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. 

Top Healthcare Conversations of 2008

Many of the great healthcare thinkers and bloggers wrapped up 2008 with end-of-year considerations of the important developments in their fields, and some looked ahead with predictions for 2009. Here are the January 1, 2009 Health Memes from around the web:

Personal Genomics in 2008: the Year in Review  Genetic Future

From 2008 to 2009  ScienceRoll

Finding Venture Capital In 2009 Will Be Tough  Pharmalot

2009 Stem Cell Trendsetters in Neurology and Psychiatry  Brain Waves

The Future of Pharma  Health Beat

The Year in Bioethics: The Highs and Lows of 2008  Bioethics Forum

2008 in Review: Ethnicity Strikes Back  Dienekes' Anthropology Blog

HIT Predictions for 2009 on iHealthBeat  Health Populi

Best of Nanomedicine in 2008  Nanomedicinecenter.com

2009: Predictions Across the Web  ReadWriteWeb

Social Media Trends 2009, TrendsSpotting  ReadWriteWeb

Top 30 Brain Health and Fitness Articles of 2008  SharpBrains

Top 10 In 2008  Health Affairs Blog

Not Exactly Rocket Science Review of 2008 [Not Exactly Rocket Science]  ScienceBlogs Channel : Life Science

Top Health Search Engines of 2008 [Highlight HEALTH]  The Highlight HEALTH Network

The Year in Biomedicine  Technology Review Feed - Biomedicine Top Stories

Health and Health Care in 2009 -- a Year of Managing Risks and Wild Cards  The Health Care Blog

(See the final week of 2008 on the December 29 archive page.)

Dark Side of the Internet: Pro-Anorexia Sites

We're always seeking to enhance healthcare choices under the assumption that the more information we have, the more control over our health we exercise, the better off we'll be. Some of the choices we make are questionable: following fad diets or quack cures; modifying our bodies with tattoos, implants or sex changes; leading sedentary lives filled with trans-fats and sugared colas. Western society tolerates the odd choices, preferring more information rather than less, but sometimes information can kill us.

A pilot study published in the journal Pediatrics, "Surfing for Thinness", examined adolescents use of web sites that promote anorexia and bulimia. (These sites are often called pro-ana and pro-mia sites. See one logo at left.) The study estimates that there are approximately 500 pro-eating disorder (pro-ED) web sites, outnumbering the anti-ED/pro-recovery sites about 5 to 1.  Like the health-interested web user population at large, up to two-thirds of adolescent girls surf the web for health information, nearly half looking for ways to lose weight. In a survey of teens, 96% said they learned new weight loss or purging techniques from the pro-ED sites. (The study also noted that some web sites also influence drug use in youth and promote anti-health behaviors such as self-injury, suicide, and smoking.)

Obviously, parents have to be aware of their kids' Internet use and be alert to signs of eating disorders in general. At About.com, Dr. Vincent Iannelli offers some advice to parents. But after the child is grown, there's no way to stop her or him from surfing sites that promote bad health. Authorities in Madrid recently shut down a pro-anorexia web site as a hazard to children, but the free-wheeling information economy of the global Internet won't always be there to save us. We'll have to be sure we make the right health choices.

Tiny In Vivo Robots Roam the Abdomen

A squad of lipstick-sized prototypes robots developed at the University of Nebraska are being deployed to test minimally invasive surgery techniques. Specialized devices for illumination, biopsy, clamping and cauterizing are planned, some of which could be mobile in the stomach or the abdominal cavity. Soldiers on the battlefield, astronauts in space and trauma victims on the roadside could benefit. See the developers' web site for a remarkable video (in Real Network format) of a motorized robot roaming a patient's abdomen.

Dr. Google Saves a Baby

Over 73 million Americans use the Internet to answer health questions, harrying their doctors with self-diagnoses and putting stress on the physician-patient relationship. Medical web sites, disease discussion forums and health blogs give the "Worried Well" an endless supply of symptoms and therapies to ponder.

But sometimes, the Internet can save some pain, some suffering -- and some billing. An article in the Google Blog reports on a premature baby admitted to an ER with very low hemoglobin levels. ER doctors told the parents that an immediate emergency blood transfusion was necessary, but Dad whipped out his Palm computer and Googled the Web. He found an on-line article in American Family Physician that a hemoglobin drop in premies was  "not uncommon." After a respectable period of further study, the docs agreed that the kid was fine. Dad wrote:

Google literally saved our newborn son from having to endure an extremely dangerous, and totally unnecessary, blood transfusion.

Maybe Googling should be added to the list of standard medical practices.

To Scan or Not to Scan: A $300 Question

In the wake of some high profile lung cancer news this month, an AP story today by Marilynn Marchione, "Smokers Flock to Hospitals for Cancer X-Ray," reports on the stampede of smokers who are signing up for CT scans that could potentially spot tumors long before they show up on a conventional x-ray. The deaths of ABC newsman Peter Jennings and Dallas star Barbara Bel Geddes, and the recent lung cancer diagnosis of Dana Reeve, wife of actor Christopher Reeve, have heightened U.S. cancer awareness.

As we wrote last month, advances in digital imaging techniques are producing stunning CT images that look more like living tissue and less like black-and-white x-rays. Marilynn's article quotes individuals who have signed up for the $300 scans -- not necessarily covered by insurance -- in order to get "piece of mind" rather than the diagnosis of a current condition. The resolution of CT scans is so good that minor lumps and bumps may cause false positives for cancer, potentially resulting in unnecessary biopsies and surgeries.

While some eminent physicians have recommended early CT scans, the American Cancer Society, the federal government and  "a raft of cancer specialists" caution against the test until a huge new study proves that such early detection is worthwhile --  so that it would be covered by insurance. One hospital lung specialist even stopped her at-risk 82 year old mother from getting scanned. Maybe it means a possible false positive, but it seems to me that $300 is small price top pay for your mother's piece of mind.

Healthwear: Wearable Medical Devices

Alex (Sandy) Pentland, a member of the Health IC Summit Advisory Board and the Toshiba Professor of Arts and Sciences, heads the MIT Media Laboratory's Human Dynamics research group. He's published a terrific article in the IEEE Computer Society's flagship publication Computer titled "Healthwear: Medical Technology Becomes Wearable." Here's the abstract from the Computer web site:

Until recently, researchers have had little success in extending healthcare into the home environment, yet there clearly is a huge demand for this service. Americans currently spend $27 billion on healthcare outside the formal medical establishment, which they find difficult, expensive, and painful to access. A dramatic shift in the composition of the US population makes it absolutely necessary to develop such distributed systems. To address these demands, a research group at the MIT Media Lab has been developing healthwear, wearable systems with sensors that can continuously monitor the user's vital signs, motor activity, social interactions, sleep patterns, and other health indicators. The system's software can use the data from these sensors to build a personalized profile of the user's physical performance and nervous system activation throughout the entire day—providing a truly personal medical record that could revolutionize healthcare.

The full article is available for purchase on-line.

Molecular Imaging: SNM's Image of the Year

Following yesterday's imaging theme, a 3D image (at left, click to enlarge) that fuses 3D molecular and nuclear imaging was named the 2005 Image of the Year at the Society of Nuclear Medicine’s 52nd Annual Meeting in Toronto last month. According to SNM:

The 2005 Image of the Year is "an exquisite structural image," notes Henry N. Wagner Jr., SNM past president and historian and professor of environmental health sciences at Johns Hopkins University The orange area indicates the uptake of F-18 FDG in a primary cancer lesion and a mediastinal lymph node. The image is provided by the Molecular Imaging Program at Stanford (MIPS), Stanford University Division of Nuclear Medicine, Quon A and Gambhir SS.

Molecular imaging is a hot topic we'll be covering at the Health IC Summit in January. It's the medical incarnation of augmented reality, the use of overlays to give more information about the world we see, coverging x-ray, infographics, position information, video and virtual reality to give us superhuman vision.

(Thanks to Medgadget.)

CT Update: Higher Res, Higher Speed, Stunning Pictures

Compared to old-fashioned monochrome x-rays, the latest Computed Tomography (CT) scanners combine innovations in digital imaging with high performance 3D and 4D volumetric computing to give diagnosticians a stunningly detailed look at our innards. Siemens Somatom Sensation 64 with z-Sharp technology, for example, delivers higher resolution 64-slice images at faster speeds by splitting the scan beam, speeding up the scan rate and exploiting high speed dual processor computer hardware to handle the stream. The resulting image (at left, click to enlarge), assembled from slices of digitized data, offers a colorized 3D view of the patient's internal layout. Cardiac applications add the fourth dimension of time to show heart beats on the doctor's workstation.

Siemens posts videos of doctors from various specialties demonstrating their use of volumetric data in practice. Today, CT systems are very expensive, complicated and touchy, but chip-driven, software-intensive digital imaging always gets cheaper and better over time.