ENTRIES TAGGED "health IT"
A report from an Open Health Tools meeting
I had a chance to listen in a recent meeting of Open Health Tools, a trade association bringing together companies, academics, and standards bodies who create open source software tools for all stages of the health care field. Open Health Tools has been around since 2007 and is attracting some impressive new members. The achievements of this “ecosystem” (as they call it) may soon put to rest the dismissive attitude many people in health care have toward open source.
A Tough Location for a Procedure
Free and open source software has lots of barriers yet to overcome in health care, similar to but in a somewhat different configuration from the barriers in other fields where it has triumphed (government, finance, commerce). Liability is at the top of everyone’s mind in health care. They have to be assured that J. Random Hacker has not just checked in a poorly tested update to the program they’re installing on their ICU monitoring station. There are many responsible stewards of open source EHRs (several packagers of the VA’s VistA project, as just one example, have spoken at our Open Source Convention) but the buyers have to understand better what is entailed in vetting and maintaining open source software.
Health care providers, outside of research institutions with technically adventurous staff, also prefer turn-key solutions. These to some extent are deceiving, because every institution needs to customize the software heavily for its own needs, and many regret the proprietary solutions they’ve tied themselves to when they find out how hard (sometimes beyond anyone’s definition of feasibility) or costly the customizations are. They are still afraid of open source’s fluidity, however. Read more…
An inside look at DocGraph, a data project that shows how the U.S. health care system delivers care.
At Strata RX in October I announced the availability of DocGraph. This is the first project of NotOnly Development, which is a Not Only For Profit Health IT micro-incubator.
The DocGraph dataset shows how doctors, hospitals, laboratories and other health care providers team together to treat Medicare patients. This data details how the health care system in the U.S. delivers care.
You can read about the basics of this data release, and you can read about my motivations for making the release. Most importantly, you can still participate in our efforts to crowdfund improvements to this dataset. We have already far surpassed our original $15,000 goal, but you can still get early and exclusive access to the data for a few more days. Once the crowdfunding has ended, the price will go up substantially.
This article will focus on this data from a technical perspective.
In a few days, the crowdfunding (hosted by Medstartr) will be over, and I will be delivering this social graph to all of the participants. We are offering a ransom license that we are calling “Open Source Eventually,” so participants in the crowdfunding will get exclusive access to the data for a full six months before the license to this dataset automatically converts to a Creative Commons license. The same data is available under a proprietary-friendly license for more money. For all of these “releases,” this article will be the go-to source for technical details about the specific contents of the file.
Fujitsu provides the Sprout device to collect and analyze sensor data in real time
Veterans Affairs is collaborating with Fujitsu on a complex and interesting use of sensor data to help rehabilitate veterans suffering from Post Traumatic Stress Disorder (PTSD). I recently talked about this initiative with Dr. Steven Woodward, Principal Investigator of the study at the VA Palo Alto Health Care System, and with Dr. Ajay Chander, Senior Researcher in Data Driven Health Care at Fujitsu Laboratories of America (FLA).
The study is focused on evaluating strategies for driving rehabilitation. During deployments, veterans adapt their driving behavior to survive in dangerous war zones that are laced with combat fire, ambushes, and the threat of improvised explosive devices. Among veterans suffering from PTSD, these behaviors are hard to unlearn upon their return from such deployments. For example, some veterans veer instinctively into the middle of the road, reacting to deep-seated fears of improvised explosive devices. Others refuse to stop at stop signs for fear of attack. Other risky behaviors range from road rage to scanning the sides of the road instead of focusing on the road ahead. At-fault accident rates are significantly higher for veterans upon return from a deployment than before it.
The VA’s research objective is to understand the triggers for PTSD and discover remedies that will enable veterans to return to normal life. For the study, the VA instrumented a car as well as its veteran driver with a variety of sensors that collect data on how the car is being driven and the driver’s physiology while driving it. These sensors included wireless accelerometers on the brake and accelerator pedals and on the steering wheel, a GPS system, and an EKG monitor placed on the driver and wired to an in-car laptop for real-time viewing of cardiological signals, as well as manual recording of the driver’s state and environmental cues by an in-car psychotherapist. With such a system, the VA’s goal was to record and analyze driving trails of veterans and assess the efficacy of driving rehabilitation techniques.
As Dr. Woodward explained, the VA had been assessing veterans’ driving habits for quite a while before getting introduced to Fujitsu’s real-time monitoring technology. ASsessments had been a significant challenge for multiple reasons. On the data collection and visualization front, the disparate sensors, the laptop, and the power supplies added up to a significant in-car IT footprint. More importantly, since all sensor systems were manufactured by different vendors and didn’t share data with each other, the data streams were not synchronized. This made it difficult for the VA researchers to get an accurate understanding of how the driver’s physiology coupled with the car’s drive and location data. Read more…
O'Reilly conference brings together health care and data
O’Reilly’s first conference devoted to health care, Strata Rx, wrapped up earlier this week. Despite competing with at least three other conferences being held on the same week around the country on various aspects of health care and technology, we drew a crowd that filled the ballroom during keynotes and spent the breaks networking more hungrily than they attacked the (healthy) food provided throughout.
Springing from O’Reilly’s Strata series about the use of data to change business and society, Strata Rx explored many other directions in health care, as a peek at the schedule will show. The keynotes were filmed and will soon appear online. The unique perspectives offered by expert speakers is evident, but what’s hard is making sense of the two days as a whole.
In this article I’ll try to show the underlying threads that tied together the many sessions about data analytics, electronic records, disruption in the health care industry, 21st-century genetics research, patient empowerment, and other themes. The essential message from the leading practitioners at Strata Rx is ultimately that no one in health care (doctors, administrators, researchers, regulators, patients) can practice their discipline in isolation any more. We are all going to have to work together.
We can’t wait for insights from others, expecting researchers to hand us ideal treatment plans or doctors to make oracular judgments. The systems are all interconnected now. And if we want healthy people, not to mention sustainable health care costs, we will have to play our roles in these systems with nuance and sophistication.
But I’ll get to this insight by steps. Let’s look at some major themes of Strata Rx. Read more…
A doctor looks to software communities as inspiration for her own research
(The following article sprang from a collaboration between Andy Oram and Brigitte Piniewski to cover open source concepts in an upcoming book on health care. This book, titled “Wireless Health: Remaking of Medicine by Pervasive Technologies,” is edited by Professor Mehran Mehregany of Case Western Reserve University. and has an expected release date of February 2013. It is designed to provide the reader with the fundamental and practical knowledge necessary for an overall grasp of the field of wireless health. The approach is an integrated, multidisciplinary treatment of the subject by a team of leading topic experts. The selection here is part of a larger chapter by Brigitte Piniewski about personalized medicine and public health.)
Medical research and open source software have much to learn from each other. As software transforms the practice and delivery of medicine, the communities and development methods that have grown up around software–particularly free and open source software–also provide models that doctors and researchers can apply to their own work. Some of the principles that software communities can offer for spreading health throughout the population include these:
Like a living species, software evolves as code is updated and functionality is improved.
Software of low utility is dropped as users select better tools and drive forward functionality to meet new use cases.
Open source culture demonstrates how a transparent approach to sharing software practices enables problem areas to be identified and corrected accurately, cost-effectively, and at the pace of change.
How a sensor glove can benefit the patient-doctor relationship.
Recently a group of three young entrepreneurs showed off a prototype of a glove that contained sensors useful for medical examinations. Their goals were not merely to make diagnosis easier, but to save the doctor/patient relationship from the alienation of modern technology. Medical student Andrew Bishara came into O’Reilly’s Cambridge studio to discuss the glove’s capabilities, how the creators were inspired to design it, and how they plan to productize it.
Here’s the full video from our discussion:
Highlights from the conversation include:
- Introduction to the glove and its purpose in bringing touch back into medicine. [Discussed at the 0:31 mark]
- Some of the purposes of the sensors. [Discussed at the 2:00 mark]
- Software on the device and in the cloud. [Discussed at the 7:58 mark]
- Creating a marketable product from the glove. [Discussed at the 9:54 mark]
- Open hardware. [Discussed at the 13:39 mark]
- How the developers were inspired by Singularity University. [Discussed at the 15:03 mark]
David Heckerman's research uses big datasets to tackle essential health questions.
David Heckerman from Microsoft Research presents a summary of his work in the session “Discovering Genetic Associations on Large Data.” This was part of the Strata Rx Online Conference: Personalized Medicine, a preview of O’Reilly’s conference Strata Rx, highlighting the use of data in medical research and delivery.
Heckerman’s research attempts to answer essential questions such as “What is your propensity for getting a particular disease?” and “How are you likely to react to a particular drug?”
Key points from Heckerman’s presentation include: Read more…
Datalanche and the Practice Fusion challenge
I find Datalanche’s upcoming search application interesting because its database mixes public health data with patients’ clinical data from a private vendor. Practice Fusion opened up their data set of de-identified clinical information for a challenge that Datalanche won last week.
Arijit Sengupta on the benefits of making health care analytics widely accessible within an organization.
Arijit Sengupta presents a summary of his work as the CEO of BeyondCore in the presentation “Advanced Analytics for All: Enabling business users to act on length of stay patterns at a leading hospital system.” This presentation was part of the Strata Rx Online Conference: Personalized Medicine, a preview of O’Reilly’s conference Strata Rx, highlighting the use of data in medical research and delivery.
Sengupta’s vision is to bring analytics to people throughout an organization who can use them in their work. He hopes to bring analytics that have traditionally been available only to those at the top of a large organization down to those making everyday decisions. Users of analytics should not need to know statistics or computer science. In this presentation, he shows how hospital employees can correlate the length of a hospital stay with other variables.
Key points Sengupta’s session include: Read more…