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Can Google Glass Transform Medical Education?

de System Administrator - jueves, 7 de agosto de 2014, 18:23
 

Can Google Glass Transform Medical Education?

Google Glass looks exciting for the medical world, and presents a particularly powerful opportunity for medical education(for examples, see Forbes article here or Phys.org here). A white paper by the Department of Emergency Medicine, Singapore General Hospital says, “simulation-based training has opened up a new educational application in medicine. It can develop health professionals’ knowledge, skills, and attitudes, whilst protecting patients from unnecessary risks”. Google Glass is taking simulation to the next level and making it more real, as the patients treated are real.

Yet the underlying concept of simulation-based-learning in medicine isn’t new. Neither are the individual components of Google Glass (such as the video recording feature and the possibility of sharing procedures online with any number of students). The biggest innovation might be having all this in one device. As Aristotle said, the whole is more than the sum of its parts.

Medical education is often a two stage process. In stage one, doctors in training need to study voluminous tomes and pass exams; stage one is the collection and storing of knowledge – perhaps too much knowledge. Richard Barker says in his book 2030, the future of medicine, that “as our bio-medical insights continue to fragment traditional diseases into multiple molecular disorders, keeping pace with advances gets tougher and tougher; … ‘head knowledge’ needs to be complemented by online decision support, distilling the wisdom and experience of the best specialist and putting it at the fingertips of the practitioner”. In other words, clinicians are starting to need real-time knowledge on tap.

Stage two focuses on learning through direct patient contact under the guidance of seniors, and Barker’s position suggests that stage two may never really end. Google Glass would support this stage of the curriculum, helping to simulate the practice of medicine, teach decision making, and then allow collaboration long after qualification. With a teacher demonstrating on patients (or that earlier revolution: a mannequin) with a headset camera, the learner is brought straight into the operating theater.

Google Glass is similar to a standard pair of glasses. It has an optical head-mounted display, sitting just above the right eye. Features include a built-in GPS, microphone and Bluetooth, and a camera which can record and live-stream videos to a Google hangout. Particularly useful is voice activation which would allow surgeons to, for example, do a web search for latest research or access EMRs or even real-time patient metrics without “breaking scrub” (compromising operating room sterility). As well as improving the provision of care, this ought to give students a more holistic understanding of each case.

Related: EHR Vendor Develops EH​R App for Google Glass to Improve Clinician-Patient Interaction

Dr. Rafael J. Grossmann, Surgeon, mHealth Innovator and Google Glass Explorer was the first to perform a Google Glass-aided surgery, including remote teaching contexts and offering clinical advice remotely via Google hang-out. Orthopaedic surgeon Dr. Selene Parekh followed with a demo of foot and ankle surgery, and then plastic surgeon Dr. Anil Shah used the device while carrying out a rhinoplasty. Recently, Medical News Today wrote about a surgeon who live-streamed a procedureusing Google Glass and a tablet device.

Grossman says that exposing students to the real life of a surgeon and their problems is critical for training and students should learn and mimic best practices early on. Furthermore, he adds that Google Glass education goes beyond the operating room, “Google Glass is a great start with practically limitless opportunities. “For example, how to connect with patients, how to teach bedside manner, how to prepare patients for surgery can all be best taught from real life examples. Google Glass records it and demonstrates best practice, from A to Z through the responsibilities of a practitioner,” he says.

Related: Is Google Glass the Future of Teletrauma? 

 

Plus, of course, these Google Glass recorded procedures can be shared across the globe. InnovatorArmando Iandolo, co-founder of Surgery Academy and his team have created an application for Google Glass that lets surgeons stream a heads-up view of procedures to students anywhere in the world. The big, bold innovation is to connect these streams in MOOCs (massive open online courses), says Iandolo. He and his co-founder are currently crowd-funding the idea on Indigogo. “Students will access an operating theatre online and watch a surgical intervention, live, for the procedure of their choice”, says Iandolo. “As we enter Universities, we want to become an integral part of the medical student’s study curriculum”.

MOOCs aren’t new either, but with the Surgery Academy everything seems to fall in place. By bringing the learner straight into theatre, simulation via Google Glass makes courses operate more like apprenticeships.

The patient would need to give their approval, but this is surely quite reassuring for the patient: which practitioner – and one good enough to teach – wants to screw up while being live-streamed to hundreds of students and fellow physicians?

The speed at which Google Glass eventually becomes a standard educational support tool is less certain, and we can learn from previous waves of innovation. In 2010, the Northern Ontario School of Medicine introduced a new mobile device program (medical students received laptops, iPhones and iPads). To assess its value, educators there how medical learners use mobile technologies. Their white paper concluded, “Students would adapt their use of mobile devices to the learning cultures and contexts they find themselves in.” Device value needs to be taught. It depends on how welcome new tech is perceived to be in classrooms, by students, teachers, and the wider ecosystem.

A typical fear is that, especially early in the curriculum (stage one above), medical students will miss out on basic knowledge. Search and find functions make it easier to zero in on an answer, but perhaps without the rich context and basic knowledge provided by reading cover to cover. Students – and teachers – could work just ‘for the test’.

Well, books have always had indices. It’s the process of search which has been accelerated, and there is no evidence that students would treat a digital medical textbook differently than its paperback version. In fact digital isn’t a replacement for the traditional textbook; it’s an opportunity to augment it. There is a generational shift in the learning styles of medical students, Mihir Gupta writes in aKevinMD article. Digital allows the stodgy textbook to be augmented with visual and multimedia, which will suit certain learning styles. “Innovative digital resources are vital for helping students retain knowledge and simplify difficult concepts”, says Gupta. These new resources are great for quick access to updated medical knowledge, but “it will not replace textbook learning, nor should it”.

Lucien Engelen, Director of the Radboud Reshape Center at Radboud University Medical Center, is currently working on various applications for Google Glass in medicine. He says that the only way to get Google Glass into education is “to make it part of education innovation”. He says, “Take some high profile doctors, professors and nurses and some patients and have them run some tests. All of a sudden the advantages (of Google Glass) seem to fall in place seamlessly”.

Frances Dare is Managing Director of Accenture Connected Health Services, which has partnered with Philips on a Google Glass proof of concept. She agrees with Engelen, cautioning that it is important to create an environment in which experimentation can take place and to understand the type of training needed to prepare clinicians to use Google Glass effectively and safely in practice.

But don’t bet against Google Glass. After all, educators have argued for decades over calculators in math class. Engelen says that he really doesn’t think of Google Glass as something special: it’s just another computer form-factor facing the same barriers of acceptance. It will take some time and discussion over privacy to achieve it, but the new wave is coming.

by Nick Saalfeld and Ben Heubl, Contributing Writers at HIT Consultant 

 

Nick Saalfeld is a corporate journalist and entrepreneur based in London, UK. He has written for seven years about health-tech for clients including Microsoft, Imprivata and Howareyou.com. He also co-founded Yoodoo, the online platform devoted to delivering behavioral change through learning experiences, with many applications in public health and clinical/pharmaceutical adherence.

 

Ben Heubl is a digital health advocate, activist and journalist for health 2.0 innovation.Ben Heubl is speaker at various healthcare innovation conferences and events, a TEDMED delegate, founded the non-for-profit organization Health 2.0 Copenhagen, Mentor at the HealthXL accelerator, and currently passionately writes for various online magazines in the context of digital health innovation and technology. Ben also currently supports a UK health innovation SME to change how citizens access healthcare. You can follow him on Twitter at @benheub

Can Google Glass Transform Medical Education? by Nick Saalfeld and Ben Heubl

Link: http://hitconsultant.net/2014/03/19/can-google-glass-transform-medical-education/

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Can innovative solutions for mobile care meet your needs?

de System Administrator - viernes, 11 de septiembre de 2015, 21:12
 

Can innovative solutions for mobile care meet your needs?

The Visiting Nurse Association (VNA) California wanted to update their mobile technology to improve timely access to data. They had a few requirements:

  • Organizational effectiveness – mobile solutions to effectively provide secure in-home care.
  • High-quality, personalized care – for the most effective care, teams needed quick and accurate collaborations.
  • PC management and data security – their small IT support staff supports a highly mobile workforce, so any solutions would need to help manage all of their data security/compliance challenges.

Download the Case Study: Mobile Productivity for a Home Health Workforce to learn how VNA California provided their personnel greater performance flexibility and improved security with Intel®-based mobile solutions.

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Cancer Antibodies & Assays

de System Administrator - jueves, 9 de julio de 2015, 15:59
 

Cancer Antibodies & Assays

Cancer research is dependent on reliable tools for interrogating and identifying the phenotypic differences between cancer cells and corresponding normal cells of the same lineage. The recent output of data from genomic, proteomic, and epigenomic studies comparing tumor and non-tumor cells points to several key traits or “hallmarks”, shared by most tumor types, that drive disease progression.

These hallmarks of cancer are important—not only because they represent opportunities for therapeutic intervention, but because they are opportunities to use tumors as models to decipher the signaling pathways underlying both normal and diseased cellular processes.

Recognizing both the tremendous opportunities and the challenges facing cancer research, Merck Millipore has been dedicated to developing and refining products for the study of cancer. With Merck Millipore’s comprehensive portfolio, including the Upstate, Chemicon, and Calbiochem brands of assay kits, reagents and antibodies, researchers can count on dependable, high quality solutions for analyzing the hallmarks of cancer.

Please read the attached whitepaper.

Link: http://www.merckmillipore.com

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Cancer Genomics Cloud Platform

de System Administrator - sábado, 18 de octubre de 2014, 21:42
 

Google Partners to Create Cancer Genomics Cloud Platform

The Research at Google team is partnering with the Institute for Systems Biology (ISB) and SRA International, Inc to develop a Cancer Genomics Cloud (CGC). The platform will serve as a large-scale data repository and provide the computational infrastructure necessary to carry out cancer genomics research at unprecedented scales.

The $6.5M two-year project funded by the NIH’s National Cancer Institute (NCI) will migrate data collected from the TCGA (The Cancer Genome Atlas) to Google Cloud Platform to provide easy and secure access to the large datasets. The new collaboration will accelerate large-scale genome sequencing for a faster understanding of the molecular basis of cancer. 

“The CGC will democratize access to the wealth of cancer genomics data by substantially lowering the barrier to accessing and computing over these datasets,” said Dr. Ilya Shmulevich, professor at ISB and CGC prime investigator in the press release. “Cancer researchers will be able to analyze and explore entire cohorts of rich genomic data, without needing access to a large local compute cluster. The CGC will also facilitate collaborative research by allowing scientists to work on common datasets and projects in a cloud environment.”

As part of the collaboration, ISB will manage the needs of the researchers spearheading development of apps that will provide community access to the cloud-based data and computational infrastructure. 

photo credit: glbrc.communications via cc

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CANCER METASTASIS REDUCED UP TO 90% IN MICE USING ENGINEERED DECOY PROTEIN

de System Administrator - martes, 14 de octubre de 2014, 18:39
 

CANCER METASTASIS REDUCED UP TO 90% IN MICE USING ENGINEERED DECOY PROTEIN

 

Written By: Arlington Hewes

Cancer often begins in one part of the body but spreads elsewhere via the bloodstream or lymphatic system. This spreading, called metastasis, makes the disease deadly and difficult to halt—even using chemotherapy drugs with serious side effects.

However, in a preclinical study in mice, a Stanford team may have discovered another way to slow or even stop tumors from metastasizing.

Cancer spreads when certain proteins link up on cells, causing them to break off from the tumor. The Stanford study focused on two such proteins. One protein (Axl) forms bristle-like receptors on the cell’s surface tailored to fit the other protein (Gas6).

When two Gas6 proteins interact with two Axl proteins, the cancer cells are able to drift away from the original tumor and form new tumors in other areas.

To prevent this interaction, the scientists engineered a decoy Axl protein that is as much as a hundred times as effective at binding with Gas6 as the naturally occuring version. When deployed in the blood, the decoy proteins can bind Gas6 proteins before they have a chance to interact with the Axl proteins on the cancer cells.

In a recent paper published in Nature, lead authors Jennifer Cochran, a Stanford associate professor of bioengineering, and Amato Giaccia, professor of radiation oncology, say the decoy protein significantly slowed metastasis in their study.

After testing the decoy protein in mice with breast cancer and ovarian cancer, the scientists found a 78% reduction in metastatic nodules in the breast cancer group and a 90% decrease in metastatic nodules in the ovarian cancer group.

And unlike current cancer drugs, the researchers say the decoy protein is nontoxic.

How the scientists engineered the protein is almost as fascinating as the results themselves. The team mimicked evolution—only at a vastly accelerated pace. Using advanced analytics software and lab equipment the team built and evaluated over ten million minor variants of the Axl protein to find the one that best fit Gas6.

The researchers hope their work may extend beyond Axl proteins. There are other receptors, Mer and Tyro3, that bind with Gas6 and are associated with metastasis—the decoys could further render both harmless as bound Gas6 wouldn’t interact with them.

There is, of course, a long way to go before a therapy based on the group’s findings might make its way into the mainstream. They’ll have to scale production of the protein, complete more animal tests, and eventually, do human trials.

In the meantime, however, it offers a ray of hope for a much more humane cancer treatment in the future and a fascinating glimpse into the promise of bioengineering.

Image Credit: protein courtesy of Shutterstock

This entry was posted in HealthMedicine and tagged Amato GiacciaAxl proteincancerdirected evolutionGas6 proteinJennifer Cochran,metastasisStanfordsynthetic biology.

Link: http://singularityhub.com

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CDI Plan

de System Administrator - sábado, 27 de septiembre de 2014, 16:26
 

71% of hospitals plan CDI partnerships to tackle ICD-10

Author: Jennifer Bresnick

The majority of hospitals won’t be staring down the challenges of ICD-10 clinical documentation improvement (CDI) on their own, Black Book Rankings says, but will seek consultants and service partners to help them make the necessary adjustments ahead of the new code set.  By October 1, 2015, 71% of hospitals plan to have engaged a CDI partner, and nearly 25% have done so already.

After gaining an extra year to prepare when the code set was delayed this spring, providers are finally realizing that collaboration is the key to a successful transition.  “Transitioning to ICD-10 is a complicated process and hospitals are leaning on the expertise and successes of outsourcing vendors,” says Doug Brown, Managing Partner of Black Book. “We still operate in an ICD-9 world, complicated by EHR implementations, value-based reimbursement models, compliance issues and optimizing reimbursement; a perfect storm from which outsourcers have the expertise to shield their clients.”

Eighty-eight percent of large hospitals that are already outsourcing CDI efforts have realized significant gains in revenue, the survey says, totaling over $1 million per facility.  Eighty-three percent also noted improvements to the quality of care and increases in the case mix index.  More than a quarter of hospitals that are already outsourcing their coding and CDI are considering upgrading their technology, as well, in an attempt to keep pace with physician practice acquisitions and EHR implementation efforts that have sapped time and resources from the ICD-10 transition.

Throughout the lengthy and oft-delayed transition, experts have urged providers to start with the basics: ensuring that the documentation produced by physicians contains every piece of information necessary for a coder to select the most detailed ICD-10 code available.  Physicians and coders often don’t view the same terms in the same way, which can lead to poor coding, a loss of rightful revenue, and a dip in quality metrics that don’t reflect the actual level of care being provided.

 

“The problem is that when physicians write in clinical terms that they understand, they assume everybody else understands those terms.  But they don’t.  We needed a bridge between clinical language and coding language, and we needed to explain to physicians that the coders cannot always interpret what they’re thinking,” said Dr. Georges Feghali Chief Medical Officer and Chief Quality Officer at TriHealth Medical, while explainingwhy his organization invested in a CDI program ahead of ICD-10.  “My doctors were looking like terrible physicians just because they weren’t documenting care the right way.”

“I’ve been doing CDI for 15 years and physicians still don’t provide all the details needed to ensure appropriate, thorough documentation,” says Mel Tully, MSN, CCDS, CDIP and Vice President of Clinical Services and Education at Nuance.  “Unless they’re being prompted and given a tool or person to help guide them, they will always document pneumonia as pneumonia.  There are many, many other ways to document it and even today, physicians still need guidance on how best to capture the specific details needed to accurately reflect the severity of the care provided.”

In the Black Book poll, Nuance Communications received the highest customer experience and client satisfaction scores among vendors of CDI and coding products or services.  Also ranking highly in the category were 3M, Optum, the Advisory Board, Navigant, Chartwise Medicla, Precyse, and DCBA.

 

Related White Papers:
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Chronic care management: 4 steps to implementation

de System Administrator - lunes, 9 de marzo de 2015, 03:26
 

Chronic care management: 4 steps to implementation

 By Debra Beaulieu-Volk

Medicare's new chronic care management (CCM) program offers practices of all specialties a major opportunity to reap revenue from services they've thus far provided for free. With 1,000 qualified patients, a practice could earn an additional $511,200 per year, noted an article from Medscape.

IT concerns top the list of barriers to the programFiercePracticeManagement has reported, and some practices may also need to add to their existing infrastructure and staff to implement code 99490. Family physician Matt T. Rosenberg, M.D., of MidMichigan Health Center, for example, told Medscape he hired a full-time nonclinical manager to obtain patients' consent to be enrolled in the program, which requires a 20 percent copay. The manager also ensures that clinicians are documenting CCM activities, including going over medications or insurance issues by phone.

But while practices such as Rosenberg's are doing their best to design programs that enhance patient care, there is little guidance available to do so, noted an opinion piece published in the Journal of the American Medical Association.

"Although there has been discussion of the fiscal and operational challenges posed by the new payment, less consideration has been given to the implications of the new policy for clinicians who will wonder what is required of them and how can they do it well," wrote authors Louise Aronson, M.D.; Christopher A. Bautista, M.D.; and Kenneth Covinsky, M.D.

Thus, they recommended four-step process for doctors to approach CCM with each patient:

  1. Determine the likelihood of care coordination needs (e.g., two or more chronic conditions)
  2. Establish goals of care (e.g., current life and health priorities, treatment preferences)
  3. Assess care needs (medical, functional, psychosocial and environmental)
  4. Match resources to needs (medical, functional, psychosocial and environmental)

With all of the effort that these measures entail, providers also have to ask themselves tough questions regarding patients who refuse to sign up for the program, noted Medscape. "The decision was tough," Rosenberg said. "The best decision we came to is that if you are eligible for this program and you chose not to sign the consent, then we will no longer offer non-face-to-face interactions."

 

To learn more:
- read the article
- see the opinion piece (subscription required)

Related Articles:

Link: http://www.fiercepracticemanagement.com

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Cloud, Big Data, Mobile and Social Drive Next Generation EMR

de System Administrator - viernes, 23 de enero de 2015, 15:08
 

Cloud, Big Data, Mobile and Social Drive Next Generation EMR

As healthcare providers respond to the Affordable Care Act and achieve initiatives for meaningful use of electronic medical records (EMR), growing demands for reduced costs and higher accountability are driving monumental change. Organizations are changing their business models with the objective of delivering safer patient care at a lower cost.

However, traditional IT infrastructures cannot continue to meet the demands of today’s value-based care model. More healthcare data is being generated than ever before as populations continue to age and the average life span continues to grow. To extract the most value from this large influx of patient data, healthcare providers need the tools equipped to ingest all of this structured and unstructured information.

Behold the hybrid cloud: a combination of public and private cloud options.

Private and public cloud tools enable healthcare IT to assimilate all of this patient health information driven by social, mobile and big data while remaining complaint to HIPPA and HITECH mandates on a limited IT budget.

Download these attached white papers to discover how a culmination of private and public cloud options offer the agility, security and cost-efficiency healthcare providers need to operate successfully.

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Colapso en Atención Primaria por la caída del “inservible” programa Medora

de System Administrator - viernes, 8 de mayo de 2015, 19:11
 

La insoportable levedad centralizadora de la HCE

por Fernando A. Alonso López | Family Physician

Los programas informáticos de HCE... qué duda cabe que son un avance en el cuidado de la salud, pero sus desarrolladores ignoran la historia y están condenados a sufrirla. Internet nació como un proyecto militar de descentralización en la toma de decisiones en momentos de crisis. Posteriormente se amplio a todos los ámbitos de nuestra vida pero en el campo sanitario "alguien" olvidó la premisa de partida y se dejó atrapar por la centralización de los datos en lugar de favorecer que se compartan (era mas "fácil" pagar por grandes máquinas que pensar, y además era mas caro...). ¿No lo hacen los bancos nos decían?, olvidando la inversión económica que suponen los Centros de Proceso de Datos repartidos por todo el mundo que estos poseen y que, obviamente, la Sanidad Pública no se puede permtir ni en su décima parte. En el camino "alguien" perdió la lógica y han de ser situaciones como la presente las que le pongan en sus sitio

Colapso en Atención Primaria por la caída del “inservible” programa Medora

Los médicos salen a las puertas de los centros de salud por la imposibilidad de pasar consulta

Médicos a las puertas de los centros de Salud de Gamazo y Casa del Barco.

Profesionales a las puertas del cenytro de salud de Plaza del Ejército.

Facultativos y personal médicos a las puertas del centro de salud de Arturo Eyríes.

La atención primaria en los centros de salud de Valladolid (y otras provincias de Castilla y León) está colapsada. El cuestionado programa Medora que utilizan los facultativos para ver historiales y poder prescribir hoy se ha caído y durante toda la mañana ha hecho imposible que se pasara consulta.

La indignación entre los profesionales ha provocado que médicos, enfermeras y personal administrativo, hartos de esta situación, hayan protagonizado una improvisada protesta a las puertas de los centros de salud.

Este es el caso de los centros de Huerta del Rey, Arturo Eyríes, Gamazo y Casa del Barco, Delicias o Plaza del Ejército, así como algunos otros de Palencia.

“Cuando he llegado a la consulta esta mañana he podido entrar en el sistema, pero iba lentísimo. Se tardaban más de 15 minutos en poder prescribir. A estas horas ya no me deja ni entrar”, ha relatado a últimoCero uno de los médicos que han protagonizado la protesta sin ocultar su hartazgo e indignación.

Los problemas de operatividad del sistema Medora no son nuevos. Distintos responsables de centros de salud han trasladado a la Gerencia de Salud sus quejas por el mal funcionamiento de un sistema “que sólo parchean y nunca ha acabado de funcionar correctamente”.

El propio presidente del Colegio de Médicos de Valladolid, Antonio Otero, uno de los facultativos que hoy se ha visto afectado por la caída del sistema y que no ha podido pasar consulta ha “lamentado las deficiencias de un sistema que, pese ha haber sido denunciadas reiteradamente, no han tenido solución”. “El problema no sólo no se resuelve sino que va a peor. Hoy ya ha sido la gota que colma el vaso: directamente no funciona”, asegura Otero convencido de que el alcance de este problema sin solucionar es ya lo suficientemente grave “como para que alguno de los dirigentes sanitarios hubiera asumido sus responsabilidades”.

El descontento de los médicos con esta aplicación se remonta prácticamente a su puesta en marcha. Sin embargo, las protestas y quejas han arreciado en los últimos meses con el intento fallido de instaurar las historias clínicas únicas y, más recientemente, la inclusión en el programa de un módulo de prescripción de forma experimental en determinadas zonas de salud que nunca ha llegado a funcionar correctamente.

Ya en abril del año pasado, el propio director general de Planificación e Innovación de la Consejería de Sanidad, Rafael Sánchez, reconocía los problemas que estaba ocasionando la implantación de esta nueva versión del programa (la IV), que se une a la migración de los servidores de datos y que en esas fechas todavía no había concluido.

“Hay que entender que este es un salto tecnológico complejo y, como ocurre en la vida real, la casa está desordenada mientras duran las obras”, afirmó entonces Sánchez, tratando de restar importancia a lo que distintos médicos califican como un auténtico “calvario”.

Un calvario que hoy se ha traducido en el colapso de la atención médica de atención primaria en no pocos centros de salud de Valladolid y el resto de provincias de la Comunidad.

Respuesta de la  Gerencia Regional de Salud

La Gerencia Regional de Salud ha difundido un comunicado en el que pide "disculpas a los usuarios y a los profesionales de Sacyl por los fallos que está registrando en la mañana de hoy el programa Medora y los consiguientes trastornos que ocasiona".

"El pasado lunes se instaló una nueva versión del programa para la adaptación al proyecto de receta electrónica, y ayer, martes, funcionó con normalidad", indican como disculpa.

"Desde la Consejería de Sanidad se está trabajando intensamente para solventarlo, de manera que los profesionales puedan seguir desarrollando su actividad sin incidencias. Además, técnicos de las empresas Oracle, Tevlent y Microsoft están en estos momentos analizando la situación y tratando de lograr una solución lo antes posible", señalan, reconociendo que el problema afecta a toda la Comunidad y que aún no se ha resuelto.

Noticias relacionadas:

Link:  http://www.ultimocero.com

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Communicate Effectively with Medical Colleagues

de System Administrator - jueves, 2 de abril de 2015, 14:01
 

Communicate Effectively with Medical Colleagues


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