Google's Project Loon - The (Ballon) Technology

Your smartphone will see you now - McLeans article on Tricorder

I have been looking for stories or updates on the Tricorder Xprize and have found a few updates here and there, but this one on the March issue of McLeans magazine just caught my attention. How could I, a member of the public, have missed it? I like the McLeans online version "View in Clean Reading Mode". Is that a hat tip to the smartphone too? Probably. Time to get one myself maybe. Anyway, no belly aching about that. And that reminds me about a conversation I had with a refugee from Ethiopia that other day. He is interested in starting "literacy" programs in Ethiopia/Eritrea. I asked him if it was true that everyone in Africa has a cellphone. He said yes it was true that everyone had a cellphone, but not bread. This article is one of those "must reads" for anyone who actually reads this blog.
http://www2.macleans.ca/2013/03/04/the-smartphone-will-see-you-now-2/
http://www2.macleans.ca/2013/03/04/the-smartphone-will-see-you-now-2/2/
http://www2.macleans.ca/2013/03/04/the-smartphone-will-see-you-now-2/3/

IEEE conference in Toronto: Theme - SmartWorld

If I find the pocket change for registration - I am there in a heartbeat. Two panelists or speakers  of interest to eHealth students are Dr. Ann Cavoukian, Privacy Commissioner of Ontario, and Dr. Alex Jadad, who is founder for the Centre for Globale eHealth Innovation lab at the University of Toronto. Having Ray Kuzweil, Steve Mann, Marvin Minsky, et al there is just "icing on the cake".

Website for IEEE ISTAS'13: http://veillance.me

Theme - "Smartworld"

Living in a Smart World - People as Sensors

ISTAS'13 presenters  and panellists will address the implications of living in smartworlds - smart grids, smart infrastructure, smart homes, smart cars, smart fridges, and with the advent of body-worn sensors like cameras, smart people.

The environment around us is becoming "smarter". Soon there will be a camera in nearly every streetlight enabling better occupancy sensing, while many appliances and everyday products such as automatic flush toilets, and faucets are starting to use more sophisticated camera-based computer-vision technologies.  Meanwhile, what happens when people increasingly wear these same sensors?  

A smart world where people wear sensors such as cameras, physiological sensors (e.g. monitoring temperature, physiological characteristics), location data loggers, tokens, and other wearable and embeddable systems presents many direct benefits, especially for personal applications. However, these same "Wearable Computing" technologies and applications have the potential to become mechanisms of control by smart infrastructure monitoring those individuals that wear these sensors.

There are great socio-ethical implications that will stem from these technologies and fresh regulatory and legislative approaches are required to deal with this new environment.

This event promises to be the beginning of outcomes related to:

1. Consumer awareness
2. Usability
3. A defined industry cluster of new innovators
4. Regulatory demands for a variety of jurisdictions
5. User-centric engineering development ideas
6. Augmented Reality design
7. Creative computing
8. Mobile learning applications
9. Wearables as an assistive technology

"Smart people" interacting with smart infrastructure means that intelligence is driving decisions. In essence, technology becomes society.

Professor Mann University of Toronto will be speaking in the opening keynote panel with acclaimed Professor of MIT Media Arts and Sciences, Marvin Minsky who wrote the groundbreaking book The Society of Mind  and has helped define the field of Artificial Intelligence (AI) among his major contributions.

General Chair of ISTAS13 and formerly a member of the MIT Media Lab under the guidance of Nicholas Negroponte in the 1990s Mann is long considered to be the Father of Wearable Computing and AR in this young field.

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:

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

Telecare, surveillance, and the welfare state.

Sorell T, Draper H.

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.

Coldfusion progamming FLOAT IsNumerc date comparison SQL

One of the systems I developed was done in the Coldfusion programming language. As I have developed and learned more about Coldfusion over the past 9 years or so, the more I realize it depends a lot on SQL. I learned how to do a lot of Coldfusion from another learner in the beginning, but after that, internet searching for code solutions is mostly what I do, as I imagine many programmers and code seekers do as well for answers. Since Coldfusion runs on a proprietary software platform and is not open source like PHP or MySQL, it is more difficult to find Coldfusion programmers to share ideas.

Recently I found the answer for a puzzle that had long baffled me, how to compare two dates then output data fields on a query for them. I knew how to do the SQL to output data from a month, day or year in the past, something like this:

<CFQUERY NAME="GetRecords" datasource="myAccessDB" >
      SELECT COUNT(id)as number_total FROM tblMyTableName Where  Month(DateReceived) Like '1' and DateReceived Like '%2010%' </cfquery>
      <cfoutput query="GetRecords">#number_total#</cfoutput><br>

In order to compare two dates in one year, I found a Coldfusion developer site that suggested using FLOAT, and here is how this is done:

   <CFQUERY NAME="GetMREBRecords" DATASOURCE="myAccessDB">
        SELECT *
        FROM tblMyTableName
          Where DateReceived BETWEEN 40358 AND 40722
        ORDER BY ID
        DESC
        </CFQUERY>

The FLOAT values in this example are actually dates. 40358 is June 30, 2010 and 40722 is July 1, 2011 (maybe give or take a day?). I have yet to find an actual table with FLOAT date equivalents. I am not even sure if this means "Floating point", a term or process used in computational data computing. All I know is, that it works for my system really well, and solved a big problem we had.

Actually, these FLOAT values have no known standard dates(times) that I can find, and are not accurate for leap years and other variables.  Thankfully, I kept searching the internet for some code that would work and finally found this:

<CFSET start_date = #CREATEODBCDATETIME("7/1/2012")#>
 <CFSET end_date = #CREATEODBCDATETIME("6/30/2013")#>

        <CFQUERY NAME="GetRecords" datasource="myAccessDB" >
      SELECT COUNT(id)as number_outstanding FROM MyTable 
   Where DateOfReceipt  Between #start_date# And #end_date# </cfquery>
          Number of 2012-2013 Records 
          = <cfoutput query="GetRecords">#number_outstanding#</cfoutput>

Programmableweb Healthcare API List

I have been having problems recently trying to understand "integration engines" or "Application Program Interface - API". This is list of Healthcare APIs helps shed some light on what I am thinking about - from the programmableweb site. I knew that Google Health, when it was active, had an excellent API system for those living in the United States who could use a variety of health services. Joining up databases in the cloud is technologically doable. In healthcare, it would seem to me that live, real time in-sync linkage of databases would be critical - something I think you might call data driven architecture (which I blogged about before). Anyhoo, still trying to understand better such things as WSDL, SOAP, REST, and web services in general. Interoperability is one of the most difficult problems in health informatics.

37 Health APIs: Google Health, Avvo and Fitbit

Wendell Santos, March 21st, 2012

Comments(0)

Our API directory now includes 37 health APIs. The newest is the DailyMed API. The most popular, in terms of mashups, is the Avvo API. We list 2 Avvo mashups. Below you’ll find some more stats from the directory, including the entire list of health APIs.

In terms of the technical details, REST and XML lead the way. There are 29 health REST APIs and5 health SOAP APIs. Our directory lists 30 health XML APIs and 16 health JSON APIs.

The most common tags within health are 17 medical health APIs, 8 reference health APIs and 6 sports health APIs

On the mashup side, we list 40 health mashups. We named Hello Vaccine as mashup of the day in August.

For reference, here is a list of all 37 health APIs.

  AIDSinfo API: Government info on HIV/AIDS treatment

  AT&T mHealth Platform API: Health system backend

  Avvo API: Lawyer and doctor directory service

  BigOven Recipe API: Recipes, grocery list, and nutrition API

  BioLabeler API: Library of Medicine text extractor and indexing engine

  BodyMedia API: Fitness tracking service

  CDC Wonder API: CDC health statistics retrieval service

  Centers for Disease Control (CDC) Content Syndication API: Health information content syndication service

  DailyMed API: Marketed drugs information service

  Data.Medicare.Gov API: Medicare information and datasets

  Deepdyve API: Scientific and medical journals

  DeepFitness API: Fitness and nutrition article service

  Diabetic Complications Consortium API: Diabetes and health care information service

  Dossia API: Health information aggregation service

  FatSecret API: Food, nutrition and recipe database and diet tools

  Fitbit API: Fitness Tracking Tools

  GoodGuide API: Green healthy product ratings

  Google Health API: Health data service

  Health 2.0 API: Directory of health-related APIs

  Health Indicators Warehouse API: Health indicators database

  HealthTap API: Online health network service

  Indivo Health API: Health record manipulation services

  MapMyFitness API: Fitness tracking service

  MedlinePlus API: Health information service

  MedlinePlus Connect API: Health information service

  Microsoft HealthVault API: Health-related data storage, security, and records

  NHS API: UK National Health Service

  Patient Opinion API: UK health ratings service

  PHIN VADS API: Public health terminology service

  Pizza-Rat Restaurant Health API: Restaurant health inspection scores

  RunKeeper Health Graph API: Health & fitness tracking service

  SimpleUPC API: Product information database

  Skinnyr API: Weight loss tracking service

  SweetSpot API: Diabetes management service

  Thomson Reuters Pharma API: Investigational drugs data

  Walker Tracker API: Step tracking service

  Withings API: Connected health devices

10 mistakes made implementing IT systems in Healthcare

IT systems tend to fail at high rates. Studying EHR systems that users in hospitals hate using is one of the classics in Health Informatics. I found this piece on the Kevin Pho newsletter and thought it was a very good precautionary guide. We should all know better, right?

10 mistakes practices make in implementing information technology

ROSEMARIE NELSON | TECH | MAY 18, 2013

What is the measure of successful technology adoption? Is it never having to hunt for a missing chart? Is it a reduction in specific operating cost line items? Is it about access to clinical information when you need it and where you need it?

Technology implementation has a significant effect on profitability. The Medical Group Management Association Cost Survey Report beginning with 2010 data shows that total medical revenue after operating and nonphysician provider costs per FTE physician actually increased as total IT expense per FTE physician increased. For multispecialty groups, for instance, among groups that invested less than $10,000 per FTE physician in IT revenue was $230,968; it was $313,900 in groups that spent between $10,000 and 20,000.

But simply acquiring technology is not enough; it is essential to implement the technology effectively to achieve those types of results.

Here, then, are the top 10 mistakes practices make in implementing information technology — and how to avoid making them.

10. Selecting a system based primarily on a demonstration session. Better to be thorough than fast in the practice management/EHR selection process.

• Apply structure to the process.
• Incorporate your workflow into the vendor’s application by defining a sample patient case in advance.
• Don’t sign a contract without a reference site visit — no matter how busy the physician claims to be in order to avoid the visit!

9. Going live with your EHR without a lab interface. Viewing lab results via PDF is cumbersome for providers and trending a patient’s labs without a lab interface requires staff to enter test result values as discrete data, which is problematic and too labor intensive to be cost effective.

Identify the lab that provides the most results to your practice and test the interface with that lab prior to a go-live implementation.

8. Waiting to implement the patient portal. Implement the patient portal first, even before you convert your practice management system or go live with your EHR.

• Save staff data entry time and effort by encouraging patients to self-register.
• The patient’s past medical, social, and family history can be captured in the portal and “accepted” or imported into the PM/EHR system.

Getting information into the system will also save the patient time by reducing time in the waiting room. Patients are also usually more accurate and comprehensive when using the portal than they are with paper and pen.

7. Accepting the vendor’s “train the trainer” plan. Your trainer must understand the application of the system, not just which screens to go to to perform which function. Your own standards and processes are critical to how to use the new technology in your practice workflow.

6. Allowing physicians access without training. Don’t issue any physician a login/password without completing the required training. Provide test-out options to the physicians that demonstrate adequate system knowledge to prevent the dissatisfaction that will ultimately arise from not having sufficient training.

• Provide one-on-two sessions specific to nurse/physician workflow.
• Include procedural training along with the system know-how training. Answer the question “How does this apply to what we do?”

5. Assigning the project to the wrong person. Do not assign responsibilities for implementation based on seniority or loyalty or because you have no other position available for a long-term employee. The clinical application project manager must have some clinical background or understanding. He or she must understand what a provider sees (and grasps) when they open a chart.

Characteristics necessary for successful project management:

• Commands authority and respect
• Able to delegate tasks and lead others
• Creative problem-solver and analytical thinker
• Has high level of energy and self-direction.

4. Not including nursing in the selection process. Nurses touch the chart more than physicians do. Messaging and nurse workflow are critical to the successful use by physicians (nurses must do more of it so that physicians do less of it).

Nurses can facilitate the implementation or create barriers to the implementation; get them involved to get the best result.

3. Not elevating the EHR project in the organization. The EHR Project Manager/Director should report directly to the CEO/COO and work in conjunction with the physician champion(s). The manager should participate in the EHR governing body to establish standards and policies and procedures.

2. Making the EHR implementation an IT project. The implementation is about clinical operations and workflow changes. It is about improving operations with the use of a new tool. The EHR is no more IT than the front desk reception is. IT supports the infrastructure, just like the telephone infrastructure.

1. Not investing in ongoing optimization. Technology implementation is not a once-and-done project; it is an evolutionary process. Technology changes what is feasible. Technology adoption is iterative. Static templates will not satisfy changing needs of the end-users.

Implement a formal rounding plan to observe users and to prioritize ongoing development, training, and required modifications.

The initial goal of an implementation should be to acquire enough knowledge to get through the day. Users don’t know what they don’t know and need support as their use of the technology becomes routine.

Remember: Optimize your technology adoption and improve your profitability.

Rosemarie Nelson is principal, MGMA Health Care Consulting Group and blogs at Practice Pointers.

TAGGED AS: HEALTH IT