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Fifth Annual Healthcare Unbound

The Fifth Annual Healthcare Unbound Conference & Exhibition, in San Fran July 7-8, is described as covering "the convergence of consumer and healthcare technologies" with a "special focus on telehomecare & remote monitoring."

I interviewed several of the speakers scheduled for this event for a recent article, so this will be a prime opportunity for me to discuss these topics further.

Problem with Google alerts

I'm glad I didn't miss last week's story about the researchers who were able to hack into the implanted cardioverter defibrillators (ICD). Worrying that I might miss the next big story about wireless technology, I set up a few Google alerts for several search terms including "medical wireless."

Problem is, I'm getting links to blogs that are merely copying what other sites are writing without attribution. Why wouldn't it be possible to limit these alerts to only well-established sites?

"The Audacity of Hype": false promises for wireless remote patient monitoring

I just submitted an opinion piece for Medical Device Daily Perspectives entitled "The Audacity of Hype." This addresses what I consider the most hyped aspect of the claims that the vendors are making regarding the use of wireless remote patient monitoring.

The research and the interviews that I did produced much more materials than I could possible include due to space limitations. As it turned out. most of the people I interviewed will be speaking at the 5th Annual Healthcare Unbound conference in SanFran this July. I'll probably get out there to spend some face time.

I hope people don't get the impress that I have a dim view of the use of this technology--nothing could be further from truth. I just think that the practicalities of clinical practice must be taken into account when these systems are designed. Most of my opinions are based on my experience in clinical pathology and general surgery.

Besides continuing to talk about these topics on this blog, I'll review some of the whitepapers I've been reading over these past two weeks in preparation for this article. There are a few that I consider very useful. There are some that are voluminous and say nothing.

If you have an opinion, or have a recommendation for a resource, I'd love to hear it.

Spacelabs Healthcare Patient Monitoring & Connectivity Solutions Earn Ascom Wireless Validation

Link: Spacelabs Healthcare Patient Monitoring & Connectivity Solutions Earn Ascom Wireless Validation.

Spacelabs Healthcare, a leading provider of patient monitoring and connectivity solutions for hospitals throughout the world, announced today that their patient monitoring systems have earned Ascom Wireless validation.

Ascom Wireless is based in Triangle Park, NC with its parent organization based in Sweden. They claim "in-building wireless telephone and messaging systems company with more than 70,000 customer sites worldwide."

 

Mahalo announcing new features

I'm supposed to attend a demo by Jason Calacanis tomorrow afternoon in advance of his keynote at the Search Engine Strategy Conference on Wednesday. Mahalo is the human-moderated search directory.

Recently, Newsweek published its Revenge of the Experts, which takes the view that the Web 2.0 user-generated content meme will be replaced by content produced by people who have some knowledge of the topic their presenting on the Web. Jason is quoted in this piece as saying that producing content in this way increases the chance to charge for premium content. He also says, "It's also easier to woo advertisers with the promise of controlled content than with hit-and-miss blog blather." I don't know if Jason is using "experts" to generate content for his directory, or if the scope of his site is as comprehensive as other search engines or even the Wikipedia.

J.P. Morgan Nears Deal to Acquire Bear Stearns for $2.2 billion

Hey, that's not even 15% of Facebook's purported value.

Implanted defibrillator/pacemaker susceptible to wireless hacks

The Medical Device Security Center released their report “Pacemakers and Implantable Cardiac Defibrillators: Software Radio Attacks and Zero-Power Defenses” which shows that they were able to gain wireless access to an implantable cardioverter defibrillator (ICD) using a laboratory simulator. They were able to program it to shut down, deliver shocks, as well as collect patient data.

Their method involved using a Medtronic Maximo, an ICD (implantable cardiodefibrillator), released in the US in 2003. “After partially reverse-engineering the ICD’s communications protocol with an oscilloscope and a software radio, we implemented several software radio-based attacks that could compromise patient safety and patient privacy.”

The researchers then came up with possible solutions they call "zero-power security." "Zero power" refers to fact that they wouldn't drain the device's battery but would use energy from the incoming signal to power these features.

"Zero-power notification" is their strategy for a device that would alert the patient if and when their implanted medical device (IMD) was being hacked, by using either sound or vibration. They also envision using better authentication from an external device and encrypting data transmitted from the device.

Below is the wireless identification and sensing platform (WISP) prototype the researchers created to test this concept. The wires from the circuit are attached to "a piezo-element that can audibly warn a patient of security-sensitive events."

The WISP was placed in a sack of bacon and ground beef to simulate human chest tissue so that they could test their zero-power security features.

Medtronic responds, according to the WSJ:

Medtronic acknowledged the report's findings but said the risk to patients was low. The company said it was gradually increasing the sophistication of devices to prevent unauthorized people from tampering with defibrillators, but said it was necessary to balance security with other factors. For example, if each defibrillator had its own password to prevent unauthorized access, a doctor might not be able to control it in an emergency situation, the company said.

It's interesting that in the same article Boston Scientific says that it uses encryption for its ICDs, and *doubts* that they can be hacked.

The WSJ Business Technology Blog cites this study from Cisco Systems where they surveyed 307 healthcare IT managers:

The survey reported that 16% of respondents had a security breach at their organization in the last six months; 24% reported a breach in the past 12 months.

This data might have a tenuous connection to the of security of IMDs, but it does suggest that security standards will need to be implemented across the entire spectrum of wireless medical devices.

Chris Anderson and Mike Arrington on Charlie Rose

Both these interviews provide a great overview of the world of Web tech.

Rose's interview with Chris Anderson (editor-in-chief of Wired magazine and creator of the Long Tail meme) covers the different economies of the Web. First, is the idea of the "freemium," where most Web sites provide free services for 99% of the users, and then charge for the premium service for 1%. Then there's the gift economy which is best typified by Craigslist. Anderson says it took the $400 million market of newspaper classifieds and reduce it to the $30 to $40 million that Cragislist pulls in. Where did the balance go? Supposedly, to us.

You also have the attention economy, the reputation economy and finally the monetary economy which has always been the hardest for the Web realized, unless you're Google.

Anderson says he believes the saying that "information wants to be free," but he still thinks that there's a market for specialized info that can demand a premium.

Looking at print content, he says that magazines should try to provide the long form writing and photography that can't be appreciated on a computer screen. Here production quality has the advantage. Sites like YouTube never considered the quality but depend on relevance to attract its users.

He feels that Microsoft will eventually have to provide Office as a Web-based app in order to compete with Google.

He sees social networking sites begin to mature and specialize. The one-size-fits-all Facebook will find competition with smaller networks that serve narrow interests. He mentioned that Mark Andreesen has started Ning, a service which already has 150,000 such networks. Anderson has his own: DIYDrones.com which covers robotics.

Charlie took him to task about US being able to maintain its superiority in designing new gadgets, when Chris said that the US has the richest consumers in the World who understand what makes a great device.

The other video was an interview with Mike Arrington of TechCrunch fame. He reports mostly about start-ups in Silicon Valley.

Mike started off by explaining how on his blog he decided that McCain and Obama were the best candidates for supporting tech. McCain is a staunch supporter in addressing the problem of ID theft. His ID was stolen by someone who is now a "guest of the state of Arizona."

Net neutrality is another important issue. He said that when Googe first set up Google.cn in China in 2006, it faced the prospect of having to the government's rules of censorship. He says that the way China does it, is that it might not block sites it doesn't like outright, but forces these sites to load slowly so that the user becomes dissatified with using the site.

This turned the conversation to mobiles, since in the developing world this is the primary means of accessing the Internet, and Arrington felt that eventually this would be the case in the US. The US is lagging behind Europe because of the way spectrum was initially allocated to the carriers in the US. More recent auctions are stipulating rules of openess, spearheaded by Google, btw.

He thinks the problem of the digital divide in the US needs to be dealt with. The use of the computer with Web access in education didn't turn out to be what it initially promised since it's more of a distraction for students than a learning aid. He said that TV will become the Internet, if it hasn't already.

Amazon's cloud computing model will be picked up by other companies such as Microsoft.

Then Charlie ask about the growing influence of blogs, and Mike said that people were more inclined to read opinions rather than the traditional objective journalism of the larger news sites, although he is a big fan of the BBC. This prompted Mike to talk about the subject he mainly covers in his blog: start-ups. These are the folks who are the modern day pirates. They see the utility of risk, supported by a strong survival instinct.

e-CareManagement blog compares Google Health and Microsoft HealthVault

Vince Kuraitis provides a useful chart showing the the features of Microsoft's HealthVault and the PHR soon to be released by Google.

Vince notes that both products allow the patient to control the data, allowing complete portability.

He also provides a link to his PowerPoint presentation which gives a good overview of the current state of chronic disease management.

Roaming hospital robots use RFID to track medical equipment and make deliveries

Story on ComputerWorld Mobile & Wireless.

These robots are provided by Aethon Inc. and use Cisco networking, VPN and wireless products to provide navigation and communication support. The robots can even use the wireless network to call for an elevator to speed its delivery.

By using the robots, Dillehunt [CIO at FirstHealth Moore Regional Hospital in Pinehurst, N.C] is able to keep his Wi-Fi network free of constant radio traffic from RFID tags on hundreds of devices, he said. "I needed a system to keep RFID from flooding my regular Wi-Fi network," he noted.