Category Archives: data saving lives

data saving lives, EF, health market quality, healthy habits, nutrition, research methodology

Jeffrey Braithwaite on Microlifes and Micromorts

Punchy.

http://www.jeffreybraithwaite.com/new-blog/2014/11/20/youll-be-dying-to-hear-about-this

You’ll be dying to hear about this

There’s lots of death in the world. Transport is risky, for instance—planes, automobiles, trains and ships can crash, maiming or killing passengers. You don’t have to go much further than seeing the road toll, or hearing about Malaysian Airlines Flight MH17 shot down over the Ukraine, or watching the TV scenes of the Costa Concordia, run aground just off Isola del Giglio near the coast of Italy, to appreciate that death is never far away.

Then there’s infectious diseases. You can all-too-readily catch a cold, or the flu, or TB, or lately, the Ebola virus. And there seem to be never-ending wars and skirmishes in the Middle East; and terror, spread by fundamentalists.

Each of these, depending on fate, can hasten someone’s demise. Wrong place, wrong time, wrong circumstances.

Lifestyle issues can cause problems for your risk profile too—but these are slower, and more stealthy. Think of smoking, drinking too much, eating yourself into a coma or just gross obesity, or the more insidious dangers of sitting at a computer for years on end with little exercise. These can translate over time into heart or lung disease, diabetes, and cancer.

Whether you are active or passive, things you do or don’t do can shorten your lifespan, or kill you a little or a lot faster than you would otherwise last. So what levels of risk do you actually, quantitatively, face in your own life?

*****

Stanford University decision scientist Ron Howard in the 1970s presented a novel way to calculate this risk. He introduced the idea of the micromort, defined as a one-in-a-million likelihood of death.  This is such an evocative unit of measurement that it deserves a little further attention.

If you live in the US or another relatively rich, OECD-style country, with good law and order, legislation that keeps society relatively risk free (such as with environmental and public health issues sorted out, effective building codes, and so forth), a well-educated population, access to health care, and a buoyant GDP, you can expect a micromort of one on any particular day. Another way of saying this is that’s the standard expected death rate for any individual today in any one 24 hour period: a microprobability of one in a million is your index of baseline risk.

These are great odds for you, today, as you read this; you are very likely to get through it. Congratulations if you do.

What circumstances lead to an elevated risk? Say if you do dangerous things or even just live life to the full? How does your micromort level get upgraded?

In the United States, you accumulate an extra 16 micromorts each time you ride a motorcycle 100 miles, for instance. Or 0.7 micromorts are added for each day you go skiing; so go for a week and you’ve added five more.

Or you might decide to do something a little more strenuous. With hangliding, the additional risk of dying equates to eight micromorts per flight; or skydiving, nine per freefall.

They are relatively benign compared to moving up to base-jumping. Do so, and you rapidly earn many more risk points: 430 micromorts per jump, in fact.

Marathon running, anyone? That will be seven micromorts to your debit account for each run. Even walking 17 miles adds one micromort, as does a 230 mile car trip, and add another one for every 6,000 mile train trip. But the puzzle is, it’s not always clear how to treat these: the walking introduces an element of risk (you could be out and about and get run over, or be struck by lightning) but it’s also beneficial (it contributes to improved health).

Perhaps even more interesting, there are microprobabilities associated with accumulated chronic risks in contrast to these other single-shot event risks. These are lifestyle choices and behaviors that incrementally add a little more risk through exposure. They won’t kill you if you have bad luck on a given day, but will slowly have an effect—and may claim you in the end.

Every half a liter of wine exposes you to a micromort because it can accrue into cirrhosis of the liver. Each one and a half cigarettes does the same, but the menace here is cancer or heart disease. Even eating 100 char-broiled steaks, 40 tablespoons of peanut butter or 1,000 bananas sneaks up on you in the form, respectively, of cancer risk from benzopyrene, liver cancer risk from aflatoxin B or cancer risk from radioactive potassium-40.

*****

Hang on though. I doubt I’ve done much to help anyone.

Because a clear problem is that people aren’t very good at doing these kinds of statistics, or applying them to their own lives—and are even less capable of acting on them. We can readily appreciate that skiing or motorcycling add some risk for the time you are doing them compared to the everyday activities of being at work or hanging out at home, yet many people are undeterred. People even cheerfully find ways of taking on more risk, such as by climbing Everest, driving fast cars, or having unsafe sex.

Everyone knows about that steadily accumulated risk, too: not too many of us are blind to the fact that drinking too much alcohol can lead to liver disease or smoking to lung cancer over time. And although both have been falling for decades, this hasn’t stopped millions of people indulging. There’s 42.1 million US smokers at last count, or 18.1% of the population, and on average each adult US citizen consumes 8.6 liters of alcohol annually.

This is not the best performance internationally but is by no means high by international standards, and Eastern Europeans smoke more heavily, and really give hard booze like vodka a nudge.  Nevertheless, both activities contribute to what public health people quaintly call excess deaths and the rest of us know by “their drinking or smoking (or both) killed them eventually.”

But what does it actually mean that you expose yourself to increased risk if you go out walking regularly or eat bananas?  We need another way of looking at this, because it’s too hard to do the sums.

*****

Enter the University of Cambridge medical statistician David Spiegelhalter and his colleague Alejandro Leiva who invented the idea of a microlife. This is another unit of risk which has the calculation built in for you. It is half an hour of your life.

If you increase your risk by one micromort, then this shortens your life by half an hour. These calculations apply to people on average, and work out for entire populations, but any one of us might be lucky or unlucky, depending on our individual characteristics. Any particular risk doesn’t convert exactly to the specific individual. But with enough people in the US (beyond 316 million now) and on the planet (7 billion and rising), there’s a relentlessness accuracy about the statistics.

So now let’s do some life expectancy math with Spiegelhalter. Smoke a pack a day? You lose up to five hours a day. Accumulated, that’s up to eight years off your life. Have six drinks a day and that binge costs you one half hour allocation—a shortened life by ten months or so. Stay eleven pounds overweight and you sacrifice half an hour every day you do so (another ten months across your lifespan), as you do if you watch TV for two hours. Your coffee habit at 2-3 cups daily takes away another half hour lot. So does every portion of red meat each day. Another ten months each time.

It’s not all negative. There’s good news. Eat five serves of fruit and vegetables every day and you gain up to a couple of hours each time. You get three years back. Exercise and the first 20 minutes per day earns you a surprising hour (there’s a good investment—a year and a half), and each subsequent 40 minutes adds up to one more half hour bonus to your credit (a bit more work but that seems a pretty good deal, too, to get a ten month return).

If you have a hobby, activity or diet and it’s not been dealt with so far, you can fill in some of the gaps with some good guesstimates. Do you have passive pursuits, akin to watching TV? This is a net deficit. Do you do active, exercise-oriented activities, such as weekly amateur netball, soccer, bowling or basketball—or just walking regularly? Add some lifespan.

These half hour allocations alter somewhat depending on your genetics of course (you can have lucky or unlucky genes) or your socioeconomic status (wealthy people typically live longer than poorer folks) or your gender (women on the whole live longer than men). That said, with this idea you are now able to alter your risk profile by changing your behavior with a tangible, calculable return.

*****

There’s a punchline to this, and it may be already occurring to you as you reflect on your own lifestyle and lifespan. There are a million microlives in fifty seven years of existence. That, for many of us, is roughly the adult allocation.

Let’s call that your life expectancy baseline. We can assume that you have had a reasonably healthy childhood (not so for everyone, of course, but true for many US children, and true for most readers). Then, from that point on, a large part of your healthy adult life is now measureable.

So: come out of your teens, reach your 21st birthday, and as the “jolly good fellow” and “happy birthday to you” songs subside, imagine you then have 57 years to go. That is, you have an allocation of 78 years in total, maybe a little longer, maybe a little shorter.

Yes, all sorts of unexpected things might happen along the way, but to some degree your lifespan is now no longer vague, but quantifiable. The actual life expectancy in the US indeed hovers around this: it’s 79.8 years overall, 77.4 for males and 82.2 for females. (It’s higher in some northern European countries and Japan, but that’s a story for another day).

However, you might be reading this thinking: Yikes. I’m not 21: I’m a bit older than that. In this case, you’ve already used up a proportion of your time left. Console yourself. At least you got through the riskiest stage of all: being a baby, up to one year of age, and childhood, up to six or so, when many things can go wrong.

But have you used what you were given so far, well? Or do you have a fair bit of regret?

To make an obvious point, however, this isn’t Doctor Who. You don’t have a Tardis to go back in time and fix the past. So stop any lamentations. Look forward.

By now, if you’ve come to value more readily each half hour and especially the cumulative effect of your lifestyle choices to date, don’t listen to me preaching. Feel completely empowered. You know what to do and how to alter your own numbers.

Now, all that’s left is to do the math. You’ll have a much clearer picture of your life and potential death than ever before. It’s your move: what’s next?

Further reading

Blastland, Michael and Spiegelhalter, David (2014). The Norm Chronicles: Stories and Numbers About Danger and Death. New York: Basic Books.

Howard, Ronald (1984). On fates comparable to death. Management Science 30 (4): 407–422.

Spiegelhalter, David (2012). Using speed of ageing and “microlives” to communicate the effects of lifetime habits and environment. British Medical Journal 345: e8223.

Spiegelhalter, David (2014). The power of the MicroMort. BJOG: An International Journal of Obstetrics & Gynaecology 121 (6): 662–663.

data saving lives, EF, entrepreneurship, health market quality, healthcare, rapid learning health systems

Health Analytics Intrapreneurial JV

Teams building analytics technology for healthcare organizations find themselves jointly holding intellectual property and equity in new arrangements not seen before in healthcare.

Extrapreneurial energy turns intrapreneurial analytics initiatives into companies in which healthcare enterprises retain some equity, remain customers, and benefit other healthcare enterprises who wish to purchase analytics technology and services.

Involves a definitive ten-year agreement valued at more than $100 million, to combine technologies, some of which Allina developed since becoming the first customer of Health Catalyst technology in 2008.

“We have a lot of confidence in our partner in Health Catalyst. Eighty percent of that [$100 million] is standard, but 20% of it is at risk, based on how we perform on key indicators, like how well the tools perform, for example, on reducing readmissions or unnecessary admissions for people who can spend nights in their own bed.

Wheeler says use of Health Catalyst technology has permitted Allina clinicians to significantly reduce readmissions, elective inductions of labor, time required to diagnose breast concerns, and sepsis rates.

http://www.healthleadersmedia.com/print/TEC-312328/Allina-Health-and-Health-Catalysts-Unusual-Deal

Allina Health and Health Catalyst’s Unusual Deal

Scott Mace, for HealthLeaders Media , January 20, 2015

Teams building analytics technology for healthcare organizations find themselves jointly holding intellectual property and equity in new arrangements not seen before in healthcare.

Follow the money, they say. It’s not always easy. “Terms of the transaction were not disclosed” is the common coin of many a deal. But despite this, some deals are harbingers of bigger things.

To make my point, I will appropriate a word: extrapreneur. It’s a word that you won’t find in most dictionaries. In 1992, the American Heritage Dictionary defined intrapreneur as “a person within a large corporation who takes direct responsibility for turning an idea into a profitable finished product through assertive risk-taking and innovation.”

So what’s an extrapreneur? One suggestion from England: Someone who shares information among organizations that they wouldn’t share among themselves.

That’s a good place to start when trying to understand what is occurring at Cleveland Clinic, Geisinger Health System, and, most recently, Allina Health, where teams building analytics technology for healthcare organizations find themselves jointly holding intellectual property and equity in new arrangements not seen before in healthcare.

Extrapreneurial energy turns intrapreneurial analytics initiatives into companies in which healthcare enterprises retain some equity, remain customers, and benefit other healthcare enterprises who wish to purchase analytics technology and services.

The term extrapreneurial also reminds me of extranets, the early e-commerce concept that extended intranets (internal TCP/IP-based corporate networks) to business partners as supply chains started being built when the World Wide Web was young.

In 2009, Cleveland Clinic’s extrapreneurial initiative spawned Explorys, an analytics platform which now counts numerous large healthcare systems among its clients. Yet, for quite some time, Explorys remained located on the Cleveland Clinic campus. And Cleveland Clinic remains an investor.

Geisinger created xG Health “to bring Geisinger’s expertise in healthcare delivery transformation to organizations nationwide,” according to xG’s Web site. xG describes itself as the primary provider of Geisinger’s health performance improvement intellectual property.

Launched in 2013 with $40 million of financing from venture capital partner Oak Investment Partners, and located in Columbia, Maryland, xG is not far from Geisinger’s Pennsylvania base of operations.

Allina and Health Catalyst
Then, on January 6, Allina Health joined the extrapreneurial ranks. A few terms of the agreement are intriguing the entire analytics industry. Allina took an undisclosed stake in analytics firm Health Catalyst.

Health Catalyst had just come off an impressive year, having raised $41 million in funding in January 2014, and convening a conference of its own rapidly-growing healthcare system analysts last fall in Salt Lake City, where the company is located.

But back to those interesting terms between Allina and Health Catalyst. It’s a definitive ten-year agreement valued at more than $100 million, to combine technologies, some of which Allina developed since becoming the first customer of Health Catalyst technology in 2008.

Once a year, a governing committee of the Allina / Health Catalyst partnership will identify a prioritized list of improvement projects, each designed to provide measurable care improvement and financial value to Allina. As the partnership achieves each goal, both partners will share in the benefits of that success.

The deal also means that Allina is outsourcing its data warehousing, analytics, performance improvement technology, content, and personnel to Health Catalyst to accelerate advances. Beginning this month, in phases, Allina employees working in these areas—some 60 in all—will become onsite Health Catalyst team members.

When you have a partnership of this magnitude, extrapreneurial forces also allow each partner to remain agile rather than locked into an arrangement that has the possibility of souring due to the changing vicissitudes of technology and healthcare.

The $100 million represents the cost of what the staff and tools were costing Allina, says Penny Wheeler, MD, president and CEO of Allina Health, a $3.7 billion not-for-profit organization whose more than 90 clinics, 12 hospitals, and related healthcare services provide care for nearly 1 million people across Minnesota and western Wisconsin.

Use the Best Tool
“We weren’t falling back on hope as a strategy,” Wheeler says. “We have a lot of confidence in our partner in Health Catalyst. Eighty percent of that [$100 million] is standard, but 20% of it is at risk, based on how we perform on key indicators, like how well the tools perform, for example, on reducing readmissions or unnecessary admissions for people who can spend nights in their own bed.

Wheeler says use of Health Catalyst technology has permitted Allina clinicians to significantly reduce readmissions, elective inductions of labor, time required to diagnose breast concerns, and sepsis rates.

“Our agreement with Health Catalyst says that if we find a better tool out there, we can use it,” she says. “So, for example, if [Epic analytics software] Cogito excels at the capabilities that we work with, then we use that,” she says.

“So it’s more about what can you use the best to improve care than any exclusivity. That just speaks to the confidence level we both have in our ability to partner and make things better, despite what else is out in the market.

“I’m pretty confident that we’re going to have a ten-year agreement and beyond,” Wheeler says.

“The margins in healthcare right now are so razor-thin, and that’s pretty apparent at Allina, given some of their recent financials. But they want to be able to create a little bit of a for-profit business around this core competency they’ve built in terms of managing their clinical performance with IT, which is what’s going on here,” notes Judy Hanover, research director of provider IT transformation at IDC Health Insights.

In the era of extrapreneurs, it’s all part of doing business.

Scott Mace is senior technology editor at HealthLeaders Media.

complex adaptive systems, data saving lives, EF, health market quality, healthcare, healthy habits, rapid learning health systems

Population Health: A riddle wrapped in an enigma

PN: The health sector is very happy to take full responsibility for the health of the population for as long as substantial monies are tied to that claim. The moment the health sector is asked to account for it, they get nervous.

Tying funding to value is a terrifying prospect for the health sector as having to account for the benefit they deliver would inevitably lead to a diminution in income and status.

“Because so many factors lie outside clinicians’ control, we need to understand what factors the healthcare system can reasonably be expected to act on, given professionals’ training, infrastructure and scope of practice,” they said. “We also need to determine the appropriate levels of health system accountability for population health outcomes.”

http://www.modernhealthcare.com/article/20150108/BLOG/301089997/population-health-improvement-still-a-riddle-wrapped-in-an-enigma

Population health improvement still a riddle wrapped in an enigma

By Melanie Evans  | January 8, 2015
Population Health
New England Journal of Medicine
The push to invest more of the healthcare industry’s time and money into promoting good health is, so far, uneven and uncertain in terms of effectiveness. Perhaps nowhere is that more apparent than in federal initiatives to broadly improve health by extending care beyond clinics and pharmacies into neighborhoods and homes.Federal funding for population-health efforts—the management of health and medical care for an entire group of patients or a community—has expanded under the Affordable Care Act. It’s included financing for states and providers to experiment with ways to better coordinate healthcare and other needs that affect health, such as housing and transportation. But the initiatives are not without risk or challenges, a point three federal officials underscored in the latest issue of the New England Journal of Medicine.

Efforts are still underway to identify what works and how to make widespread use of the most effective strategies, write Dr. William Kassler, Naomi Tomoyasu and Dr. Patrick Conway of the agency that oversees Medicare and Medicaid. The CMS Innovation Center, in a report to Congress last month, also said results were largely not yet available for nearly two dozen initiatives to bolster population health, improve quality and increase efficiency in healthcare, financed with $2.6 billion through last year.

Calculating a dividend from those investments presents another challenge, the trio wrote. Kassler is one of the CMS’ chief medical officers; Tomoyasu is deputy director of the prevention and population health care models group within the CMS Innovation Center; and Conway is the CMS’ deputy administrator for innovation and quality.

The return on any investment in prevention will necessarily take time, raising the risk that “current actuarial methods used to evaluate return on investment may underestimate potential savings,” they warned.

Investment at the federal level is not small. Medicare and Medicaid—which combined account for $1 of every $3 the nation spends on healthcare—have increasingly poured money into strategies for disease prevention and health promotion.

Those strategies extend the reach of healthcare beyond hospitals, clinics and pharmacies into neighborhoods, homes and schools. Such extended investment can include help with housing, transportation, literacy, day care and groceries, the officials wrote.

But with that expanded reach comes a debate “regarding the specific population-based activities that fall within healthcare providers’ scope of practice,” wrote the CMS officials. “Because so many factors lie outside clinicians’ control, we need to understand what factors the healthcare system can reasonably be expected to act on, given professionals’ training, infrastructure and scope of practice,” they said. “We also need to determine the appropriate levels of health system accountability for population health outcomes.”

Follow Melanie Evans on Twitter: @MHmevans

data saving lives, EF, entrepreneurship, healthcare, healthy habits, quantified self, rapid learning health systems

WSJ: Can a Smartphone Tell if You’re Depressed?

 

http://www.wsj.com/articles/can-a-smartphone-tell-if-youre-depressed-1420499238

TECHNOLOGY

Can a Smartphone Tell if You’re Depressed?

Apps, Other Tools Help Doctors, Insurers Measure Psychological Well-Being

By

JOSEPH WALKER

HUNTERSVILLE, N.C.—Toward the end of Janisse Flowers’s pregnancy, a nurse at her gynecologist’s office asked her to download an iPhone app that would track how often she text messaged with friends, how long she talked on the phone and how far she traveled each day.

The app was part of an effort by Ms. Flowers’s health-care provider to test whether smartphone data could help detect symptoms of postpartum depression, an underdiagnosed condition affecting women after they give birth. The app’s developer, San Francisco-based…

complex adaptive systems, data saving lives, EF, facts & data points, health market quality, healthcare, policy, politics, quantified self, rapid learning health systems

Yach: Changing the Landscape for Prevention and Health Promotion

 

http://www.huffingtonpost.com/dr-derek-yach/changing-the-landscape-fo_1_b_6439328.html

Become a fanExecutive Director of the Vitality Institute

Changing the Landscape for Prevention and Health Promotion

Posted: Updated:

By Bridget B. Kelly and Derek Yach*

Chronic diseases like heart disease, diabetes, and cancer are major contributors to poor health and rising health care costs in the U.S. The cost of treating these conditions is estimated to account for 80 percent of annual health care expenditures. More and more, experts agree on the great potential for preventing or delaying many cases of costly chronic diseases by focusing on environmental, social, and behavioral root influences on health. Yet the U.S. has been slow to complement its considerable spending on biomedical treatments with investments in population-based and non-clinical prevention interventions.

What is getting in the way of strengthening our investments in prevention and health promotion? A few consistent themes emerged across multiple expert consensus studies conducted by the Institute of Medicine (IOM), which were summarized in the report Improving Support for Heath Promotion and Chronic Disease Prevention — developed in support of the recent Vitality Institute Commission on Health Promotion and Prevention of Chronic Disease in Working-Age Americans.

First, prevention is challenging — chronic health problems are complex, and so are the solutions. Second, decision-makers who allocate resources have tough choices to make among many competing pressures and priorities; prevention and promotion can be at a disadvantage because their benefits are delayed. Third, there is a need for better, more usable evidence related to the effectiveness, the implementation at scale, and the economics of prevention interventions. Decision-makers need information that makes it easier to understand, identify, and successfully implement prevention strategies and policies. As noted in a recent opinion piece in the Journal of the American Medical Association (JAMA), limited investment in prevention research has resulted in an inaccurate perception that investing in preventive measures is of limited value. This has profound implications for federal funding allocations.

The mismatch in funding allocations is seen right at the source of our nation’s major investment in new health-related knowledge: the National Institutes of Health (NIH). A new paper in the American Journal of Preventive Medicine found that less than 10 percent of the NIH annual budget for chronic diseases is allocated to improving our knowledge base for effective behavioral interventions to prevent chronic diseases. This means that despite the immense potential for prevention science to reduce the burden of chronic diseases in the U.S., it is woefully underfunded compared to what we invest in researching biomedical treatment interventions for these conditions. NIH investments affect what evidence is ultimately available to those who decide how to allocate resources to improve the health of our nation, and they also affect the kinds of health experts we train as a country. By not investing in prevention science and in a future generation of scientists capable of doing high quality research in prevention, we are perpetually caught in the same vicious cycle where prevention continues to lag behind in our knowledge and therefore our actions.

There is hope that the landscape is slowly changing. Initiatives such as the NIH Office of Disease Prevention‘s Strategic Plan for 2014-2018 and the Affordable Care Act’s mandated Patient-Centered Outcomes Research Institute (PCORI) have the potential to strengthen prevention science and build the evidence-base for effective prevention interventions. Innovations in personalized health technologies and advances in behavioral economics also show great promise in improving health behaviors for chronic disease prevention.

The Vitality Institute Commission’s report emphasized the need for faster and more powerful research and development cycles for prevention interventions through increased federal funding for prevention science as well as the fostering of stronger public-private partnerships. It is essential to generate and communicate evidence in a way that enables decision-makers to understand the value of investing in prevention while taking into account their priorities, interests and constituencies. This will lead us to more balanced investments, make prevention a national priority, and boost the health of the nation.

*The authors are responsible for the content of this article, which does not necessarily represent the views of the Institute of Medicine.

data saving lives, healthcare, healthy habits, rapid learning health systems

The Temporary Tattoo That Tests Blood Sugar

 

http://www.theatlantic.com/health/archive/2015/01/the-temporary-tattoo-that-tests-blood-sugar/384581/

The Temporary Tattoo That Tests Blood Sugar

An electronic sensor may mean the end of finger pricking.

UC San Diego

A painful prick of the fingertip reveals a mountain of medical information for many diabetes patients. But health professionals have long struggled to find a reliable and painless way to gather blood sugar measurements. Just last year, Google announced that it was developing contact lenses that measure glucose levels in its user’s tears. But now, nanoengineers may have found an even easier way for diabetes patients to monitor their vital levels: temporary tattoos.

Amay Bandodkar, a researcher at the University of California, San Diego, has created a flexible sensor that uses a mild electrical current to measure glucose levels in a person’s body. Measuring blood sugar levels multiple times a day is vital for diabetes patients because it shows how well their body is managing their disease as well as the dose of insulin they require, if they need any at all. But because many people find needles unpleasant, they tend to avoid measuring their levels, which puts them at risk of developing serious medical complications. The new device is painless—It contains electrodes printed on a thin tattoo paper that patients can even dispose after use. “Presently the tattoo sensor can easily survive for a day,” Bandodkar said in a statement. “These are extremely inexpensive—a few cents—and hence can be replaced without much financial burden on the patient.”

The tattoo has already provided accurate glucose measures for seven healthy patients, the team reported in a recent issue of the journal Analytical Chemistry.The patients, all non-diabetics between the ages of 20 and 40, wore the tattoos before eating a sandwich and drinking a soda. Following the carb-rich meal, the tattoo recorded the spike in each patient’s glucose levels as accurately as a traditional finger-stick device. The tattoo is a few steps away from providing the numeric value of glucose levels, so scientists have to remove and analyze it in order to retrieve its measurements. Eventually, Bandodkar said the tattoo will have “Bluetooth capabilities to send this information directly to the patient’s doctor in real-time or store data in the cloud.”

The researchers hope the tattoo will eventually be used to monitor levels of other compounds in the blood, like metabolites, medications, or alcohol and illegal drugs. Whatever the application, the fewer needles the better.

complex adaptive systems, data saving lives

Torch: Facebook Offers Artificial Intelligence Tech to Open Source Group

 

Facebook Offers Artificial Intelligence Tech to Open Source Group

By

Mark Zuckerberg, chief executive of Facebook. By releasing tools for computers to researchers, Facebook will also be able to accelerate its own Artificial Intelligence projects.
Mark Zuckerberg, chief executive of Facebook. By releasing tools for computers to researchers, Facebook will also be able to accelerate its own Artificial Intelligence projects.Jose Miguel Gomez/Reuters

Facebook wants the world to see a lot more patterns and predictions.

The company said Friday that it was donating for public use several powerful tools for computers, including the means to go through huge amounts of data, looking for common elements of information. The products, used in a so-called neural network of machines, can speed pattern recognition by up to 23.5 times, Facebook said.

The tools will be donated to Torch, an open source software project that is focused on a kind of data analysis known as deep learning. Deep learning is a type of machine learning that mimics how scientists think the brain works, over time making associations that separate meaningless information from meaningful signals.

Companies like Facebook, Google, Microsoft and Twitter use Torch to figure out things like the probable contents of an image, or what ad to put in front of you next.

“It’s very useful for neural nets and artificial intelligence in general,” said Soumith Chintala, a research engineer at Facebook AI Research, Facebook’s lab for advanced computing. He is also one of the creators of the Torch project. Aside from big companies, he said, Torch can be useful for “start-ups, university labs.”

Certainly, Facebook’s move shows a bit of enlightened self-interest. By releasing the tools to a large community of researchers and developers, Facebook will also be able to accelerate its own AI projects. Mark Zuckerberg has previously cited such open source tactics as his reason for starting the Open Compute Initiative, an open source effort to catch up with Google, Amazon and Yahoo on building big data centers.

Torch is also useful in computer vision, or the recognition of objects in the physical world, as well as question answering systems. Mr. Chintala said his group had fed a machine a simplified version of “The Lord of the Rings” novels and the computer can understand and answer basic questions about the book.

“It’s very early, but it shows incredible promise,” he said. Facebook can already look at some sentences, he said, and figure out what kind of hashtag should be associated with the words, which could be useful in better understanding people’s intentions. Such techniques could also be used in determining the intention behind an Internet search, something Google does not do on its regular search.

Besides the tools for training neural nets faster, Facebook’s donations include a new means of training multiple computer processors at the same time, a means of cataloging words when analyzing language and tools for better speech recognition software.

cool, data saving lives, EF, healthcare, quotes & aphorisms, rapid learning health systems

Data is just a shadow of human experience. We still need to connect the dots – Roni Zeiger

http://eepurl.com/-rUf9

“Data is just a shadow of human experience. We still need to connect the dots,” Smart Patients founder and Rock Health entrepreneur Roni Zeiger argued last week. Luckily, healthcare may finally be ready for big data—just so long as the algorithms don’t ruin your life.

data saving lives, EF, rapid learning health systems

Outsourced health analytics deal

 

http://www.forbes.com/sites/neilversel/2015/01/06/108m-analytics-outsourcing-deal-puts-health-catalyst-at-risk-for-allina-health-outcomes/

$108M Analytics Outsourcing Deal Puts Health Catalyst At Risk For Allina Health Outcomes

A major Minnesota health system is outsourcing its entire analytics operation in a 10-year, $108 million deal with a twist: The technology vendor has a financial incentive to assure that Minneapolis-based Allina Health actually improves patient outcomes and reduces the cost of care.

Under the terms of the contract, announced Tuesday, Allina is sending its data warehousing, analytics, performance improvement technology, clinical knowledge and all of its related employees to privately held healthcare analytics company Health Catalyst.

In return, Allina receives full subscription rights to Health Catalyst’s technology, as well as an unspecified equity stake in Health Catalyst, which grew out of clinical improvement efforts at Intermountain Healthcare in Salt Lake City.

About 20 percent of the contract value is dependent on Allina showing better outcomes and lower costs. A committee that will govern the Health Catalyst-Allina partnership will annually make a list of clinical improvement projects, setting measurable outcomes goals, the vendor says.

“It’s really a shared-risk contract,” Health Catalyst CEO Dan Burton tells Forbes.com. “It’s the first example that we’re aware of in healthcare” in which the analytics vendor’s payments are dependent on the client’s performance, Burton adds.

Health Catalyst envisions Allina Health’s 12 hospitals and nearly 100 outpatient clinics becoming a “living laboratory” for healthcare improvement. “We expect that this process of using analytics to prioritize projects, in combination with risk-sharing economics, will encourage far more focus and alignment than is found in traditional health system-vendor relationships,” Allina CFO Duncan Gallagher says in a press release.

“We hope that this becomes a trend in the industry,” Burton says.

Providers themselves have had to become accountable to insurance companies, including the federal Medicare program. The Patient Protection and Affordable Care Act offers incentives for healthcare entities to form “accountable care organizations,” and private payers as well as state governments have followed suit.

This deal, with its performance-based component, brings accountability to a vendor, according to Burton. “The healthcare industry has invested tens of billions of dollars in upgrading their technology without holding their technology vendors accountable.”

Allina actually was Health Catalyst’s first customer in 2008, but ran out of projects for the vendor two years later. The two reconnected in 2013, having discussions that led to this 10-year contract.

data saving lives, EF, entrepreneurship, healthy habits, nutrition, policy, quantified self, rapid learning health systems

Bloomberg: Omada Health Pitch

  • Digital Therapeutics — “Prevent”
  • Digitally-mediated behavioural change
  • Business Model: Charge on success
  • Enterprise Customers

http://www.bloomberg.com/video/take-face-to-face-medicine-to-digital-omada-health-ceo-luSxUqctQcqbjUMc6Wf41g.html

Transcript:

Thanks for joining us on “bottom line.” tell me what your company does.

What is digital therapeutics?

Digital therapeutics is the idea that medicine in the past was conducted in a face-to-face setting.

On the web and social and mobile on the way we can create digital expenses is allowing us to be done digitally.

We take proven lifestyle and behavioral medicine interventions from face-to-face to digital.

That is what we do.

This could help me — well, i don’t smoke, but if i did, it could help me quit and eat healthier, which i don’t do.

Is that the idea — lose weight, quit smoking?

Matt, we can help you with that, and if you want a free pass to our program, let me know . our program helps people with high risk of type two diabetes lose weight and make lifestyle changes over the course of 16 weeks and it is conducted entirely digitally.

I use my iphone or ipad and this will actually work?

Is that the case?

That is the idea.

It can help people proven at risk for type two.

If you help them in a high-tech fashion, our program is digital, a small group environment, where you are paired with others like you and you see how others are doing and we get android and iphone apps and we have a whole bunch of things to make you successful.

Every time i want a delicious cherry coke at lunch, you suggest something that won’t give me diabetes?

The idea is that that moment you want that delicious cherry coke, you think of your health coach and your groups going on with you and maybe you will get a water instead of something better for you.

Very smart man , mark andreessen, is a big backer of you guys.

What is the future of this company?

What does he see there as far as growth is concerned?

You know, i think the interesting bit is what is happening from the company landscape is that you get folks like me with tech and health care backgrounds will bring companies.

I studied neuroscience and i worked at google for a well and went to harvard medical school.

My passion has always been tech plus health care.

I think andreessen horowitz saw a consumer grade, rich product and experience, but to an enterprise customer set with a unique business well behind it that got them excited and that is what led them to pull the trigger on the deal.

$23 million?

What’s next?

Next for us is working with customers.

We have an innovative business model and that we only charge our employer and health plan customers if we are successful with members . because of that model, we have had a lot of demand coming in and it is just scale, scale, scale.

You sold me with harvard med school and you are a neuroscientist with an nba paper you have competition out there — but you’d have competition out there.

What are the barriers?

We do have competition.

The biggest barrier is for entrepreneurs and companies like myself is figuring out health care.

It is incredibly complex.

But so far, so good.

We want competition.

This is a space where there is a lot of people at me.

One third of the adult population has prediabetes, the latest stats from the cdc.

Let’s have a lot of people take a bite.

I wonder about results.

How can you prove that your programs give people the results they want in order to pay money up front and center for your courses — sign up for your courses?

The first is in the world of behavioral medicine.

There are a lot of published studies that show you what you need to achieve from the results standpoint, and then because of the element in our program like the digital scale, the cell phone chip, we can determine if people are successful and show the results in a very transparent and authentic way to our enterprise partners.

Diabetes is obviously a huge and growing problem.

I am certainly at risk for it.

But the weight loss thing is where i guess you will make the big money.

Type 2 diabetes is correlated to being overweight but it is not the only thing good genetics comes into play as well.

As a country, if we are to avoid the stats the cdc put out, 40% of adults of finding out at some point in their life that they are thank you, there needs to be weight loss and lifestyle intervention programs.

I’m just saying that if your marketing materials show that i lost 10 pounds in weeks with this outcome everyone will sign up.

It’s fascinating, what happens when we work with a self-interested employer is that employees who go through a program and become successful rave about it and tell their colleagues and they get colleagues to sign up.

Thanks very much.