Future of Health IT: Trends and Scenarios

More on robot usage in health care : Hospital visits take on new meaning with therapeutic robots

2013-05-20T14:49:43-04:00

Portuguese and Spanish researchers in the field of social robotics are working on the use of robots to interact with children who are hospitalized for the treatment of cancer, thereby providing emotional support.

The researchers are keen to take robots out of the laboratory and place them in a real environment. Until now, most of the research on social robotics has taken place in very controlled environments. As Professor Salichs from UC3M points out, 'The introduction of a group of autonomous social robots into surroundings with these characteristics is something new, and we hope that the project will help us to advance in the development of robots that are able to relate to people in complex situations and scenarios.'

via cordis.europa.eu

Another cause for guarded optimism about health care robotics? My hope is that it will augment the efforts of often overworked staff and allow them to better prioritize the focus of their precious attention and energy. In addition to their potential social value, robots could act as in situ surveillance devices to watch for nascent or emergent health crises. My fear is that they will be used as justification for cutting costs through staff reductions, as self-checkout lanes have done in supermarkets.

Thanks to ACM TechNews for the pointer to the CORDIS story.

Robots in healthcare: scary, promising, or both?

2013-05-15T12:56:53-04:00

Robot Aids in Therapy for Autistic Children
Wall Street Journal (05/01/13) Shirley S. Wang

University of Notre Dame researchers will present study findings at the annual conference of the International Society for Autism Research showing promise in the use of robots for teaching social skills to autistic children. The study, involving 19 autistic children, is believed to be the largest trial to date using robots in this way. The children interacted with a two-foot-tall robot therapist that was programmed to ask novel questions and engage children in conversation. The study participants showed greater conversational improvement with the robot than with a human therapist alone, and parents reported more significant improvement at home as well. Children interacted in six sessions with the robot as well as with a human therapist, who provided instruction on specific skills when interacting with the robot, such as making eye contact or taking turns talking. Simplified social interactions with a robot might be beneficial to children with autism, who tend to be very interested in technology but find complex social interactions challenging. The researchers hope the children will carry over the social skills to interactions with people as well, rather than just interacting with the robot.

via technews.acm.org

Monday's ACM TechNews produced this very brief but tantalizing summary of a Wall Street Journal article.

This is one of those stories that leave me very ambivalent. In some ways, my automatic reaction to our collective desire to depend more on automation in direct patient care is fear. I am afraid we are going to abandon our elderly and otherwise hopelessly disabled kin to the unfeeling arms of robots, androids, whatever. This will spare us the feelings aroused by an out-of-control psychotic spouse, an incontinent and demented parent, or a profoundly developmentally disabled child, when we must intervene and our interventions are resisted, not appreciated, or insufficiently effective.

With this story, I see the situation is not so simple. Autistic children have difficulty relating to humans with whom they are intimately involved, and their difficulties are often reflected in others' responses to them. Machines are insensitive by nature, and can be programmed to reward positive behavior and ignore the negatives. This may be a situation, as the investigators assert, where robotic intervention is not only appropriate as an alternative but can even improve the patient's situation holistically.

I don't have a WSJ subscription so I can't follow the link ACM provides to the full story, and I don't have time at the moment to poke around on the Web for alternate sources of information about this research project. I would like to learn more, and will try to pursue this when I have more time.

In the fight against superbugs, biosensors may have an answer - FierceHealthIT

2013-05-09T15:15:46-04:00

New biosensors have the potential to detect antiobiotic resistance in bacteria, according to new research from the Journal of Visualized Experiments (JoVE).

"Antibiotic resistant bacteria is a serious problem," Vitaly Vodyanoy, M.D. said in an announcement. "It is very important [when treating a patient] to distinguish between normal and resistant bacteria; if you have a case of resistance you have to take special measures to cure it."

Vodyanoy used bacteriophages, simple viruses that can target and kill bacteria, mixed with specific antibiodies, which can be used to produce a color change in a sample that indicates antibiotic resistance. This technology can be used by clinicians treating patients and also be used to help disinfect hospital facilities.

via www.fiercehealthit.com

This sounds promising to me. The story goes on to mention potential application of the biosensor technology to Clostridium difficile, the superbug that took my father's life earlier this year. The more I learn about "C. diff", the more I appreciate the challenges involved in battling superbugs.

There are good reasons why everyone should care. Check out the inhabitat "hamburger" link below (or click here) for one good example. The odds of you coming down with a superbug infection in your lifetime are increasing rapidly.

Rogue Wave: The Synergistic Convergence of Multiple Disruptive Information Technologies

2013-05-09T09:30:44-04:00

Reading a page on the McKinsey site called Clouds, big data, and smart assets: Ten tech-enabled business trends to watch, I came across something that resonated with an obsession of mine over the past three decades of my involvement in high tech: the synergistic convergence of multiple disruptive information technologies. I firmly believe that this is the driving force behind the massive and increasingly rapid changes in modern society and culture.

Starting around the turn of the century, I wrote a series of scenario planning papers called Rogue Wave in which I first published my thoughts on this concept. I felt the metaphor of the rogue wave was especially apropos. Here's how I introduced the metaphor in my papers:

Rogue waves have been the bane of seafarers (and the joy of surfers) since time immemorial. Rogue waves happen when the crests of two or more wave patterns happen to synchronize, momentarily producing a much larger wave than any of the participating wave patterns could have produced alone. Rogue waves are the bane of seafarers because their energies can be tremendous, and therefore potentially very destructive to a ship holding to a particular course—detrimental not just to the ship’s ability to hold the course, but to the very ship itself. The inertial energy of the vessel’s mass interacts with the momentum of the wave patterns, stressing the vessel in unexpected and massive ways.

But to surfers, a rogue wave is a dream come true. Rogue waves can take you farther and faster than any normal wave, providing a much wilder, longer, and more satisfying ride, but only if you are ready to ride when the moment comes to catch the wave.

Contrary to our perceptions, ocean waves of all kinds, including rogue waves, are created not by the movement of water, but by the flow of energy. It is the energy flows that create the rogue wave, inundating the sailor’s vessel and providing the surfer’s wild ride. There are wave patterns in society as well—energies that move through our existence, and sometimes turning the status quo on its head. Technological evolution, religious and ideological movements, population bulges and dips, economic boom and recession, all are examples of the wave patterns buffeting human society.

The recently trending term Black Swan is a metaphor that characterizes the effects of Rogue Wave phenomena.

Disruptive technology is a concept introduced by Clayton Christensen in his book the Innovator's Dilemma. He contrasts them with sustaining technologies, which reinforce the status quo in the course of deriving maximum value from it. On the other hand, disruptive technologies threaten and ultimately overturn the status quo. They are game-changing by nature.

Discovery-based planning, another concept introduced by Christensen, is based on the premise that disruptive technologies require learning strategies as opposed to the execution strategies that work well with sustaining technologies.

…in disruptive situations, action must be taken before careful plans are made. Because much less can be known about what markets need or how large they can become, plans must serve a very different purpose: They must be plans for learning rather than plans for implementation. By approaching a disruptive business with the mindset that they can’t know where the market is, managers would identify what critical information about new markets is most necessary and in what sequence that information is needed. Project and business plans would mirror those priorities, so that key pieces of information would be created, or important uncertainties would be resolved, before expensive commitments of capital, time, and money were required. [italics added]

Information is the critical element in learning strategies. Information technologies are critical tools for deriving value from information. Such technologies facilitate the capture, storage, search and retrieval, analytics, and many other aspects of information processing, and thus are critical drivers of learning strategies.

Moreover, new information technologies themselves are often disruptive by their very nature, changing the learning strategy game even as they facilitated by it. And information technologies, just like all others, are beneficiaries of their own disruptive effects and those of other new information technologies. In a world where multiple new disruptive information technologies have been emerging in parallel for at least the past five decades, four of them paced by Moore's Law, the disruptive effects are synergistic, increasingly so over time.

The 2002 edition of the Rogue Wave paper set forth the Theorem of the Disruptive Value of Information, aka DVI Theorem:

Di = 1 / ( (Tu - Ta) * Ca )

The disruptive effect (Di) of a unit of relevant information is inversely proportional to the temporal distance between its moment of access (Ta) and the moment of its use (Tu) multiplied by the cost of its accessibility (Ca).

Simply put, the theorem states that relevant information is most disruptive when it is instantly accessible for zero cost. The value produced by the formula is a real number between zero and infinity. A value of zero means the information has no disruptive effect on the technological status quo; infinity means it has infinite disruptive effect. Since information always costs something to obtain and always takes some time to access, Di will never reach infinity, but lower cost and more immediate access greatly increase the disruptive effect of relevant information. At the other end of the spectrum, information that costs too much or takes too much time to obtain has little disruptive effect in spite of its relevance.

The DVI Theorem is the key to leveraging discovery-based planning. Entrepreneurial genius is involved in developing the disruptive technology and in identifying the key pieces of information that must be acquired, but the DVI Theorem sets a limit on how effectively the planning strategy can be carried out. Learning too late or too expensively is equivalent to not learning at all.

I'm going to revisit the Rogue Wave concept and the DVI Theorem in future posts and try to refresh and enrich it with things I've learned in the meantime.

The big-data revolution in US health care: Accelerating value and innovation | McKinsey & Company

2013-05-07T16:55:27-04:00

While health-care costs may be paramount in big data’s rise, clinical trends also play a role. Physicians have traditionally used their judgment when making treatment decisions, but in the last few years there has been a move toward evidence-based medicine, which involves systematically reviewing clinical data and making treatment decisions based on the best available information. Aggregating individual data sets into big-data algorithms often provides the most robust evidence, since nuances in subpopulations (such as the presence of patients with gluten allergies) may be so rare that they are not readily apparent in small samples.

via www.mckinsey.com

I found another report on Big Data and healthcare, this time from McKinsey and Company. This report leans in the direction of favoring technology over the personal interactions between patient and physician. I'm still feeling divided. This link goes to an executive summary, but it has a link where you can download the full report.