SEE THE 3D IMAGES PRODUCED BY THE FIRST FULL-BODY MEDICAL SCANNER

Thirteen years ago, UC Davis scientists Simon Cherry and Ramsey Badawi had an idea for a machine that could scan the entire human body at once, producing a 3D image that could help medical specialists with everything from diagnosing conditions to developing new drug treatments.

Now, that once-hypothetical scanner is very real. And the first images it produced are even more impressive than its creators expected.

The EXPLORER scanner uses a combination of two well-known imaging techniques — positron emission tomography (PET) and x-ray computed tomography (CT) — to scan the entire human body at once.

The full Futurism article can be viewed at this link.  

Using Artificial Intelligence To Fix Healthcare

The healthcare industry should be using Artificial Intelligence (AI) to a far greater degree than at present, but progress has been painfully slow. The same factors that make the healthcare system so attractive to AI developers - fragmented or non-existent data repositories, outdated computer systemsand doctor shortages - are the same things that have stopped AI from providing the gains that should be created.

The healthcare sector also presents unique obstacles for AI: data must flow freely through AI systems to achieve real results, but extracting data from handwritten patient files or PDFs is cumbersome for us, and difficult for AI. Despite technical and operational challenges, new research suggests that the arrival of the tech giants into the industry may provide the data and the capital required to digitize this fairly untapped market.

The AI healthcare sector is ripe for development and investment, but while the data giants figure out how to transform the system as a whole, smaller-scale projects are making real changes. Piece by piece, patient by patient, AI is on its way to fixing healthcare once and for all.

The full Forbes article can be read at this link.  

The Need to Implement and Evaluate Telehealth Competency Frameworks to Ensure Quality Care across Behavioral Health Professions

Technology is rapidly becoming a key player in care delivery, lifelong learning, and education/training. The American Psychiatric Association Practice-Based Learning and Improvement Core Competencies include the use information technology and lifelong learning. Current competencybased education (CBE) focuses on skills rather than on what is taught. Competency may be defined as a measurable human capability required for effective performance. The Institute of Medicine (IOM) suggested three key elements for patient-centered care: skills-focused education, interdisciplinary team-based care, and a technology/informaticsoriented administrative approach.

A key premise of telepsychiatric competencies published in 2015 is that faculty clinicians and educators have to first improve their care via clinical and technological competence, in order to then oversee trainees’ use of technologies in clinical care. Fundamental steps to this work are the alignment of clinical outcomes with teaching/supervisory methods, evaluation, and feedback. Professional association standards and guidelines typically do not focus on competencies, are complex, and are frequently incomplete (e.g., diverse populations and settings), and comparisons across professions are rare.

Telebehavioral health (TBH) is a broad term inclusive across behavioral health professions and technically includes both mental health and substance use care; in this paper, it will also include TP. Each BH discipline and field has its own nomenclature for telehealth (e.g., telepsychiatry, telepsychology, distance counseling) [9], though competencies related to technological standards were suggested years ago. A TBH competency set arrived in and a specific one for use of social media arrived in 2018. Care delivered by TBH may require additional skills—or adjusted behaviors—compared to in-person care.

The current paper will:

1. Review TBH evidence relevant to competencies, guidelines, and standards and compare similarities and differences across professions related to integrating technology in practice

2. Highlight TBH competency sets to date

3. Discuss implications of implementing TBH competencies across professions.

The full article can be downloaded below.  

Rural Individuals’ Telehealth Practices: An Overview

Telehealth—i.e., health services or activities conducted via phone, Internet, and other technologies—has emerged as a new way for consumers to meet their health care needs. The benefits of telehealth may be greater in rural areas, where remoteness and provider shortages may make accessing health care more difficult for rural residents. Using detailed 2015 household data, the report analyzes three basic telehealth activities as practiced by consumers age 15 or older: (1) online health research; (2) online health maintenance (communication with health providers, including communicating with medical practitioners, maintaining records, and paying bills); and (3) online health monitoring via devices that exchange data remotely with medical personnel. Rural residents were less likely than urban people to engage in the telehealth activities, with 17 percent of rural people conducting online health research, 7 percent engaging in online health maintenance, and 1.3 percent using online health monitoring (compared with 20 percent, 11 percent, and 2.5 percent of urban residents, respectively). Use of all of these telehealth activities increased among individuals with higher levels of education. Generally, use increased among individuals with higher household income, but income’s effect varied across the telehealth activities.

The full report from the U.S. Department of Agriculture's Economic Research Service can be downloaded below.  

FHIR Tools for Healthcare Interoperability

Electronic Health Records (EHR) is an essential element in human healthcare monitoring systems these days. As a large amount of data continues being archived and uploaded to healthcare repositories, virtually every second across the globe, vast amount of data mining tasks continue being modelled and modified to extract valuable decision support information. The Health Level 7 (HL7) consortium provides the framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice, management and delivery. With the large number of Internet of Things (IoT) health care kits becoming available it has become increasingly difficult to log the realtime patient monitoring information to healthcare repositories. As patients continue being monitored in real-time it has become essential that the trauma events information such as stroke or cardiac arrhythmia be uploaded to the EHR in real-time. Currently available monitoring devices can monitor and analyse an abnormal condition but may not be able to upload these events in real-time. The proposed research focused on developing real-time interoperability tools and services, which can enable wearable IoT devices to interact with the EHR in real-time and can provide real-time decision support.

The Fast Healthcare Interoperability Resources (FHIR) specification was used to develop and encode trauma related information in terms of FHIR resources, conceptual and logical models using clinFHIR tools. A HAPIFHIR application was implemented on an IoT device which could upload real-time ECG, PPG and relevant trauma information on a test FHIR server. The HAPIFHIR application code could encapsulate ECG arrhythmia, vital signs and trauma events in a single observation and could upload it to the HAPIFHIR server. Several such observations could be linked to a patient context and could be observed in real time in EHR. The ECG, the PPG, vital signs and trauma events were encoded according to Systematized Nomenclature of Medicine - Clinical Terms (SNOMED-CT) specifications. The alerts and alarms mechanism could assist the emergency response teams at the hospitals to prepare for an emergency well in time. An analogue front-end biomedical device was used for data acquisition and signal processing and the IoT devices were networked over wireless network to upload the events and observations to the FHIR server in real time. The system focussed on ‘preventive care’ as the next generation personalized health-care monitoring devices continue becoming available.

The full article can be downloaded below.  

Toward Addressing Social Determinants of Health: A Health Care System Strategy

In the US, there is growing recognition that social factors (eg, financial hardship, food insecurity, housing instability) influence individual and population health. This has led to increased efforts to address these social determinants of health (SDH) within the delivery system. Yet, limited information exists about the strategies health care systems employ to identify and address SDH. Kaiser Permanente Northwest (KPNW) is an integrated health care delivery system that has implemented a comprehensive approach toward addressing its patients’ SDH. This article describes the tools and processes used at KPNW for identifying and addressing SDH.

Tools included use of electronic health record-based data elements, International Classification of Diseases, Tenth Revision social diagnostic codes (Z codes), and the development of novel workflows via nonclinical patient navigators to address patients’ SDH through community resource referrals. Between March 31, 2016, and March 25, 2018, KPNW patient navigators screened patients with SDH.

Patient navigators screened 11,273 patients with SDH, identifying and documenting 47,911 SDH in the electronic health record. During the same 2-year period, 18,284 community resource referrals were made for 7494 patients.

The novel electronic health record-based tools developed by KPNW have led to standardized, measurable, and actionable SDH data being used to tailor and target specific resources to meet the identified needs of our patients. By disseminating information about these efforts at KPNW, we aim to help build an evidence basis of different approaches for addressing SDH within the health care system as well as defining opportunities to improve care efficiency for patients with SDH.

The full article can be downloaded below.  

What If AI Could Uber The Healthcare Industry?

Yes, it may seem like a stretch to imagine our complicated and flawed healthcare system changing overnight due to developments from AI startups. However, this is what’s meant by “little things add up.” In our lifetimes we have seen how the entrenched retail industry has morphed, taking down once seemingly invincible bastions, such as Sears. We have watched Uber challenge the taxi transportation model and Airbnb upset the regal hotels of yore. What might AI medical startups accomplish for the health industry? That future is uncertain. However, what's true is that change is in the air and that little things can add up ­— sometimes for good.

The full Forbes article can be viewed at this link.  

AI and the NHS: How artificial intelligence will change everything for patients and doctors

The current UK government has made its vision for artificial intelligence use in the NHS very clear. It wants AI, data and innovation to "transform the prevention, early diagnosis and treatment of chronic diseases by 2030", with the UK to be "at the forefront of the use of AI and data in early diagnosis, innovation, prevention and treatment".

Under this vision, AIs could ultimately become the first point of contact for the sick instead of a human doctor, could help healthcare professionals to diagnose medical conditions, and even monitor individuals' health by analysing data from their wearable devices or smart-home sensors.

It's a huge ambition for a set of technologies that are still developing, and whose use is relatively restricted in the health service today. Can AI really make a difference to the future of the NHS?

The full ZDNet article can be viewed at this link.  

AMIA calls for tighter coordination of data privacy rules

The American Medical Informatics Association is asking the Trump administration to take a close look at both HIPAA and the Common Rule to see how they might be updated or harmonized for a new era of privacy policy.

Specifically, the AMIA wants a more integrated approach to how policies aimed at both the "health sector" and "consumer sector" are defined.

The full Healthcare IT News article can be viewed at this link.  

Statement by FDA Commissioner Scott Gottlieb, M.D., on the FDA’s efforts to hold industry accountable for fulfilling critical post-marketing studies of the benefits, safety of new drugs

The FDA remains committed to ensuring that FDA-approved drugs are safe and effective for Americans. As part of this commitment, we require evidence from premarket clinical trials that the medicine will be both effective and safe for use when prescribed according to its labeling. However, it’s not unusual for the FDA to identify issues that need additional evaluation either at the time of initial approval or later, once the drug has been marketed. These issues are evaluated through the conduct of additional post-marketing studies.

Today we’re announcing our FY 2017 Report on the Performance of Drug and Biologics Firms in Conducting Postmarketing Requirements and Commitments. This report provides an update on how we’re doing at holding companies accountable for completing these important studies on time to ensure that our understanding of a drug’s safety and efficacy keeps pace with its use in all relevant populations once a product is approved. We’re committed to ensuring that PMRs and PMCs are conducted and reported as required, and to providing transparent access to the progress of these studies for the public.

The full statement can be viewed at this link.  

The 2017 report can be downloaded below.