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Hacking Health in Hamilton Ontario - Let's hear that pitch!

What compelled me to register for a weekend Health Hackathon? Anyway, I could soon be up to my ears in it. A pubmed search on Health Hack...

Showing posts with label wireless. Show all posts
Showing posts with label wireless. Show all posts

Wednesday, July 1, 2015

Fitbit and Personal Health Informatics

A surprise gift for father's day was a Fitbit ChargeHR. The HR stands for Heart Rate, that measures beats per minute (BPM). It doesn't measure blood pressure, and I don't think any device like this on the wrist will be able to do that soon. I have been counting my walking distances, steps up stairs, calories and sleep activity for about a week now. It feels good to have entered the world of the "quantified self "and big data personal health informatics at more than just a theoretical level, as I have been doing on this blog for the past 4 years. I actually have a blog post about Fitbit from 3 years ago <here>!

The data is sent wirelessly to a small "dongle" on my MacBook anytime I am within 20 feet of it. I was surprised to see how this data easily integrated with Telus (Microsoft) Health Space (Healthvault) from the Fitbit.com login settings account. The power of the API is truly awesome.

As I knew before when I was looking at reviews for smart watches, the Fitbit ChargeHR is not a great watch for telling the time. However, one advantage is I find myself saving a lot of time by not looking at my watch to find out what time it is so often. All in all, I find myself wanting to wear it more than the old watch.

Sleeping with the watch is perfectly unobtrusive. There are continual double green sensor lights flashing for the BPM readings but it is hidden under the wrist. At a different viewing angle you can see the green lights. Double tapping at night will illuminate the clock (and day of the month) but during the day it is very difficult to see the digital time in glare of light of day. When you wake in the morning, sleep activity data is automatically transmitted to the MacBook or the Fitbit app on the iPad. via the dongle. The sleep data is a bit hard to interpret. Did I really only get 5 hours sleep? Anyway, I am starting to make some sense of the times I may have been awake or restless.

If you set a goal for 10,000 steps it will buzz on your wrist when you achieve the goal. You are also sent an email congratulating you, which is repeated in the weekly email data digest updates. I tracked food consumption for data on calories, sodium levels, etc. for a few days, and this is very interesting information for me. Since I have not really changed weight since I was a teenager, I don't really have any weight goals, but I know I can align readings from the gym equipment which tracks BPM and calories burned with the Fitbit. When I am not going to the gym, I can utilize those readings. But like I said, watching calories burned is not a science I follow much because of my metabolism.

Even though the data is integrated into the Telus HealthSpace, which is a free personal health record if you have a Microsoft login, I still don't find myself using the personal health record that much (yet). I also have a McMaster PHR (former MyOSCAR) and a Health and Wellness Companion PHR through my employer's health insurance company, in both of which I have just stepped into the shallow end of the pool. I tend to keep a Word document log and paper file of health related events a lot more. If the PHR was integrated with our family health team, I am sure I would use it more.

So, I think we are still a way off from wider adoption of personal health records as integrated tools for the physician's electronic medical record. A lot depends on more research, and of course evolving software breakthroughs like APIs. I am a community volunteer with the McMaster University Family Medicine TAPESTRY program, and I can see first hand the uptake on PHRs and how much education and training is required before they are being used effectively. On our visits to seniors in our communities we also help promote the use of the McMaster PHR. Like any technology, and the toothbrush comes to mind, use comes from developing good habits, as well as promotion from health care professionals.

Because we have entered a digital culture, many people will be entering a personal health record, not through their family medicine clinic, but through some form of personalized health informatics, like Fitbit data, or smart phone apps. There will be a point when physician medical practices will want to buy into accessing or making that data available.


Sunday, January 19, 2014

A different kind of google glass - contact lens that detects glucose for diabetics


Google X is a "moonshot" group of experimental projects Google is exploring. A recent news story about one of these projects is hitting the media called Google Contact Lens. The premise behind this is one of the holy grails of diabetes research, finding a "pin-prick-less" way to test for glucose levels. I did a study of the various devices under-going development and the history is a bitter one of trial and error, fraud and failure. To my knowledge, there is no FDA approved device yet that can do this. I will set up an email alert for more news about this in the future. CBC technology coverage is great. Here is some info from our working paper on a mobile solution for self-management of diabetes:


A non-invasive technique capable of measuring blood glucose concentration with accuracy equal to or better than the current chemical glucose meters may improve compliance for glucose monitoring. 53 Considerable efforts have been made by several scientific research groups and organizations in the past few decades to develop non-invasive blood glucose monitors.  Diverse optical approaches have been proposed to achieve this objective. These approaches include polarimetry, Raman spectroscopy, near-infrared (NIR), absorption and scattering and photoacoustics. These techniques appear to be promising, but have limitations associated with low sensitivity, accuracy and insufficient specificity of glucose measurements at physiologically relevant levels. 53 Non-invasive continuous Glucose Monitors like GlucoWatch G2 Biographer and Continuous Glucose Monitoring (CGM) which are FDA approved have been found unreliable for detecting hypoglycemia. 54 There are non-invasive solutions available in Canada for measuring blood glucose level by BioSign Technologies’ UFIT Care. 25 However, this product is yet to be approved by Health Canada and therefore, cannot be used.
And various references to the above:

23. Medgadget. MedGadget Web site.
http://www.medgadget.com. Published 2009. Updated 2009. Accessed november 2009.
24. Pain-free precision: Clinical trial reveals new option for blood sugar testing. . 2002;1 No 2.
25. Biosign Technologies Inc: Online Health Monitoring, Getting the Numbers Right Fact Sheet. http://www.biosign.com/Web_Files/factsheet_biosign.pdf. Updated 2009november 2009.
53. Kirill V, Mohsen S, Montamedi M, Esenaliev R. Noninvasive Blood Glucose Monitoring With Optical Coherence Tomography. Diabetes Care. 2002;25(12). http://care.diabetesjournals.org/content/25/12/2263.abstract.
54. Accuracy of the GlucoWatch G2 Biographer and the Continuous Glucose Monitoring System During Hypoglycemia. Diabetes care. 2004;27(3). http://care.diabetesjournals.org/content/27/3/722.abstract.

Monday, January 28, 2013

Epidermal Electronic Systems

rfid microchip rice grain

I heard about this identification system on the Institute for Ethics and Emerging Technology mailing list. Instead of being subcutaneous like RFID implants, this electronic identification source is skin-like, kind of like the newer water proof bandaids that are transparent and really stick. The author of the article relates this to the potential for healthcare, but not without some caveats:
"There are some emergent ethical issues stemming from these technologies. I can already guess the EES system being potentially used to tag artificial organs and corporate patients in hospitals. Even now few of us would refuse if a hospital insisted on using an epidermal electronic tatoo patch on us for their patient inventory system. Informed consent has just taken on a whole new different set of meaning. However, the advantages far outweigh the fears of social discrimination and eugenic nightmares. Systems such as Epidermal Electronic devices could eventually help in timely drug delivery especially during medical emergencies. "
Yes, it does look like more patients might be happier to consent to wearing a device like this, as opposed to the more invasive RFID chip implant. Who could refuse?

Friday, December 21, 2012

Smartphone - brain scanner - Emotiv


Emotiv is a revolutionary EEG system (and it's wireless):

 
A revolutionary personal interface for human computer interaction.The Emotiv EPOC uses sensors to tune into electrical signals produced by the brain to detect user thoughts, feelings, and expressions. To devlope your own applications for the EPOC, license an SDK to obtain our proprietary software toolkit
.


Another piece of the Tricorder puzzle? - smartphone brain scanner.


Uploaded on 8 Sep 2011
"Holding your brain in the palm of your hand..."

We demonstrate a fully functional smartphone brain scanner consisting of a low-cost 14-channel EEG headset with a wireless connection to a smartphone (Nokia N900), enabling minimally invasive EEG monitoring in naturalistic settings. The smartphone provides a touch-based interface with real-time brain state decoding and 3D reconstruction.

The Smartphone Brain Scanner is developed by Arkadiusz Stopczynski, Carsten Stahlhut, Michael Kai Petersen, Jakob Eg Larsen, and Lars Kai Hansen, DTU Informatics, Cognitive Systems Section.

More information available at: http://milab.imm.dtu.dk/eeg
The project is open source and available at: http://code.google.com/p/smartphonebrainscanner2/

Wednesday, December 5, 2012

Father of medical informatics, Utah’s Homer Warner dies


In my eHealth studies I had not heard of Homer Warner, but I did hear about Intermountain Healthcare in Utah, where Warner was working, because they did a lot of advanced EHR informatics using HL7.  This story about how he came to use computers in the study of cardiology was fascinating.  


Father of medical informatics, Utah’s Homer Warner dies
Groundbreaking work of cardiologist is still redefining medicine.
First Published Dec 03 2012 04:49 pm • Last Updated Dec 04 2012 08:09 am
Homer Warner, a Utah cardiologist widely recognized as the father of medical informatics, died last week from complications of pancreatitis. He was 90.
Warner’s research is still redefining medicine, colleagues say. Modern intensive care units can be traced back to the electronic systems he built to monitor heart patients in the mid-1950s. And his creation of one of the first electronic medical records in the ‘70s set the stage for a new academic field and multi-billion dollar health IT industry.
     
Photos
At a glance
Funeral services
A public service will be held at noon on Thursday, Dec. 6, at the Foothill Stake Center, 1933 S. 2100 East in Salt Lake City.
In lieu of flowers, the family suggests donations to the Homer R. Warner Scholarship Fund in Medical Informatics at the University of Utah.
Online condolences may be left atwww.larkincares.com.

He had the mind of an intellectual and the soul of an adventurer, captivating University of Utah medical students in a speech just weeks before he died, said his son Homer Warner Jr. "He just had a quiet magnetism about him."
Warner checked into a hospital complaining of stomach pain before Thanksgiving, said his son. He died Nov. 30, about a week later, surrounded by friends and family.
A graduate of East High School, Warner earned his medical degree at the University of Utah in 1949 and then earned a doctorate in physiology from the University of Minnesota. While training in Minnesota, he worked at the Mayo Clinic with cardiologist Earl Wood, who spurred his interest in medical research.
He returned to Utah, where he opened a Cardiovascular Laboratory at LDS Hospital and studied waveforms as a potential path to diagnosing heart patients.
"His real genius was probably in that early work," said Homer Warner Jr. While taking an engineering math course to further his work in 1956, he once stayed up all night to analyze one heart beat using a 3-foot slide ruler.
"I got so excited because it was such an interesting way to look at things," Warner told Peta Owens-Liston, a freelance writer for the U.’s alumni magazine, in 2010. "This was a turning point for me, since it led me to the whole concept of using computers in medicine."
After the U. bought its first digital computer in 1960, Warner worked with graduate students to develop a tool to effectively diagnose congenital heart disease – but doctors were skeptical, he told Owens-Liston.
Two years later he became the chairman of what is now considered the first program to grant degrees in medical informatics. Then called the Department of Biophysics and Bioengineering, it was located in the U.’s engineering school.



In 1968, Warner wrote his first version of a software program to evaluate patient data to guide physicians. He had been inspired by seeing an Intensive Care Unit nurse overwhelmed by information from sensors.
"The venous pressure was rising, the arterial pressure was going down, and the cardiac output was dropping, and she didn’t know what to do," Warner told Owens-Liston.
As the HELP program, for "Health Evaluation through Logical Processing," was further developed, it expanded to include information about drugs, lab tests, pulmonary function testing, patients’ medical history and more. It is now considered one of the nation’s first electronic medical records – and is still operational 40 years later at Intermountain Healthcare hospitals.
"We clearly had a jewel. He gave us a huge advantage," said Intermountain’s Chief Information Officer Marc Probst.
Getting doctors to use computers is still challenging, but Warner chipped away at their resistance by providing them with not just data, but information with the power to improve care, he said.
In a 2011 announcement of the opening of the Homer Warner Center for Informatics Research at Intermountain Medical Center, the hospital chain’s chief quality officer, Brent James said, "Dr. Warner identified the field and then defined that field...It’s hard to describe that contribution, not just to Intermountain, not just to the medical profession, but to the patients that we serve."
Warner’s lab was moved to the U. in 1980 where he continued his research until retiring in 1996. He outlived two of his wives, Katherine Ann Romney and Jeanne Okland, marrying a third, June Okland Cockrell, who survives him.
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Sunday, May 27, 2012

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 >