Navigating Healthcare – Patient Safety and Personal Healthcare Management

You can’t use #AI Without Great UX #Dig

Posted in Uncategorized by drnic on April 10, 2017

You can’t use #AI Without Great UX #DigitalHealth http://ow.ly/OF5p30aI7RF

The Idea of Blockchain as a Service from

Posted in Uncategorized by drnic on April 10, 2017

The Idea of Blockchain as a Service from IBM could Spur Wider Business Adoption #HCIT http://ow.ly/9Jjs30aI8u6

Digital Health Summit

This is Australia’s premier health innovation convention on the technologies that are revolutionizing healthcare and the implementation of ehealth initiatives and I was honored to be asked to give a keynote presentation at the Digital Health Summit taking place in Melbourne 29-30 March 2017. The bonus was listening to so many great presentations throughout the day from some great speakers.

The Perfect Storm for Healthcare

The opening session that set the tone for the future came from Alfred Poor, Editor for Health Tech Insider who eloquently described the perfect storm of The Internet, wireless communications and the pervasive smartphones that last year shipped 1.5 Billion – enough to provide one for every 5 people on the planet. Innovation that can take off the shelf technology and create accessible telehealth programs that reduce readmissions from 20% to 6%.

Everything from wearables devices to non-invasive sensors and monitoring to allow the capture of data on patients, improve care and treatment options and allow the elderly to safely stay in their home. Innovations that address the major challenges around the world in the society that needs to adapt and focus on wellness:

2009 Continua Health Alliance Brigitte Piniewski, MD

 

Stuart Smith took us through the potential for Gamification: exploring the magic of video games in health and rehabilitation providing repeated examples where implementing Gamification to engage with patients was seen as some kind of Voodoo by his colleagues who were amazed at the incredible success and high utilization by patients

He showed examples of rehabilitation patients using Sony Play Station with Microsoft Kinect that made the rehab program a positive experience and even had the audience dancing along with Dance Dance Revolution explaining how they had adapted this to elderly patients and using Glenn Miller and Big band music

With the explosion of data comes increasing risks to the security and privacy of data and Nathan Steiner Veeam Software detailed the expanding risk and the staggering incidence of data breaches that extend well beyond healthcare which remains the top target for hackers. No surprise and notably the FBI highlighted the hacking community that is targeting vulnerable FTP servers.

Julian Bright and Adrian Medhurst from Amelie AI took the audience on an interactive journey with an Artificial Agent focused on mental health issues and braved the Live Demo gremlins as captured on this Periscope:

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Personalized Medicine

 

Dr Robert McLeay, Founder, DoseMe highlighted the changing nature of medicine that improves on the old style model of guess work on drug choice and dosage and builds individual models to reduce the side effects and maximize the selection of the right drug for patients first time round – practical personalized medicine available for your patients today

Professor Phil Robinson, Head, Cell Signalling Unit, Children’s Medical Research Institute (CMRI), co-lead of The Australian Cancer Research Foundation International Centre for the Proteome of Cancer (ProCan) shared the exciting international progress being made in fighting cancer with industrial scale proteomic system that they have set up in the Children’s Medical Research Unit that was Announced by Vice-President Joe Biden on 17 July 2016 in Melbourne as part of the Cancer Moon shot that has rapidly grown to include 10 Nations, 18 Institutions. They are now producing huge amounts of proteomic data and creating Digital Proteme Maps that has been committed to the public domain indefinitely to facilitate ou sharing and learning and will be providing new options for targeting cancer. You can see more about their project here.

Digital Health Innovations from the Front Line

 

We heard from 2 clinicians from the US Aenor J Sawyer, MD, MS Director, UCSF Skeletal Health Health Innovation &Tech in Ortho University California, San Francisco and Dr Megan Ranney, Associate Professor of Emergency Medicine; Director, Emergency Digital Health Innovation program, Brown University. They shared the experiences from UCSF and Brown University of applying digital technology in the clinical setting offering insights into the use of sensors, Virtual reality and how to evaluate the technology in the context of a busy hospital and Emergency room.

 

After lunch, the panel session on the future of aging was hosted by The Hon Bronwyn Pike, former Victorian Minister for Housing, Aged Care, Community Services, Health, Education, Skills and Workforce Participation focusing on the innovations in place and how the sector can benefit from the data and analytics increasingly available from the digital transformation taking place. and then a detailed review of the great Victorian Stroke Telemedicine Program that has been rolled out with great success by Prof. Christopher Bladin, Program Lead – Victorian Stroke Telemedicine Project, The Florey Institute of Neuroscience & Mental Health with a proven protocol that is statewide and heading nationwide

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Social Media in Healthcare

 

Professor Enrico Coiera, Director, Centre for Health Informatics, Australian Institute of Health Innovation offered some tantalizing insights into the way that social media is changing the way we think about health. Not only does Social Media offer a means of reaching and engaging with patients it is also a potential avenue for treatment. The social propagation of obesity as detailed in this New England Journal of Medicine article: Network Medicine — From Obesity to the “Diseasome” and these complex networks are of direct relevance

He left us wondering of social media can treat social disease (his BMJ article Social networks, social media, and social diseases talked about this concept)

Modeling of Data

 

James McCaw, Associate Professor in Mathematical Biology, The University of Melbourne shared insights into the modeling for influenza forecasting and pointed out that despite how much progress we have made in medicine the influenza pandemic of 1918/9 (Spanish Flu) would have a similar effect on the population today

The models for prediction have improved but he likened them to weather forecasting capabilities from the 1970’s

 

It was a great day filled with insights from a wide selection of experts covering a huge range of areas. All the talks were engaging with practical tips and wisdom that the attendees could take back and use.

Digital Health Summit was originally published on Dr Nick – The Incrementalist

Secure Your Accounts Today

Secure Your Accounts Today

No better example of simple security preventing what would have been at best a major disruption of my account or at worse a loss of control and embarrassment than last night

I was joining the #HCLDR tweetup when I received notification on my phone

Someone was trying to login to my account from a new and unrecognized device. I joined the chat and made the comment

Original tweet from #HCLDR chat

But secure in the knowledge whoever was trying to get in was unable to because they did not have the code that twitter was asking for that had just been sent to my phone

Fast forward to this morning and a widespread hack is revealed

In a large-scale Twitter hack, thousands of Twitter accounts from media outlets to celebrities, including the European Parliament, Forbes, BlockChain, Amnesty International, UNICEF, Nike Spain and numerous other individuals and organizations, were compromised early Wednesday.

http://thehackernews.com/2017/03/twitter-account-hack.html

(I am wondering what the criteria was by the hackers for selecting accounts given my account targeted but no one else on the chat noted any irregularities)

Enable Two Factor Authentication

A simple change in your account settings can have prevented this — at a minimum making it much harder to steal your account and credentials.

There are many choices but 2 simple options — Use Your Mobile phone and Text Messaging — or use Google Authenticator

For Twitter

Link a mobile phone to your Twitter Account and then:

Settings/Privacy — Enable Login Verification

and while you are there — Enable requirements for personal information to reset your password

For Google Accounts

Enable Two Factor Authentication using your mobile phone and text messaging — this is available for you google accounts including GMail

You can find the details for this here

Google Authenticator

Google Authenticator for Android and for Apple iOS

The impact is minimal and there will be occasions when you might be logged out and have to re-log back in but these are minor challenges compared regaining access to your accounts and the potential embarrassment of content posted under your name that is offensive

Your Digital World is being Watched and Needs Securing

Which Accounts

All of them! But if you can’t or don’t want to do that the obvious ones are anything dealing with your financials and then important to add your email accounts — if these are left unsecured then it can be trivial to reset your passwords and gain access to all the other accounts linked to your email address

This post originally appeared on Medium and LinkedIn

Secure Your Accounts Today was originally published on Dr Nick – The Incrementalist

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What Healthcare Design Can Learn from the Oscars

Posted in DigitalHealth, EHR, Healthcare Technology, HealthIT, HIT, Patient Safety, Technology by drnic on March 1, 2017

The snafu at the Oscars with another movie being announced as a winner before being corrected has created quite a stir!

Picture from Wikipedia
https://en.wikipedia.org/wiki/Academy_Awards

You can watch the fateful sequence here and the audience reaction captured by the LA Time photographer Al Seib

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User Design Thinking

The design of the User Interface is so important – as this article rightly points out: This Simple Design Change Would Have Saved The Oscars

Credit Reddit
https://www.reddit.com/r/Design/comments/5wfs74/another_award_show_cringe_brought_upon_by_bad/

As they point out – the largest thing on the card is the Academy’s logo – not useful information in this context. Simple changes would have made all the difference for the hosts reading the card including large print for the key pieces of data

Electronic Medical Records Design

The same is true for Electronic Medical Records (EMR’s). This has been an ongoing topic of discussion and challenge with the interaction – for example:

2009 Usability of Electronic Medical Records (pdf) – as they describe is a difficult task as crafting a system for the highly tangled tasks in medicine that includes that involves skilled users, complex functionality, and critical tasks is difficult in any form – and even more so from a digital user interface

Obvious problems with EMRs, such as loss of productivity and long training times, have deeper causes. These stem from the complex interaction of highly skilled physicians trying to complete complex tasks in a challenging work environment with a complex and not always usable medical information system. Yet, by applying user-centered design in this complex environment, usability professionals can contribute significantly to improving EMR usability. Greater productivity and lower costs with better health care may yet be our destiny.

Bearing in mind this was written 8 years ago we are still struggling to navigate to the greater productivity and lower costs that were the pot of gold at the end of this particular rainbow.

More recently

2013: Impact of Electronic Health Record Systems on Information Integrity: Quality and Safety Implications

We see the same challenges associated with the EMR design that contribute to suboptimal care and continue to frustrate the clinical team who’s task lists have increased in both volume and elements reducing the available time

Usability errors occur as a result of system complexity, lack of user-friendly functionality (e.g., confusing user interfaces), workflow incompatibility, or limitations of the user. Faulty functionality could mislead clinicians where there is a confusing screen display or when incorrect values result from a programming error that incorrectly converts from one measurement system to another (e.g., pounds to kilograms or Celsius to Fahrenheit). A new kind of error occurring in EHRs that is not an issue with paper-based records is an “adjacency error,” in which a provider selects an item next to the intended one in a drop-down menu, such as the wrong patient or medication.

 

And as recently as 2016 in Journal of Biomedical Informatics: Navigation in the electronic health record: A review of the safety and usability literature (behind a paywall)

A methodical review of the literature focused on the inefficient navigation of EMR’s that increases user’s cognitive load

Courtesy Pixabay

which may increase potential for errors, reduce efficiency, and increase fatigue.

As they noted, “usability researchers are frequently capturing navigation-related issues even in articles that did not explicitly state navigation as a focus. Capturing and synthesizing the literature on navigation is challenging because of the lack of uniform vocabulary. Navigation is a potential target for normative recommendations for improved interaction design for safer systems.

For anyone involved in user interface design or dealing with Electronic Medical Records and complex densely populated screens this challenge is clear. The path for healthcare is not as clear as it is for the Oscars

Using a simple San Serif Font – large print for the award category and the name of the winner followed by the people involved with the Oscars logo at the bottom.

User Design Thinking in Healthcare

Healthcare is not that simple – but that should not and does not stop us from learning from other industries to apply user design thinking to everything we do:

  • Designing with simplicity and ease of use in mind
  • Reducing not increasing cognitive load for clinicians
  • Removing or at least suppressing non-essential information from the immediate clinical dashboard
  • Capitalizing on existing intuitive multi-input interfaces that are prevalent everywhere else

The user interface remains challenging and requires a new level of focus and attention as we continue to increase the data load and resulting cognitive load on our busy time challenged clinical staff. Let’s not have an Oscar moment in healthcare

If you have ideas on how we can improve and accelerate the user centric design thinking in healthcare – share your thoughts below or reach out to me on any of my channels

 

 

What Healthcare Design Can Learn from the Oscars was originally published on DrNic1

The Best Exotic Marigold Hotel

Posted in DigitalHealth, Healthcare Technology, Innovation, Inspiration, Technology by drnic on February 9, 2017

HIMSS is rapidly approaching and I am excited to be presenting:

The Best Exotic Marigold Hospital: Learning digital lessons from the hospitality industry to personalize the healthcare experience on Monday February 20, 2017 — 01:30 PM EST – 02:30 PM EST in the Chapin Theatre (W320) – Session ID:
43

The Friction of Travel

As part of my role I travel a lot and I have watched the travel experience change over the last several years. Remember the time when you actually visited the check-in desk before proceeding to the gate to get your boarding pass?

 

I remember that in the early days I still wanted to go to the check in desk but quickly discovered that the ability to check in at home the night before made my life easier and reduced the friction of travel. The same is happening in the hospitality industry and I am excited to be presenting with Nathalie Corredor, SVP Startegy for Hilton Worldwide

 

The Hilton group have invested a huge amount of effort in refining their Digital Experience you can do everything from make a reservation, choose her room, get your digital key access once again decreasing the friction of travel. This increases the customer satisfaction and improves the hotel staff productivity so instead of spending time checking in guests and creating key cards, the staff can spend their time making sure guests feel welcome and taking care of their individual requests and needs. By removing people from the administrative process, the hotel was able to make the guest experience more welcoming and friendly.

Healthcare environments can learn some important lessons from the hospitality industry, as well as retail and travel websites. By taking service staff out of tasks that are more efficiently done by computers, these industries are able to personalize the customer experience, improve accuracy of data entry and cut their costs.

For companies in the hospitality, retail and travel industries, efficiency, accuracy and cost control is directly related to their ability to compete successfully for customers. But just as important is the customer experience. These industries have learned that a customer irritated by the friction in the buying/checking in process is a customer who will seek out other options in the future. While some customers will put up with a poor experience to cut costs if they must, as soon as those customers find an affordable option that is less irritating, they are gone. And, importantly, companies are no longer being compared just to the competition in their own market — now their competition is any optimal experience from any industry. If our online interaction with Amazon is friction-free, then we want and expect the same experience from everyone else.

You can read more here on the Beckers Health IT and CIO Site (Beckers – The Best Exotic Marigold Hospital – Nick van Terheyden)

 

 

The Best Exotic Marigold Hotel was originally published on DrNic1

New technologies only connect broadly wh

Posted in Uncategorized by drnic on October 14, 2016

New technologies only connect broadly when a mainstream audience is ready and has a compelling need

Valeant at it again as it gouges on lead

Posted in Uncategorized by drnic on October 12, 2016

Valeant at it again as it gouges on lead poisoning drug #pharama #hcr http://ow.ly/CVvo3056DUT

Behind the scenes innovation brings sign

Posted in Uncategorized by drnic on October 7, 2016

Behind the scenes innovation brings significant benefits even if it fails to create singular disruptions

Please help my daughter to help students

Posted in Uncategorized by drnic on October 5, 2016

Please help my daughter to help students in #Honduras Round 4 #education http://ow.ly/NXxH304K2eB