Thursday, July 27, 2017

FDA announces Digital Health Innovation Action Plan

Today, the FDA announced the formal launch of the Pre-Cert for Software Pilot Program and published their Digital Health Innovation Action Plan.

The Digital Health Innovation Action Plan (PDF) provides details and timelines for the integrated approach to digital health technology and the implementation of the 21st Century Cures Act.

The goals are to:
  • enable a modern and tailored approach that allows software iterations and changes to occur in a timely fashion;
  • ensure high quality medical product software throughout the life of the product by enabling companies to demonstrate their embedded culture of quality and organization excellence (CQOE); and
  • be a program that learns and adapts and can adjust key elements and measure based on the effectiveness of the program.
Learn more at the FDA Blog.

Thursday, June 1, 2017

Augmented reality in medical education

It's truly exciting to see how augmented reality (AR) is becoming incorporated into medical education. While virtual reality (VR) headsets are also gaining some notable traction, I see the use of AR growing much faster. AR interfaces can be built right into the clinical workflow and can even be used at the bedside. People can get a taste of AR using their mobile devices, so they don't need to purchase any sophisticated equipment. So, in addition to providing an enhanced educational experience, the use of AR could also lead to safer procedures and better clinical outcomes, especially for students and trainees.

Here's an example of Case Western Reserve and the Cleveland Clinic using Microsoft HoloLens for medical education:


The Augmented World Expo is happening in California this week and while applications range from gaming to enterprise use, the education sector is rapidly applying AR in very creative ways. From visualizing the invisible to enhancing psychomotor skills, the use of AR is here to take medical education to the next level!

Thursday, December 22, 2016

"Jeopardy!" show contestant battled colon cancer and gave winnings to cancer organizations

By now, a growing number of people are hearing about the game show "Jeopardy!" contestant Cindy Stowell. She was battling advanced colon cancer and she died before her episodes aired. She won five consecutive games, then gave her winnings to the Cancer Research Institute. Her ambition and passion inspire many who are battling cancer.

Cindy Stowell - you will be missed and we offer our deepest condolences to your family and friends.

Thank you for being an inspiration to a community that understands the devastating impact of cancer.

Thank you for donating your winnings to help cancer organizations fight this disease.

Tuesday, October 4, 2016

Upcoming webinar about the strategic value of CME

The Physician Leadership Forum (PLF), a part of the American Hospital Association (AHA), is hosting a complimentary webinar about the strategic value of CME. The webinar is titled, "Improvement from Within: the C-Suite’s Nimble New Partner is CME."

Monday, October 10, 2016
3:00 p.m. ET (2:00 p.m. CT, 1:00 p.m. MT, 12:00 p.m. PT)
(60 minutes)

For those attuned to the evolution of accredited continuing medical education (CME), there is a dynamic opportunity for institutional leaders to build collaborative "educational homes" that address strategic system goals while nurturing the professional development—and passion—of clinicians and teams.

Join us for our next webinar, "Improvement from Within: the C-Suite's Nimble New Partner is CME" on Monday, Oct. 10 beginning at 3:00 p.m. ET. During this 60-minute webinar, Graham McMahon, MD, president and chief executive of the Accreditation Council for Continuing Medical Education (ACCME) and Josephine Fowler, MD, former chief academic officer at JPS Health, Dallas, will offer an inside look at strategies C-suite executives can use to ensure that CME is a strategic asset for institutional excellence. Through participation in this educational activity, attendees will be able to:
  • Enumerate strategies for integrating CME into system improvement for safety and quality goals;
  • Gain practice-based insights for creating an educational home that sustains clinicians passion for medicine, nurtures their professional development, and supports their well-being;
  • Identify easy approaches to enhance the relevance and effectiveness of CME;
  • Pursue approaches that use CME to help integrate system improvement needs with faculty development.
Learn more about this webinar here:
http://www.ahaphysicianforum.org/inc-plf/dhtml/webinar-reg.dhtml

Friday, September 23, 2016

Get ready for National Health IT Week Sept 26-30 #NHITWeek

Have a health IT story to share? National Health IT Week is Sept 26-30 so be sure to follow #NHITWeek and join others who are sharing their passion about health IT! Learn more here: http://www.healthitweek.org

My critique of the JAMA activity tracker + weight loss study

Originally posted on FitnessTechMD.com

Many people have seen reports of the recent JAMA study titled, "Effect of Wearable Technology Combined With a Lifestyle Intervention on Long-term Weight Loss: The IDEA Randomized Clinical Trial." Published in Sept, 2016, this study would appear to be a reflection of recent trends in activity tracking and weight loss strategies. However, the study used an antiquated wearable device that is no longer sold (the BodyMedia FIT which is worn on the upper arm) and it was conducted from 2010-2012. How many people in 2010 were wearing activity trackers? The popular Fitbit Flex launched in May 2013. The Apple Watch launched in April 2015.


Back in 2010, relatively few people wore activity trackers. Moreover, hardly anyone wore them on their upper arm. So although the authors acknowledge that "The multisensor wearable device was worn on the upper arm, which may not reflect the effectiveness of more contemporary devices worn on the wrist..."

The term "effectiveness" is an interesting term for this type of study, since the accuracy of worn activity trackers has wide variability. In order for a digital tool to effectively change behavior in a sustainable way, people have to use it regularly and the device should provide useful feedback to the user.

I've personally tried the BodyMedia Fit and I can attest that:
  1. It draws a lot of attention (maybe not as much as Google Glass, but you'll get a lot of questions from random strangers asking, "what is that on your arm?"). How self-conscious would you be if were constantly telling everyone that you were taking part of a weight loss study? 
  2. It's not something you'll be wearing 24/7 (fabric stretch band around the arm, so you probably won't be taking a shower with it, plus I don't believe that it was water resistant) - so that can impact daily adherence. Plus, the device needs to be charged on a regular basis.
  3. The tracker is not very comfortable (imagine strapping a pager to your upper arm all day). 
  4. The device doesn't really provide any type of useful feedback such as vibration alerts, cues, smart notifications, etc. You may eventually forget that it's there. It's not nearly as engaging as modern activity trackers that have lights, screens, and vibrating alerts.

The authors also state, "the use of wearable technology was not initiated at the onset of the intervention, which may have influenced how the participants adopted and used the technology during their weight loss efforts..." Many people are missing this point. Adoption and engagement are critical factors that can impact the success of any type of sustainable behavior change.

So, if the goal is to sustain lasting behavior changes that will lead to weight loss and healthy eating, then you need to study devices that people will easily wear daily, devices that will provide useful feedback in real-time, and devices that won't make people self-conscious about their attempt to lose weight.

Finally, keep in mind that the study began with intensive weight loss interventions for 6 months (weekly group sessions), then the groups continued to participate in monthly group sessions (and received phone calls, text message reminders, etc.) Most people who choose to purchase and use a wearable device don't gain access to this type of support and structure. Most consumers are curious or they may be in a contemplative stage where they want to see how an activity tracker may help them achieve a healthier lifestyle.

Intensive, structured weight loss programs are great ways to kick-start a new journey towards healthy living, but people need to be taught how to use tools in a way that is natural to their workflow and daily habits. If you're not accustomed to strapping a large device to your arm, then you'll be one of the first ones to stop using the device after a few weeks or months. In contrast, if you normally wear a watch and use a smartphone, then it'll be much easier to wear a device that is simple and that provides useful feedback (such as smart notifications that you can customize so that you don't run into alert fatigue).

In many ways, it's unfortunate that the JAMA article was positioned by the media as a disappointment regarding the "effectiveness" of wearable technology. It's unfortunate that many consumers may now have a misconception regarding how their activity trackers may benefit them.

I'm sure we'll see many more studies in the near future assessing the "effectiveness" of modern activity trackers. Until then, we'll have to wait patiently as people read stories with misleading titles like, "Activity Trackers Are Ineffective at Sustaining Weight Loss" or "Weight Loss On Your Wrist? Fitness Trackers May Not Help" (the BodyMedia device was worn on the arm, not the wrist!)

Friday, May 13, 2016

Ingestible origami surgical robot (a real-world Transformer)

OK, maybe not quite a Transformer. But, researchers at MIT, the University of Sheffield, and the Tokyo Institute of Technology have demonstrated how a tiny origami robot can unfold itself from a swallowed capsule and crawl across the stomach wall to remove a swallowed button battery or patch a wound. The robot is steered by external magnetic fields.

Source: MIT News
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