Stories about: Information technology

Real-time influenza tracking with electronic health records

influenza tracking
Data captured from healthcare visits could be a tool for medical surveillance.

Early influenza detection and the ability to predict outbreaks are critical to public health. Reliable estimates of when influenza will peak can help drive proper timing of flu shots and prevent health systems from being blindsided by unexpected surges, as happened in the 2012-2013 flu season.

The Centers for Disease Control and Prevention collects accurate data, but with a time lag of one to two weeks. Google Flu Trends began offering real-time data in 2008, based on people’s Internet searches for flu-related terms. But it ultimately failed, at least in part because not everyone who searches “flu” is actually sick. As of last year, Google instead now sends its search data to scientists at the CDC, Columbia University and Boston Children’s Hospital.

Now, a Boston Children’s-led team demonstrates a more accurate way to pick up flu trends in near-real-time — at least a week ahead of the CDC — by harnessing data from electronic health records (EHRs).

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Reimagining connected health through home hubs

home health hubs

Through smart home hubs and the growing Internet of Things, people can now control lights, thermostats and other appliances and get information and entertainment with their always-connected digital devices. Consumers have widely adopted home automation products like Nest from Google and ecosystems like Apple’s HomeKit and Amazon’s Alexa.

But home hubs also have the potential to achieve the promise of connected health — access to health care services anywhere and anytime.

Home hubs can deliver enormous value as a means of health care delivery — not just helping casual consumers become familiar with their health and take preventive measures, but also helping manage complex care for patients with chronic illness and supporting timely decision making by clinical teams. Everybody involved with a person’s care can be plugged in, enabling coordination across providers and caregivers in a way that’s increasingly intuitive and meaningful.

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Fever, revisited: ResearchKit app will tap crowd-sourced temperature data

Feverprints temperature

What, exactly, is a fever?

It’s a surprisingly simple but important question in medicine. While a body temperature of 98.6°F (37°C) is generally considered “normal,” this number doesn’t account for temperature differences between individuals — and even within individuals at various times of the day. While a common sign of infection, fever can also occur with other medical conditions, including autoimmune and autoinflammatory diseases.

“Many factors come together to set an individual’s ‘normal’ temperature, such as age, size, time of day and maybe even ancestry,” says Jared Hawkins, MMSc, PhD, the director of informatics for Boston Children’s Hospital’s Innovation & Digital Health Accelerator (IDHA) and a member of the hospital’s Computational Health Informatics Program. “We want to help create a better understanding of the normal temperature variations throughout the day, to learn to use fever as a tool to improve medical diagnosis, and to evaluate the effect of fever medications on symptoms and disease course.”

That’s where Feverprints comes in

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Creating a blueprint for rare disease medicine

blueprint for rare disease medicinePresident Obama’s Precision Medicine Initiative, first laid out in his 2015 State of Union Address, aims to develop individualized care that empowers patients and takes into account genetic, environmental and lifestyle differences. Obama is asking Congress for $309 million for the initiative next year.

One big component is the Department of Veteran Affairs’ Million Veteran Program, which has signed up more than 450,000 veterans to date and is now open to active-duty military personnel. Another is NIH support for cancer trials that match treatments with patients’ genomic profiles.

Parent/citizen scientist Matt Might has in mind another group: patients with undiagnosed genetic disorders. In searching for a diagnosis for his son Bertrand, Might came up with a precision medicine algorithm that outlines step by step what a patient and family can do — from genomic sequencing to finding similar patients to working with biomedical researchers to find therapeutic strategies. It’s an impressively comprehensive blueprint for citizen science.

As Might detailed today at a White House summit on the Precision Medicine Initiative, he now has worms at the University of Utah modeling his son’s disease, whose symptoms include seizures, extreme developmental delay and an inability to make tears. He also has a molecular target and a list of 70 compounds that hit it, including 14 that are already approved by the FDA.

Can Might’s vision be scaled and made part of routine medical care, keeping the patient front and center?

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Tracking Zika? Use HealthMap

Like a virus, the story of Zika virus in the Americas is evolving very, very rapidly. Just in the last week we’ve seen:

To help public health investigators, policy makers, epidemiologists and others keep up with the virus, the team at HealthMap has released a dedicated Zika virus tracking resource at http://www.healthmap.org/zika/. The new map brings in Zika-related information and news from a variety of sources in near real-time, and includes a constantly updated interactive timeline of the virus’s explosive spread across South and Central America.

The HealthMap team is also providing regularly updated coverage of the Zika virus outbreak on their Disease Daily blog.

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Keeping up with marijuana use and its outcomes in kids

tracking marijuana use and outcomes in kids

For the first time since 1937, marijuana is legal for recreational use: adults now can legally possess it in Colorado, Washington, Oregon and Alaska, and there are similar ballot initiatives in many states. With laws at least partially legalizing marijuana in 23 states and the District of Columbia, it’s now a big business. A study comparing 2012-2013 with 2001-2002 found that marijuana use had doubled over the 10 year-period. And that was three years ago.

What are the public health consequences of freely available weed — both acute and long-term? Are we making a big mistake here?

Concerned about potential harms to adolescents, Sharon Levy, MD, MPH and Elissa Weitzman, ScD, Msc, of Boston Children’s Hospital’s divisions of Developmental Medicine and Adolescent/Young Adult Medicine respectively, argue for a better, real-time marijuana surveillance system in this week’s JAMA Pediatrics.

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8 winning innovations at Hacking Pediatrics

general hackersHacking Pediatrics, now in its third year, continues to experiment with its format. 2015’s “Mashup” had a greater focus on partnerships, curation and delivering value to innovators at Boston Children’s Hospital. The brunt of the idea pitching and team formation took place in advance, allowing the event, on November 14, to be collapsed into one day.

The Hacking Pediatrics team (Kate Donovan, Mike Docktor, Meg McCabe, Cassandra Bannos and Leila Amerling) brokered collaborations with a dozen industry partners such as Microsoft, Cerner, Box, CVS Health and Boston Scientific. Over the course of a hectic 12-hour day, they worked with 17 teams of Boston Children’s innovators and experts from partner organizations who presented their final ideas to a panel of judges.

In another change for 2015, the Hacking Pediatrics team issued nine awards — but no immediate prizes. This was meant to incentivize teams to continue to work and meet milestones to earn real rewards, like a $10,000 design prize offered up by design firm Mad*Pow.

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Mapping antibiotic resistance near you: ResistanceOpen

antibiotic resistance mapping ResistanceOpen

At the moment, it would appear the bacteria are winning. Antibiotic resistance is on the rise globally (in part because much of the public may not really understand how antibiotics work), threatening doctors’ ability to treat bacterial infections and potentially making surgery, chemotherapy and other medical procedures whose safety depends on antibiotic prophylaxis more risky.

Mapping antibiotic resistance — which bacteria are resistant to which drugs, and where — can help clinicians and public health officials decide how best to focus their control efforts. The challenge to date has been compiling resistance data in geographically useful ways.

“The data about antibiotic resistance are fragmented across laboratories and hospitals globally,” says Derek MacFadden, MD, a doctoral student at the Harvard T.H. Chan School of Public Health who is working with the HealthMap team in Boston Children’s Computational Health Informatics Program. “Most of the data that are available are very high level, so you can’t get an understanding of regional-level antibiotic resistance.”

This is where ResistanceOpen could come in handy. This new tool, launched by HealthMap team this week during the World Health Organization’s World Antibiotic Awareness Week, provides a window into regional and local antibiotic resistance patterns across the globe.

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IBM Watson Health and Medtronic: Where devices, data, and patient engagement meet

“When you’re dealing with a chronic disease like diabetes, 90 percent of medical care is done by the patients themselves,” says Jeff Ruiz, vice president of diabetes service and solutions at Medtronic. The time people with diabetes spend in the doctor’s office each year pales in comparison to the time they themselves spend managing their condition each and every day.

That’s why Medtronic, the world leader in diabetes management devices, is focused on patient engagement and turning real-time data into actionable insights. “You can provide all the best devices and medications, but it’s up to the patient at the end of the day,” said Ruiz, speaking on Monday during a panel discussion at the 2015 Boston Children’s Hospital Global Pediatric Innovation Summit + Awards.

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Aneesh Chopra: Five insights for innovators

In the mid-2000s, David Van Sickle, a researcher at the Centers for Disease Control and Prevention, had a hypothesis. He suspected asthma treatment might be overemphasizing direct patient intervention and underemphasizing broader environmental and health factors.

To test his hunch, Van Sickle enabled asthma inhalers with GPS technology and placed them in the hands of 1,000 people in Louisville, Kentucky. By tracking the time and location of asthma attacks and layering the results with open government data, Van Sickle discovered clusters of attacks in certain sections of the city — a finding that’s helping to clarify the link between asthma and environmental factors such as air quality.

According to Aneesh Chopra, cofounder of Hunch Analytics and the first-ever U.S. chief technology officer, Van Sickle — now the CEO of Propeller Health, a platform for respiratory health management — represents a new breed of health-care innovators who are using software and apps to draw insights from masses of data.

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