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Google Builds a New Tablet for the Fight Against Ebola

Google Builds a New Tablet for the Fight Against Ebola | Healthcare and Technology news | Scoop.it

Jay Achar was treating Ebola patients at a makeshift hospital in Sierra Leone, and he needed more time.

This was in September, near the height of the West African Ebola epidemic. Achar was part of a team that traveled to Sierra Leone under the aegis of a European organization called Médecins Sans Frontières, or Doctors Without Borders. In a city called Magburaka, MSF had erected a treatment center that kept patients carefully quarantined, and inside the facility’s high-risk zone, doctors like Achar wore the usual polythene “moon suits,” gloves, face masks, and goggles to protect themselves from infection.

With temperatures rising to about 90 degrees Fahrenheit, Achar could stay inside for only about an hour at a time. “The suit doesn’t let your skin breathe. It can’t,” he says. “You get very, very hot.” And even while inside, so much of his time was spent not treating the patients, but merely recording their medical information—a tedious but necessary part of containing an epidemic that has now claimed an estimated 10,000 lives. Due to the risk of contamination, he would take notes on paper, walk the paper to the edge of the enclosure, shout the information to someone on the other side of a fence, and later destroy the paper. “The paper can’t come out of the high-risk zone,” he says.

Looking for a better way, he phoned Ivan Gayton, a colleague at the MSF home office in London. Gayton calls himself a logistician. He helps the organization get stuff done. In 2010, he tracked down someone at Google who could help him use its Google Earth service to map the locations of patients during a cholera epidemic in Haiti. As part of its charitable arm, Google.org, the tech giant runs a “crisis response team” that does stuff like this. So, after talking to Achar, Gayton phoned Google again, and the company responded with a new piece of tech: a computer tablet that could replace those paper notes and all that shouting over the fence.

The Tablet You Dunk in Chlorine

Over the next few months, drawing on employees from across the company, Google helped build a specialized Android tablet where Achar and other doctors could record medical info from inside the high-risk zone and then send it wirelessly to servers on the outside. Here in everyday America, a wireless tablet may seem like basic technology. But in the middle of an Ebola epidemic in West Africa, which offers limited internet and other tech infrastructure, it’s not.



The tablet is encased in polycarbonate, so that it can be dipped in chlorine and removed from the facility, and the server runs on battery power. “There was a real need for this,” says Dr. Eric D. Perakslis, part of the department of biomedical informatics at the Harvard Medical School, who has closely followed the project. “It’s very impressive, and it’s unique.”

The system is now used by Achar and other doctors in West Africa, where patients are still being treated. During the testing phase, the server ran off a motorcycle battery, but now it includes its own lithium ion batteries, much like those in your cell phone, which can charge via a portable generator. Then, inside the high-risk zone, Achar can not only wirelessly send data over the fence, but also readily access information he didn’t have before, including a patient’s latest blood test results. Plus, after dipping the thing in chlorine for ten minutes, he can take it outside the zone and continue working with it after removing his moon suit.

Yes, the Ebola epidemic appears to be wane. But the system provides a blueprint for future. After catching wind of the project, Perakslis says, he’s working to help MSF “open source” the technology, freely sharing the software code and hardware designs with the world at large. The hope is that system could also be used to battle others epidemics, including cholera outbreaks, and perhaps help with medical research, including clinical trials for drug-resistant tuberculosis. “You can think of other highly toxic environments, even laboratory environments, where this could really be helpful,” Perakslis says.

Fighting Disease Like a Tech Company

But it could also provide a path to all sorts of other new technologies for fighting disease and illness in developing countries. If tech is open source, you see, you can not only use it for free, but modify it. This is actually what MSF and Google themselves did in creating their system for the Ebola wards. In fashioning the software that runs on the tablet and server, they built atop an existing open source medical records tool called OpenMRS. One technology is just a starting point for another.

What’s more, says Ivan Gayton, the project offers a lesson in how organizations like MSF should operate. In the past, they operated according to carefully organized hierarchies of employees. And they were forced to use what came down from the big software and hardware sellers. But the tablet project was an almost ad-hoc collaboration. Achar phoned Gayton. Gayton phoned Google. Soon, Google sent about a dozen employees to London, including Google Drive project manager Ganesh Shankar, who was living in Australia. Later, Gayton says, MSF roped in several other volunteer techies from outside the organization, including a 19-year-old gaming entrepreneur.

Finally, various parts of the team, spanning multiple organizations, flew down to Sierra Leone to test and deploy the system in the real world. Organizations like MSF don’t typically work in this way, Gayton explains. And they should.

“We’ve learned new ways of doing things,” he says. “In the past, we used the Roman-legion, hierarchical, triangle structure. But Google and the tech volunteers we work with organize in different ways—ways more like what you see with open source projects like Linux, with more or less one manager and then a bunch of equal peers. That can have profound implications for the humanitarian field.”


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Eduardo Vaz's curator insight, March 25, 2015 10:33 AM

#Google created a new #Tablet, but you won't be seeing it on store shelves. #ygk

Jared Stewart's curator insight, March 27, 2015 3:12 AM

A application of modern Tablet technology to help the fight against the Ebola Virus. It also shows the possibilities of this technology being used in future epidemics.

Louisa ROQUE's curator insight, April 23, 2015 5:59 AM

When technology is useful.

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An Overlooked Provision of H.R. 4302

An Overlooked Provision of H.R. 4302 | Healthcare and Technology news | Scoop.it

While everyone is talking about Sec. 212 of the Protecting Access to Medicare Act of 2014 (H.R. 4302), which would delay the compliance date of ICD-10 for another year, there is another significant provision in the bill for informatics observers.

Sec. 218 of the temporary Sustainable Growth Rate (SGR) "doc fix" bill, which was passed in the House and Senate and is awaiting Presidential approval, would provide quality incentives for computed tomography diagnostic imaging and promoting evidence-based care. Part of this provision requires the Secretary of the Department of Health and Human Services (HHS) to define clinical decision support mechanisms, determined by various industry stakeholders, that will be used by providers prescribing advanced imaging procedures for Medicare patients.

In a nutshell, says Cindy Moran, a Reston, Va.-based American College of Radiology (ACR) executive vice president of government relations, it mandates ordering physicians to use clinical decision support tools to justify the prescription of those advanced imaging procedures. The provision requires those clinical decision support mechanisms to be used in certified electronic health record (EHR) technology.  Only when the provider informs which clinical decision support mechanism was used to prescribe that study can they receive payment for those services under Medicare.

This evidence-based guideline is a “very important concept,” to Moran and the ACR folks. So much so, they asked for its inclusion in the bill working with various Congressmen and other stakeholders, she says.

They also asked for two other provisions, related to imaging.  One provision forces the Centers for Medicare and Medicaid Services (CMS) to produce data to justify a 25 percent multiple procedure payment reduction on certain imaging procedures provided to the same patient, on the same day, in the same session. The other put a ceiling on the reduction of certain codes.

ACR was one of the few groups to outright support the passage of the SGR “doc fix” bill. It applauded the delay of the ICD-10 mandate as well. Moran said that while the organization didn’t specifically request the delay, she said it will be helpful to the average physician practice, which is overwhelmed by the transition.

Overall, ACR is looking for a permanent fix to the SGR, Moran says. However unlike other advocacy groups, it is pleased with the passage of H.R. 4302.

The ACR wasn’t the only one to applaud those imaging provisions.  The Access to Medical Imaging Coalition (AMIC), which is a nonprofit group that consists of various imaging industry stakeholders, was equally as happy with the bill. In statement, the group said the appropriateness policy is encouraging.

"The best way to support physicians in ordering the right diagnostic imaging scan at the right time is for Medicare to encourage physicians and patients to make treatment decisions that best suit individualized needs and circumstances,” Tim Trysla, executive director of AMIC, said in a release.


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