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Digital Health Success Stories

Diagnostic images and reports from across the province now available to health care providers With the recent launch of the Diagnostic Imaging (DI) Common Service, health care providers can now view diagnostic images and reports performed at facilities across the province, in one place.  In August, the service was made available to all authorized users in the Greater Toronto Area as well as in northern and eastern Ontario through the ConnectingOntario ClinicalViewer.  It’s also now available at two hospital organizations in south west Ontario, providing additional patient data to ClinicalConnect users who currently see reports and images and produced within their own region, and is being rolled out to more sites in the coming months. Thanks to this integration, health care providers can now obtain a more complete picture of their patient’s health, regardless of their location.   Watch the video above to see how health care providers like Dr. Koff benefit by having quick access to their patients’ diagnostic images and reports. This helps to eliminate the need for patients to carry around CD’s containing their DI information to specialist’s offices. It also eliminates the need to mail or fax test results, and the costly duplication of scans. Most importantly for patients, this network allows specialists at one facility to access images performed at other locations, allowing for more informed, timely medical decisions.

Help Us Share This Story Help others see firsthand how our work today is enhancing delivery of patient care in Ontario. Our mission is to foster an electronic health care system that puts the patient first, by leveraging existing systems and building new ones to connect health care providers with their patients' medical information.

Korean medical TV dramas III

Life

Korean TV darma - Life

There are now many Korean dramas on Netflix. Dramafever or Viki carries many and we have found they often appear there first then end up on Netflix if they are popular. Just because they are on Netflix doesn't necessarily mean they are great or anything but indeed some are very good. The most recent medical drama is called Life.  This follows several very good Netflix posted Korean dramas that were non-medical, but are equally as enthralling. I am thinking of  Mr. Sunshine, Live, Prison Playbook, and Hyeori's Bread and Breakfast.

TV dramas about hospitals probably started out as soap operas. As a kid the soap opera General Hospital appalled us for it's lack of general intelligence and fake acting. Korean epic medical dramas, to my mind starting with Hur Jun in 1999 are extremely interesting to watch - and now that I think about it - better than reading novels. Or, maybe that is an excuse for how much time I have sunk into watching Korean dramas. In fact, I mostly read these dramas anyway because without the sub-titles I am lost. I do hear and know a lot of Korean spoken language and I understand a lot about Korean culture, but it is not a language I am fluent in. For example, sometimes, I can watch a French movie and for the most part can understand what is going on, even without sub-titles. With just French sub-titles I would have an even better understanding.

Life has a well recognizable cast of excellent actors, as they - "star studded cast". I would say it is a powerful cast which would most surely ensure the success of the drama. In fact, the Wikipedia article on Life says for a cable TV drama, the ratings are very high. Anything over 10% is high, and that is very high for cable TV. The most prominent actor is the lead, Lee, Dong Work, who we saw not too long ago in Doekebi ( 도깨비 or English translation - Guardian: The Lonely and Great God ).  He is as good looking as a model, and as the secretary to the Hospital CEO, who has a crush on him in the drama says; "Looks like a Greek God", which in a sly way is referring back to his role as "The Grim Reaper" in Doekebi (도깨비).  Followers of Korean dramas often see these kinds of comical references of actors back to previous roles in famous dramas. One scene we saw recently watching Yi San again were two palace maid friends who said "I think we have met before in a past life somewhere". "Yes, I get that feeling too", which is an obvious reference for the audience who knew those two as not so friendly adversaries in the superb medical drama Dae Jang Geum. Speaking of 'having crushes", any Korean drama would not be worth it's salt without a romance plot or twist and turn, and now into episode number 5, something appears to be developing. Though I also heard that many people were enjoying this medical drama because it lacked a romantic focus.

There is an eHealth reference in Life which startled me for several reasons. The CEO needs to find a way to generate revenue in the hospital, which is a non-profit teaching hospital so that is kind of hard to do. He decides to create a subsidiary non-profit pharmacy that would sell nutritional supplements and all his physicians under this command would be asked to help sell and promote them - a kind sole sourcing monopoly. He finds a supplement company willing to sign on as partners but only in exchange for them funding a technology that the hospital needs.  We later see a scene where the nurses start using RFID bar code readers to interrogate signals and bar codes on patient wrists, medical bottles, inventories, and charts. It is the perfect way to reduce medical error. In early scenes there was a lot of drama over physicians in cancer wards covering up for medication errors that killed a patient. The CEO asked for a solution for reducing the errors but the physicians did not think of the RFID solution. It was the brilliant young CEO who was parachuted in from a subsidiary company that efficiently ran warehouse and product shipping to discover the idea of using RFID and getting his new pharmacy partner to foot the bill. All seems really good with RFID technology until the staff learn that in exchange for the benefit of the technology they now have to be salespeople for the nutritional supplements like whale oil, shark oil, etc, substances most scientifically trained specialists don't give the light of day to. From my own studies of RFID technology, the CEO is right. They do reduce medical errors and improve efficiency.  The technology, as I understand it, is also a bit expensive to implement, and maintain securely. The other thing that startled me is that RFID technology like this is at least a decade old, but really looks new and revolutionary in this drama.

There is another eHealth component in episode 7 or 8 where the CEO of the University Hospital meets a high powered CEO of an electronics company and they talk about starting a health app. They joke that the more people follow their blood pressure on the app, the more worried they will be about their health conditions and thus more prone to book appointments at the hospital and thus more money in the coffers. Thus are the benefits of private healthcare.

The main plot of this drama is how business intelligence pits its wits against medical staff in a top level (big 5) university teaching hospital by applying an all business efficiency and revenue generating model to public healthcare. I don't know all the reality of healthcare in Korea but the trend appears to be towards more privatizations. This drama explores that idea in the extreme. It always makes me think of the journal article written by the McMaster University physician and one of the founders of evidence-based medicine, Dr. Gordon Guyatt, in which he wrote that for profit healthcare is hazardous to your health. That was not just his opinion, but the results of the meta-analysis and evidence-based literature research. In Life, the CEO is played by Cho Seung Woo, who was brilliant in the 2017 drama Stranger (which was written by the same writer as Life - Ms. Lee, Soo-Yeon). Indeed the context for the drama, though not based on reality but is fiction as stated in the intro - has a basis in reality - rural Korean public hospitals being shut down by greedy profit seeking interests.

The focus of interest in the drama is whether or not the CEO of the hospital, who is just following the orders of the Chairman of some huge conglomerate to generate revenue in the hospital after it was bought out ( and don't ask me how a non-profit university teaching hospital can be bought out), is the most unethical, cold hearted greedy capitalist to ever walk the face of the earth, or whether he has inside a human heart capable of compassion and actually being able to listen to the over worked, over stressed and over resourced medical staff, who are just about to go out on strike as a protest to the CEO decision to cut and move out  to the rural areas outside Seoul 3 departments that are losing money. As an audience we start out believing he is a "malicious jerk" to quote the sub-title translation (and I think I even know how that is said in Korean) but through the sympathetic understanding of some of the medical staff and our own inner doubts, we start to believe that the CEO is a human being, who will eventually "pivot" and be able to harmonize solutions for all concerned.

What you have to do with this drama is hinge your mind on every spoken word (or sub-title) because the nuance and intrigue comes fast. You also have to pay attention and learn a lot about business, life insurance, and medical diagnosis, all at the same time. That the drama is packed with dense intelligence is all that I can say, which is why it reminds me more of reading a novel than watching a drama. It is not a "vacuum land" where you can passively watch in an empty state on the hope of being entertained. You actually believe that you can learn about how business and healthcare can operate together. These are also universal and extremely important ideas for society, such as should MDs also have MBAs, or is that some kind of oxymoron?

There have been some other medical dramas that have appeared on Dramafever and Viki but I don't think I will go into them in this Korean Medical TV Drama III post. You can discover those on your own. They are not entirely without merit. This drama called Life, however, I think will be well worth your time watching, and we eagerly look forward to see how this one will evolve past Episode 5.

Revolutionizing healthcare - reposted from Peter Diamandis

We are on the brink of a revolution in healthcare. AI is making the drug discovery process >100X faster and cheaper, and 90% more likely to succeed in clinical trials. Mobile health is predicted to become a $102 billion market by 2022, putting a virtual doctor, on-demand, in your back pocket. And the cost of sequencing your genome (3.2 billion base pairs) has decreased 100,000-fold over 13 years, a staggering speed that is 3 times faster than Moore’s Law.   Source: Social Capital via Medium But humans have barely scratched the surface. As exponential technologies explode onto the scene all at once, we are about to witness the unprecedented rise of personalized, ubiquitous and intelligent healthcare. In this blog, we’ll discuss how converging exponential technologies are enabling: Personalized medicine Delocalized (“everywhere”) care The new era of intelligent prevention We are truly living in an era when anything is possible. Personalized Medicine  Currently, research focuses on one-size-fits-all solutions. Clinical trials aim to discover therapies for the general population — and can only introduce them after years of expensive initial research, lab testing, human testing clearance, multiple phases of patient testing and maybe ultimate approval. But what if all treatments were targeted at your individual genome, from lab testing to ready product, and at a lower cost? Using their powerful deep learning systems, NVIDIA aims to tailor treatments to an individual’s genomic makeup. Others, like a team at the University of Toronto, are building genetic interpretation engines to pinpoint cancer-causing genetic mutations in individual patients. Similarly, researchers at UNC’s Lineberger Comprehensive Cancer Center use cognitive computing to identify individually relevant therapeutic options based on one’s genetic profile. But this is only the beginning. Take Harvard Wyss Institute’s organs-on-chips. Containing microfluidic channels with living human cells and mechanical mimicry of an organ’s microenvironment, the Wyss Institute’s organs-on-chips can serve as micro artificial hearts, lungs, intestines and kidneys, among many other organs. The biotech company Emulate has raised millions for use of these organs-on-chips to replace traditional animal testing and deliver personalized medicine.  Emulate uses organs-on-chips to accurately test drugs on individual, human organs. Source: Emulate In the future, these could be your cells on a chip, tested with treatment after treatment until the right one sticks, tailored exactly to your genetic makeup. But it doesn’t stop at genetically personalized treatments. Welcome to personalized diets.  Each of us has about 40 trillion microorganisms that occupy our gut, and each microbiome — like our DNA — is distinct. Through a simple home kit, Viome applies machine learning to analyze your microbiome, recommending optimal, personalized nutritional recommendations for your gut.  Bowhead Health tackles yet another approach to personalized medicine. With either saliva or a blood-prick test, Bowhead’s small home device reads this biometric data in real time and transmits the reading to doctors. As soon as key deficiencies are identified, your in-home Bowhead device dispenses a customized, vitamin-based pill, all your own. Delocalized Care Kaiser Permanente’s chairman and chief executive George Halvorson foresees plummeting healthcare costs as care migrates farther from hospitals and doctors’ offices and into any and every setting via the Internet. The harbingers of “everywhere care” are so abundant, they deserve a blog of their own. Here are the highlights: (1) mHealth (or Mobile Health) has already grown beyond a $23 billion market, and by some estimates will surpass $102 billion by 2022. Step aside, WebMD. AI-powered medical chatbots are flooding the market. Diagnostic apps can identify anything from a rash to diabetic retinopathy. And with the advent of global connectivity, mHealth platforms enable real-time health data collection, transmission and remote diagnosis by medical professionals. Already available to residents across North London, Babylon Health offers immediate medical advice through AI-powered chatbots and video consultations with doctors via its app. Babylon now aims to build up its AI for advanced diagnostics and even prescription.  Others, like Woebot, take on mental health, using Cognitive Behavioral Therapy in communications over Facebook Messenger with patients suffering from depression. New diagnostics and screening apps are also beginning to empower the next generation of patient-doctors. In addition to phone apps and add-ons that test for fertility or autism, the now-FDA-approved Clarius L7 Linear Array Ultrasound Scanner can connect directly to iOS and Android devices and perform wireless ultrasounds at a moment’s notice.  With mHealth platforms like ClickMedix, which connects remotely located patients to medical providers through real-time health data collection and transmission, what’s to stop us from delivering needed treatments through drone delivery or robotic telesurgery? (2) AR/VR will revolutionize medical training, making it immersive and ubiquitously accessible.  It’s no wonder the healthcare industry suffers from a shortage of doctors. Medical training is not only expensive, but its conventional methods also severely limit scalability. With virtual and augmented reality, however, gone are the days of peering over a surgeon’s shoulder to learn from another’s experience. Why not perform surgery on an annotated, virtual 3D body from anywhere in the world, for minimal cost, and do no harm? Companies like Echopixel and 3D4Medical are achieving this delocalization and hands-on training with remarkable style, translating 2D scans and anatomy into live AR and VR patients. 3D4Medical translates 2D anatomical and brain scan diagrams into 3D AR realities.   Source: 3D4Medical (3) AI-aided IoMT (Internet of Medical Things) may be one of the most exciting frontiers in healthcare. Welcome to the age of intravenous nanomachines, electronic implants and pill-embedded sensors. While wearables have long been able to track and transmit our steps, heart rate and various other health factors, smart nanobots and ingestible sensors will soon be able to monitor countless health parameters and even help diagnose disease. But it doesn’t stop there. As nanosensor and nanonetworking capabilities develop, these tiny bots may soon communicate with each other, enabling the targeted delivery of drugs and autonomous corrective action. Some companies, however, are working on high-precision sensors that need not enter the body. Apple, for instance, is reportedly building sensors that can noninvasively monitor blood sugar levels in real-time for diabetic treatment. In last year’s Qualcomm Tricorder XPRIZE, we were proud to grant $2.5 million in prize money to the winning team, Final Frontier Medical Devices. Using a group of noninvasive sensors that collect data on vital signs, body chemistry and biological functions, Final Frontier integrates this data in their powerful, AI-based DxtER diagnostic engine for rapid, high-precision assessments. Their engine combines learnings from clinical emergency medicine and data analysis from actual patients. IoT-connected sensors are also entering the world of prescription drugs. Just this winter, the first sensor-embedded pill — Abilify MyCite — was approved by the FDA. Digital pills such as Abilify will now be able to communicate medication data to a user-controlled app, to which doctors may be granted access for remote monitoring. But nanobots and IoT-connected sensors get a lot more exciting when they converge with 3D printers, AI supercomputers and the power of big data. Intelligent Prevention Take a minute to imagine this unprecedented convergence: Nanobot sensors flowing through your bloodstream monitor different health parameters, measuring nutrient levels and keeping an eye on your cholesterol. As data flows in, these connected sensors transmit your health data in real-time to a remote AI-powered supercomputer geared with all your genomics, microbiome and medical history data — access secured via blockchain, of course. As abnormalities are detected, this AI-driven doctor sifts through tomes of data to identify an optimal, personalized treatment based on your genetic profile and real-time health data. Once vetted and approved, a prescription arrives at the dashboard of your in-home medical 3D printer. With customized dosage, your 3D printer separates the drug’s active ingredients with micro-barriers and embeds a printed sensor to monitor variations in drug release and effectiveness. Feedback is instantaneously communicated through IoMT, and AI again improves its personalized medicine for future treatment. You might think that AI medical powerhouses and autonomous sensors leave human doctors out of luck. But many digital healthcare startups are in fact redefining and elevating the role of our doctors. Take Forward, for example. A digitized doctor’s office geared with AI-driven diagnostics and personalized medicine, Forward is finding a way to liberate its doctors from many of the tedious necessities that so often constrain their ability to engage with patients.  As medical AI enterprises like Microsoft’s Healthcare NExT and IBM Watson Health bring incredible power to diagnostics, drug discovery and genetic therapy development, doctors may be freed to take on consultative roles — educating patients, performing many more remote surgeries with the help of robotics, and aiding in preventive care. Final Thoughts Nowhere is convergence bringing greater breakthroughs than in healthcare. As transformative technologies like CRISPR-Cas9 unlock our genetic potential, quantum computing massively ups the speed of AI-powered drug discovery, 3D printing places the power of preventive medicine in the hands of consumers, and next-generation implants enhance our minds, we are truly living in an era when anything is possible. Join Me  (1) A360 Executive Mastermind: This is the sort of conversation I explore at my Executive Mastermind group called Abundance 360. The program is highly selective, for 360 abundance and exponentially minded CEOs (running $10M to $10B companies). If you’d like to be considered, apply here. Share this with your friends, especially if they are interested in any of the areas outlined above. (2) Abundance-Digital Online Community: I’ve also created a Digital/Online community of bold, abundance-minded entrepreneurs called Abundance-Digital.0 Abundance-Digital is my ‘onramp’ for exponential entrepreneurs – those who want to get involved and play at a higher level. Click here to learn more.

Business Insider Intelligence - repost - Digital Health Briefing Iphone Research Kit

DIGITAL HEALTH BRIEFING

Apple builds out iPhone as a clinical tool — China's largest insurer touts digital health as the future — Automated claims present $11 billion savings opportunity - CLONE Nicky Lineaweaver | June 18, 2018 Good morning! DIGITAL HEALTH BRIEFING is delivered first thing every morning exclusively to Business Insider Intelligence members and BRIEFING subscribers. Have feedback? We'd like to hear from you. Write me at: lbeaver@businessinsider.com APPLE TRANSFORMS IPHONE INTO CLINICAL-GRADE TOOL WITH RESEARCHKIT UPDATES: A host of new functions in Apple’s ResearchKit 2.0 update point to an iPhone that could serve as a digital medical assistant. The new version of ResearchKit — Apple’s developer framework that allows researchers to build and maintain apps that track health data — includes features that can collect data from speech, hearing, and vision tests. The latest updates are a part of Apple’s efforts to turn the iPhone and Apple Watch into invaluable devices for the medical community. For the healthcare community, the ResearchKit framework presents an opportunity to greatly improve clinical trial participation and, therefore, the validity of the results.Developing new treatments is an expensive and lengthy process, with a high failure rate. The average development time for a new drug is 12 years and costs in excess of $2.5 billion, for example. Further, around 90% of medicines in human studies fail. Apps using ResearchKit could help to reduce barriers for participants by adapting the design of clinical trials to suit the daily routine of patients, leading to a more nuanced understanding of the disease being tested and potentially higher success rates in medical studies. One of the biggest benefits of ResearchKit is that mobile apps can provide more accurate data for clinical studies. Typically, patients in clinical trials have to self-report historical health data over a specific time in a diary. However, self-reporting has not been an effective way to track events like seizures — for example, over 40% of generalized tonic-clonic seizures are not reported by patients. Apps built using ResearchKit can more effectively track events during clinical studies. As Apple expands the capabilities of ResearchKit, it opens the door for a wider variety of experiments to be run, further entrenching the company within the healthcare landscape. For example, in April 2018, pharma giant Novartis launched a new product on Apple’s ResearchKit platform to validate whether iPhones could be used in eye studies. The company hopes the offering will broaden its reach of participants, increasing the validity of the clinical trial. TOP CHINESE INSURER TOUTS DIGITAL HEALTH ECOSYSTEM AS WAY OF THE FUTURE: China-based Ping An Group, one of the largest insurers in the world, views an ecosystem of digital services as integral to the company’s vision of health, CIO Jonathan Larsen told digital health hub StartUp Health last week. Ping An is looking to expand its telemedicine platform, Ping An Good Doctor, beyond the 192 million registered users it currently serves into new international markets. The company’s also looking at how investing in new tech can add value to its services — like mobile health (mHealth) services that put more patient data in the hands of its telemedicine providers, and AI-enabled diagnostic imaging for use in Ping An clinics. Expanding these digital offerings could help attract more patients to Ping An's services. Moreover, offering patients more digital tools means Ping An can potentially capture more patient data, which it can use to encourage health-improving behaviors that help to cut reimbursement costs.

Infoway - repost -Current and Potential Value of Canadians’ Secure Access to Their Health Information and Digital Health e-Services

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Current and Potential Value of Canadians’ Secure Access to Their Health Information and Digital Health e-Services Description: In collaboration with the Social Research and Demonstration Corporation (SRDC), Infoway recently completed a comprehensive study to estimate the evidence-based value of citizen access to their health information and a set of digital health e-services. Grounded by 2016-2017 citizen-reported utilization of four e-services, the study produced quantitative value-based estimates across a set of evidence-based indicators and highlights important areas of opportunity for research and implementation. Join us on Tuesday, June 26 at 2 p.m. – 3 p.m. ET to learn about the study results and get the most current access and utilization of e-services stats from our 2018 survey of Canadians. Presenters: Chad Leaver, Director, Performance Analytics, Canada Health Infoway​ Christina Hackett, Senior Research Associate, Social Research Demonstration and Corporation This webinar will be presented in English only. Register now

La valeur actuelle et potentielle de l’accès sécurisé des Canadiens à leurs renseignements médicaux et à des services de santé numériques Description : En collaboration avec la Société de recherche sociale appliquée (SRSA), Inforoute a récemment effectué une étude approfondie afin d'évaluer la valeur probante d'un accès des citoyens à leurs renseignements médicaux et à un ensemble de services de santé numériques. À partir des données relatives à l'utilisation déclarée par les citoyens de quatre services électroniques en 2016-2017, l'étude a permis de produire des estimations quantitatives de la valeur pour un éventail d'indicateurs probants. Elle met également en relief les domaines très prometteurs pour la recherche et l'implantation. Soyez des nôtres le mardi 26 juin de 14 h à 15 h HE pour avoir un aperçu des résultats de l'étude et obtenir les statistiques les plus récentes tirées de notre sondage 2018 auprès des Canadiens concernant l'accessibilité et l'utilisation des services électroniques. Présentateurs : Chad Leaver, directeur, Analytique du rendement, Inforoute Santé du Canada Christina Hackett, associée principale de recherche, Société de recherche sociale appliquée Ce webinaire sera donné en anglais seulement. Inscrivez-vous maintenant

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