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Healthcare providers today rely on an array of technologies to help manage key workflows, from maintaining electronic medical record (EMR) systems and performing clinical procedures to coordinating consultations and prescribing follow-up care. Yet in many cases, poor integration among technologies and outdated devices can waste time and hamper efforts to efficiently deliver high-quality care.

 

Refreshing older technologies with new solutions can improve caregiver collaboration, increase efficiency, and address security requirements. For example, caregivers need ways to securely share patient information among colleagues. They also need smooth, fast handoffs from one device or system to another—remembering multiple login passwords and transferring information among systems can be inefficient and time-consuming.

 

New Whitepaper: Workspace Transformation for Healthcare Providers

 

In today’s healthcare environment, enhancing communication and collaboration among clinical workers across the continuum of care is critical for producing optimal patient and financial outcomes.

 

Prescribing the Right Solution

Intel® mobile solutions are designed to help healthcare providers address workflow challenges simply and effectively, so they can refocus their time and resources on their patients. The latest generations of Intel® Core™ vPro™ and Core M vPro processors include technologies designed to easily integrate within the mobile healthcare environment, streamline workflows, and bolster security.

 

For instance, newer generations of devices can be equipped with WiGig technology, which can be combined with a number of commercially available wireless docking solutions. Those wireless docking stations enable healthcare providers to transition seamlessly between different clinical workstations without the hassle of connecting multiple wires. Clinical teams looking for improved ways to facilitate team-based care can also leverage the Intel® Unite™ platform, which provides a robust set of features to enable collaboration along with multiple layers of security through a simple and secure interface.

 

Further security measures in Intel® Identity Protection Technology (Intel® IPT) are built into the Intel Core vPro processor architecture. They provide role-based security that prevents unauthorized users from accessing healthcare systems, even if they have a stolen username and passcode.

 

Other solutions that depend on Intel® technologies include apps for capturing EMR data and using biometrics to access applications. All of these technologies are designed to improve clinical workflows and the patient experience.

 

The right mobile solutions and platform capabilities can simplify a wide range of communication and collaboration tasks. As a result, caregivers can stay focused on patients.

To learn more about how Intel® solutions are helping healthcare organizations achieve these goals, read Workspace Transformation for Healthcare Providers.

 

What questions do you have?

Bio-IT World is a great occasion to take stock and see what’s on the horizon. In a plenary keynote session on April 5, I spoke about three areas where we’re making progress toward achieving All in One Day precision medicine.

                                                           

All in One Day is both a vision and a challenge. The vision is that if you’re diagnosed with cancer or another genetically-influenced disease, your clinical team will sequence your DNA and provide you with a precision treatment plan based on your biomolecular profile—all within 24 hours. To do that, they’ll scour massive databases, examining the known available treatments to find the ones that are most effective for people who most closely line up with your unique biology, age, lifestyle, and other factors. So you receive the treatment that’s likely to be most successful with the fewest side effects. The upshot: less anxiety and uncertainty, less trial-and-error treatment, and the likelihood of better outcomes.

 

With enough of the right kinds of innovation and focus, Intel thinks the goal is achievable by 2020. We’re working hard to make the vision a reality, and to make it practical enough for community oncologists to use as part of their clinical workflows.

                                                 

Tools for Making the Most of Genomics Data

 

What kinds of innovation am I talking about? One crucial area is the development of open source tools for analyzing and managing genomics data.

 

Genomic analysis and precision medicine are massive big data applications. Increasingly, the limiting factor isn’t sequencing a genome, but assembling, analyzing, comparing, studying and storing it along with clinical and other data. At Bio-IT World, Intel and the Broad Institute of MIT and Harvard announced that we are advancing fundamental capabilities so large genomic workflows can run at cloud scale, as well as co-developing new open source tools to simplify the execution of large genomic workflows such as the Broad’s Genome Analysis Toolkit (GATK).

 

The Broad Institute released Cromwell, an integrated workflow execution engine designed to give organizations greater control by launching genomic pipelines on private or public clouds in a portable and reproducible manner. Broad and Intel also announced GenomicsDB, a novel way to store vast amounts of patient variant data and to process it with unprecedented speed and scalability. Broad is teaming up with Intel, Cloudera, and four leading cloud service providers to enable cloud-based access to GATK software. (Read more about optimized open source solutions on Intel® platforms.)

 

Collaborative Networks to Accelerate Breakthroughs

 

Solving massive challenges calls for deep collaborations across diverse institutions. For precision medicine, these collaborations must balance open data sharing with institutional control and rigorous protection of patient privacy.

 

The Collaborative Cancer Cloud, established last year by Intel and Oregon Health & Science University (OHSU), provides a robust foundation for such collaborations by enabling medical institutions to securely share insights from their private patient genomic data. The Cancer Cloud’s unique, federated approach to data sharing allows for rapid advances while overcoming many concerns about sharing sensitive datasets. At Bio-IT World, we welcomed the Dana-Farber Cancer Institute and the Ontario Institute for Cancer Research as recent additions to the Cancer Cloud.

 

Platform Innovation for Diverse Genomics Workloads

 

As powerful as today’s supercomputers are, All in One Day will require significant increases in computational capacity, performance, and throughput. Intel is driving progress on multiple fronts to help institutions manage, analyze, share, and store the expanding world of bio data.  We’ve created Intel® Scalable System Framework (Intel® SSF) as a next-generation approach to developing high-performance, balanced, efficient, and reliable computing (HPC) systems. We recently launched the Intel® Xeon® processor E5-2600 v4 product family, the first processor within Intel Scalable Systems Framework. Together with Intel® Xeon Phi™ processors, Intel® Omni-Path Architecture, Intel® Enterprise Edition for Lustre* Solutions, revolutionary Intel® Optane™ memory/storage technology, and other critical elements of Intel SSF, we’re dramatically advancing the capabilities needed for precision medicine.

 

What will All in One Day mean for your organization? What questions do you have? What do you need to do to get ready? Tell me in the comments.

                                                           

Dig deeper:

Stay in touch:                         

  • @IntelHealth, @portlandketan

How long before we see a real and dramatic change in the way health and care services are delivered in England on a large scale? It’s a question you can be forgiven for asking – and subsequently thinking that we’re still a long way from achieving – but the recent announcements by NHS England around the Healthy New Towns (HNT) programme had me thinking about how bricks & mortar could be the catalyst for change that health and care services need.

 

Healthcare at the Heart of New Developments

The HNT programme will facilitate joined-up thinking from clinicians, designers and technology experts who will essentially start with a blank slate with house-builders creating new developments. From designing infrastructure which will make healthy activities such as walking and cycling safer (and thus more attractive) to the sharing of technology and information across a range of public services such as healthcare and social care, the programme aims to deliver better healthcare in a more efficient and economically sound way.

 

I think we’d all agree that a new approach to the provision of healthcare is needed in England and across the UK. Budgets are under pressure, we have an increasingly elderly population and chronic diseases such as diabetes and obesity are swallowing up huge resources. So what can new models of health & care services look like in a Healthy New Town and what advantages might it bring?

 

Utilizing Technology

NHS England’s Five Year Forward View clearly states that technology will play an important role in enabling change. Three key areas where I see technology bringing significant improvements for a Healthy New Town are:

 

  • Improved communication across the health and social care ecosystem – moving patient records to an electronic system ensures that patient information is always up-to-date and always available anytime and anywhere, whether that be on a desktop computer, on a hospital ward or on a 2 in 1 device in the hands of a community nurse. The data can be easily and securely shared too, amongst authorized parties such as social care teams, thus helping to deliver a seamless patient experience through primary, secondary and social care. Often, these electronic medical records are made up of unstructured case notes which may contain hidden value to clinicians. For example, North East London NHS Foundation Trust and Santana Big Data Analytics are working together on a project to extract value from unstructured case notes using data analytics for the benefit of health and social care teams. Read this whitepaper[PDF] for more insight on that project.


  • Making new homes more accessible and connected – there are some obvious and practical considerations around accessibility for those with mobility issues which should be easy to plan into a new-build property. I’m also keen to see how the concept of smart homes and the internet of things can be incorporated into new building developments and how such technologies could be used within new health & care models.


  • Accessing healthcare in new ways – millennials access many aspects of their daily lives through a connected mobile device, whether that be banking services, social media or checking on a utility bill for example; and healthcare will be no different. With faster high-speed internet connections and 5G mobile network capabilities coming soon I see the ways in which future generations access healthcare will change too, e.g. a face-to-face consultation with a GP may no longer be the first option for patients.

 

Those are just three examples but there are certainly more and I’d love to hear how you see this Healthy New Towns programme playing out and the benefits it can bring (leave a comment @IntelHealth on Twitter or contact me via LinkedIn). We need to take a more holistic approach to health and care to make a real difference, so the design of this type of new community is a step in the right direction.

 

Precision medicine is gaining traction worldwide. Countries like China, the UK and Saudi Arabia are all committing to enabling precision medicine to improve the health of their people. In the US, I have been honored to learn from, and serve on, the NIH advisory group for the President’s Precision Medicine Initiative (PMI). Recently, Intel made corporate commitments to help accelerate the PMI effort.  We’ve launched an industry challenge called “All in One Day” to make an individual’s precision treatment possible, easy, and affordable within 24 hours from genome sequence to customized care plan.

 

As I and my team travel around the world to drive this initiative, we are hearing a common refrain around the need for robust and secure ways to share data so we can accelerate the scientific breakthroughs and insights for precision medicine.  It is increasingly clear that secure data sharing—at a scale far beyond what today’s efforts have achieved so far—is a fundamental barrier we must overcome to scale precision medicine for all. Vice President Biden’s “cancer moonshot” effort, for example, is focusing on this crucial data sharing challenge.

 

To that end, we announced our work with OHSU on the Collaborative Cancer Cloud in August. Earlier today, Intel and OHSU were pleased to announce the expansion of the Collaborative Cancer Cloud to include Dana-Farber Cancer Institute and Ontario Institute for Cancer Research. I am excited to welcome them as fellow pioneers in collaborating on this personalized medicine platform.

Cancer research and institutions doing the research, benefit greatly when the size of the datasets are maximized. By participating in the Collaborative Cancer Cloud, the institutions increase the chances of making new discoveries and finding potential life-saving insights through collaborative analytics across patient datasets the institutions have collectively assembled.

 

The Collaborative Cancer Cloud is unique because it uses a federated approach, meaning the institutions don’t need to upload their data in a centralized location in order to share or run analytics on larger datasets. This approach overcomes many of the concerns around collaborating on sensitive datasets while having access to unprecedented volumes of data. This allows for secure, aggregated computation across distributed sites without loss of local control of the data, ensuring an institution’s ability to maintain proper custody of its datasets and protecting patient privacy and any institutional intellectual property that may result.

 

As more institutions join precision medicine platforms like the Collaborative Cancer Cloud, they will break trail on many important elements of collaborating in a federated environment. The Collaborative Cancer Cloud is designed to allow researchers to determine how and when their data will be used. For example, while the Collaborative Cancer Cloud does provide a standard set of tools, it is the institutions who determine what tools they will use and what tools can be used on their data. This type of personalized medicine platform is designed to evolve and adapt to meet the needs of the institutions using it, and not having the institutions conform to the tools they are using.

 

With the announcement today of OICR and DFCI helping Intel and OHSU to prove out and scale out these tools, it feels like the All in One Day is one step closer. But we have many miles to go to drive the kind of security, the kind of scale, the kind of collaborative data sharing that will be needed to accelerate the research, and thus the clinical options, for not only people with cancer but a wide range of diseases. We look forward to bringing on more collaborators, more data, and more tools-makers in the near future.

 

Learn more about Intel Life Sciences www.intel.com/healthcare/lifesciences

If you were living in England in 2007, you probably remember the tragic death of Baby P.


Little Peter Connelly, age 17 months, died that year after sustaining more than 50 injuries over eight months at the hands of his caregivers. Despite numerous encounters with the healthcare and social care systems, Peter fell through the cracks. He died before anyone recognized the pattern of his injuries and intervened successfully to save him.

 

Peter’s death epitomizes the question that plagues case workers and clinicians around the world: How can I prevent the next Baby P? With heavy caseloads and many organizations involved, how can conscientious clinicians and caseworkers - whether they work with children, the frail elderly, victims of domestic violence, or other vulnerable individuals - assess each client’s life and health, identify clients who are at greatest risk, and get the right resources to them at the right time?

 

To accomplish this, clinicians and case workers need a comprehensive picture of the client’s encounters with diverse agencies. Oftentimes, valuable information is housed in clinical case notes and incompatible record-keeping silos, leaving care providers with only a partial view of the client’s health situation.

 

Now, there’s technology that can help. The North East London National Health Service (NHS) Foundation Trust (NELFT) recently worked with Intel and Santana Big Data Analytics Ltd. (Santana BDA) on a proof-of-concept project demonstrating a practical, affordable tool for extracting relevant information from large volumes of clinical case notes.

 

The Santana solution uses sophisticated big data analytics techniques to search through text-based clinical notes from diverse sources, such as those made by GPs, psychiatrists, community nurses, school nurses, and others. As it searches, it extracts crucial information and then presents it in a quick, easy-to-review format to authorized care professionals. Using these results, care professionals may be better able to:

  • Get value from written notes that are too voluminous for practical, timely review by humans
  • Gain a more complete understanding of the patient’s health and circumstances
  • Identify risks and prioritize caseloads to help ensure critical needs are met
  • Respond proactively rather than re-actively
  • Make better use of consultation time and conduct more focused, relevant dialogue with patients
  • Improve resource utilization through earlier intervention and potentially avoiding hospital admission


As a nurse and a former locality commissioner, I recognize just how important these technology innovations are that might help us prevent another Baby P. I invite you to read this recent paper from Intel, NELFT and Santana BDA which outlines our collective work to reduce risk and improve care.

 

I was saddened, like many here at Intel, to hear of the passing of former Intel Chairman and CEO Andrew Grove. Many kind words have been spoken about Andy in the past few days but I wanted to add my own tribute here, and talk a little more of his philanthropic work specifically around healthcare and education.

 

Andy had deeply personal reasons to donate tens of millions of dollars to translational cancer research and neurodegenerative diseases following diagnoses of cancer in 1995 and Parkinson’s disease in 2000.

 

He took on the battle with these diseases by immersing himself in the detail of the condition, the potential treatments and thoughts about how as a patient he could receive a better outcome. And how he could receive a better outcome often started with Andy looking at how existing data could be put to better use and how it could be collated and analysed more effectively in the future, not just for himself but for future generations.

 

As an advisor to the Michael J. Fox Foundation for Parkinson’s Research, Andy was focused on more and faster research into the disease which would affect him from 2000. Donating over $20m to Parkinson’s research and bequeathing $44m more to the Foundation was just one aspect of his generosity, whereas his drive to turn medical research into something practical for patients was his priority.

 

Better use of data to make informed decisions was a message Andy would carry with him wherever he went, be it Government, Medical Researchers and to colleagues here at Intel. I highly recommend reading this Forbes article on Andy which outlines in great detail his multi-faceted generosity in the field of healthcare.

 

But it wasn’t just healthcare that motivated Andy to give up his time and personal wealth, education was a real focus for him too. Specifically, Andy was hugely passionate about the value of vocational training, funding scholarships initially to schools and then to community colleges. He was vociferous and generous in equal measure when it came to illustrating that a vocational education is a real opportunity to provide a successful pathway to a thriving career.

 

Andy’s recent passing really brings into focus the importance of the work we are doing here at Intel today. We’re pushing ahead at a rapid rate to achieve All-in-One-Day diagnosis and personalized treatment for cancer patients and our partnership with the Michael J. Fox Foundation for Parkinson’s Research is working hard to harness the power of big data to measure Parkinson's disease symptoms and progression.

 

His memory will live on and his passion for healthcare, education and technology will drive us all forward to make these big advances, more quickly.

by Charlotte Rasmussen

 

As discussed in an earlier blog post, QIAGEN has been working together with Intel to bring infrastructure together with genome analysis tools to enable massively scalable whole genome analysis at lower cost. Now, there’s a new white paper detailing the reference architecture and other technical information for our joint solution.

 

Designed to help NGS scientists keep their sequencing pipelines running smoothly even at capacity — all while saving money and producing better results — our solution provides whole genome analysis for as little as $22 per genome. It meets the computational and analysis demands of Illumina’s HiSeq X Ten, but Intel’s 32-node offering can save researchers up to $1.3 million in total ownership costs compared to the 85-node cluster recommended by the vendor for a BWA+GATK variant calling pipeline.int_brand_879_LabDocTblt_5600_cmyk._lowresjpg.jpg

 

Here’s a quick look at what makes our solution different:

 

  • Built-in analysis tools: The system uses Biomedical Genomics Server solution.

 

  • Scalability: Designed to scale on-demand for computing, networking, and storage, the cluster allows labs to manage capacity easily and cost-effectively.

 

  • Proven accuracy: While efficiency and cost-effectiveness is an important factor for NGS data analysis, accuracy in both variant calling and interpretation for the solution is proven to be among the best.

 

  • User friendly: The solution masks the complexity of cluster computing with the easy-to-use Biomedical Genomics Workbench.

 

  • Fast connection to data: We used a high-speed interconnect system based on Intel True Scale Fabric to link the compute nodes and centralized storage, providing up to 40 Gbps of bandwidth per port.

 

  • Parallel storage: The solution incorporates Intel Enterprise Edition for Lustre, the world’s leading parallel storage system, to keep all the nodes, cores, and threads operating at high efficiency.

 

For more details, check out the full white paper.

 

Our tests showed that the 32-node system could process and analyze 48 genomes in 24 hours, on average — enough capacity to handle all the data produced by a HiSeq X Ten. We also tested the system with exome data and successfully analyzed approximately 1,440 human exomes every 24 hours.

 

Together with Intel we’ll be presenting this joint solution at the upcoming Bio-IT World conference in a presentation addressing the growing demand for population-scale genomics.

 

Bio-IT World 2016

 

April 5-7 we’ll be in Boston at the Annual Bio-IT World Conference & Expo and together with Intel, we’ll be presenting this joint solution in a presentation addressing the growing demand for population-scale genomics. We’ll demonstrate how our companies have partnered to design a reference architecture to address these challenges in a cost-effective manner.

 

You can visit us in booth #229 and you’re of course very welcome to join our presentation on Wednesday, April 6:

 

Title: A Reference Architecture for High-Volume Whole Genome Data Analysis

Date and time: April 6 at 3:30 PM,

Location: Vendor Theater

Speakers: Mikael Flensborg, Director of High Volume Sequencing Solutions, QIAGEN and Michael McManus, Senior Health & Life Sciences Solution Architect, Intel

 

If you’d like to learn more but are not able to attend the conference, please feel free to email us.

 

We're looking forward to seeing you in Boston!

 

More information about Bio-IT World

 

Charlotte Rasmussen is a scientific correspondent at QIAGEN, where she summarizes and communicates scientific information and customer stories.

The elderly account for two million unplanned admissions (68% of total admissions) per annum in the UK and the number is growing.  In some areas of the country each 65+ year old spends 4 days per annum as an unplanned admission in a hospital bed.  Care of the elderly, in this regard, costs the NHS £8.3bn per annum. This is a small amount in comparison with the social care costs and the wider personal and economic costs which encompass items like loss of economic productivity due to carer commitments.

 

Most of the cost arises from issues only emerging when patients present in an acute care setting. The issues associated with overcrowded geriatric wards, lack of capacity in social care beds, problems reintroducing patients back into their own home settings, higher than optimal length of stay and exacerbation of co-morbidities are all well known. Many times patients present with falls and subsequent breaks - this is what the structured record in the Electronic Medical Record (EMR) sees

 

Managing avoidable admissions

Almost always this is not the cause of the presentation and therefore the admissions are avoidable. The information that allows clinicians, service designers and payers to address this issue does not lie, fully, in the structured EMR data – it lies in Case Notes. Santana Big Data Analytics is a company geared to unlocking the value of these notes and our project with North East London NHS Foundation Trust (NELFT) is an example of our transformative technology in action.

 

NELFT provides integrated community and mental health services for a diverse population of almost 1.5 million people living in the London Boroughs of Waltham Forest, Redbridge, Barking & Dagenham and Havering. Additionally, the Trust also manages community health services in south-west Essex. NELFT has an annual budget of more than £325 million in 2013/2014. employs around 5,500 staff and is a recognised research leader and innovator, partnering with diverse academic and private-sector leaders to explore new approaches to improving the quality of its services.

 

High Quality, Succinct Case Notes are Key to Success

As a Community Provider, part of NELFT’s role is to provide services that prevent admissions and allow people to live longer healthier lives by consuming services away from hospitals. Services include those that are designed to be preventative, rehabilitatory and quality of life preserving. Clinicians in NELFT recognize that high quality, succinct case notes are key to the way they operate their services.

 

Savings are made and benefits are gained, by changing clinical and operational practice. Although there are large volumes of data to be processed using Big Data tools and techniques, this is really a small data problem: what information can be delivered in a consumable format to clinicians to inform care?

 

Trigger Alerts, Identify Unmet Needs and Prioritize Care

Clinical requirements for information are often expressed in terms of need for integrated care records that go beyond the coded EMR / commissioned care pathway data set and present data in a more timely way to integrated and yet virtual teams. They need to focus quickly on what is important without having the time to “train importance” into their data.

 

In NELFT there are a number of EMR systems, which contain data that needs to be seen in the context of Social Care data from the local Council and other care providers, including the independent sector and primary care. NELFT have an award winning business intelligence platform which is well used by many staff, however it relies on structured and often coded (thus latent) EMR data. Clinicians like the idea of a single source of clinical and operational truth in a web-based, mobile / private cloud environment, but need it to do more.  They need it to produce alerts, identify unmet need, prioritize care and most importantly have a complete overview of all the organisation knows about the patient.


Extracting Structured Information from Unstructured Text

Enter Santana BDA. Santana Big Data Analytics brings together proven expertise in the fields of business and clinical intelligence, data analytics, big data and natural language processing (NLP). They worked in conjunction with the NELFT Performance Team to address the above issues using NLP, a technique for automatically extracting structured information from unstructured text. It provides a way of generating large amounts of coded clinical data without additional data entry requirements. The potential uses of this data are enormous - case summaries, monitoring performance, critiquing clinical decisions, screening risk, etc. Natural Language Processing also provides a way of readily combining information from different electronic records systems.

 

Intel Implementation of Cloudera Technology Stack

Intel have been instrumental in this project. Having worked previously with the team that founded Santana BDA in Leeds, Intel were well positioned to provide a wide range of inputs. This ranged from user experience design, big data processing and technology optimization support alongside clinical input to assist the Santana BDA team with hardware provision. Having understood the collective needs of the team of NELFT and Santana BDA staff, Intel worked to implement the Cloudera technology stack which is driving the project.

 

Ultimately this resulted in the design of an NLP appliance where the technology is optimized for the fast processing of Case Notes and the derivation of clinical meaning through the design and implementation of sets of data classifiers. The classifiers are created using machine learning and recognized, high quality clinical research.

 

The Santana Big Data Analytics engine is architected to run in a secure cloud or server cluster running on premise or externally. The initial implementation of Santana NLP engine used SQL Server technology to process the data. This worked well at NELFT for processing batches of 100,000 patient records. To create a solution that can process larger volumes of historical data, the Santana team are working with Cloudera to utilise the power of Apache Hadoop.

 

They have implemented the NLP engine as a scalable appliance running on Cloudera Distribution for Apache Hadoop (CDH) Enterprise. Both implementations run on scalable infrastructure powered by Intel® Xeon® processors.

 

A Flexible, Affordable and Scalable Platform for Analyzing Unstructured Data

Apache Hadoop is an open-source software framework that allows massive data sets to be distributed and processed across clusters of computers. Hadoop offers a flexible, affordable, and scalable platform for analyzing unstructured data, as well as for other analytics scenarios where the velocity, volume, and variety of data make them impractical for traditional databases. Cloudera CDH provides enterprise capabilities for Apache Hadoop processing along with system management capabilities that make it well-suited to deployment in healthcare and other enterprise environments.

 

Reducing the Complexities of Existing Infrastructure

The close collaboration among NELFT, Santana, and Intel, coupled with Santana’s methods and tools, meant that the appliance could be installed quickly in the NELFT infrastructure. Within a few weeks the team had gathered the data and the Santana engine on the Cloudera and Intel appliance churned through records in seconds that would have previously taken months of labour to read and analyse manually.

 

The use of modern Big Data technologies, if architected well, can reduce many of the complexities with existing infrastructures and with the use of NLP can provide information to a clinical or operational organisation with a forward looking approach and can augment Business Intelligence (BI) systems that apply a rearward looking dashboard system currently in use today.

 

Today’s world is mobile by default. Everyone is connected. Everyone expects to have information at their fingertips. Everyone expects to have understanding and meaning immediately available to them. That’s why I think the term “mHealth” is redundant.

 

If we are going to define a term, then that implies that there is something on the other side of that term. What’s the opposite of mHealth? Is it stationary health? Or siloed health?

 

Five years ago, when smartphones and mobile devices were first coming on the scene, mHealth was an appropriate description. We were still defining what it meant to be truly connected. We underappreciate how radical the transformation has been in a very short period of time. In about seven years, these mobile devices have completely changed our expectations. They have changed the way my children interact with technology.

 

Mobile, to me, is not a product. It’s not a category. Mobile is an experience that could be better defined by terms like available, accessible, convenient, engaging, informative and even entertaining. When I think of mobile, I immediately think that I can get my needs met. When it comes to healthcare, mobile technology is a means to provide patient care. In my book, that’s just called healthcare.

 

So, it’s time to rebrand the term “mHealth.” My vote is for “connected health” because everything is connected right now. We saw this at the most recent HIMSS Conference, where connected devices are connecting caregivers in different settings. That’s what connected care is all about.

 

What do you think? Is mHealth redundant today?

Dr. William Hahn is a professor of medicine at Harvard Medical School and chief of the Division of Molecular and Cellular Oncology at the Dana-Farber Cancer Institute. We recently sat down with him to discuss bio data, genomic sequencing, and where he sees advances in technology impacting clinical practice.

 

Intel: How has bio data research changed in the last five years? How do you envision it progressing in the next five years?

 

Hahn: The medical industry has been slow to think about data. When you consider the rest of the world, you see that people take their access to data for granted. In the last five years, there’s been a realization that medicine is going to change fundamentally in both the amount of data we’re going to create for each patient and how we’re going to handle that data and protect it. In five years, I can imagine that we’re going to have a tremendous amount of data and information on each patient. We need to think deeply about how to protect this data in a way that allows access to the patient’s healthcare team, but prevents any security breaches. 

 

 

Intel: How are you seeing technology lead progress in your practice and your research?

 

Hahn: Healthcare technology is changing at an incredibly rapid rate. Just as in the home, everything from the toaster to the car has a computer chip. So does everything today in the hospital. As healthcare professionals, our ability to monitor, access, and track information has dramatically changed. In my clinic, the speed of information is very important. Right now, it’s significantly more expensive to access information in a quicker fashion. For example, we have created a panel for sequencing leukemia samples that can be done in three days rather than three weeks, but at a much higher rate.

 

Intel: Is there any disadvantage to data access?

 

Hahn: Patients increasingly have general information about diseases as well as specific information about their own health at their fingertips, which is very good. While transparency is an important component, it’s also created a situation where people are more confused than ever because the information is complex and occasionally wrong. There are scenarios where we simply don’t have an answer and it’s more difficult for patients to realize that their physician is going to make decisions based on the best available information in the absence of good data.

 

Intel: What should clinicians be discussing with their patients?

 

Hahn: First, we need everyone to have their genomes sequenced. Genome sequencing is important because it’s the blueprint that makes you who you are, makes you the same as some in your family, and different from your neighbors and coworkers. Without being able to specify your genome sequence, we’ll never be able to understand all of these questions about what makes you who you are and also what makes you different than other people. It will certainly give insight to questions that relate to your health and any relevant diseases. My hope is that what’s right for the patient will win the day.

 

Intel: Intel launched an initiative in 2015 called All in One Day, where the goal is to diagnose a cancer, sequence the genome, and provide a care plan to a patient in 24 hours. What are your thoughts on this? 

 

Hahn: The diagnosis of cancer for a patient and their family is often one that elicits anxiety, fear, and anger. One of the things we can do as physicians is to reassure patients and their families that we are going to take care of the problem. The All in One Day initiative would provide information about the molecular basis of a patient’s cancer within a very short period of time and help physicians to have a clear and specific path for treatment. The ability to give reassurance that this is not an unknown, there is a path forward, and that your physician and care team are informed is going to be tremendously helpful for patients.

As expected, HIMSS 2016 in Las Vegas was a constant buzz of activity. From the opening keynotes to the exhibit floor to Peyton Manning giving his final speech before announcing his retirement, HIMSS brought the world of healthcare technology together for discussions around moving implementation forward with the ultimate goal of improving patient care.

 

Our ears were open when attendees came by the Intel booth wanting to talk about some of the trends we are seeing, such as how the patient, and their user generated data, plays into healthcare going forward, precision medicine and personalized treatment plans, and the devices (mobile and wearables) that will drive the volume of data coming our way. booth2.jpg

 

During the event, we had the opportunity to speak with a number of CMIOs and physicians about their views of healthcare technology. The one thing they all mentioned in common was the rise in patient engagement and how consumers will be owning their own health in the coming months and years. This was perhaps the most shared trend we observed at HIMSS and something that chief information officers are preparing for as they consider the next generation of their health IT infrastructure. This movement will drive more technology adoption on both sides (consumer and clinician) so the need for interoperability and security, in my view, is at an all-time high.

 

If you were unable to attend HIMSS, or didn’t quite make it to all of the booths at the exhibition, here’s a little glimpse of what Intel was focusing on in our space:

 

Precision Medicine: Illumina* was on hand and demonstrated its Intel-based, FDA cleared MiSeqDx System*, showcasing how the industry is moving toward clinical genomics. This is especially important as the pace of diagnosing and formulating care plans around cancer accelerates.

 

Healthcare IT and Devices: Attendees toured a patient and provider experience of the future utilizing Intel® Unite™ collaboration software and Intel® RealSense™ Technology. Booz Allen Hamilton* demonstrated its CareMap* solution enabling patients to input and monitor progress toward their rehabilitation and recovery plan, share this progress with their physician, and communicate with their physician.

 

Another big topic on the show floor was that as the industry evolves, healthcare is no longer confined to the hospital. Patients now have the ability to monitor their progress with remote patient monitoring (RPM) solutions, and physicians can stay connected to patients, wherever they may be. Our booth partners InterSystems* and Care Innovations* were displaying their innovative solutions in this arena.

 

Consumer Health: Consumers are generating massive amount of data from wearable devices like the Basis Peak* fitness and sleep tracker. Intel technology is enabling the aggregation and analysis of this data to generate insights for better healthcare management with Intel Health Services Gateway and the Trusted Analytics Platform. See how Oregon Health & Science University* leveraged this technology to help cardiologists analyze Big Data in a next-generation clinical study that merges 24x7 lifestyle data with wearable devices, and clinical records.

 

Finally, the international flavor at HIMSS continues to grow, showing that healthcare is not limited to a specific country. We met with large contingents from Europe, Asia and Latin America who are looking at healthcare technology as a way to improve care and decrease costs. At the end of the day, that is the real value of HIMSS: the opportunity to collaborate and together improve solutions.

 

Thank you to everyone who stopped by to visit. It was a terrific week and we are already excited for HIMSS 2017.

 

What did you find most valuable at HIMSS this year? Did you learn something new that surprised you?

 

 

* Other names and brands may be claimed as the property of others.

Discussions of genome sequencing often focus on human genomes and precision medicine. But genomic information about the plant and animal worlds is equally crucial. On a fragile planet, our ability to study genomes across the tree of life is critical to preserving biodiversity. Knowledge of plant and animal genomes can also help us manage climate change, feed a growing population, and mitigate the impact of newly emergent diseases. It can lead to breakthroughs in drug discovery, food safety, and more.

 

Reflecting the importance of plant and animal genomics, the Smithsonian Institution has established a new Institute for Biodiversity Genomics to focus on genomic studies that can help humans understand and preserve the diversity of life on earth.

 

To run their genomic assemblies and analysis, the institute’s researchers used the Smithsonian Institution’s shared HPC cluster, a massive system with multiple generations of processors and networked storage. But, as is often the case with such systems, there were problems. Genome assemblies often took weeks to complete. Some large assemblies failed to run to completion, causing frustration for scientists and slowing the research pipeline.

 

With the clock ticking on species extinction, leaders at the Smithsonian Institute for Biodiversity Genomics set out to see what impact Intel’s latest data center technologies could provide for their genomics workloads. They worked with Intel technologists to evaluate the performance of the Intel® Xeon® processor E7-8890 v3 using dedicated Intel® Solid-State Drive (Intel® SSD) Data Center (DC) Family for PCIe P3700 series.

 

We recently worked with Dr. Rebecca Dikow of the Smithsonian Institute for Biodiversity Genomics to create a white paper describing the results of this collaboration. This paper discusses the open-source technologies used in the institute’s genomics workflows, and describes the dramatic speedups produced by the new technologies. It also shares insights about what these performance improvements will mean for scientists like Dr. Dikow—and ultimately for all of us.

 

Read the paper and share your observations in the comments. How is your work affected by plant and animal genomics? How could your work benefit from newer processors and dedicated SSDs?

 

Learn more about big data in healthcare

 

Read about the Smithsonian Institute for Biodiversity Genomics

 

Follow us on Twitter:

  • @IntelHealth, @portlandketan
  • @smithsonian, @rdikow
JohnSotosMD

Telehealth Will Evolve

Posted by JohnSotosMD Mar 8, 2016

When I think of telehealth, I think of the conventional telephone. In that light, physicians have been doing telehealth for many decades and, during this time, have gradually figured out which clinical problems are amenable to a telephone consultation and which are not. The same thing is going to happen with the new generations of “telephones,” if you will, which have video capability and built-in sensors.

 

Consulting a physician via a device will never wholly replace the in-person examination, however, after a time, the acceptable use-cases for telehealth consultations will solidify into a conventional standard of practice, just as the profession saw with the telephone.

 

But there is one important difference between telephone technology and today’s mobile technology: Before smartphones arrived, telephone technology was relatively static – it exchanged voices in an intelligible manner, no more, no less. Today, however, smartphones have become *platforms* permitting the exchange of voice, video, sensor data, and who-knows-what in the future. As a result, physician-patient telecommunication capabilities will continue to evolve, and the profession will constantly have to adapt to a moving target.

 

As with any new medical technology, reimbursement will be an issue.  Generally, telephone consultations have not been reimbursed.  With telehealth, we’re already seeing a change – a CPT code for telehealth services now exists. Although it is applicable only under narrow circumstances, we should expect evolution here, too, especially to the extent telehealth proves to deliver better outcomes at lower cost.

 

We have to be careful with telehealth reimbursement, however, because it could absolutely reformulate clinical care. No one doubts that a long-term personal relationship with a primary care physician is a good thing. It would be very easy for poorly constructed telehealth reimbursement policies to destroy the last vestiges of such relationships in today’s medical system. My personal opinion is that we should not reimburse physicians for telehealth consultations unless there has previously been an in-person consultation.  This is sensible because, just like the days when conventional telephones ruled the communications landscape, physicians will need to assess whether a particular patient can use telehealth technology successfully and give reliable information. Among the sick and infirm, using modern interactive telehealth technology will be much more problematic than using simple telephone technology.

 

There is another aspect to technology adaptation. For the younger generation of physicians just starting their careers, an important lesson is: do not accept today’s status quo as the ultimate good. Medicine is a very old profession that has always made great demands on technology, evolving workflows and information-handling procedures over thousands of years.  Workflows based on papyrus technology became incredibly well optimized, but were largely destroyed by the imposition of electronic technology that did not enable a similar degree of optimization. The profession is adapting to new technologies, but we’re far from optimized now.

 

So, if you are coming into the medical profession, do not be satisfied with the systems that are put in front of you. If you think of a way such systems can be improved, say something to the people who can make changes, or, better yet, help the profession by working yourself to make the changes happen.

Connected care is a rapidly growing and important new trend in healthcare delivery. This broad term encompasses a variety of care models – from the use of smart devices to collect data, to mobile solutions that provide point-of-care access to data, and even integration between care providers across the continuum of care.

 

Augmenting traditional care delivery pathways with connected care programs is not without challenges. As this model continues to grow, so does the amount of data generated, and the number of devices used to collect and transmit that data. This presents new challenges to scaling existing IT infrastructure and securing patient data – millions of smart devices create millions of new attack vectors for hackers and cyber criminals. Along with these challenges, sifting through large composite data feeds to find meaningful insights becomes more complex and requires increasingly sophisticated analytic capabilities which organizations may not have readily available. Intel is addressing many of these challenges with innovative new technologies and industry-wide programs to enable new wearable sensor platforms, empower big data analytics, and secure patient data.

 

Intel continues to develop the wearable device ecosystem through investment and innovation. Over the past several years, Intel has completed significant market transactions with the acquisitions of Basis and Recon Instruments as well as making venture investments in 18 wearables companies through Intel Capital. Smart devices like Basis are currently being used by health systems and payers to better manage population health as early examples of how these devices can improve healthcare. Perhaps Intel’s greatest contributions to the wearable device space, and connected care, will be the Intel Curie™ System on a Chip (SoC) platform. Already this technology has been used in a variety of exciting applications from powering analytics for extreme athletes in the X-Games, to bio-sensing clothing, and smart safety devices for children. It will be exciting to see how future innovators are able to apply this technology to develop new solutions and disruptive business models within the health ecosystem.

 

While new wearable devices are an important precursor for connected care, much of the value that will be derived from these new models comes from the analytics performed on data generated by these devices. The Intel Trusted Analytics Platform (TAP) is a comprehensive analytics platform developed for just this task. It integrates leading edge technologies for the ingestion, storage, and analysis of large data sets. The TAP platform has been open sourced and has already been successfully used by Penn Medicine to improve early detection of patients with critical conditions.

 

Finally, organizations looking to implement connected care programs must understand that these new data streams are potential targets for cyber criminals. To help health and life science organizations understand their risk of a data breach, Intel has developed a Healthcare Breach Assessment Program. The cornerstone of this program is a three-stage breach maturity model that encompasses forty key elements considered either baseline, enhanced, or advanced. This model helps health and life science organizations identify possible vulnerabilities and appropriate remediation activities. The program also includes peer and industry comparisons to help organizations on a quarterly basis, a useful tool for IT leadership when considering where to make future investments in security capabilities. Requiring only a 1-2 hour initial phone assessment, the program maps to best in class products and services today across a spectrum of solution providers and provides ongoing quarterly reporting.

 

What questions about connected care do you have?

This week at HIMSS16 in Las Vegas, the Intel Health & Life Science team displays many new and exciting ways to make health more personal through technology. In the booth, we will share the You 24x7 Cardiovascular Wellness Study – a Big Data approach to clinical research.

 

What’s unique about the You 24x7 Cardiovascular Wellness Study is researchers are using a big data analytics platform to bring together a wide range of data – from daily life plus clinical data – to get a more complete picture of the participants’ wellness. Hundreds of volunteers wore an activity tracker 24x7 for six-months and contributed their EHR, clinical lab reports and remote patient monitoring data, including weight and blood pressure, for a team of cardiologists and sleep experts to analyze at Oregon Health & Science University (OHSU).

 

Find out more: OHSU Wearables Big Data Analytics Paper

 

Study Details:

A Basis Peak watch provided minute-by-minute data on activities, sleep stages, pulse, calorie burn, perspiration and skin temperature. Participants told the investigators that having their own dashboard to view their information — on the watch itself, on a smart phone app, as well as in a web browser — helped them understand their lifestyle choices, quantifying their sleep quality and exercise levels, for example.

 

Some of the participants also had weight scales and blood pressure monitors in their home. Every time they take a reading, the data streams wirelessly to an Intel-powered remote patient monitoring gateway, and the gateway uses the 3G network to send the information securely to a cloud environment.

 

The Basis Peak watch, scale, blood pressure cuff, clinical data and EHR all contributed to a robust data set and this is definitely Big Data — a half-billion data points over the course of the trial.

 

Exploring expanded data sets:

A team of cardiologists, sleep experts and biostatisticians at the OHSU Knight Cardiovascular Institute are now drilling into all that 24x7 data using the Trusted Analytics Platform to explore associations between daily life and clinical findings.

 

It’s a new, big data approach to discovery, taking advantage of wearable devices, home monitoring devices and gateways, and a Big Data analytics platform. It allows scientists to shed light into blind spots like sleep quality to test associations and patterns in data never before available. We think information about the actual daily lives of patients is an untapped resource for a wide range of healthcare stakeholders, including patients themselves.