eHealth » health care predictions

2012 Predictions for Health IT

John Sharp — Mon, 02 Jan 2012 16:13:33 +0000

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.

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2012 Predictions – Analytics

John Sharp — Thu, 29 Dec 2011 19:14:21 +0000

There are many top 10 predictions for 2012 out there. I could probably add my own for eHealth and mHealth.
These 10 Business Intelligence Trends for 2012 from Tableau Software apply to healthcare as much as any business.

10 Business Intelligence Trends for 2012

View more presentations from Tableau Software

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Report from AMIA – All Diseases will become Orphan

John Sharp — Sat, 12 Mar 2011 07:18:27 +0000

The first speaker I heard at the American Medical Informatics Joint Summit was Kenneth Buetow from the National Cancer Institute. In his typical provocative manner, he challenged the audience on the transition day from the Translational Bioinformatics to the Clinical Research Informatics Summits. He began with promoting the P4 Medicine as the new model for healthcare: personalized, predictive, preemptive, participatory. Although throughout the conference little was articulated on the participatory aspects with one exception. More on that later.

Buetow talked about defining cancer on the molecular level and the challenge of the exponential number of patients required to do genetic screening for a single disease. He referred to Pharma 3.0 from the Ernst and Young report on Progressions 2011 where patient engagement through social media as necessary in this new age of medicine. It is here that he stated, “All diseases will become orphans” meaning that as we understand more about genomics and are able to combine these findings with clinical data, we will understand each disease process on a truly personalized level and hopefully treat it as such.

As part of Pharma 3.0 and a new model for medicine, he did note some encouraging trends in volunteers for clinical trials, true patient activism in a full participatory sense. Specifically, he reported some recent statistics from Army of Women, a joint project of Avon and Susan Love to recruit an army of those willing to volunteer for research studies. Rapid recruitment occurred consistently for studies through this resource while traditional clinical trials continue to suffer from lack of full enrollment. He also referred to adaptive clinical trials as part of this new model. Finally, he discussed the Translatable Informatics Ecosystem as a way of describing how informatics will be key in this new paradigm using Services-Aware Interoperability Framework (SAIF) as one technology to reach that goal.

Many of the presentations at this year’s conference were focussed on data warehouses of clinical and genomic data and ontology development and application include many efforts in the semantic space.

Several speakers referred to Evidence Based Medicine, Personalized Medicine and the Learning Healthcare System implying if not explicitly stating that there is a convergence of the future of medicine and that medical informatics and clinical research informatics are at the center of this convergence. Bill Hersch, noting the explosion of data both in journals and through EHRs and others sources, citing Stead on the need for “Systems of Brains” to manage the amount of information now available

All agreed that Medical Informatics is at a crossroads and has the opportunity to take leadership in the future of medicine, managing the data explosion and making it managable in the personalized medicine era we are entering.

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Innovation – Segway Style

John Sharp — Thu, 03 Feb 2011 03:17:03 +0000

Yesterday I attend the Cleveland Clinic Ideas for Tomorrow presentation by Dean Kamen inventor of the Segway and much more. His current company is called DEKA Research & Development Corporation and has several inventions to meet his goals of saving the planet and solving big problems with simple solutions. Many of these have implications for health but also he has created FIRST, an education initiative to help students become inventors and scientists. Perhaps more important that his inventions is the way that he thinks about innovation and invention. Part of this is within the mission of FIRST, “exciting mentor-based programs that build science, engineering and technology skills, that inspire innovation, and that foster well-rounded life capabilities including self-confidence, communication, and leadership.” He stated, “innovation is mostly about surprises” and lives his life expecting the unexpected. He complained about government regulation which inhibits innovation and has created his own country on an island off Connecticut as an act of rebellion. He scoffs at naysayers and believes in solving global problems. We need more of this in healthcare.

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A year in Review Perspective from Higher Education

John Sharp — Fri, 07 Jan 2011 03:18:50 +0000

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.

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Year in Review – Books of 2010

John Sharp — Sat, 01 Jan 2011 04:05:31 +0000

Following Kent Bottle’s lead in influential books in 2010, I decided to compose my own list:

Chasing Medical Miracles The Promise and Perils of Clinical Trials. Tells it like it is – to be a participant in a clinical trial.
Googled-The End of the World as We Know It – somewhat disappointing in that it discussed the advertising side of the business and less about the history of its technical evolution.
DIYU: Epunks, Edupeneurs and the Coming Transformation of Higher Education. This book was recommended by a speaker at the J. Boye conference in Philadelphia. Questions the future viability of universities as they are undermined by Web 2.0 technology.
Leading Geeks – Required reading for anyone who manages geeks, especially programmers. Helpful for anyone to understand the culture of geekdom, understanding the mindset of managing ambiguity and tearing down some stereotypes.
The Singularity is Near by Ray Kurzweil – mind blowing futurism and undying optimism in technology even though this is from 2005 and 650 pages. The law of accelerating returns puts us on a fast track to the future. I am now following Kurweil’s Accelerating Intelligence blog.
A Little Booklet About Health 2.0 – by Lucien Engelen. Brief but advancing health 2.0 concepts with a peak to the future from a European perspective.
Long Tail: Why the Future of Business Is Selling Less of More – this lead to my blog post on Partnerships with Online Communities – The Long Tail, discussing some of the implications of the long tail in healthcare.
The Collapse of Complex Societies – a venture into history and anthropology which I enjoy and blogged about: Declining Marginal Returns of Complexity
Laugh, Sing and Eat Like a Pig by e-Patient Dave – a personal, signed gift from Dave himself when he visited Cleveland and had dinner with us.
Connected for Health: The KP HealthConnect Story – Probably the best story of successful implementation of an EMR on a large scale basis with honest, realistic discussion of struggles and successes.
Program or Be Programmed – Ten Commandments of the Digital Age – read appropriately as an ebook, makes some good points without being paranoid about technology’s growing role in our lives.
The Bottom Billion: Why the Poorest Countries Are Failing and What Can be Done About It. Recommended by @Ciscoiii when visiting the World Bank in Washington, DC. Excellent analysis of failed states with recommendations at the UN level for solutions.
Founding Faith: Providence, Politics, and the Birth of Religious Freedom – found this in Philadelphia at the Liberty Bell bookstore.

One on my shelf is Reading in the Brain: the New Science of How We Read.

More book reviews to come next year and many more will be on my Sony Reader.

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Innovation Summit – Obesity, Diabetes & the Metabolic Crisis

John Sharp — Wed, 03 Nov 2010 01:51:32 +0000

This week I attended the Cleveland Clinic Innovation Summit and contributed to the live tweeting of the event. There was substantial discussion of devices in the pipeline and drugs for diabetes but a less optimistic outlook on drugs for obesity with some being shut down by the FDA. The most scientific yet controversial presenter was JefferyFriedman, who referred to his 2009 Newsweek article on “The Real Cause of Obesity” as a summary of his position that most of obesity is genetically determined. Many referred to the recent prediction posted by the CDC that the current incidence of diabetes being around 10% of the population with the potential of growing to 20 – 30% by 2050.

At the end of day two, the annual announcement of Top 10 Innovations. The final day will include health IT interventions for obesity and diabetes.

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Declining Marginal Returns of Complexity

John Sharp — Tue, 22 Jun 2010 02:53:40 +0000

Just completed the book The Collapse of Complex Societies by Joseph Tainter, an archeologist. The focus of the book is on civilizations like the Roman Empire and the Mayas but it made me wonder about the complexity of health care and whether we are at the point of declining marginal returns. It is apparent from the health care reform experience that competing stakeholders make any attempt at reform a complex and nearly impossible process. Clay Shirky wrote a blog post in April on The Collapse of Complex Business Models. Just like societies which become too complex to respond to major stressors. While I am not predicting the collapse of health care in the US but one must wonder whether some of the complexity could be simplified by the experience of other countries, such as, single payer systems and an emphasis on primary care (medical home). Would be interested in other opinions, especially from those who have read the book.

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Individualized Cancer Treatment

John Sharp — Tue, 19 Aug 2008 07:19:00 +0000

This Cancer Group from California is offering individualized treatment based on an assay of cancer cells and testing them against specific agents. It is also a revolutionary approach in that you can check on individual patient progress. This breaks out of the standard randomized controlled clinical trial and provides a new avenue for treatment. Is it the new direction for all cancer treatments as cancer represents over 100 diseases and manifests itself differently in each individual?

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