NHS to shut down Personal Health Record Service

The UKs National Health Service is going to shut down it's personal health recored service, called Healthspace.  < Here > is the story. This quote by the clinical informatics director, Dr Charles Gutteridge, citing reasons for shutting it down, is insightful:

"It is too difficult to make an account; it is too difficult to log on; it is just too difficult," he said.

I had previously read journal articles citing this as a failure, or at least there being no real benefit to eHealth technologies like personal health records:

Greenhalgh T, Hinder S, Stramer K, Bratan T, Russell J. Adoption, non-adoption, and abandonment of a personal electronic health record: case study of HealthSpace. BMJ. 2010 Nov 16;341:c5814. doi: 10.1136/bmj.c5814

Linkedin groups - Careers on the LiMS groups

Linkedin is very interesting, but after I joined so many groups, I started getting too many emails with my subscriptions, so I had to trim back.  One group I have not unsubscribed from (yet) is the Laboratory Informatics group.  I am astounded at the number of jobs for this group and will post the list I got today.  I think I get a list like this everyday. In case anyone else doesn't know, LiMS stands for Laboratory Information Management Systems.

StarLIMS Developer/Business Analyst

LabAnswer - Greater Atlanta Area

LIMS Administrator

VersityLink - Northern California

LIMS Product Specialist

Autoscribe Ltd. - Reading, United Kingdom

LIMS Manager

Microbioticos Analises Laboratoriais S/C. Ltda - Campinas Area, Brazil

Java Software Engineer (Front-End / UI / LIMS)

Natera - San Carlos, CA

Systems Engineer (R&BPD) - LIMS, CDS

MedImmune - Gaithersburg, MD

Superviseur Production

KRONOS Canada Inc. - Varennes, Qc, Canada

Sr Level Chemist / Technical Director

Silliker - Crete, IL

IT Manager

HRM Innovations - Kalamazoo

Software Implementation Project Manager – Contract Position

WuXi AppTec - St. Paul, MN

Lab Capacity / Efficiency Engineer

Hexcel Corporation - Salt Lake City, UT

Sr. Software Engineer

Siemens Healthcare - Greater Philadelphia Area

ERP Software Engineer, BAAN, SAGE, Developer, CRM

CyberCoders - baltimore, MD

Laboratory Systems Administrator/Manager

Supernus Pharmaceuticals, Inc. - Rockville, Maryland

Quality Management Solution Architect

Leprino Foods Company - Denver, Colorado

Manager, Quality Control Laboratory

Corn Products International - Stockton, CA

Quality Control Lab Manager

Riverhead Resources - Des Moines, Iowa Area

Java Developer/Software Engineer

Lawrence Berkeley National Laboratory - Walnut Creek, CA

Senior Research Investigator-Biologic Drug Development

Bristol-Myers Squibb - Princeton, New Jersey

System Administrator

Transgenomic - New Haven, CT

Lab Automation - Senior Engineer / Scientist

Becton Dickinson - Baltimore, Maryland Area

Laboratory Informatics System Engineer

Abbott Laboratories - Dallas, TX, TX

UK& Ireland Business Analyst: MMD IT Operations

Merck - Dublin, Leinster, IE

Laboratory Analyst - EM Laboratory

Merck - Durham, NC

IT Developer II

MWH Global - Greater Los Angeles Area

Hacking an insulin pump - no good unless it is your own

www.kslaw.com/library/publication/HH051412_Bulletin.pdf

Here is another reason why separate channels for health data is a good idea - if we can only get the encryption right.  A man was able to hack into an insulin pump and turn it off.  Mind you, the hacker was just doing a demo and was a computer security  expert, as well as a diabetic:

During an August 2011 Black Hat conference, a security researcher demonstrated how an outside actor can shut off or alter the settings of an insulin pump without the user’s knowledge. The demonstration was given to show the audience that the pump’s cyber vulnerabilities could lead to severe consequences. The researcher that provided the demonstration is a diabetic and personally aware of the implications of this activity. The researcher also found that a malicious actor can eavesdrop on a continuous glucose monitor’s (CGM) transmission by using an oscilloscope, but device settings could not be reprogrammed. The researcher acknowledged that he was not able to completely assume remote control or modify the programming of the CGM, but he was able to disrupt and jam the device

Story also found < here >

List of US Universities with Masters In Health Informatics

http://mastersinhealthinformatics.com/universities-with-masters-in-health-informatics-degree-programs/

I am posting a lot about the US recently.  This list is quite an extensive one for Health Informatics.  I have seen PhD programs in Health Informatics.  One curriculum for a University in Florida had courses very different from the ones I was required to take, for example, Anatomy, SQL Programming, and Datbase Management, were all individual courses.  I did not have to take anatomy, but in fact I have been invited to see surgical skills training and an autopsy in an anatomy lab in the next few weeks.  Thought it would help expand my knowledge of technology used in skills training by pathologists.

Browsing these university programs is interesting.

FCC Announcement - MBAN: Medical Body Area Network

This story was posted by a member of the HL7 working group on Personal Health Records listserv that I subscribe to, with the acclamation that PHRs will take over the world.  Body sensor data is going to be voluminous, if not ubiquitous, and having two different frequencies for wireless communication makes a ton of sense:

Thu, May 17 00:15 AM EDT

By Sinead Carew

NEW YORK (Reuters) - The U.S. telecommunications regulator is expected to announce plans on Thursday to set aside spectrum to connect wireless medical devices for more convenient health monitoring.

The Federal Communications Commission said it is scheduled to vote on May 24 to adopt the plan for so-called Medical Body Area Networks, according to the telecom regulator, which has been working on the project for about two years.

The idea is that doctors could monitor a patient's vital signs at home or in hospital via low-cost wearable sensors that are attached to the patient's body and wirelessly connected to the machines that process and display the data for doctors.

Currently, such sensors have to be attached directly to machines by wires, making it difficult for patients to leave their beds.

According to the FCC, the new devices could help speed a diagnosis or allow earlier intervention in the case of a medical problem as doctors may be able to respond more quickly.

The regulator hopes to set aside two spectrum bands for the devices, one of which would only be valid for devices used in medical facilities. A second spectrum band could be used for remote monitoring of patients who are in their own homes.

(Editing by Leslie Gevirtz)

ipod for seniors with dementia

I think this is a study that has merit. The benefits of music for developmental psychology in children is just being empirically researched, so why not in seniors, or seniors with dementia? http://www.cbc.ca/news/health/story/2012/05/11/nb-ipod-pilot-nursing-dementia.html?cmp=rss This article made me think of the music and the mind institute at McMaster University which has done a lot of research on the benefits for learning music at a young age. It also made me think of my own mother, who is in a nursing home, and also has developed forms of dementia. Unfortunately, she also has a hearing impairment. Music is a great "carrier-wave" of emotion. I have read the works of a great musician, psychologist, and philosopher from India, who maintained that music was the highest science. Wasn't physics supposed to be the king of the sciences, or was there ever an argument there to begin with?

Two ehealth mysteries

One well known ehealth mystery is typified in the Infoway TV commercial called "Knowing is Better" but takes that scenario one step further.  The comatose patient arrives in the ER with absolutely no identification. How should medics treat the patient?  RFID chip implants was proposed as one solution and there are cases where this may have saved patients. For many reasons the implant idea is not catching on. Nanotechnology might be able to create an identification code, written into our cells, that when scanned leads to a "break the glass in case of emergency" login to an EHR. Research has shown that most patients want the ER to have their health information in an EHR if they were to arrive there from out of the blue.  The same high percentage is equally concerned about the privacy and security of their health information.

The next ehealth mystery is one that is actually being developed now, but by small increments.  It is the scenario of ubiquitous computing, where any contact with the healthcare system generates digital information which is potentially transportable and interoperable through the Health Information Access Layer (HIAL) to a personal health record (PHR).  Everything would be interconnected through Service Oriented Architecture (SOA).  I have heard citizen advocates for PHR say that all forms of healthcare and wellness should be integrated.  That means anytime you visit the dentist, naturopath, personal gym trainer,  use a mobile device like fitbit, nutritionist, physiotherapist, psychologist, data from that interaction is captured, transported, tracked and analyzed in the PHR.  This is a Big Data world where public health and research have consent access to de-identifiable information. This is also the world where the "virtual self" continues to exist long after one is gone. 

Paramedic ehealth - bringing out the dead?

I started watching a movie on TVO called "Bringing Out the Dead".  Nicholas Cage was playing the role of a burnt out paramedic in the Hells Kitchen area of New York city - a really run down, high crime area of the city.  Looked like a great movie but I never had time to watch it all so I went online to my public library to place a hold on the DVD.  Turns out they didn't have the DVD, but they did have the book, written by Joe Connelly.  So now I am reading the book and it turns out that Joe Connelly was a paramedic for 10 years in New York, and is writing from front line experience. I have heard that the work of paramedics is an area that is in need of ehealth technologies. I know several researchers personally from my ehealth studies who work in this area. One is studying the messaging systems from the ambulances to the hospitals.  The other developed a mobile app that will allow anyone to locate the nearest public Automatic External Defibrillators (AEDs) . This latter study is more like public health but it was developed by a former paramedic. < Here > is a link to the paper on it.

Universal Health IDs?

This is a brilliant article by John Moehrke on his healthcare privacy and security blog.  It made me wonder if the Ontario healthcard ID could be used more universally.  I learned a few years ago that the healthcard number was ruled available for health record identification.  If anyone can confirm that, please let me know.

Storing medical images on the cloud & the PHR

In my last post I mentioned novel ways of using Personal Health Records will be devised and here is just one example - storing and sharing medical images on the cloud. When I first read this is sounded like they had created a kind of mirror of a PACS server so the patients can access their medical image, and this they called a "Personal Health Record"!  That would be novel, but I think I read the article too quickly.  What is interesting here, is the idea that (finally) the patient "owns" the image (but not the cloud?) and can have it uploaded to a personal health record.  The next great idea in phase III of this project will allow patients to consent to have the images used for clinical trial research - after de-identification.  Besides organ donation there really should be some sort of data donation system when we die.  Read it < here >

The Power of Personal Health Records?

I have written and researched about Personal Health Records - and had a Google Health account until the project was closed - but I am not sure about the future for PHR anymore.  I joined a few teleconferences for the HL7 standards group on PHR and know how much work they are doing trying to define them in terms of HL7 and interoperability. Here is an article they recommend < HIMSS blog >.  The research has shown more doctors need to adopt EMR before PHR become viable.  And it just maybe more of us need to be chronically ill to speed up their adoption - healthy people don't need to use them!  Be that as it may, time will tell what the future has in store.  My hope will be that the PHR will gain more clinical efficacy and effectiveness for physicians to place them in the trust of their patients.  I have no doubt that a great many people will be using PHR or equivalents to track their wellness in novel ways, without their physicians.  

Ayub Ogada - Kothbiro

There are some pieces of music Oliver Sacks refers to, in his book musicophilia as "ear worms" - it plays over and over again in the mind. One such recent piece had me thinking about where I had heard it before as it appears in unlikely places, CBC radio often, and once during a National Geographic documentary about finding ancient Bon writings in caves in Mustang Nepal. I searched to try to find the piece, knowing only that it was African, slow, and invoked a very sad feeling and landscape. Finally, it occurred to me it might have been in the soundtrack for the Constant Gardener, and indeed it was. The composer, Ayub Ogada, is also from Kenya, so perhaps the music invokes those same landscapes seen in the movie?