Blog: Computer Model of Spread of Dementia Can Predict Future Disease Patterns Years Before They Occur in a Patient

Computer Model of Spread of Dementia Can Predict Future Disease Patterns Years Before They Occur in a Patient
Cornell News (03/21/12) Richard Pietzak

Weill Cornell Medical College researchers have developed software that tracks the manner in which different forms of dementia spread within a human brain. The model can be used to predict where and when a person's brain will suffer from the spread of toxic proteins, a process that underlies all forms of dementia. The findings could help patients and their families confirm a diagnosis of dementia and prepare in advance for future cognitive declines over time. "Our model, when applied to the baseline magnetic resonance imaging scan of an individual brain, can similarly produce a future map of degeneration in that person over the next few years or decades," says Cornell's Ashish Raj. The computational model validates the idea that dementia is caused by proteins that spread through the brain along networks of neurons. Raj says the program models the same process by which any gas diffuses in air, except that in the case of dementia, the diffusion process occurs along connected neural fiber tracts in the brain. "While the classic patterns of dementia are well known, this is the first model to relate brain network properties to the patterns and explain them in a deterministic and predictive manner," he says.

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Blog: Hopkins Researchers Aim to Uncover Which Mobile Health Applications Work

Hopkins Researchers Aim to Uncover Which Mobile Health Applications Work
Baltimore Sun (03/14/12) Meredith Cohn

Johns Hopkins University has 49 mobile health studies underway around the world as part of its Global mHealth Initiative. The initiative aims to evaluate which mobile strategies can aid doctors, community health workers, and consumers in ways equal to traditional methods. Pew Internet & American Life Project's Susannah Fox notes that more than 80 percent of Internet users have looked online for health information. Many of the 40,000 applications already available have practical purposes, such as helping patients adhere to drug regimens, helping people change harmful behaviors, and aiding in weight loss through texts about specific goals and behaviors. There also are pill bottles that send text messages when a person forgets to take their medicine. Meanwhile, mHealth researchers have developed software to help educate medical students, doctors, and other workers about how to care for burn victims. The researchers also have developed apps to train health workers caring for those with HIV and AIDS and to screen and support victims of domestic abuse. "What they all have in common is they increase how often individuals think about their health," says mHealth director Alain B. Labrique. "There is evidence that suggests some apps can have an impact."

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Blog: Technology-induced medical errors: the wave of the future?

Technology-induced medical errors: the wave of the future?

By Denise Amrich, RN | November 9, 2011, 4:45am PST

Summary: Tuesday’s federal report addresses the strong need for safety in health IT without irresponsibly discouraging progress.

Electronic healthcare management is a really fascinating, promising topic, and most of the time, you hear people focusing on the improvements in patient care, as well as cost and time savings, partly because it helps make a case to get healthcare organizations on board with change.

The dark side of the topic is, of course, the less-often discussed and more threatening aspect of safety and security. Sometimes these fears are inflated for shock and horror or PR value. Sometimes they are glossed over. Rarely are they given credence or discussed in a detailed, productive manner. Scant attention has been paid to what harm may come from the widespread IT-ing of healthcare.

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Blog: Mining Data for Better Medicine

Mining Data for Better Medicine
Technology Review (09/19/11) Neil Savage

Researchers are utilizing digital medical records to conduct wide-ranging studies on the effects of certain drugs and how they relate to different populations. Data-mining studies also are being used to uncover evidence of economic problems, such as overbilling and unnecessary procedures. In addition, some large hospital systems are employing full-time database research teams to study electronic records. Stanford University researcher Russ Altman is developing tools to analyze the U.S. Food and Drug Administration's Adverse Event Reporting System, a database containing several million reports of drugs that have harmed patients. The Stanford researchers have developed an algorithm that searched for patients taking widely prescribed drugs who subsequently suffered side effects similar to those seen in diabetics. "There's just an incredibly wide range of possibilities for research from using all this aggregated data," says Margaret Anderson, executive director of FasterCures, a think tank in Washington, D.C. "We're asking, 'Why aren't we paying a little bit more attention to that?'"

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Blog: Social Media for Dementia Patients

Social Media for Dementia Patients
SINTEF (09/15/11)

SINTEF researchers are developing a version of the popular Facebook social media site that offers a simpler user interface designed for elderly people and those with dementia. "Why should elderly people be excluded from the social media, which are the communication platform of the future?" says SINTEF researcher Tone Oderud. The researchers want to develop a Web-based communications application that is simple and secure for elderly and senile users, their relatives, and caregivers. They say that social media can become an important tool for improving the quality of life of elderly people, while easing the burden on therapists and caregivers. In testing, the application has shown that simple contact between relatives and the support services improved all users' security. "The tests have shown us that there is great potential for all in the fields of caregiving and digital communication," Oderud says.

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Blog: Wireless Network in Hospital Monitors Vital Signs

Wireless Network in Hospital Monitors Vital Signs
Washington University in St. Louis (08/04/11) Diana Lutz

Washington University in St. Louis researchers launched a prototype sensor network in Barnes-Jewish Hospital, with the goal of creating a wireless virtual intensive-care unit in which the patents are free to move around. When the system is fully operational, sensors will monitor the blood oxygenation level and heart rate of at-risk patients once or twice a minute. The data is transmitted to a base station and combined with other data in the patient's electronic medical record. The data is analyzed by a machine-learning algorithm that looks for signs of clinical deterioration, alerting nurses to check on patients when those signs are found. The clinical warning system is part of a new wireless health field that could change the future of medicine, says Washington University in St. Louis computer scientist Chenyang Lu. In developing the system, the researchers were focused on ensuring that the network would always function and never fail. The relay nodes are programmed as a self-organizing mesh network, so that if one node fails the data will be rerouted to another path. At the end of the trial, the researchers found that data were reliably received more than 99 percent of the time and the sensing reliability was 81 percent.

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Blog: HIMSS Analytics, the 8 stages to creating a paperless patient record environment

HIMSS Analytics, the authoritative source on EMR Adoption trends, devised the EMR Adoption Model to track EMR progress at hospitals and health systems. The EMRAM scores hospitals in the HIMSS Analytics Database on their progress in completing the 8 stages to creating a paperless patient record environment.

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Blog: The biggest winner in health reform

The biggest winner in health reform

By Dana Blankenhorn; Aug 20, 2010

The biggest winners out of health reform may come from an industry you never heard of.

Predictive modeling.

The idea has been around for 20 years. Compare the risks of patients, or the costs of clinics, in an effort to lower both. Collect the data, analyze it, then act on the analysis.

Verisk Health is in this business. Much of their work in the past was done with health insurance companies, and chief medical officer Nathan Gunn (right) admitted that in the old fee-for-service era it wasn’t working.

Tiering physicians into high-cost and low-cost networks did not work. Cutting off patients based on risk assessments proved to be political poison.

But capitation, the change from a fee-for-service to a fee-per-patient model, changes everything, he said. Capitation is the health reform the insurance industry wanted, and got, in the bill that passed Congress earlier this year.

http://www.smartplanet.com/technology/blog/rethinking-healthcare/the-biggest-winner-in-health-reform/1576/

Blog: Crunching Cancer With Numbers

Crunching Cancer With Numbers
New Scientist (07/13/10) Buchen, Lizzie

In 2009, the U.S. National Cancer Institute recruited scientists from a broad range of disciplines to apply their expertise and computational tools toward the discovery of simple laws governing the fate of cancer cells. This differs from the molecular-level approach that cancer research has concentrated on for the last several decades. The researchers are testing a series of interlocking computational models they have devised from fundamental precepts to describe and predict different aspects of cancer. Within five years they hope to have a single, all-encompassing model of mouse lymphoma that seamlessly aligns with the data. The ultimate goal is to generate a model that can anticipate an individual's response to various combinations of cancer therapies by feeding it with key parameters, such as gender, blood pressure, and genetic sequences. One of the researchers engaged in this effort is Paul Newton, project leader at the Scripps Research Institute's physical sciences oncology center. His goal is to unlock the underlying mechanics of metastasis by deconstructing the process into simple steps that can each be modeled using equations.

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Blog: All Eyes and Ears on March of the Cyborgs

All Eyes and Ears on March of the Cyborgs
Sydney Morning Herald (Australia) (06/05/10) Smith, Deborah

Medical implants such as heart pacemakers, cochlear implants for the deaf, and brain implants for those with Parkinson's disease are just the beginning of the process of cyborgization, the development of high-tech implants and prostheses that will benefit many people, says Australian National University professor Roger Clarke. On the horizon are bionic eyes that enable the blind to see and muscle implants that could allow paraplegics to stand and even walk, says the University of Melbourne's Rob Shepherd. "The field of medical bionics is rapidly expanding,'' Shepherd says. ''The thing we get excited about is that Australia is at the forefront.'' Researchers also are developing electrically conducting plastics that could stimulate and guide nerve fibers to repair spinal cords. "Cyborgization will give rise to demands for new rights,'' Clark notes, such as using devices to enhance, not just restore, function.

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Blog: Free, Open Virtual Laboratory for Infectious Diseases

Free, Open Virtual Laboratory for Infectious Diseases
ICT Results (06/04/10)

A European research team has developed a virtual laboratory designed to help doctors match drugs to patients and make treatments more effective. The ViroLab Virtual Laboratory uses machine learning, data mining, grid computing, modeling, and simulation technologies to convert the content of millions of scientific journal articles, databases, and patients' medical histories into knowledge that can be used for treatment. "ViroLab finds new pathways for treatment by integrating different kinds of data, from genetic information and molecular interactions within the body, measured in nanoseconds, up to sociological interactions on the epidemiological level spanning years of disease progression," says University of Amsterdam professor Peter Sloot. The system continuously crawls grid-connected databases of virological, immunological, clinical, genetic, and experimental data and extracts information from scientific journal articles. The ViroLab Virtual Laboratory also could be used to create personalized drug rankings to aid in the treatment of people suffering from diseases.

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Blog: DNA Logic Gates Herald Injectable Computers

DNA Logic Gates Herald Injectable Computers
New Scientist (06/02/10) McAlpine, Katie

Hebrew University of Jerusalem (HUJ) researchers have developed DNA-based logic gates that could carry out calculations inside the body and may lead to injectable biocomputers programmed to target diseases as they arise. "The biocomputer would sense biomarkers and immediately react by releasing counter-agents for the disease," says HUJ's Itamar Willner. The logic gates are formed from short strands of DNA and their complementary strands, in conjunction with some molecular machinery, mimic their electronic equivalent. Two strands act as the input--each represents a one when present or a zero when absent. DNA computing allows calculations to be carried out in parallel, if different types of logic gates are represented by different ingredients. The HUJ team also was able to create logic gates that calculate in sequence. The HUJ system reforms after every step, enabling long sequences of calculations to be carried out. "Being enzyme-free, it has potential in future diagnostic and medical applications," says the Weizmann Institute of Science's Benny Gil.

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Blog: Keeping Medical Data Private

Keeping Medical Data Private
Technology Review (04/13/10) Gammon, Katharine

Vanderbilt University (VU) researchers have developed an algorithm designed to protect the privacy of medical patients while maintaining researchers' ability to analyze large amounts of genetic and clinical data. Although patient records are anonymized, they still contain the numerical codes, known as ICD codes, which represent every condition a doctor has detected. As a result, VU professor Bradley Malin says it is possible to follow a specific set of codes backward and identify a person. Malin and his colleagues found that they could identify more than 96 percent of a group of patients based only on their particular set of ICD codes. To make patients more private, the researchers designed an algorithm that searches a database for combinations of ICD codes that distinguish a patient and then substitutes a more general version of the codes to ensure each patient's altered record is indistinguishable from a certain number of other patients. The researchers tested the algorithm on 2,762 patients and could not identify any of them based on their new ICD codes.

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Blog: GE Qualibria brings decision support to patient bedside

GE Qualibria brings decision support to patient bedside

Posted by Dana Blankenhorn; March 3rd, 2010@ 7:57 am The next step beyond Electronic Medical Records (EMR) is integrating it with advice on what a doctor should do, at the bedside. That's what GE Healthcare is trying to do with its new "clinical knowledge platform," dubbed Qualibria. Qualibria was introduced at a small press breakfast during the HIMSS trade show. The development partner was Intermountain Healthcare, a Salt Lake City, Utah company that both offers health care plans and runs hospitals. This gives it an incentive to do cost effective care. A recent Dartmouth study said $40 billion could be saved a year by moving to the procedures Intermountain practices. Those procedures, along with coding, research and decision support tools, are now at the patient's bedside with Qualibria, which is "EMR agnostic" and so can ride above the systems hospitals have already installed. "The secret sauce is not only the clinical quality of Intermountain but the presentation of that knowledge," said Dr. Graham Hughes, chief medical officer for GE's Healthcare's Enterprise IT Systems division.

Blog: Golden age of population studies from health IT

Golden age of population studies from health IT

Posted by Dana Blankenhorn, February 11th, 2010 @ 6:20 am

In automating health records insurers and the government have two key goals in mind.

1. By keeping records together patients save money and time. You don’t have to fill out a paper form each time you see a new doctor. Tests follow you and don’t have to be retaken. Everyone in your “circle of care” can see all your relevant data, which reduces mistakes. Billing is simpler.
2. By collecting and sharing large amounts of data, we can find what works and what is cost-effective. Comparative effectiveness may be controversial but it is sound science with clear benefits.

As numbers get bigger small trends get clearer.

Blog: FTC Rule Expands Health Data Breach Notification Responsibility to

FTC Rule Expands Health Data Breach Notification Responsibility to Web-Based Entities

SANS NewsBites Vol. 11 Num. 66 (August 18, 2009)

The US Federal Trade Commission has issued a final rule on health care breach notification. The rule will require web-based businesses that store or manage health care information to notify customers in the event of a data security breach. Such entities are often not bound by the requirements of the Health Insurance Portability and Accountability Act (HIPAA); this rule addresses that discrepancy.

http://www.darkreading.com/security/government/showArticle.jhtml?articleID=219400484

[Editor's Note (Pescatore): If my kids grow up to be government agencies, I hope they turn out to be the FTC. Any government agency is my kind of government agency when they issues press releases with headlines like "FTC Says Mortgage Broker Broke Data Security Laws: Dumpster Wrong Place for Consumers' Personal Information."]

Blog: New Epidemic Fears: Hackers

New Epidemic Fears: Hackers
The Wall Street Journal (08/04/09) P. A6; Worthen, Ben

Under the economic stimulus bill and other U.S. federal government proposals, hospitals and doctors' offices that invest in electronic records systems may receive compensation from part of a $29 billion fund. However, such systems can be vulnerable to security breaches. Last year health organizations publicly disclosed 97 data breaches, up from 64 in 2007, including lost laptops with patient data on them, misconfigured Web sites that accidentally disclosed confidential information, insider theft, and outside hackers breaking into a network. Because most healthcare organizations keep patients' names, Social Security numbers, dates of birth, and payment information such as insurance and credit cards, criminals often target these places for identity theft. "Healthcare is a treasure trove of personally identifiable information," says Secure Works researcher Don Jackson. The U.S. Federal Trade Commission says medical fraud is involved in about 5 percent of all identity theft. Smaller practices can become easier targets, as they rarely have a technology professional or security specialists, and often lack a security plan or proper tools. The government plans to release guidelines over the next year, as part of the stimulus bill, to illustrate a secure information system, but critics warn that data encryption and other security functions are worthless if they are not correctly used. "If you take a digital system and implement it in a sloppy way, it doesn't matter how good the system is," says World Privacy Forum executive director Pam Dixon. "You're going to introduce risk."

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Blog: How Networking Is Transforming Healthcare

How Networking Is Transforming Healthcare
Network World (07/20/09) Marsan, Carolyn Duffy

High-speed computer networks have the potential to transform the healthcare industry, according to Mike McGill, program director for Internet2's Health Sciences Initiative. Internet2's Health Network Initiative is a project to help medical researchers, educators, and clinicians see the possibilities of network applications in a medical setting. McGill notes, for instance, that Internet2 has demonstrated the ability to put a patient up on a telepresence environment with a remote psychiatrist, which would go a long way toward fulfilling the U.S. Department of Veterans Affairs' mandate to provide care for wounded soldiers, who often reside in rural areas but are assigned psychiatrists based in urban areas. McGill points out that 120 of the 125 medical schools in the United States are Internet2 members, and he says that Internet2 is the designated national backbone for the Federal Communications Commission's Rural Health Care Pilot Program. Groups that the Health Network Initiative has spawned include those focusing on security, the technical aspects, network resources, and education. McGill says the Obama administration is currently pushing "for electronic health records with very limited capability," and notes that the Health Sciences Initiative is "working on electronic health records that are backed up by lab tests and images, and that's a whole lot richer of an environment than just the textual record." Another project the initiative is focused on is the creation of a cancer biomedical informatics grid that is linking all U.S. cancer centers so that the research environment can be unified to exchange data. McGill describes the last mile and cultural challenges as the key networking challenges in terms of electronic health information sharing.

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Blog: Can Pen and Paper Help Make Electronic Medical Records Better?

Can Pen and Paper Help Make Electronic Medical Records Better?
IUPUI News Center (07/20/09) Aisen, Cindy Fox

Using pen and paper occasionally can make electronic medical records even more useful to healthcare providers and patients, concludes a new study published in the International Journal of Medical Informatics. The study, "Exploring the Persistence of Paper with the Electronic Health Record," was led by Jason Saleem, a professor in the Purdue School of Engineering and Technology at Indiana University-Purdue University Indianapolis. "Not all uses of paper are bad and some may give us ideas on how to improve the interface between the healthcare provider and the electronic record," Saleem says. In the study of 20 healthcare workers, the researchers found 125 instances of paper use, which were divided into 11 categories. The most common reasons for using paper workarounds were efficiency and ease of use, followed by paper's capabilities as a memory aid and its ability to alert others to new or important information. For example, a good use of paper was the issuing of pink index cards to newly arrived patients at a clinic who had high blood pressure. The information was entered into patients' electronic medical records, but the pink cards allowed physicians to quickly identify a patient's blood pressure status. Noting that electronic systems can alert clinicians reliably and consistently, the study recommends that designers of these systems consider reducing the overall number of alerts so healthcare workers do not ignore them due to information overload.

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Blog: Vanderbilt Doctors and Software Engineers Pioneer an Advanced Sepsis Detection and Management System

Vanderbilt Doctors and Software Engineers Pioneer an Advanced Sepsis Detection and Management System
VUCast (06/15/09) Salisbury, David F.

Researchers from Vanderbilt University's Medical Center and Institute for Software Integrated Systems have developed a real-time system for sepsis detection. In May, the system was tested in the medical center's intensive care unit, and this summer an automated decision support system will be added to help guide attending physicians through complex sepsis treatments. "This is an effort to use the power of informatics to move from reactive to proactive medical treatment by creating tools to support the use of evidence-based clinical guidelines," says Vanderbilt HealthTech Laboratory director Peter Miller, who is overseeing the project. Sepsis occurs when bacteria invade the body from wounds or intravenous lines, which over-stimulates the body's immune system and causes inflammatory and abnormal clotting responses. Sepsis can result in organ failure and death. The system features an automated early detection system that alerts doctors that a patient may be developing sepsis, based on temperature, heart rate, respiration rate, and white blood count. Creating the system involved developing a special modeling language specifically designed for clinical decision-making. Although the language is specific to sepsis management, the underlying technical infrastructure can be used to model almost any medical protocol, says Vanderbilt graduate student Janos Mathe.

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