The project will see a group of internationally recognized researchers, led by Dr. Carolyn McGregor, a UOIT associate professor and Canada Research Chair in Health Informatics, use advanced stream computing software developed by IBM Research to work toward greatly enhancing the decision-making capabilities of doctors. The software ingests a constant stream of biomedical data, such as heart rate and respiration, along with environmental data gathered from advanced sensors and more traditional monitoring equipment on and around the babies.

(see rest of story on CNNMoney)

Here's a preview below.  You can watch the whole program online.

What I found most insightful about T.R. Reid's reporting was the clear and practical way he looked at the pros and cons of the national health systems in the U.K., Japan, Germany and Switzerland.  Even more impressive was learning how Taiwan went about reinventing their healthcare system by drawing on the best elements of programs around the world.

I certainly hope we can follow such a practical process to turn around the fragmented U.S. healthcare situation, which the Harvard-trained architect of the Taiwan program noted is not a system, but rather a market. Finally, I know that the politics of healthcare is a hot-button issue, and that many Americans are very wary about the role of government in healthcare (even though we are already a quasi-nationalized system via the Veterans Administration and Medicare/Medicaid). 

What I liked most about this investigation is its positive and constructive tone: what can we learn from the rest of the world, and how can we be smart about the evolution that most Americans hunger for?

We also collaborate and stay connected via instant messaging, Twitter, virtual worlds and shared social bookmarks. In fact, Jazz was able to share a post by VeeJay Burns in the MindBlizzard blog:

Virtual Healthcare 2: Palomar Pomerado Health

that she spotted via Google Reader, since she knows I'm interested in the role that virtual worlds could play in healthcare.

Congrats to Cisco and Millions of Us on their work. Maybe there's some collaboration opportunities with our own IBM Healthcare sim project?

]]> eHealth Trends Electronic Health Records Healthcare IT Innovation Virtual Worlds, Web 2.0 and eHealthcare Jack Mason 2008-03-04T13:11:25-05:00 http://healthnex.typepad.com/web_log/2008/03/google-health-v.html http://feeds.feedburner.com/~r/Healthnex/~3/243411663/scott-shreeve-m.html Dr. Shreeve's effort at defining Healthcare 2.0 is just about a year old, but it's a very worthy effort. I'm reblogging it here to advance the collective effort at building some consensus around the intersection of healthcare, social networking and Web innovations. There are excellent alternative sources for defining Health...

Dr. Shreeve's effort at defining Healthcare 2.0 is just about a year old, but it's a very worthy effort. I'm reblogging it here to advance the collective effort at building some consensus around the intersection of healthcare, social networking and Web innovations. There are excellent alternative sources for defining Health 2.0 on the Health2.0 blog Jack

"In that vein, I have attempted to capture, the quintessential characteristics of the emerging movement and body of companies that make up the Health 2.0 movement.

I have already developed the definition, described a few of the companies, and as promised, have now attempted to capture this definition in the following graphic:

The canonical representation of Health 2.0 Conceived by Scott Shreeve MD, illustrated by Hemeon Design, and Copyright © 2007 by Crossover Consulting. Distributed under the Creative Commons Attribution, Non-Commercial, Share Alike 2.5 License.Updated on 5/30/07.

"The graphic is self-explanatory, but the narrative is helpful to see how the pieces build on each other and work together to bring the concept of Health 2.0 into focus. Here goes:

1. Begin by defining Health 2.0    

2. Realize that Health 2.0 is all about Patient Empowered (not the misnomer "Consumer Directed") Healthcare whereby patients have the information they need to be able to make rational healthcare decisions (transparency of information) based on value (outcomes over price). In the Health 2.0 paradigm, everyone in the healthcare process is focused on increasing value for the patient.    

3. Realize that Health 2.0 is absolutely reliant on interoperability of health information. Everything from the Personal Health Record (PHR), to the Clinic Health Record (CHR), to the Enterprise Health Record (EHR), to the National Health Record (NHR) must be based on standards, be seamlessly transitioned between environments per standardized security and privacy protocols, and be accessible anytime from anywhere.    

4. Undergirding this foundation of information, the Four Cornerstones (Connectivity, Price, Quality, and Incentives) of the Value Driven Healthcare movement begin to create a virtuous cycle of innovation and reform. Transparency serves as a key catalyst in this process by creating positive sum competition that can deliver better outcomes at a lower cost.    

5. As more information becomes available as a result of increased transparency, there will be a wave of innovation at all points along the full cycle of care (see slide 8-12), which includes phases where health care service providers Educate, Prevent, Diagnose, Prepare, Intervene, Recover, Monitor, and Manage the various disease states. Measuring someone's HgA1c or Ejection Fraction does not tell you how effective their diabetic or cardiovascular treatments have been. You need to factor in the care provided over the full cycle of care to appropriately determine value.    

6. An increased amount of personal health and outcomes information will create an ongoing role for infomediaries and related services providers to add value at each stage of the full cycle of care. These value added Health Advisory Services (more later) will offered by hundreds of companies, in thousands of forms, to millions of people who are can benefit from the remixing of medically related information. It is easy to see how the new Web 2.0 framework, with its inherent social networking and collaboration tools, will make this "long tail" of medicine a "value"able venture.

These concepts are worthy of further discussion and debate, particularly since we are blazing new territory without any established rules, patterns, or procedures. Shooting my canonical representation of Heath 2.0 out into the ether is the proverbial "shot out of the canon" to stimulate the conversation."

Scott Shreeve, MD: The Canonical Health 2.0 Representation

Blogged with Flock

What they've built is an innovative 3D environment to help people experience how healthcare is being revolutionized by enabling health information to be deeply networked and easily exchanged.

To visit the island in Second Life, simply search on "IBM Healthcare." The island was also developed with an innovative HUD, or heads-up display, to help visitors navigate their experience.

Electronic healthcare is also about evolving toward a system more focused on patients, not technology. To that end the IBM Virtual Healthcare user experience begins with the patient in the home, where a visitor can create a facsimile of their Personal Health Record (FYI: More than 150,000 IBMers in the U.S already have access to an electronic version of their healthcare data.)

Visitors can then see how their personal, electronic health records can securely interact with the other major parts of a connected, interoperable ehealthcare system: doctors' offices, hospitals, pharmacies, laboratories, etc.

The island is debuting as part of the HIMSS 2008 conference, one of the world's largest healthcare events.

Here's a bit more on how the island will serve as an interactive simulation of eHealth:

Visitors can then walk, fly or use "transporters" to visit the various island stations:

--  The Patient's Home: In the secure environment of a private home,
    patient avatars can initiate a PHR and populate it with their personal
    health characteristics and clinical history, accessed and downloaded from
    physician EMR data.  They can also establish privacy and security
    preferences as well as health directives.  The ground floor demonstrates
    secure messaging with health systems and activates the initial PHR.  Using
    a transporter to move upstairs, patients use home health devices to take
    weight, blood pressure and blood sugar readings in the privacy of a
    bedroom, further incorporating this information into the PHR, which is
    shown on presentation screens.
--  The Laboratory: This stop offers laboratory and radiology suites to
    help avatars extend their understanding of the benefits of HIE.  Here,
    patients can check in at a Patient Kiosk and have blood work and radiology
    tests performed. The use of EHRs -- revealing only appropriate portions of
    the PHRs -- shows how consumers can also benefit through cost and time
    savings.
--  The Clinic: Patient avatars transport or walk from the Lab to the
    Clinic, where a welcome from their primary-care physician awaits.  A
    combination of scripting and information screens supports simulation of a
    patient exam, after which an electronic prescription is generated, and the
    continued development of the EHR is explained on nearby screens.

-- The Pharmacy: Here, avatars can check in at a Patient Kiosk that
    simulates the verifying of drug information.  They then receive their
    prescriptions and update their PHRs/EHRs with new medication data.  The HIE
    architecture demonstrates how use of PHR/EHR technology can prevent
    consumers from purchasing medications that are contra-indicated given the
    medicines they presently require, as well as alerting them about potential
    drug-to-drug interactions.  The PHR/EHR is again updated.
--  The Hospital: In this futuristic, three story structure, avatars
    arrive for a scheduled visit with a specialist.  Physicians' offices,
    patient rooms and exam rooms are all simulated here.
--  The Emergency Room: Avatars can chose to experience a virtual
    emergency by "touching" a specially scripted control.  This engages a
    medical episode and a ride on a fast gurney directly into the private and
    secure emergency treatment area, where a special screen is programmed to
    reveal the full incorporation of the PHR to ensure proper treatment.

   

This useful health tip comes to HealthNex courtesy of Amy Quinn at the Livesmarter blog.

But I did find the Expresso virtual cycling experience compelling, and offer it as an example of where 3D technologies may play a bigger role in healthcare by turning gym exercising from a chore into a game.

Gyms and healthclubs already have many kinds of displays, including plain-old-television, integrated into workout equipment to distract or entertain  people will they burn some calories and raise their heart rates.  What was refreshing about the Expresso experience was the way in which I didn't just feel distracted, but more immersed in the activity, like I was actually riding a bike through a beautiful park at sunset.

In fact "Bliss Park" was one of dozens of scenarios that I could choose to ride through. I could really see how this "exergaming" approach might lend itself to other scenarios, like turning a stairmaster into a mountain climbing adventure or an elliptical machine into a cross-country ski mini-vacation.

I'm sure that some people's reaction to the idea of virtual worlds workouts will be: why not just  go ride a bike in a park, climb a mountain or run in the real world? To that understandable reaction I've got two thoughts. First, I prefer to run on a treadmill than actual streets or parks.

The treadmill really compels me to keep moving, and allows me to count the calories and heart rate, while actual running requires me to convince myself to keep picking them up and putting them down. Of course, its also about the value of something like the rush of mountain climbing or skiing, without the travel, time and expense of the realdeal. (Though I'll stipulate that there's nothing better, in my view, than a great day of realworld skiiing.)

Second, there seems to be something about simulated reality that tickles our brains. Just look at the breadth and depth of electronic, multiplayer games.  In fact, there is something about the game-like, playful nature of electronic experiences that may be the real secret sauce here.

I grew up playing all kinds of sports--ice hockey, baseball, football, basketball, skiing, tennis, windsurfing, rock climbing-- and like most kids the impetus was the fun of the game itself, not the exercise or health benefit that I might derive. As an adult I've been faced with the reality that working out is a necessary evil...the work you need to do to stay healthy for one's family and one's economic well-being.

In the final analysis, I'm hungry for anything that can turn exercising back into a game. Back into fun. And I that score, I think Expresso's virtual cycling experience (which can also become a kind of competitive, online multiplayer experience as well) feels to me like the shape of much bigger things to come.

It's unfortunate, but we've probably all been affected by cancer, whether it's personal, close family or even sad news about a long lost friend.  We all know the urgency and understand the desire to find a cure, or at least a better treatment.  And we've all heard the mantra -- the sooner the better and we know that early diagnosis is key to success. 

There is  a lot of promising research but many times it is not in a stage to be funded.  That's why I think last week's announcement with IBM and researchers from The Cancer Institute of New Jersey (CINJ) and Rutgers University was so exciting and reallly showed the impact of IBM's innovation. 

We announced a collaborative research effort to further the development of diagnostic tools that will help pathologists more accurately classify cancer and develop personalized treatment options for patients.

This project was awarded a $2.5-million grant from the National Institutes of Health and received an equipment grant from IBM.  None of this could have happened without the critical proof of concept to assure that the new approach was valid and reliable and would provide results of great accuracy and detail than ever before.

All that was needed was some time on a supercomputer and luckily, we could mobilize the computational power of our "virtual supercomputer", World Community Grid.  Our "Help Defeat Cancer” (HDC) project, spearheaded by Dr. Foran at CINJ, harnessed the unused computational power from hundreds of thousands of PCs and laptops donated by individuals around the glove.  You can read more about it here in this Scientific American article.

It's a great proof point that World Community Grid is having a positive impact on research...and anyone with a computer and Internet access can help advance other research that may one day save lives!   Sign up easily by going to http://www.worldcommunitygrid.org and installing a small, secure and free program. 

PCs and laptops running Windows, Linux and Mac OS are all welcome.  And note to researchers, World Community Grid can provide the virtual supercomputing power you may need for free as well. Submit a proposal here.

What is Public Health Information Affinity Domain (PHIAD)?

 

PHIAD creates the first on-demand system in the public health industry by enabling the integration and sharing of data generated at clinical and public health institutions across proprietary systems and political boundaries.

 

The system is built upon international coding systems, as well as the coordination between open-source technologies and the 'Integrating the Healthcare Enterprise' (IHE) initiative in the use of standards to allow multi-national public health reporting and surveillance.

 

PHIAD supports hierarchical data flow across different domains. Each regional PHIAD collects data from local sources, such as doctors and veterinarians. The regional PHIAD then forwards appropriate information to a national PHIAD, which is administered by a disease control organization such as the Centers for Disease Control (CDC). PHIAD can extend this hierarchy of data sharing to international partnerships. At each level, different data-sharing policies concerning person identification, location identification, authorship, and results can be implemented.

What if algorithms from the high-resolution gaming industry and analytics from oil exploration were applied to the field of medical imaging? Using supercomputers to integrate data from multiple sources and display it in a 3D representation could help doctors improve the accuracy of diagnoses, while reducing costs to make these advancements available to more patients.  Tune in to a conversation with Dr. Brad Erickson, director of radiology informatics lab at the Mayo Clinic and Bill Rapp, IBM healthcare and life sciences CTO.

Dr. Brad Erickson director of radiology informatics lab, Mayo Clinic

Bill Rapp IBM CTO, healthcare

Listen to the podcast hosted by Lorie Luedke:

Download FutureOfMedicalImaging.mp3 

And watch this video on the new Medical Imaging Research Center that Mayo Clinic and IBM are launching.

For more information on the new field of medical imaging informatics, check out this site for a white paper, photos, etc.

So I hope I'm not wildly late in pointing folks to the very timely and important new initiative by Matthew Holt and Indu Subaiya, the Health 2.0 blog, Facebook group and wiki.

Here's an excerpt from the launch post in November, 2007:

"Welcome to The Health2.0 Blog

Since the Health 2.0 conference in September, the blogosphere has exploded with hundreds of blog posts from people all over the country and world. Among the myriad thought-provoking pieces on Health 2.0 have been contributions by Esther Dyson at the Huffington Post, David Kibbe,  Brian Klepper and Jane Sarasohn Kahn defining Health2.0, Amy Tenderich on DiabetesMine, Scott Shreeve on healthcare FICO scores, and many, many more. There’s been posts in lots of countries and several languages. Plus the opening video has been reposted and commented on in several places (usually with great compliments, but not always!)

Given the bits and pieces of interesting conversation on the Facebook group, the Health2.0 wiki, THCB and more, we decided to create a forum for our diverse and emerging community to convene and deepen the conversation. So with great fanfare…."