healthcare technology

Amid all the talk that surrounds artificial intelligence — how it will simultaneously take jobs and improve lives — perhaps no form of AI could save more lives than the kind made to combat heart cardiac arrest, which is the biggest killer on Earth.

Detection of heart attacks is easily one of the most obvious ways AI should be used today. Cardiac arrest currently claims hundreds of thousands of lives a year around the globe.

With cardiac arrest events that occur outside of hospitals, every minute counts.

In initial trials, assistance  by Corti was found to identify cardiac arrest events more quickly than human operators.

Analysis of emergency calls involving cardiac arrest in Copenhagen in 2014 (published in a research paper in April), show Corti’s analysis of thousands of calls was 30 seconds faster than that of human operators, with an accuracy rate of 93 percent compared to 73 percent for human operators.

To serve a variety of needs and make it easier to get Corti up and running in more emergency call centers, the company created a hardware device to deploy its heart attack detecting AI on the edge. Enter: The Orb.

Work is underway to deploy Corti, an AI system that detects heart attacks during emergency phone calls, and it could be coming to some of the biggest cities in Europe.

Following plans announced earlier this year to roll Corti out in more cities, this summer the European Emergency Number Association (EENA), whose members include cities like London, Paris, Milan, and Munich, will deliver AI-powered assistance to emergency 112 operators.

Emergency call centers from Seattle to Singapore also want to make Corti part of their operations, but there’s no global standard for organizations working to save lives. Some are fine with the idea of deploying the AI through the cloud, while others with privacy concerns require the AI system to operate from on-premise servers.

read more at https://venturebeat.com/2018/10/14/cortis-heart-attack-detection-ai-can-now-deploy-on-the-edge-with-scandinavian-design/

Obtaining informed consent is one of the most important things that a surgeon does.

I’d argue that obtaining informed consent is one of the most important things that a surgeon does — akin to the last stitch of an aortic anastomosis, the life-saving jolt of electricity to jumpstart a fibrillating heart, or the first pass of a scalpel during an emergent laparotomy.

Informed consent defines 21st-century medicine, contrasting sharply to the days of paternalistic care. Informed consent, when done properly, puts decision making into the hands of our patients. It can serve as a checkpoint to discuss goals of care and what constitutes a meaningful life for a particular patient.

It’s time we teach our trainees how to obtain informed consent the proper way. We need to slow down, pull up a chair, and look people in the eyes. We need to truly know our patients — how they understand their diagnoses, how they interface with medicine, their socioeconomic status, and education level. We must address goals of care with clear “if-then” statements.

When I teach younger residents how to obtain informed consent I often harp on a concept I learned in my undergraduate psychology class called theory of mind. Theory of mind is defined as “being able to infer the full range of mental states (beliefs, desires, intentions, imagination, emotions, etc.) that cause action.” In my opinion, theory of mind is an integral part of the consenting process that allows us to reverse roles, to see the world how our patients see it.

Halfway through obtaining informed consent from my patient, my attending steps in. He snags a stool from the corner of the room. He sits directly in front of the sick man.  He talks about what life will be like for him as a new amputee.

He emphasizes the importance of diabetes control and smoking cessation. We may do everything we can and the man still may die. Would he want to live if it meant he could never go home again? He conveys the gravity of the current situation in a way that is pitch perfect.  This, I think to myself, is how it’s done.

For surgeon trainees, just like making our first cut, informed consent is a skill learned by example and should be done under the watchful eye of our mentors. It’s time to pay it forward. Next time you are the chief resident, the senior attending, or anywhere in between, take a trainee with you and teach him or her how to obtain informed consent the right way. Do away with the notions of “efficiency” and speed. Your patients and your pupils will be eternally grateful.

New technology developed by Howard Hughes Medical Institute (HHMI) researchers makes it possible to test for current and past infections with any known human virus by analyzing a single drop of a person's blood. The method, called VirScan, is an efficient alternative to existing diagnostics that test for specific viruses one at a time, according to the scientists.

With VirScan, researchers can run a single test to determine which viruses have infected an individual, rather than limiting their analysis to particular viruses.

That unbiased approach could uncover unexpected factors affecting individual patients' health, and also expands opportunities to analyze and compare viral infections in large populations. The analysis reportedly can be performed for about $25 per blood sample.

Although many people with serious diseases participate in online support communities, little research has investigated how participants elicit and provide social support on these sites.

This study by Yi-Chia Wang, Robert E Kraut, John M Levine Uses Computer-Aided Content Analysis to Examine the Dynamics of Online Social Support.

A high percentage of people with chronic or life-threatening diseases use online resources to obtain information about their condition and ways to cope with it. Although informational websites are the most popular, many people—especially cancer patients and survivors—participate in online health support communities.

A recent meta-analysis suggested that online support communities are effective in decreasing depression and increasing self-efficacy and quality of life. Although several clinical trials suggest that participation in Internet-based support communities improves emotional well-being, conclusions are ambiguous because most interventions have multiple components of which support group participation is only a part.

Moreover, research also shows that support interventions often do not provide the benefits they were designed to produce. Thus, much remains to be learned about when and why support is effective in online communities.

Called Baseline Study, Google's project will gather anonymous genetic and molecular information to create a full picture of what a healthy human is.

The early-stage project is run by Andrew Conrad, a 50-year-old molecular biologist who pioneered cheap, high-volume tests for HIV in blood-plasma donations.

Dr. Conrad joined Google X—thecompany's research arm—in March 2013, and he has built a team of about 70-to-100 experts from fields including physiology, biochemistry, optics, imaging and molecular biology.

Other mass medical and genomics studies exist. But Baseline will amass a much larger and broader set of new data. The hope is that this will help researchers detect killers such as heart disease and cancer far earlier, pushing medicine more toward prevention rather than the treatment of illness.

"With any complex system, the notion has always been there to proactively address problems," Dr. Conrad said. "That's not revolutionary. We are just asking the question: If we really wanted to be proactive, what would we need to know? You need to know what the fixed, well-running thing should look like."

The project won't be restricted to specific diseases, and it will collect hundreds of different samples using a wide variety of new diagnostic tools. Then Google will use its massive computing power to find patterns, or "biomarkers," buried in the information. The hope is that these biomarkers can be used by medical researchers to detect any disease a lot earlier.

The study may, for instance, reveal a biomarker that helps some people break down fatty foods efficiently, helping them live a long time without high cholesterol and heart disease. Others may lack this trait and succumb to early heart attacks. Once Baseline has identified the biomarker, researchers could check if other people lack it and help them modify their behavior or develop a new treatment to help them break down fatty foods better, Dr. Conrad said.

Google has already built one of the world's largest networks of computers and data centers to serve online-search results quickly and run other data-hungry services like the video website YouTube. This computing muscle can now be used to store and crunch medical information and let other researchers access it more easily.

It's been tough to identify the problems that only turn up after medicines are on the market. An experimental project is now combing through data to get earlier, more accurate warnings.

No one likes it when a new drug in people's medicine cabinets turns out to have problems — just remember the Vioxx debacle a decade ago, when the painkiller was removed from the market over concerns that it increased the risk of heart attack and stroke.

To do a better job of spotting unforeseen risks and side effects, the Food and Drug Administration is trying something new — and there's a decent chance that it involves your medical records.

It's called Mini-Sentinel, and it's a $116 million government project to actively go out and look for adverse events linked to marketed drugs. This pilot program is able to mine huge databases of medical records for signs that drugs may be linked to problems.

The usual system for monitoring the safety of marketed drugs has real shortcomings. It largely relies on voluntary reports from doctors, pharmacists, and just plain folks who took a drug and got a bad outcome.

"We get about a million reports a year that way," says Janet Woodcock, the director of the FDA's Center for Drug Evaluation and Research. "But those are random. They are whatever people choose to send us."

A life-sciences-as-a-service startup called Transcriptic has opened its APIs to the general public, allowing researchers around the world offload tedious lab work to robots so researchers can spend more of their time analyzing the results.

Using a set of APIs, researchers can now command Transcriptic’s purpose-built robots to process, analyze, and store their genetic or biological samples, and receive results in days.

The high concept idea, says Founder and CEO Max Hodak, is cloud computing for life sciences — only with “robotic work cells” instead of servers on the other end. “We see the lab in terms of the devices that make it up,” he said, meaning stuff like incubators, freezers, liquid handlers and robotic arms to replace human arms.

And although Transcriptic’s technology is complex, the process for getting work done is actually pretty simple. Researchers write code to tell the robots exactly what to do with the samples (right now, the company focuses on molecular cloning, genotyping, bacteria-growing and bio-banking), and then they send their samples to the Transcriptic lab.

Alternatively, Transcriptic’s robotic infrastructure can also synthesize samples for users.

And although Transcriptic’s technology is complex, the process for getting work done is actually pretty simple.

Researchers write code to tell the robots exactly what to do with the samples (right now, the company focuses on molecular cloning, genotyping, bacteria-growing and bio-banking), and then they send their samples to the Transcriptic lab. Alternatively, Transcriptic’s robotic infrastructure can also synthesize samples for users.

When the job is done, researchers get their results. That process can take anywhere from a day to weeks, Hodak explained, in part because the company’s operation is still pretty small and in part because “cells only grow and divide so quickly.”

more at http://gigaom.com/2014/07/15/genetic-researchers-have-a-new-tool-in-api-controlled-lab-robots/

The Role of Facebook in Crush the Crave, a Mobile- and Social Media-Based Smoking Cessation Intervention: Qualitative Framework Analysis of Posts

New software could give people greater control over how their personal health information is shared between doctors and medical institutions—provided that enough health providers decide to use the system.

Today a patient’s data typically stays within a hospital group or doctor’s practice. If you get care elsewhere you are essentially a blank slate unless a special request for your data is made, in which case the entire record becomes accessible. But many patients may not want their entire medical history to be accessible by everyone they see, so there is pressure to develop tools that can be used to limit access. One tricky issue is that redacting details of a diagnosis may not remove all the clues as to that condition, such as prescribed drugs or lab tests.

A new tool developed by computer scientists at the University of Illinois can figure out which parts of a record may inadvertently reveal aspects of a patient’s medical history. The idea is that as data-sharing proposals advance, the patient would decide what parts of his or her record to keep private. A clinician would get advice from the technology on how to amend the record to ensure that this occurs.

The software bases its recommendations on a machine-learning analysis of many other medical records. This reveals what details could be associated with things like mental health episodes, past drug abuse, or a diagnosis of a sexually transmitted disease when the record is shared with another hospital or doctor. The tool could eventually automatically remove those additional details to keep that information confidential.

mHealth platforms are helping healthcare providers with Quick Access to Decision Support Resources

insight by Nrip Nihalani

Well how surprising! Collective human intelligence still works :)

As I been posting in my articles, speaking at my talks and offering my $0.02 in my insights, for all the talk of AI and Deep Learning, I feel technology’s best use in healthcare is in automation of processes and improving communication and collaboration between care teams. And such studies show that we have lots to gain by building better tools to help clinicians communicate and collaborate better. Someday , AI “may” replace human intelligence, but not today and not anytime soon.

Proposing a Transactional Model of eHealth Literacy: Concept Analysis

insight by Nrip Nihalani

eHealth literacy is the ability of internet users to locate, evaluate, and act upon web-based health information. The result of this study identifies that the role of “communication” in eHealth literacy remains underdeveloped.

Current frameworks and technologies do not account for physical and cognitive processing abilities necessary for multiway transactions.

A study of the Consumption(access by patients) patterns of a majority of patient education resources will be interesting. It may shed light on this underdevelopment being required or not.

more at https://medium.com/@plus91/healthcare-technology-insights-for-oct-1st-oct-14th-2018-8505bbd81fd9

In a study it was concluded that Web-based questionnaires can be used to validly collect data on many chronic disorders, allergies, and blood pressure readings among pregnant women

The aim of the said study was to assess the validity of a Web-based questionnaire on chronic medical conditions, allergies, and blood pressure readings against obstetric records and data from general practitioners.

The background of the said study is that Self-reported medical history information is included in many studies. However, data on the validity of Web-based questionnaires assessing medical history is scarce. If proven to be valid, Web-based questionnaires may provide researchers with an efficient means to collect data on this parameter in large populations

Self-reported questionnaire data were compared with obstetric records for 519 pregnant women participating in the Dutch PRegnancy and Infant DEvelopment (PRIDE) Study from July 2011 through November 2012.

These women completed Web-based questionnaires around their first prenatal care visit and in gestational weeks 17 and 34. We calculated kappa statistics (κ) and the observed proportions of positive and negative agreement between the baseline questionnaire and obstetric records for chronic conditions and allergies.

In case of inconsistencies between these 2 data sources, medical records from the woman’s general practitioner were consulted as the reference standard. For systolic and diastolic blood pressure, intraclass correlation coefficients (ICCs) were calculated for multiple data points.

more at http://www.jmir.org/2015/6/e149/

Google Translate has only 57.7% accuracy when used for medical phrase translations and should not be trusted for important medical communications.

However, it still remains the most easily available and free initial mode of communication between a doctor and patient when language is a barrier.

Although caution is needed when life saving or legal communications are necessary, it can be a useful adjunct to human translation services when these are not available.

Read the research paper below which formed the above conclusion.

Communication is the cornerstone of medicine, without which we cannot interact with our patients. The General Medical Council’s Good Medical Practice states that “Doctors must listen to patients, take account of their views, and respond honestly to their questions. However, we still often interact with patients who do not speak the local language.

In the United Kingdom most hospitals have access to translation services, but they are expensive and often cumbersome. A complex and nuanced medical, ethical, and treatment discussion with patients whose knowledge of the local language is inadequate remains challenging. Indeed, even in a native language there is an element of translation from medical to lay terminology.

We recently treated a very sick child in our paediatric intensive care unit. The parents did not speak English, and there were no human translators available. Reluctantly we resorted to a web based translation tool. We were uncertain whether Google Translate was accurately translating our complex medical phrases. Fortunately our patient recovered, and a human translator later reassured us that we had conveyed information accurately.

We aimed to evaluate the accuracy and usefulness of Google Translate in translating common English medical statements.

Ten medical phrases were evaluated in 26 languages (8 Western European, 5 Eastern European, 11 Asian, and 2 African), giving 260 translated phrases. Of the total translations, 150 (57.7%) were correct while 110 (42.3%) were wrong. African languages scored lowest (45% correct), followed by Asian languages (46%), Eastern European next with 62%, and Western European languages were most accurate at 74%. The medical phrase that was best translated across all languages was “Your husband has the opportunity to donate his organs” (88.5%), while “Your child has been fitting” was translated accurately in only 7.7% (table⇓). Swahili scored lowest with only 10% correct, while Portuguese scored highest at 90%.

The NHS is starting to test a sticking-plaster-sized patient-monitoring patch.

Placed on the chest, it wirelessly transmits data on heart rate, breathing and body-temperature while the patient is free to move around.

Independent experts say the system, developed in Britain, could ease pressure on wards and has the potential to monitor patients in their own home.

But the Royal College of Nursing says there is no substitute for having enough staff.

Routine checks for vital signs - including temperature, blood pressure and heart rate - are a key part of care and safety in hospitals.

Typically they may be carried out every four hours, depending on the patient's condition.

But patients can deteriorate between checks, putting them at risk.

A hospital in Brighton run by the private healthcare firm Spire has been testing the battery-powered patch, which updates information on some of the vital signs every couple of minutes.

The wireless device, developed by the Oxford-based firm Sensium Healthcare, then issues an alert if the readings fall outside pre-set levels, indicating a potential problem.

The patch is placed on the chest just above the heart when the patient is admitted. There are no cables to any monitors. Instead, readings are recorded and transmitted to a box in each room that works like a wi-fi router, passing on data to the hospital IT system.

more at http://www.bbc.com/news/health-28317509

After decades as a technological laggard, medicine has entered its data age. Mobile technologies, sensors, genome sequencing, and advances in analytic software now make it possible to capture vast amounts of information about our individual makeup and the environment around us. The sum of this information could transform medicine, turning a field aimed at treating the average patient into one that’s customized to each person while shifting more control and responsibility from doctors to patients.

The question is: can big data make health care better?

“There is a lot of data being gathered. That’s not enough,” says Ed Martin, interim director of the Information Services Unit at the University of California San Francisco School of Medicine. “It’s really about coming up with applications that make data actionable.”

The business opportunity in making sense of that data—potentially $300 billion to $450 billion a year, according to consultants McKinsey & Company—is driving well-established companies like Apple, Qualcomm, and IBM to invest in technologies from data-capturing smartphone apps to billion-dollar analytical systems. It’s feeding the rising enthusiasm for startups as well.

Venture capital firms like Greylock Partners and Kleiner Perkins Caufield & Byers, as well as the corporate venture funds of Google, Samsung, Merck, and others, have invested more than $3 billion in health-care information technology since the beginning of 2013—a rapid acceleration from previous years, according to data from Mercom Capital Group. 

A new study led by Jenine K. Harris, PhD, examined the use of the hashtag #childhoodobesity in tweets to track Twitter conversations about the issue of overweight kids.

The study noted that conversations involving childhood obesity on Twitter don't often include comments from representatives of government and public health organizations that likely have evidence relating to how best to approach this issue. The authors think maybe they should.

Twitter use is growing nationwide. In its 2014 Twitter update, the Pew Research Center found that Twitter is used more by those in lower-income groups, which traditionally are more difficult to reach with health information.

While younger Americans also are more likely to use Twitter, it is used equally across education groups and is used more by non-white Americans than whites.

This, Harris said, is one of the reasons Twitter is an avenue that the academic and government sources with accurate health information should consider taking advantage of in order to reach a wide variety of people.

"I think public health so far doesn't have a great game plan for using social media, we're still laying the foundation for that," she said. "We're still learning what works.

"Public health communities, politicians, and government sources -- people who really know what works -- should join in the conversation. Then we might be able to make an impact," she said.

more at http://www.sciencedaily.com/releases/2014/07/140710151723.htm

So far the internet of things hasn’t made much headway into patient care in the medical setting, but consumers are buying wellness devices for a variety of reasons. Will the medical world embrace that data?

The intersection of healthcare and connected devices was thrown into high relief these last few weeks as both Apple and Samsung unveiled ecosystems to take consumer health data and turn it into actionable intelligence.

But this week’s guests at the Weekly podacst at GigaOm are confident that as advanced as consumer-grade consumer grade health devices get, they won’t become something doctors are hot on for years to come — if ever.

In this week’s podcast Stacey Higginbotham discusses medical connected devices and where it may meet the consumer with Rick Valencia from Qualcomm Life. Will doctor’s prescribe our apps or devices?