Stories about: Information technology

4 tactical steps to designing for digital health

design digital health

Third in an ongoing series of Innovator’s Roadmap posts from Boston Children’s Hospital’s Innovation & Digital Health Accelerator (IDHA). Matt Murphy is Innovation Lead at IDHA.

We recently provided market sizing guidelines for healthcare innovators — strategies to help you determine your innovation’s total number of potential users and your sales opportunities. Next, we’ll take you through our approach to designing digital health products.

The research and design phase is a critical step in the development and commercialization of digital health innovations. This phase is often referred to as user-centered design or human factors design. It requires a significant investment in understanding your users (including clinicians, clinical teams, patients and/or caregivers) and their pain points (problems they repeatedly experience) before developing a technology-based solution.

In our initial consultations with innovators at Boston Children’s Hospital, we spend only a small amount of time discussing end technology solutions. Instead, we seek to understand the intended users, their pain points and how they will interact with the innovation, including clinical, workflow and business considerations.

It’s market research taken a step further. We recommend you follow a specific four-step procedure to optimize the research and design phase.

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7 digital health predictions for 2017

digital health predictions

What does 2017 have in store for digital healthcare innovations? Vector connected with clinical, digital health and business experts from the Innovation & Digital Health Accelerator (IDHA) at Boston Children’s Hospital and asked for their predictions.

Overall? “Expect to see a reshaping of the patient journey, more patient-centric care and more clinically impactful technology in 2017,” says John Brownstein, PhD, Chief Innovation Officer at the hospital. “We’re also looking forward to digital health offerings being met by industry-wide adoption as patient-centric care is provided and reimbursed.”

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Real-time contextual information could help doctors interpret children’s brain scans

Radiologists who can tune in to the nuances of brain scans in children are a pretty rarified group. Only about 3 percent of U.S. radiologists, some 800 to 900 physicians, practice in pediatrics. Those specifically trained in pediatric neuroradiology are even scarcer.

To a less trained eye, normal developmental changes in a child’s brain may be misinterpreted as abnormal on MRI. Conversely, a complex brain disorder can sometimes appear normal. That’s especially true when the abnormality affects both sides of the brain equally (see sidebar).

It can be hard to find the cause of a child’s developmental delay without a proper read. “Pediatric brain scans of children under age 4 can be particularly tricky to read because the brain is rapidly developing during this period,” says Sanjay Prabhu, MBBS, a pediatric neuroradiologist at Boston Children’s Hospital. “If you’re looking at adult scans all the time, it’s incredibly difficult to transition to pediatric scans and understand what is considered ‘normal’ and ‘abnormal.’ Clinicians often wonder, ‘Should I repeat the scan? Should I send the patient to a specialist?’”

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News Notes: Research and innovation news

A few things that caught Vector’s eye during the week:

FDA drug evaluation staff: An unmet need

overflowing inbox at FDA

New laws or initiatives to expedite drug approvals, especially for orphan drugs, have prompted the Food and Drug Administration to create new positions to review the applications. Unfortunately, these slots are proving hard to fill. Kaiser Health News reports that the FDA has more than 700 job vacancies in its Center for Drug Evaluation and Research (CDER), which approves new drugs. The problem? Pharma pays more — “roughly twice as much as we can,” said CDER director Janet Woodcock at a recent rare-disease summit. The 21st Century Cures Act, still awaiting Senate approval, could help by allowing the FDA to offer higher salaries and relaxing postgraduate degree requirements for some positions.

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Health care wants YOU: 9 opportunities, 4 pearls for digital health startups

digital health startups - reverse pitches
A visual summary of reverse digital health pitches (illustration: CollectiveNext).

Boston’s digital health world is humming with tech talent, idealistic health care professionals and business-savvy accelerator organizations. The passion was palpable last week as 300-plus people gathered at MassChallenge’s latest Pulse@Check digital health meetup, hoping to turn their health care ideas into reality.

The event, hosted by Boston Children’s Hospital’s Innovation and Digital Health Accelerator (IDHA) and Cerner, a lead developer of health care IT systems, presented numerous opportunities and tips for digital health startups.

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Startup uses Uber to get patients to their medical appointments

Uber medical transportation Circulation

Getting to the doctor will soon get easier for some struggling patients. Boston Children’s Hospital has joined forces with the ride-hailing service Uber to pilot a non-emergency medical transportation platform.

The online, HIPAA-compliant tool, called Circulation, connects with health care information systems, enabling hospitals to schedule Uber rides for patients. The pilot will serve Boston Children’s, Mercy Health System in Pennsylvania and Nemours Children’s Health System in Wilmington, Delaware.

A 2005 study estimated that 3.6 million people miss medical appointments because they don’t have access to transportation. While Medicare and Medicaid and other payers provide non-emergency transportation benefits, such as taxi vouchers, patients may be unaware of the programs or have trouble navigating reimbursement rules for the rides. Frequently, the taxi or car service arrives late or doesn’t show up at all.

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I feel good! How mood influences time management

time management and mood
(JESHOOTS/Pixabay)

Most theorists boil human behavior down to a pursuit of pleasure. Yet all of us engage in mundane, even unpleasant activities. It’s called being an adult, right? Happy Monday!

But Maxime Taquet, PhD at the Computational Radiology Laboratory at Boston Children’s Hospital (who by day helps conduct advanced brain imaging in children with neurologic conditions) wondered why. If we’re such pleasure-seekers, how do we muster the will to do our taxes or vacuum the house?

Taquet, with Jordi Quoidbach, PhD, of the Department of Economics and Business at the University Pompeu Fabra in Barcelona, and other colleagues developed a smartphone app to track the activities and moods of more than 28,000 French-speaking people for an average of 27 days. At random times during the day, the app asked users to rate their current mood on a scale of 0 to 100 and indicate what they were doing at that moment from a list of options.

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Tracking the public health effects of the Rio Olympics: HealthMap

Olympics Brazil Zika Health Map
Athletes around the world are converging on Brazil. What effects will this have on Zika and public health generally? (Nuno Lopes/Pixabay)

This past week, the 2016 Summer Olympic and Paralympic Games began in Rio de Janeiro, Brazil, with more than 11,000 athletes and 500,000 international fans expected to arrive. As a major mass gathering, the Olympic Games are always vulnerable to disease outbreaks. This summer, all eyes in public health are on the concurrently occurring Zika virus and the under-reported H1N1 influenza outbreak in Brazil.

According to the European Centre for Disease Prevention and Control (ECDC), visitors to the 2016 Games are most at risk for gastrointestinal illness from waterborne pathogens and mosquito-borne infections, including dengue, chikungunya and Zika virus. So far in 2016, we have seen an estimated 165,000 cases of Zika virus, 1,345,286 cases of dengue, 137,808 cases of chikungunya and more than 6,500 cases of H1N1 influenza, with an additional 1,233 deaths from H1N1 — all in Brazil alone.

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Moving one step closer to smartphone-like, interoperable EHR apps

Medical app buttons croppedToday, most people’s clinical records remain siloed at a single hospital or health network. For the most part, health apps can’t tap into these data, nor can medicine learn from them. Also, most electronic health records (EHRs) are unable to import the biometric data people are collecting from their own devices, much less interpret them.

In 2009, Kenneth Mandl, MD, MPH, and Isaac Kohane, MD, PhD, of Boston Children’s Hospital published a manifesto in The New England Journal of Medicine calling for health care information systems to have iPhone functionality. This would entail several key attributes: liquidity of data, modularity of applications, accommodation of both open-source and closed-source software through open standards, and the ability to support diverse applications.

In short, they envisioned a “plug and play” health IT platform.

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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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