Posts Tagged ‘Cloud Computing’
2013 Year in Review
December 31, 2013
It’s been another year of achievement and learning. It would have been difficult a year ago to predict how my professional life would change.
My first trip mixed pleasure and work. Being in Salt Lake City, I agreed to speak to the Utah Center for Clinical and Translational Science on some of my work at the Cleveland Clinic and the Cleveland Clinical and Translational Science Consortium. Bernie LaSalle made the event into a series of presentations by the University of Utah Bioinformatics team which was very informative.
Next it was off to the American Medical Informatics Association Joint Summits in San Francisco in March. Presented two posters:
In May and June, I taught my first online course for the Health Informatics program at Kent State University in Clinical Analytics. Earlier in the year I designed the course and had an experienced group of students who were eager to learn this emerging area of informatics.
Related to Clinical Analytics, I participated in the Clinical and Business Intelligence Data and Analytics Task force of HIMSS, wrote a blog post on Teaching Clinical Analytics and then did a virtual event for HIMSS in September on “Transforming Care by Improved Decision Making: Deriving Meaning from Big Data.” Presentation is here.
September brought the Midwest Hospital Cloud Forum in Chicago where I presented on a panel: Closing the Loop in Healthcare Analytics – Correlating Clinical and Administrative Systems with Research Efforts to Deliver Clinical Efficiency in Real Time.
In early November, I was in Houston as the keynote speaker for the Texas Gulf Coast Association for Healthcare Quality. I gave two presentations:
- Revision on my chapter on eResearch for Health Informatics
- Chapter on Computing and Information in Wireless Health
- Chapter on Social Media Hubs for a new book on Social Media in Healthcare published by HIMSS (to be available at the HIMSS conference in February)
What will 2014 bring? Certainly opportunities to enhance national collaboration on consumer health issues especially at the HIMSS14 conference where I will be managing the Connected Patient Learning Gallery. In many ways, patient engagement and the connected patient are no longer concepts but are at the tipping point of real change. Things will look very different a year from now and I plan to play a part in it.
Clinical Analytics – Teaching and Learning
September 5, 2013
Recently I had a blog posted on “Teaching Clinical Informatics” on the HIMSS Clinical and Business Intelligence blog. It is a topic that has not received enough attention in HIT but it is the logical next step as more hospitals, health systems and practices implement EMRs.
Also from HIMSS, I will be speaking at a virtual event, Transforming Care by Improved Decision Making: Deriving Meaning from Big Data on September 18. My topic will be “Developing a Centralized Repository Strategy: The Top Three Critical Success Factors.’
On September 9, I will be on a panel at the Midwest Hospital Cloud Forum in Chicago. The panel is titled, “Closing the Loop in Healthcare Analytics – Correlating Clinical and Administrative Systems with Research Efforts to Deliver Clinical Efficiency in Real Time.” I have posted slides on my initial thoughts on national trends related to the topic.
On a side topic, I was interviewed by Deanna Pogorelc of MedCityNews (a Cleveland news outlet) on the topic of “A healthcare innovator’s guide to must-know tech terms for the next decade of medicine.” I address the topics of Artificial intelligence/algorithm medicine and the Internet of Things
More on analytics and innovation in future weeks.
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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.
- “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.
2012 Predictions for Health IT
January 2, 2012
Like others (see Daniel Kraft) , I have my own opinions about what trends will be most influential for health IT in 2012.
- Big Data and real-time analytics and decision support – IBM Watson and Explorys are in this space, others will follow and adoption will grow enabled by cloud computing, NOSQL/Hadoop and natural language processing
- Continued focus on EMR adoption as more health systems pursue meaningful use. This will again be the main focus at HIMSS as well as other conferences
- Social media in health care will continue to grow among patients as the e-Patient movement continues to gain in strength and public awareness and as advocates like the Reshape Innovation Center find creative uses to influence the future of health
- Mobile health and apps usage will expand but what is needed is a way to integrate personal health information, such as, PHRs and apps that promote wellness and disease management. For health care professionals, apps and mobile devices need to be integrated into clinical workflow rather than being an adjunct or distraction
- Research will be further enabled by EMR data as more academic medical centers develop data warehouses for research and quality studies and as initiatives like QueryHealth make it possible to combine data across systems and states using health information exchange and other tools
There are many more but these are the primary one’s I will be following.
Share this:A year in Review Perspective from Higher Education
January 6, 2011
Lev Gonick, CIO of Case Western Reserve University, has written 2011: The Year Ahead in IT, a fresh perspective looking forward instead of back. There are many parallels to healthcare.
1. The Big Picture: The State of the Global Economy and What It Means for IT on U.S. College Campuses (or, globalization and localization). He says that universities are tied to the cities they live in and community partnerships are crucial for global competitiveness. The same could be said for urban and academic medical centers.
2. How do you spell opportunity? A-U-S-T-E-R-I-T-Y (shared services and entrepreneurship). With greater austerity in health care, shared services and making IT a profit center through entrepreneurship are key to IT survival in healthcare as well.
3. Operational Excellence Is Good Enough (leveraging the cloud for strategic reengagement). Instead of a focus on operational excellence, moving toward cloud-based services and software/platform as a service. Healthcare continues to be skittish about the cloud but with the appropriate SLAs and security, may provide appropriate solutions.
4. We Go to University to Learn (mobility, simulations, gaming, and unified communications). Best quote: “While the rhetorical debates will continue, blended learning models based on hybrid pedagogies of face-to-face interactions with online exploration, discovery, reflection and mentoring are emergent realities.” This is emerging in education of health professionals and more experimentation should be welcomed.
5. Content is King… No, No, Platform Is King … No, No (learning management, publishing, and learning middleware). Another quote: “Given the maturity of the traditional course management platforms, the lethargic character of the academic publishing industry satisfied with its annuities in traditional textbooks, and the early state of e-books for learning, a new set of players in the area of student engagement, assessment, and support is likely to offer to stitch together the layers between the content and platform providers.”
6. I Used to Walk 10 Miles in Snowshoes to School (rich media and 21st-century learning). The move from text-centric learning to video conference, multimedia learning and more. The possibilities in healthcare are apparent and some are being utilized with YouTube and 3D anatomical models. Will holograms be next?
7. If We Hang In There We Will See an ROI on Our 8- and 9-Figure ERP Implementations (new models for administrative systems). Expensive enterprise systems moving to SaaS platforms changing the legacy of large implementations into short cycles of outsourced applications.
8. Consumer Sovereignty Can Be Stopped at the Gates of the Campus (governance and enterprise program management]. Sounds alot like centralized healthcare IT departments. “Frustration with the lack of agility, available resources and talents has led to a growing position that IT needs to get out of the way other than provisioning reliable network access, limited security and related regulatory and risk-mitigation roles.”
9. Overcoming the Myth of the University as Open. Global research endeavors requiring data sharing free faculty to go beyond the walls of the institution. Healthcare may be moving faster than the rest of the university community by translational research efforts and health information exchange as facilitators.
10. American Global Competitiveness and Research and Education Networks (IT and its contribution to reducing the town-gown divide).
Another quote true for healthcare: “IT and network engineering, and a commitment to supporting evaluation and at the same time catalyzing innovation, attracting investment and supporting the value of quality of life.”
With all the hype about mobile and clouds, it is refreshing to have a more thoughtful analysis of what is ahead.
Share this:Google Public Data Explorer for Healthcare
March 16, 2010
Google recently released its public data explorer which combines the Google visualization tools with public datasets include population data and health data. For healthcare, the initial launch includes Sexually Transmitted Diseases in the U.S. and Cancer cases in the U.S. The charts allow selection by state and time options. For these two charts, CDC data sources are used.
So could this data explorer be used more broadly with other health data sets. For starters, those at Data.gov (although most of the health data sets are Medicare cost data). But could major disease registries open themselves up to this API so that medical researchers could visualize more data sources and generate more research questions more quickly. This could be one solution for the for the lethal lag time. The CDC has additional data sets available. But what about opening closed data sets, such as, those from the Society of Thoracic Surgeons or other disease-specific registries. Then there is the growing volume of patient reported data from sites like PatientsLikeMe and CureTogether.
The limitation of this approach is having researchers capable of interpreting these data visualizations to make meaningful interpretations. The peer review process would prevent publication of misinterpretations of the data. An additional control would be combining the data explorer with social networking tools for users to discuss visualizations and research observations of the data. Perhaps this could be accomplished through Google Wave.
Comments and data sets welcome.
Share this:Book Review: Googled-The End of the World as We Know It
February 27, 2010
I recently completed this book by Ken Auletta who promotes his unique access to the search engine giant. The books follow the history of Google from the earliest days of the founders at Stanford, to rocketing to fame, going public and then being labeled as the evil empire. More recently, he chronicles conflicts with the government, traditional media, traditional advertising, publishers and China. He leaves with Google at a crossroads of maturing founders which he suggests may be losing focus, competitors in social media, and ongoing challenges from Microsoft and others.
The book describes each new major app and the process and culture of building new tools and keeping them free. Only two pages are devoted to Google Health, however. Generally, the books focuses much more on the advertising business which has made lead to Google’s financial success sometimes overshadows description of apps and the engineering culture. Too many pages are devoted to the failing of traditional media and, of course, Google and the competition continue to evolve since the publication of the book.
The closing question in the book is: has Google become so big and entangled in conflict that it has lost its innovative edge? Recently the excitement over Google Wave and Buzz have met there match with Apple’s iPad. Yet the dominance of cloud computing and Google’s dominance in the cloud may continue to have more of a long term impact than the devices that connect to the cloud.
Share this:Thinking about the Future
October 29, 2009
What will the Web Look Like in 5 years? Gartner presented Eric Schmidt, CEO of Google to talk about the future. Some of his key points include:
- Five years from now the internet will be dominated by Chinese-language content.
- Today’s teenagers are the model of how the web will work in five years – they jump from app to app to app seamlessly.
- Five years is a factor of ten in Moore’s Law, meaning that computers will be capable of far more by that time than they are today.
He also talks about being trapped in a 1980s architecture. I heard a webinar demo of an app today which uses client-server technology. It seems to me that any application which does not use the web with AJAX and hosted on a virtual server is old technology and not something that should be supported.
Schmidt also talks about the Google business model and pricing. He notes that Google customers ask for more features for a price that is less that what they are paying for desktop applications. They are starting at the bottom with the largest customer for Google docs/email of 35,000 seats but 10s of thousands of companies (at $50 per seat).
“We are not trying to design the future, we are trying to invent it along the way.”
“We have migration tools and no one seems to migrate back.”
Is the implication that the majority of companies will move the cloud for desktop apps and enterprise apps? Are current vendor supported enterprise apps inflexible as he says. Are companies and health care missing out on mobile opportunities? Open source also adds to that flexibility.
Five years from now, will be all on powerful wireless devices, running open source, cloud-based apps, with books on netbook tablets and running a Wave-like instantaneously messaging. What will that mean for health care and especially collaboration in health care? How about collaboration so fast that medical treatment is communicated and executed faster than we can imagine either at home or at a local clinic thru virtual technology promoting health and treating symptoms to minimize side effects. Support of participatory medicine will be seamless through these mobile, real-time social networks.
Finally, thanks to Eric Schmidt for his humorous quips throughout. Check out the full 45 minutes also.
Share this:Cloud Computing Tops Gartner’s list
August 26, 2009
Gartner’s Hype Cycle for Emerging Technologies includes an evaluation of cloud computing. They view cloud computing as being at the Peak of Inflated Expectations. While companies look to the cloud for cost effective solutions, “The levels of hype around cloud computing in the IT industry are deafening, with every vendor expounding its cloud strategy…”
Another post on the Emerge Blog, sees cloud computing as a promise without hype noting three cloud based models:
- Infrastructure-as-a-Service (IaaS)
- Platform-as-a-Service (PaaS)
- Software-as-a-Service (SaaS)
This is a helpful formulation especially since so many platforms are becoming available in the Cloud and specifically in health care: Google Health and Healthvault to mention just two. While there is still concern about security in cloud computing limiting its adoption in health care, these three models should be considered when talking about private and hybrid clouds more common in the future of health care.
Also of note is the expansion of cloud offerings from Amazon. Adoption of Amazon Web Services faces some barriers: “The single biggest barrier to enterprise adoption that exists today is the
reluctance to live with one foot in each of two worlds, the on-premise IT
infrastructure and the world of the cloud. What Amazon Virtual Private Cloud
aims to do is bridge those two worlds.”
Public and Private Clouds – Health Information Exchange (HIE)
August 13, 2009
In healthcare, there has been hesitancy to consider cloud computing in spite of the promise of funding for electronic medical records and perhaps HIE. The main issues in cloud computing and EMRs are security and availability. Security is governed by HIPAA including the upcoming regulations on data breaches. Security of EMRs and PHRs is also key in maintaining public trust in EMRs and by implication, medical practices. Availability is key as well as medical practices become dependent on real-time data from EMRs for medical decision making.
- Can the cloud provide the security and availability/reliabity for EMRs?
- Alternatively, are EMRs now becoming private clouds which can potentially interact with the public cloud, such as in the case of disease registries and public health initiatives?
- Are Health Information Exchanges at type of private cloud or would it be helpful to redefine them as such?
Several recent articles give some insight into this issue:
- The New Sentinel Network — Improving the Evidence of Medical-Product Safety – NEJM, 8/13
- Einstein, Sharks and Clouds: IT Security In The Cloud – .NET Developer’s Journal
- Cloud computing for the enterprise: Part 1: Capturing the cloud – IBM Developer Works
- 1 In 3 Developers Working On Private Cloud Apps- Information Week
