e-Seminar: Designing Digital Health Apps

 

e-Seminar: Designing Digital Health Apps

Dr Chris Paton, BMBS BMedSci, MBA, FACHI, FFCI

This recorded e-Seminar covers how to design, develop and evaluate a digital health app.

Recorded: November 2018 (60 minutes)

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Health Informatics News


Originally founded in 2010 in the UK and later acquired by Google, DeepMind describe themselves as "...on a scientific mission to push the boundaries of AI, developing programs that can learn to solve any complex problem without needing to be taught how." 
 
The mobile app for clinicians that they developed named Streams was the subject of their recently released Blogpost entitled "Scaling Streams with Google" where details are given regarding plans for those behind Streams, to join Google.
 
 
This news comes after Dr. David Feinberg, former Geisinger Health CEO joined Google to lead their newly-formed health team as detailed by CNBC.  

"One of the reasons for joining forces with Google in 2014 was the opportunity to use Google’s scale and experience in building billion-user products to bring our breakthroughs more rapidly to the wider world. It’s been amazing to put this into practice in data centre efficiency, Android battery life, text-to-speech applications, and now the work of our Streams team." says the DeepMind blog. 
 
"Our vision is for Streams to now become an AI-powered assistant for nurses and doctors everywhere - combining the best algorithms with intuitive design, all backed up by rigorous evidence. The team working within Google, alongside brilliant colleagues from across the organisation, will help make this vision a reality." the entry continues, concluding: "Over the coming years, we expect AI to help scientists make transformative advances on problems ranging from protein folding to image analysis, potentially improving medical diagnosis, drug discovery and much more. We’re excited to play our part in that journey both at DeepMind and at Google, in the service of patients and clinicians around the world."

 

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A UK report recently issued from the Royal College of Physicians (RCP) entitled "Outpatients: the future – adding value through sustainability"  describes the need for a re-appraisal of how outpatient care functions and discusses how this might be brought into line with current patient expectations and lifestyle.
 
The RCP report highlighted the cost to both patients and the NHS that the traditional outpatient care system incurs. It describes that one in five attending pensioners reportedly feel worse flowing their outpatient appointment due simply to the stresses incurred by the journey itself and explained that if A&E were excluded, remaining hospital activity would consist primarily (85%) of outpatient appointments and yet DNA's (where a patient Did Not Attend) occur roughly a quarter of the time.
 
Assessments of value (cost vs outcome) and sustainability (enduring consequences) are needed, says the report, and moving forwards the volume of face to face consultations might be substituted, where appropriate, with more modern alternatives while patents might be encouraged to take control of their care, becoming partners in all relevant decisions, with trusts being flexible enough to facilitate this. At the heart of these changes is suggested adoption of modern technology and other innovations including telephone consultations, skype, apps and online tools, text messaging and remote monitoring systems.
 
5 key recommendations were determined in this report focusing on improvement being measured in terms of population and system effects (as well as individual outcomes), remuneration of trusts for clinical value, national guidance creation in relation to outpatients, collaboration with organisations/charities in order to develop resource signposting and finally guidance being established regarding partnerships with the voluntary and community sectors.  
 
Professor Stephen Powis National medical director of NHS England is quoted here as calling for "honest conversations within our local health communities – with patients, with colleagues in primary care and community services, and with professionals across different specialties and providers – to ensure that reforms are in the interests of all concerned and sustainable in the long term. This report provides an excellent basis on which to base those conversations, and on which to build the consensus for change."
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The paper entitled "Prevention is better than cure. Our vision to help you live well for longer" describes the UK government's vision for targeted preventative interventions, empowering and facilitating people with regards to their health and harnessing modern technology. It outlines a goal of improving healthy, independent life by at least five additional years before 2035 through these and other means.
 
Technology is seen as significant moving forwards in prevention with the paper noting: "It also allows us to target support far better to those that need it most." and in more detail the section entitled "The Future of Healthcare: our vision for digital, data and technology" explains "Over the next ten years, digital services will become even more widespread, and the first point of contact for many. The management of health will move out of clinical settings, and into the hands of people. Devices and applications will provide guidance and support around the clock. To reach this potential, we need to get the basics right: personal data security, the digital architecture of the health and social care system, open data standards, secure identity services, and improved interoperability. This will allow people to use their personal health data for prevention, as well as enabling developers to build products and services that meet the needs of users. The aim is to become a global leader in health technology, and to create a thriving ecosystem of innovation. "
 
Predictive prevention is to be optomised with the paper noting "We want to have the most advanced healthcare system in the world - so as part of our long-term plan for a 21st century health and social care system, the way we view public health must evolve. Moving to the next phase means a more intelligent and personalised approach to improve the health of the nation." and " Predictive prevention will transform public health by harnessing digital technology and personal data - appropriately safeguarded - to prevent people becoming patients. The availability of public data, combined with the existing understanding of wider determinants of health, means we can use digital tools to better identify risks and then help the behaviours of people most in need - before they become patients."
 
This paper concludes "Prevention and supporting good health matters at every stage of life. It matters in the decisions taken by our parents before we are born, and in decisions we make throughout our lives. If we embrace opportunities to live well, we maximise our chances of a long, happy and fulfilled life."
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In order for organisations to measure their improvements in the field and also to compare against others locally and globally HIMSS Analytics® constructed EMRAM, an eight-tiered model, with attainment stages 0 - 7, detailing specific measures for the adoption and use of Electronic Medical Record (EMR) functions and notably those that support optimised patient care through technology and are needed in order to achieve a paperless environment.  
 

Stage 6 of this ladder indicates that the organisation should achieve “technology enabled medication, blood products, and human milk administration; risk reporting; full clinical decision support”.

HIMSS EMRAM stage 6 organisations now include Cambridge University Hospitals NHS Foundation Trust (CUH) as one of only three stage 6 validated NHS organisations in the UK. 
 
CUH news describes the validation announcement on November 1st 2018 and credits Epic (the Trust’s electronic patient record system). Details of their adoption this year of the international best practice of medication administration via barcode were also given (and constitute scanning a wristband barcode on the patent and also the barcode on medication).
 
Renal Consultant and Chief Clinical Information Officer, Dr Afzal Chaudhry was quoted in this CUH news article as saying: “We are absolutely delighted to be validated and would like to thank our hard-working staff and our Epic colleagues for making this happen. Clinical decision support combined with electronic prescribing is helping prevent at least 850 significant adverse medication reactions a year with allergy-related alerts triggering a change in prescriptions, and we have reduced sepsis mortality by 42 per cent with electronic alerts designed and built by ourselves within our Epic system. Today over 99 per cent of all our clinical activity is recorded in a patient’s health record within Epic, in real-time, using integrated computers, laptops, handheld and mobile devices.”  
 

HIMSS Analytics Regional Director for Europe and Latin America, John Rayner is quoted here as saying: “It was a real pleasure to return to Cambridge after three years to successfully revalidate the Trust against the international EMRAM standards. This organisation has made enormous progress since their initial go live in 2014. I can see genuine value and benefit to patient safety and to the overall quality of clinical care following their move from paper to electronic records. They are making good use of electronic clinical decision support and there are well calibrated alerts and warnings in their Epic system to improve the quality of inpatient medication prescribing, and an extensive array of order sets to enhance and improve the standardisation of clinical care - a good hospital with dedicated clinicians and staff.”  

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Chiraphat Boonnag is now a member of Health Informatics Forum
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Shalondra F. posted a discussion
Hello,I am about to apply to a graduate program to get my master’s in health informatics administration instead of bioinformatics. The program is CAHIIM accredited and I will be able to sit for the RHIA exam after graduation. I will also get a stude…
yesterday
Chris Paton posted a blog post
Originally founded in 2010 in the UK and later acquired by Google, DeepMind describe themselves as "...on a scientific mission to push the boundaries of AI, developing programs that can learn to solve any complex problem without needing to be taught…
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Josie Nunez Huerta and Jonathan Stewart joined Health Informatics Forum
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Chris Paton posted a blog post
A UK report recently issued from the Royal College of Physicians (RCP) entitled "Outpatients: the future – adding value through sustainability"  describes the need for a re-appraisal of how outpatient care functions and discusses how this might be b…
Tuesday
BALIRWA PRISCILLAH replied to BALIRWA PRISCILLAH's discussion Inquiry about Health informatics Internship opportunities
"Thank you Chris"
Tuesday
Chris Paton replied to BALIRWA PRISCILLAH's discussion Inquiry about Health informatics Internship opportunities
"Hi Balirwa! My advise would be to attend the HELINA conference in a few weeks in Nairobi - http://conf.helina-online.org/index.php/2018/Dec2018 - there will be lots of experienced health informatics people there to help get advice on internships. Be…"
Monday
BALIRWA PRISCILLAH posted a discussion
Hello all,I am soon graduating with a Masters in Health Informatics from Moi University in Kenya. Would like to inquire if anyone knows of health informatics internship opportunities where fresh graduates can get hands-on experience.Thank you
Monday
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Career Transition from Microbiology to HIM with no Clinical or IT Experience

Hello, I am about to apply to a graduate program to get my master’s in health informatics administration instead of bioinformatics. The program is CAHIIM accredited and I will be able to sit for the RHIA exam after graduation. I will also get a student discount to join professional networks. Here’s my background. -B.S. Biology with Chemistry minor -4 years work experience in Microbiology (2 years food science and 2 years pharmaceutical/medical device) and even some engineering…

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Hello!

Hi Everyone, This is sadhana Jitta, currently Pursuing Helath Information Management program at Fleming College, Canada. I have complete Doctor of Pharmacy back in india. Health Informatics is a feild of my interest and I’m very excited to know new insights of this feild. Thanks,  Sadhana Jitta

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