The Cardiocam: Physiological Monitoring via Webcam

Published on December 19, 2010 by Bob in Medical Devices and Technology. 0 Comments Tags: .

Today’s New York Times Magazine The Year in Ideas: 10th Anniversary Special features the MIT Cardiocam:

Cardiocam is a low-cost, non-contact technology for measurement of physiological signals using a basic digital imaging device such as a Webcam. The ability to perform remote measurements of vital signs is promising for enhancing the delivery of primary health care.

Medgadget covered this in October: MIT Student Uses Webcam to Measure Heart Rate From a Distance includes a video that shows how the Cardiocam is used to create a “medical mirror” for home health monitoring.

A link to a PDF (here) has a full description of the research, including their Cardiac pulse recovery methodology:

The method uses Blind Source (Signal) Separation (BSS) by Independent Component Analysis (ICA) of the changes in the video signal:

Volumetric changes in the facial blood vessels during the cardiac cycle modify the path length of the incident ambient light such that the subsequent changes in amount of reflected light indicate the timing of cardiovascular events.

Very cool.

Hacking Your Own Health Data

Published on December 15, 2010 by Bob in EMR and PHR. 1 Comment Tags: .

The MassDevice article Doctors to patients: Track your own health data has an interesting take on the  personally controlled healthcare record (PCHR).

Keely Wray advocates that PCHR data should be “Hackable” (my highlight):

I mean “hackable” in the sense of the word that is quickly growing in popularity: allow owners of a product to manipulate, re-purpose or add to the functionality of a product to serve their own personal needs.

Ms. Wray asks:

Doesn’t it make sense to allow patients to put the technologies together in a way that meets their needs?

Their own needs? Maybe yes, but probably not.

The biggest incentive for innovation will be where someone sees an opportunity to meet a lot of other people’s needs. This may well be for group that shares a common problem or aliment with the technologist(s).  The initial intent may be altruistic, but real growth will only take place when a market emerges.  This is the reality that could lead to significant new health data management solutions.

For example, PatientsLikeMe started off this way (from the About Us page):

Our personal experiences with ALS (Lou Gehrig’s disease) inspired us to create a community of patients, doctors, and organizations that inspires, informs, and empowers individuals.

There’s nothing wrong with that.

Your Brain on Ads

Published on November 14, 2010 by Bob in EEG. 1 Comment Tags: .

Today’s New York Times article Making Ads That Whisper to the Brain gives a pretty balanced view of using EEG monitoring for doing market research — “Neuromarketing.”

This is not a mind reader,… We can only measure whether you are paying attention.

I write frequently on EEG related technologies, and often sceptically about some of its applications. The term “pop neurology” seems to apply here, especially when it comes to the ability for this technology to correlate to purchasing behavior. The establishment of NeuroStandards will only ensure that everyone is fooling themselves the same way.

Also, “brain-whispering” makes no sense. Most ads I see are loud and intellectually insulting (TV) or are visually annoying (Web) — it’s more like brain-shouting.

Here’s a Today show segment on this: Inside the brain of a shopper.

Agile Software Development in Regulated Environments

Published on October 16, 2010 by Bob in Agile, FDA and Software Quality. 3 Comments Tags: .

As part of a series on High Assurance Agile Development in Regulated Environments is the article
Agile Software Development in Regulated Environments Example: Medical Devices. The purpose of this article and future posts is to introduce the FDA regulatory landscape and then

… see what we can do to “agilify” our practices under these standards as we move forward.

It’s been three years since I wrote Agile development in a FDA regulated setting.  I’ll be interested to see if the application of “agile, high assurance activities” in this environment — and the associated issues — have changed since then.

UPDATE (10/23/10): Can and should agile be used for medical device development? Absolutely!

UPDATE (11/27/10): More discussion here: Can Agile Software Methods be used in medical device software development?

UPDATE (11/28/10): Agile Medical Device Software Development?

UPDATE (12/17/10): GE Healthcare Goes Agile

UPDATE (1/5/11): Missed this one: Four Reasons Medical Device Companies Need Agile Development

Brain Monitoring News

Published on September 8, 2010 by Bob in EEG and HCI. 0 Comments Tags: , , , .

There have been some interesting EEG related stories lately:

I’ve followed BCI: Brain Computer Interface and EEG work for a long time. There is still a long way to go on the “mind reading” front, but these types of developments are all encouraging.

Second Annual Medical Device Connectivity Conference

Published on September 2, 2010 by Bob in Interoperability and Medical Devices. 0 Comments Tags: , .

This year’s Medical Device Connectivity Conference is being held Sept. 28-29, 2010 in San Diego.

From the press release Tim Gee says:

The only conference devoted to the topic of medical device connectivity, the program will offer a unique opportunity to get immersed into every aspect of connectivity, workflow automation and enabling technologies. The keynotes and panel discussions on the first day frame the conference’s focus on connectivity and tackle two of the biggest issues facing health care: industry standards and regulatory issues. Program tracks on the second day provide a survey of connectivity applications, clinical capabilities and outcomes, and explore the gap between regulated vendor-managed systems and the customer-managed and controlled environments in which these systems are used.

Here are just a few of the topics I’m particularly interested in:

  • EMERGING PROBLEMS AND RISING AWARENESS OF MEDICAL DEVICE SYSTEMS ON ENTERPRISE NETWORKS
  • LOOKING BEYOND CONNECTIVITY IN HOSPITALS TO HOME HEALTH AND MOBILITY
  • OPEN EHR MANIFESTSO: OPPORTUNITIES FOR MEDICAL DEVICE COMPANIES
  • INTEROPERABLE MEDICAL DEVICE SYSTEM ARCHITECTURES

Looks like another great conference!

Closer to Launch: Healthcare IT Q&A

Published on September 2, 2010 by Bob in General. 3 Comments Tags: , , .

The reverse psychology I used in Failure to Launch: Healthcare IT Q&A is finally starting to work. The question definitions are complete and the commitment phase has begun:

Go over and sign up today.

A Threat Analysis of Networked Medical Devices

Published on August 14, 2010 by Bob in HIPAA, Medical Devices and Microsoft. 2 Comments Tags: , .

Here’s an interesting analysis of security threats within a Windows-based hospital network for embedded medical devices: A threat analysis of critical patient monitoring medical devices.

The threat models are fairly complex and clearly a product of wider enterprise network IT security needs. I’ve discussed some of the other issues of putting medical devices on an institutional network in Networked Medical Devices. Security threats were not covered and this is an important topic for every hospital network.

There are a couple of items in this article worth commenting on.

The top five unmitigated threats were found to be:

The corrective action for the top threat (T002) was (my highlight):

After it was decided to remove all ePHI from the medical device data storage, the risk assessment changed and the threat of the medical device infecting the hospital enterprise network (T017) then became our primary concern.

This may be the “most effective countermeasure possible for HIPAA compliance and protecting patient privacy”, but it is a not practical solution in the real world. Many medical devices store patient demographics. Because the benefits of patient identification outweigh the security risks, this practice is not likely to change in the future.

On these questions:

  1. Can the medical devices be infected from the enterprise network?
  2. Can the medical devices be infected via removable media?
  3. Can infected medical devices propagate malicious software back into the enterprise network?

I generally agree with the conclusions for the device under analysis. The challenge for a hospital is how do you ensure that every networked medical device follows these best practices (communications integrity, hardened OS, clean distribution media, etc.)?

Technical Debt in Medical Software

Published on August 4, 2010 by Bob in FDA, Programming and Software Quality. 2 Comments Tags: , , .

Software development is software development. Most of the life cycle and quality issues faced in medical software are the same challenges for any software product. Technical Debt in Medical Software points out what technical debt is:

  • Complexity
  • Code Duplication
  • Documentation Debt
  • Testing Debt
  • Architectural Debt

A Martin Fowler article is referenced that nicely identifies the source of technical debt:

The benefits of paying down the debt are:

  • Increased R&D efficiency and improved time to market
  • Hitting commitment dates
  • Performance and technology upgrades

Of course if you don’t want to pay it off, there’s always the option to go bankrupt. This may have long-term advantages, but it will surely be a more expensive route. There is one statement in this regard that I think needs some qualification:

In this case the technical debt can be retired along with the legacy system, and like filing Chapter 11, you are no longer responsible to address all the sins of the past.

I know this refers to code sins, but just because you decide to do a re-write doesn’t mean you no longer have responsibility for the legacy product. You still have customers using the old software that you’re obligated to continue to support.  For FDA approved medical software, this is a legal requirement. Most of the time this means that the legacy code will need to be maintained and periodically updated in the field, sometimes even after the “new” product is released. This just makes the cost of bankruptcy even higher.

Failure to Launch: Healthcare IT Q&A

Published on July 19, 2010 by Bob in General. 1 Comment Tags: , , , , .

It seems like a great concept (to me anyway). Grow a community of like-minded Healthcare IT geeks that want to participate in an on-line Q&A site which rewards contribution and facilitates constructive dialog. As of today, it appears unlikely this will happen anytime soon.

Even after being endorsed on HISTalk News 6/25/10 less than 900 people have visited the site.

The attraction that programmers have for Stack Overflow just doesn’t translate for this group of professionals. I suppose it’s the nature of the business.

  1. Programming, like Food and Cooking, have a much larger audience. Since only a small percentage of the interested population will actively participate or become community leaders, the numbers game is critical.
  2. Even though Healthcare IT seems like a broad topic, the number of non-subjective questions that could be asked is probably fairly limited.  The .NET Framework and bread recipes have tons of facts.
  3. Maybe HIT experts are a shy bunch?  The activity level also seems surprising low on Chris Paton’s Health Informatics Forum site which has over 4000 members.

Anyway, it’s really too bad there isn’t a way for a site like this to gain traction. It would be a valuable HIT resource if it could get off the ground.

Subscribe

Categories

Twitter Updates