1. Design of Health Technologies lecture 24 John Canny 12/05/05

2. Course Wrap-up In this class, we’ll lay out what we’ve discovered in looking at Health IT over the semester. I’m going to start by collecting together some resources that have been useful (books, journals, conferences, websites). Then we’ll summarize the major themes of the course. Treat this as a collaborative design exercise. How would you design this course now if you were giving it?

3. Resources - Books “Medical Informatics" by E.H. Shortliffe et al., Springer, 2001 Note: This is part of a series on Health Informatics at Springer.

4. Resources - Books “Handbook of Medical Informatics,” J.H. van Bemmel and M.A. Musen, Springer 1997.

5. Resources - Books “Healthcare Information Systems” Ed. By K. Beaver (Auerbach)

6. Journals Journals we drew from: JAMIA – J. of the American Medical Informatics Assoc. Telemedicine and e-Health IEEE Trans. on Information Technology in Biomedicine Health Informatics Studies in Health Technology and Informatics Biosensors and Bioelectronics PLoS (Public Library of Science) Biology The Lancet JAMA – Journal of the American Medical Association Disease Management and Health Outcomes

7. Journals Other Journals/Magazines we used British Journal of Psychiatry Journal of Health Psychology Nature and Nature Reviews: Neuroscience Sensors Healthcare Informatics Online (Magazine) IEEE Technology and Society IEEE Technology and Society British Computer Society British Computer Society

8. More Journals Artificial Intelligence in Medicine (Elsevier) Computers in Biology and Medicine (Pergamon Press) Computers in Biomedical Research (Academic Press) Computer Methods and Programs in Biomedicine (Elsevier) IEEE Engineering in Medicine and Biology Magazine Journal of Medical Systems (Plenum Press) MD Computing (Springer-Verlag) Medical Informatics & The Internet in Medicine (Taylor & Francis) Methods of Information in Medicine (Schattauer) Yearbook of Medical Informatics (Schattauer)

9. Conferences EMBC: Annual International Conference of the Engineering in Medicine and Biology Society AMIA Annual Symposium (and Spring Congress) HEALTHCOM: Health Communication Conference MEDINFO: (every 3 years, next in 2007), run by the IMIA (International Medical Informatics Association) WWW conference has a health track (one theme day) ISTAS

10. Web Sites National Library of Medicine http://www.nlm.nih.gov/ and http://www.ncbi.nlm.nih.gov/PubMed/http://www.nlm.nih.gov/http://www.ncbi.nlm.nih.gov/PubMed/ Agency for Health Research and Quality http://www.ahcpr.gov/ http://www.ahcpr.gov/ California Health Care Foundation http://www.chcf.org/http://www.chcf.org/ Healthcare Guidelines Clearinghouse http://www.guideline.gov http://www.guideline.gov Cochrane database of clinical trials: http://hiru.mcmaster.ca/cochrane/ http://hiru.mcmaster.ca/cochrane/ Physicians for Human Rights (PHR) www.phrusa.orgwww.phrusa.org

11. Summary Health Care IT is a huge industry – apparently one of the top-4 markets for IT. In spite of this, Medical Informatics has rather loose ties with the rest of IT, both in research and industry. Some Reasons: High overhead – legal, medical, public health, policy, ethics Hard to identify fundamental research problems Some is info. science rather than computer science

12. Summary Early adopters need to package some good research problems for other CS researchers. Or practitioners can come and present their priorities directly to engineers. Easier to publish in existing venues – and explore new ones

13. Opportunities CPOE Telemedicine Sensors and Labs-on-a-Chip EMR

14. Opportunities - CPOE CPOE (Computerized Physician Order Entry) – esp. speech based – fits well with existing practice – clear market advantages, once error rates are low enough. Pen computers may also win here – less clear what’s needed

15. Opportunities - Telemedicine Telemedicine – esp. in developing countries Local sensor data collection, possibly analysis Store-and-forward technology Video conferencing, high-speed links Medical image/lab results transfer, compression

16. Opportunities - Sensing Sensing- General health/wellness, cardiac, breathing Chronic conditions – esp. implanted sensors Immunosensors Labs-on-a-chip Health care is always easier and cheaper when problems are caught earlier – sensing is cheap in principle. Needed - fairly high level of automation to filter information to caregivers. TCO improvements.

17. Opportunities - Sensing Continued -

18. Opportunities - EMR Federation of many data sources/formats Must be privacy and security compliant – better privacy filtering methods, fine-grained access controls, robust authentication (possibly biometric) XML/rich media – –Should allow rich and efficient queries – –Fast visualization/manipulation Improved interface design, and adaptability to local work practices. Short-term target – published guidelines and workflows.

19. Opportunities - EMR Continued -

20. Other Opportunities ??

21. Discussion Questions Discuss the main open challenges in Health Technology – where would you push? How would you structure a course in Health Technology? What other approaches (projects, workshops etc.) would you take to mobilize interest in computer science?