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Iris Thiele Isip Tan MD, MSc, FPCP, FPSEMChief, UP College of Medicine Medical Informatics UnitAssociate Professor 4, UP College of MedicineSection of Endocrinology, Diabetes & Metabolism, Philippine General Hospital
“Unitron Sky Walker” by pasukaru76, http://www.flickr.com/photos/pasukaru76/6271854325/
eHealth Challenges
7 Dec 2012
Saturday, December 8, 12
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http://www.engineeringchallenges.org/cms/8996/9221.aspxSaturday, December 8, 12
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http://www.engineeringchallenges.org/cms/8996/9221.aspxSaturday, December 8, 12
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“jigsaw puzzle” by spekulator, http://www.sxc.hu/photo/944284
Make solar energy
economical
Provide energy from fusion Develop carbon
sequestration methods
Manage the nitrogen cycle
Provide access to
clean water
Advance health
informatics
Engineer better
medicines
Restore & improve urban infrastructure
Reverse-engineer the brain
Prevent nuclear terror
Secure cyberspaceEnhance
virtual reality
Advance personalized
learning
Engineer the tools of scientific discovery
Saturday, December 8, 12
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Kulikowski et al. AMIA Board white paper: definition of biomedical informatics and specification of core
competencies for graduate education in the discipline. J Am Med Inform Assoc 2012;19:931-8.
Saturday, December 8, 12
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Kulikowski et al. AMIA Board white paper: definition of biomedical informatics and specification of core
competencies for graduate education in the discipline. J Am Med Inform Assoc 2012;19:931-8.
Saturday, December 8, 12
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eHealth Challenges
Image from katerha, http://www.flickr.com/photos/katerha/5021019816/
Center for Development of Advanced Computing (India)
Electronic Medical Record
Systems for improved patient education
and compliance
Data mining for medical knowledge
Saturday, December 8, 12
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eHealth Challenges
Image from katerha, http://www.flickr.com/photos/katerha/5021019816/
Center for Development of Advanced Computing (India)
Electronic Medical Record
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http://www2.fraserhealth.ca/media/how%20hazardous%20is%20healthcare%202.jpg
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Adverse events
2.9%Colorado
& Utah
3.7%New York
Medical Errors
50%Ooops 44,000 -
98,000 deaths/year
To Err is Human: Building a Safer Health System
Institute of Medicine 1999
6.6-13.6% mortality
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http://www.youtube.com/watch?v=7Ks3hezVSIM
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Electronic Medical Record (EMR)
Core application for patient-specific information
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EMR: Challenges
Structured data entry vs free text
Y N Visual disturbancesY N Eye itchingY N Eye pain
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EMR: Challenges
Universally agreed-on medical vocabulary or standard terminology
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EMR: Challenges• Protection of
patient privacy and confidentiality–Health Insurance
Portability and Accountability Act (1996)
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Good information is the best medicine. Michael E. DeBakey, MD
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http://youtu.be/2ikjOSmqpyo
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EMR: Challenges
UsabilityIntegrate EMR into busy clinical workflow
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“NextGen is unusable” by juhansonin,
http://www.flickr.com/photos/juhansonin/3857845956/
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EMR: ChallengesOptimal computing device for the clinical setting?
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Incident record
Patient record
Health record
Data generated when individual interacts with HCP
A series of incident records generated by specific HCP
All patient records generated over an individual’s lifetime by all HCPs who provide services
http://www.hc-sc.gc.ca/ohih-bsi/Saturday, December 8, 12
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http://youtu.be/Lo_3qOejQzI
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EMR: Challenges• Standards: to facilitate integration of
data, especially across systems from different vendors
–Digital Imaging & Communications in Medicine (DICOM)
–Health Level 7 (HL7)
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http://www.emrindustry.com/index.php/will-next-generation-emrs-be-platform-stack-of-apps/
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http://www.carepractice.com/emr-needs-a-kick-in-the-app-hole/
“The utopic future of medicine will seamlessly combine data from your daily apps and personalize a health treatment plan based on the life you actually live.”
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http://vimeo.com/38063992
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“As opposed to the doctor-centric, curative model of the past, the future is going to be
patient-centric and proactive.”Elias A. Zerhouni MD, NIH Director
Dec 2007
Image by JD Hancockhttp://www.flickr.com/photos/jdhancock/4100030094/
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Participatory Medicine
Image by Liz Gracehttp://www.flickr.com/photos/liz-grace/5078868809/
“Movement in which networked patients shift from being mere passengers to responsible drivers of their health ...
providers encourage and value them as full partners”
Society for Participatory Medicine
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Personal Health Record
• Provider-owned and provider-maintained digital summary– Read-only for patient– Access to lab results
through a password-protected Web site
– Commercial EHRs offer digital summaries through patient portals
• Patient-owned software program
– Patient can enter, organize, retrieve own health information
– Web-based i.e. Google Health, Microsoft HealthVault
Endsley et al. An Introduction to Personal Health Records http://www.afp.org/fpm
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Personal Health Record• Portable, interoperable digital file
–Selected, clinically relevant health data can be managed, secured and transferred
–Platforms: Smart cards, PDAs, cellphones, USB-compatible devices
Endsley et al. An Introduction to Personal Health Records http://www.afp.org/fpm
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No longer fill out formsAuthentication
Protection from fraud if lostRapid access to previously unavailable information
Paperwork for health record transfers are eliminatedElectronic prescriptions can be stored on the card
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eHealth Challenges
Image from katerha, http://www.flickr.com/photos/katerha/5021019816/
Center for Development of Advanced Computing (India)
Systems for improved patient education
and compliance
Saturday, December 8, 12
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http://www.chaindrugreview.com/front-page/newsbreaks/thrifty-white-introduces-smart-cap-to-spur-rx-complianceSaturday, December 8, 12
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http://www.ama-assn.org/amednews/2010/05/10/bisb0510.htm
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Gamificationuse of game play mechanisms
for non-game applications
http://www.imedicalapps.com/2011/08/2011-mobile-health-world-congress-gamification-health-care/Saturday, December 8, 12
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http://www.informationweek.com/healthcare/mobile-wireless/10-wearable-health-tech-devices-to-watchSaturday, December 8, 12
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eHealth Challenges
Image from katerha, http://www.flickr.com/photos/katerha/5021019816/
Center for Development of Advanced Computing (India)
Data mining for medical knowledge
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Slide from presentation of Desikan et al, 2011 Siam International Conference on Data MiningSaturday, December 8, 12
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“toes” by basheertome, http://www.flickr.com/photos/basheertome/7001981033/
We are drowning in data but starving for knowledge!
clinical decision support
healthcare resource management
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Challenges in Data Mining for Healthcare
data set from various data sources
bias from heterogeneous data
missing values, noise and outliers
Pink Sherbet photography, http://www.flickr.com/photos/pinksherbet/4621820292/
protection of security, integrity and privacy
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eHealth Challenges
Image from katerha, http://www.flickr.com/photos/katerha/5021019816/
Center for Development of Advanced Computing (India)
Electronic Medical Record
Systems for improved patient education
and compliance
Data mining for medical knowledge
Saturday, December 8, 12
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Thank Youhttp://www.endocrine-witch.net
@endocrine_witch
Image from http://wthr.frumph.net/
Saturday, December 8, 12