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Big Data and Health

At the end of last month, in a speech at the UK Policy Exchange, Minister for Universities and Science, David Willetts, described how the £600m provision for science, contained in the government’s Autumn Statement, will be used to boost growth in ‘eight great technologies.’ The lion’s share, £189m, will go towards big data and energy efficient computing. 

The much anticipated data deluge is now upon us, with many of the consequences and advantages already chronicled. In his report, Willetts states that: 

“Capturing value from all this data – for economic growth and social benefits such as improved health – requires a transformation in data analysis. With the right investments, the UK is well placed for the big data revolution.”

The UK possesses some of the world’s best and most complete data-sets in healthcare and their value is increasing, with new ways to extract information from them.This means benefits for many sectors such as social science studies and the Economic and Social Research Council led Life Study, the most ambitious birth cohort study yet, which will track around 100,000 children from birth. 

Telehealth and Mobile Communications: The New Frontier

Whether you call it telemedicine, telehealth, e-health, or anything else, telehealth is here and it’s happening. In short, telehealth is just using technology to manage your health, but it can take any number of forms. Video doctor visits from an urban medical center to a medically underserved rural community are a form of telehealth, as are self-diagnosis kiosks at clinics, where you can fill in symptoms on a questionnaire and receive a diagnosis and prescription without waiting hours for a doctor or nurse.

But probably the biggest sea change in healthcare today is going to be mobile telehealth. We’re living almost our entire lives on our smartphones these days, and there’s no reason to assume health care will be any different. Opportunities to use mobile technology to enhance our care are practically unlimited. Just within diabetes care, you could set up reminders in your phone for your foot and eye exams and insulin shots, or have your own personal food database or carbohydrate counter to help you make safer choices when you’re eating out. Diabetes is a big problem in the UK today, so there’s a big market for apps and other technology to make it manageable.

But of course it’s not all about diabetes; mobile telehealth options work for monitoring any number of conditions. Mobile equipment could allow you or a caregiver to photograph a wound or bite and upload it to a facility with trained staff who can assess the wound, recommend treatment, and even forward an e-prescription to your nearest pharmacy. Recently the FDA approved an app that allows doctors to take diagnostic images with iPhones, sharing them with colleagues for peer review, second opinions, and referrals, and getting feedback in real time. And the Veterans Association in the US has developed a Posttraumatic Stress Disorder (PTSD) coaching tool to share signs, symptoms, and coping strategies following a major trauma; the spouse of a combat vet might certainly appreciate being able to quickly look up what’s happening and learn how to handle it in the moment - no scheduling an appointment and hoping to hear back from the doctor.

Large institutions are frequently understaffed and insufficiently equipped, and mobile telehealth options can be a boon for these facilities as much as for individuals. It’s always a tragedy when a prisoner dies in custody, and these apps can go a long way toward reducing that likelihood, at least with medical causes. Smartphones are far cheaper than large equipment, and, unfortunately, medical provider salaries. So even workers with no medical training can check patient symptoms against a checklist, send the data to a consulting physician, and receive quick responses. The patient gets speedy, effective care, and the worker isn’t put in a position to make an underinformed judgment call. Even if tragedies do happen, the use of mobile technology, and its accompanying documentation, can show that staff followed protocols and made the best efforts to provide care.

While the days of the in-person house call may be long gone, mobile telehealth options bring that level of care a little closer to all of us. You can’t always reach your doctor, and sometimes you can’t even reach the urgent care nurse. You can’t lug around a calorie counter or a carb counter. Your memory may be fading and you may not always remember to take your meds. Or you may just be a patient or provider in a rural area with few nearby options for health care. Whatever your need may be, it’s a guarantee that if there isn’t a mobile telehealth option available to you right now, it’s likely that there will be one soon.

May 8

The Management of Health Conditions Through the use of Mobile Technology

With the advent of new technology, it has become possible for the medical field to be interlaced with technology, to offer more efficient services in the field of medicine. One particular field that has emerged through this interaction between technology and medicine is mobile telehealth.

Mobile telehealth refers to the delivery of medical services and information through mobile communications technology, so called mHealth. This normally involves the curative, preventive and even diagnostic aspects of medical practice, but can also be used for cost effective patient management and clinical trials, with the right kind of applications.

The concept of emedicine is largely established in developed countries but has recently become more common in developing countries due to the rapid growth of mobile phone accessibility in most developing countries. It has greatly helped to improve the capacity of stretched health-care facilities in these developing countries.

Benefits of mHealth

Cost Reductions:
The use of mobile telehealth has proved to be a lot cheaper. The main reason behind this is reduction in transportation: an individual living in a remote location will have to incur transportation costs when visiting a medical facility. This cost can be very high if the facility deals with specialised conditions since such clinics are very few and far between. The use of this kind of technology usually serves to eliminate the cost of transportation.

Furthermore, there are many hidden costs when processing a patient through a medical facility. These costs can be bypassed, or at least reduced by the management of health conditions through the use of mobile technology.

Access to Specialists:

Mobile telehealth can be very instrumental in ensuring that individual gets effective medical attention. Generally specialists tend to be busy, and it can take many days for an individual to get an appointment with a specialist. Telehealth providers usually have a team of specialist and sophisticated software on standby specifically for the patient. Telehealth services are usually available on a 24 hour basis. This offers real time solutions to condition management and improves access to health-care.  This not only flattens the demand curve for face-to-face appointments, but also improves and optimises the patient/doctor interaction.

Appointments:

There are several factors that can contribute to a patient missing an appointment and the associated costs. However by the use of mobile technology, patients can access medical attention from the comfort of their home.

Despite these benefits and cost savings, the idea of mobile telehealth is not universally accepted amongst some medical practitioners and even specialists in the field of technology. Their concerns are primarily about the quality of health information, patient interaction, accountability of the service providers and practitioners, and also the development/maintenance of expensive systems and software to make the project sustainable.

Fortunately, modern mobile development platforms, such as Android and the latest smartphones and tablets, are providing the tools to shortcut much of the fears of health-care professionals. Nevertheless, there is still a need for proper measures to be put into place, so as to ensure that the service providers and also the practitioners behind this service adhere to proper medical practice.

May 1

Two Competing Concerns with Mobile Health

While mobile telehealth is steadily becoming the norm in the healthcare industry, the high tech equipment being sold and marketed to the healthcare field is truly still in its development stages. Perhaps there is no way around that – because it is through actually embracing, exploring, and using the mobile telehealth equipment out in the trenches that we are better able to understand it, identify glitches, share potential concerns, and solve common problems. For users in the field, especially medical professionals required to utilise their company-provided smartphones to enter and access client/patient data on a daily basis, there are currently more concerns than kudos regarding the telehealth equipment. Two of the most common complaints are included here, along with the one and only “kudo” that many users have expressed.

Concern #1: Smartphone keyboards are too small. Since users are accessing their telehealth smartphones throughout the day as they meet with each client/patient, it puts a strain on their eyesight to be forced to read and manipulate such tiny keys when entering and accessing information. Also, since most smartphones are heat-sensitive (meaning that it is from the heat that is generated from the user’s fingertips that enables their use), users are finding that they are constantly accidentally entering the wrong keys/letters when trying to type in client/patient information. If the user does not lift his/her finger up off the keyboard high enough while typing each letter, the letters that are passed over en route to the actual desired keyboard letter will accidentally be “ignited” by the heat and added to the typed content. This is not only frustrating but also time consuming for the user.

Possible solutions: Bigger keys, bigger keyboards, or making smartphones pressure-sensitive so that a pencil or pointer can be used to access the keyboard letters and applications instead of just the heat-generated fingertip access.

Concern #2: Smartphones batteries have to be recharged regularly. For a medical professional in the field who is visiting several clients/patients each day, the current battery in the smartphone is not able to handle all the use it gets throughout the day without having to be charged in the user’s car between clients; otherwise, users have found that by 4pm, all the entering of patient data throughout the day, all the business-related phone calls they’ve  made, and all the applications they’ve accessed during the day have drained the battery and their smartphone simply shuts off. Though it will save the data previously entered, the user then has to go home and charge the battery for 6-8 hours and then finish entering all the patient documentation into the smartphone’s health-related software.

Possible solution: a bigger, better battery capable of lasting longer throughout a busy workday.

Of all the telehealth gizmos and gadgets on the market today, the biggest benefit of using a smartphone is: its portability. Because smartphones weigh so little (compared to an Ipad or a laptop, for example), it physically puts less strain on a user’s body when lifting it and carrying it throughout the day. It’s tiny enough to slip into a pocket of a jacket, briefcase, or portfolio, and light enough to feel almost nonexistent in the user’s hand. With a device so small, it can easily be locked away in the glove-box of a car or stored away during the user’s lunch break in the side pocket of a car door. Protecting a laptop from the heat of the sun or the eyes of an interested pedestrian is not so easy; the bigger the telehealth monitoring equipment, the harder it is to conceal and protect from theft or damage.

Balancing these two concerns is the challenge…

Mobile Telehealth

In the past couple decades, we’ve seen virtually every area of our lives changed by the astounding march of progress in the fields of computers and communications. Twenty years ago, you probably weren’t on the Internet unless you were particularly tech-minded. Now, you probably access it daily from your smartphone.

This spread of computers and communications has also begun making changes to the way that health providers work with their patients. Despite surprisingly little public fanfare, the field of mobile telehealth has been growing steadily, and is already an industry that brings in billions of dollars a year. Whether you’re a medical provider yourself or you’re in the communications field, this is an exciting area that forward-looking people should be keeping an eye on.

What is Mobile Telehealth?

Telehealth is a catch-all phrase that covers pretty much any form of remote health assistance. One of the most common uses today is utilising videoconferencing to allow doctor-patient consultations across long distances. Depending on the quality of video needed, this can often be done using nothing more sophisticated than the standard cameras found on laptops and smartphones.

If quality imaging is needed, advanced fiber-optic or satellite systems can be used to deliver high-resolution video around the world with only momentary lag/latency. In this way, doctors can easily consult with patients in remote areas, such as on islands or offshore drilling rigs, while saving thousands in transportation costs.

Remote patient monitoring is another booming area of mobile telehealth. Biofeedback indicators can be linked into a wireless communications network to provide a nearly-live data feed to specialists, allowing them to monitor a patient’s pacemaker or vital signs from a distance. Patients can be kept “under observation” while still being free to leave the hospital, and free up those beds.

The Rise of Telesurgery

Mobile telehealth can be taken even further – into the operating room. This isn’t even purely speculation; the first successful instance of robot-assisted remote surgery was conducted in 2001, called the Lindbergh Operation. A man in France had his gallbladder successfully removed through a cholecystectomy that was performed by a team of doctors in New York. While those surgeons used a setup made specifically for the operation, including a custom dedicated fiber-optic line, the communications technology needed to conduct these sorts of remote operation is becoming increasingly commonplace.

At this point, we have nearly all the pieces in place to be able to perform nearly any surgical operation remotely. The only thing lacking is more advanced haptic feedback (force feedback) to give the surgeon precise the physical resistance needed to conduct delicate operations. We’re not far from it now, though. Research in the field continues to march forwards, and universities are beginning to implement it in their studies. Ohio University, for example, recently implemented a Virtual Haptic Back to allow their osteopathic students to train in palpatory diagnosis without involving live patients.

In the Future

Mobile telehealth is virtually certain to be a driving force in future medical developments, and governments are beginning to embrace it. Great Britian’s national medical system is currently implementing their “3 Million Lives” programme, using telehealth services to provide care for patients in need. The government of California has recently been looking into telehealth solutions for their prison system, to reduce costs and increase prisoner security.

In short, medicine ten years from now is likely going to be much different than how it looks today. New technologies will be implemented in the field as quickly as they can be researched and approved. If you aren’t currently following mobile telehealth advances, now may be the time to start getting involved.