Thursday, January 27, 2011

Client News: Oakwood Hospital in Taylor Opens $1.5M Healing Center

Source: The Detroit News
Written by: Melissa Burden
Oakwood Healthcare Inc.'s Heritage Hospital in Taylor has opened a $1.5 million Center for Wound Healing and Hyperbaric Medicine.
The center replaces a temporary single-chamber hyperbaric oxygen therapy unit — where 100 percent oxygen is pressurized and used to improve healing of chronic wounds — with four individual chambers featuring flat-screen televisions and Netflix accounts. The investment also includes a new waiting area and four new exam rooms
The new design gives patients more privacy and comfort and allows the hospital to serve bed-ridden patients, whom it could not serve before, according to a news release.
It's part of a three-year, $31-million investment at the 209-bed hospital that began in April 2010. Other investments include a 12-unit, bone-and-joint patient care center that has opened and planned expansions to operating rooms, and a new entrance to the operating/surgical area of the hospital.

Wednesday, January 19, 2011

Industry News: Healthcare iPad Deployment To Approach 70% In 2011

Source: Information Week
Written by: Nicole Lewis
The rising number of iPad point-of-care applications are accelerating its use by physicians, finds Healthcare Information and Management Systems Society survey.
Results from a survey of nearly 950 Healthcare Information and Management Systems Society (HIMSS) members indicates that iPad deployments are accelerating in large part due to the mobile device's compelling point-of-care applications and uses.
Conducted October 26 during an online webinar cosponsored by HIMSS and BoxTone, a mobile service management (MSM) company, the survey's results were released earlier this month.
Data showed that nearly 70% of the attendees were from hospitals or healthcare organizations with more than 1,500 employees, and 15% of attendees were executive-level staff or physicians.
More than 25% of the HIMSS respondents plan to deploy the iPad and other iOS devices immediately and nearly 70% plan to deploy the devices within the next year
One-third of respondents identified point-of-care applications -- including lab order visualization and results, clinical decision support, and medical image viewing applications -- as top priorities, while 18% identified general administration, including billing, coding, and claims applications, as top priorities.
Nearly 75% identified secure configuration and deployment as the number one iPad IT management challenge, and 53% identified mobile application deployment as a key issue.
Lynne Dunbrack, analyst with IDC Health Insights, said security will remain a top concern for healthcare CIOs, especially if clinicians bring in their own devices to access the hospital's healthcare information systems, such as electronic medical records (EMRs) and computerized physician order entry (CPOE) systems.
"As more patient information is moved into EMRs and made accessible both inside and outside the organization via a range of devices, including mobile devices and tablets, the risk of a privacy breach rises. Organized deployment and virtualized clients will help to mitigate this concern," Dunbrack said.
Dunbrack also noted that the iPad, which has a sleek design, an intuitive user interface, and a large screen (relative to a smartphone), is becoming increasingly popular among clinicians. As the iPad gains traction among healthcare providers, EMR vendors will develop bidirectional integration between their EMR applications and clinicians' mobile point-of-care devices such as smartphones and tablets.
Vendors are also developing EMR applications specifically for the iPad, Dunbrack observed. One example is St. Louis-based ClearPractice, a company that develops Web-based ambulatory EMR and revenue cycle management applications. ClearPractice recently launched Nimble, a comprehensive EMR application designed and developed specifically for the iPad.
Alan Snyder, BoxTone's CEO, said in a statement that the iPad is redefining how organizations leverage mobile technology in the enterprise and the healthcare community is leading this paradigm shift.
"As these devices are used more frequently at the point of care, IT must ensure both data security and privacy, as well as superior remote connectivity," Snyder said.
These organization have the data, but accessing, sharing, and securing that data remain problematic. That story and more in the new all-digital supplement to InformationWeek Healthcare. Download it now (registration required).

Monday, January 17, 2011

Industry News: Remote Access Is Not Mobile Access

Source: HISTalk Readers Write 1/17/11
Written by: Cameron Powell, MD

Healthcare organizations are quickly learning that both remote and mobile access strategies are required. See Table 1.
Remote access lets providers work in the hospital computing environment when they are not on location. This includes accessing the EMR and clinical applications via a PC or laptop from office or home. Secure the session with something like VPN, add the necessary authentication and encryption, and clinicians can use their Windows desktop and a browser to interact with hospital applications.
Offer mobile access when you need to empower providers to perform specific tasks anytime, anywhere. This would include visual assessment of images and waveforms, checking lab values, reconciling medication lists, checking allergy status – all while on the go. Providers want the data transformed into meaningful chunks; they don’t want to navigate the medical record from their Droid in order to make timely treatment decisions. Mobile data should be provided via native applications, built to run securely on a specific device and operating system.
Some organizations have considered using Citrix to provide interpreted or emulated application access to the EHR or CIS via a mobile device. Accessing patient monitoring data via a non-native solution is discouraged, because visual distortion is almost certain when things like medical aspect ratios cannot be controlled. [1] Further, the FDA is mandated to regulate mobile devices. [2], [3]
Mobile versus Remote Access
ConsiderationMobile AccessRemote Access
Single, personal mobile device
Anytime, anywhere cellular or Wi-Fi access
PC, laptop, or workstation-based, even if it’s a workstation on wheels
Native Application – Designed to run in the computer environment (machine language and OS) being referenced (i.e.: Android, iPhone, Blackberry, etc.)
Citrix or web access to desktop applications
Data Transformation
Improves clinical decision making at the point of care through data transformation – does something with the data.
Adds meaning with graphing, trending, colors, visuals cues, etc.
Looks and functions like the desktop electronic health record (EHR).
Presents data in the same fashion as the computer program being accessed.
Added Value
Works with clinician workflow by delivering in meaningful ways.
Incorporates evidence based medicine and knowledge-based prompting.
Supports office- or home-based access via computer.
Meaningful Use
Physician usage quickly ramps up, is sustained over time.
Initial usage spike, unsustained; often drops off after weeks/months.
Physicians will seldom help organizations achieve data access/sharing objectives when they have to go to the data.
Cameron Powell, MD is president, chief medical officer, and co-founder of AirStrip Technologies of San Antonio, TX

Friday, January 14, 2011

Industry News: Xbox Kinect Applications to Health and Medicine

Source: Sector: Public Article
Written by: Chris Niehaus 
It’s not quite the technology from Minority Report, but in some ways it’s even better (no gloves!): Microsoft recently launched a new entertainment product named Kinect for the popular Xbox 360 gaming platform. The launch involved the usual amount of fanfare you might expect, including a massive Times Square event with dancers, gatherings across the country with actress Minka Kelly (Esquire’s sexiest woman alive, no less), and fanboys blogging about the pros and cons of the new product.

But technologies like Xbox and Kinect, while mainly advertised as fun and games, will also have serious government, health, education, and other “public good” applications in the not-so-distant future.

Natural User Interfaces as a Bridge to the Future
Kinect is amazing by itself, but it is just the most prominent example of an area that Microsoft and other companies are heavily investing in. This topic area, called Natural User Interfaces (NUIs), includes everything from speech recognition to multi-touch surfaces (i.e., more than one person can touch a surface at the same time), and include products like Windows 7 and Surface (the latter of which has been hilariously parodied).

NUI can sound a little vague, or ill-defined, perhaps, spanning many boundaries. It is perhaps best described by a Microsoft researcher named Bill Buxton in a video called “Making User Interfaces Natural” as follows:

It’s not about speech, it’s not about gesture, it’s not even about the phone, and it’s not about human-to-human communication. How these things work together in a natural and seamless way that reduces complexity for the users – that’s what we’re about. Getting these things right opens up another dimension in how we have technology integrated into our lives.
It is with this sentiment that we start to see a vision for devices like Surface and Kinect that goes beyond the trivial, and beyond the purely entertaining, into realms like healthcare and education, those heavily influencing public good and forming the foundation of a robust public life.

Three Intriguing Features of Kinect
For better or worse, I’ve been an avid gamer for quite some time (Xbox Live handle = CorbinHood), and I had a Kinect long before it was in public view. Besides seriously impressing my wife, through experimenting with the product I also discovered three nonobvious technological breakthroughs (while unproductively racing cars, spiking volleyballs, or flying in zero gravity). In no particular order:

(1) Kinect gets a lot of attention because of its motion tracking abilities. But its speech recognition, while less discussed, is just as powerful. It can do things like filter out background noises from what’s really important – the user’s voice. That means, for example, that you can blast Kanye West or Taylor Swift in the living room, and Kinect still picks up you saying “pause” to it – without screaming. The secret here is that there’s an incredible amount of “audio engineering” behind the scenes that effectively builds a listening cone around your body, even while you’re moving.
(2) On top of motion detection and speech recognition, Kinect has pretty good facial recognition too. That means, for example, that it can tell different users apart based on facial characteristics, whether as a gaming feature or as an added security feature. The idea that security can be performed initially with an ID and password, and then later using biometrics offers more control over access for both consumers (i.e., keeping kids off adult-rated games on the console) and business/government (i.e., hospital access restricted to certain specific doctors with surgical or other privileges).
(3) Kinect is quite inexpensive, coming in at $150 in the U.S., and as such this highly advanced piece of technology will be immediately available to a wide swath of society. Of course, one can debate whether the price is too high for a gaming console “add on,” and some are, but few would debate that $150 is too high to bring innovative healthcare or educational features into your home (more on that soon).
Although it is not the topic of this article, it isn’t hard to see how these features could apply to not only gaming consoles but also mainstream PC’s in the not so distant future. (In other words, what if you could plug Kinect into your computer?)

Healthcare Applications of Kinect Technology
One of the most compelling applications of Kinect technology for public good is in the area of healthcare. Just as an initial example, the new game Your Shape: Fitness Evolved (by game publisher Ubisoft) does an excellent job of demonstrating how Kinect can power “home rehabilitation” via facial recognition validating patient identity, and the cameras grading aspects like range-of-motion of a body part. In future instantiations of products like this, doctors and patients could connect through the Xbox Live social network, with rehab courses prescribed, graded, and assessed according to a schedule.
In discussions with researchers, developers, and customers, we see at least four broad areas of health/medicine within which technologies like Kinect can be applied:

(1) Physical therapy and rehabilitation: As described above, your device can verify who you are, measure what you’re doing, and connect you to your doctor(s) in various ways. There are probably positive effects of this technology on medical conditions that we can’t quite envision yet; One early “success story” in this regard involves Kinect and child autism.
(2) Telemedicine: There are many ways in which medicine can be performed remotely using something like Kinect. Features like the ability to interface with other video chat platforms like Windows Live Messenger allow general hands-free communications while walking around a room – or even the outdoors.
(3) Medical training and education: Everyone knows that doctors go through lots of instruction before they become “doctors.” Technology like Xbox and Kinect can be used not just for remote learning, but also to display virtual human patients that are interacted with through motion-sensing. Virtual teachers can take students through a digital gross anatomy course (no formaldahyde, either).
(4) Neurocogitive and psychological practices: Whether it’s the ability to visualize and analyze brain images taken through Functional Magnetic Resonance Imaging (fMRI), or to perform group psychological therapy with some people with the counselor in person and some remote, there are immense possibilities here.
When the top six health insurers have 100 million members, and when over 120 million people between ages 20 and 65 are overweight, there is a huge opportunity to engage audiences on medical and health issues in a proactive way. Kinect may be an affordable tool for everything from virtual doctors’ visits to  injury rehabilitation to general preventative medicine and healthy lifestyle habits. Commerical off-the-shelf software (COTS) for medicine and related fields is suddenly a very real and exciting possibility.

Beyond Requirements: U.S. Army Health and Medicine
One of the biggest researchers on and users of technology in the realm of NUIs is the military. In one project, Microsoft’s public sector innovation team is working with the U.S. Army’s Communications-Electronics Research, Development, and Engineering Center (CERDEC) to bring new and useful interfaces to the warfighter – whether in forward combat areas or in medical facilities like the Walter Reed Army Medical Center.
One of these projects is called COMET, which is a Microsoft Surface-powered multi-touch “command and control” applications, but the possibilities go far beyond that. Our discussions with Army medical personnel and technologies about the four areas above – rehabilitation, telemedicine, training and education, and neurocognitive and psychological treatment – are of great interest for many reasons. Consider that the Army is deployed around the world, trains people under heavy stress for very difficult missions, and deals with an inordinate amount of conditions like post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI).
While it’s very fun to play Kinect games and imagine the possibilities, for public sector organizations like the Army this technology is very serious business. We are working with them to go “beyond requirements” to push the limits of how emerging technologies like NUIs can help them with their very difficult, very human problems.
A Glimpse Ahead: Computers Will Never Be the Same
Wired recently ran a bold story explaining how technology like Kinect shows where the future of Microsoft – and computing – may lie, once that technology “merges” with what we now know as the PC. It’s smart speculation, but with the recent acquisition of a 3D-gesture company named Canesta, there’s no question that Microsoft (and surely other companies) will be interested in this emerging area of NUIs for some time to come. To paraphrase Bill Buxton, making technology work in a natural and seamless way for users is the ultimate goal.
And this goes beyond health and medicine into other areas of public good like education, where “gaming” is getting a fresh look. Unlike the somewhat lackluster “edutainment” of decades past, NUIs put new approaches in a higher class. For example, the Smithsonian is using NUIs on Surface devices to engage children in learning.
Eric Kloper, Scot Osterweil, and Katie Salen, in their MIT research paper Moving Learning Games Forward: Obstacles, Opportunities, and Openness, write:
They [commerical games] are changing the perception of the nature of video games, making them more accepted in a greater diversity of places. For example, gaming is becoming part of activities now a a regular activities in senior centers, in libraries and museums, as well as within the workplace.”
Technologies like Surface and Kinect that use NUIs are lowering the barriers for engagement among people both young and old, and this will free up new gaming and interaction scenarios that can be fun and productive at the same time.
An interesting blog post called “The Future of Kinect: How Microsoft Plans To Put A Video Game Controller In Everything” digs deeper into where Microsoft’s Kinect team sees the technology going, and how it is but one piece of a broader portfolio of Microsoft innovations. Kinect creative director Kudo Tsunoda comments in the article, “Think about a world where machines understand what people want from them. You can see that extrapolate out to a host of other devices.” The post also highlights theoretical ways in which Microsoft might work with partners like AT&T and Ford to bring these technologies into new spaces in creative ways.
Kinect in your car? The pace of technological advances might be accelerating faster than you think.

Chris Niehaus is the Director of U.S. Public Sector Innovation at Microsoft.

Credits: Photo of Kinect health from, photo of Microsoft Surface from the album Images for the Future, photo of facial recognition from Moggs Oceanlane, photo of fMRI from ChrisDag, photo of military rehab from the U.S. Army, photo of Canesta poster at SXSW by Nan Palmero. All used under Creative Commons

Monday, January 10, 2011

Client News: WellSpan Uses New Weapon for Treatment of Lung Cancer

Source: Around WellSpan Newsletter
Dr. Brian Pettiford, a thoracic surgical oncologist with WellSpan, became the first surgeon in Central Pennsylvania, and one of the few surgeons in the commonwealth, to employ a new minimally invasive procedure combined with brachytherapy to treat lung cancer.
The procedure is known as VATS (video assisted thoracoscopic surgery) sub-lobar resection with brachytherapy. Dr. Pettiford removed a cancerous portion of the left lung of a 71-yearold patient by using a thoracoscope, which was inserted through small incisions.
In collaboration with WellSpan Radiation Oncology, he then employed a technique known as brachytherapy by implanting a mesh seeded with radiation as a means to reduce the risk of recurrence while minimizing damage to surrounding areas.

Wednesday, January 5, 2011

Client News: Midwest Medical Center Officially Opened for Patient Service on January 3, 2011

Less than two years after breaking ground, the Midwest Medical Center officially opened for patient service on Jan. 3.  Oakwood President & CEO Brian Connolly and Dr. Mark Saffer of Midwest Health Clinic were joined by Dearborn Mayor Jack O’Reilly, Jr., Wayne County Executive Robert Ficano and Dale Watchowski of REDICO Development Company to celebrate the completion of the building project during a Dec. 15 ribbon-cutting celebration of the Midwest Medical Center, at 4700 Schaefer Rd. in downtown east Dearborn.
Located within the new Dearborn Town Center development, the Midwest Medical Center will provide citizens of Dearborn, Detroit and southeast Michigan with comprehensive healthcare services including: 24-hour walk-in urgent care, primary and multi-specialty medical care, state-of-the-art imaging technologies, and on-site laboratory and pharmacy, an operating room, enhanced corporate health and occupational medicine programs, as well as a restaurant and retail amenities.
Midwest is part of a multi-specialty corporation established by Dr. Saffer in 1981, which was acquired by Oakwood in January 2009. Dr. Saffer, who has been recognized for his innovation of healthcare delivery models, oversees the day-to-day management of all Midwest facilities and will also lead the new Dearborn center.

Client News: Gettysburg Hospital Begins Construction of a New Emergency Department

Source: Around WellSpan Newsletter

A 19,000-square foot addition to Gettysburg Hospital will provide patients with a private, patient-centered care experience and meet the needs of the community well into the future.  The new emergency department will feature 18 private treatment rooms as well as new patient amenities such as a vending area, cafĂ© seating, pediatric waiting area and an increase in patient and visitor restrooms.
Construction of the new emergency department is Gettysburg Hospital's biggest project in 20 years. It is expected to cost $18.1 million. The new emergency department is scheduled to open in February 2012. The project should be entirely completed by August 2012. The hospital's emergency department currently cares for 28,000 patients per year. It was originally designed to treat 15,000.