I have been going to the mHealth Summit for the past four years. As much as the mHealth industry is progressive and dynamic, it is also in some ways very slow to develop as many of the discussions and keynotes from this year were not altogether different from those of four years ago.


However, I do see progress and I’m optimistic about the positive impact mHealth will eventually have. Here are three developments that I find encouraging:


1.) Doctor Prescription of Apps. According to PC Magazine(1), doctors are now starting to prescribe mobile apps. Some of the top prescribed apps mentioned included:


• Allergist- four-day pollen forecast

• Cardiologist- Smoking cessation support

• Dentist- tooth brushing education

• Dermatologist- mole tracking

• Obgyn- Pregnancy education and social support

• Pediatrician- activity tracking

• Nutritionist- glucose trending


I can envision additional Apps that enable consumers to take a more proactive approach to their health (e.g., quality of sleep tracking and education).  Are there other Apps that you would consider using if your doctor prescribed it?


2.) Patient Engagement. In the U.S., several of the Meaningful Use capabilities that are being incentivized from the HHS HITECH Act promote mHealth for patient engagement. These include:


• Patient ability to view online, download electronic copies of their health information and clinical summaries

• Patient reminders for preventive/ follow-up care

• Patient-specific education resources

• Electronic messaging to communicate between patients and care providers

• Access to self-management tools


Mobile devices will make it easier to use these capabilities and should result in better informed, engaged consumers. If these capabilities were available now from your Provider, would you take advantage of them?


3.) Proven Results. There have been many trials and implementations with positive outcome indicators as follows:


• 30 percent reduction in medication errors (2)

• 50 percent reduction in wait time (ER, admission, transport) (3)

• 85 percent faster to transact admission, discharge, and transfer changes (4)


Driving costs down will continue to be a high priority for care centers and proven ROI savings from mHealth implementations are important to increase adoption.


The mHealth initiative is moving forward and will inevitably impact our lives and change the way we approach our health.  While the market is not transforming as fast as some anticipated, there is no denying that we are making progress.  I’m encouraged by the developments discussed above and am looking forward to what is to come in the future.


What are your thoughts on mHealth advancement?



1) http://www.pcmag.com/slideshow/story/309765/doctor-recommended-7-top-health-apps

2) Wireless at El Camino Hospital, California

3) St. Luke’s Episcopal Hospital, Houston, Texas

4) RFID at St. Vincent’s Hospital, Alabama

As the healthcare industry transitions from fee-for-service to fee-for-value, and to team-based care models that require a high degree of care coordination (such as PCMH), a more holistic, 360 degree view of the patient is needed. Over time, this patient view will be built not only from traditional data types such as claims data and healthcare data (e.g. from the EHR), but also non-traditional data types such as patient or member sentiment data from social networks. So what new approaches are needed to respond to this changing data landscape?


Organizations need to be able to apply analytics to Big Data; data from varied repositories that exist structured, semi-structured and unstructured form.  Solutions that enable this need to be high performance, horizontally scalable, and balanced across compute, network and storage domains (e.g. to mitigate impact of I/O bottlenecks). High-performance analytics software, with capabilities such as natural language processing, machine learning, and rich visualization also enable these Big Data solutions. 


Innovative Payers and Providers are pursing these solutions to improve the user experience for their patients and members, better market produces and improve outreach to encourage healthy lifestyles. Take a look at this paper to learn what Blue Cross Blue Shield of North Carolina and Carolinas HealthCare System are doing in these areas.


The paper also describes 5 steps for getting started with Big Data:


1. Work with business units to articulate opportunities

2. Get up to speed on technology

3. Develop use cases

4. Identify gaps between current and future state capabilities

5. Develop a test environment


Payment reform and care models that foster a patient-centric approach have the potential to transform healthcare.  Analytics solutions that break down traditional data silos to develop a complete view of the patient, enable effective outreach programs, and promote collaboration across the continuum of care will be the technical foundation of this transformation.


Are any of you deploying Big Data or advanced analytics solutions in your organizations? Please feel free to share your observations and experiences below.  You can follow me on Twitter @CGoughPDX.

For the past four years, I’ve watched thousands of health and technology influencers, developers, policy makers, business leaders, and others pack themselves into the mHealth Summit for a glimpse at the latest in mobile and wireless health technology. And why not? It’s a good time, and the policy changes, apps launches, and new comers to the field are always worth noting.


But this year, as we head into the 5th Annual mHealth Summit, I’m looking beyond the 300 exhibitors and 450 speakers—I’m following the money to the most promising new mHealth tech.


What choice do I have? Last quarter, as reported by CB Insights, venture capital investors deployed some $1.2 billion to U.S. mobile-related companies, making Q3 2013 the wildest VC financing quarter in history for the Mobile & Telecom sector.


Health IT overall drew $2 billion in funding this year, according to a Healthcare IT News report, but if you look at VC deal volume in mobile, the Health & Wellness sub-industry barely registered in Q3. So, yes, investment dollars are flowing to mHealth, but my take is that, despite the boom, we’re just getting started. That’s likely to be good news for mHealth entrepreneurs as they continue to bring their own innovations to market, and the money works its way deeper into the health niche.


Although VC funding is hardly the end-all-be-all for tech entrepreneurs—and somewhat less relevant to healthcare CIOs—financing trends obviously play an important role in the growth and evolution of mHealth. To the extent that new mobile and wireless devices (and apps) will need to be added, integrated, and supported by health IT professionals, these funding trends could prove very relevant to CIOs indeed.


That’s why one of the presentations I’m most interested in this year is the Venture+ Forum.


Keynoted by Qualcomm Life Fund’s director Jack Young—an electrical engineer and former EVP with the world’s fourth largest mobile phone manufacturer (ZTE)—this session should be eye-opening.


Young, who has questioned the sustainability of current funding trends, believes digital health is at a crossroads. Among other things, he’s planning to talk about the viability of today's boom in mHealth funding, and where investment dollars might trend over the coming years.


Personally, I welcome input from Young and others on this topic, as the industry prepares for the next wave of mHealth technologies that promise to span everything from mobile-clinical integration platforms, to personal genomics, to clinical research technologies.


The Venture+ Forum also will review presentations from 11 mHealth startups, which is always fun and inspiring. So, whether you have a mobile solution on the market, in the works—or you’re just wondering how the next wave of mHealth offerings will impact workflows—there should be some actionable information coming out of the Venture+ Forum. Hope to see you there!


As a B2B journalist, John Farrell has covered healthcare IT since 1997 and is Intel’s sponsored correspondent.

The 2013 mHealth Summit is coming up next week and will feature a tremendous lineup of sessions and exhibitors all focused on mobile health IT. Below is a guest blog from Ken Jarvis, Director, Health & Life Sciences Industries, Americas Region at HP.


In the lead up to the fifth annual mHealth Summit next week, HP is working with Intel to highlight how clinician mobility is transforming patient care and access to data capturing. As the vision of mobility in healthcare becomes reality, we are seeing a transformational shift in the way health is managed and care is delivered. Mobile health technology gives healthcare providers the power to offer care at the right time and place.


The use of mobile devices has the potential to save time, enhance accuracy and improve bedside attention. Tablet PCs, notebook PCs, mobile workstations and mobile thin clients give hospitals the option to choose the product, or combination of products, that best suit their needs. Companies like HP aren’t just offering options in devices, but rather an opportunity for change, which can help providers create better experiences for patients during their medical stay.


For example, physicians use tablet PCs like the HP ElitePad 900 to be more efficient and accurate in their day-to-day activities. With remote access to medical records, the physician is able to have productive face-to-face interactions with patients by providing them with personalized healthcare information in real-time. The physician can also use the tablet to capture patient information digitally in the moment so detailed information can be created and retained faster and more efficiently. For practices that want to streamline processes, windows-based tablet PCs are a smart choice as they can run the same programs available on their existing desktop PCs.


Next week, we’ll be on the mHealth show floor at Intel’s booth #1311. HP’s mobile portfolio will be on display including the HP ElitePad 900, HP EliteBook Revolve and HP EliteBook Folio. For more on what you can do to improve your mobile strategy, HP’s Ken Jarvis will be speaking in his session on the general stage on Monday December 9 at 2:45 p.m. about Creating a Secure, Effective and Popular BYOD Policy.


Learning objectives in this session will include:

• Enablers and inhibitors to an effective BYOD policy

• Current and future landscape of BYOD

• Tips from practitioner experiences on how to develop an IT strategy and foundation for an expected surge in clinicians’ adoption of BYOD


What questions do you have? If you will be at the event stop by the Intel booth #1311 and say hello.

Below is a guest blog from Alice Borrelli, director of Global Healthcare Policy for Intel.


During today’s forum, hosted by Intel Corporation, The Aspen Institute and Bipartisan Policy Center, we will discuss how the promise of technology solving society’s complex goals will rely, in part, on how we manage the information explosion. And, nowhere is the challenge more evident than in personalized medicine where the human genome consists of 3 billion DNA based pairs. Intel and our partners are compressing processing time for genome sequencing to accelerate targeted and personalized medicine.


In a new policy paper -- Compute for Personalized Medicine -- Intel gives seven policy recommendations that will accelerate the usage of this critically important health information. We invite policy makers to join us in the quest to make genomics information accessible and clinically useful by considering the following recommendations:


1. Share the Data: Create and ensure the interoperability of technical standards for managing and sharing sequenced data in research and clinical samples.

2. Show me the Evidence: Determine clear guidelines for data sharing from clinical trials.

3. Streamline privacy regulations: Harmonize existing privacy laws to protect patient data while offering a pathway to maximizing the research data available today.

4. Show me the Money: Provide reimbursement models for clinical use of genomics and predictive modeling.

5. Clarify the Regulations : Provide guidance to reduce the regulatory overlap between CMS and FDA.

6. Protect My Predictions: Ensure that current genomic privacy laws provide adequate coverage for non-discrimination.

7. Bring it Now: Integrate the scientific discoveries into everyday clinical usage.


What questions do you have?

I recently joined a panel of learned colleagues working in public health, telemedicine and acute care at an Institute of Medicine (IOM) forum focusing on the state of our nation’s healthcare system relating to population health and emergency preparedness and response due to natural disaster or other factors.


Along with seeking programmatic opportunities within the Affordable Care Act (ACA), I was asked to represent the view of the healthcare information technology sector on ways to advance resilience through technology that keeps the focus on the patient.


Doing so means establishing an infrastructure around current national standards (such as Direct & C-CDA) for data exchange and readable content, as well as increasingly open architectures around application programming interfaces (APIs) that expand integration with emergency response departments, responders, hospital EDs and HIEs, along with the current integration of electronic health records.


The expansion of patient portals, personal health records and cloud technology must also keep pace with available standards such as Blue Button, along with the ability for providers to utilize mobile EHR innovations to access these standard and readable patient records. After all, hospitals and practices are not immune to disaster, as the nation experienced certainly with Hurricane Katrina and most recently during Hurricane Sandy.


Also, a national patient identifier strategy is equally crucial to develop, one that can link the needed clinical information to the right displaced patient.


Both the American Recovery and Reinvestment Act (ARRA, 2009) and ACA provide the means to put this infrastructure in place, and in fact such networks are already taking shape. The ACA’s Health Center Controlled Networks fund was primarily focused on EHR and meaningful use adoption in the front lines, and provides the opportunity for resiliency expansion.


ARRA’s HIE Cooperative Agreement Program seeded state and regional HIEs, from which a debut collaboration this year of 10 HIEs has formed under the name SERCH, specifically to manage emergency response using vetted exchange standards, all while some individual state HIEs are expanding linkage to include EMS and fire departments.


And yes, taking a measured, national and analytical approach to resilient, technology-driven strategies is a best practice for achieving best practices in the field. Here too, ACA can be leveraged through a pair of well-funded and important programs, the Patient Centered Outcomes Research Institute (PCORI) and the Prevention and Public Health Fund, where respectively analysis and additional research options for emergency healthcare and IT exist, and where implementation can follow.


And finally, it’s again not just emergency response, but also preparedness, where for example outbreak surveillance, immunizations and registries have long been a national goal. Here there are new and existing collaborations between ONC, CDC and EHR developers that can be further integrated.


Right now the opportunities far outweigh the barriers toward establishing a coordinated national approach to population health when we may need it most, and it’s important to continue this discussion as the health IT industry itself continues to mature.


See the IOM panel presentation slides here.


Justin Barnes is a vice president with Greenway Medical Technologies, chairman emeritus of the national Electronic Health Record Association (EHR Association), co-chair of the Accountable Care Community of Practice (ACCoP) and a board member of the CommonWell Health Alliance.

To fully realize the benefits of personalized medicine while avoiding negative impacts such as breaches, we must minimize the associated privacy and security risks. Personal information, including a patients genetic data, used to support personalized information is considered sensitive information, and is regulated in the US by the Genetic Information Non-Discrimination Act (GINA) and the HIPAA Privacy Rule. This prevents abuse of this information, for example for discrimination based on genetic information for employment or health coverage, or breaches.


A best practice in identifying and mitigating such risks is to follow the sensitive information through its lifecycle, identifying and assessing risks, and implementing safeguards to mitigate at each stage. In previous blogs we discussed the collection, use, retention, and disclosure stages. In this blog I’ll focus on the disposal stage. This last stage is often overlooked in privacy and security risk assessments, and can be the source of security incidents such as breaches. Several examples of breaches resulting from improper disposal of protected health information can be seen on the HSS Breaches Affecting 500 or More Individuals, by searching on “disposal.”


More examples can be found globally, for example in Britain: Buy A Computer On eBay, Find Sensitive Health-Care Records!, where computers containing sensitive patient health information (that as not properly disposed of) were sold on eBay. As we can see from this last reference, impacts of such breaches can easily run into several hundreds of thousands of US dollars. In fact, the impact of such breaches can even run into millions of dollars as reflected by the Ponemon 2013 Cost of a Data Breach Study which found that in the US breaches on average cost US $5.4 million.


In order to minimize these kinds of risks, a best practice is to securely dispose of patient information used for personalized medicine when it is no longer required for the purpose to which the patient has consented, and is outside of any regulatory/legally or policy imposed mandatory retention periods. Disposal could also be explicitly requested by a patient. In this case the healthcare organization should inform the patient of the benefits of retaining their information, for example to ensure the completeness of their longitudenal patient record. However, in the event that the patient record must be securely disposed of, the last thing a healthcare covered entity or data controller wants is to have a breach and then have it further exacerbated by the scope of the breach include patient information they should no longer have.


To accomplish secure disposal, all of the sensitive data for a given patient, throughout the personalized medicine process needs to be securely disposed of. It is helpful to review some of the key data records created in personalized medicine process.


This starts with blood or saliva samples taken from patients, then the raw genetic data produced from sequencing the DNA in these samples. A variance file is then produced from the raw genetic data, in comparison with baseline genetic data, to produce a variance file highlighting specific variations in the patient genetics from the norm. Lastly a risk factors report is produced from the variance file that identifies patient propensities to specific traits such as diseases, and pharmacogenetics or the efficacy or toxicity of specific medicines to the patient based on their genetics. We also need to consider any personal information in backups, archives, or offsite for example to support business continuity/disaster recovery.


Any information shared with third parties, known as Business Associates in the US, or data processors in Europe, should also be securely disposed of. Disposal methods can range from incinerating samples, to shredding paper records, to secure wipe of storage media, physical destruction of hardware devices, encrypting and securely disposing of the key, and so forth. In the case of backups and archives it may not be practical to delete a specific record. However, in such cases if the patient record is disposed of in the online tier 1 storage, eventually within a set time period as backups / archives reach end of life, for example after 6 months, the deletion of the patient record will effectively propagate to those backups/archives as well.


There are several places a patients personal information can hide to make this job even tougher. An example is caches, for example in web applications, proxies, performance caches and so forth. Another example is the patients personal health information exchanged with other healthcare organizations through health information exchanges. Fortunately, once exchanged through such HIE’s the patient information retained by another healthcare organization is subject to their regulatory compliance.


Unfortunately for the patient this may mean that they need to go to the various independent entities holding their information and explicitly request disposal of their information if their goal is deletion of their record more broadly than a single healthcare organization. As healthcare workers are increasingly empowered with more devices, apps, online services, and also wearables and Internet of Things, the risk of sensitive patient personal information being retained or transmitted in places or ways that it should not be, increase considerably. Examples today can be seen in Workarounds in Healthcare, a Risky Trend, driven by healthcare workers use of workarounds. DLP (Data Loss Prevention) can be an effective tool in discovering such personal information at rest or in transit, enabling a healthcare organization to securely dispose of it or move it somewhere more secure as needed.


Lastly, but not least, one should keep a good audit log of such disposal activities, to enable effective audit and compliance and implementation of policy, as well as demonstrate due diligence should you ever need to in the event of a breach.


What kinds of challenges are you seeing with securely disposing of health information used for personalized medicine?

Remember when the iPad arrived on the healthcare scene? As a non-enterprise device, it snuck in the back door—often in doctors’ pockets—and redefined user expectations in the process. Health IT professionals hated the idea at the time, but they slowly came around to it as Apple added basic enterprise features and let third-parties add incremental support. Of course, that was back when healthcare organizations had few viable alternatives to the iPad. Times have changed.


When I reached out to CIOs for a sense of their familiarity with some of the extreme low power Windows tablets that are coming to market, I was surprised to find that many, if not most, weren’t very familiar with them at all. But there is a sense of growing interest at healthcare organizations of all sizes.


J. Barron Breathitt, CIO at Louisville, Ky.-based All Children Pediatrics, is among those concerned with power consumption and battery life. The 57-employee physician’s practice group, which is in the process of merging two offices, upgrading its servers, and moving to a virtualized environment, currently runs on upgraded Fujitsu T730s and T731s. Right now, he’s sizing up the T734, which has the Haswell chipset, uses less power, and extends battery run time.


“It makes sense for us because our physicians require the ability to ink on the screen for signing and noting issues on charts,” Breathitt says. “They also use iPads when working remotely.”


Healthcare CIOs across the board—especially those looking to standardize away from the iPad—might want to check out the latest offerings from vendors like Dell, HP, and Lenovo.  With the combination of Intel Clover Trail and Windows* 8, devices such as the Dell Latitude 10, the HP ElitePad 900, and the Lenovo ThinkPad Tablet 2 are blending the best consumer elements of the iPad with the enterprise features that HIT professionals wants in their next generation tablets.


For starters, the new breed of enterprise tablets’ base battery life is competitive and can be configured to last twice as long as the iPad 4. They also deliver both more baseline expandability and additional expandability, with optional manufacturer-supported accessories. Plus, they offer the same PC enterprise features already deployed and in use at healthcare organizations.


These extreme low power Windows tablets also support touch-based scenarios with known IDE, while supporting backward compatibility with legacy peripherals and software. That’s a significant advantage over iPad, which requires new apps be written with new IDEs and don’t support legacy OSX apps and hardware.


When you factor in the cost of additional management tools, iPads are just more expensive. For a detailed breakdown of the latest tablets, check out a new report from Moor Insights & Strategy, entitled The Latest Extreme Low Power, Windows Tablets Now Ready for the Enterprise.


As a B2B journalist, John Farrell has covered healthcare IT since 1997 and is Intel’s sponsored correspondent.

There are really two aspects of sharing of patient information—directly with patients and between providers. We are going take a look at both in the next couple of blogs, but let’s start with providers.


Provider-to-provider sharing is by far the more crucial dilemma to be solved. Nothing against the average patient, but the overwhelming majority are ill-prepared to fully consume and act on detailed and often confusing medical information (although the concept of shared decision making may help—but more on that in another blog).


Providers are pretty experienced at sharing with each other. Every time a referral is sent from primary care doc to specialist there is some degree of information exchange. And the technology that they use—phone and fax—are pretty good. User friendly, reliable, ubiquitous—a hard combination to beat.


So what’s the problem? While fax and phone are Steady Eddies, there is plenty of room for improvement. Phones are wonderful for nuanced conversations, but very inefficient for quick logistical tasks. Faxes are reliable but can only be stored within an electronic medical record as an image as opposed to discreet data. Both phone and fax are foundational elements of the old world, not the new world. You can’t do big data with fax machines.


We’ve making progress. Prodded by Meaningful Use incentives and new EHRs, healthcare providers large and small doing a much better job of electronically communicating within their own organizations. But electronic exchange dramatically breaks down when providers attempt to communicate with providers across the street. The problem is that the infrastructure for conversations between organizations is woefully incomplete.


Part of the challenge is a HIPAA security artifact—providers don’t have the freedom to send a traditional email and with an attachment of the last progress note.


Also, communication systems don’t work unless the overwhelming majority of providers have them. That’s why telephone and fax have been so successful and persistent; they are easy to use, everyone has one, and they are cheap. This is tough competition. 


The current nascent efforts are a mixed bag; secure email is cumbersome, poorly integrated with EHRs, a pain in the neck to use, and has spotty penetration. The Continuity of Care document (CCD) provides a reasonable standard for electronic patient summaries that can travel back and forth between EHRs.


However, before I can send a CCD from my EHR to your EHR, a CCD integration needs to be built between our two systems. There appears to be no universal CCD integration. Each EHR to EHR CCD interface is built one at a time. With 200+ EHRs out there, that’s a ton of integration work—hardly the recipe for universal and seamless sharing.


Health information exchanges (HIE) offer the most promise. Conceptually, they are right on; a secure, digital infrastructure, broadly designed for information exchange among trusted parties all seeking to manage patient care. HIEs are not perfect. Business models are problematic (public exchanges will probably flop when the government money runs out and the privates exchanges will have to morph to be more inclusive). HIEs also have room for improvement on the work flow side (i.e. referral management tools), so that average provider can perform specialized information sharing tasks quickly and easily.


Despite these issues, some form of HIEs will be the information highway for health care, allowing much improved provider communication and care coordination. But just like the real interstate highway system, it will take a lot of money and time to build. Don’t throw away that fax machine just yet.


What do you think?  


Bruce Kleaveland is President of Kleaveland Consulting and a sponsored health IT correspondent for Intel

Below is the fourth in a series of guest posts from Nirav R. Shah, MD, MPH, the commissioner of health for the state of New York. Look for more of his blogs in the Intel Healthcare Community in the coming months.


Mr. Jones shows up in the emergency room, complaining of severe insomnia. The problem list on his electronic health record highlights his ailments -- diabetes, asthma, anxiety, depression and migraines. A doctor prescribes a stronger anti-anxiety medication, but his insomnia does not subside.


Now imagine if that problem list also reveals that Mr. Jones is homeless, struggles with a substance abuse problem, and has a son who is in and out of prison – a surefire recipe for insomnia, if ever there was one.  Instead of giving him a pill, the staff uses that information to reach out to existing community agencies that help Mr. Jones find stable housing, a new drug counselor and support for his son -- for less than the cost of an emergency room visit.


That’s what happens when you have a health home, a health care model that delivers coordinated care to the state’s neediest patients, those who have complex behavioral, medical and long-term health needs and two or more chronic conditions.


A health home is not a physical place, but rather a model of health care in the Affordable Care Act geared for the 5 percent of the population that accounts for 50 percent of our total health care costs. Maimonides Medical Center has created the Brooklyn Health Home, which targets adults with complex health issues, serious mental illness, HIV and substance abuse issues, and is funded by the New York State Medicaid program.


Each patient in the Brooklyn Health Home has a care team comprised of a care manager, care navigator, and primary care doctor, and if needed, a psychiatrist and/or therapist. Other potential team members include specialty physicians, home care nurses, social workers, residence managers, substance abuse providers and caregivers in the home.


The team members are linked through the Statewide Health Information Network for New York, or SHINY-NY. If a patient sees a specialist or gets a new medication, everyone on his team knows about it.


Medical problems are only part of the equation. Problem lists in the Brooklyn Health Home also include social challenges and together with medical issues, get prioritized from the patient’s perspective. Everyone on the team knows if a patient gets evicted, experiences domestic violence or loses his home health aide. That’s what makes the model unique – an entire team is looking out for patients who not only have multiple medical needs but are vulnerable to social factors that sabotage good health.  After all, the social determinants of our lives – income, education, housing -- have as much of an impact on our health as medical ones, if not more.


With Mr. Jones, we know that connecting him to a new substance abuse counselor is likely to go farther than simply handing him a new medication. By creating a patient-centered problem list, we can lower the use of hospital emergency departments, reduce hospital inpatient admissions and cut back on 30-day readmissions. We can also improve patient care.


When we know the social context of a patient’s life, we get a bigger picture of his health needs. Health data lets us do that and makes it possible for us to address the social hindrances to good health as well as the medical ones.


What questions do you have?

Genome resequencing allows us to understand how genetic differences affect health and cause diseases. This is an important step in detecting anomalies associated with many genetically inherited diseases like Heart Disorders, Down Syndrome, Cystic Fibrosis and Chromosomal Abnormalities.


Next Generation Sequencing (NGS) technologies running on High Performance Computing (HPC) architectures have enabled the sequencing on DNA at groundbreaking speeds. However the storage, analysis and management of the massive DNA sequence datasets produced as a result of NGS research, is a new challenge. Hadoop and Mapreduce technologies come into play here by allowing parallel read-mapping algorithms to scale effectively and resulting in shorter execution times and lower costs (from software execution and hardware).


Among other areas Hadoop technologies may be useful are data storage, data management, statistical analysis and statistical association between various data sources. Organizations are now able to store large datasets in Hadoop Distributed File Systems (HDFS) and are able to use real-time analytics software to access data directly from HDFS bypassing any data migration headaches. Software packages like Myrna, developed by Ben Langmead, Kasper Hansen and Jeff Leek (John Hopkins University) is one such tool that allows the calculation of differential gene expressions in RNA-seq datasets on cloud (Amazon Elastic Map Reduce) or Hadoop clusters .


Innovative companies like Intel Corporation are interested in collaborating with various key partners in the Life Sciences area in an effort to accelerate such work. Intel wants to provide businesses with an open enterprise Hadoop platform alternative for next generation analytics and life sciences, called the Intel® Distribution for Apache Hadoop Software, which provides better manageability and performance – optimized for Intel Xeon processors.


In this paper, we demonstrate how to install and configure Myrna and its required components – Bowtie, R/Bioconductor and SRA toolkit within the Intel® Hadoop Distribution. Read the paper.


What is your experience with big data and Hadoop in life sciences? Do you think Hadoop is ready to become the life sciences research and analytics platform of the future?

Recent privacy storms around government surveillance, big data / analytics, social media and so forth have led many media publications to proclaim “privacy is dead.” To cope with these trends, as well as wearables, drones, Internet of Things (IoT) and other technologies just around the corner we need to move beyond a view of privacy in absolutes. If we truly had no privacy, and all of our personal information was available to anyone that wanted it then we would be in much worse shape from a privacy standpoint than we currently are.


Research studies have shown that users are increasingly empowered with mobile devices, apps, social media, and new trends around wearables and IoT are sure to compound this. This empowerment has enabled users to be productive in ways we couldn’t imagine a decade ago. However, this has also provided a lot of rope with which users can, mostly inadvertently, hurt themselves and others from a privacy standpoint. This is evident in studies such as Workarounds in Healthcare, a Risky Trend that shows that when usability is lacking in solutions or security, or IT departments get in the way of healthcare workers they find alternative workarounds that get the job done, unfortunately also adding non-compliance issues and additional privacy and security risk. This trend is particularly acute in healthcare where personal information can be very sensitive and is heavily regulated, for example by HIPAA, and healthcare and wellness apps working with such information are proliferating at an amazing pace.


To cope with this increasing empowerment of users, and the fact that user behavior is a major and growing source of privacy risk, users need to make better decisions regarding how to engage in technologies. Consumers make purchasing decisions every day, where they evaluate the value of the purchase against the cost and make a decision whether to buy or not. Viewing decisions whether to engage in technologies through this metaphor we can think of the purchase as the potential engagement in technology, the value as the benefit of the engagement, and the cost as what privacy we are giving up by engaging which depends on the personal information that will be shared as part of the engagement.


In many technology engagements today users pay little to no attention to the “privacy cost” as evidenced by studies that show little attention to permissions granted to apps being installed on mobile devices. To address this we need to improve technologies that show end users the “privacy cost” of their decisions. Further, effective privacy and security awareness training for users is much needed. We can learn from the gaming industry where gamers, including young children, learn highly complex games “on the go” without ever reading a manual.


Technologies such as app permission watchers, ad network detectors, site advisors, endpoint DLP have started to shine a light on “privacy cost” and risks and thereby influence users to make better decisions regarding where and how they engage including what apps they use, what websites they visit, and what actions they perform on their devices.


Much work remains to be done here to help users make better decisions about what technologies they want to engage with, and how they want to engage including how they will configure and use the technologies to both achieve their goals, while minimizing the privacy cost and risk.


What questions do you have?

The third annual Intel Health & Life Sciences Innovation Summit webcast series is coming Oct. 23. These online sessions will feature panel discussions with experts on the next wave of healthcare technology and personalized medicine, plus live Q&A so you can ask questions to those who are on the forefront of healthcare transformation. Register for the webcast series here and reserve your spot for these hour long broadcasts.


Leading up to the online webcasts, we have asked industry leaders to share some of their thoughts on the future of healthcare technology. Below is a guest blog from Cliff Bleustein, MD, MBA, Managing Director & Global Head of Healthcare Consulting Dell Services - Healthcare & Life Sciences, on the widespread adoption of clinical data warehouses and how analytic tools holds the promise of better health, not just better healthcare. Let us know what you think and remember to sign up for the webcasts.



Now that the nation has invested billions of dollars in electronic medical records, it’s time to start looking for ways to make a better return on that investment. To date, we’ve seen some gains in quality of care as a result of EMR use, but not much in the way of cost savings or improvements in the health of the U.S. population. But realists in the industry never expected EMRs alone to rescue a health system in which poorly managed chronic conditions and health costs are constantly increasing.


EMRs are, by and large, a tool for creating a new system, not a new system in and of themselves. And you have to go way beyond basic EMR adoption to make that tool really productive. Given that the vast majority of hospitals and physician practices are a long way from Stage 7 of the HIMSS Analytics model of EMR adoption, it’s not surprising that we are not seeing the kind of changes that we all want.


There is good news on the horizon, however. Industry-wide, healthcare IT companies are focusing a lot of attention on developing new analytic tools to help us find the cost-savings and health improvements of which we dream. The most sophisticated new tools are designed to marry the clinical data gathered by EMRs with financial and population data available from other sources to provide deeper understanding of the interaction between disease, individual patient characteristics and the health system.


These new analytic tools will depend on the creation of data integration and management systems that can pull data from clinical applications, EMRs, patient-reported data, healthcare financial systems and demographic and population data sources. The baseline for using these tools is a clinical data warehouse, or CDW, that can extract and house data from the clinical silos that are everywhere in healthcare.


The idea of the CDW is taking hold even as hospitals struggle to fully adopt electronic systems. In some ways, those hospitals that are laggards in the EMR adoption process may benefit from their procrastination by creating a CDW concurrently with an EMR system. They’ll be ready to quickly move from EMR adoption to analytics adoption if they build in a data integration function as they build their electronic systems.


With wide spread adoption of clinical data warehouses, enormous amounts of patient data can be de-identified and made available for researchers to study and analyze. When you add the promise of genomic data to the clinical data, and add in demographic, sociologic and financial data, the vehicle for creating new understanding becomes even more powerful.


So how do we find that intersection of population health and individual well-being that will help save our struggling health system? Analytics. Knowledge is the engine that will power our vehicle, driving us to that intersection where we can see all the forces that act on health. Analytic tools can refine crude data to a form that can fuel the knowledge of how people get sick and what processes we need to change to improve health.


Want an example of how population health studies have the power to give life and health to individuals? Think of the revolutionary finding that a lack of folic acid during the first weeks of pregnancy was the cause of many neural tube defects, like spina bifida. Food manufacturers started adding folic acid to a wide variety of common foods, and the rate of neural tube birth defects declined precipitously.


That understanding took years of hard work. With more data and sophisticated analytic tools, insights like this can come much faster and with less effort. The result will be an explosion of knowledge and the ability to reform our lives from conception to be healthier and less prone to the illnesses that plague our lives and cost us billions to treat.


What questions do you have?

The third annual Intel Health & Life Sciences Innovation Summit webcast series is coming up next week on Oct. 23-24. These online sessions will feature panel discussions with experts on the next wave of healthcare technology and personalized medicine, plus live Q&A so you can ask questions to those who are on the forefront of healthcare transformation. Register for the webcast series here and reserve your spot for these hour long broadcasts.


Leading up to the online webcasts, we have asked industry leaders to share some of their thoughts on the future of healthcare technology. Below is a guest blog from Stanley Crane, chief innovation officer at Allscripts, on accessing healthcare data. Let us know what you think and remember to sign up for the webcasts.


There’s a different aspect of Allscripts Open initiative that occurred to me while I was watching a TED talk by Intel’s Eric Dishman.


That idea is Care Anywhere. Previously, I had limited my thinking about Open as being a data-sharing, innovation, collaboration initiative.


But Open is about more than breaking down the silos around information. It’s about helping to transform care by making it easier for patients and providers to escape physical limitations around care delivery.


Overcoming physical barriers to detect heart trouble


Spaulding International has an electrocardiogram (ECG) device that patients can use anywhere, with the result saved in the patient’s electronic health record (EHR). The patient no longer has to go to the physical hospital for an ECG.


Compare that with wearing a Holter monitor, a technology that has been in clinical use since the 1960s. You go to the doctor’s office, and they attach leads. You walk around with it for 24 hours. Then you bring it back. A few days later, you get a report.


When do the doctor and patient make a decision based on that report? A week after the fact? It’s inefficient because the doctor and patient have to be in the same place at the same time – a doctor’s office or hospital. And what if the results warranted a quick response?


We can use Open to help overcome that physical limitation, as we did for ECGs with Spaulding. And there are other technologies, too – a continuous glucose monitor, scales, various pedometers – with lots more coming from our diverse developer base.


Care Anywhere means that no matter where the patient is, he or she can contribute to the corpus of knowledge that may help the physician make a better, faster decision. Open technology, and our partnership with Intel, will help get the information to the right place at the right time.


Mobile devices usher in a new era in healthcare


In my career, I’ve seen three major transitions. From 80 column cards to terminals (yes, I started that long ago), from terminals to PC’s, and from character-based to a graphical user interface.


Today, we’re in the midst of another, maybe the largest transformation of them all – from primarily a keyboard and mouse interaction model, to a touch and gesture method of navigating through systems.


And at the same time, we’re moving away from being tied to a physical location for information. (As a 3-year-old recently asked his mom, “Does your phone know everything?”). Windows 8 devices (and others) enable change in how we practice healthcare today.


These new interfaces challenge healthcare IT organizations to build new ways – both provider and patient-centric ways – of navigating the growing data we have available about the patient. Previously we’d build a system by saying, “Here are the fields in the database; make a form to help us fill them out.” Those days are long gone.


Today, we try to anticipate what the doctor wants to see, and bubble those things to the top. We want them to have exactly the information they need so they can plan the best care for the patient.


Our Windows 8-based mobile EHR will automatically make charts and graphs to help the doctor educate the patient and show the effect of their medications. We’re optimizing screens and touches to “make things easy” not just “make all things possible.”


We live in revolutionary times. With the confluence of the pervasive Internet, the next generation of devices, new operating systems, wearable devices, and Open toolkits – we’re on the verge of realizing this idea of Care Anywhere and making healthcare into a team sport.


Isn’t that what you want for your family?

The four finalists for the 2013 Intel Innovation Award have been announced and they represent a wide range of innovation that is occurring in healthcare technology.


Congratulations to Bioscape Digital, Greenway Medical Technologies, IPG, and Velocity Medical Solutions for advancing to the finals. Read more about each company and their submissions for the award.


From here, each company will present at the 2013 Health IT Leadership Summit on Nov. 12 at the Fox Theater in Atlanta. One will be named as the top innovator.


You can see the past winners and finalist here and see some of their innovative products and services


The daylong The Health IT Leadership Summit features panels and presentations on the issues most affecting industry growth, including the Affordable Care Act, health information exchanges, payer programs and disruptive technologies. The Summit was founded by three organizations:  Georgia Department of Economic Development, Metro Atlanta Chamber and Technology Association of Georgia (TAG) Health. Additional information and registration: www.healthITLeadershipSummit.org.


What type of innovation are you seeing in healthcare? Let me know, and be sure to stay tuned as the winner of the Intel Innovation Award is announced next month.

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