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?

Integrated Digital Pathology - no more microscopes?

At the Advances in Health Informatics Conference a few days ago, we saw several amazing presentations on digital pathology.  Dr. Slyvia Asa talked about integrated digital pathology with telepathology, robotics, and streamlined processes for diagnoses to the point of care - all with a rapid turn around time.  She quoted something by Sir William Osler, which I was able to find on the net for another talk she gave on pathology and informatics < here > and that was "As is your pathology, so goes your clinical care".  When Osler was a young student he used to study bacteria from a reedy marsh not far from where I am typing this, and examined it with the greatest new technological marvel of that age - the microscope.  Listening to Dr. Asa describe their integrated pathology labs at Toronto's University Health Network, it sounds like radiologists are exclusively using digital imaging to read pathological sample slices and make diagnosis.  This was evident to me as well when I visited an anatomy lab in the Faculty of Health Sciences at McMaster, where the instructor showed us how digital imaging was being used more frequently than microscopes.  He took a picture of a human cardio sample with his iPad, and then displayed the image on a big screen.  He was able to zoom in with great detail on the pixels.  

To quote from this article by Dr. Asa:

The future of pathology will be reports that are comprehensive clinical consultations that incorporate all of the imaging, biochemical, histologic, molecular, cytogenetic, and epigenetic data. Pathologists will not have two screens in front of them; most will have four. And they won’t want that microscope at their desk because it’s not good for their neck.

So what I see in the year 2020 as pathology is digital radiology, digital endoscopy, digital cardiology, digital genetics, all the relevant information on my four-screen computer in front of me, wherever I happen to be, always with quality assurance as an important part of it, and as the center of personalized medicine.

Progress on Python Programming for Plone

I am trying at least to learn some Python programming, because it is the main programming behind the Plone content management system.  I have been given a site to manage and I would ideally like to extend the capability of the site, beyond just designing content using the built in CSS.  I am up to exercise 19 on the Python hard programming site.  I am more used to programming in Coldfusion and PHP but what I want to do with CF or PHP I have no clue right now with Plone or Python.  I just want to learn how to do some simple CRUD (create, read, update, delete) in Plone and Python.  If anyone knows how to do this, please let me know. I would like to start with uploading a CSV file exported from an Access database, then displaying the content in an edit/update form in Plone.  I learned how to create a feedback form in Plone, which was a fairly simple built in module, but I have not found out yet how to create a form creation utility through Zope.  I also don't have command line access to the Plone site, and have to work through an administration that charges by the hour for the service, so I need to get that right.  I have searched the internet for CRUD documentation on Plone, but the documentation is not easy to read or understand, so I am not sure if I need an Archetype or ContentMirror, or whatever.  But just now I googled "CRUD Python" and got an interesting result - < here >  The more I see this the more I miss CPANEL, PHPMyAdmin, or CFAdministrator and Dreamweaver.