Archive for 2013
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.
Social Media in Healthcare Quality
November 1, 2013
Today I presented at the Texas Gulf Coast Association for Healthcare Quality on social media in healthcare. Slides are posted on my Slideshare. The video, Empathy: The Human Connection to Patient Care is below
Quality professionals in healthcare including risk management and patient safety are relatively new to social media. They have some realistic concerns about HIPAA and sharing proprietary information on safety issues. However, they are receptive to learning and sharing best practices. But where to start?
- Look for LinkedIn groups, for instance, the Institute for Healthcare Quality.
- Follow your own institution’s LinkedIn, Twitter and Facebook accounts
- Follow specific hashtags on Twitter, such as, #ptsafety
- Look for videos related to quality issues – search on YouTube
- Join a tweetchat such as #hcsm (health care social media)
- Look for social media policies
- Follow e-Patient blog posts
- Consider entering the Voices of Quality Video Contest from the Robert Wood Johnson Foundation.
I think there is real potential for healthcare quality professionals to share best practices on social media and begin to develop communities around issues like patient safety, risk management, and patient satisfaction.
Share this: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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Glass in Medicine – Why There is Promise
August 19, 2013
In an interview on GlassStories, Kyle Samani gives the most cogent discussion of the pros and cons of Glass. He emphasizes that there is a cost to glass – not just financial but the fact that you have to wear them all the time while you have a fully functional smart phone in your pocket. So he sees limitations to the appeal to general consumers other than the geek coolness. However, on the enterprise side, especially in medicine, he sees real use cases. Specifically,
- physicians (and other healthcare providers) need their hands to work whether it is surgery or a physical exam
- physicians (and other healthcare providers) are mobile whether moving from one exam or hospital room to the next or traveling between care sites
- physicians (and other healthcare providers) are constantly interacting with people, either patients or colleagues
- physicians (and other healthcare providers) need to look things up, communicate with others
- physicians (and other healthcare providers) need to have clean hands – handling a mobile phone means transmitting germs, they need to wash their hands after each use even if they are using their mobile device at the bedside. The hands free commands in Glass enable them to avoid this
- he also thinks the privacy concerns are exaggerated – less deceptive than a mobile phone
Watch the full video interview.
Global Center for Health Innovation
August 15, 2013
Got to visit this new new center in downtown Cleveland last Friday. Great space to demo new health IT – sponsors committed, space still being built out.
See my post on Health IT Link, a new place to follow my content.
Update on the Internet of Things and Google Glass
July 29, 2013
Since there already is a convergence of the Internet of Things (IoT) and wearable computing like Glass, I am combining updates on these.
Recently I came across Sen.se, a platform of IoT but includes data from humans as part of their open platform. They refuse the label of IoT:
“We rather believe in an Internet of Everything where Humans, Nature, Machines, Objects, Environments, Information, Physical and Virtual spaces all mix up, talk, intertwine, interact, enrich and empower each other in all sorts of ways. This is what we are building and we think that we are not alone.”
They are currently in beta and are inviting a limited number of users to the free platform. They also have a blog which is worth watching. Those in the Quantified Health community might check this out as an extension of human data with device and environmental data.
Second, I wanted to call attention to ReShape with Glass, an initiative by the ReShape Innovation Center at Radboud Hospital in Nijmegen, Netherlands. Already a healthcare innovation hub, ReShape will be on the cutting edge of healthcare uses for Glass. Follow them on Google+ .
Finally, I wanted to toot my own horn and mention my listing with some good friends as Best Healthcare IT Blogs . This is a nice addition to my status as one of the 10 healthcare IT professionals you should follow on Twitter.
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The Internet of Things Creeps into Healthcare
July 19, 2013
This post originally appeared on Health Works Collective.
One of the hottest trends in technology today is the Internet of Things or IoT. IoT was recently featured on the cover of Wired magazine for an article titled, “Awake: Welcome to the Programmable World.” The article begins, “When the objects around us can talk to each other, the elements of our physical universe converge and spring to life.” (Wired, June 2013 ).
The authors point out three stages for the IoT:
1) There need to be more devices on the network, everything from sensors to devices with embedded wireless.
2) The devices must coordinate with each other without human intervention.
3) Connected devices become ubiquitous, a programmable platform.
So is this just a techie dream born out of science fiction? And what is its relevance to healthcare?
There are several ways that hospitals are already part of the IoT. One big advance is smart IV pumps and their impact on patient safety. Not only can doses be preset, but the pumps can communicate with electronic medication administration records (eMAR) and bar code technology making them intelligent infusion devices. The use of robotics in hospitals continues to grow. Robotic-assisted surgery isbecoming widespread if not controversial . Other uses of robots include, “packaging drugs or delivering lab results, and telemedicine-based technologies that connect clinicians and patients in ways that previously didn’t exist”. Radio-Frequency Identification (RFID) is being used to track assets, such as, IV pumps, which can be difficult to find in a busy hospital or even hoarded. Others are using RFID to track medications administered to patients.
Another trend is the use of unique imaging technology, such as, Wireless Capsule Endoscopy, or camera in a pill, where the patient swallows this device and it moves through the GI track taking pictures as an alternative to the tube-based endoscope. (image at right from GIHealth)
It is only a matter of time, as these technologies mature and become ubiquitous, that these devices will begin to talk to each other and inform care throughout the hospital.
At the same time, the IoT is available to patients. The Quantified Self movement believes in monitoring many body functions from blood pressure to sleep and more. This is becoming fertile ground for innovation and startups are offering more consumer devices every week. One recent example is the Scanadu Scout that allows you to quickly check your vital signs by placing the device on your temple. (image below from Scanadu) David Pogue of the New York Times wrote a review of many devices which promote health from companies like FitBit, Nike, Jawbone and Flex. But he also critiques them for lack of Bluetooth connectivity in some cases or less than adequate user interfaces.
It is still early in the development of personal health devices for them to talk to each other or to larger systems through the Internet. In the area of telehealth, there are many devices and systems providing home monitoring of the chronically ill. These can provide an alternative to frequent clinic visits or visits by home health services when the data is reliably sent to the provider and algorithms are available to flag warning signs. The Veterans Administration is moving forward with an extensive program of telehealth to serve veterans everywhere.
Finally, there is the rare startup that is focusing just on the IoT. One company out of Cleveland has even taken on that name, iOTOS. They have developed hardware, a wireless device, which can be imbedded in all kinds of devices which is tightly integrated with their proprietary software platform. iOTOS is just beginning to look at healthcare applications of the device/software from diagnostics to home monitoring. Because it is cloud-based, the devices can display data through mobile devices. (image below from iOTOS)
In conclusion, the Internet of Things is creeping into healthcare, almost unnoticed. But the ubiquitous nature of IoT makes it self almost invisible to humans. Both in hospitals and at home, the possibilities are endless. Although we are early in the maturity of this technology as noted by the Wired article, we will soon connected devices become ubiquitous, a programmable platform, with medical devices talking to each other while improving care provision and our personal health.
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Further Thoughts on Google Glass
July 10, 2013
Here are some major advantages:
- hands free browsing and video/photos
- lightweight and minimally intrusive
- can look at someone while browsing or during a hangout rather than looking down at a cell phone
- many possibilities for uses in healthcare and medicine – see this article from iMedicalApps. One additional thought – how about physicians receiving alerts on their patients’ lab results via Glass
- camera quality is excellent
Some downsides or challenges for developers to fix:
- dependent on open wireless networks or activating your phone as a personal hotspot ($$$$$)
- messages, searches and alerts limited to short text – considering the scale of the device, not sure how much more we can expect. If there is something that requires more detailed attention, we are at least alerted and can view it on a laptop
- especially in healthcare, privacy concerns since one can take an image of anyone without their permission. Maybe the device should have a small light indicating that a recording or photo is being taken
- If you are close to someone who also has Glass, their device might follow your verbal commands, “OK, Glass”. This actually occurred during my orientation
- Availability of prescription Glass
Most of these are easy to solve. The challenge is using this new technology in healthcare, developing apps, use cases and broader adoption.
Share this:Google Glass – Day 3 – Future Applications for Healthcare
July 9, 2013
On day 3, I brought Glass to work and introduced it to my staff and others at the hospital. Unfortunately, I could not connect to the internet thru Glass. The private wireless network did not allow a connection from the device and the public network requires browser authentication (like many airports and hotels) which is not possible in Glass. So the main demo was videos and photos I had already taken and demonstrating how to take photos and videos or having Glass read aloud alerts, such as, those from the New York Times.
So what applications are there for medicine and healthcare for this device? Already there are many ideas coming forward:
- “Google Glass makes some people uneasy, but a medical app that tells folks how to perform CPR not only could save lives, but also highlights what’s so awesome about our connected, sensor-rich future.”
- Google Glass Invades Social Media With #ThroughGlass
- Chloe Glass – a simulator wearing Glass to evaluate medical practice in training
- Use of Glass in surgery
- How Google Glass Is Changing Medical Education
- Glass on hospital rounds
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Google Glass – Day 2
July 9, 2013
Day 2 was spent at home trying it out on my home network and showing it to neighbors. I was becoming more comfortable with using and wearing it. The hands-free aspect of Glass does have a freeing sense.
Sunday I discovered that a flood of NY Times alerts came through. Fortunately, Glass with read them to you if you like (headlines only). Also tried a Google search which resulted in a Wikipedia entry for some (first line) which was more or less relevant to my request. Since I don’t routinely use Siri or Google Voice, my proficiency with voice to text was lacking but this is something that could improve with practice.
Also attempted a video call to Lucien Engelen in the Netherlands. Unfortunately, it was choppy and the screen froze for both of us at times. Not sure if that was Glass, as I moved around the house trying to maintain the wireless connection or the speed of my wireless network or the international connection. Another item which would require more trial and error, common with adopting new technology.
Someone pointed me to this video by Sergey Brin at TED which starts with the intro to Glass and then his statements of the purpose of Glass – to move us away from staring down at our phones and again facing our fellow human beings while staying connected to the world. Interesting concept. Would like to see some human factor researchers do a test of highly connected people using a mobile phone vs. Glass.
Two examples of videos taken Saturday in NYC
These 20 second videos are easy to do with a voice command.
More tomorrow on potential applications in healthcare.
