E-health services ill-prepared for epidemics

August 14, 2013 –  Inderscience Publishers – National and international organizations are ill-prepared to exploit e-health systems in the event of the emergence of a major pandemic disease, according to a research paper to be published in the International Journal of Biomedical Engineering and Technology.

Laptop and StethoscopeE-health systems and associated information technology could radically alter the course of a pandemic disease, such as a major outbreak of influenza internationally. It could provide healthcare workers, emergency services, patients and those at-risk with access to much-needed data on how disease is spreading and what measures could be taken to halt its progress. Unfortunately, suggest Junhua Li of the Asia-Pacific Ubiquitous Healthcare Research Centre (APuHC), at The University of New South Wales, Australia, and colleagues, the widespread adoption of e-health represents a significant disruption to current healthcare protocols and systems and stakeholders are not in a position to take full advantage of it.

Emergent infections have spread wildly throughout human history, plague, influenza and more recently SARS and MERS have claimed many lives. With the advent of global air travel, the potential for a previously unknown strain of an animal pathogen to jump the species gap and cause widespread human illness seems to be much greater than it ever was in the days when a round-the-world trip would take many months rather than a day or two.

Conversely, technology has brought us a much greater capacity through modern medicine to treat those infected and to stymie the spread of any given pathogen. Additionally, fast global communications and super computers allow information and data concerning any given disease to be shared and studied in ways that were not possible even a decade ago.

Li and colleagues, Holly Seale, Pradeep Ray, Amina Tariq and Raina MacIntyre, suggest that the adoption of e-health principles could allow healthcare facilities to mitigate against the spread of pandemic influenza, and perhaps other emergent pathogens. They have devised a multi-pronged approach to assessing the preparedness of authorities and organizations to utilize effectively e-health on the basis of specific knowledge, supportive policies, computing and communications facilities and access and adequate funding. Their approach should allow organizations to ascertain what is missing from their e-health systems if they have them and to implement the necessary technology and protocols where they are absent before a pandemic hits.

“Are organizations prepared for e-health implementation to respond to pandemic influenza?” in Int. J. Biomedical Engineering and Technology, 2013, 11, 215-230

Mathematical Models Target Disease with Drugs Chosen by Your DNA

MP900337348HERSHEY, Pa. — Medicines that are personally tailored to your DNA are becoming a reality, thanks to the work of U.S. and Chinese scientists who developed statistical models to predict which drug is best for a specific individual with a specific disease.

“Traditional medicine doesn’t consider mechanistic drug response,” saidRongling Wu, director of the Center for Statistical Genetics and professor of public health sciences within the division of biostatistics and bioinformatics at the Penn State College of Medicine. “We want to look at how an individual person responds to an individual drug by deriving and using sophisticated mathematical models, such as differential equations.”

The current method of prescribing medication now sometimes includes a pharmacogenomic approach, but researchers recognize the limitation of this approach in predicting a response to a particular drug and dosage combination.

Pharmacogenomics uses a person’s genes to explain the difference between how one person responds to a drug compared to another. The team’s equations take this field one step further by also including information about how the body processes a drug and how the drug acts in the body.

Wu focused on the big picture by studying drug response and drug reaction. In particular, the team looked at pharmacokinetics, which influences the concentration of a drug reaching its target, and pharmacodynamics, which determines the drug response. Metabolic, environmental and developmental factors also play a role in medication response.

The researchers created a statistical analysis framework of differential equations that they expect will help doctors and pharmacists, by simulating such variables as protein-protein and protein-DNA interactions a drug has in a patient. The framework characterizes a drug’s absorption, distribution and elimination properties, yielding information on pharmacological targets, physiological pathways and, ultimately, disease systems in patients, resulting in predictions of treatment effectiveness.

“The results from this framework will facilitate the quantitative prediction of the responses of individual subjects as well as the design of optimal drug treatments,” the researchers noted in a recent special issue of Advanced Drug Delivery Reviews.

This framework will expand to shed light on the variability of drug response based on information the medical community continues to gather about how an individual responds to a particular drug and dose combination. The information collected is then combined with information about the patient’s genes, proteins and metabolism to help determine what drug and dose might be best for that person.

“If we know how genes control drug response, we can create a statistical model that shows us what will happen before using the drug,” said Wu, who is also a member of Penn State’s Huck Institutes of the Life Sciences. This means a future with more effective medications, faster healing and fewer side effects. “That is our final goal,” Wu said.

Working with Wu were Yaqun Wang and Ningtao Wang, both graduate students in the Center for Statistical Genetics at Penn State; and JianxinWang, professor, information science, and Zhong Wang, computer scientist, both at the Center for Computational Biology at Beijing Forestry University.

The National Center for Advancing Translational Sciences of the National Institutes of Health supported this research.

Source: Penn State – original article was written by Victoria M. Indivero.

Understanding English medical terminology

Webinar by Alessandra Martelli, April 22nd. 

“The technical language of medicine can sound pretty obscure at a first glance: words like electrocardiography and echocardiography can look pretty alike and might sound confusing.

In medical translation, precision and utmost attention to terminology is a must. This webinar is designed to provide participants with a good grasp on English medical terminology based on the morphology of medical terms – i.e. how medical terms are created.

In an hour, we will go through the most common Latin and Greek roots, prefixes and suffixes used in medical terminology and you will learn how to recognise these elements and use them to decode medical terms effectively and precisely.”

Complete info and registration here.

Picture credits: Photo protected by copyright. License purchased on iStockphoto.com –www.istockphoto.com

Resource Management in Hospitals: Still a Largely Untapped Potential

Logo_conhIT_Berlin9 – 11 April 2011, Berlin, Germany.
For years hospitals have been forced by cost-saving pressures to improve their internal processes to ensure they remain competitive. Not all options have been exploited yet. Multidimensional resource management can not only improve efficiency, but can also benefit the patient. At conhIT 2013 providers and users will be discussing the IT demands on modern hospital resource management as well as the obstacles that still stand in the way of solutions for the entire hospital sector.

A glance at the operating schedules is the easiest way to find out what modern hospital resource management can achieve. “A lot has been accomplished in recent years,” says Angelika Händel of Universitätsklinikum Erlangen. “In many hospitals nowadays, the employees involved can find out at any time about the operating schedule, operation details and when to bring in the next patient.” Even ordering operating materials and work schedules are unimaginable without using IT.

The fact that operating theatres are at the forefront of IT-assisted resource management hardly comes as a surprise: “An empty operating theatre costs several thousand euros every hour. At a time when economically speaking many hospitals are barely viable that is something they do not want to afford,” says Dr. Christoph Seidel, CIO, Klinikum Braunschweig. Together with Angelika Händel, a board member of Deutscher Verband Medizinischer Dokumentare (DVMD), Seidel, who is also director of the Competence Center for the Electronic Signature in Healthcare (CCESigG), will be chairing a Congress session on resource management at conhIT 2013.

Multidimensional resource management maximises benefits
Proper planning of resources has the potential to improve efficiency outside of the operating theatre as well. To date, however, hardly any steps have been taken in this direction. “Generally speaking, one can say that IT-assisted resource management works well in cases in which a hospital information system’s task is to assign a job, for example an X-ray examination.” Extra medical information is then provided for this job and combined with an order for transporting a patient. In many hospitals that is an efficient and automated process.

However, when the necessity arises to organise complex, IT-assisted planning processes many hospitals quickly reach their limits. “As soon as several planning factors have to be considered at the same time, which may also involve different departments, things become difficult. Most IT systems are incapable of handling such a multi-layered approach,” says Händel.

There are many examples that bear this out. At the top of the wishlist of many CIOs is a hospital-wide appointments management system. That would require drawing on data from completely different systems, inconceivable in a normal work situation, especially if the relevant systems are not from the same company. “HL7 represents an excellent communication standard for the hospital sector. What we do not have are cross-sectoral standards for resource management,” says Seidel.

Efficiency is in the patient’s interest too
The industry is aware of these deficits, as Andreas Kassner of the German Association of Healthcare IT Vendors (bvitg) points out: “The complex nature of day-to-day work in hospitals means that in many cases human beings still act as an interface. That is why there is definitely a need for standardisation. Hospitals should enter into a dialogue with manufacturers and offer concrete suggestions for improvements.”

What is clear is that efficient hospital resource management not only saves money but eases nerves as well. “Good resource planning should mean that patients do not have to wait all day for an operation or to stand around for ever in the emergency waiting room,” says Händel. A hospital might not be a car factory. “But with the help of IT and within certain limits it should be feasible to organise what would otherwise be impossible.”

More on this subject at conhIT 2013
On Thursday, 10 April 2013 at conhIT, experts taking part in the Congress Session no. 7 (Resource management) will be holding several lectures on their latest experiences of how hospitals work in practice. Resident practitioners and patients can also benefit from instruments that optimise day-to-day processes, for example online appointments systems. Also on 10 April 2013, the conhIT Forum “Focus on online services – from doctors for patients” will also be examining this topic. Anyone wishing to find out more ahead of conhIT about the products and services relevant to this subject can find the exhibitors in question in the conhIT Virtual Market Place and can already book an appointment at the Industrial Fair.

For further information, please visit:

About conhIT – Connecting Healthcare IT
conhIT targets decision-makers in IT departments, management, in the medical profession, nursing, doctors, doctors’ networks and medical care centres who need to find out about the latest developments in IT and healthcare, meet members of the industry and make use of opportunities for high-level advanced training. As an integrated event, over a period of three days conhIT combines an Industrial Fair, a Congress and Networking Events which are of particular interest to this sector. Launched in 2008 by the German Association of Healthcare IT Vendors (bvitg) as the meeting place for the healthcare IT industry and organised by Messe Berlin, this event recently recorded 270 exhibitors and 5,300 visitors and has now become Europe’s leading event for the healthcare IT sector.

conhIT 2013 is organised in cooperation with the following industry associations: the German Association of Healthcare IT Vendors (bvitg), the German Association for Medical Informatics, Biometry and Epidemiology (GMDS), the German Association of Medical Computer Scientists (BVMI). The National Association of Hospital IT Managers (KH-IT) and the Working Group of Directors of Medical Computing Centres at German University Clinics (ALKRZ) have provided contributions to the subject matter.

Source: conhIT Pressemitteilungen

Speech recognition booms as EHR adoption grows

The market for speech recognition software has been growing tremendously over the past few years, partly because of the spread of electronic health records, KLAS Research analyst Ben Brown told InformationWeek Healthcare.

Brown also noted that some physicians don’t want to document in EHRs by pointing and clicking or typing, so they use speech recognition or some combination of methods. Brown made this observation during a discussion of his report on how healthcare providers perceive the leading speech recognition solutions. In the past, these solutions have cut time and costs for transcription and imaging documentation. Now, the report noted, “the hottest steam” in the market is around EMRs/EHRs.

KLAS’ survey measured the popularity of applications in three categories: speech EMR, front-end speech imaging and back-end speech. Front-end refers to applications that require clinicians to edit the transcribed text after they dictate, while back-end applications are those in which transcriptions or editors fix the text generated by speech recognition.

In the speech EMR category, Nuance Dragon Medical, the only reviewed product, received a relatively high rating. Nuance has the most live clients at this point, with Dolbey a distant second and M*Modal third. “The ability to improve documentation efficiency across thousands of hospitals appears real,” the report said.

Nuance has the broadest technology portfolio of any of the speech recognition vendors, but Dolbey’s front/back-end solution is gaining market share. M*Modal, formerly known as Medquist, is also gaining momentum on the back of the speech engine Medquist garnered when it acquired M*Modal and took its name.

In the area of front-end speech imaging, used for imaging documentation, Afga and Dolbey are improving their performance while Nuance and M*Modal struggle, the report said. It attributes Nuance’s problem to “delayed implementations and poor training.” M*Modal lags because it is using an older SpeechQ engine created by Philips and later acquired by Nuance.

However, M*Modal is picking up momentum in back-end speech with its Fluency for Transcription product, which uses the M*Modal speech engine. The leader in that category is Nuance, followed by Dolbey, M*Modal and 3M.

Overall, Brown said, speech recognition has improved incrementally in recent years. But the real determinant of accuracy is the proper training of applications to recognize users’ voices. “Most people who have the right training and applications tend to see better results,” he noted.

While the survey didn’t ask about natural language processing or computer-assisted coding, the speech recognition vendors are among the leaders in those categories. Nuance recently announced that at the IHE North America Connectathon 2013 event in Chicago, it successfully completed testing for extracting discrete data from paper records and automatically populating appropriate fields in medical documents, using its clinical language understanding solution. And M*Modal has just reached an agreement with 3M to turn transcribed text into structured documentation for purposes of computer-assisted coding (CAC), clinical documentation improvement (CDI), quality metrics and analytics.
[Read more…]

By Ken Terry, InformationWeek Healthcare
News > Speech Recognition Booms as EHR Adoption Grows, 27/02/2013

MSc in Global eHealth: Under Development

06/02/2013 – A new online programme in Global eHealth is currently being developed under the auspices of the Centre for Population Health Sciences (CPHS) and the Global Health Academy. This modular and interdisciplinary programme will allow students to acquire in depth knowledge of eHealth from an international perspective and with reference to issues for global development. Foundational courses will cover key concepts and methods in health informatics, global health challenges, eHealth policies and international health systems. These will be complemented by a programme of interdisciplinary options covering digital health innovations with reference to effectiveness, sociological and cultural aspects of implementation, ethical and governance issues and business processes. While evidence-based eHealth will be a pervasive theme through the programme, completion of the module in Research Methods for eHealth will be a core requirement for progression to the MSc project. The course is expected to appeal to clinicians, eHealth implementation personnel, allied health practitioners, NGOs, eHealth policymakers, innovators and technologists, and academic researchers. All modules will be credit bearing and may be used towards a certificate, diploma or masters qualification, depending on the duration of study (one, two or three years).

The announce reads,”We have set up a short survey and would be delighted to hear from anyone interested in online postgraduate study in Global eHealth. Your feedback will help shape the content and structure of this new programme, and there is an opportunity to leave your contact details so we can keep you up to date on any developments.”

For further information, please visit:

About the Centre for Population Health Sciences
The Centre for Population Health Sciences (CPHS) draws on a long history of public health and general practice at the University of Edinburgh. The Centre brings together researchers with expertise in epidemiology, statistics and modelling, sociology, social policy, psychology, economics, geography, health promotion, nursing and medicine. Thus CPHS research projects can take advantage of a multi-disciplinary approach when needed, which is often the case in population health research. The mission of CPHS encompasses four inter-linked activities.

Source: ehealthserver.com

EMA publishes guidance on preparing and reviewing summaries of product characteristics

logo_ema21/01/2013 – The European Medicines Agency has published guidance for pharmaceutical companies on how to prepare and review summaries of product characteristics (SmPCs) for human medicines. The guidance consists of a set of presentations detailing the information that should be included in each of the sections of the SmPC, together with background information on SmPCs both as a presentation and a video. Two videos explaining how to complete the SmPC sections on the therapeutic indication and pharmacodynamic properties of a medicine and on undesirable effects are also available.

The guidance, prepared by the Agency’s SmPC Advisory Group, outlines the principles in the European Commission’s guideline on SmPC. It is intended to enable companies to make sure that the information in SmPCs is of high quality when they submit them to the Agency as part of applications for new marketing authorisations or updates to existing marketing authorisations.

The background presentation and video also aim to raise awareness of the information provided in SmPCs among healthcare professionals.

SmPCs are a key part of the marketing authorisation of all medicines authorised in the European Union and the basis of information for healthcare professionals on how to use a medicine safely and effectively. They are kept updated throughout the lifecycle of a medicine as new efficacy or safety data emerge.

SmPCs are also the basis for the preparation of package leaflets, so are important documents in enabling information on medicines to reach patients.

Source: EMA News