Sunday, April 26, 2009

"Giving Healthcare a Digital "Touch" via Microsoft

According to the PR release from Microsoft, Texas Health Resources and Microsoft partner Infusion Development have developed a prototype to assist with doctor-patient communication and collaboration:

Medhost has created an emergency department dashboard that can assist medical professionals decision-making process more efficiently:

Vectorform developed an application to assist children in rehabilitation at the Cook Children's Health System in Fort Worth, Texas. The application allows the rehabilitation specialist design their own evaluations for patients:

The only drawback is that the Surface has a very high price tag. I think I'll stick with HP TouchSmart PC projects with my students!

(cross-posted on the Interactive Multimedia Technology blog)

Wednesday, April 22, 2009

More about everyware health care and emerging technologies:

Below is a compilation of posts I've written on another blog pertaining to health technology:


I'm visiting my dad who recently was transferred to a LTACH. LTACH stands for Long Term Acute Care Hospital. One of the goals of an LTACH is to work with people who have medically complex issues, often after a longer-than planned stay in an intensive care unit at a "regular" hospital, and then get them to the point where they can return home, with the maximum degree of independence as possible.

Given the fact that my dad has been deeply immersed in the medical/health care system lately, and the given the fact that I'm a techie, it has been difficult to ignore the wellspring of health care-related technology news peculating around, especially since
the new stimulus plan has a provision for the funding of health care IT. This is explained in detail the following presentation from the McKessen EMRresource blog:

I'll comment a bit on the following articles and links in my next post:

iPlan Net
"iPlan Net Session Sharing enables two or more clinicians at different locations to work on the same plan simultaneously. With Session Sharing, physicians no longer need to be in the same room to collaborate—it's all possible over the iPlan Net browser...iPlan Net connects entire surgery, radiotherapy and radiology departments—increasing cooperation, productivity and efficiency."

G.E. and Intel Working on Remote Monitors to Provide Home Health Care
Steve Lohr 4/2/09 New York Times

Intel Health Guide
"The Intel® Health Guide offers interactive tools for personalized care management and includes vital sign collection, patient reminders, surveys, multimedia educational content, and video conferencing and alerts."

GE HealthCare

GE Healthcare Community Technology Update: Aging in Place

New Touch Screen Monitors to Reduce Hospital Patient Waiting Times

Kindred Hospitals Customer Story (pdf)

Effective Healthcare Identity Management: A Necessary First Step for Improving U.S. Healthcare Information Systems Brief (pdf) (Smart Card Alliance)

FDA Probes Potential Overlap Between Electronic Health Records and Devices

DOD, VA set new target for lifetime health record
Government Health IT, Peter Buxbaum 3/27/09

The Stimulus Plan's Impact on the Healthcare Business Model

Scott Anthony, Harvard Business


Today I received an e-mail from Charles De Vilmorin, from Linked Seniors, about their entertainment products and services for people who live in senior communities, including skilled nursing facilities.

Invention Helps Seniors Get Plugged In: Device Caters to Interests, Needs and Tastes
Fredrick Kunkle, Washington Post, 3/19/09

Here is a quote from the article:

"Two young inventors have created a device, with the help of hands-on testing at a Fairfax County retirement community, that they say might change the way older Americans get news and entertainment.

Using modified MP3 players, computers and large touch-screen monitors in high-contrast colors for people with impaired vision, Charles De Vilmorin and Herve Roussel have created a digital kiosk that serves as a sort of iPod for older people."

who moved my dentures? musings on aging

Internet Surfing Better than Reading for Brain Stimulation

"“The study results are encouraging, that emerging computerized technologies may have physiological effects and potential benefits for middle-aged and older adults,” says principal investigator Gary Small, a professor at the Semel Institute for Neuroscience and Human Behavior at UCLA and director of the campus’ Memory and Aging Research Center."

EVERYWARE HEALTH CARE: Mobile Patient Communicator: an interactive touch screen for patient education

Via the Cloud Computing Journal:

New Mobile Patient Communicator Gives Patients and Interactive Education Tool and Boosts Nurse Productivity

"“Nurses spend a lot of time simply escorting patients from the waiting room to the exam room. We have found that the MPC can effectively room patients, while creating more value-added time for nurses to assume additional clinical tasks,” said Kelvin Buncum, president of International Medical Solutions. "

"“A compelling attribute of the MPC is that it increases nurse and support staff productivity, since it frees up caregivers to devote more of their valuable time to patient evaluations,” noted Buncum, who with his partner Jaime Mitchell, developed the MPC in conjunction with a family practice physician who saw the need to improve his medical support staff‟s productivity to meet growing demand and patients‟ knowledge of their chronic disease."

"During their wait time patients can view educational videos in private to learn about critical matters involving their acute illness, chronic condition and procedures. The user-friendly MPC delivers subject matter specific to the patient‟s stage of care, treatment regimen, rehabilitation, care plan and disease management."

"Serving as a personal health tutor and trainer, the MPC can perform pre- and post-instruction tests, scoring patients on their disease knowledge and retention. Healthcare providers can also grant users access to their clinical Web portal and patient applications via the MPC, providing significant utility over stationary kiosks."

The International Medical Solutions company offers a selection of touch-screen mobile patient communicator devices that would have come in handy during my father's longer-than-expected stay in an intensive care unit:

7 Inch MPC
IMS Seven Inch MPC

10-Inch MPC

12 Inch MPC

IMS Twelve Inch MPC

11-inch Rugged MPC

IMS Rugged MPC

History of International Medical Solutions and the MPC
Whitepaper (pdf)


I'm devoting some of the posts I write for this blog on the topic of "Everyware Health Care", an over-arching concept that emphasizes how existing and emerging technologies can help to improve delivery of health care and also enhance health-care user experience.

About 182,000 patients at the Cleveland Clinic use MyChart, an in-house electronic medical record. More recently, the hospital is testing out Google Health Records with 1,500 patents and Microsoft's Health Vault with 500 patients. According to an article in the Plain Dealer, the hospital supports the use of electronic medical records because it can reduce costly mistakes and redundancies.
Checking blood pressure

The video above shows how blood pressure can be charted and tracked daily, providing the physician with information that can better monitor and adjust medications. With Microsoft's Health Vault system, patients can upload medical information via a glucometer, pedometer, weight scale, or blood pressure monitor, depending on the nature of their health concerns. The system provides a means for uploading information to the system wirelessly, which is important for people who travel a lot for their jobs.

My Family Health Portrait is an on-line tool provided by the U.S. Department of Health and Human Services that allows people to enter their family health history, create drawings of family health history to share with health care providers or other family members, and to integrate the health history of other family members into your own. The source code for developers is available for free.

Some of the basic work related to integrated electronic medical information systems is hospital-focused Microsoft's Amalga software, which has been rolled out in several hospitals around the world. The following video shows how the system works at Bumrungrad International Hospital, and how it improves the hospital user experience, not only for the patient, but for the medical staff as well:

Cleveland Clinic makes electronic medical records personal, more accessible
Sarah Jane Tribble, Plain Dealer 3/31/09

News about wireless technology in healthcare
from Healthcare Informatics

Telehealth Services

POST: ElderGadget: Tech Devices for Health

POST: "Everyware Health Care": A Personal Focus

POST: Everyware Healthcare: Microsoft Health's Common User Interface website, usable health care applications, pervasive health games....

POST: SoftKinetic 3D Gesture Recognition for Games and Rehabilitative Play

Microsoft plans big move into European healthcare market
Tola Sargeant, Ovum
"Amalga does not complete with electronic health or patient records, it compliments them. As well as providing a single view of the patient, it enables analysis of all data from across the organization, which in turn can be used to drive change and performance improvement."

Microsoft releases hospital IT system as Amalga
Dana Blankenhorn, ZDNet Healthcare 2/13/08

Will Behavioral Health Be Left Behind?

David Raths, Healthcare Informatics 3/30/09

"While the stimulus bill was being written, Scalia said, his company worked with the National Council for Community Behavioral Healthcare to try to have the Medicaid incentive language changed. They were not successful, he added, because there was a concern that it would increase the cost of the incentive section above the $20 billion mark.


From the
Microsoft Research SenseCam Website:

"SenseCam is a wearable digital camera that is designed to take photographs passively, without user intervention, while it is being worn. Unlike a regular digital camera or a cameraphone, SenseCam does not have a viewfinder or a display that can be used to frame photos. Instead, it is fitted with a wide-angle (fish-eye) lens that maximizes its field-of-view. This ensures that nearly everything in the wearer’s view is captured by the camera, which is important because a regular wearable camera would likely produce many uninteresting images."

New study proves that Microsoft's sensory innovation aids memory recall

Technology Review Article

Images from Microsoft Research:
The SenseCam application has the potential to be a resource for people who have developmental delays, traumatic brain injury, severe attention deficits, and autism spectrum disorders. It would be a great tool for special educators, occupational and speech/language therapists, and rehabilitation specialists.

SenseCam Videos

Research and Publications


For the next few weeks, I'll be focusing some on my experiences with technology and health care.

This time, my posts will be on a more personal level. As I write this post, I am sitting in the family waiting area of the cardiac ICU at the Cleveland Clinic. My dad's surgery was Tuesday, and it is now Sunday, so I have had plenty of time on my hands to observe how technology is used to deliver his care, monitor his progress, and support his recovery.

Since I view things from a broader human-computer interaction perspective, I've decided to share some of my thoughts the"Hospital UX" picture, putting myself in the shoes of patients, family members, and medical professionals.

A Clean and Sterile Wait

This is the new lounge where families wait while their loved ones undergo cardiac surgery. The old family waiting area at the Cleveland Clinic had a cozy, home-like feel, with comfortable chairs and cheery art. The new waiting area has a very sterile, minimalist feel. The chairs are NOT comfortable, especially if you are middle-age or older and have the usual aches and pains!

Corridor to Nowhere?

Some of the corridors at the hospital have a surreal, institutional feel.

Hospital Corridor Eye Candy

Other corridors are a bit more...uplifting?

You are.... where?!

It is still quite difficult to figure out where you are and how to get to where you are going.

Note: I'll revisit this post to discuss this further - below are a few interesting links:

Microsoft Health Common User Interface: Patient Journey Demonstrator
via Martin Grason: Adventures of a 'Devigner'

Future Hospitals form Designit 12/30/08
"How can hospitals offer a better service – for patients and visitors? And improve working conditions for staff? Designit has been asked to find the answer by applying explorative, user-driven innovation at the heart of public sector delivery: Odense University Hospital, Denmark's largest hospital."

"The project, which starts in January, aims to deliver groundbreaking service innovation that could serve as a blueprint for future public healthcare improvements – in Denmark and abroad."

Obama's Plan to Digitize Medical Records Draws Criticism from Doctors
Dan Nosowitz, Gizmodo, 3/7/09

Computer Will See You Now Anne Armstrong-Coben, New York Times, 3/5/09

"Now that I’ve been using a computer to keep patient records — a practice that I once looked forward to — my participation with patients too often consists of keeping them away from the keyboard while I’m working, for fear they’ll push a button that implodes all that I have just documented...Room is provided for text, but in the computer’s font, important points often get lost. I have half-joked with residents that they could type “child has no head” in the middle of a computer record — and it might be missed....The personal relationships we build in primary care must remain a priority, because they are integral to improved health outcomes. Let us not forget this as we put keyboards and screens within the intimate walls of our medical homes.."

Note: Anne Armstrong-Corben is a clinical professor of pediatrics at Columbia.

Obama's Big Idea: Digital health records
David Goldman, CNN Money 1/12/09


Today I came across the ElderGadget Blog when I was searching for technology that might be helpful to my father, who recently spent the last few weeks in an intensive care unit.

Here are a few things I found on the blog, including what I found when I followed a link to the bindependent website:

Smart Table: A Broadband Communication System for the Elderly

ID Studiolab, Delft University of Technology, NL

"The smart system is aimed to prevent possible social isolation between elderly people and their social contacts. It consists of the Smart Table and the Smart Messenger, which provide easy and intuitive way for elderly people to benefit from the advantage of communication technology and improve the satisfaction of their social activities."

"During the design research, a working prototype is made and evaluated by a user test. The Smart Table offers people a way to use broadband communication without the need for a computer. The television will be used for video communication (web-cam) and the table as user-interface. On the table contact persons can be selected and images and video can be shared. The elderly person can capture images that will be shared instantly. The contact person can select images from his or her computer, which will be projected on the table of the elderly person". (TU Delft - Faculty Industrial Design Engineering - Master Design for Interaction - Project Interactive Technology Design - Vincent Steurs & Juin-Yi Huang)
Demy Kitchen Safe Touchscreen Reader
Photo Watch
Clarity-C900: Amplified Big Button Cell Phone
911 Guardian Phone
911 Guardian: "Tiny wearable speakerphone"

Big Digit TV remote
Extra Large TV Remote Control

SmartShopper electonic grocery-list maker

SmartShopper: Electronic grocery-list maker
Bierley's ColorMouse Video Magnifier

Voice Pod: Digital recording and playback system


Live from CES - Dakim's Brain Fitness Keeps Seniors Sharp

Dakim Brain Games

Previous post: Ubiquitous Computing - Grandpa and grandkids use a webcam and Skype across the miles

YouTube Vlogger: Geriatric1927

Geriatric Gripes and Grumbles


Malignant Spaghetti: A Symposium on Wireless Technologies in Hospital Health Care
(A must-read)
Wireless Sensor Networks for In-Home Healthcare: Potential and Challenges (pdf)

ALARM-Net: Wireless Sensor Networks for Assisted Living and Residential Monitoring

(Crossbow Blog, 9/28/08)

"Wireless Nodes Dynamically Link to Build Intelligent Sensing Networks"
John Suh, RTC 6/2005

Wireless sensor and data transmission needs and technologies for patient monitoring in the operating room and intensive care unit
Paksuniemi, M., Sorvaja, H,; Alasaarela, E.' Mylyla, R. Engineering in Medicine and Biology Society, 2005, IEEE-EMBS 2005

Healthcare Service with Ubiquitous Sensor Networks for the Disabled and Elderly People

Yung Bok Kim & Daeyoung Kim, Computers Helping People with Special Needs 7/2006

Cross-Post: Everyware Health Care: Microsoft Health's Common User Interface website, usable health care applications, pervasive health games...

I've been concerned about the problems people encounter with health technology, especially over the past year or so as I witnessed my father's journey in and out of hospitals, the emergency room, and various medical offices.

Technology can support quality health care. Systems that incorporate user-friendly electronic medical records (EMR) can support effective communication and collaboration among the members of medical teams. Technology that is not user-friendly can lead to inefficiency among health care team members, and can also contribute to errors that affect patient safety, if not lives.

In my opinion, health care software systems should ensure that the applications used by the patient inter-operate with those used by practitioners and health care facilities. The system should also allow for interaction with family members, especially when the patient is elderly, has a serious illness, or is a minor. This would be a good way to provide guidance for family members caring for the patient at home, and also provide an effective means of monitoring the patient's progress.

Microsoft Health's Common User Interface website provides a design guidance document, examples of toolkits and samples, a toolkit download, a showcase, and a roadmap that offers more detailed information. This is a great move on the part of Microsoft.

Microsoft's Silverlight and Windows Presentation Foundation (WPF) are used for toolkit controls, which I think is a good idea. I've played around with both, and also Expressions Blend, and have been surprised at how quickly I've been able to create prototypes for my various "experiments".

Microsoft Health's Common User Interface guidelines appear to be user-friendly for developers, which might ensure that user-friendly applications for healthcare eventually get into the hands of health workers and patients alike. This is important.

Related Thoughts:
Last year, I read an article in Pervasive Computing about new technologies that might prove to be useful to health care workers. Despite the efforts of researchers to incorporate user-centered design concepts and usability studies during the development of health care software, health care workers continue to be frustrated with technology.

Since I've found myself on the receiving end of user-unfriendly technology for most of my working life, I decided to write a letter to the editor of Pervasive Computing and offer a solution or two. Why not harness power of the 100,000+ nurses who've participated longitudinal studies about womens' health, and apply their knowledge by inviting them to play a role in user-centered development and usability testing of software for the health care industry?

More thoughts...

I was thinking about the Games for Health conference I attended last week and how developers could go about conducting usability studies for their games. Developers of health-oriented games and related applications should also consider tapping into this great resource. Nurses are represented in all facets of health care, and their hands-on experiences with patients could inform the development of user-friendly and useful health games.

Pervasive Health Care, Pervasive Games for Health:

I envision that in the near future, mini-health games, along with health-monitoring applications, will be widely available on mobile phones and other mobile devices. Wouldn't it be fun to play a health game on your mobile while waiting for your medical appointment?

I've noticed that many clinics and pharmacies now have large screens running health info-mercials. Wouldn't it be cool to harness the display for some serious health gaming?

One place to start might be at CVS minute-clinics. These clinics are led by nurse practitioners and supported by a medical doctor in another location, and offer care to a large number of people, close to where they live.

Audio about CVS Minute Clinics
Minute Clinic Website
American Well: The next generation of health communication

Related World Health Care Blog Posts:
The New Place for Health Care is Everywhere
EMR's Might Work for Physicians in PHM
EMR "The Movie"- Coming Soon (Maybe)
On the Coming "Everyware" Bubble in Health Care

(This was previously posted on the Technology Supported Human-World Interaction blog.)

Health 2.0 Meets Ix: Conference & Related Resources

The 2009 Health 2.0 Meets Ix Conference is underway in Boston.

With the growth of social networking, electronic medical/health records, and emerging technologies, there has been a growing interest among medical and IT professionals and the public to participate in the discussion about the future of health care.

Health 2.0 Conference FAQ

I haven't learned all there is to know about Health 2.0 and Ix (Information Therapy), so I'll post more information over time. Here is a start:

hellohealth is a new system that provides access to doctors in person as well as on-line. The hellohealth offices are located in Williamsburg, Brooklyn, and West Village, New York. "We're a revolutionary new experience with your neighborhood doctor. We mix office and online visits to give you personal attention when and how you want it.
" The IT behind hellohealth is Myca Health Inc.

"Myca is the power behind a revolution in health care. We positively impact the relationships between health care experts and their patients by pairing the latest in communication technology with brands that consumers can trust. Transforming the health care experience is the focus of our technology, our businesses, and our company."

Below is a video of Jay Parkinson, CMO of Myca/hellohealth, discussing electronic medical records and his ideas of how medical practice can be transformed:

Jay Parkinson, Hello Health from Health 2.0 on Vimeo.

Health 2.0 Accelerator

Center for Information Therapy

"Information Therapy (Ix®) is the timely prescription and availability of evidence-based health information to meet individuals' specific needs and support sound decision making. Ix prescriptions are specifically targeted to an individual's needs at a particular moment in care and are delivered as part of the process of care."

"Mission: To advance the practice and science of prescribing and using information to improve people's health."

"Vision: A future in which every health decision is informed."

"Online Records Get Patients Involved in Care" Wall Street Journal, 3/18/09


Interesting Posts by ePatient Dave:

Regarding Google Health

"Yes, ladies and germs, it transmitted
everything I’ve ever had. With almost no dates attached...the system transmitted insurance billing codes to Google Health, not doctors’ diagnoses. And as those in the know are well aware, in our system today, insurance billing codes bear no resemblance to reality."

"I'm putting my data in Google and Health Vault"

"Imagine someone had been managing your data, and then you looked." (4/1/09) (Be sure to read all of the comments.)

Note: I "lifted" the following links to companies involved in the Health 2.0 Conference for convenience. I did not accept a fee for doing so.


Kaiser Permanente


A.D.A.M.American WellPhilipshello healthMicrosoft Health Vault


Deep Dive



HealthwiseCalifornia HealthCare Foundation


RelayHealthElizaMSD HealthcareODPHP


NaviNetiGetBetterMedullanPharmaSurveyorRelief In SitePhreesiaProject HealthDesignRobert Wood Johnson FoundationAmericare Services/Call MDHealth Buddy

Media Partner

Health AffairsPharmacy TimesHCPLiveHIT NewsMass Technology Leadership CouncilIcyouEHealthInitative