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Social Media in Clinical Practice: Chapter 15, E-mails and Privacy Concerns

When I realized Springer made the individual chapters of my book, Social Media in Clinical Practice, available, I thought it would be useful for future readers to get some insights about each chapter one by one.

Here is the short summary of what you can read about and an excerpt of the fifteenth chapter, E-mails and Privacy Concerns:

E-mail or electronic mail is a method of sending and receiving digital messages online. This is one of the most common forms of online communication and while patients usually send simple questions via e-mail to their doctors, it might contain sensitive information which could lead to legal consequences if medical professionals do not know about such potential issues and the ways to avoid these.

  • The most common topics in patients’ e-mails include
  • The potential advantages and disadvantages of using e-mails in the doctor-patient relationship
  • A typical e-mail consists of these elements
  • Suggestions About Dealing with E-mails
  • Privacy Concerns in Social Media

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Chapters that have already been covered:

The Relation Between The Human Touch and Medical Technology: AND Instead of OR

I’ve been giving talks about the future of medicine for years and many times, part of the audience is worried about losing the human touch of practicing medicine by using more technologies. As a medical futurist, I want to make things clear here.

The relation between the human touch in medicine and disruptive innovations is and; instead of or as people tend to think. By losing the quintessence of practicing medicine, the real-life doctor-patient relationship, we would lose everything. Although without using innovative technologies, it is becoming more and more complicated (if not impossible) to provide proper care.

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When I was 10 years old, I volunteered in computer shops to learn the hardware part of PCs. That time a man kept on coming back to the shop as he was expecting a delivery of a brand new hard drive he ordered some weeks ago. It was a hard drive of 40 megabytes (yes, megabytes) and he told me he had no idea what he would do with so much space on his computer. After almost two decades we have over a zettabyte of information online. It is practically impossible to keep up with that without using proper technologies. Moreover, it doubles now every 12 months, and soon will double every 12 hours.

The real challenge here is finding a balance between these; and it’s easier than you would think. By preparing for what is coming regarding medical innovation for all stakeholders of healthcare, we get a chance to start working out the methods and solutions in time, therefore we can use more and more efficient and secure technologies in medicine without losing the human touch of the doctor-patient relationship.

This is the topic I cover in my new book which should be out in a few months’ time. Wish me luck!

 

 

Website for Comparing Health Trackers

The recent CES showcased plenty of wearable health trackers, therefore the timing was right for launching a new website that compares the numerous trackers at once. Here is Bioniq Health:

The more interesting elements are yet to come. “Bioniq will help individuals to find tools and technologies most relevant to their specific needs (i.e. I want to run a marathon, I want to better understand and manage my sleep, or back pain, or high blood pressure),” writes Co-Founder Dr. Daniel Kraft to me in an email.

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20 Predictions in Medicine And Healthcare for 2014: From DIY Biotech to Mind-Controlled Exoskeletons

Every January, I publish my predictions for the upcoming year regarding medicine and healthcare. Usually, the majority of these predictions turn out to be valid later on, although I prefer calling them apparent trends rather than actual predictions. Here are my 20 points for 2014.

1) Google Glass to be used in everyday healthcare: Google Glass has shown its potentials as demonstrated by forward-thinking medical professionals such as Lucien Engelen, Christian Assad and Rafael Grossmann, even the first clinical study came out focusing on the use of Glass in the clinic in 2013. Prepare to see the first real practical examples in 2014.

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2) IBM Watson’s first commercial use by hospitals: IBM’s supercomputer has been tested by US clinics for months and it has proven its validity and value in medical decision-making processes. The first hospitals that make their doctors understand that Watson does not replace them, instead, it assists them, will buy the service in 2014.

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3) Direct-to-consumer genomics to get new rules: The recent story about the FDA and 23andMe demonstrated how insufficient the regulation around DTC genomic testing is, therefore it is time to come up with standards that only the best services can achieve. By standard I mean the FDA should make sure only companies with deep scientific knowledge and expertise get the permission to perform genomic analysis online. Now it’s certainly not the case.

Close View of a DNA Strand

4) 3D printing artificial limbs and biomaterials goes mainstream: We have already seen some great examples when artificial limbs and different types of biomaterials such as kidney or heart tissues were printed out in 3D but in 2014 this industry becomes mainstream with the first home 3D printers in the market.

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5) The healthcare experience will be brought to the home: See the recently published “doctor chair” that can measure a user’s blood pressure, pulse, temperature, body motion, and other vital signs just by having the user sit in the chair as an example and expect more similar solutions which will, by time, make hospitals almost useless as we will measure everything about ourselves at home.

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6) LEGO Mindstorms to be applied for DIY biotech: The amazing concept behind LEGO Mindstorms that teach you how to build an actual robot at home could be applied to the biotech industry with people growing cells and performing even simpler biotech tasks at home resulting in a new generation of scientists.

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7) Home diagnostics to be the key trend: Not only Scanadu will ship the first prototypes early 2014, but other similar devices with which patients can measure simple health parameters at home will become available.

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8) Wearable MRI technology: What if we could use radiology imaging without those huge machines? A Swiss group has been working on a wearable magnetic resonance imaging (MRI) detector and sensor arrays. It would vanish long waiting lists and allow medical professionals to literally see through the patient in emergency situations.

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9) Optogenetics to be featured at major scientific journals: I’ve been following the latest developments related to optogenetics and I was amazed when scientists were able to create false memories in the hippocampus of mice which was the first time fear memory was generated via artificial means. We might see even more studies that will put its potential implications on display.

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10) Bigger role of MOOCs as medical schools change approach about digital literacy: By the time the majority of medical schools worldwide realize the potential and importance of teaching digital literacy for future medical professionals, we will need more and more massive open online courses such as The Social MEDia Course to serve their needs and train a new generation of doctors.

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11) More connected digital healthcare devices and services: This should be one of the key trends this year as for the last years, we have been seeing plenty of great solutions either as medical devices or unique online services, but the connectivity has been a major issue. John Nosta featured the imperative of connectivity in his recent Forbes column.

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12) The first steps of Google Calico to be public: When Larry Page announced the launch of Calico, their new venture focusing on reversing and stopping the process of aging and related diseases, nobody knew what to expect. They will announce the first steps in 2014 led by the former CEO of life sciences giant Genentech and a chairman at Apple.

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13) EEG controlled devices to appear: There have been little games available on Amazon which let you control a ball with your “mind”, but what about those devices that really use your thoughts to control things? I’ve used myself a wheelchair which was controlled by thoughts and will meet soon the team behind SynetIQ, a platform for neuromarketing.

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14) Exoskeletons will be featured worldwide: We have been talking about the potential use of exoskeletons for disabled people but this year the technology will become available for the masses. Also related to the EEG controlled devices, a mind-controlled exoskeleton will kick off the 2014 football World Cup watched by billions of people.

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15) First really useful food scanners to be released: While there are thousands of wearable devices and smartphone apps focusing on fitness, what about a healthy diet? Using a simple meal diary makes no significant change in a lifestyle. The device of a Toronto-based company, Tellspec, detects allergens, chemicals and nutrients in your food. We could also link such data to our own genomic background to make the truly best diet choices.tellspec-17

16) Gamifying the healthy lifestyle: HapiFork measures whether you eat properly, a smart bra spots cancer in time; FitBit, Shine and hundreds of wearable devices were meant to help us live a healthy life by measuring our health parameters/lifestyle and gamifying the steps required for making positive changes.

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17) Finally remote touch and simpler data input become possible: The technology behind designing touchscreens that can work on any surfaces has made crucial steps in the past 2 years therefore it’s time to make simple data input possible. Omnitouch seems to be a valid player in this area.

Turn Any Surface Into A Touchscreen

18) Nanotechnology to be included in the medical curriculum: For years, nanotechnology has presented the potentials of using nanotech devices in treating diseases, but as bombing cancer cells and using less invasive diagnostics became possible in 2013, we can expect to see nanotech-based clinical trials soon which also means we must teach students about such solutions..

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19) Decision on newborn genome sequencing to be made: Although the recent FDA vs 23andme debate prolonged this, certain countries (mainly in Asia) might start providing newborn babies with their own genome sequences at birth. The decline of the cost of sequencing and the rise of genome centers in Chine could be the key factors in this.

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20) First results of Ray Kurzweil’s work at Google to be revealed: One of the most exciting collaborations of recent years is Google hiring Kurzweil to create the first artificial intelligence brain. While no details about his actual work have been released so far, 2014 could be the year when they present at least a roadmap, if not real results.

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Your Cardiac Rhythm as a Password for Computer Access

The new technology developed by Nymi was just announced and will certainly raise important questions about security. This is a bracelet using ECG authentication serving as a password to access computers or open doors.

The benefit of the Nymi’s new and exciting ECG authentication is that it is highly secure without compromising convenience. The Nymi has a 3-Factor system ensures that you and only you have access to your Nymi, and control of your identity. To access the Nymi you must first have possession of the wristband. Second, you must possess your unique heart rhythm, and finally, you must have access to the secure application on a registered smartphone. Once you’ve authenticated, you will remain authenticated so long as the wristband is not removed.

While the idea is great, what about people with different forms of arrhythmia? What about ECG results available in medical records of almost everyone? I hope the team behind Nymi will give us the responses.

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Google Glass Keeps On Rocking Healthcare: But For How Long?

Since the launch of Google Glass, I’ve been closely following updates and developments related to healthcare and medicine. It seems clinicians worldwide can leverage its potentials but there is a long way to go to reach wide clinical adoption. A few concepts have to be taken into consideration:

  • Healthcare institutions should be open to experimenting with it (and determine privacy and legal issues). Test drives such as the one in Hartford Hospital are needed.
  • Medical professionals should deal with patient privacy and put evidence behind using it in practice.
  • Patients should be clearly informed if Glass is used in their care.
  • Moreover, start-ups focusing on Google Glass and medicine should be able to join accelerators and incubators. Fortunately, this step has been taken as Palomar Health and Qualcomm Life teamed up to build an incubator for developers called Glassomics.
  • All the stakeholders should watch the sporadic examples (see the links in this post).

Here are 3 examples how Google Glass could be used in medicine and healtchare:

1) It could be used in emergency situations. While you are performing CPR, it could call the ambulance to your GPS location.

 

2) The Radboud REshape & Innovation Center launched a Flickr group so they can share the photos they take while experimenting with Glass in the OR.

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3) Stanford medical doctor, Abraham Verghese, started using it because he can now make videos about patient examination for his medical students.

Glass has many a potential use in education, of course, although there’s going to be a number of concerns about its privacy implications when it comes to sensitive information like a real-world patient’s medical data.

20 Potential Technological Advances in the Future of Medicine: Part II.

As I mentioned in the first part of this series, the job of a medical futurist is to give a good summary of the ongoing projects and detect the ones with the biggest potential to be used in everyday medical practices and to determine the future of medicine. Here is the second part of the list of 20 technological advances:

11) Switching from long and extremely expensive clinical trials to tiny microchips which can be used as models of human organs or whole physiological systems provides clear advantages. Drugs or components could be tested on these without limitations which would make clinical trials faster and even more accurate (in each case the conditions and circumstances would be the same). The picture below shows a microchip with living cells that models how a lung works. Obviously, we need more complicated microchips that can mimic the whole human body, but this ultimate solution will arrive soon.

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12) Medical students will study anatomy on virtual dissection tables and not on human cadavers. What we studied in small textbooks will be transformed into virtual 3D solutions and models using augmented reality. We can observe, change and create anatomical models as fast as we want, as well as analyze structures in every detail. Examples include Anatomage, ImageVis3D and 4DAnatomy.

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13) Optogenetics will provide new solutions in therapies. A recent study published in Science reported that scientists were able to create false memories in the hippocampus of mice. This is the first time fear memory was generated via artificial means. By time, we will understand the placebo effect clearly; and just imagine the outcomes we can reach when false memories of taking drugs can be generated in humans as well. The idea is a bit futuristic, but the basics of the method are almost available now.

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14) With the growing number of elderly patients, introducing robot assistants to care homes and hospitals is inevitable. It could be a fair solution from moving patients to performing basic procedures. The robot in the picture below is the prototype made by a company based in California that aims at combining robotics and image-analysis technology so then it can find a good vein in your arm and also draw your blood. In the next step, it will also perform analysis on the blood from detecting biomarkers to obtaining genetic data.

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15) Now we wear a FitBit and other devices that measure easily quantifiable data, but the future belongs to digestible and wearable sensors that can work like a thin e-skin. These sensors will measure all important health parameters and vital signs from temperature, and blood biomarkers to neurological symptoms 24 hours a day transmitting data to the cloud and sending alerts to medical systems when a stroke is happening real time. It will call the ambulance itself and sends all the related data immediately.

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16) It is not just about checking and monitoring vital signs but intervention is also the key to a better health. Imagine tooth-embedded sensors that can recognize jaw movements, coughing, speaking and even smoking so it records when you eat too much or smoke no matter what the doctor told you. Again, it’s going to be extremely hard not to keep the doctor’s pieces of advice. Imagine the same wireless technology used in organs providing real-time data.

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17) If wearing thin e-skins or having embedded sensors is not a viable option for us, then let’s make an old dream come true. The concept of the tricorder from Star Trek has been there for decades and we still don’t have it. The Qualcomm Tricorder X Prize challenge will hopefully lead to the development of a device that can diagnose any diseases and give individuals more choices in their own health. The competition is hard as devices such as Scanadu are also being developed. What matters is patients will control their own health.

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18) I’ve always been a fan of IBM Watson and seen its potentials as huge opportunities in medicine. Watson will assist physicians in everyday medical decision-making, although it will not substitute humans at all.  While a physician can follow a few papers, maybe a few dozens of papers with digital solutions, Watson can process over 200 million pages in 3 seconds, therefore with the increasing amount of scientific data, it would be a wise decision using this in the practice of medicine.

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19) Since the completion of the Human Genome Project, we have been envisioning the era of personalized medicine in which everyone gets customized therapy with customized dosages. The truth is that there are only about 30 cases when personal genomics can be applied with evidence in the background according to the Personalized Medicine Coalition. As we move along this path, we will have more and more opportunities for using DNA analysis at the patient’s bedside which should be a must have before actually prescribing drugs.

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20) I thought I would put the simplest and most predictable medical advance to the bottom of this list. In the near future, whether it is the right and reliable medical information, dynamic resources or medical records; everything will simply be available to everyone which might not sound that interesting, but this would purely be the most important development in the history of medicine.

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It would be great if you could share your insights about other technological advances in the comment section after the post. I hope you enjoyed these two journeys into the future of medicine.

20 Potential Technological Advances in the Future of Medicine: Part I.

As there are so many amazing things going on worldwide in medicine and healthcare, I thought creating a shortlist of some of the most promising ideas and developments would give us a glimpse into the future of medicine. The job of a medical futurist is to give a good summary of the ongoing projects and detect the ones with the biggest potential to be used in everyday medical practices.

1) New disease categories due to the excessive use of virtual reality solutions in gaming and other industries will appear. Examples include virtual post-traumatic stress disorder (v-PTSD) which might be the diagnosis for gamers who participate in large virtual battles wearing VR masks (such as Call of Duty of Battlefield) and experience similar symptoms as those soldiers who fought in real wars. Expect to see ICD codes assigned to such new conditions.

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2) Real-time diagnostics should be in the focus for the next few years. The intelligent surgical knife (iKnife) was developed by Zoltan Takats of Imperial College London and works by using an old technology where an electrical current heats tissue to make incisions with minimal blood loss, but with iKnife the vaporized smoke is analyzed by a mass spectrometer to detect the chemicals in the biological sample. It means it can identify whether the tissue is malignant real-time. Surgeons will love this surgical Jedi knife which can significantly reduce the length of operations.

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3) While better and better data input solutions arise, we will probably not even need hardware to add data to a laptop or PC as screens and keyboards will be projected on the wall or on the table making it simple and accessible everywhere in the clinical settings. Holographic keyboards will make us forget about smartphones and tablets, but only small projectors will be needed while the data will be stored only in the cloud.

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4) Medical communication is something that affects all patients and medical professionals worldwide without exceptions. This is one reason why social media has the potential to become a huge “mind machine” making it possible to transmit, share, crowdsource and store medical pieces of information either for e-patients or medical professionals if such social platforms are used in a proper way. Don’t underestimate the power of digital/medical communication.

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5) By the time Google Glass fulfills its whole potential of leveraging the power of augmented reality, similar contact lenses will be presented which are capable of the same functionalities but without the need for wearing real glasses. Google Glass can be controlled through voice and hand gestures; while the contact lenses will be controlled with brain waves as there are more and more developments in this area.

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6) Ian Pearson wrote in his book, You Tomorrow, about the possibility that one day we will be able to create digital selves based on neurological information. It means we could upload our minds to a computer and live on in a digital form. As Google hired Ray Kurzweil to create the ultimate artificial intelligence controlled brain, this opportunity should not be so far away. We might have been searching for the clues of living forever in the wrong places.

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7) Cyborgs will be everywhere around us including a new generation of hipsters who implant devices and technologies in their bodies just to look more cool. Advances in medical technology will not just repair physical disadvantages such as impaired eye sight but will create superhuman powers from having an eyesight of an eagle to having a hearing of a bat. While a patient wearing implanted defibrillators or pacemakers can also be added to the group of cyborgs, I expect to see more cases when patients ask for the implantation of a certain device without having medical problems.

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8) If guns and other objects can be printed now and the biotechnology industry is working on printing even living cells; why would the appearance of 3D printed drugs be surprising? It will destroy and re-design the whole pharmaceutical world, but regulation will be a huge challenge as anyone will be able to print any kind of drugs that contain patented molecules at home. Bionic ears and simpler organs will be printed at the patient’s bedside.

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9) Adherence and compliance represent crucial issues in improving the patients’ health and decreasing the cost of delivering healthcare. Several start-ups have targeted this issue with different solutions such as a pill bottle that glows blue when a medication dose should be taken and red when a dose is missed (winner of the recent Healthcare Innovation World Cup); or tiny digestible sensors that can be placed in pills and can transmit pill digestion data to physicians and family members. In the future, it’s going to be extremely difficult to lie to your doctor.

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10) Radiology is one of the fastest growing and developing areas of medicine, therefore this might be the specialty in which we can expect to see the biggest steps in developments. One multi-functional machine will be able to detect plenty of medical problems, biomarkers and symptoms at once. Check the machine used in the film, Elysium from the 36th second in the trailer. With one quick check up it tells you what percentage of your cells are cancer free.

Here is the second part!

FindZebra: A Search Engine That Diagnoses Rare Diseases

The Danish researchers behind FindZebra would not be happy about my title as they published a warning on the top of their search engine with the message: “This is a research project to be used only by medical professionals.” This search engine only uses medical databases similarly to SciencerollSearch and named the rare disease correctly after entering the symptoms 67%  of the time, compared to 32% using Google.

I think educating both patients and medical professionals about the proper use of search engines and operators would provide even better results.

Here is their description.

There are close to 7,000 rare diseases recognized by rare disease organizations. We index over 31,000 documents covering rare and genetic diseases from 10 reputable sources. Given the number of rare diseases and rate of publication, we think FindZebra is a good companion for medical professionals.

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The Future of Medical Records: Visualized

Designers dreamed up what the future of medical records will be like. You might remember when Wired reported the blood test makeover. It is inevitable to create medical records that can be better interpreted not only by patients but medical professionals as well.

The practical concerns pointed out by the study include ease of use and ability to share information across systems. But another important metric — the corollary to questions like Would You Want to See Everything Your Doctor Writes About You?” — is, What would you, the patient, do with that information provided you were granted access?

The federal government took the Department of Veterans Affairs’ current record system, which “looks and feels like a receipt,” and challenged designers to reimagine the Continuity of Care Document, an EMR output used to describe a patient’s health history.

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