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Showing posts with label telehealth. Show all posts
Showing posts with label telehealth. Show all posts

Thursday, March 26, 2020

digital health initiatives in the wake of COVID-19


6. 17-year-old builds a website to closely track the Coronavirus epidemic and now millions are using it:https://www.democracynow.org/2020/3/13/meet_the_17_year_old_behind

7. Flatten the Curve. Volunteer engineers and clinicians big data real-time heatmap of potential and confirmed COVID-19 cases: https://flatten.ca/

8. Ontario, Alberta, etc., billing codes for primary virtual visits: https://ontariomd.news/

9. Wildly Popular South Korean covid-19 tracker app: https://www.marketwatch.com/story/wildly-popular-coronavirus-tracker-app-helps-south-koreans-steer-clear-of-outbreak-areas-2020-03-18

10. South Korean coronavirus tracking apps: https://www.businessinsider.com/coronavirus-south-korea-photos-apps-location-outbreak-where-2020-3#the-app-collects-data-from-public-government-info-including-the-korea-centers-for-disease-control-to-show-the-date-a-patient-was-diagnosed-with-covid-19-along-with-the-persons-nationality-age-gender-and-where-they-visited-2

11. WeDoctor - free consultation from medical clinicians: https://promo.guahao.com/en/global/pneumonia

12. Donate PPE in Canada: https://togetherwecandothis.ca/

13. National Emergency Library - Free books online: http://www.openculture.com/2020/03/the-national-emergency-library-makes-nearly-1-5-million-books-free-to-read-right-now.html

14. MIT Emergency Ventilator Project: https://e-vent.mit.edu/

15. Canadian MD Ventilator Hack 1 ventilator for 9 people: https://www.upworthy.com/canadian-doctors-brilliant-evil-genius-hack-turns-one-ventilator-into-nine

16. Nobel Laureate Leads Push for Made in Canada Ventilator: https://www.theglobeandmail.com/canada/article-nobel-laureate-leads-push-for-simple-made-in-canada-ventilator/

17. Medical Futurist - COVID-19 Was Needed for Telemedicine to Finally Go Mainstream: https://medicalfuturist.com/covid-19-was-needed-for-telemedicine-to-finally-go-mainstream/

18. Project Northern Lights - Groups of Canadians using Slack to hack projects for COVID:  https://www.theglobeandmail.com/canada/article-canadians-use-crowdsourcing-to-produce-medical-supplies-for-health/

19. SECDEV looking for Cybersecurity IT Professionals to volunteer to protect healthcare centres from disinformation, ransom ware attacks, etc:https://www.secdev.com/

20. FutureLoop - Pandemic Edition: https://futureloop.com/register/coronavirus/












32. How is my Flattening?  includes vaccination percentages for Ontario

33. Canada's Public Health Data Meltdown - MacLeans article by Justin Ling


35. ProMed - International Society for the Infectious Diseases









Saturday, June 30, 2018

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. 
Cost Per Genome
 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 personalizedubiquitous and intelligent healthcare.
In this blog, we’ll discuss how converging exponential technologies are enabling:
  1. Personalized medicine
  2. Delocalized (“everywhere”) care
  3. 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. 
Organs on a Chip
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.
Lung - 3D4Medical 2
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.

Sunday, September 8, 2013

Surgery transmitted by Google glass

Google glass apparently wasn't used here first, according to a poster at the Kurzweil site:

Great accomplishment BUT not the 1st time! It was a FutureMed/Singularity grad who performed the first Surgery s GoogleGlass! See:
Google Glass In The Operating Room! http://t.co/bMR64jVCTQ
&in Med Ed”OK Glass:Teach me Medicine!” http://t.co/0vYPZcrzKk

The spanish Clinica Cemtro looks like an interesting organization with eHealth applications like this, even though I am not sure how this can be applied in the future.


Saturday, June 1, 2013

Bioethics and eHealth - for example - Telecare, Surveillance, and the Welfare State

Key stakeholders in the project management of an eHealth project include, clinicians, nurses, software engineers, Senior Management, Project Manager, statistician, healthcare administration, etc. But often I think a key player that should be added more to the list is a Bioethicist.  This article from the American Journal of Bioethics - Telecare, Surveillance and the Welfare State - is  illustrative about why a bioethicists on the team may be essential. Unless you have some sort of institutional access you might not be able to read the whole article. In this article, the Bioethicists argue the pros and cons of surveillance technology for the elderly who are being monitored in their homes for their chronic health conditions. The authors come out in favour of the surveillance technology - it is not Big Brother - but it all depends on how a chronic a condition a senior might have. Anyway, I value the point of view(s) of bioethicists because they tend to see healthcare differently from front line workers and administrators.

Here is the abstract:

 2012;12(9):36-44. doi: 10.1080/15265161.2012.699137.

Telecare, surveillance, and the welfare state.

Source

University of Birmingham, UK. t.sorell@bham.ac.uk

Abstract

In Europe, telecare is the use of remote monitoring technology to enable vulnerable people to live independently in their own homes. The technology includes electronic tags and sensors that transmit information about the user's location and patterns of behavior in the user's home to an external hub, where it can trigger an intervention in an emergency. Telecare users in the United Kingdom sometimes report their unease about being monitored by a "Big Brother," and the same kind of electronic tags that alert telecare hubs to the movements of someone with dementia who is "wandering" are worn by terrorist suspects who have been placed under house arrest. For these and other reasons, such as ordinary privacy concerns, telecare is sometimes regarded as an objectionable extension of a "surveillance state." In this article, we defend the use of telecare against the charge that it is Orwellian. In the United States, the conception of telecare primarily as telemedicine, and the fact that it is not typically a government responsibility, make a supposed connection with a surveillance state even more doubtful than in Europe. The main objection, we argue, to telecare is not its intrusiveness, but the danger of its deepening the isolation of those who use it. There are ways of organizing telecare so that the independence and privacy of users are enhanced, but personal isolation may be harder to address. As telecare is a means of reducing the cost of publicly provided social and health care, and the need to reduce public spending is growing, the correlative problem of isolation must be addressed alongside the goal of promoting independence.




Tuesday, February 19, 2013

Not why eHealth but when

I was reading COACH - Canada's Health Informatics Association "eHealth Convergence Forum Report: Addressing Key Issues in First Nations Health" report. Somewhere in there I read that the consensus or attitude towards eHealth among First Nations was no longer a question of why but when. eHealth representatives among First Nations have presented at recent eHealth conferences and I think it is a smart move on their part.

Tuesday, January 29, 2013

Leprosy and eHealth

I found this story  in my Google Reader I think because my search query for RSS news feeds is set on Health informatics and bioinformatics. The focus of the article is the fund raising of David Bousfield for leprosy. I think Google picked up that David was "an expert in biomedical publishing and informatics". Anyway, who doesn't think leprosy is a terrible disease? We don't see it much here in Canada, but I have seen it in Guatemala, South Korea, Nepal and quite up close in India. Seeing it in South Korea was very rare until I remembered that a friend of mine worked there with the Peace Corps in the 1980s helping treat persons with leprosy.  In India, one may meet persons with leprosy on almost any given day of the week, or so it might seem.

Maybe there can be an eHealth solution to assist in this cause, as David says:

“Being a repeat rider you become aware of how global healthcare is evolving. What Lepra originally did was distribute drugs, but these days it’s about information. The drugs are there but it has become more focused on making that link between somebody who has the disease, where the drug is and what you’ve got to do to get it.”

Just get some recycled cell phones, and a used computer to act as a messaging server, and an SMS system can really do wonders in terms of collecting information and helping to create a support structure. It has been done successfully by FrontlineSMS all over the world. Of course some persons with this disease are not going to be able to handle a cell phone, and that's were some other forms of adaptive technology might come in. For example, isn't Google Glass kind of a hands free voice activated system?

Yes, I know that lepers wearing Google Glass isn't going to happen overnight and Google Glass isn't on the market yet in order to create recycled items or competitive items to drive the price down - it is just a fact that new technologies kind of cycle this way and end up on the "bottom of the pyramid" at the same time as they start to support the structures above.

David's £50k helps the fight against leprosy

David Bousfield recently completed his 10th gruelling cycle ride in aid of a charity at the frontline in the fight against leprosy – taking his fundraising total to almost £50,000. He tells LOUISE MARTIN why it’s time to remove the stigma associated with the disease.
Riders and support crew
Riders and support crew
Every two minutes in the world, and every four minutes in India, someone is diagnosed with leprosy. One of the oldest and most stigmatised of diseases, leprosy is a chronic infection of the skin and nerves; left untreated it can lead to loss of sensation in hands and feet, ulcers and deformities, and can even result in blindness.
India is home to more than half of the world’s new cases of leprosy each year. The disease thrives in the country’s poor, overcrowded areas where the chronic condition is easily spread via coughing and sneezing. Every year, the international health charity Lepra transforms the lives of 73,000 people with leprosy by working at the frontline to treat, educate and rehabilitate those affected by leprosy – as well as other diseases associated with poverty and prejudice including TB, HIV, lymphatic filariasis and malaria.

As the world’s first ever leprosy prevention organisation Lepra’s work is crucial, but it can only continue its life-saving work with the support of dedicated fundraisers like Cambridge resident David Bousfield.

An expert in biomedical publishing and informatics, 63-year-old David got involved with the charity in January 1999. “I saw a tiny advert in The Guardian saying ‘Do you want to get fit? Do you want to go to Brazil? Do you want to do something worthwhile?’” he remembers.

“They were all things on my list of New Year resolutions so I thought I could tick them all off in one go.”

The trip to Brazil was based around a 450-mile group cycle ride which helped to raise vital funds for the charity, while visiting some of the communities it works to support. Although interested in the charity’s work, David admits at the time, for him, the real draw was the cycling. “Brazil kind of got me hooked on the bike rides but my attitude has slightly changed,” he says. “To begin with it was an opportunity to go with a group of people and cycle in a country that I wanted to know more about and what Lepra did was the bit on the side. But now, because of the work that I do, I’ve become more interested in how health information is used in developed countries, so it’s an interesting way to learn more about what’s happening in developing countries such as India and Brazil.”

A couple of months ago, David completed his 10th cycle ride for Lepra and took his fundraising total for the charity to almost £50,000. As part of a team of 12 cyclists, he accompanied a Lepra health education van across project sites on a 500km route in the state of India’s Madhya Pradesh. The team was visiting poverty-stricken rural villages, health centres and hospitals to give vital health education. The poor areas have low or no literacy rates so the education team teaches communities how to detect the symptoms of diseases through the forms of plays, puppet shows and films broadcasted from the back of rickshaws.

“Compared to many other diseases, there is relatively little known about the leprosy transmission process, apart from that there is a cocktail of drugs to cure it,” explains David.

David back home in Cambridge
David back home in Cambridge
“Being a repeat rider you become aware of how global healthcare is evolving. What Lepra originally did was distribute drugs, but these days it’s about information. The drugs are there but it has become more focused on making that link between somebody who has the disease, where the drug is and what you’ve got to do to get it.”

Lepra ’s aim is to make people aware of the symptoms and curability of leprosy and other diseases through education and increasing the charity’s visibility. The organisation has 26 leprosy and TB referral centres across India providing specialist services such as testing and treatment for people with TB and physiotherapy and reconstructive surgery for those with leprosy but, despite there being a cure for leprosy, there is no vaccine to prevent infection in the first place and there is still much prejudice associated with it.

One of the aims of the Lepra cycle rides is to help break the stigma associated with diseases such as leprosy. During the trip, David met a father and his two children who live under a tarpaulin on the side of a road. The mother left her husband and two young daughters, Sita and Gita, after they contracted leprosy. “You see all sorts of things which are absolutely horrific. If you remove the stigma that is associated with leprosy and other diseases so that the village actually helps, people in the village will know what the symptoms are and spot the symptoms and then instead of telling people to get out of the village they’ll tell people to get help. The stigma is still very much there but by acting quickly the infection can be stopped. You have to be pretty quick off the mark to come out with no lasting consequences, but you can stop the infection.”

The November trip was David’s fifth visit to India. Previous cycle rides have been in the Orissa region and this was only the second time the Madhya Pradesh route had been undertaken by a Lepra group and, according to David, it was a positive experience. “It was really great,” smiles David. “The weather was perfect – apart from on the last day when it was very hot – but we cyclists love to grumble and I think at the end of the day if you haven’t had a few really tough days then you don’t have stuff to go back and moan about at home!”
The keen cyclist is modest about his impressive achievement, but the living conditions and hazards on the road are not for the fainthearted. “We rode on some motorways but mostly it was on quiet rural roads. There were some that were very badly water eroded so there were lots of potholes, loose gravel and boulders,” explains David. “Indian driving looks a bit chaotic, and it was a bit hairy in places, but the lorry drivers in particular seemed to be very forgiving and would give us a wide berth.”

In order to cover as many miles as possible the days were long and there was no five-star hotel to relax in at the end of a gruelling stint in the saddle. Yet despite the tough conditions on the road, the team only had to deal with three punctures during the whole 500km route and, to reduce the risk of food poisoning, most meals were prepared by the support team. “The quality of the cooking was so good that it was difficult not to put on weight during the ride,” says David. “We start and end in reasonable hotels and then there are quite a number of government properties in between. There was one guest house which was very basic. There was one double bedroom where the four men were and there was a sitting room where most of the women went, but they had to spill over into the hall. There was only one loo which was in the one bedroom.
A family outside their ramshackle home.
A family outside their ramshackle home.
“You do forget the bad times but partly you do know they’re going to be there – there’s always going to be some horrible loo situation!”

David’s wife, Judy, and his two sons, Nick and John, are supportive of his charity work but they haven’t offered to join him on a ride just yet. “It’s just something I do and they absolutely don’t want to come with me,” he smiles.
David has seen first-hand how the vital money he has raised is making a difference and, despite saying that this year’s ride would quite possibly be his last, after just a couple of weeks back at home he is already thinking about next year’s Lepra trip.

“I’ve seen how the money is helping and I suspect if there is another one next year I’ll consider it.”

l For more information about Lepra or to make a donation visit www.leprahealthinaction.org.
louise.martin@cambridge-news.co.uk

40 million cases
40 million people are disabled by lymphatic filariasis. Items as simple as a bucket, soap and special shoes, together with simple techniques taught by Lepra, help people cope
India is home to more than half of the world’s new cases of leprosy each year.
£3 could pay for a special pair of shoes to restore dignity; £5 could pay for a self-care kit to help a patient manage their condition; £25 could pay for a healthworker to visit.
Last year LEPRA helped 700,000 people access diagnosis, treatment and testing.
More than 1.3 billion people worldwide are at risk from infection

Wednesday, August 29, 2012

Would you use Skype for a doctor's appointment?

This article is a little breezy but it asked the question to the public if they would be willing to use Skype for a doctor's appointment.  A few citizens have replied with comments.
http://www.cbc.ca/news/yourcommunity/2012/08/would-you-use-skype-for-a-doctors-appointment.html?cmp=rss
I heard a Nurse at an eHealth conference in Toronto talk about how Skype was being used for remote villages in Newfoundland.  A lot of education and training is being done by web conferencing these days - saving on travel expense.  A Skype interaction between patient and physician is a no brainer in my opinion, as soon as physicians can work out how to bill for Skype calls.  It is in a way a return to the home visit tradition.  Dedicated telemedicine centers like Ontario Telemedicine Network are more robust versions of this, but the convenience and common sense of the Skype appointment needs more implementation.  I am not sure about the privacy and security of a Skype call, nor Skype's ownership by Microsoft, but I expect those are technological problems that can be worked through.  A quick search on "Skype" in Pubmed brought up some interesting research < here > articles.