From the category archives:

Information technology

This interactive map of the Ebola outbreak, produced by HealthMap, paints a picture of the epidemic's course from its first public signs in March. Mouse around, scroll down, zoom and explore. And click play to see how events have unfolded thus far.

Sobering news keeps coming out of the West African Ebola outbreak. According to numbers released on August 6, the virus has sickened 1,711 and claimed 932 lives across four nations. The outbreak continues to grow, with a high risk of continued regional spread, according to a threat analysis released by HealthMap (an outbreak tracking system operated out of Boston Children’s Hospital) and Bio.Diaspora (a Canadian project that monitors communicable disease spread via international travel).

“What we’ve seen here—because of inadequate public health measures, because of general fear—is [an outbreak that] truly hasn’t been kept under control,” John Brownstein, PhD, co-founder of HealthMap and a computational epidemiologist at Boston Children’s Hospital, told ABC News. “The event started, calmed down and jumped up again. Now, we’re seeing movement into densely populated areas, which is highly concerning.”

If you’re interested in keeping tabs on the outbreak yourself, there are several tools that can help. Full story »

Leave a comment

(Pyh2/Wikimedia Commons)

(Pyh2/Wikimedia Commons)

Geoffrey Horwitz, PhD, is a business development associate in the Technology and Innovation Development Office (TIDO) at Boston Children’s Hospital. Follow him on Twitter @GeoffHorwitz

At the recent 2014 Biotechnology Industry Organization (BIO) International Convention, the message was clear: Digital health is the new blockbuster. For the first time ever, BIO spotlighted digital health, with a specific focus on how digital health is influencing the pharmaceutical and biotech industries. Also featured was a digital health zone where companies and other exhibitors from all over the world could demo their products and services to thousands of attendees.

In pharmaceutical lingo, a blockbuster is a drug that generates revenues of at least $1 billion. Digital health certainly fits this definition. By 2018, reports suggest that revenues will exceed $6 billion for wearable wireless devices alone. A recent McKinsey study found that 75 percent of consumers surveyed, of various ages and located throughout the world, would like to use digital health devices. Full story »

Leave a comment

a wave of wearable devicesProjections that the global mobile health market will boom to nearly $50 billion have ignited interest among innovators. A pair of physician innovators from Boston Children’s Hospital peg wearables as the technology to watch and offer a sneak peek at what adoption might mean, while others ask about the pediatric market for wearables and point to a few potential stumbling blocks. Read on for their views. Full story »

Leave a comment

Tracking patients between clinical visits

A randomized trial will soon test whether web-based updates from parents and teachers improve outcomes in ADHD, autism and more.

Eugenia Chan, MD, MPH, is a developmental-behavioral pediatrician and health services researcher in the Division of Developmental Medicine at Boston Children’s Hospital. She runs the Developmental Medicine Centers ADHD Program and is co-developer of ICISS Health, a web-based disease monitoring and management system.

When I set out with my collaborator Eric Fleegler, MD, MPH, to build a web-based tracking system for children with attention deficit hyperactivity disorder (ADHD), we focused on a single problem—getting parents and teachers to fill out symptom questionnaires in time to help doctors make informed clinical decisions at follow-up visits. We had no inkling of the possibilities that this kind of software platform could hold, or how it might grow in the future. Full story »

Leave a comment

Three teenagers wearing hospital masks flu influenza healthmap social media twitter digital epidemiology digital disease detectionElaine Nsoesie, PhD, is a research fellow at Boston Children’s Hospital’s HealthMap, Harvard Medical School and Virginia Bioinformatics Institute. In this post, which originally appeared on HealthMap’s Disease Daily, Nsoesie looks at the trend of detecting disease digitally by monitoring mentions on social media. She delves into one of the major limitations of this technique—namely telling those who are curious about a disease apart from those who actually have it.

There are plenty of studies about tracking diseases (such as influenza) using digital data sources, which is awesome! However, many of these studies focus solely on matching the trends in the digital data sources (for example, searches on disease-related terms, or how frequently certain disease-related terms are mentioned on social media over time, etc.) to data from official sources such as the Centers for Disease Control and Prevention. Although this approach is useful in telling us about the possible utility of these data, there are several limitations. One of the main limitations is the difficulty in distinguishing between data generated by healthy individuals and individuals who are actually sick. In other words, how can we tell whether someone who searches Google or Wikipedia for influenza is sick or just curious about the flu?

Researchers at Penn State University have developed a system that seeks to deal with this limitation. We spoke to the lead author, Todd Bodnar, about the study titled, On the Ground Validation of Online Diagnosis with Twitter and Medical Records. Full story »

Leave a comment

ICISS screengrab2What happens when you try to scale up a successful quality initiative? Eric Fleegler, MD, MPH, and Eugenia Chan, MD, MPH, are facing that challenge with ICISS, their web-based system that went quickly from ideation to adoption by 3,000 patients with attention deficit hyperactivity disorder (ADHD) and their families.

ICISS enables parents, teachers and patients to give online updates on medications, symptoms and school performance in close to real time, then packages that data for clinicians in a visual, actionable fashion. But tasked with introducing ICISS into four other clinics at Boston Children’s Hospital—autism, asthma, depression and epilepsy—a raft of practical, legal and philosophical questions came up about how to handle these patient-generated health data. For example:

  • How should we inform families that they need to contact their provider directly with immediate concerns?
  • What if a parent indicates that a child is at risk of self-harm, and how can we manage this in a timely manner?
  • How can clinics afford to hire additional staff to screen and manage alerts from ICISS when this activity is non-reimbursable?
  • What is the obligation of the provider if actionable data show up months in advance of the scheduled visit?

Fleegler and Chan discuss the challenges and lessons learned in our sister publication, Innovation Insider. We’d be interested to hear from others facing similar questions in handling patient-generated health data.

Leave a comment

Cameron with Galina Lipton, MD

By the time Cameron Shearing arrived at the South Shore Hospital Emergency Department (ED) during a December snowstorm, he wasn’t breathing. He didn’t have much time. The two-year-old had aspirated a chocolate-covered pretzel, which sent tiny bits of material into his lungs.

The odds of a good outcome were not high. Pretzel is one of the worst foods to aspirate for two reasons: The small pieces can block multiple small airways, and the salt, which is very irritating, causes a lot of inflammation.

“Cameron was one of the sickest patients I ever cared for as an emergency physician. I did everything I could within my scope of practice, but he needed the tools and expertise of pediatric subspecialists,” recalls Galina Lipton, MD, from Boston Children’s Department of Emergency Medicine, who was staffing the South Shore Hospital emergency room that evening. Full story »

Leave a comment

Last week, Boston Children’s Hospital’s Innovation Acceleration Program hosted a jam-packed Innovators’ Showcase where teams from around the hospital networked, traded ideas and showed off their projects. Here are a few Vector thinks are worth watching.

isotropic diffusion reveals information on axons on DTI1. An imaging ‘biomarker’ after concussion

Thirty percent of people who suffer a mild traumatic brain injury—a.k.a. concussion—have ongoing symptoms that can last months or years. If patients at risk could be identified, they could receive early interventions such as brain cooling and anti-seizure medications. New MRI protocols that can measure free, non-directional diffusion of water, coupled with sophisticated analytics, are achieving unprecedented pictures of what happens inside the brain after injury. Full story »

Leave a comment

Google Glass worn by Alex Pelletier croppedAlexandra Pelletier is a manager in the Innovation Acceleration Programat Boston Children’s Hospital. She directs the FastTrack Innovation in Technology Program, a hospital initiative to accelerate, rapidly develop and deliver innovative clinical software solutions.

Do you know the feeling of opening a new box with technology in it? I’m not a tech geek, but when my Google Glass arrived, with its crisp and simple packaging, my visceral reaction was “this is really cool.” Nonetheless, I’m approaching Glass carefully, because even the best technologies still require humans to use them. That means that they must be easy to use, must connect with other systems seamlessly and must offer value that makes its adoption worthwhile.

Google Glass is gaining some real excitement in health care. Each day my Twitter feed lights up with a new report of a hospital or practice trying it out. Here at Boston Children’s, we too are investigating the use of this technology through the Google Glass Explorer Program (watch Vector for more to come). We see promising potential for Google’s head-mounted display technology to transform communication and access to real-time information. Full story »

1 comment

Stethoscope and keyboard health insurance claims dataThe only time most of us ever look at an insurance claim is after a hospital or doctor visit, when we get a claim summary from our carrier. And then as far as we know, it gets filed away, never again to see the light of day.

But there’s a lot to be learned from these claims data.

As with electronic medical records (EMRs), behind every claim an insurer receives is a detailed record about symptoms, tests, diagnosis and treatment. Properly compiled and analyzed, claims data can be an excellent resource for taking population-level snapshots of disease, helping to identify trends and reveal or probe associations.

That’s why claims data recently caught the eye of Kenneth Mandl, MD, MPH, and Mei-Sing Ong, PhD, two researchers in Boston Children’s Informatics Program (CHIP). Using claims records for roughly 2.5 million Americans, they turned their attention to two conditions—epilepsy and asthma—with interesting results. Full story »

Leave a comment