Weighing the Odds

This was a very effective ad that I saw in the doctor's office for weight loss. 

Look at all the problems that excess weight causes.

And see how unattractive that big gut can be--no offense. 

While this week, research studies on monkeys were reported not to extend life span, I think we all know intuitively well that staying "trim and fit" is the way to go from a health perspective. 

There is a good saying that I plastered up a couple of years back that said "nothing tastes as good as thin feels!"

Many years ago, my cousin David was diagnosed with brain cancer. He tried all sorts of traditional medical treatments, and nothing much was working. After consulting some nutrition experts, his wife supported him in going on a macrobiotic diet, and this seemed to help him for some time.  Finally though David succumbed to the brain tumor after struggling about 10 years. 

This past week, a friend of mine, who has had some health problems recently, told me he was trying the vegan diet too for a couple of weeks, but already after a few days was touting how much better he was feeling. 

From my experience, the carbs and processed foods are the worst for us--and on top of it, completely addictive.  

When I am strong enough mentally, I really believe in Dr. Atkins high protein diet--although after a few days, you lose your appetite for good reason--it tastes, horrible.

With the odds against those carrying around a lot of extra pounds, we all need to keep fighting the good fight here--against the battle of the bulge. 

(Source Photo: Andy Blumenthal)

Weighing the Odds

Electronic Health Records, Slow But Steady

The best article I have seen on the subject of Electronic Health Records (EHR) was in Bloomberg BusinessWeek (21 June 2012) called "This machine saves lives so why don't more hospitals use it."

What I liked about this article was how straightforward it explained the marketplace, the benefits, the resistance, and the trends.  

Some basic statistics on the subject of EHR:

The healthcare industry is $2.7 trillion annually or ~18% of GDP.

Yet we continue to be quite inefficient with only about half of hospitals and doctors projected to be using EHR by end of 2012.

Annual spending on EHR is expected to reach $3.8 billion by 2015.

Basically, EHR is the digitization of our medical records and automation of medical services so that we can:
 
- Schedule medical appointments online
- Check medical records including lab and test results
- Communicate with our doctors by secure messaging/email
- Send prescriptions into the pharmacy electronically
- Automatically keep track of dosage and refills
- Get alerts as to side effects or interactions of medication
- Analyze symptoms and suggest diagnosis
- Receive prompts as to the latest medical treatments
- Recognize trends like flu outbreaks or epidemics
- File and speed claim processing

So why do many doctor's seem to resist moving to EHR?
 
- Cost of conversion in terms of both money and time
- Concern that it can be used against them in medical malpractice suits
- Potential lose of patient privacy
- Lack of interoperability between existing systems (currently, "there are 551 certified medical information software companies in the U.S. selling 1,137 software programs"--the largest of which are from GE and Epic.)

The government is incentivizing the health care industry to make the conversion:

- Hitech Act (2009) "provides $27 billion in financial incentives" including $44K from Medicare and $63K from Medicaid over 5 years for outpatient physicians that can demonstrate "that they are using the technology to improve care."
- Patient Protection and Affordable Care Act (2010)--a.k.a. Obamacare--calls for "accountable care organizations" to receive extra money from Medicare and Medicaid for keeping patients healthy, rather than by procedure--"they are expected to do so using computers."

The big loophole in EHR right now seems to be:

- The lack of standards for EHR systems from different vendors to be compatible, so they can "talk" to each other.
- Without interoperability, we risk having silos of physicians, hospitals, labs, and so on that cannot share patient and disease information.

So, we need to get standards or regulations in place in order to ensure that EHR is effective on a national, and then even a global level. 

A number of months ago, I went to a specialist for something and saw him a few times; what he didn't tell me when I started seeing him what that he was retiring within only a few months.
Aside from being annoyed at having to find another doctor and change over, I felt that the doctor was not too ethical in not disclosing his near-term intentions to close up shop and giving me the choice of whether I wanted to still see him. 

But what made matters worse is that I got a letter in mail with the notification--not even in person--along with a form to fill out to request a copy of my medical records at a cost per page, so that I could transfer them--hardcopy--elsewhere. 

Of course, this was also the doctor who hand wrote prescriptions still and wasn't able to get test results online. 

To me, seeing someone with a great amount of experience was really important, but the flip side was that in terms of organization, he was still in the "dark ages" when it came to technology. 

I look forward to the day when we can have both--senior medical professionals who also have the latest technology tools at their disposal for serving the patients. 

In the meantime, the medical profession still seems to have some serious catching up to do with the times technologically. 

Let's hope we get there soon so that we not only have the conveniences of modern technology, but also the diagnostic benefits and safeguards. 

(Source Photo: Andy Blumenthal)

Electronic Health Records, Slow But Steady

Sniffing Out Cancer

A few years ago, researchers found that Dogs could actually identify people with cancer at a 99% accuracy rate by simply smelling human's breath. 

One of the problems with this diagnostic method though is that hospitals and doctors offices have not been inclined to house and care for these animals in medical facilities treating people.

Technology to the rescue and this one has no dog in the fight...

The Metabolomx is a computing machine with attached breathing tube that can be rolled over to a patient who breathes into it for just 4 minutes to can get a diagnose on the spot.

This is very different from current methods and is without painful and intrusive tests (such as biopsies) or waiting weeks for lab results to come back and be read by your doctor.  

The machine captures and analyzes the chemistry of the person's exhaled breath in the form of aerosolized molecules and determines it's "smell signature".

According to Bloomberg BusinessWeek (5-11 March 2012), by comparing the sample smell to the biomarkers for cancer, the Metabolomx has already achieved an 80% success rate for detecting lung cancer.

A newer version of the machine is 100 to 1,000 times more sensitive, which should greatly improve accuracy, hopefully hitting at or above 93%, which will make it viable for commercial use.

The Metabolomx is envisioned be able to detect and differentiate between various types of cancer such as lung, breast, colon, and more. 

Moreover, this technology is not limited to just cancer--but other companies such  as Menssana are testing it with tuberculosis and pediatric asthma.  

Further, another benefit of the Metabolonx is that is can not only be used to diagnose cancer, but to signal reduction or elimination of the cancer with various treatments.

I hope the next step for technology like the Metabolomx is to not only detect the cancer, but be able to "zap it" and rid it from our bodies--then we'll have a technology that can really snuff out the cancer.

Sniffing Out Cancer

The Water Crisis and Enterprise Architecture

According to Wikipedia: “The Earth has a finite supply of fresh water, stored in aquifers, surface waters and the atmosphere. Sometimes oceans are mistaken for available water, but the amount of energy needed to convert saline water to potable water is prohibitive today, explaining why only a very small fraction of the world's water supply derives from desalination.

There are several principal manifestations of the water crisis.

• Inadequate access to safe drinking water for about 1.1 billion people
• Groundwater overdrafting leading to diminished agricultural yields
• Overuse and pollution of water resources harming biodiversity
• Regional conflicts over scarce water resources sometimes resulting in warfare

Waterborne diseases and the absence of sanitary domestic water are one of the leading causes of death worldwide. For children under age five, waterborne diseases are the leading cause of death. At any given time, half of the world's hospital beds are occupied by patients suffering from waterborne diseases. According to the World Bank, 88 percent of all diseases are caused by unsafe drinking water, inadequate sanitation and poor hygiene.”

How critical is water to life?

While a person can live 4-6 weeks without food, survival without water is limited to between 3-7 days. (http://www.survivaltopics.com/survival/how-long-can-you-live-without-food/)

The Wall Street Journal, 23 June 2008, reports that that a new invention, “The LifeStraw is a personal, portable water purifier,” “that “has the potential to save many lives.”

The LifeStraw was created in 2005, is 10 inches long, and weighs 4.3 ounces. “One straw is capable of purifying at least 700 liters (182 gallons) of water, removing an estimated 99.9% of bacteria and 99% of waterborne viruses.”

This is a game-changing invention:

“The product, which costs as little as $3, has won a number of awards including the 2008 Saatchi & Saatchi Award for World Changing Ideas.”

So simple, yet so effective:

“When someone sucks through the straw, the water flows through textile and iodine filter, which kill off viruses and bacteria.”

Already hundreds of thousands have been purchased and are being distributed in countries with non-potable water.

As an enterprise architect, nothing is more satisfying than seeing an innovation that saves lives and improves the way of life for millions of people around the world.

While we are all introduced to inventions such as those “As Seen On TV” with new doodads for kitchen appliances, household/personal/car-care, tools, and novelty items, the introduction of something truly extraordinary like the LifeStraw just makes one do a double-take.

As an enterprise architect, I believe we need to hold up transformative innovations, such as the LifeStraw, as examples of best-in-class architectures that combine business process improvement with technology innovation that positively impacts millions of otherwise suffering people around the world.

As I go about my day-to-day responsibilities I’d like to keep this one in mind as an inspiring example of what can be achieved when technology is applied to global problems. Perhaps you’d like to do the same!

The Water Crisis and Enterprise Architecture