The KHIT Blog: Gorilla in our midst

Monday, August 25, 2014

Gorilla in our midst

Health Gorilla Goes Mobile, Gets Big Funding Boost
Greg Goth, Aug 25th, 2014

Healthcare information marketplace vendor Health Gorilla has released a mobile app for iOS devices.

The Sunnyvale, Calif.-based company says its Health Gorilla Mobile enables physician users to securely and compliantly forward diagnostic test results, radiology images, admission and discharge summaries, and other clinical documents to patients and care coordinators through secure messaging.

Features of the platform include its HIPAA-compliant and ONC modular certified Meaningful Use Stage 2 status, immediacy of receiving and forwarding results to patients and other clinicians, the elimination of paper processes, and a no-charge business model for doctors and their teams...

They just got $1.2 million in VC funding from venture capital firm True Ventures. I wish them well.

IN OTHER HEALTH NEWS

From Salon.com. No sugarcoating this.

1. Americans consume, on average, 765 grams of sugar every five days. To put that in perspective, in 1822 we consumed on average 45 grams every five days. That is equal to one can of soda. Now we consume 17 times that, or the equivalent of 17 cans of soda.

2. Americans consume 130 pounds of sugar every year. Our 1822 predecessors ate under 10 pounds of sugar a year. 130 pounds a year means about three pounds a week. That equals about 3,550 pounds in an average lifetime—approaching two tons of sugar.

3. More on that last one: 130 pounds of sugar equals about 1,767,900 Skittles. Or just fill an industrial a dumpster with Skittles.

4. The American Heart Association recommends we consume less than 10 teaspoons of sugar a day. The average adult American misses that mark by a lot. Like about 12 teaspoons. The average American gobbles down on average 22 teaspoons a day. And the average child? 32 teaspoons. Pretty sure none of us needs that much to make the medicine go down. Mary Poppins, it seems, was an enabler.

5. Our sugar consumption is both in plain sight and hidden, ingested from the most unlikely places. Sugar in cookies seems obvious. Sugar in potato chips not so much. And ketchup and TV dinners and soup and crackers and just about every other processed food out there. Who are the biggest baddies? Soft drinks lead the list at 33% of our sugar consumption (drink water instead of coke and you’ve already made a huge dent). Candy and other obvious sweets, 16%. Baked goods like cookies and cakes, 13%. Fruit drinks 10%. Sweetened yogurt, ice cream and milk almost 9%.

6. One can of Coke, 12 ounces, contains 10 teaspoons of sugary goodness. That’s more sugar than two Frosted Pop Tarts with a Twinkie thrown in.

7. The average American consumes 53 gallons of soda a year. Let’s do the math. 128 ounces in a gallon times 53. That’s 6,784 ounces. Or just to simplify it, that’s 565 cans of soda a year.

8. If you took away all the sugar in an average American diet, you would subtract 500 calories a day. Of course, since we are not taking it away, that means sugar adds 500 calories a day to our diet (and waistlines). That is like eating 10 strips of bacon a day. Even bacon-loving Americans might stop short of that.

9. So, given all the bad stuff: Diseases, bad teeth, expanding waistlines. Zero nutrition. Why do we keep consuming sugar? Well, there is that DNA connection. Sugar is how we are wired for energy, but evolution never took processed sugar into account. Sweets eaters survived because they ate more energy-efficient fruit and veggie sugar that metabolizes slowly and doesn’t kill us.

Sugar is as addictive as cocaine. Brain scans after sugar consumption, are very similar to when we do blow. Dopamine floods the brain and, boy, do we feel good...

I use maybe a quarter teaspoon of sugar in my coffee. Don't drink soft drinks, maybe break down and have a coke a year. Hardly use any salt in my cooking either. Inveterate label reader too -- "High fructose corn syrup" is a no-buy.

Then there's Gluten.

I only drink gluten-free water.
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In other news...

"According to the CDC, on any given day, about one in twenty-five hospital patients have at least one HAI"

Data mining keeps HAIs from spreading
Infection surveillance technology proving to be a critical tool

..."One of the great things having a software as a service model is that we have the ability to do population-wide analysis, not only at the hospital-level but across health systems, CDC regions, and nationally," said Glover. Moreover, he said, "standardized data enables us to know that we're viewing the data in the same manner at a hospital in Birmingham Ala. as we're viewing the data at a hospital in Seattle."

MedMined employs the use of advanced analytics to help pinpoint patient population groups that need additional focus or that further evaluation of care. This is accomplished through a patented nosocomial infection marker. That patented algorithm, said Glover, identifies patients who have likely acquired an HAI.

"We utilize algorithms to look at the patient's current condition as we receive them; it's not making the final clinical determination," he said. "The algorithm reviews all of the patients and acts as a filter to narrow the scope of what needs to be evaluated by the clinicians."

Glover said it becomes very challenging for infection preventionists to be able to do whole-house surveillance on all infection types, not just does that are required to be reported to the government.

"Our system uses data mining technology to mine through all the hospital data and identify trends that could be outbreaks or clusters that have occurred that the hospital may not have previously identified. We really look at this technology as identifying the smoke before the fire."...

BobbyG THCB rant

Re: The Data Response Curve (In Honor of the Dose Response Curve)
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NAPA

I live about 40 miles from the epicenter. Didn't feel a thing.

We were just up there last week, took our daughter to Brix for a glorious Sunday birthday brunch. Drove right through the area that was to become the epicenter.

Lots of injuries, some of them critical. No deaths thus far.
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More to come...

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Brave New Health

Commonwell Health Alliance

Another important read (pdf)

I love this kind of stuff. It sustains and humbles me. "As politicians, advertisers, salesmen, and propagandists for various political, economic, moral, religious, psychic, environmental, dietary, and artistic doctrinaire positions know only too well, fallible human minds are easily tricked, by clever verbiage... Common language—or at least, the English language—has an almost universal tendency to disguise epistemological statements by putting them into a grammatical form which suggests to the unwary an ontological statement. A major source of error in current probability theory arises from an unthinking failure to perceive this."

Quotes

"An economist is a person who sees something that works in practice and tries to figure out whether it will work in theory."

- J.D. Kleinke, medical economist
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"The only person who enjoys change is a baby with a wet diaper."

"Every misspent dollar in our health care system is part of somebody's paycheck.

- Brent James, M.D., M.Stat

“We could do healthcare, at markedly higher quality, for everyone in this country, without rationing or denying anybody the care that they need, without having the government dictate how doctors practice or whether hospitals could expand, at half the cost we do it now.”

- Health Care Futurist Joe Flower

Most of the sciences, unlike parts of medical science, are not concerned with the impossible. There is not complementary and alternative physics, or chemistry, or biochemistry, or engineering. These disciplines compare their ideas against reality, and, if the ideas are found wanting, abandoned."

- Mark A. Crislip, MD

"Q: How much alcohol is too much?
A: More than your doctor drinks."

- a physician I once heard speak during a CME presentation

“Just because science doesn’t know everything, doesn’t mean you get to fill in the gaps with whatever fairy tale most appeals to you.”

- Dara O’Briain

'[I]t is one small step from using the computer for "helping" doctors to monitoring them, judging them, dictating to them what to do, and withdrawing payment for computer non-compliance. The use of computer data is a multi-edged sword. It can be used for the "good," facilitating diagnosis and treatment and making it more accurate and up-to-date, and for “evil,” invading privacy, inviting security breechs, and making decisions based on the opinions of remote authorities rather than those present at the patient-doctor encounter.'

- Richard Reece, MD

“[T]here ARE statistics which are non-political. Just because The Washington Post/Fox News reports the temperature is 75 degrees doesn’t mean it’s really snowing and sunscreen is a liberal/conservative plot. Even if you earn a living being ideological.”

- Michael L. Millenson

"It is a generally a fairly convincing argument that people shouldn’t have to be subsidized to undertake a change which is in their best interest.

The reconciliation seems to be that EHR is not supposed to make a doctor’s practice more efficient and higher quality. It is supposed to make the system of care more efficient and higher quality, which is not the same thing. Those of you who took calc recall that maximizing the total of variables is not achieved by maximizing any one variable and this is a perfect example of that.

Those of you have served in combat certainly noticed that too — if everyone works as a team the unit takes fewer casualties. If you try to save your own hide, you might, but at the expense of more casualties overall."

- Al Lewis

"There are two ideas to keep in mind about Bayesian reasoning and how we tend to mess it up. The first is that base rates matter, even in the presence of evidence about the case at hand. This is often not intuitively obvious. The second is that intuitive impressions of the diagnosticity of evidence are often exaggerated."

- Daniel Kahneman, "Thinking, Fast and Slow"

"Physicians apply advanced scientific knowledge, but they must do so without the favorable conditions that experimental scientists create for themselves. Multitasking is forced on physicians, often in chaotic environments and under severe time and resource constraints."

- Lawrence and Lincoln Weed, "Medicine in Denial"

"It’s time to stop the whining about Obama care and acknowledge we already have universal health care. We just pay for it in the stupidest way possible that ensures problems are that much more disastrous and complicated when they’re finally treated."

- Mark Hoofnagle, MD, PhD

"Every act of conscious learning requires the willingness to suffer an injury to one's self-esteem. That is why young children, before they are aware of their own self-importance, learn so easily."

- Thomas Szasz, MD
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"Of course, one reason that process metrics* are so popular is that processes are much easier to define and measure than outcomes."

- The Skeptical Scalpel
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"There is an “illusion of validity” for any random data point, a seductive sense that is colored by what we hope will be true. Mountains of pharmaceutical claims are often made from mere molehills of data."

- Danielle Ofri, MD
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"Joy empowers people. It is a source of energy that enables people to hope and plan and change their lives for the better. Spend some time around someone who is relentlessly negative and how do you feel–drained, right? More and more research shows that joy is not something that just happens to you, like a bolt of lightening out of the blue. Joy is, instead, a habit to cultivate. Negative thinking and despair are the crabgrass of our souls–weeds that take root and spread, sometimes to all areas of life. Joy, in contrast, is a soul’s rose–hardy when cared for, able to put down roots over time and withstand disease and extremes. Like a rose, however, your joy can become blighted from neglect or harsh conditions. We all need to tend to our joy–to prune away the badness, and to know that, even though it may look like a prickly bare root, if you invest time in a joyous outlook, gorgeous things will bloom, even in the harshest conditions."

- Dr. Jan Gurley
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"'Solutions' exist only in mathematics."

- Karen Martin
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"The issue of how to regulate clinical software is, in the long run, indistinguishable from the issue of how to regulate medicine. The only difference is that medicine is practiced in the open, without secrecy, subject to peer review, and under a merit-based state license."

- Adrian Gropper, MD
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"Economist, rope, tree: some assembly required."

- Source unknown

DISCLAIMER:

I write this blog wholly on my own time and my own dime. The views proffered are expressly my own as a concerned and active citizen/taxpayer (in addition to being the result of my substantive experience in the various IT fields), and in no way reflect any policy views of my former employer, notwithstanding that some of the thinking has indeed obviously been spurred by the implications of the work with which I have been doing for them.

FAIR USE POLICY
I cite a ton of news and web sources spanning the breadth of relevant technical and policy domains, sometimes at substantial length. I believe I remain well within the bounds of "Fair Use," as [1] I am not doing any of this for profit, [2] I always provide attribution and links -- which, [3] far from negatively impacting any copyright holders' commercial interests, might actually increase traffic to and interest in their offerings.

Nonetheless, should I post anything of yours regarding which you have any objection, just let me know and I will remove it forthwith.

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Monday, August 25, 2014

Gorilla in our midst

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