Weekend ‘Must Read’: Are Big Tech/Big Pharma’s health tech promises nothing but a dangerous fraud?

July 24, 2020 | by

If it sounds too good to be true, it isn’t. And watch your wallet. In 14 words, this summarizes Leeza Osipenko’s theme for this article. It may seem to our Readers that Editor Donna is out there for clicks in the headline, but not really. Dr. Osipenko’s term is ‘snake oil’. It’s a quaint, vintage term for deceptive marketing of completely ineffective remedies, redolent of 19th Century hucksters and ‘The Music Man’. Its real meaning is fraud.

The promise is that Big Data, using Big Analytics, Big Machine Learning, and Big AI, will be a panacea for All That Ails Healthcare. It will save the entire system and the patient money, revolutionize medical decision making, save doctors time, increase accuracy, and in general save us from ourselves. Oh yes, and we do need saving, because our Big Tech and Big Health betters tell us so!

Major points in Dr. Osipenko’s Project Syndicate article, which is not long but provocative. Bonus content is available with a link to a London School of Economics panel discussion podcast (39 min.):

  • Source data is flawed. It’s subject to error, subjective clinical decision-making, lack of structure, standardization, and general GIGO.
  • However, Big Data is sold to health care systems and the general public like none of these potentially dangerous limitations even exist
  • Where are the long-range studies which can objectively compare and test the quality and outcomes of using this data? Nowhere to be found yet. It’s like we are in 1900 with no Pure Food Act, no FDA, or FTC to oversee.
  • It is sold into health systems as beneficial and completely harmless. Have we already forgotten the scandal of Ascension Health, the largest non-profit health system in the US, and Google Health simply proceeding off their BAA as if they had consent to identified data from practices and patients, and HIPAA didn’t exist? 10 million healthcare records were breached and HHS brought it to a screeching halt.
    • Our TTA article of 14 Nov 19 goes into why Google was so overeager to move this project forward, fast, and break a few things like rules.
  • We as individuals have no transparency into these systems. We don’t know what they know about us, or if it is correct. And if it isn’t, how can we correct it?
  • “Algorithmic diagnostic and decision models sometimes return results that doctors themselves do not understand”–great if you are being diagnosed.
  • Big Data demands a high level of math literacy.  Most decision makers are not data geeks. And those of us who work with numbers are often baffled by results and later find the calcs are el wrongo–this Editor speaks from personal experience on simple CMS data sets.
  • In order to be valuable, AI and machine learning demand access to potentially sensitive data. What’s the tradeoff? Where’s the consent?

Implicit in the article is cui bono?

  • Google and its social media rivals want data on us to monetize–in other words, sell stuff to us. Better health and outcomes are just a nice side benefit for them.
  • China. Our Readers may also recall from our April 2019 article that China is building the world’s largest medical database, free of those pesky Western democracy privacy restrictions, and using AI/machine learning to create a massive set of diagnostic tools. They aren’t going to stop at China, and in recent developments around intellectual property theft and programming back doors, will go to great lengths to secure Western data. Tencent and Fosun are playing by Chinese rules.

In conclusion:

At the end of the day, improving health care through big data and AI will likely take much more trial and error than techno-optimists realize. If conducted transparently and publicly, big-data projects can teach us how to create high-quality data sets prospectively, thereby increasing algorithmic solutions’ chances of success. By the same token, the algorithms themselves should be made available at least to regulators and the organizations subscribing to the service, if not to the public.

and

Having been massively overhyped, big-data health-care solutions are being rushed to market in without meaningful regulation, transparency, standardization, accountability, or robust validation practices. Patients deserve health systems and providers that will protect them, rather than using them as mere sources of data for profit-driven experiments.

Hat tip to Steve Hards.

Health 2.0 NYC Empowered Patients event rescheduled to 16 May; apply now to the Digital Health Breakthrough Network (NYC)

May 8, 2018 | by

Empowered Patient 2018: Using Big Data & Technology to Empower Patients & Providers to Make Healthier Decisions
Verywell, 1500 Broadway (at 43rd), 6th Floor (Verywell)–now 16 May

Overview: Big Data is rapidly transforming the healthcare industry – from personalizing content to the patients’ individual needs to making medical diagnoses and outcomes more predictive. The panel of industry experts from various companies ranging from healthcare publishing, research, and technology will discuss how Big Data is enabling this evolution with content, product, and services to democratize health information and provide insights that improve medical care, research, and the overall patient experience. Technology is already making a difference, but raises privacy and ethical issues.

Agenda:
6:00 – Meet, Greet, and tweet with healthy snacks provided by event sponsor: Verywell
6:30–  Panel Discussion
7:15 – Get to know other healthcare innovators in the community

Moderator: Dr. Deepna Devkar, Senior Director, Data Science, Dotdash
Panel:
Marlene Guraieb, PhD – Senior Data Scientist, Oscar Health
Dmitriy (Dima) Gorenshteyn, PhD, Senior Data Scientist, Memorial Sloan Kettering Cancer Center
Rob Parisi, SVP/GM Verywell – This evening’s sponsor and site host is a leading health and wellness site that provides trusted advice for a healthier life to its 20 million monthly unique visitors.
Joy Fennel, Empowered Patient – pilot patient on mymee, a digital therapeutic solution for autoimmune disorders – see www.mymee.com
Libbe Englander, PhD., CEO, Pharm3r, a healthcare analytics company helping improve outcomes with big data

Tickets $15, the snacks and drinks (and crowd) are great. Register and pay here. TTA and Editor Donna are longtime supporters of Health 2.0 NYC and Medstartr, the organizing groups behind this event.

A startup looking for funding? Look no further than the Digital Health Breakthrough Network. Sponsored by NYCEDC and HITLAB, they are in the process of recruiting their fourth class of startups. Eligible companies are early-stage startups (pre-revenue/pre-Series A), based in NYC (50 percent+ of employees), with an innovative digital health technology that presents a novel solution to a significant need in the health marketplace. Applications are open until 15 June. More information here and here.

From despair to hope? New study charts future of patient-generated data in care delivery

March 15, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/03/Most-Useful-Sources-of-Health-Care-Data-Today-and-in-5-Years.png” thumb_width=”150″ /]A frustration of everyone in healthcare and technology is the unfulfilled promise of Big Data. A study conducted by a team for NEJM Catalyst (New England Journal of Medicine) of 682 health care executives, clinical leaders, and clinicians indicates that at present, very few (<20 percent) believe that their healthcare organizations extremely or very effectively use data for direct patient care; 40 percent believe it is not very effective or not at all effective.

The hope comes in a trend over the next five years (NJEM chart at left above, click to enlarge). Presently, the most useful sources of data are clinical (95 percent), cost (56 percent), and claims (56 percent). In five years, they project that the top four will be clinical (82 percent) and cost (58 percent) joined by patient-generated and genomic data (both at 40 percent). How that patient-generated data will be compiled to be useful is not described, but the hope is that “With patient-generated data and genomic data, we will be able to create true “n of 1” medicine with options specific to each patient’s needs, giving a boost to priorities such as care coordination and improved clinical decision support.”

A possible roadblock is the lack of interoperability of EHRs. Less than 10 years ago, the EHR was touted as The Solution to patient records and a repository of Everything. 51 percent indicate that interoperability is weak. One-third believe that ease of use and training for EHRs are also weak.

Other findings indicated strong support for greater patient access to personal medical records (93 percent), fee/price information for comparison shopping (80 percent), and outcomes information listed by hospital (73 percent)–but not by doctor (55 percent).

The full report is available for download at the NEJM Catalyst link here. Also Mobihealthnews.

Broadband and health in USA

August 5, 2016 | by

The Federal Communications Commission (FCC) has been investigating [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/08/C2H-BroadbandMap_Gaps-America.png” thumb_width=”150″ /]the relationship between broadband and health in the US through their Connect2Health Task Force and this week it has released an online tool “Mapping Broadband Health in America”.
It is an interactive map that allows users to visualise, overlay and analyse broadband and health data at the national, state and county levels.

This tool allows easy access to existing health and broadband access data to anyone who wants to look at the possible influence of broadband access on health over a period of time or to identify gaps which may provide opportunities to develop or expand online health services.

The interactive tool allows the user change the broadband availability measure (by say proportion of coverage or download speed for example) and select a health measure such as say obesity rate or preventable hospitalisation days and shows where the selected broadband measure is satisfied, where the selected health measure is satisfied and where both are satisfied. The types of health measures are currently limited but if users find the tool useful and feedback to the FCC there may well be further expansion.

Have a play with the map here.

Two RSM events of interest on medicine’s future and Big Data/IoT (UK)

April 20, 2016 | by

Make a place in your calendar for two Royal Society of Medicine full day events coming up in May and June. Both organized by the Telemedicine and eHealth Section. Hat tip to Charlotte Cordrey, Event Team Manager, RSM

The future of medicine – the role of doctors in 2025
Thursday 19 May 2016  (Chaired by our own Editor Charles Lowe)

Big data 2016 (Clouds and the Internet of Things)
Thursday 2 June 2016

 

A gallimaufry of short digital health items to start the day with

March 22, 2016 | by

The WHO has produced an excellent report on the state of eHealth in the European region, including a review of telehealth readiness. Ericsson have produced a very interesting report confirming what I guess anyone will have realised if they’ve traveled by public transport or have children: young people downloading video content are driving a surge in data usage: there’s much detail here though. Both are well worth the read.

Mentioning Ericsson reminds that the Telegraph recently produced a summary of the 20 best-selling mobile phones of all time – takes you back, with the substantial number once produced by Nokia.

The Royal Society of Medicine has it’s fifth annual medical app conference on April 7th – numbers booked have already well exceeded last year’s sellout so they are expecting to fill this year’s much larger conference venue. The focus this year is on the many legislative, regulatory and voluntary measures being introduced that will impact medical apps – there’s still room for old favourites though, such as Richard Brady’s always-topical (more…)

Personal health ‘big data’ exchange is all good, right? Perhaps wrong.

September 29, 2015 | by

Many of our recent stories have touched on ‘big (health) data’ as Achieving the Holy Grail–how it can be shared, how it can work with the Internet of Things and how poorly implemented personal health record (PHI) databases can derail national health systems (and careers) [TTA 22 Sep]. They are, after all, 1) extremely difficult to design to preserve privacy and 2) must satisfy patients’ requirements for easy use as well as privacy including opting out. But when despite all good intentions, data goes awry, the consequences can be severe.

  • A daughter applies for health insurance from Aetna, and her mother’s medications, about which she had no knowledge, are attributed to her. How? Data mining off Milliman’s IntelliScript data service which mixed up the records.
  • EHR exchange can spread errors such as a dropped critical health or medication record. One led to the death of an 84 year old woman. VA also had a problem with its EHR (not cited but likely VistA) slotting medication histories into the wrong patients’ files. An Australian hospital mixed up discharge files in electronically sending them to doctors. The more records are exchanged, the more possibility there is for propagation of errors.
  • More information is shared with third-party suppliers; survey companies are increasingly tapping into these databases to send annoying, potentially privacy-invading treatment questionnaires to individuals.

Bloomberg Business’ conclusion is that this could be a problem, but much beyond the tut-tutting doesn’t get into solutions. The Pitfalls of Health-Care Companies’ Addiction to Big Data

Big Data at work in the Emergency Room

September 15, 2015 | by

Did you watch the Panorama programme yesterday on BBC (only available in the UK, I understand)? [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/Beth-Israel.jpg” thumb_width=”150″ /]Subtitled “Could a Robot do my Job?” reporter Rohan Silva was looking at the impact of Artificial Intelligence (AI) on the workplace and jobs, primarily in the UK.

The last section of the programme was on a data analysis system at a Boston hospital (Beth Israel Deaconess Memorial Center). The reporter mentioned they use an “artifical intelligence supercomputer” (!) in their emergency department that can “forecast if you’ll die in the next 30 days”. Well, not quite, but, “forecast the probability of a patient dying with almost 96% confidence” according to the very enthusiastic doctor (and the only one featured in the programme) at the hospital. Not sure if that is all PR or verified independently.

I was very impressed when it was mentioned that the computer had 30 years of data from over 250,000 patients,so it could recognise rare deceases quicker than a doctor. After all my navigator can find me a route a 100 times faster than I can, so why not.
But then I got thinking. 30 years ago they didn’t collect patient’s blood oxygen level and blood pressure every 3 minutes like they are doing now. This was an emergency department, not the obvious place for lots of people with a rare diseases to turn up. How many rare diseases had this system diagnosed so far? So there was a fair bit of mirrors and smoke to make it look far better than it really is I think. In fact, I think the Boston system is actually just good example of what is called Big Data at work.

This tendency to exaggerate was true of the rest of the programme too which can be fairly described as sensational rather than educational.

No doubt the publicity will help the hospital. I see that the story about the dying prediction appears on many newspaper websites right now with headlines like “the supercomputer that can predict when you’ll die”!

Thanks Donna for telling me about the programme.

mHealth Summit now HIMSS Connected Health Conference

August 7, 2015 | by

Another sign that mHealth is now in our rear view mirrors [TTA 24 July] is that one of the main conferences on the US and international conference calendar is changing its name. Since 2009, the mHealth Summit has closed the year. Its organizing groups have changed and it’s gone international to Europe (the recent summit in Riga). Now it has been renamed (though not on the website yet) the HIMSS Connected Health Conference-–an umbrella event comprising the mHealth Summit (including the Global mHealth Forum), and two new conferences:  the Cyber Security Summit and Population Health Summit.

The shift in the industry and new concerns are clearly reflected in this reorganization. Transitions were visible last year to this Editor in covering the sessions, speaking with exhibitors and attendees. It’s not about the tech anymore, but how it fits into care models, saves money/avoids costs, improves care, improves the experience–all population health metrics–and fits with other technology and analytics. (It’s also how it fits into government payment models, an endlessly changing equation.) What is surprising is the lifting of cybersecurity to equal status, given the Hackers’ Holiday that healthcare is now (see TTA here). (Also this Editor notes that last year’s Big Buzzwords, Big Data and Analytics, has faded into where it should be–into facilitating population health and we should expect, inform data security. We also note that HIMSS has stepped forward as the organizer. HIMSS release  Telehealth & Telecare Aware has been a media partner of the mHealth Summit for most years since 2009. 

An important intervention on mHealth from the EU Data Protection Supervisor

May 25, 2015 | by

At the end of last week, the EU Data Protection Supervisor (EDPS) published an excellent document entitled Mobile Health – Reconciling technological innovation with data protection. To quote the press release:

Failure to deploy data protection safeguards will result in a critical loss of individual trust, leading to fewer opportunities for public authorities and businesses, hampering the development of the health market. To foster confidence, future policies need to encourage more accountability of service providers and their associates; place respect for the choices of individuals at their core; end the indiscriminate collection of personal information and any possible discriminatory profiling; encourage privacy by design and privacy settings by default; and enhance the security of the technologies used.

The document itself contains much of interest. To this editor, who has heard many people poo-poo the importance of wellbeing data, it was good to see:

Lifestyle and well-being data will, in general, be considered health data, when they are processed in a medical context (e.g. the app is used upon advice of a patient’s doctor) or where information regarding an individual’s health may reasonably be inferred from the data (in itself, or combined with other information), especially when the purpose of the application is to monitor the health or well-being of the individual (whether in a medical context or otherwise). (Page 5)

As someone who gets concerned at turning people off sharing their health data, it was nice to see the recognition that: (more…)

Really big data analytics enlisted to fight soldier suicide (US)

May 14, 2015 | by

Suicides by US active duty soldiers have more than doubled since 2001, according to a January Pentagon report, and current prevention programs have not been that effective in reducing the over 200 reported suicides per year. Enter a huge database program called STARRS–Army Study to Assess Risk and Resilience in Service–to identify risk factors for soldiers’ mental health. The US Army not only likes acronyms, but also never does anything small–a five-year, $65 million program analyzing 1.1 billion data records from 1.6 million soldiers drawn from 39 Army and Defense Department databases. Researchers are looking at tens of thousands of neuro-cognitive assessments, 43,000 blood samples, more than 100,000 surveys, hospital records, criminal records, previous risk studies, family and job histories plus combat logs. The study, also using resources from the National Institute of Mental Health, the University of Michigan and other educational institutions, will conclude this June–and researchers are now wrestling with the privacy and moral consequences of responsibly using this data for health and in leadership. NextGov

The Future of Medicine – Technology & the Role of the Doctor in 2025 – a brief summary

May 10, 2015 | by

The following is a brief summary of a joint Royal Society of Medicine/Institute of Engineering & Technology event held at the Academy of Medical Sciences on 6th May. The event was organised, extremely professionally, by the IET events team. The last ticket was sold half an hour before the start, so it was a genuine sell-out.

The speakers for the event were jointly chosen by this editor and by Prof Bill Nailon, who leads the Radiotherapy Physics, Image Analysis and Cancer Informatics Group at the Department of Oncology Physics, Edinburgh and is also a practising radiological consultant. As more of those invited by Prof Nailon were available than those invited by this editor, the day naturally ended up with a strong focus on advances in the many aspects of radiology as applied to imaging & treating cancer, as a surrogate for the wider examination of how medicine is changing.

The event began with a talk by Prof Ian Kunkler, Consultant Clinical Oncologist & Professor in Clinical Oncology at the Edinburgh Cancer research Centre. Prof Kunkler began by evidencing his statement that radiotherapy delivers a 50% reduction in breast cancer reappearance, compared with surgery alone. He stressed the importance of careful targeting of tumours with radiotherapy – not an easy task, especially if the patient is unavoidably moving (eg breathing) – Cyberknife enables much more precise targeting of tumours as it compensates for such movement. Apparently studies have shown that 55% of cancer patients will require radiotherapy at some point in their illness.

This was followed by Prof Joachim Gross, Chair of Systems Neuroscience, Acting Director of the Centre for Cognitive Neuroimaging & Wellcome Trust Senior Investigator, University of Glasgow, talking about magnetoencephalopathy (MEG), which enables excellent spatial & temporal resolution of the brain. However it currently uses superconducting magnets that in turn require liquid helium, so is very expensive to run. He then showed an atomic magnetometer which apparently is developing fast and will be a much cheaper alternative to MEG – he expects people will be able to wear sensors embedded in a cap soon. He then went on to show truly excellent graphics on decoding brain signals with incredible precision; he explained that the 2025 challenge is understanding how the different brain areas interact. Finally he described neurostimulation, using an alternating magnetic field with the same frequency as brain waves to change behaviour; whence the emergence of neuromodulation as a new therapy. Both exciting, and just a little scary.

Dr David Clifton, Lecturer, Dept of Engineering Science & Computational Informatics Group, University of Oxford, followed with a talk on real-time patient monitoring. He began by explaining the challenges that clinicians face with this wall of patient data coming towards them: only “big data in healthcare” enables all the data generated by patients to be analysed to identify the early warning signals that are so important to minimise death and maximise recovery. (more…)

Set that disease data free! A call to break down those data silos.

March 31, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/BlueSiloCollapsing-41.jpg” thumb_width=”175″ /]Awash in a rising sea of data generated by devices and analytics–around treatments, population health, costs–there’s a struggle to make sense of it. We’ve noted the high value and merchandisability of 23andme‘s genomic data (gained by individual user consent) [TTA 5 Mar], but our healthcare institutions which should be codifying and sharing disease and treatment data, largely do not. Those with rare or ‘orphan’ diseases struggle to find information, diagnosis, fellow patients, treatments. They sometimes win breakthroughs by, believe it or not, blogging, and having their articles widely disseminated. Reasons why? According to David Shaywitz in Forbes, they are:

  • Hospitals, even research based centers, struggle to codify their genotype and phenotype data of their patients in a meaningful way that would be usable for clinical decision making. We’ve also noted (oddly not Mr Shaywitz) the long implementation process of IBM Watson cognitive processing/decision making tools in healthcare, the concentration on single diseases and their spread into other industries plus third-party integration outside of healthcare [TTA 9 Oct 14].  (more…)

Something for (almost) everyone – a digital health gallymaufry

January 13, 2015 | by

The Association of British Healthcare Industries (ABHI) is looking for companies to share the British Pavilion at the CMEF trade show from 15th – 18th May 2015 in Shanghai, China. It is apparently the the leading Healthcare trade show in China and is now the largest Medical Equipment exhibition in the Asia Pacific region attracting over 60,000 visitors. Details here.

Still need to see some more predictions for 2015? – try these 12 for telecoms, which does include the odd interesting nod towards subjects we cover, including interconnection of wearables and connected homes.

Prompted by our mention of V-Connect in our review of our 2014 predictions, MD Adam Hoare has pointed out that his company also won the Medilink ‘partnership with the NHS’ award for their renal project with The Lister Hospital in Stevenage. Congratulations!

Accenture has produced an interesting (more…)

Looking back over Telehealth & Telecare Aware’s predictions for 2014, part II

January 9, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/01/magic-8-ball.jpg” thumb_width=”150″ /]Editor Charles has treated you to a look back on his 2014 predictions, daring Editor Donna to look back on hers. Were they ‘Decidedly so’, ‘Yes’, ‘Reply hazy, try again’ or ‘My sources say no’? Read on…

On New Year’s Day 2014, it looked like “the year of reckoning for the ‘better mousetraps’”? But the reckoning wasn’t quite as dramatic as this Editor thought.

We are whipping past the 2012-13 Peak of Inflated Expectations in health tech, diving into the Trough of Disillusionment in 2014.

There surely were companies which turned up ‘Insolvent with a great idea’ in Joe Hage’s (LinkedIn’s huge Medical Devices Group) terms, but it was more a year of Big Ideas Going Sideways than Crash and Burns.

Some formerly Great Ideas may have a future, just not the one originally envisioned. (more…)

2015: a few predictions (UK-biased)

January 3, 2015 | by

As intimated in our review of last year’s predictions, we feel little need to change course significantly, however some are now done & dusted, whereas others have a way to go. The latter include a concern about doctors, especially those in hospitals, continuing to use high-risk uncertified apps where the chance of injury or death of a patient is high if there is an error in them. Uncertified dosage calculators are considered particularly concerning.

Of necessity this is an area where clinicians are unwilling to be quoted, and meetings impose Chatham House rules. Suffice to say therefore that the point has now been well taken, and the MHRA are well aware of general concerns. Our first prediction therefore is that:

One or more Royal College/College will advise or instruct its members only to use CE-certified or otherwise risk-assessed medical apps.

The challenge here of course is that a restriction to CE-certified apps-only would be a disaster as many, if not most, apps used by clinicians do not meet the definition of a Medical Device and so could not justifiably be CE-certified. And apps are now a major source of efficiencies in hospitals – (more…)