"health care" entries

What the IoT can learn from the health care industry

Federated authentication and authorization could provide security solutions for the Internet of Things.

Adrian Gropper co-authored this post.

Nyckel_erik_forsberg_FlickrAfter a short period of excitement and rosy prospects in the movement we’ve come to call the Internet of Things (IoT), designers are coming to realize that it will survive or implode around the twin issues of security and user control: a few electrical failures could scare people away for decades, while a nagging sense that someone is exploiting our data without our consent could sour our enthusiasm. Early indicators already point to a heightened level of scrutiny — Senator Ed Markey’s office, for example, recently put the automobile industry under the microscope for computer and network security.

In this context, what can the IoT draw from well-established technologies in federated trust? Federated trust in technologies as diverse as the Kerberos and SAML has allowed large groups of users to collaborate securely, never having to share passwords with people they don’t trust. OpenID was probably the first truly mass-market application of federated trust.

OpenID and OAuth, which have proven their value on the Web, have an equally vital role in the exchange of data in health care. This task — often cast as the interoperability of electronic health records — can reasonably be described as the primary challenge facing the health care industry today, at least in the IT space. Reformers across the health care industry (and even Congress) have pressured the federal government to make data exchange the top priority, and the Office of the National Coordinator for Health Information Technology has declared it the centerpiece of upcoming regulations. Read more…

Health games platforms mature in preparation for mainstream adoption

Business models and sustainability will drive success in the health games space.

SPARX_screenshot

SPARX, a behavioral therapy game for youths,
combines a fantasy setting with skills for life.

For the past several years, researchers have strived to create compelling games that improve behavior, reduce stress, or teach healthy responses to difficult life situations. Such healthy games tend to arise in research settings because of the need to demonstrate clinically that the games are effective. I have covered such efforts in my postings from the Games for Health conference in 2012 and 2013.

These efforts have born fruit, and clinical trials have shown the value of many such games. Ben Sawyer, who founded the Games for Health conference more than 10 years ago, is watching all the pieces fall into place for the widespread adoption of games. Business plans, platforms, and the general environment for the acceptance of games (and other health-related apps) are coming together.

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Where did the issue of health data exchange disappear to?

More visible at Health Privacy Summit than Health Datapalooza.

On the first morning of the biggest conference on data in health care–the Health Datapalooza in Washington, DC–newspapers reported a bill allowing the Department of Veterans Affairs to outsource more of its care, sending veterans to private health care providers to relieve its burdensome shortage of doctors.

There has been extensive talk about the scandals at the VA and remedies for them, including the political and financial ramifications of partial privatization. Republicans have suggested it for some time, but for the solution to be picked up by socialist Independent Senator Bernie Sanders clinches the matter. What no one has pointed out yet, however–and what makes this development relevant to the Datapalooza–is that such a reform will make the free flow of patient information between providers more crucial than ever.

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Sequencing, cloud computing, and analytics meet around genetics and pharma

Bio-IT World shows what is possible and what is being accomplished

If your data consists of one million samples, but only 100 have the characteristics you’re looking for, and if each of the million samples contains 250,000 attributes, each of which is built of thousands of basic elements, you have a big data problem. This is kind of challenge faced by the 2,700 Bio-IT World attendees, who discover genetic interactions and create drugs for the rest of us.

Often they are looking for rare (orphan) diseases, or for cohorts who share a rare combination of genetic factors that require a unique treatment. The data sets get huge, particularly when the researchers start studying proteomics (the proteins active in the patients’ bodies).

So last week I took the subway downtown and crossed the two wind- and rain-whipped bridges that the city of Boston built to connect to the World Trade Center. I mingled for a day with attendees and exhibitors to find what data-related challenges they’re facing and what the latest solutions are. Here are some of the major themes I turned up.

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Citizens as partners in the use of clinical data

A Knowledge Currency Exchange for health and wellness

This article was written together with Mike Kellen, Director of Technology at Sage Bionetworks, and Christine Suver, Senior Scientist at Sage Bionetworks.

The current push towards patient engagement, when clinical researchers trace the outcomes of using pharmaceuticals or other treatments, is a crucial first step towards rewiring the medical-industrial complex with the citizen at the center. For far too long, clinicians, investigators, the government, and private funders have been the key decision makers. The citizen has been at best a research “subject,”and far too often simply a resource from which data and samples can be extracted. The average participant in clinical study never receives the outcomes of the study, never has contact with those analyzing the data, never knows where her samples flow over time (witness the famous story of Henrietta Lacks), and until the past year didn’t even have access to the published research without paying a hefty rental fee.

This is changing. The recent grants by the Patient-Centered Outcomes Research Institute (PCORI) are the most visible evidence of change, but throughout the medical system one finds green shoots of direct patient engagement. Read more…

Changes in the health care system driven by self-service and DIY health

Apps reflect the public's pressing health concerns

Health care is migrating from the bricks-and-mortar doctor’s office or care clinic to the person him or herself at home and on-the-go–where people live, work, play, and pray. As people take on more do-it-yourself (DIY) approaches to everyday life–investing money on financial services websites, booking airline tickets and hotel rooms online, and securing dinner reservations via OpenTable–many also ask why they can’t have more convenient access to health care, like emailing doctors and looking into lab test results in digital personal health records.

The public clamor for digital outreach by health providers

85% of U.S. health consumers say that email, text messages, and voicemail are at least as helpful as in-person or phone conversations with health providers, according to the Healthy World study, Technology Beyond the Exam Room by TeleVox. Furthermore, one in three consumers admits to being more honest when talking about medical needs via automated voice response systems, emails, or texts than face-to-face with a health provider.

And three in ten consumers believe that receiving digital health care communications from providers—such as texts, voicemail, or email—would build trust with their providers. Half of people also say they’d feel more valued as a patient via digital health communications. When people look to engage in health with an organization, the most important enabling factors are trust and authenticity.

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Health IT is a growth area for programmers

New report covers areas of innovation and their difficulties

infofixO’Reilly recently released a report I wrote called The Information Technology Fix for Health: Barriers and Pathways to the Use of Information Technology for Better Health Care. Along with our book Hacking Healthcare, I hope this report helps programmers who are curious about Health IT see what they need to learn and what they in turn can contribute to the field.

Computers in health are a potentially lucrative domain, to be sure, given a health care system through which $2.8 trillion, or $8.915 per person, passes through each year in the US alone. Interest by venture capitalists ebbs and flows, but the impetus to creative technological hacking is strong, as shown by the large number of challenges run by governments, pharmaceutical companies, insurers, and others.

Some things you should consider doing include:

Join open source projects 
Numerous projects to collect and process health data are being conducted as free software; find one that raises your heartbeat and contribute. For instance, the most respected health care system in the country, VistA from the Department of Veterans Affairs, has new leadership in OSEHRA, which is trying to create a community of vendors and volunteers. You don’t need to understand the oddities of the MUMPS language on which VistA is based to contribute, although I believe some knowledge of the underlying database would be useful. But there are plenty of other projects too, such as the OpenMRS electronic record system and the projects that cooperate under the aegis of Open Health Tools

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Leading by example: two stories

When health care institutions are charging outrageous prices, we need to stand up and say, "That's insane."

I was struck recently by two stories in the New York Times. The first, “Bishops Follow Pope’s Example: Opulence Is Out,” tells how bishop after bishop, either inspired by the Pope’s example or afraid of being shamed for not doing so, is moving out of his expensive, newly renovated residence and emulating Pope Francis’ emphasis on living simply. “Francis has very definitely sent out a signal, and the signal is that bishops should live like the people they pastor, and they shouldn’t be in palaces.”

I contrast this in my mind with the “do as I say, but not as I do” style of leadership shown by the US Congress on health care, where the message of “bending the cost curve on health care,” and limits on “Cadillac plans” was for everyone else. Congress’ own gold-plated plan remained in place, despite posturing to pretend that members of Congress were in the same boat as everyone else.

But when the leaders themselves don’t lead, sometimes individuals stand up to be counted. Read more…

Advances in health IT must be viewed as a whole

New report ties together devices, data, records, and aspects of care.

Reformers in health care claim gigantic disruption on the horizon: devices that track our movements, new treatments through massive data crunching, fluid electronic records that reflect the patient’s status wherever she goes, and even the end of the doctor’s role. But predictions in the area of health IT are singularly detached from the realities of the technical environment that are supposed to make them happen.

To help technologists, clinicians, and the rest of us judge the state of health IT, I’ve released a report titled “The Information Technology Fix for Health: Barriers and Pathways to the Use of Information Technology for Better Health Care.” It offers an overview of each area of innovation to see what’s really happening and what we need to make it progress further and faster.

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Visualizing Health IT: A holistic overview

O'Reilly report covers major trends and tries to connect the neurons

If visualization is key to comprehending data, the field of health IT calls for better visualization. I am not talking here of pretty charts and animations. I am talking, rather, of a holistic, unified understanding of the bustle taking place in different corners of health: the collection and analysis of genetic data, the design of slim medical devices that replace refrigerator-sized pieces of equipment, the data crunching at hospitals delving into demographic data to identify at-risk patients.

There is no dearth of health reformers offering their visions for patient engagement, information exchange, better public health, and disruptive change to health industries. But they often accept too freely the promise of technology, without grasping how difficult the technical implementations of their reforms would be. Furthermore, no document I have found pulls together the various trends in technology and explores their interrelationships.

I have tried to fill this gap with a recently released report: The Information Technology Fix for Health: Barriers and Pathways to the Use of Information Technology for Better Health Care. This posting describes some of the issues it covers.

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