The digital health space refers to the integration of technology and health care services to improve the overall quality of health care delivery. It encompasses a wide range of innovative and emerging technologies such as wearables, telehealth, artificial intelligence, mobile health, and electronic health records (EHRs). The digital health space offers numerous benefits such as improved patient outcomes, increased access to health care, reduced costs, and improved communication and collaboration between patients and health care providers. For example, patients can now monitor their vital signs such as blood pressure and glucose levels from home using wearable devices and share the data with their doctors in real-time. Telehealth technology allows patients to consult with their health care providers remotely without having to travel to the hospital, making health care more accessible, particularly in remote or rural areas. Artificial intelligence can be used to analyze vast amounts of patient data to identify patterns, predict outcomes, and provide personalized treatment recommendations. Overall, the digital health space is rapidly evolving, and the integration of technology in health

Thursday, December 12, 2013

HealthCare.gov

The Obamacare Paper Pileup



When HealthCare.gov and some state-run insurance marketplaces ran into trouble with their Web sites in October and November, they urged consumers to submit paper applications.



Now, ProPublica's Charles Ornstein reports , it's time to process all that paper. And with the deadline to enroll in health plans less than two weeks away, there's growing concern that some of these applications won't be processed in time.

Some key points compiled from reporting around the nation:

  • After a conference call earlier this week with federal health officials, Illinois health officials sent a memo Thursday to their roughly 1,600 navigators saying there is no way to complete enrollment through a paper application.
  • Covered California in recent days disclosed that it had a backlog of 25,000 paper applications that had to be processed before the Dec. 23 deadline to sign up for coverage that begins Jan. 1.
  • In Oregon, a state official disclosed this week that more than 30,000 people who submitted health insurance applications still don't have enrollmentpackets

  • In Maryland, another state whose exchange has been plagued by difficulties, 8,500 paper applications were pending as of last week.
  • In Vermont, there is a backlog of 1,210 applications, some dating back to as early as Oct. 30.
It does not look good for a smooth transition to a January 1 startup date.  Even for those who have enrolled there have been no reports as to who has received premium billings. That is the bottom line......no $$ no insurance. Perhaps our government should automatically pay the premiums for the first 90 days to make up for their negligence, and not really giving a damn if this works.

The full story is available here: http://www.propublica.org/article/the-obamacare-paper-pileup



Project Moonshot-----Dell launches mini-servers

Project Moonshot, Dell's innovative approach to the cloud and servers is coming to healthcare. Many providers utilize cloud services for electronic medical records to avoid hardware expense, and maintenance of software.  Other than real security issues it allows HIT and EMRs to be affordable.



However the large data centers use considerable energy for running the servers and cooling.  They are often located in areas where energy costs are low, such as near hydroelectric generating facilities.

Moore's law of computer processing power doubling every year is no longer a limitng or consideration in designing new systems.



What is HPs new server? Basically, it’s a server, a very small server that consumes very little energy.  Smaller than a typical hardcover book, it consumes 89 percent less energy to operate, and takes up 94 percent less space than a typical server. And, when packed into a large rack with many more servers like it, the amount of computing power that can be harnessed in one relatively small place is pretty impressive.  The idea is pretty straightforward: Cram 2,800 servers into a single rack that would today house a few dozen, or at most 128, blade servers. 



Moonshot m300 server cartridge based on Intel Avoton Atom chips 

ARM processors are found in tablet pcs, cell phones. They draw less power and generate less heat than conventional x86 processors.  attribution for some content is given to:

About Daniel Robinson is technology editor at V3, and has been working as a technology journalist for over two decades. Dan has served on a number of publications including PC Direct and enterprise news publication IT Week. Areas of coverage include desktops, laptops, smartphones, enterprise mobility, storage, networks, servers, microprocessors, virtualisation and cloud computing.




Friday, December 6, 2013

The Secret Life of a QUANT

Whatsa  "Quant" ?

It sounds like a new previously undiscovered subatomic particle somewhere between a quark, a string, a lepton,a boson,a prion,mesons and baryons.

Well, a quant is none of that. While those fundamental particles are essential to matter and energy and some are theoretical, the "Quant" is a far more threatening player in health care and the financial world. On one hand quants offer great hope for some, and for others they are a barrier to obtaining health care.


Quants are the math wizards and computer programmers in the engine room of our global financial system who designed the financial products that almost crashed Wall st.

The Quants arrived quietly some time ago in  health care. The similarities between the crash of the global financial system and current health care systems is frightening.

Quants are sometimes known as "Algos".

Barbara Duck, who writes at The Medical Quack:

     Attack of the Killer Algorithms – “Algo Duping 101″

     In health care this is well underway with the Affordable Care Act,
     Accountable Care Organizations, Outcome Studies, Preferred Practice Pattern;  all have been developed by "Quants".

Here’s a selection of videos that offer a lot of information, which I call “Algo Duping”. Barbara Duck has written several posts on the Medical Quack about this topic and here’s a group of MUST SEE videos if you want to understand what is happening in the world. The general public does not like math, is afraid of it, etc. but banks and corporations are not and they use it against us.

First off let’s hear from Charlie Siefe, Who Wrote the Book, “Proofiness, The Dark Arts of Mathematical Deception.


 Physicians, too are afraid of the math, although trained in scientific methodology. One cannot defend against something one does not know about. For most, statistical probability and algorithms fall into that category.

Health insurers have been big on algos, that is how they separated the sick,(read expensive) and infirm from the healthy (read inexpensive) beneficiaries.

How will they work around the Affordable Care Act ?  When there is challenge their is opportunity (to make a profit). The  Affordable Care Act's initial thrust is to eliminate pre-existing conditions as a reason for non insurability.  This flies in the face of previous algo's.

The first law of algo's is: "If the first algo fails, another algo will appear"

The second algo will disavow the original algo as "obsolete and not suited to the changes in health finance".

Jobs in quants are fluorishing in health care with enterprises attempting to game the system.

There is a continuing tension between quants and quals (those who emphasize quality, regardless of cost ).

As in the financial world risk is a key metric for a health algorithm. Population health is a field in which quants are essential.



Is this occurring in health reform? This is a documentary called “Quants, the Alchemists of Wall Street” and they make the math and formulas that move money. Banks and companies use these all the time and the one interview tells you that yes they are smart and talks about their attitudes as they literally have the CEOs by the balls, as they don’t understand their own business models that they pay royally for the Quants to write. In this video you see the software designer who created the software for the big mortgage scam. It’s not his fault but rather how it was used and abused. He makes one very good quote at the end, “You Can Do Anything With Software”

There is a saying amongst quants (read statisticians) “You Can Do Anything With Software” and also points out the software models and the real world do clash

Challenges of Interoperability in Healthcare

Although regional  health information exchanges were promoted and funded early in 2004-2006 by then appointed David Brailer MD and the Office of the National Coordinator for Information (by George Bush), progress has been slow due to a number of factors.


At the recent 2013 AHIMA meeting, interoperability was a topic discussed by Steve Bonney, VP of Business Development and Strategy at BayScribe.

 In this video interview. Steve discusses the challenges of getting structured data in healthcare and how you can use good technology to get the healthcare data without disrupting the physician workflow. Steve also discusses some of the benefits of having interoperable data in healthcare. Then,we ask him if Meaningful Use is going to make structured, interoperable data a reality.

Despite the increased acceptance of EHR many providers, and hospitals are reticent to 'buy in' to connectivity based upon costs and an unknown ROI. On the other hand there are many large outstanding and credible health institutions that have built networks between their hospitals and providers.

Perhaps the addition of the Affordable Care Act, it's mandates and looming deadlines have diverted manpower and financial  resources from health information exchanges, making it a lower priority with unknown results financially from the Affordable Care Act. Providers and hospitals are clearly challenged with developing Accountable Care Organizations, EHRs, Health Information Exchanges, and the possible change in reimbursement paradigm.

On the one hand health information exchanges could reduce costs, however achieving both ends....interoperable EHRs and the Affordable Care Act may take longer to achieve than originally antcipated.

Nevertheless the sum of the parts should be greater than the whole, and the transformation cannot be complete without each paradigm suceeding. Each part has it's proponents.

In my next blog posting, we'll discuss 'BIG DATA' and analytics...the promises and disappointments to come.