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Digitally managed clinical trials will accelerate results and reduce costs 

Digitally managed clinical trials will accelerate results and reduce costs  | Healthcare and Technology news | Scoop.it

Digitally managed clinical trials have the potential to accelerate results report and reduce costs but workflow questions and regulatory questions remain. In many facets of our lives, digital data collection has improved services, eliminated errors, and reduced waste in time and resources. Think about the ticketing and check-in process at airports ten years ago vs. today: when airlines put the information in our hands we were able to do the check-in, seat selection, and other work for them. Plus, we were happy to do it. Also consider ATMs, online banking, and retail banking for how we are able to move money, get cash, and get loans by providing data ourselves and get immediate services. When we think about the medical industry, though, very little of the kind of automation created by self-service digital data collection exists. While we can see some patient portals and self-service triage apps appearing in limited uses, large-scale use seems very far away. One specific area that digital data collection can, potentially, literally save lives is in clinical research. The use of digital collection tools, primarily mobile devices, in clinical studies, is nascent but growing. Evidence indicates that these tools have the potential to significantly improve the quality of research outcomes and reduce the costs associated with such research, but there are still questions about how exactly these tools will work and some of the issues surrounding electronic data collection. To help answer some common questions, I spoke with James Emerson, who is a director of clinical research and helps run a variety of clinical trials.

How are mobile devices being used for digital data collection in clinical research?

For several years now, IT in the enterprise has been moving toward consumerization; that is, people are bringing their own devices to work and many of the same applications are used outside of the office. Clinical researchers have realized that same consumerization of IT that is revolutionizing the way that we work can do the same for research. Trial participants using clinical trial research technology are able to use their own smartphones, tablets, and other mobile devices, which makes it much more likely they will comply with the requirements of the study.

Essentially, depending on the setup of the study, patients simply need to input information into an application, eliminating the need for paper journals or surveys.

 

While research indicates that most patients actually prefer this technology over other forms of data collection, in particular, voice response systems, there are still some challenges. One thing that researchers need to overcome are the differences among devices themselves, and how applications actually function on different devices.  Training trial participants — and providers — in the use of the application is an important task. Connectivity issues are also a concern, as is privacy. Protecting sensitive personal information is of paramount importance, and researchers are cognizant of the need for data protection protocols and security, both in terms of protecting the devices themselves and in the transfer of data.

Why are digitally managed clinical trials ideal for clinical research?

Digital data collection has many significant benefits. For starters, it reduces costs. Major clinical studies often have thousands of participants, all of whom need to be trained in how to record data and submit it to their providers. That data also needs to be collected and analyzed, often manually. Digital data collection reduces or eliminates the need for many of those expensive tasks. When clinical trial participants are allowed to use devices that they already own and are familiar with, the complexity of the training and on-boarding decreases and compliance increases.

 

The simplified data collection process also has a significant impact on the overall quality of the study. Again, compliance is a major benefit. Studies have shown that patients vastly prefer mobile data collection over other options like paper journals or interactive voice response systems. It’s simply much easier to input your data into your mobile device and move on with your day than it is to navigate a complex menu of voice response options or fill out a paper questionnaire.

 

The accuracy of the data collected also improves; when patients use paper journals, for instance, they have a tendency to add additional extraneous information or skip questions, which can affect how the data is analyzed. Not to mention, when the researchers have access to real-time data, they can identify compliance issues earlier on and monitor patient safety more efficiently, improving the overall outcome of the trial.

 

While digital data collection can improve the accuracy of the data collected, there are some obstacles to overcome. Digital data collection protocols require that researchers consider facets of study design that they might not have otherwise. For example, what happens if a device is lost or stolen? How can we protect that data and the integrity of the study? We need to use a technology infrastructure that complies with regulatory protocols, but that is also easy for subjects to use.

 

Many researchers are also concerned about equivalence among the devices being used. In other words, are all of the subjects having the same experience when using the application, and how do differences affect outcomes? These are all questions that researchers are considering in their study design.

Can digitally be managed clinical trials really save that much money?

The short answer is yes. In 2014, the Department of Health and Human Services released a report estimating that using mobile technologies in clinical trials has the potential to save clinical research organizations (CROs) tens of millions of dollars. The greatest savings come in the later stages of trials, but even in the early stages, mobile saves money.

Are there regulatory issues related to the use of digital collection tools that CROs face?

The FDA is actually encouraging CROs to do as much electronically as possible. That being said, yes, there are some stringent regulations that CROs must adhere to that ensure the accuracy and protection of the data. The FDA has issued guidance on how CROs can capture and use data to maintain those protections.

Are there times when digital data collection isn’t ideal? What about barriers to participation?

While it might seem like everyone on the planet has a smartphone these days, the fact is that there are some people who either do not have access to the technology necessary to participate in a research study via a mobile device or have the skills to do so correctly. It’s important to carefully assess the target population of the study to determine whether digital data collection is appropriate or if more traditional methods would be a better choice.

 

For example, many older adults either do not have or do not use smartphones and aren’t interested in learning how to use the application to participate in the research. For someone who isn’t a digital native, using an application to record data could be intimidating or confusing.

 

Another issue is a lack of access to the internet or cellular service. In many rural areas of the country, access to broadband is still limited, and cell service is limited or nonexistent. Relying solely on digital data collection via smartphone has the potential to exclude viable candidates from research studies, simply because they cannot provide data efficiently. We need to be very careful in how we design studies, and the technological requirements, or risk inadvertently creating disparities within the study population based on economic or geographic situations.

 

And of course, not all studies lend themselves to self-reporting — and as with any self-reported data, there will always be a margin of error. Researchers need to carefully consider their reasons for choosing digital data collection, and evaluate whether they are ideal for an individual study.

Are digitally managed clinical trials really the future of clinical research?

Yes, we believe so. The fact is, the old ways of doing things are no longer infallible. Using digital tools has the potential to solve many of the long-standing problems within clinical research, including low study recruitment numbers, gender bias, accuracy, compliance, and more. By incorporating digital tools, new, more effective treatments can get to market faster while keeping patients safe and improving their overall health.

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Are Wearables Dangerous for Health?

Are Wearables Dangerous for Health? | Healthcare and Technology news | Scoop.it

It’s been repeatedly stressed by healthcare practitioners how beyond a balanced diet and exercise, getting sufficient sleep is vital to our health and wellbeing.

 

There are wearables that can already track our daily activities such as heart rate when we exercise and even the number of steps we have walked that day and the distance. In addition to that, some wearables can monitor your sleep patterns.

 

But how accurate are they and are they good for you?

 

Sleep specialists at Rush University Lab in Chicago reported an increase in patients who were complaining about sleep disorders. However, it was observed that those who wore wearables that tracked their sleep started to develop an obsession over getting enough sleep.

 

As most people are aware, eight hours is what is commonly referred to as the “right amount of sleep.” And because of this, people who tracked that they were getting less than that started to develop anxiety over not getting enough sleep, and the strain resulted in disrupted sleep.

 

Furthermore, sleep trackers cannot differentiate between light and day and could be tracking the wearer as asleep when they are in fact just resting. Ultimately, it has been observed that sleep trackers aren’t always accurate.

 

Remember that sleep trackers like other activity trackers are wearable digital devices that measure, amongst other things, your arm movement with a detector called an accelerometer. So it is entirely possible that the sleep tracker is indicating you are asleep when you are in fact, not.

 

If you are struggling with a sleeping disorder such as insomnia, a sleep tracker will only tell you how much sleep you didn’t get and is not sensitive or sophisticated enough to diagnose the problem. Ultimately, it may keep people from seeking the medical attention they need to fully diagnose if they have a sleeping disorder that may be detrimental to their overall health.

 

Furthermore, those who are tracking that they are getting a full eight hours of sleep may be misled that they have no sleep disorder, when in fact, they do. Their tracker may indicate they slept for eight hours, but it will not always accurately track if they were restless or had brief moments of awakening.

 

The bottom line is that too many people may be relying too much on the numbers that their wearables are recording and not on the actual quality of their sleep. Are they waking up refreshed and feeling restored? Are they energised or did they wake up more tired than before they slept because their sleep was restless and disruptive?

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The digital hospital: Streamlining workflow to improve care

The digital hospital: Streamlining workflow to improve care | Healthcare and Technology news | Scoop.it

Hospitals are complex ecosystems with hundreds of clinical and business processes. In this guest post, Brendan Ziolo, head of large enterprise strategy at an IP networking, ultra-broadband access and cloud technology company, gives hospital executives a glimpse at how digitization and automation of processes are key to streamlining workflows to enable providers to spend less time on non-care related tasks and more time on patients.

 

Patient care teams handle multiple patients and care management tasks. The result is a multifaceted web of workflows that can be prone to decision bottlenecks or missed/delayed tasks that can impact patient safety and care quality.

If properly integrated and automated, these processes have the potential to seamlessly unite patients, doctors, staff, assets and information throughout the hospital.

Digital strategy

But, it’s not just about adopting new technology; hospitals must have a clear digital strategy across their entire organization and IT infrastructure. To become a digital hospital, processes must be streamlined and reengineered to create paperless automated digital workflows.

Many functions within hospitals are already on their way to becoming digital. For example, electronic health records (EHRs) are being widely implemented to help track patient health data and support medical decisions. Digital medical imaging systems are quickening the process of reviewing medical images by physicians and other healthcare professionals.

Hospitals are extending workflow through mobile health (mHealth) initiatives, which enable physicians and patients to use mobile devices such as smartphones and tablets to record and find the right information and resources anytime from any location. In fact, according to the 2014 HIMSS Analytics Mobile Devices Study, more than half of U.S. hospitals are using smartphones and/or tablets and 69% of clinicians are using both a desktop/laptop and a smartphone/tablet to access information.

In addition, hospitals are eliminating distance barriers with telemedicine through the use of network and communication technologies to provide broader access to standard or specialized care, regardless of location. Other functions and processes that are being digitized and automated include delivery robots that can handle a number of fetch-and-deliver tasks, and real-time location systems (RTLS) are used to locate equipment, patients and staff.

Duplication of processes

Progress is being made, yet most digital information and processes in hospitals reside in disparate systems or devices that must be interconnected and integrated to truly improve workflow and quality care. Duplication of information and processes must be avoided to eliminate unintended consequences.

Often you can find staff doing double data entry or pulling information from different systems, and jumping through hoops to pull together the knowledge required for the best patient care. There are many tasks throughout the hospital that staff spend time on every day just to get their jobs done. The goal in a digital hospital is to automate as many of these tasks as possible to improve staff efficiency, information accuracy and overall cost savings.

By standardizing procedures and breaking down processes into their component parts, digitizing, connecting and analyzing them, hospitals can realize unprecedented efficiency. Once processes are well understood, technology solutions can be leveraged to streamline these processes and integrate disparate elements. Essential to this integration is the information and communications technology (ICT) infrastructure that interconnects all aspects of care delivery and hospital administration.

The big picture

The use of mobile, cloud and new communication technologies can create a platform that can capture data from disparate sources, such as EHRs, wearables, clinical information systems, mobile devices and more.

Pull it all together and a caregiver is given a holistic and real-time view of a patient’s health on any device that is accessible to the patient, or other specialists as needed, for the best ongoing care.

This is just one view of how a digital workflow could look and the impact it might have on both the patient and provider. But it’s clear that the only way healthcare providers can meet the growing expectations of the healthcare consumer is with a streamlined, digital workflow that not only improves care but still meets critical compliance and security regulations.

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Barbara Lond's curator insight, December 22, 2017 3:42 PM
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Technology benefits the elderly, but can it help those with dementia?

Technology benefits the elderly, but can it help those with dementia? | Healthcare and Technology news | Scoop.it

The buzz is building about technology’s ability to enrich the lives of the elderly, effectively turning back the clock and opening up new possibilities. The statistics back it up, with 67 percent of adults over 65 accessing the news on mobile devices and 77 percent of adults over 65 owning a mobile phone. Anecdotally, I hear it all the time: So many people talk about how their parents or grandparents initially resisted the adoption of technology, but after learning to use iPads and other devices, their lives are transformed.

Still, amidst all of the valid excitement over technology’s positive effects on the aging population, huge gaps and opportunities remain in the space. Much of the technology is dedicated toward the concept of “aging in place,” with the goal of keeping older adults as independent and healthy for as long as possible. These products are aimed at keeping people connected and brain-fit, as well as enhancing wellness and longevity. These are all valid endeavors, and it’s fascinating as every year goes by to see what’s on the horizon.

 

However, in the wake of that well-justified enthusiasm, folks dealing with cognitive decline, and in particular dementia, can be left out of the equation. Arguably, those experiencing cognitive decline have the most to gain from adopting technology of any group. And the good news is that finding ways to help this group through technology isn’t very complicated.

 

The right technology for the right person

It’s important to realize that the dramatic impact we have seen with technology and dementia over the years has not usually come from new and groundbreaking technologies. Instead, it typically comes from repurposing tools already at our fingertips. Many of us have become blasé about new technologies. While our lives are changed through these tools, it happens incrementally, so the novelty and astonishment can wear off. Not so for those living with dementia. Do you know what it’s like for a 93-year-old with mid-stage dementia to see the house she grew up in via Google Earth? Or a grandmother in Iowa watching her granddaughter get married in France via Skype? Or how about a Korean War pilot reliving the experience of flying simply by navigating a joystick with off-the-shelf flight simulation software? The Jetsons weren’t so far off! We have these tools and many more at our disposal every day; it’s just a matter of integrating them into the dementia landscape. Of course, we must account for the cognitive and physical realities of each individual person, but that reality does not change the human desire we all feel to stay connected and to stay relevant.

 

Fortunately, we’ve had hundreds of providers over the years help us with thousands of ideas as to how to change the paradigm and make technology more accessible to the aging. What these valued partners have taught me is that what matters is not technology for its own sake, but searching to find the right technology that is most relevant to that one person. To the geography teacher, it’s putting together a puzzle of the United States; to the priest, it’s hearing the rosary, to the farmer, it’s being immersed in multimedia videos of farming, and to me, it’s hearing my daughter, Perrin, sing! We all have our own quirks and interests, and the communities that do it right are the ones that proactively look for technology solutions that match the needs of each person. It’s a fun, rewarding puzzle to put together.

 

Our journey into technology for the aging population is just beginning. Thanks to the promise of virtual reality, augmented reality, voice activation, holograms and more, the future is bright, and full of endless possibilities. So, if you are part of an organization that works with older adults, keep looking for technology that will keep the folks you serve as healthy and independent as long as possible. It’s without question a noble endeavor. But I guarantee you will be blown away by the outcomes if you also look for ways to benefit the folks that seem like they are the hardest to reach. The smiles you get back will make it worth the effort!

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5 Amazing Healthcare Technology Innovation

5 Amazing Healthcare Technology Innovation | Healthcare and Technology news | Scoop.it

1.   Interoperability between Health Systems

Interoperability solutions for exchanging patient information across care settings is one particular technological development that will shape the future of healthcare organisations.

 

Value-based care and health information exchanges are an increasingly important part of the overall healthcare landscape, and the ability for all providers – from general practitioners and specialists to post-acute care organisations, etc. – will only grow as a critical component of care delivery in the future.

These types of solutions have only started being developed in the past few years by companies such as referral-MD, that are changing how healthcare companies communicate by including post-acute care providers in critical interoperability workflows, as these providers are expected to be a big part of health care cost containment.

 

By including post-acute care in interoperability strategies, healthcare organisations can ensure that critical patient information across all care settings will be connected, providing a more detailed patient picture for more specific treatment plans and improved patient care.

The statistics are damning, hospitals lose $75+ million per year per 100 affiliated physicians due to referral leakage, a burden that can be reduced by proper referral network management that companies such as referral-MD can help monitor.  Hospitals are just starting to get make changes in their budgets to include programs that can truly help patients receive better care, and save their staff’s time in the process.

Not only are hospitals affected but so are small-to-mid sized practices, with many having to juggle 100's of speciality offices with different workflow requirements, without an electronic way to exchange information, the process breaks down, information is not accurate, and time is wasted.

2. Robotic Nurse Assistant

I have many of friends that are nurses that are injured every year from having to move or lift patients in bed or after an emergency from a fall.  The problem is very common and many of times there is not someone around that is strong enough to lift a patient immediately after one of these occurrences.

There are many variations from a full robot such as RIBA (Robot for Interactive Body Assistance) developed by RIKEN and Tokai Rubber Industries and assisted hardware such as HAL (Hybrid Assistive Limb) robot suits delivered by Cyberdyne.

 

 

RIBA is the first robot that can lift up or set down a real human from or to a bed or wheelchair. RIBA does this using its very strong human-like arms and by novel tactile guidance methods using high-accuracy tactile sensors. RIBA was developed by integrating RIKEN's control, sensor, and information processing and TRI's material and structural design technologies.

A company by the name of HAL is a robotics device that allows a care worker to life a patient with more stability and strength and helps prevent injuries to our nurses.

 

 

3. Artificial Retinas

The United States typically defines someone as legally blind when the person’s central vision has degraded to 20/200, or the person has lost peripheral vision so that he sees less than 20 degrees outside of central vision. Normal vision is 20/20, and people can usually see up to 90 degrees with their peripheral vision. An estimated 1.1 million people in the United States are considered legally blind.

This has led to companies like Nano-Retina to develop a sophisticated and elegant solution intended to restore the sight of people who lost their vision due to retinal degenerative diseases. The miniature Nano Retina device, the NR600 Implant, replaces the functionality of the damaged photo-receptor cells and creates the electrical stimulation required to activate the remaining healthy retinal cells. NR600 consists of two components; a miniature implantable chip and a set of eyeglasses worn by the patient.

 

 

Very interesting technology for those that are always sitting in front of the computer like myself, hopefully it will not be needed by me, but it's great that companies are advancing for those that suffer this debilitating illness.

4. Tooth Regeneration

Hey Kids, here is some candy!  All kidding aside, this could be an amazing advancement if the technology holds true in the coming years.

Colourful fish found in Africa may hold the secret to growing lost teeth. In a collaborative study between the Georgia Institute of Technology and King’s College London, researchers looked at the cichlid fishes of Lake Malawi in Africa, who lose teeth just to have a new one slide into place. Their study, published in the Proceedings of the National Academy of Sciences, identifies the genes responsible for growing new teeth and may lead to the secret to "tooth regeneration" in humans.

"The exciting aspect of this research for understanding human tooth development and regeneration is being able to identify genes and genetic pathways that naturally direct continuous tooth and taste bud development in fish, and study these in mammals," said the study’s co-author Paul Sharpe, a research professor from King's College, in apress release. "The more we understand the basic biology of natural processes, the more we can utilise this for developing the next generation of clinical therapeutics: in this case how to generate biological replacement teeth."

Another study from a Harvard team successfully used low-powered lasers to activate stem cells and stimulate the growth of teeth in rats and human dental tissue in a lab. The results were published today in the journal Science Transnational Medicine.  Stem cells are no ordinary cells. They have the extraordinary ability to multiply and transform into many different types of cells in the body. They repair tissues by dividing continually either as a new stem cell or as a cell with a more specialised job, such as a red blood cell, a skin cell, or a muscle cell.

alt="tooth regrowth">Dentures and dental implants may soon become a thing of the past. Stem cell research is making it possible to regrow your missing teeth! This is a much-needed medical advancement, especially considering that by age 74—26% of adults have lost all of their permanent teeth.

 

5. Light-bulbs that Disinfect and Kill Bacteria

Hospitals are known to be potentially dangerous place with lot's of people with different elements and diseases.  One company, Indigo-Clean has developed a technology using visible light that continuously disinfect the environment and bolsters your current infection prevention efforts.

How it works

  1. The 405 nm emitted from Indigo-Clean reflects off of walls and surfaces, penetrating harmful micro-organisms
  2. The light targets naturally occurring molecules called porphyrins that exist inside bacteria. The light is absorbed and the excited molecules produce Reactive Oxygen Species (ROS) inside the cell
  3. 405 nm creates a chemical reaction inside the cell, similar to the effects of bleach
  4. The Reactive Oxygen Species inactivates the bacteria, preventing it from re-populating the space

 

 

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VC Funding in Health IT Dips

VC Funding in Health IT Dips | Healthcare and Technology news | Scoop.it

For the first time in a long time, venture capital funding in healthcare IT suffered a drop off, Mercom Capital Group, an Austin Texas-based research firm, reported.


The research firm reported that the total venture capital funding in the first quarter of 2015 was $784 million in 142 deals compared to $1.2 billion in 134 deals in Q4 2014 and $858 million in 163 deals in Q1 2014. While the end of the year to beginning of a new year drop off isn’t totally unexpected or unprecedented, the year-over-year decrease is the first time since the decade began venture capital funding in health IT has seemed to taper off. Since 2010, Mercom reports that the health IT sector has raised more than $10 billion.


Healthcare practice-centric companies raised $347 million in 44 deals in Q1 2015 compared to $568 million in 43 deals in Q4 2014. Consumer-centric companies raised $437 million in 98 deals this quarter compared to $643 million in 91 deals in Q4 2014. There was one exception to the drop off.


“Funding fell across the board with the exception of mobile health (mHealth), which was the bright spot this quarter. There was also significant M&A activity in the first quarter for mHealth companies. We have already seen 10 M&A transactions in Q1 compared to 21 in all of last year, which bodes well for exits in mobile health,” Raj Prabhu, CEO and Co-Founder of Mercom Capital Group, said in a statement.

Health Catalyst, a Salt Lake City-based analytics firm and former Healthcare Informatics up and comer, garnered the largest VC deal of 2015 thus far with a $50 million investment. A data analytics company, Invalon, went public and raised $600 million.


While VC funding was down, mergers and acquisitions were up. There were 56 deals in Q1, compared to 52 of Q4 of last year and 53 last year at this time. The largest was MyFitnessPal, a mobile health app, being bought by UnderArmour.


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Venture capital funding for health IT doubles in 2014

Venture capital funding for health IT doubles in 2014 | Healthcare and Technology news | Scoop.it

A report from Mercom Capital Group LLC found that venture capital funding for health care information technology sector more than doubled in 2014.

VC funding came in at $4.7 billion in 670 deals, compared with $2.2 billion and 571 deals in 2013.

"In the five years since we started tracking funding data, the sector has raised $8.8 billion in VC funding and anther $3.6 billion in public market and debt financings, bringing the total to $12.4 billion — largely driven by the HITECH and Affordable Care Act," Mercom CEO and co-founder Raj Prabhu said in a statement. "However, the enthusiasm in the sector shown by the VC community was not quite matched by the public markets when you look at market performance of companies that went the IPO route in 2014."

There were six initial public offerings that raised a total of $1.8 billion.

Mobile health companies received the largest share of VC funding, bringing in $2.3 billion in 436 deals. Of that, $526 million went to wearables and another $507 million went to mobile health apps.

But mobile health apps saw the most growth with a 341 percent year-over-year increase.

Mercom is a global communications and consulting firm based in Austin, Tex.


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Empowering Patients through Decentralized Information Governance 

Empowering Patients through Decentralized Information Governance  | Healthcare and Technology news | Scoop.it

Health care will be transformed if we empower patients and physicians through access to information. Don Rucker is right to focus attention on APIs to enable the transformation. A year and a half into the new administration and the massively bipartisan 21st Century Cures Act, the Department of Health and Human Services (HHS) is having to navigate between the shoals of highly unpopular Meaningful Use regulations and the apparent need for regulation to undo the damage of market consolidation that they caused. From my perspective, it looks like HHS is doing a good job.

Prediction is a dangerous game but it’s necessary for investments that depend on health information technology. Nowadays, pretty much everything in healthcare depends on information technology, particularly if we need effective quality measures to enable transition to value-based healthcare.

Based on Verma’s most recent remarks, it’s safe to predict that HHS will use the power of the $900 Billion purse as a way of avoiding regulation as it tries to break down the oligopoly of the consolidated “integrated delivery networks” and their even more consolidated EHR vendors. What’s more interesting is to anticipate how Rucker’s recent remarks about Persistent Access will be translated into decision support information for patients and physicians that will actually drive the practice innovation Verma is talking about.

 

Today, the information available to physicians and patients at the point of care is centrally governed by hospitals and by EHR vendors. A service seeking to present a piece of information such as therapeutic alternatives, quality ratings, out-of-pocket expenses, and research or clinical trials opportunities, must run a gauntlet of censorship by both the hospital and the EHR vendor. A thoughtful paper on how preemptive genomic testing has significant impact on subsequent treatment decisions shows the evolving connection between medical science and information governance.

The barriers to providing independent decision support when it matters most, during the physician-patient encounter, are immense. Let’s list some of them.

An independent information service

  • Must be “certified” by the hospital even if a particular physician wants to get it
  • Must be “certified” by the EHR vendor before it’s even accessible to the hospital certifiers
  • Involves up-front certification costs that are incompatible with open source or other non-profit information sources
  • Can’t access the complete patient’s record in the EHR
  • Requires the physician to sign-in to a separate system with a separate password
  • Is not covered by insurance, or, if covered, is subject to pre-certification delays that the physician won’t put up with
  • Is unaffordable because each EHR and each hospital presents a different integration challengecan’t get investors because the EHR vendors will demand unspecified rent on access to the physician-patie t relationship or, in many cases, actually demand access to the intellectual property itself.

The task ahead for HHS is formidable. Regulation that drives patient empowerment at the point of care (when the physician is about to sign that order that drives $3.5 Trillion of healthcare costs) is inconceivable under the US healthcare system and out of reach for even the nationalized health systems in other rich countries. The proprietary EHR vendor business model means EHRs must control the “app store” as the driver of future growth. Separately, the Accountable Care Organization business model for hospitals drives them to control their physicians and restrict access to “out-of-network” providers regardless of what’s best for a particular patient.

But there is hope, particularly if CMS, ONC, and maybe even the VA orchestrate their actions. The hope lies in the upcoming definition of “information blocking” as mandated by 21stC Cures.

HHS can and should define information blocking in terms of independent decision support at the point of care.

Access to independent decision support at the point of care is an outcome rather than a process. It’s easy to tell if it’s blocked without resort to heavy-handed regulation of the API technology. No new legislation is required because HIPAA, HITECH, and 21stC Cures already enable patient-directed information sharing via API at no significant cost. Patient-directed APIs are also directly accessible to the physician, subject to patient consent.

Technically, what’s required is that *every* API of an EHR be supported as a patient-directed API. That’s not much to ask since the EHR vendors are already building the APIs to use in the app stores they need to stay competitive. What’s also required is what Rucker calls Persistent Access which is what FHIR calls Refresh Tokens and is already widely implemented in the Apple Health APIs. Finally, what’s needed is the ability for a patient to direct information anywhere we choose, without censorship or delay, via the API. (Note that patient-directed exchange is different from patient access rights that require information to flow through personal health records. PHRs have largely failed in the marketplace.) Under HIPAA, patients have this right to patient-directed use for in-person requests to send patient records using paper forms, but this right to uncensored patient-directed exchange needs to be made accessible via the patient portal and linked to the FHIR API. The technical term for this is Dynamic Client Registration and it’s a unimplemented security capability of the FHIR API.

Patient-directed APIs can impact the physician-patient encounter in real time when one or both parties have a smartphone, although ideally the independent decision support will also be available in the EHR as long as the physician and the patient approve.

I’m calling this prescription for empowering patients Decentralized Information Governance. It’s completely consistent with both Verma’s and Rucker’s vision. Because it’s also consistent with current law, it can be implemented by Medicare, Medicaid, VA, and All of US immediately by joining the Health Relationship Trust (HEART) workgroup and implementing our profiles in the VA BlueButton 2.0 and CMS MyHealthEData projects.

The key is for all of us to reject calls for centralized governance of information services by government, academic hospitals, or global corporations (Facebook, Google, etc…) that have all proved resistant to regulation in the digital age. We must also reject the idea that new information governance bureaucracies like DirectTrust, or CARIN Alliance, or some government-controlled Recognized Coordinating Entity can be invented to ensure that our incredibly valuable health information drives open medical science. Decentralized information governance explicitly gives each patient the power to choose which patient interest groups, community organizations, or congregations one trusts to control access to his or her health records for both clinical and research uses.

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How Technology Is Changing The Medical And Healthcare Fields

How Technology Is Changing The Medical And Healthcare Fields | Healthcare and Technology news | Scoop.it

Astonishing Advantages In Technology

Heart attacks are terrible and can kill you, but assisted cardiology methods today are saving lives across the world. This is just one example of technological advancement, but there are quite a few different changes which you may even be surprised by.

  

Let’s start with IoT. The Internet of Things is creating a network wherein common devices are connected continuously to the internet. This provides several advantages. One, information is uploaded regarding network and device operations such that optimization can occur. Hospitals can additionally monitor patients directly and proactively.

  

The second thing that happens is a sort of “floated” cloud—a cloud on the cloud, if you will. Cloud computing is a network of servers that function together as a whole. Edge computing outsources processing to individual IoT devices, so they function similar to how the cloud does. Here’s the thing: IoT has many more devices than the cloud. It can potentially be more effective.

  

Between cloud computing and the internet of things, information can continuously gather identifying trends that are negative, and curtailing them. Outbreaks can be caught and treated earlier. Pandemics can be contained with greater speed. Additionally, lifestyle choices resulting in extended lifespans can be found and studied almost collaterally.

  

Additional Areas Of Tech Development

 

Something else that’s characterizing the medical industry today is innovations which reduce operational expenses over time, allowing for expanded outreach, development, and innovation.

  

A substantial cost-reducer in terms of research comes from automated mouse ear tags; according to RapIDLab.com, these tags: “Are the newest, most humane miniature automated mouse ear tags available…[these are] the most cost-effective automated lab animal identification on the market.”

  

Basically, imagine a tattooed barcode instead of a clip through the ear. It takes less time to apply the tag, and it takes less time to scan the tag. Instead of writing each individual number down, researchers can use a barcode scanner and just run down the line. What took hours will now take minutes. Hours are worth hundreds, often thousands, of dollars to research facilities.

  

If fifteen hours are saved a month, that works out to 180 hours a year. At $100 an hour, that’s $18,000 a year. At $1,000 an hour, that’s $180,000 a year. How much does it cost an hour to run your research operation? Many operational managers will likely find even greater savings through such solutions.

Component-Specific Production And Maintenance

Another game-changer in the medical technology industry comes from Weiss-Aug.com; according to the site: “Whether a part requires stitching of terminals, molding of multiple inserts simultaneously, laser welding or wire attachment, we can help you with the proper assembly methods for your program.”

  

Now medical institutions can outsource business needs which previously could only be accomplished through skilled employees sourced internally, or who require a regular service agreement. This can substantially curb expenses while simultaneously expediting technology advancements which are often life-saving.

  

Increasing Tech Innovations Define A Zenith In Medicine

Many medical businesses are called “practices” for a reason: as much as medicine has advanced in the last several decades, the human body seems to have become more mysterious, not less. For example: we know what DNA is, and we have some idea as to its inner-workings. But it’s an example of three-dimensional code more complicated than deliberately designed computer code—it’s beyond mankind’s ability for design.

  

Even though there are greater opportunities today in medicine than ever before, perhaps the most interesting feature of this situation is that these developments have revealed even greater potential than could have been imagined.

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4 Important Ways Healthcare Technology Improves Your Patient Care

4 Important Ways Healthcare Technology Improves Your Patient Care | Healthcare and Technology news | Scoop.it

Healthcare technology continues to be a hot topic of conversation, as the world that we’ve long visualized gets closer to being our reality.

It’s changing how healthcare providers diagnose, treat, manage and monitor. Health tech has the potential to save lives, improve quality of life, and completely redirect the downward trajectory of hard to manage patients.

Let’s explore how 4 important health techs are improving patient care.

Predictive Analytics & Machine Learning

Physicians today utilize predictive analytics & machine learning to better identify high risk patients and put the right interventions in place to:

  • Prevent admissions
  • Prevent readmissions
  • Reduce decline and relapse
  • Improve medication compliance
  • Speed up recovery
  • Help patients respond to triggers
  • Better engage patients in between visits

Patients today want more personalized care Health tech like this helps give patients what they want as it improves patient care and patient outcomes.

Continue on see more.

Wearable Technology

For patients suffering from chronic conditions, wearable technology provides a better way for patients to meet their health metrics.

This is because they receive immediate feedback about their health, current state of being, and behaviors that will impact those metrics. In many cases, the data can even be accessed by their physician in real time.

Wearables provide tools patients need to track and adjust behavior on a moment-to-moment basis rather than waiting until they have a doctor’s visit.

Today doctors are using wearables to:

  • Help patients be more active
  • Keep patients informed about day to day heart health
  • Help those with musculoskeletal injuries and physical developmental delays regain or gain mobility, including paralysis of the lower extremities
  • Track sleep patterns
  • Better understand mood disorders
  • Painlessly monitor glucose levels
  • Relieve chronic pain

The potential of remote monitoring to improve care has long been studied, but more recently we are finding it within our reach.

Virtual Reality

Medical students today can use virtual reality (VR) to get hands-on without a real patient in sight. This allows for more in-depth training and real time feedback that doesn’t include your patient screaming when you make a wrong move.

Furthermore, doctors today use VR to help treat patients with:

  • Anxiety
  • PTSD
  • Depression
  • Phobias

Through systematic desensitization, patients can face their fears, anger and sadness in a controlled setting. Before VR, such “facing of fears” would have been much more logistically challenging and less controlled.

Telemedicine

As part of the patient’s desire for more personalized care, they’re looking for healthcare services that align with their personal needs. This goes beyond medical treatments.

Telemedicine does this in several very effective ways.  For example, telemedicine:

  • Provides ultimate convenience to patients who think they don’t have time to see the doctor, so patients don’t delay seeing the doctor.
  • Meets the needs of the elderly and other individuals who may be home-bound or even bed-ridden.
  • Eliminates that boring waiting room experience.
  • Helps keep patients with immune disorders out of medical facilities that, despite best efforts, become breeding grounds for infections and even superbugs.
  • Delivers most of the benefits of face to face, especially when combined with wearable technologies.
  • Provides a secure, HIPAA-compliant platform on which doctors and patients can connect.

Healthcare Technology Makes a Big Difference in Patients’ Lives

Whether you’re a doctor, nurse or other medical services provider, you understand that it’s not about medicine. It’s about people.

Through healthcare technology, you can make sure every patient gets the care that they deserve. You can tear down barriers to care, expand your reach, and improve patient outcomes.

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The Top Five Digital Health Innovations For Food Tracking and Eating

The Top Five Digital Health Innovations For Food Tracking and Eating | Healthcare and Technology news | Scoop.it
Almost 700 million people have some health problem with food or eating

For some, eating is the most natural process on Earth. You are hungry, you get some nice food and some company, you sit down and have the meal making you happy and full. These people do not know how lucky they are. Researchers estimate that up to 15 million Americans have food allergies, including 5.9 million children under age 18. That’s 1 in 13 children or roughly two in every classroom. According to some estimations, 1-5 percent of the whole population of the EU has a type of food allergy.

Although it is not easy to measure it, some analysts say that there could be as much as 70 million people worldwide affected by various eating disorders such as anorexia nervosa, bulimia or binge eating disorder. There are also concerning numbers when we look at the WHO statistics concerning obesity. According to the UN organization, in 2014, more than 1.9 billion adults were overweight; of theses over 600 million were obese. Moreover, worldwide obesity has more than doubled since 1980.

All these issues need to be addressed. Although digital devices, food trackers, calorie counters, etc. cannot offer alone long-term, comprehensive solutions, they could support eating healthily and reduce the harm we do through food to our bodies.

1) Smart utensils

It is not easy to find time for a long meal in our mad, mad world, but I’m sure that you also experienced that eating too fast leads to poor digestion and poor weight control. The HAPIfork, powered by Slow Control, is an electronic fork that helps you monitor and track your eating habits. It also alerts you with the help of indicator lights and gentle vibrations when you are eating too fast.

But what if you experience eating as a living hell? Imagine, that you cannot enjoy your food no matter how great it looks and smells. Your hand is shaking so intensely, you cannot lift your spoon or fork to your mouth without dropping it to the ground. There are many people out there with Essential Tremor, Parkinson’s Disease, or other motion disorders. For them, eating is a torture due to their condition. Designed by Lift Labs which was acquired by Google Life Sciences, Liftware is a stabilizing handle and a selection of attachments that include a soup spoon, everyday spoon, and fork. Liftware is specially designed to improve the lives of those with such motion disorders.

 

2) Food scanners

There are many uncertainties around eating. Usually, we have no idea what we are eating. Where did the chicken come from that was on your plate at the Indian restaurant last week? Where were the beans or the carrots packaged? What does the pre-packaged tiramisu on the supermarket shelf contain? Many burning questions of 21st-century living, as most of us, urban dwellers, are unfortunately not living near enough to our food sources. The solution might come from food scanners. Canadian TellSpec has developed a hand–held food scanner that can inform users about specific ingredients and macronutrients. The company brings together spectroscopy and a unique mathematical algorithm in a revolutionary system that can analyze the chemical composition of food.

The Israeli company, SCiO, uses a technology similar to TellSpec’s but is designed to identify the molecular content of foods, medicines, and even plants. The company says that in milliseconds the ingredients and molecular make–up of the foodstuff will appear on the user’s smartphone. However, their promises have yet to be fulfilled, as the scanner, they introduced on the market does not exactly deliver what the demo did.

The Nima gluten-sensor (already on the market!) was named one of Time Magazine’s 25 best inventions of 2015. It is a portable, nicely designed gadget. The Nima is able to tell you from a small food sample within two minutes, whether the food on your plate contains gluten. The firm also aims to apply its technology to detect other food allergens, including peanuts and dairy. They plan to introduce their peanut sensor in fall 2017.

 

3) Nutrigenomics

It is a brand-new cross-field combining genetics and nutrition science. The basic idea behind nutrigenomics is that our genome reveals valuable information about our organism’s needs, which we should map out and utilize in order to lead a long and healthy life. After having your DNA sequenced (perhaps already at home!), a smart app could let you know which food you should eat and what you should avoid at all cost. As we are all genetically different, our diet should be personalized.

For example, the California-based start-up, Habit, plans to use genetic markers to identify the ideal meal for each of its customers and send that meal directly to their doors.  You only need to send back their required blood sample kit, do their so-called “metabolic challenge” and provide a series of body metrics like height, weight, and waist circumference as well as lifestyle habits like how often a person walks, runs, or exercises. All of this analysis leads to a personalized meal plan of foods that works best for the user’s body.

 

4) Calorie counters

Finding the ideal weight is a challenge for many people; while there are as many bits of advice regarding healthy eating and diets as sand in the desert. While there is a lot of debate around calories as well, it is common knowledge that if you reduce your calorie intake to a certain amount, you will lose weight. You should obviously not forget about the quality of your food while cutting on calorie intake to make sure you feel good and ultimately shift the fat in the long term – not just the weight in the short term.

But first things first. If you want to know your eating habits better and see how much you are really eating, you might want to use a calorie tracker. Similarly to counting steps and following your fitness activities closely, there are plenty of trackers on calories on the market. For example, you definitely know Fitbit and the Fitbit Surge as your fitness companion; but you should also consider the Fitbit Charge 2 as your choice for the best of what the company has to offer for calorie counting. Although if you do not want to have a separate wearable just for calories, you can choose from many apps whose goal is to help you log your meals. If so, let’s try MyFitnessPal, Lifesum, Calorie Counter Pro, HAPIcoach or Noom Coach.

My favorites are MyFitnessPal and HAPIcoach. Both are great for diet management and calorie counting. MyFitnessPal has over 5 million food items in its database and it is super easy to log what kind of food or drink you had during the day. Moreover, the counter can be synced with various health apps, fitness bands or smart scales. With HAPIcoach, you can take a photo of your meals for 5 consecutive days; then send them back to a real nutritionist, who will give you advice on how to adjust your diet to the ideal. It’s a great way to acquire your very own, personalized diet.

5) Food chatbots

Has it ever happened to you that you stood in the middle of a supermarket wondering about where the tortilla chips with jalapeno dip are and whether they are very far away from shampoo so that you have to make another round in the store again? Has it ever happened to you that you had no idea what to eat or what to cook tomorrow that does not involve asparagus which you have been eating for the whole week already?

Food chatbots might be here to help you. In 2016, Whole Foods announced the launch of their very own chatbot developed by Conversable. It lets customers browse through the store find products, and then, with a few taps in a Facebook Messenger chatbot, find recipes for an upcoming meal. So, you just select a tomato emoji, and the chatbot will find you great recipes for spaghetti bolognese for example. The Food Network TV Channel launched a similar chatbot: you can search for various recipes by ingredient, meal type, your favorite chef or show. Both sound like a lot of fun and a great way to explore new ways in cooking.

 

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How EHealth Empowers Patients And Healthcare Providers 

How EHealth Empowers Patients And Healthcare Providers  | Healthcare and Technology news | Scoop.it

Over the last couple of years we have seen a great rise in the number of websites, mobile ehealth apps and in house devices. All offering patients new ways to take control of their health. This has resulted in more self-tracking and testing patients using ehealth products and services.Healthcare providers on the other hand are finding ways to use this technology to their advantage. Reducing costs, enhancing care management and improving outcomes.

Patients however need guidance. So they are not left to track and interpret the collected information on their own. This is why healthcare providers need to focus on engagement and education. Empowering patients will help them fully benefit from the patient generated ehealth data.
 
The Self-managing Patient

Today’s digital patient has unlimited access to tools to self-test, self-diagnose and self-treat. The number ofwearable health and fitness devices are growing by the day. Apple Health, Fitbit and Samsung’s S Health are just three examples of healthcare tracking platforms.

Users can measure anything from blood pressure to nutrition and activity levels. Putting valuable healthcare data in the hands of the patient. Allowing them to self manage their own health. And even check hydration levels, brain activity and sunlight exposure.

This data does not just affect patient empowerment – it’s also of great value to healthcare providers.

 

Patient Empowerment through eHealth

Technology offers patients great benefits. It gives them more valuable health insights and more control over the outcomes. Resulting in patients rapidly adopting technology as an important health asset.

High quality health data empowers patients to choose how, when and where they receive care. It allows them to choose the manner in which they receive care, diagnosis and treatment. And offers more options and increased convenience.

They can choose traditional service at a hospital if they prefer the in person approach. Or can decide on a more convenient virtual visit with a tele- physician or even request a house call.

 
As this trend seems to be here to stay, healthcare providers worry patients might be getting a little too independent. Patient empowerment through patient education and patient engagement has been a focus of hospitals for a while. Important now is to focus on patient empowerment outside the hospital. And ensuring patients can still reach professional help when needed.
 
Healthcare Provider Empowerment through eHealth

Patient empowerment through data, information and technology is a great thing. But patients should stay aware of the importance of physicians. There is still a strong need for professional guidance and intervention. Only professional healthcare staff can accurately translate and act upon the collected data.

Ehealth data doesn’t just empower patients, it empowers healthcare providers as well. Tracking this continuous stream of data can provide completely new insights into a patient’s health. Healthcare providers have to find the benefits of this valuable information. Incorporating the eHealth data into the care process and workflow.

This can massively increase efficiency – allowing for cost reduction. But it can also help move into a more preventative based model of care. Detecting possible health risks and issues before they’re visible.

 

There is no way we can keep patients from self tracking, diagnosing and treating. They will use the information they receive from their wearable or in-home device. But it provides healthcare providers with a great opportunity to lead the way – using patient generated data to improve patient outcomes and patient experience.

 
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Personalized Medicine Informatics: The Sky’s the Limit

Personalized Medicine Informatics: The Sky’s the Limit | Healthcare and Technology news | Scoop.it

President Obama’s 2016 budget includes a $215 million investment in research on personalized medicine to provide clinicians with new tools, knowledge, and therapies to select which treatments will work best for which patients. That figure includes $5 million for the Office of the National Coordinator to support the development of interoperability standards and requirements that address privacy and enable secure exchange of data across systems.

Last week I had the opportunity to interview A John Iafrate, M.D., Ph.D., founder and director of the Center for Integrated Diagnostics (CID) at Massachusetts General Hospital, about some of the informatics challenges his organization faces as personalized medicine takes off.

The CID was one of the first centers to look at large panels of genes in cancer to support clinical decision-making, Iafrate said. It looks for mutations and other genetic alterations in patient tumors with the idea of getting those patients on new targeted agents. Its SNaPshot assay screens for well over 100 cancer-associated mutations that have important clinical implications. Iafrate’s organization has begun using the HealthShare health informatics platform from InterSystems to target issues involving large data set management and cross-organizational collaboration in support of genomic research and clinical innovations.

At Mass General, once a tumor is genotyped, the patient’s oncologist receives that information in a plain-text report in the EHR. The oncologist can act on that information if they have a clinical trial open or a drug available, Iafrate said.

 I asked him how the oncologists keep track of all the available trials.

“In fact, one of our first projects with InterSystems is a clinical trials locator,” he said. “That is app No. 1.” An oncologist who sees 100 patients, all with different genetics, cannot keep track of it. “If I am in an academic practice group, maybe there are 50 trials. Someone could make an Excel spreadsheet of genome types and trials available,” Iafrate explained. “But how would I know next Wednesday, when I see Mrs. Smith, whether or not she has other clinical parameters that make her ineligible? But a piece of software can have all the entry criteria, know the lab values for all the patients, and in real time know the genotype and entry criteria for trials and whether there is a spot available in those trials.”

Iafrate says that there seems to be some consensus that this “apps” model is the approach of the future. “To get novel analytics, you need a stable database structure and then let people build reliable apps you can put on top,” he said. “That is what we are excited about. I think most people would view that as the most efficient way forward.”

He said InterSystems has helped solve a lot of the problems around data security and data formats. “One of the reasons we liked InterSystems is their focus on building HIEs,” he said. “This is not a research project. We are dealing with identified data that needs the highest level of security. The capabilty to share between sites is critical.”

There are still many informatics issues to address, he said. “How do we get data out of the current data repository and how do we share data between institutions in a safe way that limits the risk?”

There are big macro-issues with genetics, he added. “In this day and age, when we can sequence a genome, is any data de-identifiable? You can de-identify some clinical data, but if you have DNA sequence linked, that is no longer de-identified,” he said. “There is no consensus on how to deal with this issue,” he said, and no national consensus within the healthcare informatics world on how risky someone’s DNA sequence is.

Iafrate said another challenge is all the unstructured data in healthcare settings. “That is the major issue we are dealing with,” he said.  “As good as any natural language processing software is, there will always be data quality problems.”

He said the CID hopes to create a physician portal — not just a viewer, but a way for clinicians to generate their notes in a way that is as fully structured as possible. “To do cutting edge research and cutting edge clinical analytics, you really need the highest quality data possible,” he explained, because every data point will have noise associated with it. You can have a physician’s note that says ‘Mrs. Johnson has been receiving chemotherapy and is doing fantastic. She feels great.’ If you want to do research on quality of life, natural language processing will hone in on it, but there is noise associated with it. “What you really want is a scale of 1-10,” he said. “We want to build into a physician portal a way they could enter data that is as high quality quantitative data as possible.”

I asked Iafrate if it was likely that EHR vendors would soon start to build in tools that support genetic data sharing. “Definitely, everyone is moving in that direction,” he said. “Epic has a working group around that. Everyone understands that personalized medicine is important.”

Iafrate is working with the Global Alliance for Genomics and Health, which was formed in 2013 to create a common framework of harmonized approaches to enable the responsible, voluntary, and secure sharing of genomic and clinical data. He said most of the work in genomics has been done by a few large research facilities. “They have an interest in sharing data among large genome centers but not in sharing it widely with community hospitals and primary care physician practices,” he said. “They can agree on one or two large databases they share with each other, but that does not solve the problem of how we democratize it,” he said. “Without standards, you are limited in transporting data and comparing studies. We won’t get companies like Epic to invest a whole lot unless there is a standard format.”

Iafrate said that once data is structured sufficiently and a single database can store large amounts of genetic data and can bring it together with clinical data, then “the sky is the limit.” 

“We could create real-time clinical analytics apps that you could put into Epic or another EHR, he said. One future app could be called “Patients Like Mine.”

Here is how Iafrate explained it to me: Twenty years ago oncologists would rely on their medical knowledge and experience to make decisions because they didn’t have so much data. Now when the genetics results come back, they are complicated. “Can we help those clinicians by showing them real-time survival rates?” he asked. “How can you generate a Kaplan-Meier curve, a survival curve, for the patient sitting right in front of you? This is not a research tool, but a clinical real-time tool.” What if you had structured data on every time the patient came in, what drugs and dosage they had, and a CT scan measurement of the size of the tumor at each point in time. You could do a quantitative measure of drug response in that patient — and that is the equivalent of a clinical trial, he said. “Today that is not done in routine clinical care, where you quantitate the response rate or tumor shrinkage, because there is not a need for doing that in the clinic.” But now there would be a reason. If you measure the tumor size of every patient that comes through, the oncologist sitting with that patient could pull up a Kaplan-Meier curve of all the patients in their practice and say ‘query the data by defining 50-year-old females with this mutation and this tumor type. Tell me how my patients have done.’

And providers could toggle between looking at only their own patients or patients in the HealthShare HIE network. “Once you structure that data, if you can de-identify it to some degree,” Iafrate said, “then it could be shared and turned into something really special.”


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