Saturday, May 9, 2009
Everyware Health Care: Vena, the Wireless Asthma Inhaler Delivers Readings to PC, SmartPhone, or Online Electronic Health Records
According to a recent CNET article written by Dong Ngo, Cambridge Consultants is offering a wireless asthma inhaler that links patients with health care providers via wireless technologies and electronic medical records such as Google Health or Microsoft Health Vault.
"The platform, called Vena, employs two emerging wireless standards, including the Infrared-based IEEE11073 and the Bluetooth Medical Device Profile. Vena embeds the two into a single chip as the combination of them ensures compatibility of data exchanged between different types of devices and the security in the transmitting of medical data."
The design of this inhaler is stylish, and I'm sure that children and teens with asthma wouldn't mind carrying this around at school. Why is this important?
Asthma is the leading serious chronic illness of children in the U.S.
According to the American Lung Association, "Asthma is the leading serious chronic illness of children in the U.S. In 2006, an estimated 6.8 million children under age 18 (almost 1.2 million under age 5) currently had asthma, 4.1 million of which had an asthma attack, and many others have "hidden" or undiagnosed asthma. In 2006, the highest current prevalence rate was seen in those 5-17 years of age (106.3 per 1,000 population), with rates decreasing with age. Overall, the rate in those under 18 (92.8 per 1,000) was much greater than those over 18 (72.4 per 1,000). Asthma is the third leading cause of hospitalization among children under the age of 15 and one of the most common causes of school absenteeism."
A less-attractive alternative for the connected teen is the bulkier prototype, a collaboration between SiliconSky GPS and David Van Sickle, a University of Wisconsin researcher.
According to another CNET article by Dong Ngo, "The prototype GPS inhaler is packed with technologies. It features Assisted GPS, a GSM modem, integral antennas, an embedded microprocessor, and an internal rechargeable lithium ion battery. The battery allows for up to 10 days of operation between charges."
The GPS inhaler might be useful and usable, but will not used as medically intended unless it has a great "look & feel".
With the increase in the numbers of children and teens with asthma, it is important to design on-the-go medical devices that increase compliance and healthy choices. It has to be cool.
Some references from the American Lung Association:
Centers for Disease Control and Prevention. National Center for Health Statistics, National Health Interview Survey Raw Data, 2006. Analysis by the American Lung Association, Research and Program Services Division using SPSS and SUDAAN
Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion. Healthy Youth! Health Topics: Asthma. December 7, 2007. Available here.
Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion. Healthy Youth! Health Topics: Asthma. December 7, 2007. Available here. Accessed on December 20, 2007.
Centers for Disease Control and Prevention. National Center for Health Statistics, Advance Data from Vital and Health Statistics. The State of Childhood Asthma, United States, 1980-2005. Number 381, December 12, 2006 (Revised December 29, 2006). Available here. Accessed on December 20, 2007.
Thursday, April 2, 2009
Everyware Healthcare: IT in the LTACH and beyond
I'm visiting my dad who recently was transferred to a LTACH. LTACH stands for Long Term Acute Care Hospital. One of the goals of an LTACH is to work with people who have medically complex issues, often after a longer-than planned stay in an intensive care unit at a "regular" hospital, and then get them to the point where they can return home, with the maximum degree of independence as possible.
Given the fact that my dad has been deeply immersed in the medical/health care system lately, and the given the fact that I'm a techie, it has been difficult to ignore the wellspring of health care-related technology news peculating around, especially since the new stimulus plan has a provision for the funding of health care IT. This is explained in detail the following presentation from the McKessen EMRresource blog:
I'll comment a bit on the following articles and links in my next post:
iPlan Net
"iPlan Net Session Sharing enables two or more clinicians at different locations to work on the same plan simultaneously. With Session Sharing, physicians no longer need to be in the same room to collaborate—it's all possible over the iPlan Net browser...iPlan Net connects entire surgery, radiotherapy and radiology departments—increasing cooperation, productivity and efficiency."
G.E. and Intel Working on Remote Monitors to Provide Home Health Care
Steve Lohr 4/2/09 New York Times
Intel Health Guide
"The Intel® Health Guide offers interactive tools for personalized care management and includes vital sign collection, patient reminders, surveys, multimedia educational content, and video conferencing and alerts."
GE HealthCare
GE Healthcare Community Technology Update: Aging in Place pdf
New Touch Screen Monitors to Reduce Hospital Patient Waiting Times
Kindred Hospitals Customer Story (pdf)
Effective Healthcare Identity Management: A Necessary First Step for Improving U.S. Healthcare Information Systems Brief (pdf) (Smart Card Alliance)
FDA Probes Potential Overlap Between Electronic Health Records and Devices
DOD, VA set new target for lifetime health record
Government Health IT, Peter Buxbaum 3/27/09
The Stimulus Plan's Impact on the Healthcare Business Model
Scott Anthony, Harvard Business
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Tuesday, March 31, 2009
Everyware Health Care: Real Life Examples
I'm devoting some of the posts I write for this blog on the topic of "Everyware Health Care", an over-arching concept that emphasizes how existing and emerging technologies can help to improve delivery of health care and also enhance health-care user experience.
About 182,000 patients at the Cleveland Clinic use MyChart, an in-house electronic medical record. More recently, the hospital is testing out Google Health Records with 1,500 patents and Microsoft's Health Vault with 500 patients. According to an article in the Plain Dealer, the hospital supports the use of electronic medical records because it can reduce costly mistakes and redundancies.
| Checking blood pressure |
The video above shows how blood pressure can be charted and tracked daily, providing the physician with information that can better monitor and adjust medications. With Microsoft's Health Vault system, patients can upload medical information via a glucometer, pedometer, weight scale, or blood pressure monitor, depending on the nature of their health concerns. The system provides a means for uploading information to the system wirelessly, which is important for people who travel a lot for their jobs.
My Family Health Portrait is an on-line tool provided by the U.S. Department of Health and Human Services that allows people to enter their family health history, create drawings of family health history to share with health care providers or other family members, and to integrate the health history of other family members into your own. The source code for developers is available for free.
Some of the basic work related to integrated electronic medical information systems is hospital-focused Microsoft's Amalga software, which has been rolled out in several hospitals around the world. The following video shows how the system works at Bumrungrad International Hospital, and how it improves the hospital user experience, not only for the patient, but for the medical staff as well:
RELATED
Cleveland Clinic makes electronic medical records personal, more accessible
Sarah Jane Tribble, Plain Dealer 3/31/09
News about wireless technology in healthcare from Healthcare Informatics
Telehealth Services
POST: ElderGadget: Tech Devices for Health
POST: "Everyware Health Care": A Personal Focus
POST: Everyware Healthcare: Microsoft Health's Common User Interface website, usable health care applications, pervasive health games....
POST: SoftKinetic 3D Gesture Recognition for Games and Rehabilitative Play
Microsoft plans big move into European healthcare market
Tola Sargeant, Ovum
"Amalga does not complete with electronic health or patient records, it compliments them. As well as providing a single view of the patient, it enables analysis of all data from across the organization, which in turn can be used to drive change and performance improvement."
Microsoft releases hospital IT system as Amalga
Dana Blankenhorn, ZDNet Healthcare 2/13/08
Will Behavioral Health Be Left Behind?
David Raths, Healthcare Informatics 3/30/09
"While the stimulus bill was being written, Scalia said, his company worked with the National Council for Community Behavioral Healthcare to try to have the Medicaid incentive language changed. They were not successful, he added, because there was a concern that it would increase the cost of the incentive section above the $20 billion mark."
Friday, March 6, 2009
The Web of Things, Wireless Sensor Networks, Embedded Systems, and (Everyware) Health Care
What is the Web of Things?
I just came across the blog of the same name. The concept is similar to the "Internet of Things", but in my opinion, Vlad and Dominique, the guys behind the blog, have wrapped the concept into a more "user-friendly" package. They have found a way to articulate this concept far better than my feeble attempts, and for this, I am very thankful.
Web of Things: Architecting the Web of Things, for techies and thinkers!
Here is what I lifted from the "About" Section of this blog, plus a few other quotes:
"What is WebofThings.com?
It is a web page founded by Vlad Trifa and Dominique Guinard, two researchers/geeks working at ETH Zurich and SAP Research Zurich. It is more a scrap book that is here to dump our thoughts ideas on our research and work topic, which is the Web of Things. Unlike most Web 2.0 sites that are about advanced powerpoint engineering, we talk about real things that’s under the hood.
There are three main topics in here. First technologies, this section is only for geeks, simply put. It’s about coding, developing toys, plugging kettles on the web (and we actually did that!). The second part is about new ideas, new technologies that are in the lab. It’s about research papers, and software philosophy, and about researchers worldwide. The third part is about end-users and products. You, me, but especially my grand-ma. It’s about products that exist, or at least should exist (or should not!). It’s about marketing and new ideas out there.
Thanks, but it doesn’t help. What is the Web of Things then?
It is an alternative vision to what the Web of tomorrow will look like. It’s about taking the Web as we know it and extending it so that anyone can plug devices to it. It’s basically about giving eyes, ears, and all kinds of sensory appendixes located worldwide to it. It’s about seamlessly connecting the physical world with the virtual.
Why do you want to change the Internet? What’s wrong with it?
Not much really. It’s just a little boring. It only contains data published by other humans, but it’s not enough linked with our physical reality, not real time / real world enough for our taste!
Why should I read this blog?
Well depends how much you care about technology. It’s both for geeks/hackers who need a playground to develop and try ideas. But it’s also for the security expert who wants to take part to make the Web a safer place to hang out. It’s also for people who want to find new ideas.
Cool! SAP has a blog!
Actually, not really. All what we write here is only our own opinions and thoughts, and doesn’t reflect the views of any of our employers. "
"One things that I don’t understand, is that most people in our field do not really like our approach, or maybe they simply don’t get it. Indeed, we’re kind of stuck between several worlds: wireless sensor networks (WSN) people that find our approach too esoteric, and HCI people that find it not enough sexy. It is a bit annoying, as people don’t take us very seriously, especially not WSN researcher. I overheard comments like “What? You want to use the Web to connect devices? hahaha! I can’t stop laughing, haha it hurts me! Come on, be serious dude! Using the Web for that!! Man, you’re great, I gotta call my colleagues to tell them your idea, they’re gonna *love* it“. Jeez! -Vlad Trifa"
"Let’s do something concrete with WSN, that works, and that’s usable, and that people will really need."
Note: When you visit the Web of Things blog, make sure you visit their links!
Why do I think this is important?
First of all, I'm someone who would love to take a class about embedded systems and wireless sensor networks. I got a taste of some of this in a ubiquitous computing class I took a couple of years ago, and I'm still fascinated with these concepts. Imagine a web-browser that could support all sorts of data streaming in from all sorts of things and places, an intelligent web browser that could make perfect sense of he wealth of information that is potentially "out in the wild".
I think that the Web of Things is a concept that will have numerous applications in the very near future. The arena that is foremost in my mind is health care.
Why? I've spent hours hanging around hospitals and health care facilities since my father's health took a down-turn a couple of years ago. If you've been in my shoes, you know what I mean.
I'm writing this from the family waiting room of the cardiac ICU at the Cleveland Clinic, where I've spent the better part of the week with my father, who had surgery and a few complications. I've had plenty of time to spend listening and observing.
Earlier today, as I was visiting my father in the ICU, I had a chance to chat with a nurse who was an IT guy in his previous life. I rarely have a chance to engage in "geek speak" in my day job as a school psychologist, so I welcomed the chance to talk about the concept technology and health care.
I asked the guy if he'd heard of the "Internet of Things", and we discussed how a cross platform web browser, linked to all of the various devices and patient monitors in the ICU could potentially solve many of the problems faced by nurses and related health professionals in their day-to-day tasks. The nurse pointed out that wireless technologies would eliminate the need for a number of the wires connected to my dad's body. That was a good point!
We had a good discussion about how software needs to be user-focused and user-friendly. In health care, as in many domains, it is not. Usable, intuitive software, at least in the health care setting, would decrease medical errors, increase efficiency, save time, save lives, and in the mid-to-long run, save lots of money.
Somewhat Related
(Previous post)
Everyware Health Care: Microsoft Health's Common User Interface, website, usable health care applications, pervasive health games.....
Wireless Sensor Networks for In-Home Healthcare: Potential and Challenges (pdf)
ALARM-Net: Wireless Sensor Networks for Assisted Living and Residential Monitoring
(Crossbow Blog, 9/28/08)
"Wireless Nodes Dynamically Link to Build Intelligent Sensing Networks"
John Suh, RTC 6/2005
Wireless sensor and data transmission needs and technologies for patient monitoring in the operating room and intensive care unit Paksuniemi, M., Sorvaja, H,; Alasaarela, E.' Mylyla, R. Engineering in Medicine and Biology Society, 2005, IEEE-EMBS 2005
Healthcare Service with Ubiquitous Sensor Networks for the Disabled and Elderly People
Yung Bok Kim & Daeyoung Kim, Computers Helping People with Special Needs 7/2006
Conferences:
Malignant Spaghetti: A Symposium on Wireless Technologies in Hospital Health Care
(A must-read if this topic is of interest)
S-CUBE 2009
The first international conference on Sensor System and Software
"The widespread acceptance of these new services can be improved by the definition of frameworks and architectures that have the potential to radically simplify software development for wireless sensor network based applications. The aim of these new architectures is to support flexible, scalable programming of applications based on adaptive middleware. As a consequence, WSNs require novel programming paradigms and technologies. Moreover the design of new complex systems, characterized by the interaction of different and heterogeneous resources, will allow the development of innovative applications that meet high performance goals. Hence, WSNs require contributions from many fields such as embedded systems, distributed systems, data management, system security and applications. The conference places emphasis on layers well above the traditional MAC and routing, and transport layer protocols."
Monday, May 12, 2008
Everyware Health Care: Microsoft Health's Common User Interface website, usable health care applications, pervasive health games...
I've been concerned about the problems people encounter with health technology, especially over the past year or so as I witnessed my father's journey in and out of hospitals, the emergency room, and various medical offices.
Technology can support quality health care. Systems that incorporate user-friendly electronic medical records (EMR) can support effective communication and collaboration among the members of medical teams. Technology that is not user-friendly can lead to inefficiency among health care team members, and can also contribute to errors that affect patient safety, if not lives.
In my opinion, health care software systems should ensure that the applications used by the patient inter-operate with those used by practitioners and health care facilities. The system should also allow for interaction with family members, especially when the patient is elderly, has a serious illness, or is a minor. This would be a good way to provide guidance for family members caring for the patient at home, and also provide an effective means of monitoring the patient's progress.
Microsoft Health's Common User Interface website provides a design guidance document, examples of toolkits and samples, a toolkit download, a showcase, and a roadmap that offers more detailed information. This is a great move on the part of Microsoft.
Microsoft's Silverlight and Windows Presentation Foundation (WPF) are used for toolkit controls, which I think is a good idea. I've played around with both, and also Expressions Blend, and have been surprised at how quickly I've been able to create prototypes for my various "experiments".
Microsoft Health's Common User Interface guidelines appear to be user-friendly for developers, which might ensure that user-friendly applications for healthcare eventually get into the hands of health workers and patients alike. This is important.
Related Thoughts:
Last year, I read an article in Pervasive Computing about new technologies that might prove to be useful to health care workers. Despite the efforts of researchers to incorporate user-centered design concepts and usability studies during the development of health care software, health care workers continue to be frustrated with technology.
Since I've found myself on the receiving end of user-unfriendly technology for most of my working life, I decided to write a letter to the editor of Pervasive Computing and offer a solution or two. Why not harness power of the 100,000+ nurses who've participated longitudinal studies about womens' health, and apply their knowledge by inviting them to play a role in user-centered development and usability testing of software for the health care industry?
More thoughts...
I was thinking about the Games for Health conference I attended last week and how developers could go about conducting usability studies for their games. Developers of health-oriented games and related applications should also consider tapping into this great resource. Nurses are represented in all facets of health care, and their hands-on experiences with patients could inform the development of user-friendly and useful health games.
Pervasive Health Care, Pervasive Games for Health:
I envision that in the near future, mini-health games, along with health-monitoring applications, will be widely available on mobile phones and other mobile devices. Wouldn't it be fun to play a health game on your mobile while waiting for your medical appointment?
I've noticed that many clinics and pharmacies now have large screens running health info-mercials. Wouldn't it be cool to harness the display for some serious health gaming?
One place to start might be at CVS minute-clinics. These clinics are led by nurse practitioners and supported by a medical doctor in another location, and offer care to a large number of people, close to where they live.
Audio about CVS Minute Clinics
Minute Clinic Website
American Well: The next generation of health communication
Related World Health Care Blog Posts:
The New Place for Health Care is Everywhere
EMR's Might Work for Physicians in PHM
EMR "The Movie"- Coming Soon (Maybe)
On the Coming "Everyware" Bubble in Health Care
