October 31, 2012
At the Cleveland Clinic Medical Innovation Summit, there was a discussion about big data in health care which moved to the issue of patient engagement and the need for not only transparency of data but also providing tools to manage and interpret data. Two panelists had important inputs – 23&Me and Dr. Harris, CIO of the Cleveland Clinic. What is needed includes PHRs, like MyChart, but also interpretation of results, such as offered by 23&Me. The tools must provide actionable results.
IBM Watson was also featured with a new initiative with Cleveland Clinic to “send Watson to Medical School” using medical students and others to improve paths for medical decisions. This exciting prospect is an experiment in human-computer interaction and machine learning. See this video for more details:
Finally, the top ten innovations announced at the conference including everything from handheld imaging to bariatric surgery.Share this:
October 26, 2012
This is a new textbook editted by Mehran Mehregany for the Wireless Health course at Case Western Reserve University in Cleveland (the course is actually conducted in San Diego). I wrote Chapter 12, Computing and Information, which outlines changes in information technology in the past 10 years and how these are enabling pervasive computing in health care. The release date is February 2013 so stay tuned. Check out the table of contents which includes a broad range of topics from gaming and social networks to medical device design and electronic instrumentation.Share this:
October 24, 2012
Two recent items emphasize this them. First is an interview with James Merlino, MD, Chief Experience Officer at Cleveland Clinic and e-Patient Dave at TEDMED.
The interview asks pointed questions about Improving Doctor-Patient Communication from the provider and patient perspective. ePatient Dave gives Cleveland Clinic a big endorsement. See Dave’s blog post about the video.
Second is a post by Dr. Cosgrove, CEO of Cleveland Clinic on One Question that Changed our Organization or How Cleveland Clinic went from doctor-centered to patient-centered. It is a description of a water-shed moment. “Yes we do teach empathy. We’ve made it part of our culture.”Share this:
September 8, 2012
Informatics 2.0 is the title of an editorial in the Journal of the American Medical Informatics Association (JAMIA). Subtitled, “implications of social media, mobile health, and patient-reported outcomes for healthcare and individual privacy”, this article reviews some of the recent work published in the journal including social media and mHealth. But what really is Informatics 2.0. We already have multiple definitions of medicine 2.0 and health 2.0. Is this an indication that Medical Informatics is broadening their horizons? Precise definitions are hard to find, but one should inlcude:
- consumer health informatics as evidenced by social media in health care
- e-Patient movement and participatory health care
- online interventions for healthcare
- Mobile devices and mobile apps for healthcare
- Use of social media in research recruitment
- Social networks and social media for medical informatics collaboration
- The semantic web in healthcare
- Patient Center Medical Outcomes enabled by online tools
- Reference wikis in medical informatics
As you can see, the scope of Medical Informatics is broad as the use of Web 2.0 technologies spreads to many opportunities and transforms medical informatics into a more dynamic endeavor.Share this:
August 22, 2012
The Rainforest was recommended to me by my friend Enoch Choi who lives in Silicon Valley. The book has a fresh perspective on Silicon Valley pointing out the affect of the western pioneer spirit on California in general and the Valley in specific. A spirit of independence and willingness to take risks is proposed as a basis for the unique entrepreneurial direction of the Valley. The book uses several summaries of principles, such as, extra-rational motivations and “err, fail, persist”, what stood out to me were two themes which may sound contradictory: Rule breaking and Trust. This quote about rule breaking sums it up:
“For the Rainforest to thrive, people must accept that rule breaking and believing in grand aspirations are acceptable forms of social behavior. They enable someone to believe that what was previously been considered impossible is in fact possible.” And regarding trust: “the willingness to take the initiative to trust others” and “demonstrate the transparency of its motivations as part of its routine transactions.”
Although the rainforest analogy seems to go to far at times, the concept of enabling international collaboration is right on. The book makes a strong case for the unique environment which spawns innovation in the Valley and questions the ability of many cities and regions which would like to foster innovation and new companies to do so without that unique environment. One exception Cleveland Clinic which has not only generated multiple patents and spin offs but also is now showing other health care organizations how to commercialize their intellectual property.Share this:
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.Share this:
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
- “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.
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:
- 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.
- 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.
- 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:
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.Share this:
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.Share this: