers include others from the US representing Mayo, Hopkins and Kaiser.
My presentation will be on: Electronic Medical Records: From Clinical Decision Support to Precision Medicine. Will post after I speak on Tuesday.
My main points will be: the EMR as the platform for decision support, its impact on quality of care, the role of disease registries, personalized and precision medicine, reducing the lethal lag time.
Looking forward to meeting Catalan colleagues   and others from Europe as well.

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A Look at Social Media in Health Care — Two Years Later – iHealthbeat post

May 21, 2012

Last week I had a follow up post on iHealthbeat on Social Media in Healthcare to one that I posted two years ago. Some of my predictions were correct but who could predict the explosion of healthcare apps.  There were so many other trends I could have cited including the study of healthcare social media in European hospitals.

Coincidentally, I attended the Cleveland Clinic Patient Experience Empathy and Innovation Summit on Sunday.  One track in the afternoon was devoted to social media with a good mix of speakers covering the latest trends in healthcare and beyond. Check out the Twitter stream here.

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Video Introducing eResearch

May 9, 2012

Having written a chapter on eResearch for a book on Health Informatics, I decided to make a video which will be used by the editor, Bob Hoyt, in an eBook edition to come out soon. Both the video and the chapter emphasize the progress that has been made in informatics tools to support every phase of clinical research.

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Usability in Healthcare

May 1, 2012

UX has always been one of my favorite topics. So often ignored in application development, usability is key to the success of any website or app. Fortunately, there is  a Usability Professionals Association dedicated to the concept.  A recent presentation at the Northeast Ohio Chapter focused on the evaluation of the usability of the Cleveland Clinic website. This comprehensive review lead to the development of standards for the website based on user input.

Check out the presentation by Kaitlan Chu:

 

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