Again, in the last week, I have come across a few reports and news items which are worth passing on.
These include first:
by George Lauer, iHealthBeat Features Editor
This story has a prerequisite: If you haven't already seen SEEDIE.org and Extormity.com, you might save yourself confusion and frustration by checking them out before reading further.
For those already familiar with the two satirical sites spoofing the health IT industry in general and electronic health records in particular, this story will shed a little light on the motivation behind them. Emphasis on "little." We won't tell you who's behind the sites. They're not ready to go public yet.
But they did agree to answer a few questions from iHealthBeat. Two "executives" -- Extormity CEO Brantley Whittington and SEEDIE Executive Director Sal Obfuscato -- take turns answering in character.
And then site creators do it for real ... sort of.
Much more here:
http://www.ihealthbeat.org/articles/2008/8/7/Satirical-Sites-Take-Aim-at-Health-IT-Industry.aspx?a=1
The sites referred to are found here:
The interview and the two sites are very amusing – and well worth a browse – in the spirit they are offered!
Second we have:
PM - Thursday, 7 August , 2008 18:34:00
Reporter: Mark Colvin
MARK COLVIN: For a century or more, the main weapons of medicine have been the stethoscope, the syringe and the surgeon's saw.
But in modern medicine they're increasingly being supplemented by information technology.
Computers can help a great deal in diagnosis, record-keeping and analysis.
But in some areas Australia is lagging behind in the field of what's called health informatics.
And there's pressure for huge centralised computer systems which could prove extremely costly, especially if things go wrong.
Enrico Coiera is Professor of Health Informatics at the University of NSW.
He spoke at the Centre for Independent Studies Consilium, where I asked him about how Australia rated when it came to computing in medicine.
ENRICO COIERA: Our General Practitioners have about 90 per cent penetration of computers on their desktops which is fantastic by world standards.
But our hospitals certainly are laggards. We can turn out attention to what's happening say in England where the National Health System, the NHS has spent something like 12-15-billion pounds in the last three or four years to start to modernise the IT use underpinning their hospitals and that's certainly not yet happened in Australia.
More here:
http://www.abc.net.au/pm/content/2008/s2328090.htm
It is good to see some good publicity for e-Health on a major national news program. The full interview is available for download from the ABC site.
Third we have:
5-Jun-2008
By Dr Tony Copperfield
DO you remember the Internet before pop-up blocking software became the norm? Every website you visited would be hidden by a snowstorm of unwanted invitations to meet hot girls from your area, and malicious Windows Messenger prompts: “Your computer may be infected with a virus. Click here to make certain.” And sure enough, if you did, it was.
Nowadays, there’s only one arena where the uninvited and annoying pop-up window still holds sway, and that’s my consulting room.
As Mrs Blob waddles in and I click the mouse to pull up her medical record, I’m already bracing myself for the avalanche of mindless cyber-guano that’s about to rain down.
“ALERT! QOF* data incomplete! Mrs LZ Blob does not have an HbA under 7% on file!” Followed by: “Mrs LZ Blob does not have a total cholesterol under 5.8mmol/l on file!” And: “Mrs LZ Blob does not have a BP reading under 140/85 on file!”
Well, she does now. Because I’ve just made one up. There, right there, on her ‘Current Values’ template, I’ve just typed 138/82 and quite shamelessly clicked on ‘Enter’. Sorted. Ker-ching. No sphygmomanometer, nothing up my sleeve, just Copperfield’s Clinical Acumen being exercised to the max.
Respect is due to Mrs B, for she is the NHS’s ideal punter an ‘Expert Patient’ [The Expert Patients Programme is a self-management program developed for people living with long-term conditions. The aim is to support people to increase their confidence, improve their quality of life and better manage their condition.].
More here (subscription required):
http://www.australiandoctor.com.au/articles/a9/0c0573a9.asp
The article then goes on to say that Mrs B essentially resists all his attempts to have her co-operate in her treatment for a range of serious chronic diseases and it is a problem as his remuneration is linked to compliance with the UK Quality and Outcomes Framework (QOF). Frankly his approach in just making information is essentially illegal and what “Dr” Copperfield should do is remove himself from the care of this patient as his clinical relationship with his patient is clearly over!
Really a sad approach and quite wrong to write such material – even if it tongue in cheek as I suspect (and hope) it is
Fourth we have:
Grant McArthur | August 08, 2008
A MELBOURNE-developed computer program that could save thousands of lives has taken the fight against killer superbugs to cyberspace.
The web-based prescribing program, designed by Royal Melbourne Hospital doctors, raises alarms when inappropriate or excessive quantities of antibiotics are prescribed. Such prescriptions are a major factor in the development of drug-resistant superbugs in hospitals.
Potentially fatal bugs such as MRSA are contracted by about 200,000 people in Australian hospitals each year.
They are most dangerous to the frail and elderly.
Preventing the overuse of antibiotics would reduce the chances of bacteria developing into antibiotic-resistant superbugs, infections expert Karin Thursky said.
She said 40 per cent of hospital patients were given antibiotics, half of which were inappropriately prescribed.
She said the Guidance DS program would have a huge impact as it was rolled out to 14 hospitals in Victoria and Tasmania, as it had done at the Royal Melbourne.
More here:
http://www.australianit.news.com.au/story/0,24897,24147129-15306,00.html
Antibiotic prescribing in the seriously ill has always been a challenging problem and this work seems to have great promise in making it just that much easier and safer. Well done to all involved – I hope the system can be quickly spread nationwide to all those centres where it can make a difference – once proof of its value is confirmed – which sounds to be very near.
Fifth we have:
August 7, 2008 - 7:00AM
Inspired by the human anatomy, researchers in the United States have created the world's first curved electronic "eye" camera, according to a new study.
The size and shape of a human eye, the device weaves a network of silicon detectors into a flexible mesh, and could usher in a new generation of distortion-free digital and video cameras.
Experiments already under way are testing other potential applications, including a thin, pliable monitor to detect electrical signals travelling across the undulating surface of the human brain.
Its breakthrough design also points the way to the development of artificial electronic retinas that could one day help restore sight, says the study, published in the British journal Nature.
"This approach allows us to put electronics in places where we couldn't before," said John Rogers, an engineer at the University of Illinois, who led the research along with Yonggang Huang of Northwestern University.
"We can now, for the first time, move device design beyond the flatland constraint of conventional wafer-based systems."
A curved array of detectors is "much better suited for use as retinal implants," Rogers said in a statement.
Animal eyes are naturally curved for capturing images, but up to now artificial vision systems have been limited to flat image-recording surfaces.
More here:
http://news.smh.com.au/world/electronic-retinas-a-step-closer-20080807-3rbb.html
Another report with a useful picture is found here.
http://www.smh.com.au/news/technology/just-picture-it--bionic-terminator-eyes/2008/08/07/1217702198814.html
This is interesting as is the report there is progress on the Bionic Eye project from the 2020 Summit as reported here.
Volunteer … Steve Horan will receive a bionic eye this year.
Photo: Jacky Ghossein
Louise Hall Health Reporter
August 10, 2008
AUSTRALIA'S first bionic eye will be implanted by two Sydney researchers.
Using the same cochlear technology that allows the deaf to hear, the device aims to restore basic vision in patients with degenerative eye diseases, allowing them to walk without a cane or guide dog and differentiate between night and day.
Minas Coroneo and Vivek Chowdhury, from Sydney's Prince of Wales Hospital, say the visual prosthesis could be the first - and cheapest - to hit the world market.
Rather than "reinventing the wheel", they have adjusted the cochlear implant to allow patients to perceive light, rather than sound.
"We're using a bionic ear to make a bionic eye," Professor Coroneo said.
It should not cost much more than a cochlear device - $20,000. Instead of a microphone, it will use a camera and more electrodes.
There are 23 groups around the world racing to invent the first functional bionic eye. The ultimate goal is a permanent implant with enough resolution to enable patients to recognise faces and read large print.
More here:
http://www.smh.com.au/news/science/bionic-breakthrough-in-sight-with-an-australian-first/2008/08/09/1218139162870.html
Good luck to those involved in this important work – but it does seem there is a bit of competition for the prize! The sooner a really useful technology emerges the better!
Sixth we have:
Mark Metherell
August 5, 2008
"CYBERCHONDRIA" - the imagined conditions afflicting patients who have turned to the internet for diagnosis - can be a bane for doctors convincing patients of their misdiagnosis, says an internet health expert, Jared Dart.
Dr Dart recalls an elderly patient's relative suggesting on the basis of internet research that the patient required a biopsy of skull tissue. Diagnosis by a doctor actually found "the poor old guy had been having headaches as a result of a muscular-skeletal problem in the neck".
"Many doctors have lamented the rise of the e-health information consumer, suggesting it has led to patient 'cyberchondria' and anecdotal reports of patients bringing health information to doctors abound," Dr Dart says.
His survey of 700 people has found that surfing the net for medical explanations is widespread, although many remained uncertain about the veracity of the information.
More here:
http://www.smh.com.au/news/web/cyberchondria-gives-gps-a-webache/2008/08/04/1217702000290.html
I think Dr Dart has raised an important issue but as we have found the jurors who research those they are judging these days you have to go with the flow and I think the best thing to do is, as a practitioner, have a list of sites that you know are trustworthy and accurate and say to patients if they want to read more – here is where you can go for an independent view. If given 4-5 full scope quality sites the patient will soon be able to be confident of the advice they are receiving.
Last we have our slightly technical note for the week:
What app developers need to know to make their software work on new-gen CPUs
Tom Kaneshige (InfoWorld) 05/08/2008 08:56:33
Call it the great multicore discord: a parade of major hardware and software vendors promising desktop applications powered by multicore chips yet all marching out of step, leaving confused software developers in the dust -- but times are changing.
Far out front, chipmakers Intel and AMD have delivered quad-core chips for desktop computers earlier this year. And computers with dual-core chips are now the norm. But only the savviest of developers can harness this massive processing power by weaving a mind-bending web of code that foundational software vendors should have provided. So much of the multicore chips' processing power is unharnessed.
Software vendors are finally closing the gap: Microsoft, Apple, third-party platform vendors, and software developer consortiums are tweaking everything from the operating system schedulers to APIs to languages and libraries to make them multicore-friendly. The goal, of course, is to make it easier for developers to join the multicore movement.
There's no question that the pace is quickening, the gap closing. Apple, for instance, claimed earlier this month that its upcoming Mac OS X Snow Leopard will boast a new technology, code-named Grand Central, that supports multicore chips, along with developer tools that let applications leverage up to eight cores of processing power.
To take advantage of multicore-enabling technologies such as Grand Central and whatever Microsoft may be working on for Windows 7 (the company declined to comment), developers must move up a steep learning curve in areas such as multithreading, parallel, and concurrent.
More here:
http://www.computerworld.com.au/index.php?id=1145268561&eid=-255
This is an interesting long article that essentially explains that most of the extra computing power in the modern multi-core processers is yet to be even partially exploited. It seems the software writers have a bit of work to do yet to catch up with the hardware colleagues!
More next week.
David.
