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A Whole New Way of Being Old: Book Review of The New Mobile Age

Posted on March 15, 2018 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

The recently released overview of health care for the aging by Dr. Joseph Kvedar and his collaborators, The New Mobile Age: How Technology Will Extend the Healthspan and Optimize the Lifespan, is aimed at a wide audience of people who can potentially benefit: health care professionals and those who manage their clinics and hospitals, technologists interested in succeeding in this field, and policy makers. Your reaction to this book may depend on how well you have asserted the impact of your prefrontal cortex over your amygdala before reading the text–if your mood is calm you can see numerous possibilities and bright spots, whereas if you’re agitated you will latch onto the hefty barriers in the way.

Kvedar highlights, as foremost among the culture changes needed to handle aging well, is a view of aging as a positive and productive stage of life. Second to that comes design challenges: technologists must make devices and computer interfaces that handle affect, adapt smoothly to different individuals and their attitudes, and ultimately know both when to intervene and how to present healthy options. As an example, Chapter 8 presents two types of robots, one of which was accepted more by patients when it was “serious” and the other when it was “playful.” The nuances of interface design are bewildering.

The logical argument in The New Mobile Age proceeds somewhat like this:

  1. Wholesome and satisfying aging is possible, but particularly where chronic conditions are involved, it involves maintaining a healthful and balanced lifestyle, not just fixing disease.

  2. Support for health, particularly in old age, thus involves public health and socio-economic issues such as food, exercise, and especially social contacts.

  3. Each person requires tailored interventions, because his or her needs and desires are unique.

  4. Connected technology can help, but must adapt to the conditions and needs of the individual.

The challenges of health care technology emerged in my mind, during the reading of this book, as a whole new stage of design. Suppose we broadly and crudely characterize the first 35 years of computer design as number-crunching, and the next 35 years–after the spread of the personal computer–as one of augmenting human intellect (a phrase popularized by pioneer Douglas Engelbart).

We have recently entered a new era where computers use artificial intelligence for decision-making and predictions, going beyond what humans can anticipate or understand. (For instance, when I pulled up The New Mobile Age on Amazon.com, why did it suggest I check out a book about business and technology that I have already read, Machine, Platform, Crowd? There is probably no human at Amazon.com or elsewhere who could explain the algorithm that made the connection.)

So I am suggesting that an equally momentous shift will be required to fulfill Kvedar’s mandate. In addition to the previous tasks of number-crunching, augmenting human intellect, and predictive analytics, computers will need to integrate with human life in incredibly supple, subtle ways.

The task reminds me of self-driving cars, which business and tech observers assure us will replace human drivers in a foreseeable time span. As I write this paragraph, snow from a nor’easter is furiously swirling through the air. It is hard to imagine that any intelligence, whether human, AI, or alien, can safely navigate a car in that mess. Self-driving cars won’t catch on until computers can instantly handle real-world conditions perfectly–and that applies to technology for the aging too.

This challenge applies to physical services as well as emotional ones. For instance, Kvedar suggests in Chapter 8 that a robot could lift a person from a bed to a wheelchair. That’s obviously riskier and more nuanced than carting goods around a warehouse. And that robot is supposed to provide encouragement, bolster the spirits of the patient, and guide the patient toward healthful behavior as well.

Although I have no illusions about the difficulty of the tasks set before computers in health care, I believe the technologies offer enormous potential and cheer on the examples provided by Kvedar in his book. It’s important to note that the authors, while delineating the different aspects of conveying care to the aging, always start with a problem and a context, taking the interests of the individual into account, and then move to the technical parts of the solution.

Therefore, Kvedar brings us face to face with issues we cannot shut our eyes to, such as the widening gap between the increasing number of elderly people in the world and the decreasing number of young people who can care for them or pay for such care. A number of other themes appear that will be familiar to people following the health care field: the dominance of lifestyle-related chronic conditions among our diseases, the clunkiness and unfriendliness of most health-related systems (most notoriously the electronic health record systems used by doctors), the importance of understanding the impact of behavior and phenotypical data on health, but also the promise of genetic sequencing, and the importance of respecting the dignity and privacy of the people whose behavior we want to change.

And that last point applies to many aspects of accommodating diverse populations. Although this book is about the elderly, it’s not only they who are easily infantilized, dismissed, ignored, or treated inappropriately in the health care system: the same goes for the mentally ill, the disabled, LGBTQ people, youth, and many other types of patients.

The New Mobile Age highlights exemplary efforts by companies and agencies to use technology to meet the human needs of the aging. Kvedar’s own funder, Partners Healthcare, can afford to push innovation in this area because it is the dominant health care provider in the Boston area (where I live) and is flush with cash. When will every institution do these same things? The New Mobile Age helps to explain what we need in order to get to that point.

Healthcare Is Going to Benefit from the Confluence of Consumer Technologies

Posted on December 28, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Next week is the annual CES conference in Las Vegas. It’s a unique event that brings together 170,000 people across 4 of the largest conference venues in the world. It’s enormous and a little hard to process.

Having attended for the last ~11 years, it’s been amazing to see the pace of progress with so many technologies. Remember that it’s only been about 9 years since the iPhone was launched. While smartphones and tablets have gotten so much better over this time period a whole slew of other consumer technologies have as well.

Looking forward to CES, it’s amazing to see the development of things like: 3D Printing, Virtual Reality, Augmented reality, IoT (Internet of Things…or as I like to call it Smart Everything), voice recognition, AI, robotics, sensors, etc etc etc. It’s an exciting time to be in an industry where so many things are developing so quickly.

Maybe I’m skewed because I’m a blogger in healthcare, but it’s really amazing how healthcare sits at the confluence of so many of these technologies. The overlap that’s going to happen between augmented reality, 3D printing, AI, sensors and new things we barely understand is going to be extraordinary.

I recently saw a 3D printing conference for healthcare. While 3D printing is very exciting for healthcare, it wouldn’t be nearly as exciting if we didn’t have all of the other innovations in cameras, storage, data sharing, virtual reality, etc. We needed evolutions and innovations in all of these spaces for the other technologies to really work well.

I’ve often said that the most interesting things in healthcare happen at the intersections. I think that’s particularly true in the digital health space. As I head to CES, I’ll be watching for this type of crossover of technologies. I think this year we’re going to see a lot of companies utilizing multiple technologies in ways we’d never seen previously.

Will mHealth Apps Replaced by Chatbots?

Posted on May 26, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Michael Yuan has a great post that looks at chatbots for healthcare and uses the great headline that “mHealth apps are so 2014!” Michael makes some great points about the challenges of getting patients to download mobile health apps and to get them to engage with those apps long term. There have been very few breakout hits in the mobile health app space.

For those not familiar with Chatbots, they essentially use artificial intelligence to appropriately respond to you on your favorite chat platform (Facebook Messenger, Kik, Whatsapp, Wechat (China), Google Messenger etc etc etc). Some of you may have seen my post about the way a Chinese Health Tracker integrates with WeChat. There are some really incredible benefits of engaging a patient on a messaging platform that they’re using daily already.

I think that most people just fear that messaging platforms aren’t powerful enough to really engage the patient. They often ask, can a text message change patient behavior? If you look at the WeChat integration mentioned above, you’ll see that most of these messaging platforms are becoming much more than just a set of simple text messages. However, let’s set that aside and just think about the power of a text message.

When Facebook announced their new partner program to allow people to create chatbots on their messaging platform, I asked my friend Melissa McCool from STI Innovations and MindStile if you could change people’s behavior with something as simple as a series of text messages. Her answer was a simple, “Yes.”

Of course, the devil’s in the details, but I trust that Melissa knows about how to influence patient behavior based on her experience doing it in many large healthcare organizations. The challenge isn’t technical though. Sending a text message, building a chat bot, sending a message on any of these platforms is completely academic. My 12 year old son could do it. What’s hard is what you should send, when you should send it and to whom.

While it’s great to see technology become easier and easier, that hasn’t made the challenge of behavior change that much easier. Sure, it’s great that the patient will actually read the message the majority of the time if you send it using one of these popular messaging apps. However, that doesn’t mean that the message will be effective. We still have a lot of work to send the right messages at the right time in the right way to the right people.

Drones in Healthcare

Posted on June 3, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I think the world has become fascinated by drones. I know I have. I got one for Christmas and it’s really fun to play with. The one I got is really hard to fly, but in many ways that makes it more fun.

What a lot of people don’t realize is how many ways drones are going to be part of our future life. No, I’m not talking about the military drones. In fact, using the term drones is so tied to the military that it’s almost not right to use the term. However, many people have become more familiar with drones thanks to Go pro cameras that are attached and bring us some really amazing footage even from amateurs.

Another thing that has helped people to understand the impact of drones is when Amazon talked about using drones to deliver products. That’s a powerful idea. It’s still a few years away at least, but it’s exciting that some of the smartest people in the world are working on it.

What I love about the Amazon example is that there are many things in life where you need to get a physical object somewhere quickly. As good as UPS and FedEx have become, drones could take this to the next level of speed and efficiency.

In healthcare, I think about emergency incidents. Could drones play a role in getting healthcare supplies to a disaster area that is inaccessible for ambulances and other emergency personnel? If you’ve ever seen the ambulances in Italy trying to navigate traffic, you can see how a drone would be much more effective. If it had a mounted camera with video streaming, those in the hospital could literally see what’s happening and provide remote support to the bystanders at the scene. Is that a new form of 911 experience?

We already know that drones are being used in third world countries to distribute medical supplies as well. It’s a powerful thing. I can’t remember where I saw it, but I once saw a map that mapped out how many drones it would take to cover an entire country. It was amazing to see this map of overlapping circles. Plus, the drone technology is going to get better and better.

There are certainly a lot of challenges and questions about pricing and privacy when it comes to drones and healthcare, but I’m excited about the possibilities. I’m sure there are plenty of more opportunities as well that we just haven’t had time to think of yet.

Medical Robot Infographic

Posted on September 11, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Who doesn’t love medical robots? Combine that with an inforgraphic and you have must see content. At least that’s what I thought about when I saw the following medical robot infographic. We’ve come a long way with robots in healthcare, but the best part is that I think we’re just beginning. Enjoy the medical robot infographic below.
Medical Robot Infographic
Thanks to healthcare-administration-degree.net for creating the infographic.