Healthcare and IT

First it was the office, then banking/finance and now the healthcare space is the next domain to be revolutionized by information technology. Almost 15% of US GDP is spent on healthcare expenditure, so the market opportunity is enormous for the solutions that would save the costs in this field. Information Technolgy application in healthcare has been in the form of cutting edge computer graphics/visualization solutions for medical imaging. There are specialized software for effective visualization of the data gathered e.g. 3D reconstruction of organs from Xray/CT/MRI scans. But data management in healthcare has been a forgotten child. Also with the advent of Web 2.0, mobile and ubiquitous computing paradigms, we need to think of innovative approaches to improve healthcare IT. Below are some of the applications I have thought of :

-RFID for hospital asset management and location tracking. RFID is the new wave in asset tracking. They are being used right from theft prevention in Barnes and Nobles to inventory management in Walmart. RFIDs in a hospital can be a powerful technology. They can be used to track the equipment right from the time it arrives in the hospital. They can also be used for sensing the location of machines etc in real time. Imagine a controller's console which gives an interactive map of every floor/room of the hospital and lists the items that are in there. Another application is to account for all the Biohazardous waste or tracking the objects in an OR. So the next time there is an intelligent system to point out that there is a gauze piece missing. This system again can be linked to the hospital's real time order management system. So for example all the equipment and medicines/food needed can be ordered just days in advance for the surgeries scheduled and hospital wastage can be reduced.
Patients tagged with RFID bracelets can be used to track them through various treatment workflows and standard workflow improvement techniques like parallelization/pipelining can be used to increase efficiency for reducing patient wait time and increasing personnel/equipment utilization.

-Hospital planning : Right now in most of the ER rooms there are whiteboards detailing the doctors on call. All this can be easily automated by provided large screen interactive information screens (like Microsoft Surface) which update the status of the doctors in real time based on location sensing , lets say of the doctors' PDAs.

-Information Integration : As has already been done in the Azyxxi system all the patient information can be integrated for a unified view of the patient data including MRI scans , Xrays etc captured directly at source and associated with the paient ID sensed automatically lets say the RFID bracelet . Thus the information on a patient can be made available in real time. Visualization of this integrated information is a possibility , an example being all the prescriptions given to the patient depicted on a timeline or a slideshow to gauge a fracture's healing progress.

Integration of the data at the hospital or the hospital system level is another possibility. Innovative dashboards coupled with BI data processing , can be constructed to give a high level view of the different activities in the hospital. Consider an app through which the planners can see in real time all the financial, operational parameters like ER admissions and perform better capacity planning. They can drill down in different dimensions of the data and see what kind of specialists are more in demand, what procedures are more frequent and what equipment is most used.

-Patient Data availability : The patient data can be stored in a central repository which is accessed from a web portal like the MS healthVault. In health data privacy has been a major concern, so the data can actually be encrypted and stored locally with the patient, in lets say USB drives or the patients can opt in for the data to be stored within the portal. The idea of a persistent storage with the patient is compulsive because the storage itself can have the encryption keys in it to access the public data. This way the patients would not have to fill in the information forms everytime they go to a new provider. The thumb drive can plug in to any windows computer running "doctor's version of Windows" and the data accessed/updated replicating it with the encrypted public vault too. Imagine wearing a thumb drive which can act as a life saviour by providing all the vital medical data (drug allergies etc.) in an ER.

-Web 2.0 : Web 2.0 has enabled easy collaboration betweeen people using intutive interfaces. Also it has demonstrated the power of crowdsourcing. Web 2.0 apps again have not targeted the health domain barring a couple of companies like zocdoc, InSTEDD and a handful of other health oriented social networks. There is a great need for a portal with different dimensions of health mapped in the mashups. For example track my IP location and show me all the doctors in my area for psychological disorders. Then enable me to set-up an appointment and remind me automatically on my smartphone on the specified date. Also the doctors can share the research and can be effective in detecting pandemic based on the sysmptoms observed by doctors in areas where the outbreak has actually happened. Consider a doctor in China who has dealt with patients suffering from H5N1 and he can share his findings with the doctors in US through this social network.
Also the plain old social networks of patients are invaluable in detection of community problems. Imagine a social network of patients with elaborate dashboards. You can input any symptom and it gives you details of what can be the causes. So if someone enters the symptom "tingling sensation in fingers" the portal shows the dashboard stats based on the other users who have reported the same symptom. So it shows 90% of the people have tunnel carpal who reported this sysmptom, 5 % have MS and so on. You can input demographics like age and the system spits out more precise/focussed information. This system would calm down the hypochondriacs and give early warning signs to at-risk individuals.


-Crowd sourcing : can be used for early diagnosis of diseases. As the healthcare costs rise, a collaborative framework can be built which uses the doctors (available at lower than US rates) in countries like India and China for early detection of diseases. They get paid for each positive identification they refer to a provider (and maybe penalized for a false positive). This network can also be used for time sensitive tasks like detection of tumors in xrays/CT scans. The doctors can opt in to for consultation or medical students can even be trained on such a collaborative set-up. Imagine an ebay for medicine. It might sound unethical but it is just discussed as a possibility. After all we hoped to find Jim Gray by such a collaborative approach.

Also digitization of legacy health records has been a big problem. Again crowdsourcing can be used for this purpose by using workers in low cost countries for digitizing the data. Benefits of this digitization can be demonstrated to the insurance providers to foot the bill for such an effort.

A rather benign scenario is having your own personal trainer sitting in a remote part of the world. You come in and sync your workout data (collected from a device like nike pod) over the web and he gives you food and exercise advisories.


It is estimated that post-hospitalization neglect costs around $10B in healthcare costs. These stem from missed medication to poor monitoring. The monitoring aspect can be solved by having remote patient monitoring personnel (akin to a healthcare call center) who monitor the vitals over web enabled, bluetoothed devices and can also give reminder calls for medications, doctor visits, perscription fills etc. Such a network coupled with intelligent devices can be effective in geriatric care too.

-Convergence : all the information sources need to be unified and given the technologies available today it can be easily done. e.g. a prescription can be pushed into a smartphone in the form of SMS alerts for drug time reminders. This data can also be relayed to a MSN-Direct enabled watch worn by the patients. Also bluetooth interfaces can be built into BP/Glucose monitors which automatically communicate the vital data to the Portal and onto the doctor if anomalies are detected. Inside the hospitals the different machines can all feed the data onto a single visual monitor like Microsoft Surface, which will contain an intutive interface for the doctors and nurses on rounds to check the vitals, history etc.

The API

So these days we see everyone exposing their API. Faceboook made it the most popular because you could suddenly get the exposure to users, you craved for, as a software developer. Even Stanford gave a course on how to build facebook apps. Then came Opensocial, Digg API and Google social graph API. I even regard Android as an API. So what is the big deal about exposing the API. Isn't that what we software developers have been doing for ages. Its the API whose help documentation fills up the piles in MSDN. Windows exposed various API in the form of COM objects, system calls etc. Apparently the API was only exposed by "Platforms". Windows, Linux kernel, QuarkXpress, Adobe Acrobat, MS Office, Internet Explorer are some API exposing platforms from the past. The whole idea was to make the platforms more usable and let developers extend the functionality by coming up with innovative uses. It is a way to tap into a mindshare of highly intelligent people - the developers and use them for promoting your platform. I remember the Quark developers had developed some pretty ingenious solutions for some problems in the platform. But there is an ethical downside in this model. When the developers make new apps, the platform owners get to see what apps are being built and nothing stops them from making those apps themselves. In traditional software loaded on the PC (windows , IE etc) the apps used to sit locally and so the app owner never knew what was popular unless explicitly communicated. In web world all the apps come/connect to the single web platform and so the owners know exactly what app is getting attention and that what is a more compelling use they never thought of. This was the case with the facebook API because the some of the most popular third party apps were later duplicated by facebook itself or (to be politically correct) their functionality was incorporated into the platform itself. Google's Android is an interesting experiment because in my view its like scratching and sniffing before buying. If there are compelling apps it makes sense to release the full blown platform on the real phones. The next frontier - tap into a bigger mindshare - build tools so intutive that the normal users can create the apps easily. Imagine a VB like drag and drop interface with which you could build a facebook app in minutes.

New Media Dilemma

It seems everyone these days is talking about new Media. So what is it ? Well there is a definition on wikipedia : New Media . New media has especially been made prevalent after the spread of Web 2.0. Traditionally people had their main recreation source as the TV. So whatever time they had, was spent in watching TV; but online video is changing the rules. A quote from BBC : "Some 43% of Britons who watch video from the internet or on a mobile device at least once a week said they watched less normal TV as a result.". This means that people are looking at things other than the TV too. This fact poses a big dilemma for the major media corporations because their viewership is not only going down but the time an average user can be bombarded with ads is going down too. Thats why Google stock is up because of Google being the leader in the online ad space especially on a site like youtube which has a high viewership and is owned by Google itself. Consequently, a major strategy shift is needed for the old media (TV, newspaper etc) corporations to compete with this new found love of the users.

New media will be a disruptive force when all that the users want, on the TV, can be seen through the web. Microsoft has taken some positive steps in this direction by launching Silverlight which supports HD Video as compared to a Adobe's flash standard. This has some powerful implications. Imagine your TV (lets say connected to a media center PC) can show videos on demand from various sites like CNBC, Fox, Discovery etc. The convenience of a web like searching and taxonomy combined with a TV like quality can be a disruptive solution.

Then there are the extreme applications of new media apps like plugging directly into the 3d virtual worlds. Imagine your boring social network browsing to be an interactive 3d browsing where you can visit friends' houses , call ad-hoc parties, chat with them in real time and more. So if I feel like I want to see my high school buddy, I can visit his virtual world house and if he is available, call a small ad-hoc reunion by messaging other high school friends who are on the instant messenger. Then maybe record the party and send it as an online video to other friends ( as a video podcast to people subscribing highschool XYZ parties) so they attend the party next time. The RIA (Rich Internet apps) platforms like silverlight and flash can enable us to do these things. With the availability of gaming engines like Xbox and PS3 in every home we can easily make 3d virtual interaction a possibility and fun experience. Imagine being able to navigate second life through an Xbox360 like an MMORPG.

So in short new media enables much more interactivity than the old media. But that does not mean old media is obsolete. The professional production quality techniques of the old media can be applied to new media increasingly for enhancing the quality and overall experience. People would still want to read a news paper made up of fresh content tailored to their tastes.
New media taps into the creative of the masses , because of which, its more interesting than the old media tailored by an elite few. Also new media allows personalization which feeds people only the information that is most interesting to them. After all TiVo showed us how good personalization can work. Buckle-up for your morning newspaper which contains a mixed subset of wall street journal, new york times and the local newspaper but only containing stuff that you like. Or your personal magazine with snippets from fortune, popular mechanics and wired. Now that is on-demand.....