Can social robots help children in healthcare contexts? A scoping review

This review identified 73 studies that explored the use of social robots for children in healthcare applications. Robots were used to serve a range of purposes, including a companion role, teacher/coach, to connect unwell children to school and to assist in therapeutic and educational endeavours. The wide range of target populations highlights many potential applications, in particular for children with disabilities, impairments, and diabetes, who require intensive ongoing care. Although hospitalisation is not necessarily long term, anxiety, pain and distress are often heightened during hospitalisation. There are potential benefits of using social robots if they can help reduce burden in all three of these contexts. Some of the key findings suggest that social robots can help children with diabetes to improve knowledge; reduce anxiety, anger and depression in children with cancer, and engage children with cerebral palsy in exercises to help improve physical functioning.

The humanoid NAO robot was the most widely used, likely due to its commercial availability, ability to be personalised and relatively autonomous capabilities. Its size and appearance makes it appropriate and appealing. The level of control of robots ranged from almost fully autonomous, to entirely controlled by a human operator. There is a clear need for technological developments to increase the autonomy of all of the robots, particularly in speech recognition and speech production.

The results highlight the significant promise and potential held by social robots to help children in healthcare, but demonstrate the need for more and higher quality research. In particular, more randomised control trials (RCTs), experimental designs and longer-terms studies are required, with larger sample sizes. There is considerable excitement surrounding the use of robotics in healthcare, but there remains a long way to go in terms of technological developments, integration into the healthcare system and establishment of effectiveness.

The full article can be downloaded below.  

Machine Learning in Health Care: A Critical Appraisal of Challenges and Opportunities

Examples of fully integrated machine learning models that drive clinical care are rare. Despite major advances in the development of methodologies that outperform clinical experts and growing prominence of machine learning in mainstream medical literature, major challenges remain. At Duke Health, we are in our fourth year developing, piloting, and implementing machine learning technologies in clinical care. To advance the translation of machine learning into clinical care, health system leaders must address barriers to progress and make strategic investments necessary to bring health care into a new digital age. Machine learning can improve clinical workflows in subtle ways that are distinct from how statistics has shaped medicine. However, most machine learning research occurs in siloes, and there are important, unresolved questions about how to retrain and validate models post-deployment. Academic medical centers that cultivate and value transdisciplinary collaboration are ideally suited to integrate machine learning in clinical care. Along with fostering collaborative environments, health system leaders must invest in developing new capabilities within the workforce and technology infrastructure beyond standard electronic health records. Now is the opportunity to break down barriers and achieve scalable growth in the number of high-impact collaborations between clinical researchers and machine learning experts to transform clinical care.

The full article can be downloaded below.  

Cigna Eclipses 50% In Value-Based Care Pay To Providers

Cigna says it’s paying more than half of its reimbursements to medical care providers in its top markets via value-based models that are quickly overtaking fee-for-service medicine in the U.S.

Value-based pay is tied to health outcomes, performance and quality of care of medical-care providers who contract with insurers via alternative payment vehicles like accountable care organizations (ACOs), a delivery system that rewards doctors and hospitals for working together to improve quality and rein in costs.

The full Forbes article can be viewed at this link.  

Telemedicine’s challenge: Getting patients to click the app

Walmart workers can now see a doctor for only $4. The catch? It has to be a virtual visit.

The retail giant recently rolled back the $40 price on telemedicine, becoming the latest big company to nudge employees toward a high-tech way to get diagnosed and treated remotely.

But patients have been slow to embrace virtual care. Eighty percent of mid-size and large U.S. companies offered telemedicine services to their workers last year, up from 18 percent in 2014, according to the consultant Mercer. Only 8 percent of eligible employees used telemedicine at least once in 2017, most recent figures show.

“There’s an awful lot of effort right now focused on educating the consumer that there’s a better way,” said Jason Gorevic, CEO of telemedicine provider Teladoc Health.

Widespread smartphone use, looser regulations and employer enthusiasm are helping to expand access to telemedicine, where patients interact with doctors and nurses from afar, often through a secure video connection. Supporters say virtual visits make it easier for patients to see a therapist or quickly find help for ailments that aren’t emergencies. But many still fall back to going to the doctor’s office when they’re sick.

The full Associated Press article can be viewed at this link.  

Dynamic prediction of hospital admission with medical claim data

We present an efficient model adapted for periodically updated data such as the monthly updated claim feed data released by CMS to predict the risk of hospitalization. In addition to processing big-volume periodically updated stream-like data, our model can capture event onset information and time-to-event information, incorporate time-varying features, provide insights of variable importance and have good prediction power. To the best of our knowledge, it is the first work combining sliding window technique with the random survival forest model. The model achieves remarkable performance and could be easily deployed to monitor patients in real time.

The full article can be downloaded below.  

Achieve Privacy-Preserving Priority Classification on Patient Health Data in Remote eHealthcare System

The Wireless Body Area Network (WBAN) has attracted considerable attention and become a promising approach to provide a 24-hour on-the-go healthcare service for users. However, it still faces many challenges on privacy of users’ sensitive personal information, confidentiality of healthcare center’s disease models. For this reason, many privacy-preserving schemes have been proposed in recent years. However, the efficiency and accuracy of those privacy-preserving schemes become a big issue to be solved. In this paper, we propose an efficient and privacy-preserving priority classification scheme, named PPC, for classifying patients’ encrypted data at the WBAN-gateway in a remote eHealthcare system. Specifically, to reduce the system latency, we design a non-interactive privacy-preserving priority classification algorithm, which allows the WBAN-gateway to conduct the privacy-preserving priority classification for the received users’ medical packets by itself and relay these packets according to their priorities (criticalities). Detailed security analysis shows that the PPC scheme can achieve the priority classification and packets relay without disclosing the privacy of the users’ personal information and confidentiality of the healthcare center’s disease models. In addition, the extensive experiments with an android app and two java server programs demonstrate its efficiency in terms of computational costs and communication overheads.

The full article can be downloaded below.  

Empathy: A critical ally in battling physician burnout

With almost half of doctors nationally experiencing burnout, one medical group turned to physician empathy training. Learn how empathy reduces burnout. 

At the Northeast’s largest nonprofit independent medical group, 48 percent of physicians reported burnout. That high rate of physician burnout—fed by the competing demands of contemporary medical practice—can make cultivating a healthy sense of empathy a struggle. That, in turn, can negatively affect professional satisfaction, which is why this medical group’s journey to reducing burnout began with physician empathy training.  

While physicians are commonly viewed as being empathetic, their behavior might come across differently to the patient in the room. The physician might seem rushed, distracted or trying to squeeze too much into one visit while simultaneously entering notes on the computer, said Steven Strongwater, MD, president and CEO of Atrius Health. The Boston-area medical group’s 1,300 clinicians deliver care to more than 720,000 patients. 

Committed to making physician burnout a thing of the past, the AMA has studied, and is currently addressing issues causing and fueling physician burnout—including time constraints, technology and regulations—to better understand the challenges physicians face. 

The full American Medical Association article can be viewed at this link.  

Top Five Digital Health Technologies in 2019

Digital technologies are constantly evolving and finding new applications in healthcare, even while the industry is struggling with adoption and ‘digital transformation’. Each year new applications emerge, but the underlying technologies driving them remain the same. For 2019, we asked companies around the world one basic question: “Please indicate the key technology which you believe will have the most profound impact on the healthcare industry during 2019?” The results are not very surprising:

The full Forbes article can be viewed at this link.   

How Is Telepsychiatry Revolutionizing Care

Psychiatry is the branch of healthcare devoted to the diagnosis, prevention and treatment of mental disorders, related to mood, behaviour, cognition and perceptions. The psychiatric care pathway begins with a case history and/or mental status examination, which leads to a preliminary diagnosis. The next step of the psychiatric care pathway is to confirm the diagnosis using psychological tests and neuroimaging techniques. Mental disorders often fall within a spectrum, and the current definitions used for diagnosis comes form Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association (APA) in 2013. The treatment phase is often a prescription of psychotherapy combined with psychiatric medication. The dosage is updated at regular intervals. However, there are still significant socio-economic barriers to delivering this care pathway to patients. This includes the stigma around mental health which discourages individuals from seeking help, cost of psychiatric care (including lost work hours, childcare, or transportation) and access to competent psychiatric clinics.

Telepsychiatry promises to solve these real-world barriers without further adding a cost of care for the patients. For example, telemedicine can make care accessible to individuals who may not feel comfortable visiting a psychiatrist’s office. Studies show that because of the stigma, patients are more inclined to open up while they’re communicating electronically rather than face-to-face. Telepsychiatry also reduces the cost of care for individuals, since patients don’t lose work hours for transportation or childcare associated with visiting a specialist’s office. Since telepsychiatry platforms are mostly covered by insurance, it also costs the same amount as a conventional doctor’s visit. Another significant impact of telepsychiatry is that can deliver care in remote locations. Rural areas are often understaffed with specialists, and telepsychiatry makes it easier to intervene faster in crisis situations.

The full Forbes article can be viewed at this link.  

Rhode Island docs alarmed by subpoenas they link to EHRs

In recent days, process servers have delivered subpoenas charging doctors at a Rhode Island hospital with medical misconduct — mistakes reported by the clinicians themselves that didn’t injure any patients but were meant to draw attention to risks in their EHR system.

The episode has upset the doctors and their colleagues, who say the state health department’s punitive response could frustrate voluntary reporting of medical errors, reportedly the third leading cause of death in the United States. EHR safety researchers concur, saying that penalizing doctors for self-reported mistakes like this sends the wrong message.

“Anyone punishing individual providers for these events is punishing the wrong thing,” says Jason Adelman, chief patient safety officer at New York-Presbyterian Hospital. “These are system issues, not the provider being reckless. The focus should be on things like EHR usability and safety.”

The full Politico article can be viewed at this link.