What is HealthIT from the Discovery Channel
Part 4 http://discoveryhealthcme.discovery.com/patiented/patiented.html
Part 4 http://discoveryhealthcme.discovery.com/patiented/patiented.html
Tuesday, December 20, 2011
Tuesday, December 6, 2011
What is HealthIT Part 3
What is HealthIT from the Discovery Channel
Part 3 http://discoveryhealthcme.discovery.com/patiented/patiented.html
Part 3 http://discoveryhealthcme.discovery.com/patiented/patiented.html
Monday, December 5, 2011
Social media to educate clinicians
In an interesting response to a problem of getting the word out
>>>>Despite these compelling findings, an audit of UK hospitals in 2011 showed that, of 412 trauma patients who were ill enough to need a blood transfusion and therefore be eligible for tranexamic acid treatment, only 12 (3%) received the drug. The implementation rate in low-income and middle-income countries could well be lower still. The CRASH-2 trial results were published in this journal, widely reported in the international media, and presented at many trauma and intensive care conferences. How else could researchers reach out to practising clinicians and make them aware of this life-saving treatment?
<<<<<
Despite the compelling evidence implementation and uptake is low so the team came up with a "viral" video to get the word out.
>>>>>
An enterprising idea that the CRASH-2 team rolls out today involves an adaptation of the concept of viral marketing—ie, a compelling video that internet users pass on to their online contacts. Drawing on the elements that tend to increase sharing (humour, surprise, emotion), the collaborators made a stop-motion animation in which a clay trauma victim, blood squirting heartily from a gaping hole in his abdomen, happily avoids imminent exsanguination by means of a timely injection. The video ends with an invitation to view the CRASH-2 trial results<<<<<
Expect more activities like this in the future
Wednesday, November 30, 2011
What is HealthIT - Part 2
What is HealthIT from the Discovery Channel
Part 2
http://discoveryhealthcme.discovery.com/patiented/patiented.html
Part 2
http://discoveryhealthcme.discovery.com/patiented/patiented.html
Tuesday, November 22, 2011
What is HealthIT - Part 1
Soem interesting video presentation on HealthIT and Informatics from the Discovery Channel Part 1:
Wednesday, November 16, 2011
Get on Board the Social Media Train or Get Left Behind Like the Bank of America
Bank Of America Just Had The Ultimate Social Media Fail
This makes you wonder if Bank of America, which is currently axing 30,000 of its staff globally, already cut their social media team.
Or if they don't already have a social media team, they should really consider getting one after this social media fail.
It's been just a week since Google Plus started allowing for companies to have pages on the social networking site and it looks like someone already beat Bank of America to the punch, according to Carl Franzen at Talking Points Memo.
BofA's Google Plus profile bashes the already embattled Charlotte, North Carolina-based bank. The page, which is no longer available, features unflattering pictures of former CEO Ken Lewis and mocking wall posts.
One wall post said, "Living under a tarp? I am too. My TARP is much bigger, however, and billions of dollars more expensive."
It's possible that the page could have been created by the bank initially and then later hacked.
However, according to Chester Wisniewski at the IT security blog NakedSecurity, the page was likely created by a group that tricked Google into thinking they were Bank of America.
We've included a screen shot below. [via TalkingPointsMemo]
Image: TalkingPointsMemo
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The power of social media - few hospitals or healthcare facilities have any focus on this area (building a web site and running and e-mail server does not count).
The University of Maryland Medical Center (http://www.umm.edu/) springs to mind as one of the leaders in this area with an impressive outreach and connection. I'm not sure what or how they staff it but am willing obey its built into every area and not confined to one or two social media job functions.
For those hospitals considering Social Media - this presentation on slideshare is a good foundation on why this is important and what it can do for your facility and originates from the University of Maryland:
Hospitals & Social Media
View more presentations from Ed Bennett
This is not just some passing fad. It is messy and this troubles many facilities and executives as it is hard to control and manage but that is just part of our future engagement with our staff, patents and colleagues around the country and indeed world.
This train has left the station - get on board or get left behind
Friday, November 11, 2011
Dragon Express - Available now in the App Store
The App store has made the ease of purchase an installation a breeze and finding the app and installing is as simple as clicking the Dragon Express Logo 
or this link (which will take you to the web page and open up your App Store).
Watch the application in action with Peter Mahoney - the Dragon Dictator
There has been good coverage from GigOM, Ars Technica, MacWorld and Cult-of-theMac to mention a few and has done well in the App store rankings reaching #8 (behind 7 apple applications and one other "Growl"). Not bad for the first day
Let me know what you think and how you get on with the application
Wednesday, November 9, 2011
Is Siri the New Personal Health Assistant and Coder?
Brian Dolan thinks so: 
And even for coding in OCD-9Based on our own in-house testing here at MobiHealthNews, Siri in its current form could be helpful to both patients and healthcare providers alike. After asking Siri a number of questions, we were surprised how she answered some and that she was able to answer others.
For health and diet
Release a product and people will find new and unimagined ways to use it. We are only just starting to scratch the surface of the potential
Tuesday, November 8, 2011
The One Chart You Need To See To Understand Mobile
The "Blue Ocean" (non-smart phones ripe for putting smart phones in the hands of users) is "huge". There remains much opportunity in the mobile market place but the penetration is increasing for Apple and Android with Android on a tear with its open-source strategy.
Mobiel devices are the mainstay of communication tools for people and as these increase in penetration and function voice integration and in particular the addition of intelligent interaction will become increasingly important and necessary.
I imagine the speech recognition business opportunity chart would look very similar offering the potential for a ver exciting and dynamic upcoming year.
Once again - its so great to be in a cool business that's growing so dramatically.
Improved systems for vehicle voice recognition coming
via freep.com
Cars that understand what you say....coming to a car near you.
Part of the ongoing push and the new age of speech recognition is the ability to understand what the driver asks for with interpretive system that include natural language processing (NLP) and some element of Artificial Intelligence (AI) to offer drivers a more conversational and useful interaction with their voice. A safer interaction that will be easier and faster.
Monday, November 7, 2011
Butterfly Effect of Healthcare Quality Measures
via advisory.com
In an interesting unanticipated effect the AHRQ has highlighted the potential for the government changes to encourage physicians
>>>
"... may "fire" noncompliant patients from their practices, push back against quality-improvement initiatives, and minimize patient empowerment efforts, CQ HealthBeat reports. Some physicians already are "firing" unvaccinated patients, noting that they pose a risk to others and reflect a lack of trust for physicians' medical advice.
Since there already appears to be some instances of this where patents are unvaccinated it may well extend to other groups and would certainly be classified as an unintended consequence.
Tuesday, November 1, 2011
Mobile Voice Recognition is Going to Rock Your World | Apple's Siri on the iPhone 4S is leading the way | Business News Daily
Voice is cool! Voice recognition and its most recent persona - the now well known Siri on the Apple 4S is a star and has really captured the imagination of the public..... something we have been working at for a number of years in the healthcare sector.
The key to the success is the natural language understanding that is baked in to the solution. We have seen the value of this with the Dragon Go Product in the Apple App store and the healthcare sector is getting medical intelligence built into their solutions in the form of Clinical Langauge Understanding (CLU) and the latest medical intelligence in the new product of Computer Assisted Physician Documentation (CAPD)
Instant information and interaction comes to healthcare documentation helping create high quality specific detailed clinical documentation first time.
Speaking in Context: Medical Language Models and Mobile Dictation
Speech recognition is an increasingly common interface - we interact with speech systems on the phone, using our phones and in our cars. But as Jonathan Dreyer points out in this piece - speech for general use is different to use in healthcare. In Healthcare it requires an appropriate context to attain the necessary levels of accuracy.
>>>What’s “humerus” to a clinician, and what’s “humorous” to a consumer are two very different things
Quite! So using the right versions tuned for the user and his domain - and int eh case of healthcare there are many different domains that can be applied for different specialties (Radiology, orthopedics, general surgery, general medicine...to mention just a few). With the right context and model applied medical speech recognition has become an integral part of clinical solutions and is becoming increasingly important in mobile applications where the keyboard interface is not always ideal or as easily accessible.
So while general speech recognition solutions are delivering real value to derive the same results in healthcare it is important not to fall into the trap of offering generic solutions that will work but generate too many errors to make them useable and worse will turn clinicians off the tools before they have even had a chance to experience the results that are possible today with the right tools for medical speech recognition
So if you are looking to integrate speech into your healthcare applications - use the right version that includes the relevant context and vocabulary models to at the outset and help create a positive experience for users from the beginning.
Wednesday, October 26, 2011
How EMRs can detract from a clear narrative, and facilitate spoliation and obfuscation of evidence; UPMC and the Sweet death that wasn't very sweet
In a detailed and extensive post on the hcrenewal blog that covers the pending case from Pittsburgh and the challenges relative to complexity of EMR systems, understanding the data including all the meta data that is gathered within these systems but not always available for review by clinicians.
The post is illuminating on so many levels delving into the case providing links to the court papers and documents and offering analysis of the sequence of events both prior to the tragic loss of Mr Samuel Sweet's life as well as the subsequent review and legal case.
Others can make their own minds up on the case - what is interesting is the detailed analysis and reference to actual data and documents for the EMR. It offers some window into the difficulties we face in practicing medicine in an increasingly complex arena and our increasing reliance and need to apply technology support the healthcare team deliver safe, appropriate and cost effective care to every patient, every time.
Tuesday, October 25, 2011
Apple Siri Advert - Speech Recognition in Action
The Siri application in the latest Apple Advert showing off the power of your voice
Monday, October 24, 2011
Bad Science, Politics and the Need for Clinical Data
Ben Goldacre, Saturday 31 October 2009, The Guardian.
Every now and then it’s fun to dip into the world of politics and find out what our lords and masters are saying about science. First we find Brooks Newmark, Conservative MP for Braintree, introducing a bill to reduce the age for cervical cancer screening to 20. The Sun has been running a campaign to lower the screening age, on the back of Jade Goody’s death at 28 from cervical cancer, and gathered 108,000 signatures on a petition. The Metro newspaper have commissioned a poll showing that 82% of 16 to 24-year olds in England agree with lowering the screening age.
“Cervical cancer may be rare in women under 25,” says Mr Newmark: “but it is inexcusable to dismiss the cases that occur as negligible statistics.” Oh, statistics. “We have a vaccination programme that ends at the age of 18 and a screening programme that begins at the age of 25. That leaves young women between the ages of 18 and 25 caught in a medical limbo, eligible for neither vaccination nor screening.”
Somebody should do something: an intuition which you will find at the bottom of many calls to extend screening programmes beyond the population in which they can provide useful information, and into low risk populations where they simply waste resources, or do more harm than good.
If screening worked, you would expect to see a reduced incidence of cervical cancer diagnoses in people who have been screened, compared with people who have not been screened, in the 5 years after screening: because precancerous lesions will have been detected and dealt with before they got to a more advanced stage.
In August 2009 the British Medical Journal published a large study examining this very question. It found that screening was associated with an 80% reduction at age 64, 60% at age 40, and so on. But cervical screening in women aged 20-24 has little or no impact on rates of invasive cervical cancer in the following 5 years. Only the Liberal Democrat MP Evan Harris introduced these findings to the debate (with the rather excellent line: “The honourable Member for Braintree cited evidence from The Sun, so I want to refer to a recent edition of the British Medical Journal”).
Meanwhile on the very same day David Tredinnick, Conservative MP for Bosworth, stood up to speak on medicine. Scientists and doctors who doubt the efficacy of alternative therapies are superstitious, ignorant, and racially prejudiced, he explained. “It is no good people saying that just because we cannot prove something, it does not work… I believe that the Department needs to be very open to the idea of energy transfers and the people who work in that sphere.”
He went on. “In 2001 I raised in the House the influence of the moon, on the basis of the evidence then that at certain phases of the moon there are more accidents. Surgeons will not operate because blood clotting is not effective and the police have to put more people on the street.”
Where does this moon stuff come from? “I am talking about a long-standing discipline—an art and a science—that has been with us since ancient Egyptian, Roman, Babylonian and Assyrian times. It is part of the Chinese, Muslim and Hindu cultures… Criticism is deeply offensive to those cultures,” says Tredinnnick: “and I have a Muslim college in my constituency.”
Any attempts to challenge Tredinnick’s ideas are based, he explains, on “superstition, ignorance and prejudice” by scientists who are “deeply prejudiced, and racially prejudiced too, which is troubling.” So I hardly dare to mention that Tredinnick tried and failed to claim £125 in parliamentary expenses for attending an intimate relationships course teaching how to “honour the female and also the male essence and the importance of celebrating each”, run by a homeopath.
Meanwhile the flag-bearers for conservatism at the Spectator are now promoting climate change denialism, as George Monbiot has pointed out, and Aids denialism, under the tedious flag of “only starting a debate”, even in their print edition. And finally, the NextLeft blog recently pointed out that of all the top ten conservative blogs, every single one is sceptical about man-made climate change. It could be an interesting five years ahead.
via badscience.net
Ben Goldacre from the Guardian does a great job of exposing the world of politics and politicians as they step into the world of science.
As always Ben does a great job of exposing the lack of science and data as some politicians jump onto a personal hobby horse.
As he points out in the attempt to introduce Cervical Cancer Screening he suggests that despite "Cervical Cancer being rare in women under 25" and suggesting we "do something".
The BMJ published a study in 2009 that did! And it demonstrated the value of screening in different age groups with "little or no impact" in the 20 - 24 age group.
Progress depends on data and introduction of new treatments, diagnosis and thinking should be based on scientific analysis of data and not on hunches.
The foundation of this is generating clinical data that can be analyzed and while our medical records are chocked full of data that remains locked in narrative blocks that are inaccessible to computer analysis without the extraction or abstraction of that information typically through manual steps
The Voice of Healthcare, The Value of Understanding (Imperial)
- Janet Dillione, Executive Vice President and General Manager for Healthcare, Nuance Communications, Presented "The Voice of Healthcare, The Value of Understanding" that highlighted the potential for bridging this gap with technology that takes the narrative and turns it into clinically actionable data using advanced NLP technology; Clinical Language Understanding. This is the first step on what will be a critical pathway to the future of medicine based on data and science.
Thursday, October 20, 2011
Impossible to Keep up with the news
My news reader(Netnewswire) reports 27,773 unread feeds... 
Yikes
Wednesday, October 12, 2011
Tuesday, October 11, 2011
Hospitals make almost no headway in cutting readmissions
via ama-assn.org
Minimal progress in what is a challenging problem for healthcare facilities in preventing readmission of patients. Surgical patients fared the best with a 12.7% readmission rate which was unchanged but in the top 3 killer category Congestive Heart Failure remained a recalcitrant problem with 1 in 5 patients returning to hospital - up slightly from the previous years.
The good and bad news is the looming ICD10 coding requirements will increase the visibility of this failure in the care system.
Good news in the long term as to improve anything we have to be abel to measure it, the bad news that it will shine an uncomfortable spot light on failures in the coordination of care.
THe incentives are in place for facilities as the government steps up the pressure with penalties for facilities with readmissions for heart attacks, heart failure and pneumonia coming in 2012. But this is just the tip of the iceberg of incentives and penalties.
Fundamental to these changes is the need for clinical data and the ability to report on progress that can only be achieved with discreet data on all patients. Some of this will come from direct data entry but the vast majority is currently locked away in the narrative and bridging this gap without burdening the clinician with data entry tasks will be essential.
Recent advances in the ability to extract and tag discreet clinical data contained in the narrative has been shown and is emerging as key "must have" technology for providers. Increasingly this is being built on the foundation of speech recognition that has clearly reached the point of wide spread adoption and acceptance in the clinical community. Demonstration projects and solutions are already showing the ability to satisfy the data reporting requirements directly from dictated clinical reports using technology to extract the data instead of asking the clinicians to enter the data manually through forms and data entry tools.
These tools will be increasingly important as we are pushed along the path towards higher quality lower cost care which must be built on measurable clinical data for each and every patient seen and treated in the healthcare system.
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