Predictive Healthcare: Innovative growth in USA

Filed under: Innovation,Technology — lenand @ 10:31 pm
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McKinsey have analysed the applications of big data technology in US healthcare and show that direct intervention and predictive power is increasing:

Big Data in Healthcare

Big Data in Healthcare


If early successes are brought to scale, we estimate that big-data applications could eventually strip more than $300 billion in costs from the nation’s health-care system and improve transparency to drive better patient outcomes. Such applications might help avoid costly readmissions, enhance the understanding of chronic diseases, and ensure that patients are treated in the care setting that best meets their needs.”

This should encourage UK and EU investment in smart software to help in diagnosis and treatment to improve health outcomes.  There’s big money for those innovators that provide scalable machine learning and prediction.  The Internet of Things is capable of generating more data than can be analysed easily by traditional techniques.  Singapore is doing it.



Predictive Monitoring: Hackathon success

Filed under: Technology — lenand @ 2:13 pm
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In the era of big data, analytical methods have to be fast and effective.  Traditional statistical and rule based methods cannot keep pace with volumes and variety of data being collected.  They will miss patterns of data that could improve decision making.

The time has come when there is little option other than starting to consider automatic machine learning on an enterprise scale.  Patterns in data can be identified and used to calculate the probability of events in the future.  The prediction can be done in real time applications, such as intensive care monitoring in hospitals.

There seems to be a view that machine learning, pattern matching and prediction is expensive, slow or inaccurate – or all three!  Here is an example that demonstrates otherwise.  A Hackathon produced a prediction of blood sugar level in a diabetic patient in less than a day.  The machine learning algorithms were not meditated by any additional clinical input.

Blood sugar prediction

Blood sugar prediction

Similar techniques could prove invaluable in care of the elderly, early dementia and psychiatric patient monitoring.

This Predictive Monitoring hackathon was held in Singapore.  The UK should be more proactive in supporting such machine learning innovation, or a lead in vital technology could be lost.


Ageing: Digital Half-Life Policy

Filed under: Innovation,People,Policy,Technology — lenand @ 7:53 am
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Digital technology will impact everybody in the second half of their lives.  The age from 50 to 100, for the vast majority of people, will be a decline of most faculties until death do them claim.  Now is the time to think of the technology implications and develop a policy for public debate.

Here’s a table that shows the decreasing personal digital needs of people over 50 and the increasing needs of their family, friends and service agencies.  There’s an shift from being active and independent to moribund and entirely dependent and others. There a wide range of intermediate states of health and vigour, and digital needs should be individually tailored for the best outcomes.

Digital half life - Needs

Digital half life – Needs

The active, social person with no major health problems has lots of choice with the faculties to manage digital technology with ease.  For many this can last into their nineties.  However, the vast majority steadily need more external support. They wish to live independently, and this becomes easier and more economical if they accept external monitoring services. Currently these are expensive, using old technology in the home.  There are gaps in the market for home monitoring services – some idea is given in the table below:

Digital half life - Gaps

Digital half life – Gaps

The Internet of Things will lead the revolution.  Low cost home networked sensors are critical to the way forward.  It also needs good communications to data centres and analytical software as part of an affordable infrastructure.  Automatic sensing of changes to normal behaviour are necessary, in addition to the commonplace detector alarms.  With intelligent investment, the UK could develop a World leading technology industry.


Ageing: House of Lords should know

Filed under: Technology — lenand @ 6:26 am
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A recent report from the House of Lords Committee on Public Service and Demographic Change warns that the Government and our society are woefully underprepared for ageing.  During 2020–2030 they expect:

  •  51% more people aged 65 and over in England in 2030 compared to 2010
  •  101% more people aged 85 and over in England in 2030 compared to 2010
  •  10.7 million people in Great Britain can currently expect inadequate retirement incomes
  •  over 50% more people with three or more long-term conditions in England by 2018 compared to 2008
  •  over 80% more people aged 65 and over with dementia (moderate or severe cognitive impairment) in England and Wales by 2030 compared to 2010.

Among their many recommendations, these stand out as a message to everybody, before they, and their families, are too old to benefit.  People need to:

  • be more focused on prevention, early diagnosis, intervention, and managing long-term conditions to prevent degeneration, with much less use of acute hospitals
  • be centred on the individual person, with patients engaged in decisions about their care and supported to manage their own conditions in their own homes so that they can be prevented from deteriorating
  • have the home as the hub of care and support, including emotional, psychological and practical support for patients and caregivers
  • ensure older people only go into hospitals or care homes if essential, although they must have access to good specialist and diagnostic facilities to ensure early interventions for reversible conditions and prevent decline into chronic ill health.

Technology has a part to play – small in terms of overall costs – but a critical part of the Ageing Infrastructure.  Today, this is inadequate, fragmented and and inflexible.  This provides great opportunity for UK technology and the TSB is investing, such as the DALLAS programme. Innovation is key.

Another source of innovative ideas is coming from social media culture; informal meetings of people with ideas and energy.  Have a look at the Meetup network.  The Internet of Things has a very active group and Health 2.0 is looking at Dementia this week (there are spaces).


Prepare to grow old

Filed under: Innovation,People,Technology — lenand @ 7:54 am
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Quarkside does not need to do research when there are already good resources. For example, a review of the Telecare market produced by the Aktive project.  The UK claims to be leading the world and the Technology Strategy Board is pumping funds into ageing related projects.

The message is that people should consider installing technology in the whilst they are fit and active. This will have to be self-funded, because statutory health and care agencies bodies will not pay until there is a crisis. By monitoring normal daily activity, advanced software can detect changes that point to action that could prevent a crisis.  Potential savings are enormous.  Being able to live in your own house for one year extra is worth £30,000 to £50,000.

The minor problem for the elderly, or major opportunity for entrepreneurs, is that nobody is supplying a low cost home activity monitoring service.  DIY is not an option.


#IOT: Passive Path to Protection

Filed under: Technology — lenand @ 1:18 pm
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There’s a lively growth in the Internet of Things (IOT).  The prices are crashing down and manufacturers can see profit in the huge numbers of sensors that will be deployed.  The costs will be low enough for families to contemplate installation in the homes of elderly relatives.

Most old people prefer to stay at home in familiar surroundings.  But they are still at risk and unobtrusive monitoring is needed give reassurance.  What is a passive monitoring service worth? What might it cost annually?  Compared with spending £40k – £60k on full time care in a residential home, IOT monitoring has both financial and well-being benefits.  Everybody is a winner – plus the Health services, who will need fewer days of frail people in hospital.

IOT is part of the pathway to more years of safer life at home.telec

The ideas are simple – the implementation is complex and needs partnership.



Integrating Social Care and Health

Filed under: Local Government,Technology — lenand @ 9:37 am
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The Government has mandated the integration of health and social care services by 2018, potentially imposing a financial penalties for siloed services.  Good.  There is a budget of about £1bn to ensure there are integrated projects in every part of the country by 2015.

Who is going to lead it in locations where services are delivered?  How is the funding going to be allocated?  These questions do not seem to be answered.  Quarkside suggests looking again at the Framework for Multi-agency Enviroments.  It does not give the answers – but it has a method for bringing all the issues together.  Perhaps the Local CIO Council may give some leadership.

The elderly and their families are most likely to benefit.  Two separate industries, for telehealth and telecare, are growing rapidly.  The new political direction now opens an opportunity for telehealthcare, extending the period older people can remain safely in their own homes.  An integrated service should support all levels of the Kaiser Pyramid.

Observe the need for technology that has to transition from Self Care to Professional Care.  Be aware of the interoperability requirements as more complex monitoring has to be added with increasing risk.  Families will need telehealthcare products that are simple to use.


Sustaining digital engagement by older people

Filed under: Governance,People,Policy,Technology — lenand @ 6:57 am

Not many people realise that elderly people become more disengaged with ICT as they become older.  They ‘fall off the bandwagon’.  There is plenty evidence and the relevance is summarised in this St George’s House Consultation.

“It has been shown that ICTs can help the fifty-plus population to live independently, access government and commercial services, and engage socially. However, very many older people remain offline and unconnected. Even more worryingly, some of the older people who may at some point have gone online may subsequently disengage, i.e. they do not stay online. They face particular, age-related barriers including physical and cognitive changes, transformation of social and family environment, as well as fast-altering technology. More general barriers include distrust lest they be exploited by commercial providers, and incomprehension of ICT terminology and jargon. Meanwhile, technologies continue to evolve at a bewildering rate. The challenge is not just to help (older) people to get online in the first place, but to provide a context which will help them to overcome challenges posed to their on-going digital engagement (whether by changes in capability, social support or technology) and to develop their own skills and competencies as far as they wish to do so.”

This theme will be followed in subsequent postings.


Google risks Gmail defections

Filed under: Governance,Technology — lenand @ 11:14 am
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The new Compose is a serious threat to use of Gmail.

It is so trimmed down as to be unworkable. Things like sending address, to: CC: and BCC, reply to all, attach a file and even more, were easily viewable and usable with one click. Now it is several clicks through meaningless icons. It is a hindrance to productivity. Fewer clicks and comprehension wins over blank space every time.

The old screen, which used words, is impossible to re-find.  The very least should be a clear option to choose.  In their defence, it may be easier to use on a small screen smartphone device and that may be their most lucrative target market.  However, they could easily identify the screen size and adjust the presentation to suit.

Their user interface design team should take note of the differing needs of their clients, especially the elderly – who disengage if change disrupts their normal behaviour. Randomly moving a mouse pointer brings up new icons, which may or may not be useful.  What is wrong with showing all the options available?


Who should trust “Trusted Computing”?

Most PC devices can connect to network resources, either on a public (Internet) or private network.  The Trusted Computing Group has developed standards for “Trusted Computing”, which has a specialised meaning.  With “Trusted Computing”, PC behaviour is enforced by standards and technologies that shift the root of trust from software to hardware embedded in the device.  For example, PCs with a TPM (Trusted Platform Module) could have hardware preset by the supplier:

  • to restrict the operating system versions;
  • to restrict software to specific versions;
  • to provide encrypted access to data stores;
  • to measure and report on the integrity of platform, including the BIOS, disk MBR, boot sector, operating system and application software.

In a corporate environment with a private network, it increases confidence in the integrity of the system.  Hardware identification of the end-points increases levels of information assurance is a benefit and could justify the complex processes of TPM deployment.  There is a case for extending the use of TPMs into more mobile devices.  Such reasons have led to mandation for business communications with the US DoD.

However, before anybody thinks of mandating “Trusted Computing” for the general public, let’s look at some of the implications.  Depending on how the standards are deployed, both PCs and mobile devices could lose flexibility, freedoms and privacy.  The superficial attraction of improved security on private networks could constrain the use of public networks and deter innovation.

Many areas of concern are reviewed in Wikipedia:

  • In order to trust anything that is authenticated by or encrypted by a TPM … , one has to trust the company that made that chip, the company that designed the chip, those companies allowed to make software for the chip, and the ability and interest of those companies to not compromise the process;
  • “Trusted Computing” (TC) would have an anti-competitive effect in the IT market;
  • TC can support remote censorship;
  • Software suppliers can make it much harder for to switch to competitors’ products;
  • TC-protected documents may be unreadable by competitive software;
  • Digital rights management technology could prevent users from freely sharing and using potentially copyrighted files without explicit permission;
  • A user who wanted to switch to a competing program might find that it would be impossible for that new program to read old data;
  • With remote attestation, a website could check the Internet browser being used and refuse to display on any browser other than the specified one;
  • The migration section of the TPM specification requires that it be impossible to move certain kinds of files except to a computer with the identical make and model of security chip;
  • Users unable to exercise legal rights, under headings such as fair use, public interest or whistle-blowing;
  • Users vulnerable to vendor withdrawal of service;
  • Users unable to override restrictions even if confirmed to be physically present to allow the computer to use a secure I/O path to another user;
  • Loss of anonymity could have a chilling effect on political free speech, the ability of journalists to use anonymous sources, whistle blowing, political blogging and other areas where the public needs protection from retaliation through anonymity;
  • TPM hardware failure creates the possibility of a user being irrevocably cut-off from access to private information.

The risk is that “Trusted Computing” becomes mandated without a full debate of these concerns before incorporation into government policy.  When you look at the list of financial supporters of “Trusted Computing”, many have a lot to gain from anti-competitive application of the standards.  Arguments for policies and regulations that might curtail current liberties should be balanced against those from less well-financed champions of Open Source, Open Rights, Open Internet and Civil Liberties.  We must avoid the scenario where honest citizens, without TPMs installed in their communications devices, could be locked out of using digital public services.

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