Navigating Healthcare – Patient Safety and Personal Healthcare Management

Incremental Steps to Health

Incremental Steps to Health

The Incrementalist Graphic Khan Siddiqui

This week I am talking to Dr Khan Siddiqui (@DrKhan ) radiologist, programmer, serial entrepreneur, and Founder, CTO, and CMO of HIGI – the company that is taking the concepts of consumer engagement and tracking to the next level and creating actionable insights that patients and their care team can use

Much of Khan’s journeys mirrors my journey into the space of Digital Health – starting as a programmer in school where he was building applications on a PDB-11 using punch cards and continuing on through his early work on the Electronic Health Record mining data and applying machine learning and deep learning as far back as 2005 to healthcare data.

Microsoft Kinect

Listen to his story of a turnabout of shared innovation at Microsoft where the work the healthcare team had done on image analytics was applied to the Kinect bar and gaming solving one of the challenging problems of “missing body parts”

He was involved in the early work of Microsoft Health Vault and like others believed in the mission of sharing clinical data with patients and getting them engaged was a key requirement to solving health challenges – many of which are tied up with personal behavior. Frustrated by the lack of uptake compared to the Xbox gaming system he took this experience with him to found Higi and replicate the gaming user engagement and bring this to healthcare

Listen in to gain a different perspective to Xbox gaming and how healthcare has contributed and learned from this world.


Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.


Listen along on HealthcareNowRadio or on SoundCloud

Incremental Steps to Health was originally published on Dr Nick – The Incrementalist

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Artificial Intelligence in Medicine

Artificial Intelligence in Medicine – Better More Rewarding Medicine

The Incrementalist Graphic Anthony Chang

Incrementalist Chang

It was great to catch up with colleague and friend Dr. Anthony Chang (@AIMed_MD) Pediatric Cardiologist, Founder of Artificial Intelligence in Medicine (AIMed) and Director of Medical Intelligence and Innovation Institute (MI3) .

How did a pediatric cardiologist find his way into the field of Artificial Intelligence, Machine and Deep Learning?

Those of you that saw the original Watson Jeopardy Challenge

Anthony like me had the same reaction to this incredible achievement by the IBM Watson team that beat out the top 2 Jeopardy champions with an Artificial Intelligence Computer system that consumed the contents of the internet library and tested out the correct answers more frequently than the two human champions.

With a background teaching statistics augmented with an MS in Biomedical Data Science/Artificial Intelligence, he has blazed a path to attract colleagues and data geeks from around the world to participate in the future of healthcare augmented by data

For those of you challenged understanding the terminology of the space this Venn diagram is helpful in putting the various disciplines in perspective

AI Deep Learning and Big Data Venn Diagram

Along the way, he like many of my other guests has discovered the value of the adjacent possible – in his case adjacent to data scientist and technologists with clinicians deeply invested in day to day clinical care – both learning from each other

We cover everything from machine learning and data science through the requirements for clinicians (or not) to gain qualifications in data science. Hear his eloquently answers the age-old question of

Will I still have a job once AI has replaced me

TL;dryes and it will be more rewarding

Join me as you hear how and why you should change the way you think of medicine and data. The good news is – you can participate in the next AI Med event which mixes specialist, clinicians, data geeks and patients from around the world in a unique experience that offers a great learning and mind opening experience.


Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.


Listen along on HealthcareNowRadio or on SoundCloud

Artificial Intelligence in Medicine was originally published on Dr Nick – The Incrementalist

Healthcare in the Year 2030

The Year 2030

by Dr Nick van Terheyden (@DrNic1)

How will the world of medicine change in the next 15 years? Well 15 years ago AOL had just bought Time Warner, the human genome had just been deciphered and published and the first inhabitants of the International Space Station had arrived.

The Year 2030 – my bed has been tracking my vital signs throughout the night and notices I was restless and managed fewer REM cycles during sleep than usual. Prometheus (my personalized artificial automated agent) checks my calendar and traffic and elects to wake me an hour later. Appointments for the morning are rescheduled and my drone pick up is postponed. Prometheus sends an update to “Hestia” (my kitchen AI) with instructions to increase the energy component of my meals for the day to adapt for the lack of sleep and deliver a boost of energy with almond snacks through the day. Prometheus sends my updated sleep and vitals data to my personal health record. While I rest peacefully the rest of the household is awakened and sets about their day.

 

Time to Get Up

When it’s time to awaken, the bed starts warming to ease the process, the lights slowly turn on and the GPR (Galactic Public Radio) custom news cycle is playing gently in the background. My calendar has been reorganized, and there’s an additional appointment with Asclepius (My health AI) before I leave in the morning. My food is ready and waiting and contains a boost in energy, helping me wake up and acclimate after the poor night’s sleep. I hear the inbound calling for Asclepius and take the call. We review the reasons for my poor night’s sleep and agree I should track this more closely for the next few days to ward off any potential problems. In this instance Asclepius suggests no further investigation is warranted, but if I am worried a drone will be dispatched with some auto investigator tools to apply and track additional parameters if necessary.

Personal Drone
Personal Drone

As we finish my personal drone arrives and I step outside, catching my foot on a fallen replicator brick discarded by one of the children. As I fall my head strikes the corner of a table and carves into my cheek. Prometheus is immediately on top of the situation checking on my vitals, and while no major damage to my body, the cut will need review and probably some stitches. Checking with local urgent care facilities, the optimal treatment for me today is a quick trip to the urgent care clinic and my drone is reprogrammed to take me there immediately.

Urgent Care in the Future

As I arrive my MedicAlert Digital Bracelet transmits my allergy to lignocaine and identifies me based on the bracelet

and my retinal scan taken as I walk through the door, which authenticates my presence and consent initiates transfer of my medical data and records to the clinic.

Robot Nurse
Robot Nurse

 

 

I’m guided to a room where a robot nurse cleans my wound and positions me on the bed and brings in the Panacea (the medical repair robot). My medical record shows I have had a recent Tetanus shot, and a comparison of my previous vitals shows there are no serious changes that would warrant additional investigation. Repair completed, my records are updated with the new details and a drone appears to take me to work.

 

 

 

Medical Offices and Care in the Future

As I step into my office my team are all walking in (virtually) and the central console and screens around the room light up with data on our first patient. We process through the details provided by the various Artificial Intelligence agents and data gathering tools. “Jane” (name changed to preserve her privacy) has been having some frequent dizzy spells and falls – her mother had Meniere’s disease and a degenerative disease linked to the A2ML1-AS1 / ADAM20P1 / MTor Complex 2 / WDFY3-AS2 – we think there may be a link. Even though Jane does not have these gene expressions there may be a new epigenetic influencer she received that is affecting her stable sequence. We need to get to the bottom of this. Jane is here too (virtually) – with her mother and father – and they are looking at the same data, shown with basic annotations to help them understand the details.

South Korean Researchers unveil first CRISPR nanobot editor
South Korean Researchers unveil first CRISPR nanobot editor

We think we have an answer, but want to share the details and show Jane and her family the model of the CRISPR editor nanobot and its effects before we decide on the next course of action. Do we create a more realistic model of her body functions with the cell printer and test on that? Or is the confidence in our simulation high enough to warrant immediate therapy? Whatever we decide we will get real time approval from the GMAA (Galactic Medical Agent Agency that replaced the FDA in 2021). Jane and her family have seen a new therapy advertised and they want to understand how that might work for them. We pull up the details and all the data on patients and do an immediate comparison. The data’s questionable but, more importantly, it’s contraindicated in anyone with GRAMS domain, Heat Shock 70kDa protein expression and several others that disqualify Jane.

We elect a wait and see approach – so much easier these days with the real time monitoring and detailed data we have on patients that allows us the scope to wait and watch while reassuring patients. Directives are sent to their family “agents” and a drone dispatched to their location with some additional monitors for Jane to wear to give more detailed data on her for the next few days.

Amazon Prime Air Drone Delivery
Amazon Prime Air Drone Delivery

 

As we complete the consultation a drone arrives with my almond snacks and some water – perfect timing.

 

 

 

 

 

 

This post appeared in abbreviated form on SHIFT communication site – and is included in their downloadable ebook

 

Healthcare in the Year 2030 was originally published on DrNic1

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The Patient Electronic Show – CES

https://digitalhealthsummit.com
CES Digital Health Summit

Once again I am headed to CES this year. Last year the DigitalHealth pavilion was overflowing with people, innovation, and wearables designed to influence us to a healthier life.

The show still features the big sections of technology for cars, televisions and 3-D printers but much of the show is being turned over to healthcare and the Digital Health pavilion. Like my friend and colleague Jane Sarasohn-Kahn I see the big move towards high-deductible consumer driven health plans (HDHP) beinge a key part of the major uptake in digital health devices and wearables. We already got a sneak peek into this post the holiday period with FitBit rising to the top of the Apple App store charts and coming in in the top 3 of Amazon’s list of holiday gifts.

So this years hot trends

Wearables and the Internet of Medical Things

With personal financial responsibility comes a much bigger focus on the costs of healthcare services and how to avoid them. To avoid expensive costs later in life requires focus on behavior now on as captured in this excellent graphic from Bridgitte Piniewski, MD:

Lifestyle is the biggest factor in improving health
Lifestyle is the biggest factor in improving health

Expect CES 2016 to feature much more Digital Health and especially focused on the Internet of (Medical) Things – the key to engagement is making the workflow frictionless. Its no use creating yet another app or solution that requires consumers to download, install, learn or use yet another option. The success in this space will be around integrated solutions.

Wearables will expand and include even more data and the recent announcement of Samsung of the expanded capability in their new health-focused chip

that will add body fat, skeletal muscle mass, heart rate and rhythm, skin temperature, and stress level to the biometric tracking capabilities.

Expect many more additional features to the wearables mobile platform with add on modules, some already on show like the Philips Ultrasound, others work in progress

3-D Printing

Reaching new levels of innovation. Simple ideas like creating 3-D models base don actual patient anatomy prior to taking on complex surgery, printing prosthetics that are customized to the individual but now increasingly merged with wearables and printing biosensing strips that can be used for in home diagnostic testing. Researchers at Florida Atlantic University printed strip with bio material including antibodies and nanoparticles that can detect bacteria and viruses

 

Thin, lightweight and flexible materials developed by researchers at Florida Atlantic University, Stanford University and Harvard University, integrate cellulose paper and flexible polyester films as new diagnostic tools to detect bioagents in whole blood, serum and peritoneal fluid. Credit: Florida Atlantic University

Artificial Intelligence

Take a look at Lunit that helps physicians make accurate diagnosis with machine learning that offers object detection (application of existing technology to the healthcare domain)

http://lunit.io/static/img/illust_proj1.png

There are others including IBM’s Watson for Healthcare and in our Dell’s portfolio announced at RSNA ZebraMed

 

Repurposing Existing Technology

In my review from CES 2015 there were plenty of drones (with some medical applications) and technology to aid flying and use. Many were showing image stabilization as captured in my video here:

and I captured this on a custom video gimball
https://vine.co/v/ehj1nZH175x/embed/simplehttps://platform.vine.co/static/scripts/embed.js

We have so much opportunity to innovate in healthcare by repurposing existing technology for DigitalHealth. This image stabilization technology has been applied to the task of eating which for most of us is easy but for some eating is a challenge of hand stabilization due to tremors:

You can buy these from Giftware (which was acquired by Google).

Parkinson is one of the leading causes of these tremors (about 1 Million americans are living with Parkinson’s and an estimated 7-10 Million worldwide). Its a simple idea (not to diminish the brilliant application and innovation by the founders) and a testament to the bright minds that fill our world and will continue to find solutions to problems we face in healthcare.

Join me at CES16

We’ve come a long way from CES in 1967

So I invite you to follow along for #CES16 my twitter handle (@DrNic1), my Instagram (DrNic1) account for pictures and Vine (DrNick) for insights, posts, pictures and short video segments of innovation throughout the course of the show

 

If you are here come join me and my fellow panel participants:
Shai Gozani, M.D., Ph.D., CEO and President, NeuroMetrix, Inc.
Beth Bierman, Partner, Morgan Lewis & Bockius
Bakul Patel, Associate Director for Digital Health, FDA, Center for Devices

Roadmap to FDA Approval: What You Need to Know
3:30-4:30 PM Tuesday, January 5
Las Vegas Convention Center, North Hall, N259

The discussion will be moderated by Alfred Poor, Editor, Health Tech Insider

and on Thursday the DigitalHealth Summit that will be in the Venetian, Level 4, Lando 4304

 

The Patient Electronic Show – CES was originally published on DrNic1

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Our Remote Future in Healthcare

Its an exciting time to be in healthcare and medicine – technology is bringing so much innovation and opportunity to improve the delivery, quality and reduce the cost of healthcare. Much remains to be done

At our our recent DellWorld conference we captured insights into this exciting future

As Dr. Jai Menon vice president and chief research officer for Dell Research Data said data may well be the oil of the 21st Century and in healthcare this is especially true as we see an explosion of insights and data into our health, clinical status, genome, biome and beyond

We finished sequencing the first human genome in 2003

and things have only accelerated from there with sequencing now taking less than 24 hours and costing less than $1,000

Just this one area is going to add huge amounts of data that needs to be turned into knowledge as I shared in this presentation to the Austin Healthcare Thinktank Roundtable

http://www.slideshare.net/nvt/slideshelf
But even before we get to that point there are so many opportunities emerging into our daily lives to improve the service and the healthcare delivery system. Telehealth or Telemedicine is a clear winner and the regulatory and reimbursement systems seem to be catching up (details in this presentation form Connected Health).

Integrating the data and providing intelligence and insights from the mass of data that is sweeping over healthcare will be important but as we gather more our understanding improves expect this area to accelerate with deeper more meaningful insights tied closely to the ability to integrate the data from multiple (and importantly non-traditional sources).

To get a sense of the opportunities and changes coming watch the video compilation form the conference below:

 

Its a great time to be in healthcare as we open new doors to knowledge with the data

Our Remote Future in Healthcare was originally published on DrNic1

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Speech and Medical Intelligence – Allowing Doctors to Focus on Patients Not Technology

I spent some time at Medicine 2.0 and participated on the panel Bridging the Digital Divide and will presented: Speech and Medical Intelligence – Allowing Doctors to Focus on Patients Not Technology

This is an exciting time for mobile devices and while we know there is a discrepancy in the accessibility of mobile technology (I’ll be participating on the panel Bridging the Patient Digital Divide) some of this divide in access can be linked to the complexity of this technology. With ubiquitous technology comes ubiquitous complexity – adn this is especially true for doctors who face challenging User Interfaces – captured here in this post: How Bad UX Killed Jenny. As doctors we feel we are loosing touch with the Art of Medicine

Which for many of us was the reason we started on the journey to being a healer. Physicians don’t go to medical school because they want to document and code clinical information. Doctors choose their path because of their compassion and desire to deliver care to patients in need. There are increasing physician frustrations with technology and their struggle to keep the focus on patients and not data entry.

Medicine is part science, part art. The relationship between physicians and patients is at the core of healing. This begins with hearing and understanding but is followed by focusing on the patient not the technology. I will be presenting our prototype “Florence” that combines artificial intelligence and speech recognition to offer innovative new speech technologies that help capture and understand not just what the clinician says but what they mean. With new tools that speech enabled systems we simplify access and empower clinicians to capture information and thoughts as they occur. Through the innovative use of natural language tools, context awareness and the generation of high-value clinically actionable medical information clinical systems become efficiently integrated into care delivery process offering the opportunity for doctors to return to the Art of Medicine and focus on the patient.

Here’s a video showing off Florence

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Speech and the Digital healthcare Revolution at #SpeechTek

Come join me in the conversation with my colleagues at the SpeechTek 2014 conferencein Marriott Hotel in Time Square, Manhattan New York.

The Panel: C103 – PANEL: The Digital Healthcare Revolution at 1:15 p.m – 2:00 p.m. The panel moderator Bruce Pollock, Vice-President, Strategic Growth and Planning at West Interactive and on Social Media @brucepollock

I will be joined by Daniel Padgett, Director, Voice User Experience at Walgreens and on Social Media at @d_padgett and David Claiborn, Director of Service Experience Innovation at United Health Group.

We will be discussing the opportunities and challenges associated with the current digital healthcare revolution and of course how speech plays an essential role in integrating this technology while maintaining the human component of medicine that we all want. Rather than Neglecting the patient in the era of health IT and EMR

We have progressed from the world of Sir Lancelot Spratt

And the Doctor need to look at the patient not the technology perhaps in a cooperative Digital Health world like this

Is this future of Virtual Assistant Interaction good, desirable

Demo Video 140422 from Geppetto Avatars on Vimeo.

We will be discussing

  • What are the biggest obstacles to digital healthcare becoming a reality?
  • Where do speech technologies bring the most value to healthcare?
  • How will health providers, insurers, and payers provide patient support in the world of digital healthcare?

Perhaps the emerging Glass concepts improve this interaction as they are exploring in Seattle

Join us for analysis of the state of digital healthcare today and predictions for its future.

In the end

People forget what you said and what you did but they remember how you made them feel

Come join the discussion as we explore the digital technology and how it should be used in healthcare and how speech can help

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Virtual Assistants in your Future – Personal Healthcare Delivered

You can always rely on Hollywood to take concepts and extend them into the future – sometimes correctly (cloaking, holographic TV, forcefields and eco skeletons with mind control), sometimes incorrectly (aluminum dresses, atmosphere that is completely controlled, suspension bridge apartment housing). We have had speech recognition and Spock’s request:

So it was no surprise to find the latest Hollywood idea is the “Her” – a lonely writer develops a relationship with a newly developed operation system

Intriguing and challenging our current concepts with an exploration of artificial intelligence, voice and natural language technologies. These new styled avatars understand, listen and decipher what we say and something that Nuance has been developing and reinventing the relationship that people and technology can have. We can engage with our devices on our own terms and we have show these concepts in healthcare with our very own Florence – who is getting ready to launch in 2014

Ambitious you say – maybe but imagine the environment with intelligent personal assistants that hear you, understand you, know your likes and preferences – and in our world exist across your doctors office, the phone, surgery, hospital and elderly care and hospice. Cool? Liberating? Impossible?

If you’re Nuance, the idea is not only brilliant – it’s our focus and drive as we reinvent the relationship between people and technology. It is the chance to connect with your devices on human terms and presents infinite possibilities for intuitive interfaces that adapt to you.

Liberating our clinicians to focus on the patient and providing patients with someone they can talk to, interact with and who does have time for them. That future – coming to a doctors office near you:

Artificial Intelligence – Good or Bad

Posted in AI, Artificial Intelligence, medical intelligence, virtual assistant by drnic on November 11, 2013

I received a link form a friend to this article Robots, Soldiers, & Cyborgs: The Future Of Warfare – I think in part because I post on the value and opportunity of the intelligent agent
In fact I just talked about this recently around the concept of smart shelves instead of selling shelves. It was this comment in the article that stood out

Are we at the beginning of an inevitable process leading to the rise of “killer robots” predicted by science fiction, or can robots actually make war less destructive?

We know technology can be used for good and bad but even with the concern of the possible super soldier ala Terminator and the Rise of the Machines in Judgement Day…as seen in the opening scene from Terminator 2

Remember folks – this is Hollywood. No battery or power issues amongst the many other challenging technical problems. There is a school of thought that we will reach singularity and artificial intelligence will have progressed to the point of a greater-than-human intelligence that will “radically change human civilization, and perhaps even human nature itself.

Critics are also concerned that advanced artificial intelligence (AI) could develop in directions not anticipated by scientists. Because of this unpredictability, the US military has indicated that it will never remove humans from the decision loop completely. While unmanned weapons systems will become gradually more autonomous so that they can carry out very specific missions with less human direction, they may never entirely replace human soldiers on the battlefield.

While there is some potential for the bad I remain optimistic that the inherent good prevails – we develop smarter, faster and better technology to deliver an improved world and a new era of Super Intelligence that will chaperone in a new and exciting era

Meanwhile adding medical intelligence to the systems we interact with to simplify the interaction freeing people up to focus on tasks and the individual – not the technology offers interesting and exciting potential and I found this latest piece Startup Gets Computers to Read Faces, Seeks Purpose Beyond Ads on reading faces another step toward intelligence which like the smart supermarket shelves can be used for good or bad….
Imagine the doctors office or even the hospital waiting area that is using technology to triage patents intelligently based on their needs not the time of their arrival.

Life is good – my glass is always full