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Cloud Medicine IT

Healthcare IT's Achilles' Heel: Sensors 84

Nerval's Lobster writes "Tech publications and pundits alike have crowed about the benefits we're soon to collectively reap from healthcare analytics. In theory, sensors attached to our bodies (and appliances such as the fridge) will send a stream of health-related data — everything from calorie and footstep counts to blood pressure and sleep activity — to the cloud, which will analyze it for insight; doctors and other healthcare professionals will use that data to tailor treatments or advise changes in behavior and diet. But the sensors still leave a lot to be desired: 'smart bracelets' such as Nike's FuelBand and FitBit can prove poor judges of physical activity, and FitBit's associated app still requires you to manually input records of daily food intake (the FuelBand is also a poor judge of lower-body activity, such as running). FDA-approved ingestible sensors are still being researched, and it'd be hard to convince most people that swallowing one is in their best interests. Despite the hype about data's ability to improve peoples' health, we could be a long way from any sort of meaningful consumer technology that truly makes that happen."
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Healthcare IT's Achilles' Heel: Sensors

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  • I thought the achilles heel of healthcare IT was the dumbass doctors and nurses who put passwords to everything on sticky notes attached to the monitors?

    • And it's not like the supposedly HIPAA-obscured records hospitals keep aren't enough to identify a patient. However, IT security in the field of technology is beyond the scope of the article, no?
    • by PPH ( 736903 )

      Wait!? That was a password?

      The pharmacy figured that scribble was a prescription and they've been having me stuff strange suppositories up my ass for weeks.

      • "The pharmacy figured that scribble was a prescription and they've been having me stuff strange suppositories up my ass for weeks."

        Calm down. You aren't getting the wrong medicine. That wasn't the pharmacy's mistake, that was the NSA.

      • by bmk67 ( 971394 )

        Wait!? That was a password?

        The pharmacy figured that scribble was a prescription and they've been having me stuff strange suppositories up my ass for weeks.

        I hate to break it to you, but those aren't suppositories. Around here, we call them "crutches".

    • Healthcare IT's actual problem is audit and compliance, oversight and regulation and how it slows adoption of useful technologies.

      HIPAA, SOX, PCI compliance for payments, JCAHO audits, internal audits, external audits, record retention laws, the list goes on and on.

      • "Healthcare IT's actual problem is audit and compliance, oversight and regulation and how it slows adoption of useful technologies.

        HIPAA, SOX, PCI compliance for payments, JCAHO audits, internal audits, external audits, record retention laws, the list goes on and on."

        Aaaaaaannnnddd... that leads us into the other big question. Let's say hypothetically the sensors were all working fine. So, then...

        Who gets the data?

        • The same systems that already get your data, where it has to conform to a pile of other regulations -- some silly, some sensible.

          The the external monitors people get sent home with now...

          Some data will be kept.
          Some data will be discarded.
          The kept data will be part of the ever increasing nightmare of healthcare IT data policies.

          • "The same systems that already get your data, where it has to conform to a pile of other regulations -- some silly, some sensible."

            No, you missed my point.

            Say your "sensors" work through a smartphone app. Who is to say the data doesn't get sent to third parties, the way your current smartphone sensor data often does?

            • by Eskarel ( 565631 )

              I hate to break it to you, but your health care data isn't anywhere near as private as you think it is.

              That's not to say that it's being shared improperly or that it's particularly insecure, merely the fact that the number of people who have perfectly legitimate access to your health care information. We all treat health information like it's some sort of deep dark secret, but all the legislation is quite sensibly based around allowing medical professionals to actually do their jobs. Then of course the peop

              • Yes, but these new home sensors generate jnew/more healthcare data, sent to an app on your smart phone, that you may not want your health insurance provider to know about. For example, you are a diabetic, you let your blood sugar get too high. You are not in compliance. If your health insurance provider knows, will they charge you extra premiums for not keeping your blood sugar in the proper range? Once the data is generated, the insurer will demand a copy of it. Read The Circle by Dave Eggers.
              • "I hate to break it to you, but your health care data isn't anywhere near as private as you think it is."

                You didn't tell me anything I didn't already know, and that's still not the point.

                Regardless of whether there is a reality of "privacy" or not (and there is supposed to be), my POINT was that if this runs through something like a smartphone, and things don't change soon, then you'll soon have even LESS privacy than you already have.

                I am aware that medical privacy has not lived up to expectations. But there ARE still regulations, and there ARE still expectations.

                And I don't agree with you about "leg

                • by Eskarel ( 565631 )

                  The point is that health information needs to be available to the people who actually need it. In every jurisdiction I have ever worked in your privacy comes second to the doctor, the nurse, catering staff's ability to not kill you. In most places you'll actually have a consent form which will allow them to share this information with additional third parties, but the number of people they don't need that consent for is actually fairly high.

                  For one, obviously your health insurance company also needs all you

                  • That was YOUR point. My point was something else entirely. You are attempting to have a discussion about a different subject than what was being discussed.
                    • by Eskarel ( 565631 )

                      I'm attempting to make a point about the privacy of medical information and the way most people don't really understand it. Your point about your telco spying on you isn't really all that interesting so there wasn't much to say about it. They can already collect the information from the existing sensors if for some reason they wanted to whether you installed a medical app or not and unless the medical app was deliberately sharing with your Telco relatively trivial security mechanisms would stop them from ge

        • Insurance, which uses the information to determine that you are violating your health care policy. That it wasn't an accident that your leg is broken and you have a concussion, but that it was because you were stupidly going 50 mph down the side of a mountain on a gravel road when your tire blew and you hit a tree, therefore you aren't covered. Will that be cash, charge, or will you be remortgaging your home today?

      • by jon3k ( 691256 )
        Someone mod this man up, please.

        I'd like to add in RAC audits, Federal Oversight Surveys, anything the OIG has ever done and why not CMS while we're at it.
        • Also, I hope you don't have a hospital in California, because if you do, your new technology is going to require us waiting for the new building to be built - because any construction-related infrastructure improvement (to, say, fit in the new full-body scanner) would require earthquake retrofitting the entire building, which is out of the question.

      • As I put it to a friend recently, I am a practicing physician. I can think of several multibillion-dollar ideas in health care - but I don't see how you can implement them without several hundred million dollars worth of investment and about a decade of lead time, at which point the ROI isn't so spectactular.
      • Now that we have Obamacare, why can't HIPAA be crumpled up and tossed?

        The whole point of HIPAA was to keep your health info secret from insurance companies, so that they wouldn't deny you coverage or overcharge you for being a sick person. Of course, that was a stupid idea- insurers don't care about the juicy details of why you're sick. They only care about which policyholders are costing money. You obviously can't keep your insurer from finding out about the claims payments they're making on your behalf. A

      • Healthcare IT's actual problem is audit and compliance, oversight and regulation and how it slows adoption of useful technologies.

        Exactly - in the biotech field I've heard it referred to as the 17-year problem, because that's the amount of time it can take to get FDA approval for any new tech.

        Try to get people to fund or work on your product when it can take up to 20 years to start getting a return on your investment.

  • by 140Mandak262Jamuna ( 970587 ) on Tuesday December 17, 2013 @06:12PM (#45720109) Journal
    They should have gone with a proven technology shown in this early patent application: http://xkcd.com/644/ [xkcd.com]

    Instead they went for bluetooth and the damn thing says "enter 0000 in the device" and the damned device is buried 3 cm under the subcutaneous layer of the Gluteus maximus. How am I going to do that?

  • data mongering (Score:2, Interesting)

    by Anonymous Coward

    And somewhere an NSA analyst is beating himself frantically thinking about the data collected when insurance companies require* everyone to wear one of these.
    *With drastically reduced deductibles!

  • I disagree with the notion that "it'd be hard to convince people" to ingest medical sensors. Perhaps blood-based sensors would fall prey to that kind of thinking, but those aren't quite possible as of yet. Although a certain number of so-called skeptics will be eager to outline the GPS-tracking possibilities with this kind of technology (which, amusingly enough, could be thwarted by wearing foil), implanted and ingested sensors fill some of the main voids in medical security, namely the current failure to t
    • by Fwipp ( 1473271 )

      Simplifying communication with your doctor is cool and all, but I'm more worried about the sensor failing with an "All systems nominal" reading. Some doctors are already too prone to believing your problem is imaginary - without a faulty device telling them that you're fine.

      I don't mean to suggest that internal medical sensors are inherently a bad idea; I just think we need to be careful to not let our medicine get too reliant on them.

      • The average person has no idea how many people come in with vague pain complaints that are clearly psychiatric in origin. They are legion.

        That doesn't mean that the pain isn't perceived as real - I have no doubt that people with fibromyalgia hurt. But the pain is inside their brain, not in their muscles or guts. Opioid pain medications are a terrible choice.
      • As is the case with most technological advancement, it will benefit the vast majority of cases while being detrimental to a vast minority of cases. If anything, false positives will be a bigger issue than false negatives, as is the case with most sensor systems (such as in security). More important is that implantable sensors don't do anything other than replacing non-implantable sensors. You can have a series of sensors monitor your body temperature, which might have very important implications in early-wa
    • higher muscle mass tends to put them in the overweight category by BMI

      BMI also does not account for body frame size

      • I entirely agree that BMI is a flawed system. It doesn't pretend to be an absolutely foolproof statistic, either. Body fat percentage is more indicative of overall health, of course, but the main issue with using body fat by ratio is that it's much harder to measure accurately. And that's a recurring theme within medicine, especially the types of medicine that focus on improving the overall health of the patient, rather than simply finding a problem to solve. It's a problem that implanted and ingested senso
  • by Anonymous Coward

    If you need the "cloud" to tell you to step away from that bag of chips, you have issues that technology (short of unpleasant stuff like wiring your mouth shut) can't solve.

  • by Anonymous Coward

    The only place they belong is in my colon.

  • ... they'll be wiring a plethysmograph to sex offenders' GPS ankle bracelets.

    • I'm sure there's an amusing joke here, I'm just missing it. What does their respiration rate have to do with anything?
  • by Stormy Dragon ( 800799 ) on Tuesday December 17, 2013 @06:27PM (#45720317)

    In theory, sensors attached to our bodies (and appliances such as the fridge) will send a stream of health-related data — everything from calorie and footstep counts to blood pressure and sleep activity — to the cloud, which will analyze it for insight; doctors and other healthcare professionals will use that data to tailor treatments or advise changes in behavior and diet.

    Yeah, because I find that what I'm really lacking in my life is having a insurance executive following me around every minute of the day nagging me about everything I do.

  • by Anonymous Coward

    I can't even trust the government not to snoop on my browser history, and you want me to hand a third party a complete record of my day from the inside out?

  • Tell a triathlete (or any athlete) that they can get data that can help them perfect their diet or training and they'll try this in a heartbeat.
  • Can't wait for Clippy 2.0 and all his sensors.

    I see you're smoking. Your health insurance has been revoked automatically.
    I see you haven't shat in 2 days. I've ordered an enema from Amazon and emailed your office to let them know you'll be out Monday.
    I see you're trying to masturbate. Microsoft Bob will read you 50 Shades of Grey to help maintain engorgement of your genitalia.

  • Wrong Context (Score:5, Interesting)

    by dave562 ( 969951 ) on Tuesday December 17, 2013 @06:49PM (#45720521) Journal

    I think the author is looking at "Healthcare IT" through the wrong lens. The major advances over the next decade are going to come via "big data" (mind the buzzword) and analytics. For example, I was at an EMC presentation the other day and they were making the case for Greenplum (EMC'ized Hadoop / Map Reduce). One of the breakthroughs they were touting was cancer research. There was a woman who went through half a dozen cancer treatments that did not improve her condition. They were able to run models and simulations and ended up finding an off label drug that put the cancer into remission.

    Prior to being able to simulate those complex drug interactions, they never would have been able to test an off label drug like that. Now the potential exists to research all sorts of combinations and treatments that would have been computationally impossible five years ago.

    Somewhat less cool is the ability to use analytics to track treatment and billing data. The health care system is so inefficient that there is a lot of low hanging fruit there. It only starts showing up at larger scales, once the data sets get bigger. For example, hospitals cannot really correlate the effectiveness of specific treatments for specific conditions versus their peers at other hospitals. Yet with a big enough data set, statements along the lines of, "Last year, 50,000 people were treated for condition X by 50 different hospitals. Of those 50 hospitals, there were 16 different methodologies used. Of those 16, THIS 1 treatment was the most effective, based on these subsequent observations..."

    Take a simple use case... the over prescription of antibiotics. With a decent data warehouse and some analytical tools, it will be possible to quickly zero in on cases where antibiotics were inappropriate prescribed. The same thing goes for everything else. "We noticed you are prescribing the brand name medication, when this generic drug is available, and 85% of your peer organizations are using the generic without any loss of efficiency in treatment."

    As much as people dislike the government and feel that the Affordable Care Act is a mixed bag, I have a suspicion that when the government gets into really pinching pennies, they are going to drive down the cost of healthcare.

    • by Anonymous Coward

      Because the government has been so successful at driving down costs in all it's other agencies?

      Call me skeptical.

      • by dave562 ( 969951 )

        While I am skeptical, I also see the potential for improvement. There is already a lot of M&A activity in the health care space due to shrinking margins and the inability of hospitals and physicians groups to provide services at prices the market can afford. With a single payer like the government getting involved, costs are going to continue going down. Big data and analytics are going to stabilize some of the price fluctuations for procedures. Currently the payout for any given procedure can fluct

  • by Jah-Wren Ryel ( 80510 ) on Tuesday December 17, 2013 @06:54PM (#45720595)

    In theory, sensors attached to our bodies (and appliances such as the fridge) will send a stream of health-related data -- everything from calorie and footstep counts to blood pressure and sleep activity -- to the cloud

    No fucking way. My sensors will send my data to my computer in my house where no one else has access to it. Any automated analysis will be done on my computer where I control who can see the results. Any other design is nothing more than putting the band-wagon ahead of patients' interests.

  • So the poor Sensors can be used to black list people

  • 'Despite the hype about data's ability to improve peoples' health.'

    Healthiness, here's how:

    Eat real food (mostly vegetables and meat/dairy. Not too much grain. Not too much in all).

    Get plenty on outdoor activity.

    Drink moderate amounts of alcoholic beverages (about 1.5 - 2 times the "recommended levels").

    Don't smoke.

    Have an engaging and intellectually challenging hobby.

    Brush your teeth.

    Do fun things.

  • Poor eating habits & inadequate exercise are the problem. But heaven forbid people are responsible for their own actions.

  • Eventually insurance companies will make use of these sensors required in order for you to purchase their policies (or at least not pay exorbitant rates), and of course they'll penalize you if the sensors detect you living an unhealthy lifestyle, not following your doctor's instructions, and so on. And now that we have compulsory insurance in this "free country," there'll be no escaping being surveilled and coerced like this.

    Aren't you glad you supported Obamacare? Say goodbye to yet more of your freedom.

    • My wife's insurance now requires her to do a drug, tobacco, alcohol (you would be surprised how many have a trace in the morning) , body mass, and health assessment to keep he insurance. Then rates are adjusted accordingly. Worse she works for a large hospital and they are starting to test patients for those same things to get "advanced" treatments. And the people on state insurance are getting told no for a lot of treatments that are too costly, Remicade ain't cheap.
  • A coworker had to wear an activity bracelet for a few days for a health assessment. He put it on his ankle and tapped his foot or bounced his ankle most of the time. The results showed his 5 foot 11 inch (1.8m) and 285 (129kg) Eric Cartman frame was walking/running +7 miles (11km) per day.
  • Perhaps if they put a sensor on the heel they would be able to detect this problem.

  • Our society itself is sick. The problem is, thus far, not worded, but is trying to be masked with technology. Our bodies are evolved from billions of years of Nature's advancements with it's own set of bio-logic. Until we learn to utilize that bio-logic for the good of all, we are simply bullshitting ourselves into thinking that we're innocent, and have no wrong-doings in our diet, physical habits, or our thought habits.
  • "Tech publications and pundits alike have crowed about the benefits we're soon to collectively reap from healthcare analytics. In theory,sensors attached to our bodies (and appliances such as the fridge) will send a stream of health-related data
    — everything from calorie and footstep counts to blood pressure and sleep activity — to the cloud, which will analyze it for insight; doctors and other healthcare professionals will use that data to tailor treatments or advise changes in behavior and die

  • According to my Nike Fuel Band, I just masturbated two miles.

The explanation requiring the fewest assumptions is the most likely to be correct. -- William of Occam

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