Biomedical Sensor Networks: Monitor your body in real-time

Growth of mHealth technology has seen the emergence of low-power, single-chip radios and this has allowed the design of small, wearable, and networked medical sensors. These sensors relay vital data to receiving devices like PDAs carried by physicians or laptop base stations in ambulances. The wireless sensors allow monitoring of the patients at home so that the elderly or patients with chronic diseases can receive treatment and medical monitoring in their homes. They also increase the efficiency of treatments in hospitals.

Biomedical Sensor Network (BSN) is tailored to the patient’s own medical needs and can provide notifications such as alerts to take medicine using an in-network wearable interface. It can also integrate SATIRE, a body network that classifies Activities of Daily Living (ADLs) by analyzing accelerometer data generated by a wearer’s movements. Body networks contain a designated gateway device that mediates interaction with the surrounding WSNs. This modularizes the system’s interaction with the body network to ease its integration.

However, wireless transmission of patient data presents certain security concerns. There can be an outsider attack where the attacker node is not an authorized participant of the sensor network or there can be an insider attack where the attacker obtains key information by physically capturing a node and reading its memory. The long-term success of BSNs depends upon addressing these threats successfully. Several security solutions have been proposed but there exists considerable scope for further research.

References

Realistic Applications for Wireless Sensor Networks by John A. Stankovic, Anthony D. Wood and Tian He

Security Issues in Biomedical Wireless Sensor Networks by Tassos Dimitriou and Krontiris Ioannis

http://www.fiercemobilehealthcare.com/story/wireless-sensor-networks-need-clear-few-hurdles-mhealth/2014-04-09

Mobile: The future of Healthcare

There has been phenomenal increase in the use of mobile technologies in all aspects of our lives. The disruptive powers of these technologies have altered the ways in which people communicate and conduct business and the advantages and disadvantages of mHealth is discussed in the video shown above. This disruptive power and the innovations that have been made in their wake are transforming the health care industry.

Mobile device users who downloaded at least one mHealth application doubled between 2011 and 2012 in America. This significant increase in the use of mHealth is for a number of reasons such as improvement of technology, change in demographics, better accessibility etc. The article by Susanna Fox and Maeve Duggan concluded that women between the ages of 30 and 64 and smartphone owners are more likely than other cell phone owners to have signed up for health text alerts. Mobile health information also seems to appeal to certain groups of health consumers: caregivers, people who went through a recent medical crisis, and those who experienced a recent, significant change in their physical health such as gaining or losing a lot of weight, becoming pregnant, or quitting smoking.

Aging population, increasing chronic illnesses and accelerating health costs will propel mobile solution growth. A major hurdle to the growth has been the uncertainty around regulation. Mobile health applications exist in an area between medical devices which are highly regulated and computer applications which are not much regulated. When does a mobile device warrant regulation by the FDA? Unless developers are sure how the applications will be regulated they may not be very willing to spend their time on developing innovative products.

In conclusion, mHealth will define the future of healthcare. However, like all novel technologies it must first overcome hurdles to fulfill its promise.

References

mHealth in an mWorld How mobile technology is transforming health care by Deloitte

Mobile Health 2012 by Susannah Fox and Maeve Duggan

The Big deal of Big data in Healthcare

There is no doubt about that, big data has a potential of generating $38 billion annual revenue, $165 billion in clinical operations and $105 in R&D.  But, what is the big deal of big data?

According to Rob Friehl, Chairman of PerkinElmer, ⅓ of the revenue of PerkinElmer are generated from detection and imaging instruments. Detection involves using different types of data such as mass spectrometer etc. and looking at minute details. It is referred to as “finding an individual cash chip on the Vegas strip and knowing its exact chemical composition”. Big data is the new frontier in competition in the healthcare sector as it allows synthesis of large volume of data from a variety of sources at high velocity.

With the use of big data, a heel prick can detect approximately 54 million diseases and this process was used successfully on 21 million babies. Big data has enabled efficient collaboration of different research organizations across the globe and revolutionized the system by setting up a “self-service” model for scientists. Big data has allowed scientists to acquire large volumes of data and connect with other experts in the field using mature technologies.

Another key challenge faced by the healthcare system is correlation. Currently, 55% of the drugs prescribed to patients do not work and 70% of the cancer drugs prescribed to patients do not work. What is needed today is personalized healthcare that is effective and efficient.

According to Rob Friehl, 1 genome produces 240 billion bytes of data and if the interaction of our biological processes with the environment is included, then the volume of data collected significantly increases. Recent experiments have indicated the genetics and environment are not mutually exclusive but are rather interrelated.  The idea that environment plays as big a role as genetics in an individual health was confirmed by studies conducted on identical twins. The DNA of identical twins are almost identical. However, it was found that one twin might get cancer while the other is not susceptible, for example. The differences stem from chemical modifications in the genes over the years. These epigenetic effects, as they are called, are the result of chemical exposure, dietary habits and other environmental factors.

Thus, big data does not only help identify disease early by analyzing large volumes of data but can also help take precautionary measures to prevent it by providing personalized health care treatment based on epigenetics.

References

https://www.youtube.com/watch?v=trKmVFDUFwo

Rob Friehl, Chairman, CEO and President of PerkinElmer talks about PerkinElmer and the role big data plays in healthcare

https://www.youtube.com/watch?v=OVBZTDREg7c

Jeffrey Hammerbacher, Founder and Chief Scientist at Cloudera, Director at Sage Bionetworks and Assistant Professor at Mount Sinai School of Medicine, talks about Big Data 

“Super convergence” of Technology and Medicine

We live in an exciting age where converging technologies like personal genomics, artificial intelligence and mobile has become faster and smarter and at greatly reduced costs. We now have tools at our disposal when confronted with unmet needs and challenges like primary care shortage that call for novel, convergent and disruptive solutions.

A “massive convergence” of smartphone technology, computing power, and genetics is rapidly transforming medical practice, Eric Topol, MD, Director of the Scripps Translational Science Institute in La Jolla, California, told HIMSS members during a seminar. In 2012, Modern Healthcare ranked Topol as the most influential physician executive in the United States.

In his book The Creative Destruction of Medicine Eric Topol discusses the many structural issues in the healthcare system and how technology is “rebooting” the system. With personal technology doctors can see a continuously updated picture of each patient and treat them individually. This is possible with the powerful tools now available to sequence one’s genome and predict the effects of drugs. In his best-selling book he calls for a "jailbreak" from the ideas of the past. It is a riveting book that helps us think of solutions in novel ways.

References

http://dw2blog.com/2012/03/25/smartphone-technology-super-convergence-and-the-great-inflection-of-medicine/

http://histalkmobile.com/super-convergence-of-technologies-now-changing-medical-practice-eric-topol-md/

Introduction

The current healthcare system is often compared to the 19th-century cottage industry. The US healthcare delivery system is described as expensive, fragmented, highly decentralized and poorly organized. Why has a sector that can be traced back to the medieval era still be so inefficient? How is Information and Communication Technology (ICT) driving the sector towards better care through prevention? What are the key challenges faced by the sector today?

I come from a healthcare background and I have always been interested in the influence ICT has on healthcare. This blog aims to provide an insight into this complex sector and analyze how ICT is changing the healthcare sector.

Healthcare Information Technology: The Push and Pull

There has been significant progress in developing and evaluating computer applications aimed at improving personal health and healthcare and this often referred to as “medical informatics”: the intersection of information technology (IT) and medicine. By focusing on healthcare that is predictive, preventive, personalized and participatory (P4 medicine) new frontiers in Healthcare Information Technology (HIT) are emerging. However, the road to successful implementation of IT has been challenging, with strong factors pushing it up the path of progress while simultaneously pulling it down.

The Push for HIT

“Prevention is Quality. Prevention lowers cost”. The healthcare sector will save trillions of dollars if healthcare is made convenient while simultaneously improving quality and lowering cost. While this sounds difficult, it is not an impossible task. According to Robert Pearl during his speech at the 8th Annual American Health Care Congress, sending secure email to physicians and getting almost immediate diagnosis increases productivity by $28,000/year. Only a few minutes are required to make initial medical assessment and there is no need to meet the physician in person. In areas such as dermatology, 70% of the patients received care almost immediately because of sending information safely and securely via internet.

Another emerging sector in HIT is mobile apps. This sector aims to better connect medical professionals with patients and decrease the divide between patient, doctors and nurses. The technology also aims to improve the flow of information among the medical community by allowing doctors and nurses in the same health institution to communicate efficiently and provide the right medical treatment at the right time.

Hurdles faced by HIT

The barriers to shifting healthcare to a predictive and preventive system includes costs, technical issues, system interoperability, concerns about privacy and confidentiality, and lack of a well-trained clinical informatics workforce to lead the process.

While there is an increased demand for HIT, its development has been rather slow. Evaluation by means of randomized controlled trials (RCT) has not yet provided any major indications of improved patient outcomes or cost effectiveness. The evaluation technique adopted has a severely negative impact on the progress of information as clinical information technology is not comparable to a drug and cannot be evaluated using randomized controls. The major drawbacks to using RCT is cost and difficulty related to external validity. Further, a negative result from such trails do not provide any constructive feedback as it does not help us understand the effects of the clinical system or help us build better ones in the future.

In conclusion, HIT is a disruptive technology that has the potential to steer the healthcare system towards the path of success if IT and healthcare are able to more easily merge to form one cohesive sector.

References:

http://www.youtube.com/watch?v=Ws37ra7FIg

Dr. Robert Pearl's speech at the 8th Annual American Health Care Congress

http://www.bmj.com/content/316/7149/1959

The article “Evaluating information technology in health care: barriers and challenges” evaluates the issues faced by clinical informatics

http://medicalcenter.osu.edu/about

http://medicalcenter.osu.edu/aboutus/personalized_health_care_stories/Pages/index.aspx

Impact of ICT on healthcare

ICT is not a novel technology; it is a continuous improvement of computing and communication. The combination of ICT and Healthcare has ushered in a new field called “e-health” that impacts each and everyone of us: payers, providers, practitioners and patients.

E-health is the “a concerted effort undertaken by leaders in health care and hi-tech industries to fully harness the benefits available through convergence of the Internet and healthcare”. This emerging sector aims to address three main communication networks. The “Business to Consumer“ (B2C) section aims to improve the interaction of consumers with the system, the “Business to Business” (B2B) aims to enhance the institution-to-institution transmission of data and the “Consumer to Consumer” (C2C) explores new possibilities of peer-to-peer communication. 

The reasons why e-health is revolutionizing the healthcare system is because it is easy-to-use, exciting and entertaining. The NHS Direct in the UK provides advice on health and medical problems via internet and telephone. WebMD provides online group discussions with medical experts. CyberDocs offer “virtual house call” with board-certified physicians for $50 -$100 a session and the demand for these services are ever increasing. One system which is still under development assists men with enlarged prostates to make an informed decision on whether to watch and wait or take recourse to medication and surgery. Another interesting application uses automated computer interviews as well as multimedia presentations to help patients choose treatment options for deep-vein thrombosis.

Kaiser Permanente has spent over $2 billion to move all of its operations onto the Internet and has created a computerized patient record. This has allowed all 361 of its clinics and hospitals and every physician, nurse, and dentist in these hospitals communicate with one another and with patients. Members can also use the system to search online for health information, obtain advice from nurses and pharmacists, request an appointment, or join an online discussion group.

But what are the drawbacks? Is it good to allow consumers access to information? Are the consumers using the information made available efficiently? The information available online is many a time incomplete and this often leads to misdiagnosis and panic for the consumers. Many argue that this free access to information will lead to adverse selection. Consumers will generally choose high-quality providers based on the performance review and this will unfairly penalize healthcare providers and organizations that treat high-risk patients. This might discourage surgeons from operating on high-risk patients.

Thus, while ICT promises to make access to quality healthcare easier and more cost effective the drawbacks discussed above remain to be addressed.

References:

http://www.medscape.com/viewarticle/415047_2I

In the article “How the Internet Is Transforming the Physician-Patient Relationship” James G. Anderson provides a detailed analysis of the impact e-medicine has on patients and physicians.

https://tspace.library.utoronto.ca/html/1807/4615/jmir.html