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Posts from the ‘Mobile’ Category

Augmented Reality in Operating Rooms Soon!

A clinic in Germany started experimenting with an application using augmented reality on iPads in the OR. During operations, surgeons can see through anatomical structures such as blood vessels in the liver without opening organs therefore they can perform more precise excisions.

A CT scan is performed before the surgery and the imaged vessels are identified within software, all of which is then transferred to the iPad. During the procedure the surgeon can navigate the imaged liver to see where the vessels are, and if the camera is turned on and pointed at the exposed liver the app automatically superimposes the vessel structure of the organ onto the live picture. Notably, the app is not simply a concept, but was already tested successfully during a liver tumor removal at Asklepios Klinik Barmbek in Hamburg.

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Years ago, I wrote about an experiment of similar kind performed at the Computer Assisted Medical Procedures Institute at the Technische Universitat München.

The technology is now there, we just have to put evidence behind using it in practice. Exciting times ahead!

 

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.

Mobile Health with the eyes of a Medical Futurist: Video for Stanford University

A few weeks ago Stanford University asked me to make a video with a professional crew and talk about mobile health from the medical futurist’s perspective which they can add to the Mobile Health Without Borders course. I was happy to accept this challenge; and I hope you will find the video interesting and useful.

Re-taking an Exam in Medical School Because of a Mobile Application

What happens when a university lecturer published a mobile application with questions-answers about different medical specialties and decides to include some of those public questions in the test of a university examination? Well, trouble.

Students from Kings College London who recently sat through an Obstetrics & Gynaecology exam were surprised to note that a large proportion of the questions were identical to those found in an OB/GYN medical question app.

The author of the £1.49 app is a lecturer at the University who wrote some of the questions on the exam paper using information from the medical app that had been published.

This is why I don’t think it’s enough to  teach medical students about the meaningful use of social media and digital technologies, but medical professionals and lecturers as well.

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Introducing Personal Medical Apps

I recently blogged about pApp that lets doctors create mobile apps for their patients without knowing anything about mobile app development. They just choose the functions (bundles) the app should have such as logging blood pressure or medications and the patient can download the app right away. I received a significant amount of questions and requests about that on Twitter and other channels so I thought I would ask for a bit more pieces of details from the developers.

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pApp consists of:

  • a web platform to create your own medical apps, even share them with the community.
  • a mobile phone app to use the app and gather data.
  • a profound back-end solution called ‘The Cortex’, on par with the latest standards and protocols used in healthcare (HL7, DICOM) to store, show and share data.
  • a complete set of APIs to connect to external platforms, wearables and sensors.
  • a portal for patients and HCPs to view results in an understandable way.
  • a scientifically backed-up validation process for the content of the apps.
  • a quality mark and/or CE-certification where appropriate.
  • an Implementation Team to make it actually work in a hospital.

It could serve e-patients, medical professionals, pharma companies, insurance companies and hospitals as well. Let me know if you would like to get connected to the developers.

Google Glass in the OR and in Medical Education: Becoming a Disruptive Technology

It’s not the first time I say Google Glass can be the biggest hit in medical technology this yeas, and now as the number of good examples is still rising, it’s becoming more and more evident. Here are a few cases and experiments.

Rafael Grossmann, MD, FACS had a pilot project with this team about the use of Google Glass in medical education. Here is his summary:

We worked in three basic forms; first, a critical care LoM RN, emergently treating a patient and requesting advice from a remote GoogleGlass Surgeon. The second scenario involved the G-Glass Surgeon, remotely teaching a procedure to a group of students (PA’s, medical students and EMS students); here, the instructor is hands-free, concentrating on the actual procedure and the different steps to make it easy for the students to learn. The third one was a clinical situation where a request for advice was placed to a remote GoogleGlass cardiologist, my good friend and colleague, glass Explorer pioneer Dr. Christian Assad (@Christianassad), whom was able to give his expertise to the provider in need, from a remote location, wearing GoogleGlass in a Hang-out. Unfortunately, When Dr. Assad gives his advice to the me through GoogleGlass, you are not able to appreciate that on the video, since the audio comes to the GoogleGlass user by the way of bone conductivity.

And the videos:

It seems there are serious technical issues, but that’s always the case with disruptive technologies.

Lucien Engelen and his team at REshape created a video that shows what a regular patient-doctor interaction would look like with the Google Glass and what additional features it could add to the process:

Just one more thing. Get prepared for more and more applications/services based on Google Glass. I recently came across GlassFit that guides you safely through a circuit of workouts while helping you keep track of your full set of workouts. We can also expect to see more and more examples when patients use it in their health management.

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If the majority of the technical issues related to the use of Google Glass can be worked out, it’s going to be a real hit in medical technology. I cannot wait to get mine and test it in medical education.

 

Operation is Recorded with Google Glass!

I’ve been in contact with Rafael Grossmann, MD, FACS for years on Twitter and Google+ and we first met at Futuremed where we discussed the potential opportunities of using Google Glass in the OR, then he let me try his Glass at the recent Doctors 2.0 and You in Paris. And now the great news, he had a chance to do an operation while wearing his Google Glass.

By performing and documenting this event, I wanted to show that this device and its platform, are certainly intuitive tools that have a great potential in Healthcare, and specifically for surgery, could allow better intra-operative consultations, surgical mentoring and potentiate remote medical education, in a very simple way.

The patient involved needed a feeding tube (Gastrostomy) and we chose to placed it endoscopically, with a procedure called PEG (Percutaneous Endoscopic Gastrostomy. You can Google that to learn more…). Being the first time, I wanted to do this during a simple and commonly performed  procedure, to make sure that my full attention was not diverted from taking excellent care of the patient.

Just imagine the future of operations being recorded with Google Glass and the videos will be checked for potential mistakes not by people but by IBM Watson supercomputer.

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Creating a Customized Mobile App for Patients

At the recent Doctors 2.0 and You conference in Paris, I came across an amazing idea. The so-called pApp lets doctors create mobile apps for their patients without knowing anything about mobile app development. They just choose the functions (bundles) the app should have such as logging blood pressure or medications and the patient can download the app right away.

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The Future of Mobile: Video

I’ve come across a great presentation:

Shooting a Short Film for a Course of Stanford University

I was asked by Homero Rivas, Assistant Professor of Surgery, Director of Innovative Surgery, School of Medicine, Stanford University to shoot a short film for their online course entitled “Mobile Health Without Borders“. The course was described as:

The course will function like a conference, but it takes place over three months rather than two days, and encourages the transformation from passive audience observer to active participant and thought leader. The themes to be addressed are: 1) Global Health Challenges. 2) Mobile Health Opportunities. 3) Entrepreneurship in Health Care.

The shoot was fun and we all enjoyed it. The video should be submitted in a few days’ time. I will, of course, publish it here. Until then, a few photos:

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