For most people, going to the doctor means thinking about co-pays and when they’ll feel better. For me though, it means thinking about those plus the cyber security of the computer systems being used by the medical professionals.
I’ve spent more time than usual visiting doctors recently. I broke my hand – sure I’ll tell you how. It was a hit-and-run accident with a woodchuck.
I was riding my bike, the woodchuck ran in front of me, I ran over him, and he fled into the woods, leaving me lying on the ground moaning in pain. Okay now that we got that out of the way…
So the emergency room doctor ordered a CT scan (to check for a concussion and the presence of a brain) and various x-rays. I thought about the computer controls while in the CT scanner, but what was really interesting was when the hospital emergency room digitized the results and gave them me on a CD to provide to the orthopedist.
Before going to the orthopedist, they had me fill out a bunch of forms online. As I provided the detailed medical information, I wondered how secure the web interface is, and whether someone could attack the medical record system through the patient input interface.
LOOKING for needles in haystacks is boring. But computers do not get bored. Contracting out to machines the tedious business of assessing the dangerousness of cancer cells in histological microscope slides ought thus to be an obvious thing to do. Cervical-cancer smear tests aside, however, such electronic intrusions into the pathology laboratory are limited. Grading cancer cells into “indolent” and “aggressive”, and hazarding an opinion about whether they spell a treatable condition or an untreatable one, has remained the realm of the human expert.
But not for much longer, if Daphne Koller, a computer scientist at Stanford University, and her colleagues have their way. They recently reported in Science Translational Medicine that they have written a program which can distinguish between grades of breast-cancer cell—and in a way that provides a more accurate prognosis than a human pathologist can.
The Pap smear is the most effective cancer-screening test ever developed. When it was introduced in the United States in the 1940s, about 26,000 women died every of year of cervical cancer. Today, the exam—now known as the Pap test, since the modern method of preparation no longer requires smearing cells on a slide—is performed about 55 million times a year in this country, and about 120 million times annually worldwide. The effect of widespread, routine testing has been dramatic: Fewer than 5,000 American women now die each year of cervical cancer. If you account for population growth since the 1940s, the Pap test has reduced cervical cancer mortality by more than 90 percent.
The Pap test isn’t just good for women. It’s also a good business for doctors and diagnostic laboratories—maybe as much as a $500 million industry in the United States. The techs and doctors who look at Pap slides are the TSA agents of the medical world: They spend their days examining dozens of slides in search of tiny, subtle, and rare visual cues of disease. The process begins with a doctor collecting a sample of cells from a woman’s cervix. The cells are preserved in liquid, mixed with laboratory reagents, separated from blood and other biological material by centrifuge, and then deposited onto a slide. The cervical cells are examined first by cytotechnologists—specialists trained to analyze certain types of medical slides. If abnormalities are found, the Pap slides are then screened by pathologists, medical doctors who diagnose disease. Because the vast majority of Pap tests are performed on healthy women, about 90 percent of the slides seen by a typical lab are completely normal. The entire process costs about $25 to $100 per test, depending on the lab’s efficiency.
One of the nation’s leading drug store chains, Rite Aid, has begun rolling out online physician chat rooms in its stores, allowing customers to participate in virtual face-to-face consultations prior to purchases.
Rite Aid today said it worked with healthcare provider OptumHealth to introduce its NowClinic Online Care services, which are currently available at pharmacies in the Detroit area.
The NowClinic offers Rite Aid customers real-time access to medical information and resources from doctors and OptumHealth nurses. Rite Aid said it is the first to provide a virtual clinic in a retail pharmacy setting.
Currently, conversations with nurses are free and a 10-minute consultation with a doctor is $45.
Earlier this month, Kazuma Obara became the first photojournalist to gain unauthorised access to the power plant and produced an exclusive glimpse of life inside the facility
A federal committee that includes a major donor to President Obama and whose company stands to profit from the panel’s recommendations holds in its hands the future of health information technology policy.
Judith Faulkner, founder and CEO of Epic Systems Corp., secured a seat on a panel charged with recommending how $19 billion in stimulus money dedicated to health IT be spent, despite opposing a key administration position on the issue.
Faulkner and her company oppose the president’s vision for health IT, but Epic employees are massive Democratic donors. They’ve given nearly $300,000 to Democrats since 2006, according to the Center for Responsive Politics.
That may help explain both Faulkner’s appointment to the 13-member Health Information Technology Policy Committee as a representative for health IT vendors, and the accolades her company regularly enjoys from prominent Democrats.
The Federal Government should not be subsidizing Health Care Information Technology with our tax dollars. Organizations should choose automation services that make sense, for them, not for tax reasons….
Doctors treating the poor in the US are braced for significant reductions to their services amid increased pressure from both the Obama administration and Republicans for deep cuts in health spending.
Twenty-nine Republican governors have called for greater flexibility in how states administer Medicaid programmes for the poor, a move which coincides with the Obama administration’s withdrawal of stimulus funds used to pay for treatment.
Nearly 49m people in the US, or one in six Americans, were covered by Medicaid in 2009. The figure is thought to be higher today.
The federal government increased its subsidies to the states under the stimulus programme, spending $2.68 for every dollar a state spent on Medicaid, nearly twice as much as before the stimulus.
Michael Galpert rolls over in bed in his New York apartment, the alarm clock still chiming. The 28-year-old internet entrepreneur slips off the headband that’s been recording his brainwaves all night and studies the bar graph of his deep sleep, light sleep and REM. He strides to the bathroom and steps on his digital scale, the one that shoots his weight and body mass to an online data file. Before he eats his scrambled egg whites with spinach, he takes a picture of his plate with his mobile phone, which then logs the calories. He sets his mileage tracker before he hops on his bike and rides to the office, where a different set of data spreadsheets awaits.
“Running a start-up, I’m always looking at numbers, always tracking how business is going,” he says. Page views, clicks and downloads, he tallies it all. “That’s under-the-hood information that you can only garner from analysing different data points. So I started doing that with myself.”
His weight, exercise habits, caloric intake, sleep patterns – they’re all quantified and graphed like a quarterly revenue statement. And just as a business trims costs when profits dip, Galpert makes decisions about his day based on his personal analytics: too many calories coming from carbs? Say no to rice and bread at lunchtime. Not enough REM sleep? Reschedule that important business meeting for tomorrow.
The founder of his own online company, Galpert is one of a growing number of “self-quantifiers”. Moving in the technology circles of New York and Silicon Valley, engineers and entrepreneurs have begun applying a tenet of the computer business to their personal health: “One cannot change or control that which one cannot measure.”
A reader asked me to write tonight about the Health Information Technology for Economic and Clinical Health Act, which is about as far from something I would like to write about as I can imagine, but this is a full service blog so what the heck. The idea behind the law is laudable — standardized and accessible electronic health records to allow any doctor to know what they need to know in order to treat you. There’s even money to pay for it — $30 billion from the 2009 economic stimulus that you’d think would have been spent back in 2009, right? Silly us. Now here’s the problem: we’re going to go through that $30 billion and end up with nothing useful. There has to be a better way. And I’m going to tell you what it is.
But first a word from my reader:
For the past week, I’ve been complaining that journalists covering possible radiation dangers from Fukushima plant have abandoned the old convention of putting radiation exposures in context (usually by comparing them to chest x-rays). The result is that all “radiation” sounds equally dangerous, and people in Plano, Texas, start stocking up on potassium iodine.