Posts Tagged ‘Disruptive Technology’
Favorite Quotes from TEDx Maastricht
April 10, 2012
Last week I was fortunate to attend TEDx Maastricht in person for the second year in a row. There were several great talks, all inspiring and some surprising. The beginning and end represented innovations in care of very different types. Beginning with a demonstration of FaceTalk, a live demo of an interdisciplinary consultation between 3 physicians on 3 continents sharing CT scans and more in real time. The final presentation of a video of interviews with young adult cancer survivors even facing death with courage. Patients were certainly invited and had an impact on the overall tone of the conference. One example was Clarissa Silva who said about her recovery from mental illness, “Courage is being afraid but doing it anyway.”
A big hit was Paul Levy who talked about healthcare and soccer (football). One choice quote is advice to a girl from the team of 11 year olds he coaches: “Think about what you are going to with the ball before it arrives.” This certainly applies to future thinking in the dynamic health care environment. Check out his book, Goal Play. Then there was Paul Grundy from IBM made the comparison of physicians as the master builders of European cathedrals, trying keeping everything in their head as knowledge explodes. This leads to his conclusion of Smarter healthcare by smarter use of data.
Much anticipated was Roni Zieger, formerly of Google Health presented on Embrace the Patient Story. He talked about his own experience with a medical problem but then discussed how patients can become experts in their own care and therefore experts with others. His collaboration with Lucien Engelen, MyHealthStory, was a beginning down his new path. Now he is planning with Gilles Frydman of ACOR a new venture called Impatient Health, because they and many patients are impatient to participate fully in not only helping others as Patient Experts but also as active participants in research.
A great surprise was the introduction to the documentary “The Waiting Room.” Afterwards I had the opportunity to view the film – it is a heart-wrenching view of the real struggles of the uninsured in the US using the emergency room for primary care. I hope with the producers that the film will have a role in the health care reform debate.
Thanks to Lucien Engelen and Corine Jansen of the Radboud Reshape and Innovation Center for making this event possible. Looking forward to The Future of Health 2013.
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Electronic Medical Records: From Clinical Decision Support to Precision Medicine
February 24, 2012
This is a presentation I gave to the Dutch delegation to HIMSS. It reflects much of my current thinking about current and future trends in health IT.
Algorithms in Medicine
February 14, 2012
Algorithms have a growing place in medicine. There are at least two kinds of algorithms – practice guidelines and predictive.
Practice guideline or best practice algorithms may emerge out of practice-based research or consensus panels which recommend specific practices to improve care. One example relates to algorithms in intensive care. Cleveland Clinic has excellent examples on their medical education website which include everything from weaning to acid-based disorders. Some may criticize this as “cookbook medicine.” But with the complexity of care, especially intensive care, these kind of algorithms should be welcome. How these can be integrated into clinical decision support in electronic medical records is yet to be fully realized.
Predictive models, on the other hand, use patient-specific data to determine future risk of disease or risk. Predictive models are usually based upon large data sets and in recent years that means EMR data. A couple of examples:
- Predicting 6-Year Mortality Risk in Patients With Type 2 Diabetesby one of my colleagues
- Development and Validation of a Predictive Algorithm to Identify Adult Asthmatics from Medical Services and Pharmacy Claims Databases
- http://prostatecancerinfolink.net/tips-tools/kattan-nomograms/ by another colleague
- nomograms.org
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Future Med This Week
February 7, 2012
Although I am not there, I feel the spirit of FutureMed. Sold out again, this program of Singularity University covers topics including:
- Exponential and Emerging Technologies
- Regenerative Medicine
- Information and Data Driven
- Future of Medical Practice
- Personalized Medicine
- Future of Intervention and Robotics
- Neuromedicine
- Innovation and Entrepreneurship
- Global Health
- Government and regulatory
- Longevity
Daniel Kraft from The Doctor’s Channel on Vimeo.
Share this: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:Distracted Doctors – Living in an App World
December 19, 2011
The NY Times article on how devices are distracting doctors certainly rings true as hospitals push patient safety and preventing data breaches. New devices, specifically smart phones and tablets (especially the iPad) are becoming pervasive in hospitals and outpatient settings often outside of the control of hospital IT departments. Medical schools as well attempt to increase awareness of the risks while evaluating the advantages of these devices.
One aspect of smart devices yet to be addressed is, does the app model in iOS and Android devices fit with medical practice. Part of the purpose of integrated EMRs is to bring all of the information to the user in one place. This increasingly includes CPOE and embedded clinical decision support tools. But an app model requires the user to jump from one app to another to acquire the information needed. This is a classic dilemma of an integrated application/portal (EMR) versus a better user experience (apps). Which works best for physician workflow? When will EMRs look more like apps?
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Social Media in Clinical Trials
October 28, 2011
Today I presented on a panel at Case Medical School on clinical trial recruitment. My notes and references are contained in these slides.
This is a topic that needs more discussion in the online community:
Book Review: The Googlization of Everything
August 27, 2011
This book by Siva Vaidhyanathan has the provocative subtitle “And why we should worry”, which defines the subtext of the book questioning whether the “Do no evil” search engine company has become something else as a result of its efforts to monetize everything. The book covers the broad domains that Google impacts modern life and discusses the predominant thinking driving the company – “faith in aptitude and technology” and infrastructure imperialism.”
The two pivotal chapters are “The Googlization of Knowledge” and “The Googlization of Memory”. The former deals primarily with the Google Book project and makes a point about the importance of preserving knowledge in the digital age, particularly preserving out-of-print books. But, the author cautions, should a for profit company hold such a public trust that has traditionally been held by public libraries. Similarly, in the latter, the author questions whether “Google is making use stupid” or not. Does consuming snippets of knowledge limit our ability to read for extended periods and reflect?And what impact does it have on education, particularly higher education? Both are valid questions and it may be that the way we think and consume information is changing. However, not all of this is due to Google as much as it is to social media and Wikipedia. Consumption of knowledge is becoming the ability to think critically about the volume of available information and not be controlled by the filters and overload of information. Understanding knowledge algorithms rather than being subservient to them is the key.
In conclusion, the author proposes a bold new project, The Human Knowledge Project, which appeals to the need to have more public control over knowledge through libraries and democratic processes rather than commercial interests. One might agree with him since the recent demise of Google Health. If Google Books are not profitable in 5-10 years, will this project also be abandoned leaving the legacy of digitalized books behind? Yet much of the books skepticism about Google and fears are overdrawn. Perhaps Google’s service to higher education through Gmail and other services will help it keep a commitment to educational and knowledge resources in the future.
This book by Siva Vaidhyanathan has the provocative subtitle “And why we should worry”, which defines the subtext of the book questioning whether the “Do no evil” search engine company has become something else as a result of its efforts to monetize everything. The book covers the broad domains that Google impacts modern life and discusses the predominant thinking driving the company – “faith in aptitude and technology” and infrastructure imperialism.”
The two pivotal chapters are “The Googlization of Knowledge” and “The Googlization of Memory”. The former deals primarily with the Google Book project and makes a point about the importance of preserving knowledge in the digital age, particularly preserving out-of-print books. But, the author cautions, should a for profit company hold such a public trust that has traditionally been held by public libraries. Similarly, in the latter, the author questions whether “Google is making use stupid” or not. Does consuming snippets of knowledge limit our ability to read for extended periods and reflect?And what impact does it have on education, particularly higher education? Both are valid questions and it may be that the way we think and consume information is changing. However, not all of this is due to Google as much as it is to social media and Wikipedia. Consumption of knowledge is becoming the ability to think critically about the volume of available information and not be controlled by the filters and overload of information. Understanding knowledge algorithms rather than being subservient to them is the key.
In conclusion, the author proposes a bold new project, The Human Knowledge Project, which appeals to the need to have more public control over knowledge through libraries and democratic processes rather than commercial interests. One might agree with him since the recent demise of Google Health. If Google Books are not profitable in 5-10 years, will this project also be abandoned leaving the legacy of digitalized books behind? Yet much of the books skepticism about Google and fears are overdrawn. Perhaps Google’s service to higher education through Gmail and other services will help it keep a commitment to educational and knowledge resources in the future.
Share this:More on Health Apps
August 18, 2011
The Mobile Health LaunchPad will be announce winners who will pitch their products on September 19. They want apps that are more than content, in an early stage and ones that can actualize utilize capital.
The Blue Button initiative from the VA will award $50,000 for a non’government provider to add the Blue Button on a PHR website or create a PHR with one. The blue button is a function to allow patients to download their medical records. Submissions open until Oct. 19th.
The Cleveland Clinic announced a incubator for Health Care Apps. This according to according to Scott Linabarger, the Clinic’s director of Internet marketing, speaking at the World Congress Leadership Summit on mHealth.
Jen McCabe is making news with combine HealthMonth and Contagion Health to make a new company, Habit Labs. She even got attention on TechCrunch for funding from Y Combinator.
Health apps are popping up everywhere. Hoping that the market will sort out or create aggregators to manage our health with multiple tools. Health apps are eclipsing PHRs. The future looks promising.
Share this:Health Apps and Real Time Consults
July 19, 2011
There was more on the FDAs decision about health apps today. According to an informative blog post by Brian Dolan on MobileHealth News, the FDA will not regulate most apps. Some specific use cases for apps that won’t be regulated include:
- “that are electronic “copies” of medical textbooks, teaching aids or reference materials
- “that are solely used to log, record, track, evaluate, or make decisions or suggestions related to developing or maintaining general health and wellness.
- “that only automate general office operations with functionalities that include billing, inventory, appointments, or insurance transactions.
- “that are generic aids that assist users but are not commercially marketed for a specific medical indication”
As always with the FDA, the concern is how the app influences treatment.
Also announced was the real time iConsult where physician users can “consult” in real time with specialist and others and include photos and xrays in the request. Sounds like twitter consult but more secure.
In a 2010 post by @Berci Mesko, he notes doing consults via Twitter:
| What would I do if | in 2000 | Now |
| I need clinical answer | Try to find a collegue who knows it | Post a question on Twitter |
| I want to hear patient story about a specific condition | Try to find a patient in my town | Read blogs, watch Youtube |
| I want to be up-to-date | Go to the library once a week | Use RSS and follow hundreds of journals |
| I want to work on a manuscript with my team | We gather around the table | Use Google Docs without geographical limits |
My take is that most physicians are concerned about doing this but early adopters can share their successes and issues for the others.
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