Healthcare NBIC

Consolidating this blog at JPowers.IN3.ORG

Caught up in academic fervor over intellectual property in my graduate studies at the City University of New York, I've decided to consolidate my blogs and social media content onto my own server in order to "own my own logs."

For more on digital ownership, listen to Columbia Law Professor Eben Moglen's outstanding talk:

Before and After IP: Ownership of Ideas in the 21st Century, Digital Studies Group, CUNY Graduate Center, November 17. 2010 (audio stream). Download: Ogg Vorbis | MP3

and for a more radical view on who should on what in cyberspace, read Mogeln's classic:

DotCommunist Manifesto

From now on, follow my work at my new blog address:

JPowers.IN3.ORG

Subscribe to JPowers.IN3.ORG via RSS

 

Tablet PCs and EMRs: Survey

On the day of Apple's tablet computer introduction, Chris Thorman of SoftwareAdvice.com has posted a survey asking"Which Tablet PC Will Rule the Halls of Healthcare?"

The results should be enlightening. I've seen early-adopting docs who use tablets as naturally as paper clipboards, but you can imagine how hard it must be to bring new gear into the examining room. There's been plenty of pushback to adding tablets into clinical settings: they're often hard-to-use, underpowered, proprietary and un-secure. Evangelists for electronic medical records and tech futurists are absoltely sure these things are the wave of the healthcare future, but that future has been on the horizon for decades. 

EMRs: Don’t Wait for the Government

The billions earmarked for electronic medical records (EMRs) as part of the American Recovery and Reinvestment Act of 2009 (ARRA) could provide the tipping point for doctors to spend the money, time and aggravation needed to automate their offices.

A new report from SoftwareAdvice.com, Don’t Wait for the Government to Start Your EHR Implementation, advises physicians to install the new gear now because "it’s nearly certain that you will qualify for ARRA incentives" to pay for the effort, and besides, the potential savings are bigger than the stimulus bump.

I'm an EMR skeptic, and there seems to be a lot of clauses, criteria and certifications attached to the money, but analyst Chris Thorman thinks docs will get the money back from the feds, "more than likely."

Survey: Which Smartphone Will Own the Healthcare Market?

The folks at Software Advice are conducting a short survey on smartphones in the healthcare market with questions about applications, carriers and purchasing preferences. The survey closes tomorrow, Tuesday, July 28th at 5 PM CDT. It's only six questions long and takes just a couple of minutes to complete. Results will be emailed to respondents.

What are the Healthcare Milestones?

I've just updated the IN3 think piece Age & IT Experience that plots the current age of managers, employees and customers against the big developments in information technology. It's a good party starter: find your age when the IBM PC was launched, when streaming media happened, when Google Maps came out.

What are the milestones that define generations in healthcare?  The dawn of managed care, the Clinton initiative, PET scans, robotic surgery, Health 2.0?

This Week: Google Health sharing, Walmart EMRs and Skeptics on Health IT, Integrative Medicine, Research Bias http://cli.gs/6sjyJ6

Health Memes Week At A Glance for March 9-12, 2009

Question of the Week:

"How do cardiologists ... get to the point where they are able to act primarily in their own best interests, while insisting to everyone ... that they are actually acting in the best interests of others?"

Plus various perspectives on embryonic stem cells.

This Week: Cognitive Training, Self-Experimentation, Selling Embryos, Junk Science

Health Memes Week At A Glance for March 2-5, 2009

Question of the Week:

What's the opposite of "social media"?

Permanent Wisdom from the Health Memes Stream

The river of daily Health Memes contains many keepers, so I've started a section of permanent links that will grow to extra pages as the content develops. Here's the first batch. (Suggestions are welcome.)

PERMALINKS
Attention should be paid to such posts.

A 21st Century Plague? The Syndrome of Inappropriate Over-Confidence in Computing   Healthcare Renewal
A timely rant on rotten studies, clueless simulations, IT arrogance and the "cyber-industrial complex."

Consumer-Driven Healthcare  Dr. Wes
"What a crock of excrement."

Next Steps for Progressive Stem Cell Politics Center for Genetics & Society

Are We Finally Entering the Golden Age of Healthcare Transparency?  Wachter's World
A little sunshine goes a long way.

The impact of gene patents on the future of personal genomics  Genetic Future
Important topic: Companies own patents on specific genes for specific diseases. Good comment thread. "It's like patenting the stars."

My Genome, My Self  NY Times Magazine
Harvard psychologist Stephen Pinker's excellent review of the possibilities and limitations of consumer genetics.

Why Most Published Research Findings Are False  PLoS Med
"It ain’t what we don’t know that hurts us. It’s what we know that ain’t so.” -- not Mark Twain

The Chart Is Dead, Long Live The Chart  The Last Psychiatrist
If the chart is not shaped by the doctoring, the doctoring will be shaped by the chart.

Stem cells, cosmetic genomics and med-tattoos

We don't cover politics at daily Health Memes. Outside of an occasional opinion from policy stars like Maggie Maher or Ezra Klein, most of the posts track the revolution of rising patient expectations, the big gaps between reality and popular medical wisdom, and the brilliant new science and technology innovations derived from the NBIC convergence. That's a broad beat.

THIS WEEK'S REDUCTIO

Regenerative medicine approaches a tipping point.

After a decade of gathering promise -- and some touches of outright fraud -- regenerative medicine is unleashing the power of human cells to grow into the tissues we need. Scientists working on animal models have been getting closer. A Medgadget post told of a Stem Cell Grown Into Prostate and PhysOrg.com reported how Scientists succeed through stem cell therapy in reversing brain birth defects.

This month, the U.S. FDA approved the first trials of human embryonic stem cell therapy in humans by Geron Corp. On Monday, we read How the Geron Stem Cell Treatment is Supposed to Work from the WSJ Health Blog. Next Monday a meme from  Science Daily will show how a Stem Cell Transplant Reverses Early-stage Multiple Sclerosis using a technique similar to those used to treat leukemia and myeloma.

It's only been about 10 years since the first human embryonic stem cell lines were derived. (It's been 16 years since the last big U.S. healthcare reform plan.)

COSMETIC GENOMICS

There's a growing body of memes about misusing genetic testing for non-therapeutic ends. This week, Eye on DNA interviewed Dr. Tzung-Fu Hsieh of RedTracer DNA Test for the Red Hair Gene, MC1R who implied that having red hair could lead to discrimination and skin cancer. Like last week's story about the baby girl tested for breast cancer predispositon before conception, testing the unborn is always supposed to be for their own good -- except for the unspoken punchline that if they fail the test they stay unborn.

As a species, humans are too selfish and too stupid to think these things through. The priceless Neuroskeptic dissects the hubbub over a recent pre-natal study in yesterday's meme  Autism, Testosterone and Eugenics.

MED-TATTOOS

Wednesday a Technology Review story described  The Glucose-Monitoring Tattoo, a nanosensor injected into the skin that fluoresces in infrared light when it detects blood sugar.  If the technique gets applied to humans, diabetics won't need to stick themselves for blood samples, they'll just check the glow of their tatts. According to researchers, other nanosensors could check for chemicals like sodium or calcium. (or maybe alcohol? THC? serotonin?) Someday, we may wear our bio-status on our foreheads.

See all this week's Health Memes.

We don't know anything, really

Two months ago, I began the daily Health Memes coverage on this site, and I've been immersed in scores of great journals, blogs and news sources from scores of different perspectives. In an effort to wrestle some meaning out of all that content, I'll post a weekend review examining the big themes against our NBIC template.

THIS WEEK'S REDUCTIO

We don't know anything, really.

Marcia Angell's essay in the January 15 New York Review of Books, Drug Companies & Doctors: A Story of Corruption, outlines the crooked dance of clinical trials in which medical schools, researchers and Big Pharma select the most profitable results. Susan Dentzer's' commentary in the New England Journal of Medicine decries the Pitfalls of Health Care Journalism in which ignorance, sloth and linkbaiting produce shoddy and even harmful news coverage. Much worse, David Gorski unveils active pseudoscience in his Science-Based Medicine post Chopra and Weil and Roy, Oh My! Or: The Wall Street Journal, coopted. In the policy arena, audacious hopefuls get a dose of reality from The Health Care Blog as Robert Laszewski pours cold water on The Five Myths of Healthcare Reform.

It's hard to live the evidence-based life.

BIOTECHNOLOGY

The first annual Consumer Genetics Show debuts in Boston this summer. Psychologist Stephen Pinker's New York Times Magazine cover story My Genome, My Self brilliantly describes the possibilities of personal genomics and discusses its limitations for individual health. Medical News Today tells of the First Baby Tested For BRCA1 Before Conception Born In UK but not about her brothers and sisters who failed that first test. And the Center for Genetics and Society brought us the Mercury News story It's a boy! Asian immigrants use medical technology to satisfy age-old desire: a son.

INFORMATION TECHNOLOGY

Tim Gee in Medical Connectivity offers an outstanding analysis of how Medical Device Networks Trouble Industry as open architectures, commodity hardware and consumer electronics intrude upon regulated, proprietary, embedded legacy apps. Reality similarly intrudes in Scott Shreeve's Crossover Healthcare essay The Problem with VistA: “Its the Platform, Stupid” and the good comment thread about the VA's pioneering electronic medical record.

Evidence-based reality comes up against the World Wide Web's "wisdom of the crowd" in a thoughtful post on Laika's MedLibLog The Web 2.0-EBM Medicine split. [1] Introduction into a short series. Bob Doherty at The ACP Advocate Blog asks Do patients really want to see their doctor's report card? The disruptive Scott Shreeve of Crossover Healthcare suggests putting some sunlight into insurers' Explanations of Benefits with a call to a Transparency Trek: The Million EOB March. And KevinMD.com tells of a little too much transparency in A vasectomy, live on Twitter.

NANOTECHNOLOGY

Last month, Nature Nanotechnology published a study from Yale which was released in Medical News Today with the headline Nanotech Culture Wars Possible. A PhysOrg.com story worries about Nanotech in your vitamins, and the gap between nano-reality and visions of self-replicating molecular machines prompts Biopinionated Nils Reinton to ask Anybody Seen a Nanobot Lately?

COGNITIVE SCIENCE

Zack Lynch in Brain Waves describes a conference on the Decade of the Mind, and Shannon Proudfoot in the Calgary Herald declares "Brain gyms" a new industry. The World of Psychology reports Tetris Inoculation Against PTSD Flashbacks.

Returning to this week's reductio, in The Chart Is Dead, Long Live The Chart, The Last Psychiatrist describes how patient records (which all the revolutionaries want to digitize) are "unreliable, misleading and worse than useless" because of politics, financial interest and fear of litigation. Paraphrasing Ted Nelson, "If the chart is not shaped by the doctoring, the doctoring will be shaped by the chart."

See all the week's Health Memes for January 12-15 and January 19-22.