ENTRIES TAGGED "medical"
Driven to distraction: How Veterans Affairs uses monitoring technology to help returning veterans
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…
Doctors rate doctors in HealthTap’s medical quality project
Physician/patient knowledge sharing site branches out into quality measures
HealthTap, a network of physicians and patients, routinely breaks new ground and tries bold experiments in the area of generating trust. I remember how, in my first posting about the company, I questioned whether the company could sign up both patients and doctors and extract the information it planned to offer. Its current network of more than 16,000 physicians vindicates CEO Ron Gutman.
HealthTap has always included a modest “Agree” button that lets a doctor approve of a particular posting by another doctor, but now the company is delving much deeper into the mission of externalizing information that has long remained hidden. They are conducting a series of initiatives to rate doctors. The one announced today, the Top Doctors competition openly asks doctors to rate each other. Every specialist has strong opinions about who is best in his or her field, and is willing to direct patients to the most respected colleagues, but never have they been asked to publicize their opinions.
Gutman is confident that this gambit will pay off. Doctors are naturally competitive, he says, and will sign up to rate one another. He is asking for extremely fine-grained ratings: not just for “best eye surgeon,” but for “best retinal surgeon.” This kind of detail matches the requests made by anxious patients.
Patients will also be able to rate their physician’s bedside manner. Such ratings are known to be very subjective and poorly correlated with clinical results, so the physician and patient ratings will be presented separately on HealthTap. Read more…
How to open an industry: data points from Strata Rx
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…
Open source software as a model for health care
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:
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Like a living species, software evolves as code is updated and functionality is improved.
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Software of low utility is dropped as users select better tools and drive forward functionality to meet new use cases.
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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.
Sensor-laden glove brings medical examination to the masses
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]
Discovering genetic associations using large data
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…
Combining patient data sets for better medical research
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.
Advanced analytics for all in the health care system
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…
Privacy concerns and regulatory challenges in personalized medicine
Ann Waldo examines obstacles to patient data and offers specific reforms that can help.
Ann Waldo, a partner in Wittie, Letsche & Waldo, LLP in Washington, DC, presents a summary of her work in the webcast “Overview of Privacy Concerns and Regulatory Challenges Concerning Personalized Medicine — and Some Modest Suggestions for Change.” 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.
Waldo highlighted how HIPAA regulations and other laws passed by federal and state governments contain restrictions that make research with patient data unnecessarily difficult. She offers several suggestions for reform.
Key points from her presentation include: Read more…
Challenge to Meaningful Use by House leaders highlights difficulty of asking incumbents to be innovators
Working too closely with an industry can undercut innovation
Four leading members of the House Ways and Means Committee tore away last Thursday at the polite, cautious, incremental approach that the Department of Health and Human Service has been taking toward key goals of HITECH act that was meant to drag health care into the 21st century.
Specifically, the House leaders signaled their disappointment at the Stage 2 Meaningful Use rules, promulgated last August by the Office of the National Coordinator and the Center for Medicare & Medicaid Services. The Congressmen isolate certain rules that appear to be less stringent than Stage 1, point out that the key goals of interoperability and data exchange are weak, and most notably ask for a total stop to payments made to health care providers under Meaningful Use.
