Ideas

Hi,

This sounds like very interesting and ambitious project for you to take on.

The concept is something I am very familiar with since, around 20 years ago I partly funded the development of a software package for two hospitals one in Toronto, one in new York . These Hospitals are both world leaders in the treatment and clinical research of Crohn's and inflammatory bowel Disease.

The software package did pretty much everything you describe above.

Your project is much more ambitious, since you want a similar but more advanced product which does clinical research on all diseases, however it is now 20 years later on, so why not.

If you are doing this as a real project, please feel free to contact me.

Good Luck.

good idea!

BIG is the right word

I guess even withou web2.0 this is doable as customized interactive portal or data system for any hospital. My concern is on security and privacy of the datas.

@ vizminda:

Thank you so much for you comment on this idea. Indeed, security and privacy of any data is very important. Just as in paper medical records and even visitors coming in and out of the wards who may chance to see patients awaiting tests in the hallways or in transport, privacy (and dignity of the patient) is absolutely essential. I thank you for pointing out that important factor and for contributing =)

Having worked in various hospital systems in both suburban and urban settings, when one comes into the service of medical care, patient privacy in regards to HIPAA laws are to be taken very seriously. Making data encrypted while being transmitted by a server or to storage, or safeguarding computer monitor with physical visibility shields or passwords/firewalls and network monitoring are a few options that can contribute to this dedication to accountability for the patient. There is no exception to taking extra measures--digital data should be treated with even greater concern for ensuring security and privacy. By this, rapport is established and many are protected.

What kind of help would you like from the CH community?

@ zentropy:

Ah goodness, you'll have to pardon me for my lack of clarity =)

(1) When it comes down to what products/technologies are available on the market, if anyone does possess knowledge of similar concepts or research in improving quality of health care and safety or medical performance, please point me there so I can gather some more research to refine the concept.

(2) IT, software design & development, and database administration help/advice! I'm afraid that I'm not much of a guru when it comes down to crunching algorithms or code. A detailed glimpse into current network/server security and protection options or approaches would be appreciated as well.

(3) Any medical administration insight or knowledge on hospital policy, protocol or infrastructure would be much appreciated.

I'm checking up with some good doctor friends of mines from various local hospitals and specialities to conduct a bit more market and R&D research. If you've got any pointers for me, feel free to speak up.

Thanks!

On a side note, a crowd-sourced question:

What technologies or products/services would you like to see researched/developed and implemented into the the current health care systems?

If a story would help illustrate a frustration, observation, or something that needs improvement in our hospitals/private practice/or clinics, please feel free to post.

I'm extremely curious about what people have to say about modern health care in terms of quality and improvement. How to make medical care better?

PS: And by all means, non-USA health care stories welcomed as well! I've got a good number of physican classmates in my international health studies who want to look at solutions for other countries as they study/teach/provide medical care abroad.

Its a great idea i have to say, however i'm not to sure whether you can actually implement the idea without it costing millions.

> (1) When it comes down to what products/technologies are available on the market

Your main potential added value (service) is not related to computer security and I can not see any potential need specific to your project upon this matter (I'm an IT security professional, had been for years, and happen to superficially know a couple of medical information systems). You will need standard software components (you named a few of them) protecting the main application, in a setup devised and built by developers and consultants. Not easy, but no big deal and if you are not proficient in all those matters please let the pro tackle this and don't waste your precious time with that.

The core of the envisioned application is directly related to optimization, or, with a more 'applied' way to put it, to "operations research". Your application will allocate resources (beds, machine, nurse time, whatever) in order to satisfy constraints (time, resource availability and cost ...). Most underlying mathematical problems (definitively not easy ones!) are solved by 'implemented' algorithms (programs!) in ways sometimes weird from a theoretical standpoint, but practical and 'sufficiently efficient' when run on the average computer. Bottomline: if you don't know about all this stuff please refrain also from trying to tackle this by yourself, or even with a team, if you don't want to throw huge amounts of time/money away for more-or-less purely theoretical research. You will have to build your application on an existing set of software (often called a 'library'). A bunch of them exist, some proprietary and some free, some generic and others very specific, available for various programming languages... and so on. A well-known one is http://www.ilog.com/...ion/tech/concert.cfm and you may be interested in http://www.ilog.com/...HomertonHospital.pdf and its more technical version http://www.ilog.com/...h/custpapers/nec.pdf (disclaimer: I know people working for this company)

Your real added value will, in my opinion, mainly proceed from your ability to obtain a good knowledge of your prospects culture and needs. By 'culture' I mean objectives, language (terminology: knowing the sense of every word used by the prospects is of paramount importance for grasping their reality), habits, constraints... You have to cover this for all aspects, for example even legal (pertinent ones may differ between states, and surely will between nations) and technical (if some parts of your application has to drive some hardware...). In other terms "let's assemble as many existing code (programs) as possible, then add some specific, in order to obtain a software which will be flexible, easy to use and robust". Basically you have That's what the developers of those CareWare and ProAINUS applications did. Analyze all existing pertinent software packages.

Another challenge is to build then manage the adequate team, where at least a member is proficient in operations research (maybe even on non-linear programming, I don't know at this stage, exploring the needs will lead to conclusions) and somewhat in programming (go to your math dept, ask for people doing operations research and programming), a pure developer interested in operations research (or at least somewhat knowledgeable on the underlying maths), and a person with a real good knowledge of the IT used by your prospect (the bet pick may be a health pro liking IT and who already did, and liked, some software development). Your duty will be to find and mobilize them. Software development, which is the goal, is their common culture, enabling you to refrain tweaking the bits and bytes as long as they reasonably agree upon the corresponding choices and deliver, in order to focus on your real input at this level: prospects needs, abilities, tastes, habits... therefore what the software has to do and how.

> I'm checking up with some good doctor friends of mines from various local hospitals and specialities to conduct a bit more market and R&D research

That's a key. Beware: you have to collect their needs, then to really think hard because one of your most important added value is the ability to go beyond what they say, to discover what they really think and, even better, what they really need, without being able to think of it, because they are 'captives' into their own habits. For example think of a guy only knowing unicycles and doing long trips. You ask him about what he needs and he replies "some pole, I will hold it to get a better balance and to rest, it will be suboptimal because I will then only have one hand free, but better". You can provide the darn pole (good) or invent something (a bicycle? a motorthe bike? maybe a train?)

As Tommy (vanhees) pointed out, a BIG project. I think another thing you have going is the potential to leverage your relationships with your medical friends/colleagues/associates. We have been trying to work with some hospitals here in Canada and it is really quite a nightmare. There are so many issues with budgets and interactions with other departments (i.e. politics).

Every meeting I have been to at one particular hospital required about 10 to 12 hospital staff from various departments. Granted, they were trying to leverage the system purchase over TWO different departments, I couldn't imagine if we tried to implement a hospital wide system.

I suspect your efforts are best spent coordinating the resources required, as noted by natmaka. Listen to your users and deliver the system that doesn't completely change their workflow, but ENHANCES it to take advantage of the system's efficiencies.

how about partner with WebMD and get diagnosed BEFORE you waste the trip to emergency room-

also isn't big problem with emergency rooms the clientele may not understand the system?

There are now clothing and textile products that monitor physiological parameters such as:

HR, pulse pressure, respiration volume and frequency, temperature, EMG, head or body acceleration, posture, pressure

I read about one that monitored up to 125 military infantry, simultaneously, and wirelessly transmitted over hundreds of meters. This type of technology could serve in some parts of the project(s) you describe.

This is a good idea, and since you are "in the industry" and regularly seeing opportunities improve the system, you are in a great position to develop this idea. Consider the breadth of feedback you recieve. The idea might grow too big to tackle, so be ready to identify and focus on a small aspect that can be developed successfully.

@ tlyden

Thanks for the comment! That's a really interesting suggestion. How do you propose that the two combine to make that an effective service/product? Yes, pairing with a web portal would be new, but I know that a lot of times, patients come into ERs or hospitals already having had some idea of what they might have and all of the implications for it on sites like WebMD and so they only come when their self-diagnosis is something they feel is serious. Are you talking on terms of tele-medicine?

@ Summertime

Excellent input! You've definitely provided an interesting possibility. I've heard a bit about these new technologies and what you've mentioned could have a lot of applications in civilian health care, though I imagine it might be an expensive undertaking. A friend of mines works in tele-med for the military and mentioned that this is quite a robust product/service though and so it wouldn't be surprising if consumer targeted ones follow. Thanks for bringing this to my attention!

MAh,

Thanks for clarifying and answering my comment.

Goodluck!

There are other applications already pending for physiological tracking garments: firefighters and team-sport athletes for example. But, regarding tracking dangerous body temperature fluctuations in threatening environments (firefighting, sport training in hot climates, high altitude sporting), I think the thermometer pill is preferred (See the Nova show "Deadly Ascent" for the application on Denali).

I was a hospital clinical director in a past incarnation...

I like it...If you get the JCAHO to sign off...

I don't see HIPPA issues as long as the date has access restrictions that comply...

Training old dogs to do new tricks will be a challenge...And in-house cross-over to a new system will be costly in terms of training hours, but I would give it a try...

I came across a utility that someone made to help them check vitals on a regular schedule at a hospital.

http://www.donationc...63.msg87431#msg87431

MAH, I don't have time to assist but let me map out how it might be done in a way that would gain my maximum interest.

Before you can build software which makes recommendations, you need to populate a database with prior monitoring data from which you can analyze for rules to make recommendations by.

Planning out recommendation software which you, yourself will write is kind of like planning out a great website which will survive by Google AdWords revenue... before AdWords has even been created. For now, you need to focus on how that database will be populated.

SOMEHOW start collecting patient monitoring data, with patient identity hidden but still tracked with a unique identifier. The purpose of this is to collect something of value which can be data-mined.

Put the collected data under a license where any hospital collecting similar data and submitting it to you will in return get access to the entire database for data mining purposes. So for the sake of access to what will eventually be a very large database, it will be to their advantage to allow some of their own patients to be monitored.

Any biz which does not have access to fresh patient monitoring data could pay money for access instead. This is so (hopefully) an ecosystem of companies could either simply mine your data for valuable insights, or perhaps write a treatment recommendation system for incoming patient data feeds, based on rules constructed from historic data.

Your own biz could of course offer this as well, you'd have an advantage when creating this. But I think isolating the data collection problem and trying to build a viable biz around that would help break up this massive vision into problems which can be addressed by separate biz entities.

There is a good deal of money to be made in the medical field if you do it right!

@ Summertime

Thanks for the utility link! And of course for the insights and information on physiological tracking garments and the thermometer pill =)

@ culturefish

Hospital clinical director you say? Wow, thanks for your comment and for the encouragement!

@ GordonMcDowell

Your suggestion is definitely appreciated will be well considered. I agree with the database population/collection and was intrigued by the notion of building a business around data collection�"fascinating indeed! Thank you for commenting and for the wisdom!

@ Brenden

Agreed! =D

@ Cambrian House

Thank you everyone for your votes and comments! They've been very helpful in building something with crowd sourcing. Cheers!

I'd also suggest making two list of top grossing hospitals (public & private). Then note what systems(software) they currently use, as well as administrative processes and structure. The key to making this idea successful from the start is to put your software in a position that it can integrate into existing systems and software that the hospitals already use. Generally, the more money the hospital has, the more advanced their systems. Make sure to also look into where the industry is heading technology-wise so that you don't go and create a piece of software that no one will be able to use.

You might also wish to split the software up into phases. This way you can build the first part(phase) of your software that would simply collect and store data safely. This would allow you to do the research & analysis you'll need to finish mapping out the remainder of your software. This would also put you in a better position to find a hospital willing to be a test-case. Especially if you can provide all the research costs through the "first phase" of your software (i.e. a program to gather the information for the "data-mine").

Well done, and best of luck.

Brilliant, this is tantamount to the democrats plan to cut the cost of healthcare, by making it more efficient!

whats the latest on this are you collaborating with the amiable Charonv?