May 29, 2007
Patient's Trust Physicians About Health Data Exchange Information
In a survey this month of 1,000 adults by the eHealth Initiative, consumers were asked who do they trust most to deliver information about secure electronic health data exchange. Sixty-seven percent of consumers say that they trust their physicians most. This was compared with 8% who said they trust hospitals, 7% trusting the federal government and 3% of respondents said that they trusted employers while 3% trusted the state government.
The survey found that 70% of respondents support the development of health data exchange while 21% oppose its development.
Source: California Healthcare Foundation
May 25, 2007
Simultaneous Imaging of the Brain by MRI and PET
Siemans announced this week that they have devised the world's first fully-functioning device capable of performing both Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET). According to the company, the simultaneous MRI and PET scanning of the brain will likely further improve the diagnostic power of these imaging modalities.
MR-PET presents a leap forward in imaging capabilities. Siemens is the first company to have an MR-PET prototype, which brings the exceptional soft tissue contrast and high specificity of MR together with PET's excellent sensitivity in assessing physiological and metabolic state. MR-PET has the potential to become the imaging modality of choice for neurological studies, certain forms of cancer, stroke, and the emerging study of stem cell therapy.
Researchers believe that MR-PET will foster new advances in understanding the pathologies and progression of various neurological disorders like Alzheimer's, Parkinson's, epilepsy, depression and schizophrenia. For example, PET can currently differentiate mild cognitive impairment from early-stage Alzheimer's, but cannot determine reduced brain volume caused by atrophy. By combining MR and PET, clinicians may be able to make a more sound determination of both cognitive impairment and atrophy. Furthermore, combining MR-PET and the new emerging neurological biomarkers, has the great potential to strengthen the assessment of the condition.
Similarly, in stroke patients, the technology holds the promise of allowing physicians to study which brain tissues might be salvageable after a stroke. In other rehabilitation settings, such as for patients with traumatic brain injury, the Siemens MR-PET approach would improve care and workflow. Patients would need to be scanned once instead of having to go to two different locations.
The technology also holds great promises for emerging therapeutic research as well, as in the case of stem cell therapy. Since this approach allows simultaneous measurement of anatomy, functionality and biochemistry of the body’s tissues and cells, it may enable researchers to correlate MR and PET data in a way not previously possible before. This correlative approach will enable to get a much deeper understanding of track stem cell migration to damaged parts of the brain, determination over a prolonged period whether or not cells are still alive, and identification of how stem cells have been integrated into the body’s neurological network.
May 22, 2007
Implantable Biocomputers
Researchers at Harvard and Princeton universities have taken a crucial step toward building biological computers, tiny implantable devices that can monitor the activities and characteristics of human cells. The information provided by these "molecular doctors," constructed entirely of DNA, RNA, and proteins, could eventually revolutionize medicine by directing therapies only to diseased cells or tissues
Published this week in the journal Nature Biotechnology, researchers describe that these biocomputers can translate complex cellular signatures, such as activities of multiple genes, into a readily observed output. They can even be programmed to automatically translate that output into a concrete action, such as labeling a cell for a clinician to treat or they could trigger therapeutic action themselves.
The scientists demonstrate in their Nature Biotechnology paper that biocomputers can work in human kidney cells in a culture. Research into the system’s ability to monitor and interact with intracellular cues such as mutations and abnormal gene levels is still in progress.
Each human cell already has all of the tools required to build these biocomputers on its own, What is needed is the a genetic blueprint of the machine and our own biology will do the rest. Our cells will literally build these biocomputers for us.
May 18, 2007
Cornell Researchers Use "Virtual Iraq" Simulation to Study PTSD
Weill Cornell Medical College researchers are using a virtual reality simulation called "Virtual Iraq" to better understand how symptoms of post-traumatic stress disorder (PTSD) develop. Virtual Iraq is a 3-D virtual-reality simulation of an urban combat scenario. Subjects wear a headset, through which they hear, see, and — using a keypad — "move" through a "virtual world" in which images change in a natural way along with head and body movement.
According to a recent Archives of Internal Medicine study as many as 13 percent of recent veterans are diagnosed with PTSD. The Weill Cornell researchers are testing whether physiological arousal (heart rate, stress hormones) and anxiety while viewing the simulation — as well as suppressing memories after viewing the simulation — affect the ability to remember the scenario and suppress intrusive scenario memories.
The researchers from Cornell are testing the hypothesis that verbalizing the traumatic experience, instead of suppressing it, enables patients to better integrate the experience into regular conscious memory, in turn, making the triggering of intrusive traumatic memories (and other re-experiencing symptoms, like flashbacks) less likely. Research suggests that memories formed during trauma exposure are easily cued by environmental stimuli, and memory suppression has been associated with the development, maintenance and severity of PTSD.
The "Virtual Iraq" virtual-reality environment was developed by Dr. Albert Rizzo of the University of Southern California (USC) Creative Technologies Laboratory and Ken Graap of Virtually Better, Decatur, Ga., with funding from the U.S. Naval Research Office.
Weill Cornell Medical College Press Release
May 10, 2007
Computers Need To Learn To Forget
Harvard Professor Viktor Mayer-Schönberger, from the JFK School of Government argues that too much information is being retained by computers, and that our machines need to learn how to forget things as humans always have. He writes in his paper, “if whatever we do can be held against us years later, if all our impulsive comments are preserved, they can easily be combined into a composite picture of ourselves. He notes that we are becoming increasingly anxious about “how our words and actions may be perceived years later and taken out of context, the lack of forgetting may prompt us to speak less freely and openly."
He believes this continuous collecting and retention of data is creating a panopticon in which everything is being watched. In contrast to having an omnibus data protection legislation, Dr. Mayer-Schönberger proposes a combination of law and software to ensure that most data is "forgotten" by default. A law would decree that "those who create software that collects and stores data build into their code not only the ability to forget with time, but make such forgetting the default." Essentially, this means that all collected data is tagged with a new piece of metadata that defines when the information should expire.
In practice, this would mean that iTunes could only store buying data for a limited time, a time defined by law. Should customers explicitly want this time extended, that would be fine, but people must be given a choice. Even data created by users—digital pictures, for example—would be tagged by the cameras that create them to expire in a year or two; pictures that people want to keep could simply be given a date 10,000 years in the future.
Mayer-Schönberger’s goal is to help us avoid becoming digital pack rats, and he believes that we need to curtail the amount of time that companies and governments can collate data about users and citizens "just because they can." Whenever there's a real need to do so, data can be retained, but setting the default expiration date forces organizations to decide if they truly do need to retain that much data forever.
Dr. Mayer-Schönberger’s Paper: (pdf)
Useful Void: The Art of Forgetting in the Age of Ubiquitous Computing
May 04, 2007
Virtual Reality To Help MS Patients Walk
Researchers at the Technion Institute of Technology in Israel have created a wearable virtual reality device to provide patients suffering from balance disorders with supplemental auditory and visual information to restore normal gait.
The device combines a wearable, audio component the size of a cell phone which measures body movement, processes it and sends feedback to the user through earphones. A visual feedback apparatus is also used.
The visual component presents users with a virtual, tiled-floor image displayed on one eye via a tiny piece that clips onto glasses worn by the user. This allows the user to distinguish between the virtual floor and real obstacles, making it possible to navigate even rough terrain or stairs.
The researchers found that auditory feedback significantly improved the gait of both MS and Parkinson's patients (though the improvement was less pronounced in Parkinson's patients). With regard to walking speed, patients showed an average improvement of 12.84% while wearing the device. There were also positive residual short-term therapeutic effects (18.75% improvement) after use. Average improvement in stride was 8.30% while wearing the device and 9.93% residually.
Health individuals receive sensory feedback from muscle nerves, which report on muscle control, telling them whether or not they are using their muscles correctly. In MS or Parkinson patients or in the elderly this feedback is damaged These researchers have demonstrated that auditory feedback can be used to help them walk at a fixed pace.
Results from a small study (14 randomly selected patients with gait disturbances predominantly due to MS) on the device are published in the February 2007 issue of the Journal of the Neurological Sciences .
The integrated device - the first to respond to the patient's motions rather than just providing fixed visual or auditory cues - is already in use at a number of medical centers in Israel and the United States, including the University of Cincinnati and the State University of New York.
May 03, 2007
Self-Service Technology
Recently, a trip to a bank, supermarket, or airport shows a growing presence of self-service technology. Interactive kiosks are being used for concierge functions, reservations, registrations, and check-out because the always-available, always-on technology lets the guest / customer to control their experience. Self-service technology is giving experienced business travelers the efficiency they demand while freeing up hotel or airline employees to help the casual traveler.
How is this technology being applied to the healthcare industry? Technology providers are trying hard to entice the healthcare industry to use these solutions.
Calgary Health Region in Canada last year installed kiosks for its employees to use to submit health benefit claims, view paycheck information and check e-mail. The result is a more efficient use of staff time and less frustrated employees. This also empowers the individual to be able to check and monitor their own information.
The health care industry has been slow to adopt self-service technology, which has shown potential to steamline administrative processes and cut costs. The self-service interface should be intuitive and user friendly, and it should be appropriate for the workflow and care setting. As individuals experience this technology in travel, banking, supermarkets and hotels it will become more widely adopted at hospitals or clinics.
If you have ever used the online check-in service at an airport, you know that printing a boarding pass at home allows you to skip long lines and proceed to security and the gate. Imagine using this same technology at an emergency room, hospital admission or clinic visit. Even the fact that a patient will be confirming their next day appointment, can help clinicians plan their time.
Article from Digital Healthcare & Productivity