Crowd Sourcing for Maternal Health

The high rate of devastating complications of pregnancy, labor and delivery continues to be a desperate problem, especially in poorer parts of the world. The good folks at Oxford University are trying a new approach to understanding the barriers to better maternal health and perhaps to finding answers: they're asking folks. Which folks? Just about everybody who takes care of expectant mothers in third world settings.  They've set up a web site, Global Voices for Maternal Health, to use crowd-sourcing to get more and better input into this problem. (Even if you're not a third world maternal health provider, you're welcome to participate in the discussions.)

Crowdsourcing is the use of large numbers of distributed workers (usually interacting over the Internet) to solve problems or do tasks that are difficult for smaller teams to do. It has been used in the arts, business (especially marketing), and in science, but hasn't had much application in health that I know of. (Innocentive has applied it to biomedical science, but not to health care delivery.) So, this project is a bit of first.

Will they get the magic bullet answer that has eluded all the experts and policy makers for decades? Probably not. But they might get more than a few really great ideas that can have a positive impact on the lives of millions. It's a clever way to take advantage of new technologies to generate more and better information and certianly worth a try.

The Next Great Healthcare Revolution?

Your hosts here at HIE are happy to share the bully pulpit on occasion with folks who want to put their 2 cents in about moving information around to make care better. So, here is piece by guest blogger Alexis Bonari.

Health Information Systems: The Next Great Healthcare Revolution 

As online database technology moves to the forefront in many industries, we are faced with a crucial question: would a Health Information System create an environment that fostered a higher standard of patient care?  It would certainly make the transfer of records from one doctor or healthcare provider to another much simpler than it currently is.  

How it would work.
A comprehensive Health Information System would encompass all of the patient’s medical records.  Often, a patient might forget to report a treatment they had undergone years in the past.  When seeking treatment for a more current problem, the doctor overseeing the case might benefit from knowing about the previous procedure or diagnosis. 

Prevention is key.
Further, the past case history might be used to develop a preventative care plan for given potential illnesses.  Let’s say, for example, that a patient had suffered from an eating disorder during their adolescence.  That person would be more likely to experience the effects of weakened bones and teeth later in their adult life.  A few simple preventative measures would potentially prevent them from losing teeth due to calcium deficiency or from allowing osteoporosis to gain a foothold.  Without access to their adolescent medical records, a doctor wouldn’t have the information necessary to create such a plan.

The power of statistics.
Over the long term, a Health Information System would allow the medical community to track the health of the nation, individuals, families, and certain demographics.  No longer would we have to rely upon statistical sampling techniques to determine the exact incidence of cancer in a given population.  We would already have the data available. Currently, data used to determine such statistics is expensive and difficult to gather.   

Family ties.
Further, families could identify disease trends over multiple generations. As more is understood about the genetic component of certain types of cancers, etc. a statistical model could be produced for each individual that would predict the likelihood that they would develop particular diseases or conditions. Once again, preventative care could be tailored to the specific needs of the individual.

Privacy issues.
The primary concern when creating a Health Information System would be the problem of patient privacy.   If steps weren’t taken to prevent it, financially interested individuals and organizations, such as health insurance companies and any government health organization, might use the information obtained as justification to withhold or limit treatment from currently healthy individuals.  This problem would have to be foreseen and prevented from the inception of the Health Information System.  Ideally, the system should only be used for improving patient care and for disease prevention. 

Alexis Bonari is a freelance writer and blog junkie. She is currently a resident blogger at  First in Education, researching various accredited online degree programs. In her spare time, she enjoys square-foot gardening, swimming, and avoiding her laptop.

Secure messaging for everyone?

HIE has it on good authority that the feds are looking at a particularly attractive combination of technologies to enable all sorts of users, from sophisticated gear heads with fancy EMR installations to solo docs with just a web browser, to exchange secure messages across platforms. This would be a substantial step forward for both one-at-a-time patient coordination across practices and for automatic messaging to provide decision support and other intelligence. It will need an interface that is really, really simple for the basic user (not much different than a standard e-mail program), flexible hooks to allow interfacing with EMRs and registries, AND highly secure transmission across firewalls. If it meets all these criteria, NHIN Direct will be a winner.

How do you actually DO the "exchange" part of Health Information Exchange?

In spite of the great leaps made in standardization of message formats and contents (HL7, CCR, XML, etc., etc.), it is still sometimes remarkably difficult to get a message out of one electronic system and into another. Each laboratory information system, Electronic Health Record, registry or portal has its own requirements, issues and quirks.  Absent a true lingua franca, those of us doing health information exchange spend a lot of time and money designing, negotiating, implementing and repairing interfaces.

A financial services company out of San Mateo, CA called CloudPrime has been doing this kind of translation and interfacing for banks for some time and is now moving into health care. They say they can build an encrypted interface between two systems in a matter of days and can guarantee delivery of all messages. Their stuff looks good on paper (on browser?) and their rep, Jeremy Miller, quoted some pretty attractive prices, so it could be a real resource as we develop new ways to move the data around.

Mobile technology and global health

The National Institutes of Health, through its Foundation, is getting more interested in mobile technology for health care.

Call for presentations about mobile technology and global health

mHealth Summit A Public-Private Partnership of the Foundation for the National Institutes of Health November 8–10, 2010 Walter E. Washington Convention Center Washington, D.C. Abstract Submission Deadline: Thursday, July 1, 2010, 11:59 p.m. EDT The 2010 mHealth Summit will bring together leaders enabling cutting-edge research, evidenced-based practice and innovative policy solutions to advance the benefits mobile technology can bring to the health and well-being of developed and developing world populations. The event organizers are seeking abstracts for presentations from the public and private sectors that highlight ground-breaking health research, information and communication technologies, systems architecture and global partnerships that leverage mobile technology to improve global health outcomes. The organizers also are seeking demonstrations of research technologies such as mobile phones, smart phones, mobile phone applications, global positioning systems (GPS), personal digital assistants (PDAs), mobile electronic sensors (e.g., accelerometers), portable physiological sensors (e.g., ambulatory glucose monitors), mobile environmental sensors, integrated mobile devices and other wireless technologies. Topic areas include: Remote Data Collection & Patient Monitoring (assess/track health in the real world) Health Disparities & Underserved Populations (high-risk and difficult to reach groups) Disease Prevention & Health Promotion (reducing risk factors for disease) Medical Compliance & Adherence (following treatment regimen) Environmental Exposure Assessment (studying environmental causes of disease) Childhood Obesity (energy intake and expenditure in individuals) Maternal, Newborn and Child Health (prenatal and postpartum health) Infectious Diseases (diseases attributed to virus, bacteria, or other infections) Patient Reported Outcomes (quality of life and other patient-driven health indicators) Point of Care Diagnostics (diagnostic testing performed at or near patient care setting) Educational Tools for Health Professional Training Software System Development and Information Technology Infrastructure (enterprise architecture) Emergency or Urgent Care (medical care where threat of disability or death is imminent) All submissions will be reviewed by the mHealth Summit steering committee. Oral presentations will be grouped thematically in tracks, presented as moderated sessions, and are expected to last 12 minutes with additional time for a Q&A session. Some presentations will be integrated into planned super sessions. To submit an abstract or for more information, please visit http://fnih.omnicms.com/fnih/mHealth10/collection.cgi Discounted registration for the mHealth Summit is available through September 24. Register today athttp://www.mHealthsummit.org

David Kibbe on NHIN Direct

Rich Elmore's Health Information Technology blog has a particularly useful overview of NHIN Direct by David Kibbe. For those of us more interested in how to use Health Information than in how to build networks, this article will provide a useful introduction. Nice work!