Physician aims to link artificial intelligence with medical practices

As a former women’s health medical practitioner, Dr. Michael Dent is at his core a physician on a mission to save lives. But rather than treating patients individually, he’s out to save them on a global scale.

That was his goal when he founded Fort Myers-based NeoGenomics in 2002: helping to grow the cancer diagnostics lab company from a $300,000 capital investment into publicly held company with $277 million in revenue in 2018. He says his newest venture, Bonita Springs-based HealthLynked, has even greater potential.

HealthLynked is first and foremost a technology company with an emphasis on health care by linking patients with providers on multiple levels through a cloud-based software platform, Dent, 55, says. 

The company's system is capable of merging patients’ health records from a variety of sources into a comprehensive, portable, accurate health record instantly accessible by participating doctors who sign on to have the HealthLynked hub placed in their offices. Free to patient members, the service not only makes continually updated records accessible by physicians but also tracks every aspect of their patients’ visit.

And soon, an under-development artificial intelligence component will even provide diagnostic information based on factors including patient history, geography, environmental exposures and symptoms, providing the patient voluntarily maintains the profile.

The mission? Manage care, head off health issues before they present and create a connection beneficial to both patients and their providers. “We're not looking to change the dynamic of the doctor-patient interaction; we're looking to augment it,” says Dent, HealthLynked Chairman and CEO. “We’re looking to supplement, not replace.”

The full Business Observer article can be viewed at this link. 

Drugs And Blockchains

For decades, prescriptions have been written on paper. While this method is certainly easier for doctors, it presents many risks which need to be mitigated. The use of e-prescribing is up 500% in the U.S. since 2015. Though the UK and Europe are lagging in adoption, there is a significant drive to make Electronic Prescribing Systems (EPS) the norm.

International evidence shows that EPS may improve the safety of inpatient medicines management processes, reduce medication errors and, to a lesser extent, reduce adverse drug events. However, unintended consequences, including new errors, may occur. Evidence on the effects of EPS on workflow is limited and in my experience, e-prescribing can add significant time and administrative burden for busy doctors.

The full Forbes article can be viewed at this link.  

Smart wearables to unlock the next level of precision medicine

Wearables have come a long way from being merely entertaining to bringing in tangible health benefits.

Early on, bands with basic functionality were mostly appreciated by fitness enthusiasts and professional athletes. A few years later, the variety and capabilities of wearables evolved way beyond counting steps taken and calories burnt. Next generations of smart clips, rings and watches expanded their data collection and analytical abilities toward overall health and activity awareness. They began identifying individual patterns related to the user’s mood, sleep quality and vitals.

As soon as wearables became more functional, they evolved from the “sports-only” category to personal smart gear. Such democratization surged the adoption and attracted multiple user groups with goals beyond explicit association with sports and fitness.

The full Mobi Health News article can be viewed at this link.  

The Truth About Painkiller Addiction

In the early days of the opioid crisis, public officials had reasons to blame it on all the pills. News stories featured people who, to the shock of their neighbors and loved ones, had died unexpectedly of a drug overdose. In an emergency, authorities do what they can with the tools at hand. In tightening controls on doctors who prescribed pain relievers, state and federal agencies were focusing on the aspect of the problem most subject to regulatory intervention.

To some degree, that strategy worked. According to the Centers for Disease Control and Prevention, overdose deaths declined by about 5 percent in 2018—a dip attributable almost exclusively to fewer deaths from oxycodone, hydrocodone, and other prescription opioids. (Fentanyl deaths are still climbing.) Now that the fever of the opioid crisis may be breaking, Americans can revisit some of the stories we have told ourselves about the role of prescription medication in the crisis.

Did policy makers and public-health experts correctly assess who was at risk of becoming addicted to opioid medications? Were their views on the addictive potential of such drugs realistic? Did they anticipate the consequences of policies devised to constrain doctors from overprescribing? In retrospect, policy makers seriously misjudged the answers to these questions, overestimating the risk that these drugs posed to the average patient while simultaneously doing too little to urge clinicians to identify those most vulnerable to addiction. The best time to correct course is now—while the opioid problem still commands public attention, and before the restrictions imposed at the height of the crisis harden into permanent practice.

The full article from The Atlantic can be viewed at this link.  

The Futures of eHealth: Social, Ethical, and Legal Challenges

Looking into the futures of eHealth? The title of this publication might seem quite presumptuous at first. Its objective, however, is to serve a much more modest purpose, in that it strives to take a look at potential, likely, desired, anticipated or feared futures of digital health technologies and practices. When analysing the opportunities and risks associated with them as well as the social, legal and ethical challenges they might pose, what we also see in the process are the expectations and promises projected onto them.

eHealth or “digital health”, according to the World Health Organization’s European Office, “involves a broad group of activities that use electronic means to deliver health-related information, resources and services: it is the use of information and communication technologies for health” (World Health Organization 2017). As far as current developments and technological solutions are concerned, the WHO has further identified the following areas:

• Electronic health records and interoperability of data;
• Mobile health or mHealth;
• Telehealth, where a patient can consult with a healthcare worker using Skype or even a regular telephone;
• Wearable technologies (fitness trackers, medical devices, etc.) and
• Technologies to support integrated care (WHO 2017).

Looking into the futures of anything always involves creating narratives. Rather unsurprisingly, the WHO’s definition characterises the role of technology use as entailing “strengthening health systems and health information systems” (World Health Organization 2017), a narrative of opportunity. These promises of eHealth are embedded in and reflective of much larger discourses that are often associated with (digital) technologies, which are mainly seen as a remedy to existing social problems. These discourses often centre around terms such as “empowerment”, “democratic potential”, “unifying cross-border force”, “special care for vulnerable groups” or “bridging distances”. And, indeed, there is an abundance of opportunities in digital health solutions that are directly associated with these technologies and practices.

The full paper can be downloaded below.  

Improving Data Privacy Using Fuzzy Logic and Autoencoder Neural Network

Data privacy is a very important problem to address while sharing data among multiple organizations and has become very crucial in the health sectors since multiple organizations such as hospitals are storing data of patients in the form of Electronic Health Records. Stored data is used with other organizations or research analysts to improve the health care of patients. However, the data records contain sensitive information such as age, sex, and date of birth of the patients. Revealing sensitive data can cause a privacy breach of the individuals. This has triggered research that has led to many different privacy preserving techniques being introduced. Thus, we designed a technique that not only encrypts / hides the sensitive information but also sends the data to different organizations securely. To encrypt sensitive data we use different fuzzy logic membership functions. We then use an autoencoder neural network to send the modified data. The output data of the autoencoder can then be used by different organizations for research analysis.

The full article can be downloaded below.  

The Critical Role of Hospital Information Systems in Digital Health Innovation Projects

Societal demand and political support still drive researchers and practitioners to work in numerous initiatives to create Digital Innovations (DI) in healthcare. Despite all support, the problem of unsuccessful or not-satisfying translation of project outputs into the healthcare reality remains. One critical aspect is the integration of a DI into evolved Hospital Information Systems (HIS). As DI projects often are conducted in practice research consortia, such projects can provide close insights into real-world settings. Therefore, a rigor analysis is necessary, which we perform using the Action Design Research approach that helps to analyze the role of HIS in DI projects for healthcare. The main contribution of this paper is the detailed description of a context-specific framework for the formalization of learning plus a systematic presentation of enablers and barriers of DI projects in healthcare. The framework matches both a project management perspective by considering different stages of a DI project and an interoperability perspective as an overall key factor for successful implementation.

The full article can be downloaded below.  

How do mobile health applications support behaviour changes? A scoping review of mobile health applications relating to physical activity and eating behaviours

The objective of this review was to analyse how researchers conducting studies about mobile health applications (MHApps) effectiveness assess the conditions of this effectiveness.

We conducted a scoping review of efficacy/effectiveness conditions in high internal validity studies assessing the efficacy of MHApps in changing physical activity behaviours and eating habits. We used the PubMed, Web of Science, SPORTDiscus and PsycINFO databases and processed the review according to the O'Malley and PRISMA-ScR recommendations. We selected studies with high internal validity methodologies (randomised controlled trials, quasi-experimental studies, systematic reviews and metaanalyses), dealing with dietary and/or physical activity behaviours; covering primary, secondary or tertiary prevention and dealing with behaviour change (uptake, maintenance). We excluded articles on MHApps relating to high-level sport and telemedicine. The process for selecting studies followed a set protocol with two authors who independently appraised the studies.

Twenty-two articles were finally selected and analysed. We noted that the mechanisms and techniques to support behaviour changes were poorly reported and studied. There was no explanation of how these MHApps work and how they could be transferred or not. Indeed, the main efficacy conditions reported by authors refer to practical aspects of the tools. Moreover, the issue of social inequalities was essentially reduced to access to the technology (the shrinking access divide), and literacy was poorly studied, even though it is an important consideration in digital prevention. All in all, even when they dealt with behaviours, the evaluations were tool-focused rather than intervention-focused and did not allow a comprehensive assessment of MHApps.

To understand the added value of MHApps in supporting behaviour changes, it seems important to draw on the paradigms relating to health technology assessment considering the characteristics of the technologies and on the evaluation of complex interventions considering the characteristics of prevention. This combined approach may help to clarify how these patient-focused MHApps work and is a condition for improved assessment of MHApps in terms of effectiveness, transferability and scalability.

The full article can be downloaded below.  

Impact of Integrated Care on Patient-Related Outcomes Among Older People – A Systematic Review

This systematic review has explored multiple patient-related outcomes of integrated care targeting older people. The findings suggest that integrated care may have a positive impact on hospital admission rates in older age. Integrated care may also positively influence the length of hospital stay and possibly also patient satisfaction and readmission. In contrast, integrated care did not have an impact on mortality. However due to lack of robust findings, the effectiveness of integrated care on patient-related outcomes in later life remain largely unknown. Whilst this review has tried to identify patient-related outcomes important in integrated care provided to older adults, further theory-based research is needed to assess the effect on these outcomes in integrated care settings.

The full article can be downloaded below.