Showing posts with label programming. Show all posts

Sunday, April 23, 2017

Hacking Health in Hamilton Ontario - Let's hear that pitch!

What compelled me to register for a weekend Health Hackathon? Anyway, I could soon be up to my ears in it.

A pubmed search on Health Hackathons...https://www.ncbi.nlm.nih.gov/pubmed/28250965 came up with a research article that shows that Hacking Health does have very useful benefits. I am intrigue and would even like to do my own research on this.

I attended a pitch workshop and learned that intellectual property on ideas is not what it appears to be. From that perspective, and in the interests of ehealth promotion:

1. Medical School ePortfolio - So you want be a Doctor eh? [app, educational]
Problem:
Getting into medical school is like a lottery. Or is it? How can students best prepare so they don't become disappointed or feel like they are gambling getting in, or getting in and realizing it is not their ideal career choice?

Solution:
This app will be for students who want to be physicians. Maybe it could even be aimed at three levels; elementary, high school, and university. It would allow students to track their interest in a career in medicine from early days. Students are also getting into medical school after high school these days at Queens University. It could have tests and quizzes, links to schools, CV prep, volunteer opportunity suggestions, how to apply, what's involved in the actual application process at very schools. The book "So you want to be Doctor eh?" by Anne Berdl is an excellent resource to model this on. Also, many universities have learning portfolios and that is also a model. Possible mentor relationships or chats or talks with professionals in the field. By tests and quizzes, it could also have an educational role to survey student empathy, compassion training, aptitude, in addition to preparation for MCAT and other formal tests.

2.Smart Forms Builder for Healthcare [ app, software]
Problem:
Hospitals were faced with a crisis in screening patients and visitors for SARS at Ontario hospitals in 2003. The paper system they had was bogging down entry to the hospital. A LAMP (Linux, Apache, MySQL, PHP) online screening system was eventually created to streamline the process. Healthcare administrators and even IT need to develop online forms quickly without programming skills as well as have access to useful data.

Solution:
There are smartform software systems like Google docs and commercial ones like Jotform, but they are not private and secure for personal health information. As well, smart forms need to be smart enough so people without programming experience can quickly develop an application. These kind of systems are evolving, but they just need something more akin to artificial intelligence to make them really smart and inexpensive to setup. API, mobile and REST applications would also be good integration components.

3. eHealth enabled browser [ browser, app, big data]
Problem:
Personal Health Records come in many different types, tethered, stand alone, and integrated. The people who benefit most are those who need to monitor and access a lot of medical records and visits. However, tracking health, IOT, and fitness device data can be integrated into Personal Health Records to create an overall digital health snapshot. Not everyone likes to login to a portal and track their health data.

Solution:
The idea here is to integrate Watson IBM analytics, or google alpha Go search engine analytics built into a dedicated open source browser built on chrome (or chromium). While this might sound just like an app running on a smartphone, the idea is to build a Firefox, Chrome or Safari browser that is actually a dedicated health analytics and digital health single sign on personal health record browser. What you search and read in every day life is all fodder for personal health anlaytics. This is digital "google flu" writ larger for an individual. In a way, think of it is a browser add on or extension that is a personal health record data collector, storage, and dashboard, but it is actually the browser itself.

4. Universal Healthcare Observatory [Big Data app]
Problem:

The problem is that not everyone has access to free healthcare. Statistically, millions of people are rising out of poverty every year, according to the late Global Health researcher Hans Rosling. Access to free or affordable healthcare should be a basic human right.

Solution:
The purpose of the project is based on the scientific based belief of evidence based medicine that "for profit healthcare is hazardous to your health". The United Nations and even the WHO have many observatories, and this one would be similar to the European Observatory of Health Systems and Policies. It will be a big data app that pulls data and statistics from disparate sources to monitor the global healthcare systems in the world and promote any trends towards universal healthcare. It might be able to use the Trendalyzer software. The bold target would be to achieve universal access to free or affordable healthcare for everyone on the planet by 2050.

5. eHealth Garage [ infrastructure, service]
Problem:
In my neighbourhood there are two former automobile/gas stations that are now a Vietnamese restaurant and a Holistic Health Clinic. Gas stations used be found on almost every block in every neighbourhood in every city and town. Cars no longer break down because the technology is better and gas monopolies are pushing gas stations out of neighbourhoods. Needless to say, electric cars are moving in soon. Also in my neighbourhood is a legal Medical Marijuana Clinic. Why not an eHealth Garage?

Solution:
With an aging population living longer and a coming generations that might may well live easily way over 100 years of age because of advances in exponential medicine, preventive medicine and holistic health services need to be accessible with digital health services in the community. This is also a way to deconstruct medicine.The eHealth Garage could be a component of a Family Health Team but they might call it an eHealth clinic. I see the Garage being full of healthcare technology: x-ray machines, ultrasound, MRI, fitbits, resistance training gym machines, Transcranial Magnetic Stimluation (TMS) - almost any health technology that can be coupled with a digital health technology or record. DIY healthcare, though with options for professional healthcare oversight.

Sunday, May 1, 2016

South Korean eHealth Connections

Today's post is about recent random connections between eHealth and South Korea.

I came across a South Korean eHealth company called Health Connect, which is collaboration between one of the largest telecommunication companies SK Telecom and the premier university in South Korea - Seoul University. Seoul University Medical Centre is one of the top NIH funded clinical trial research centres in the world. I like their website design.

Earlier last year I was contacted by someone at Samsung Medical Centre about eREB (Research Ethics Board) online systems. They developed one of their own in-house systems for online research ethics review and I have a research interest in "in-house" eREB systems development ( having programmed and designed one myself). Too bad my Korean is still not good enough to understand everything on their website in Korean, even though I lived in Korea for almost 4 years, have a Korean family, and still watch Korean TV dramas every day!

I would like to bring to your attention the prevalence of the Fitbit device. I went to a Health & Safety meeting and noticed that half of the people were wearing Fitbits on their wrists. There are activity competitions with teams at work and people are buying more Fitbits because the cheap pedometers reset unexpectedly and data is lost. A year or so ago I read an article that Fitbit was a fading fad, but that just does not seem to currently be the case. Outside of work, I am seeing more and more people wearing and connecting to these devices. Some days they even look ubiquitous.

Now here is the surprising Korean connection - the President and inventor of the Fitbit, James Park, is Korean!

One of the major problems I am having now with my Fitbit device is Ubuntu. The Fitbit dongle and sync tracking isn't supported for Linux or Ubuntu. A program called Galileo was written for free by Benoit Allard. I had it working just fine when I was using Ubuntu 14.0 but then I just upgraded to Ubuntu 16 and it isn't working. I am hopeless trying to share two Fitbits on the Mac and the iPad so I really need to try to get this working again on Ubuntu 16 so I can sync and see my online data. I have started to sink my toes into the murky depths of the Ubuntu Galileo setup, without too much hope. Posted the bug on the Allard Galileo website though.

An interesting direction for Googles' Deepmind appeared in the news & I immediately tweeted it out on my eHealth Twitter feed: "Why does Google want British patients' confidential records"? http://ibt.uk/A6XCB

I have blogged about Deepmind before < http://earthspiritendless.blogspot.ca/2014/02/ethics-boards-for-googledeepmind-end-of.html >. Deepmind recently was the technology behind Alphago, an artificial intelligence Go program that beat the best Go player in the world. The best Go player in the world is the South Korean Lee, Seodol, fitting for this slightly Korean blog post. It doesn't surprise me that Deepmind is following the way of IBM and Watson, using AI to find discoveries using big health data.

Well that is the South Korean eHealth Connection for now.

Tuesday, December 22, 2015

Kaiser Survey Links Portal Use With Improved Perceptions of Health | Healthcare Informatics Magazine | Health IT | Information Technology

Kaiser Survey Links Portal Use With Improved Perceptions of Health | Healthcare Informatics Magazine | Health IT | Information Technology

I posted this link automatically after the story turned up in my google search RSS feed. The website with this Kaiser Survey story had over 280 reference (or Add This ) RSS icon links for sharing the story. I often share stories to my Twitter feed which also has an eHealth theme. My Facebook feed is mostly for personal stories. I can remember before Facebook when RSS was just developing, what a liberation it was from the inbox. Some email programs had a way to receive RSS feeds into a local folder or there was a browser navigation item where one could store the RSS links, kind of like bookmarks. These days I am told that the younger kids don't even read email - they are just message chatting on their smartphones or other social media sites. I still think RSS - Real Simple Syndication - is the greatest technological invention since newspaper publishing. In fact, I have "health informatics" set in a google search feed, which is just an RSS program.

RSS is programmed in XML. I took a course in XML once and started creating my own RSS feeds on the websites I had created. It was not that difficult. XML is also the basis for the HL7 standard for health records and interoperability. It is too bad that more personalized RSS "news" doesn't come into our google or other email accounts in terms of our own personal health records. I personally don't see the interoperable difficulty in doing that. Add to that developments in "web services", API, and inter-database sharing platforms like REST, and there are a lot of open doors for data sharing.

This eHealth enabled browser blog is dedicated to eHealth. Personal health records are a major interest that I like to share with others. After doing research for 5 years on PHR I still think they have many decades to go before they will be widely used. I could be mistaken here, but I just don't think the technology is ripe for wide spread PHR use. It is just not the technology, it is also the social awareness of health and wellness that is lacking. Newer forms of technology might enable an evolution of this awareness - hard to say. A friend of mine who I follow on Facebook recalled the time in his university in 1990 when he and a colleague decide to get email accounts so they could stay in touch. They could not convince anyone else to use email because no one could see the reason for using a technology that no one else was using.

To get back to this story about the Kaiser Survey that showed that people thought that their health was improving because of using a PHR, I think that there is a need to find more evidence that PHRs can be a technological tool physicians may ultimately prescribe to help their patients.

Thursday, October 8, 2015

CBC - Keeping Canada Alive website design & programming

The navigation web programming & design is excellent for this CBC project.
http://www.cbc.ca/keepingcanadaalive/

I looked at the Page Source for the coding trying to see if I could identify how they designed it. I am still not sure. I missed the ajax boat in programming utility and so I am not sure how that programming forms the navigation circle, if at all. Some of the navigation circle might be all done in CSS, maybe what they call "CBCcarousel":
http://www.cbc.ca/i/css/v11/scripts.css
Then I found out that "carousel" is actually a CSS class for design < here >.

It reminded me of an old style of web page design using photoshop image over layers. The circle mouse over links to entire video documentaries is very useable. CBC may be selling off their buildings and laying off employees but at least they know how to deliver digital information. It could even be flash scripting? I've really not kept up with that either.

I think web design and programming for healthcare sites is part of a study of Health Informatics. We may recall the fiasco of the Obamacare healthcare.gov website that had usability and server crashing issues. For that matter, any electronic medical record system is first and foremost a web design application that must prioritize usability.

Speaking of Usability I have been trying to read through Steve Krug's "Rocket Surgery Made Easy: The Do-It-Yourself Guide to Finding and Fixing Usability Problems." Krug is right - he is not a book writer. Interesting layout for a book though.

The episodes for the CBC series don't appear to have one dedicated to an ehealth contextual scenario. I think that is because ehealth is usually kind of implicated throughout many aspects of healthcare, and not an all star focus?

Anyway, having watched a half dozen or so episodes, I am finding the whole thing quite an awesome educational trip! Here is a short clip intro to the project:

Wednesday, July 1, 2015

Fitbit and Personal Health Informatics

A surprise gift for father's day was a Fitbit ChargeHR. The HR stands for Heart Rate, that measures beats per minute (BPM). It doesn't measure blood pressure, and I don't think any device like this on the wrist will be able to do that soon. I have been counting my walking distances, steps up stairs, calories and sleep activity for about a week now. It feels good to have entered the world of the "quantified self "and big data personal health informatics at more than just a theoretical level, as I have been doing on this blog for the past 4 years. I actually have a blog post about Fitbit from 3 years ago <here>!

The data is sent wirelessly to a small "dongle" on my MacBook anytime I am within 20 feet of it. I was surprised to see how this data easily integrated with Telus (Microsoft) Health Space (Healthvault) from the Fitbit.com login settings account. The power of the API is truly awesome.

As I knew before when I was looking at reviews for smart watches, the Fitbit ChargeHR is not a great watch for telling the time. However, one advantage is I find myself saving a lot of time by not looking at my watch to find out what time it is so often. All in all, I find myself wanting to wear it more than the old watch.

Sleeping with the watch is perfectly unobtrusive. There are continual double green sensor lights flashing for the BPM readings but it is hidden under the wrist. At a different viewing angle you can see the green lights. Double tapping at night will illuminate the clock (and day of the month) but during the day it is very difficult to see the digital time in glare of light of day. When you wake in the morning, sleep activity data is automatically transmitted to the MacBook or the Fitbit app on the iPad. via the dongle. The sleep data is a bit hard to interpret. Did I really only get 5 hours sleep? Anyway, I am starting to make some sense of the times I may have been awake or restless.

If you set a goal for 10,000 steps it will buzz on your wrist when you achieve the goal. You are also sent an email congratulating you, which is repeated in the weekly email data digest updates. I tracked food consumption for data on calories, sodium levels, etc. for a few days, and this is very interesting information for me. Since I have not really changed weight since I was a teenager, I don't really have any weight goals, but I know I can align readings from the gym equipment which tracks BPM and calories burned with the Fitbit. When I am not going to the gym, I can utilize those readings. But like I said, watching calories burned is not a science I follow much because of my metabolism.

Even though the data is integrated into the Telus HealthSpace, which is a free personal health record if you have a Microsoft login, I still don't find myself using the personal health record that much (yet). I also have a McMaster PHR (former MyOSCAR) and a Health and Wellness Companion PHR through my employer's health insurance company, in both of which I have just stepped into the shallow end of the pool. I tend to keep a Word document log and paper file of health related events a lot more. If the PHR was integrated with our family health team, I am sure I would use it more.

So, I think we are still a way off from wider adoption of personal health records as integrated tools for the physician's electronic medical record. A lot depends on more research, and of course evolving software breakthroughs like APIs. I am a community volunteer with the McMaster University Family Medicine TAPESTRY program, and I can see first hand the uptake on PHRs and how much education and training is required before they are being used effectively. On our visits to seniors in our communities we also help promote the use of the McMaster PHR. Like any technology, and the toothbrush comes to mind, use comes from developing good habits, as well as promotion from health care professionals.

Because we have entered a digital culture, many people will be entering a personal health record, not through their family medicine clinic, but through some form of personalized health informatics, like Fitbit data, or smart phone apps. There will be a point when physician medical practices will want to buy into accessing or making that data available.

Monday, March 10, 2014

Autosave with Coldfusion and CKEditor

Autosave is an essential feature for online forms. Web-based EMR or PHR systems should probably have it for physician and other administration notes. I would say it would probably be an essential service to have as a default, with no other option. Well, having an option to save and store regular drafts of the text would be great, and which could be deleted when the text is finally saved or submitted. The next best feature to have would be a system that regularly stores versions of the text input into a form or page. You have probably noticed autosave functions in current email systems like Gmail, and I think some word processing applications have them as a feature, but maybe not a default feature. Gmail stores draft versions regularly. Very useful to have.

From my experience with a Coldfusion application that uses CKEditor, there is nothing worse than having a user loose 2 hours of textual notes, especially on a system that times-out after one hour. The forms I developed have a manual save button and a button to submit the data to be saved. The latter function just sends email confirmations. CKEditor does have a plugin for autosave, and I have tested it, but was not happy with the way it notified about reloading saved data. I upgraded to a higher version of CKEditor and the autosave plugin, but now it doesn't work at all, so I am twice as unhappy (: (:

So there are programming alternatives to autosave without CKEditor and I have tried several (like the dynamic drive one) and they are just not working. The most promising one I have tried is a coldfusion demo version from a coldfusion tutorial. I tried this demo on my coldfusion server and the demo version works but when I program it into my coldfusion pages - nothing. The downside of that is that it doesn't look like it integrates well with CKEditor. You know the autosave works if you type some text into a comment box and do a page refresh and the text doesn't disappear.

Another promising one looked like Sisyphus which integrates into the javascript for the CKEditor. Even though the developer of Sisyphus was very kind to answer my emails, I still have not been able to get it work. This is going to be one of those trial and error experiments that I will have to return to many more times before, almost by chance, I get it to finally work.

Tuesday, February 11, 2014

Ethics boards for Google/Deepmind: The end of computer programming?

Hat tip to the folks on the LinkedIn CAREB group who posted this story from Forbes "Inside Google's Mysterious Ethics Board". OK. Here is my initial impression. The ethics surrounding new technology is becoming as serious as stem cell bioethics. One of the authors of Forbes article also contributes to the Institute for Ethics and Emerging Technology - appropriately.

It was actually an Artificial Intelligence (AI) company that Google bought called Deepmind, that insisted on the technology ethics board as a condition of the sale. More about the founder of that company, Demis Hassabis is interesting to follow. This "technology ethics board" is not, I think, at all the same as an Institutional Review Board, or Research Ethics Board. It is more of an internal ethics review committee, probably examining agile developments of new technology. Might just be corporate whitewash, or it might actually be driven by social and moral responsibility, as well as a dash of liability insurance, to paraphrase the IEET author.

Deepmind, which has the most minimalistic website I have ever seen, is advancing AI into computers that can learn and program themselves. Must be the vanguard to the end of programming, as current Brain research is predicting. Try reading this paper about how Deepmind programmed a computer to win Atari games "Playing Atari with Deep Reinforcement Learning". Understand now why programming might come to an end when computers learn how to program themselves?

What possible relevance could this have for ehealth, as is the primary purpose of this blog? Well, as this article on Recode says about the founder of Deepmind: "(Demis) Hassabis has closely studied how the brain functions — particularly the hippocampus, which is associated with memory — and worked on algorithms that closely model these natural processes." Apparently, the Journal Science says this research was one of the top scientific breakthroughs one year (this from Wikipedia):

Hassabis then left the video game industry, switching to cognitive neuroscience. Working in the field of autobiographical memory and amnesia he authored several influential papers.^[14] The paper argued that patients with damage to their hippocampus, known to cause amnesia, were also unable to imagine themselves in new experiences. Importantly this established a link between the constructive process of imagination and the reconstructive process of episodic memory recall. Based on these findings and a follow-up fMRI study,^[15] Hassabis developed his ideas into a new theoretical account of the episodic memory system identifying scene construction, the generation and online maintenance of a complex and coherent scene, as a key process underlying both memory recall and imagination.^[16] This work was widely covered in the mainstream media^[17] and was listed in the top 10 scientific breakthroughs of the year (at number 9) in any field by the journal Science.[1

Still, that really isn't about health informatics really. Sorry. Except if the ethics of new technology in health and medicine is important? There is a real intersection I believe between health informatics and health technology assessment.

Sunday, December 1, 2013

IBM's Watson now an API for cloud development - is there a Doctor in the House?

I am still trying to pin down a focus on eHealth application for this, but IBM has opened an API (application program interface) for the Watson cognitive computing intelligence. This sounds like developers can open up smartphone applications to query the cognitive fireworks of the Watson computer that defeated the best humans in the world of TV game Jeopardy.

For eHealth, the API needs to tap into the right data content. IBM already has several services for this:

MD Buyline: This provider of supply chain solutions for hospitals and healthcare systems is developing an app to allow clinical and financial users to make real-time, informed decisions about medical device purchases, to improve quality, value, outcomes and patient satisfaction.Hippocrates powered by IBM Watson will provide users with access to a helpful research assistant that provides fast, evidence based recommendations from a wealth of data, to help ensure medical organizations are making the best decisions for their physicians' and patients' needs.

Guess there's not much else you could ask for? But yes there is - Welltok:

Welltok: A pioneer in the emerging field of Social Health Management™, Welltok is developing an app that will create Intelligent Health Itineraries™ for consumers. These personalized itineraries, sponsored by health plans, health systems and health retailers, will include tailored activities, relevant content and condition management programs, and will reward users for engaging in healthy behaviors. Consumers who use Welltok's app -- CaféWell Concierge powered by IBM Watson – will participate in conversations about their health with Watson. By leveraging Watson's ability to learn from every interaction, the app will offer insights tailored to each individual’s health needs.

And there is more. Watson Path is diagnostic education program, and perhaps even a clinical decision support aid for diagnosis? All this from a game of Jeopardy?

Tuesday, August 27, 2013

ehealth enabled Word Cloud with NVivo

I have tried experimenting with NVivo on some research data we collected from an online survey. Using the website for this blog I created a PDF and imported it into NVivo, ran a query, and created this Word Cloud for the site. This isn't for the entire site, but I think it is an intriguing picture of the weather patterns the data is sending forth.

I went back to the drawing board and make a Word Cloud for as much as the website I could get into Adobe Acrobat before it "ran out of memory" - about 1300 pages. The word count frequencies on the top 40 words was much much higher but the cloud still looks about the same as I will post it here. By the way, there are much better uses for NVivo, but this is the most fun so far:

Wednesday, May 29, 2013

Coldfusion progamming FLOAT IsNumerc date comparison SQL

One of the systems I developed was done in the Coldfusion programming language. As I have developed and learned more about Coldfusion over the past 9 years or so, the more I realize it depends a lot on SQL. I learned how to do a lot of Coldfusion from another learner in the beginning, but after that, internet searching for code solutions is mostly what I do, as I imagine many programmers and code seekers do as well for answers. Since Coldfusion runs on a proprietary software platform and is not open source like PHP or MySQL, it is more difficult to find Coldfusion programmers to share ideas.

Recently I found the answer for a puzzle that had long baffled me, how to compare two dates then output data fields on a query for them. I knew how to do the SQL to output data from a month, day or year in the past, something like this:

<CFQUERY NAME="GetRecords" datasource="myAccessDB" >
      SELECT COUNT(id)as number_total FROM tblMyTableName Where Month(DateReceived) Like '1' and DateReceived Like '%2010%' </cfquery>
      <cfoutput query="GetRecords">#number_total#</cfoutput><br>

In order to compare two dates in one year, I found a Coldfusion developer site that suggested using FLOAT, and here is how this is done:

   <CFQUERY NAME="GetMREBRecords" DATASOURCE="myAccessDB">
        SELECT *
        FROM tblMyTableName
        Where DateReceived BETWEEN 40358 AND 40722
        ORDER BY ID
        DESC
        </CFQUERY>

The FLOAT values in this example are actually dates. 40358 is June 30, 2010 and 40722 is July 1, 2011 (maybe give or take a day?). I have yet to find an actual table with FLOAT date equivalents. I am not even sure if this means "Floating point", a term or process used in computational data computing. All I know is, that it works for my system really well, and solved a big problem we had.

Actually, these FLOAT values have no known standard dates(times) that I can find, and are not accurate for leap years and other variables. Thankfully, I kept searching the internet for some code that would work and finally found this:

<CFSET start_date = #CREATEODBCDATETIME("7/1/2012")#>
<CFSET end_date = #CREATEODBCDATETIME("6/30/2013")#>

        <CFQUERY NAME="GetRecords" datasource="myAccessDB" >
      SELECT COUNT(id)as number_outstanding FROM MyTable
   Where DateOfReceipt Between #start_date# And #end_date# </cfquery>
Number of 2012-2013 Records
          = <cfoutput query="GetRecords">#number_outstanding#</cfoutput>

Wednesday, May 22, 2013

Programmableweb Healthcare API List

I have been having problems recently trying to understand "integration engines" or "Application Program Interface - API". This is list of Healthcare APIs helps shed some light on what I am thinking about - from the programmableweb site. I knew that Google Health, when it was active, had an excellent API system for those living in the United States who could use a variety of health services. Joining up databases in the cloud is technologically doable. In healthcare, it would seem to me that live, real time in-sync linkage of databases would be critical - something I think you might call data driven architecture (which I blogged about before). Anyhoo, still trying to understand better such things as WSDL, SOAP, REST, and web services in general. Interoperability is one of the most difficult problems in health informatics.

37 Health APIs: Google Health, Avvo and Fitbit

Wendell Santos, March 21st, 2012

Comments(0)

Our API directory now includes 37 health APIs. The newest is the DailyMed API. The most popular, in terms of mashups, is the Avvo API. We list 2 Avvo mashups. Below you’ll find some more stats from the directory, including the entire list of health APIs.