Dec 30, 2008

Three Points about Medical Informatics in India.


As knowledge expands and requires better management, role of I.T in health care can only become more important. India has a large number of trained I.T professionals and is in a position to leverage its Brain power to take Health informatics to new heights. As i have argued before, smart use of health informatics can also help us attain Health rights for all in many ways (lower costs, better quality, better informed patients, e.t.c). Here, i have tried to showcase a few points about Use of Health Informatics in India as well as the various educational courses available within India.

The Three major uses of Health informatics in India
1) For better training of Health care professionals ( includes Doctors, Paramedicals and Non-medicals)- e.learning
2) For improved delivery of high quality health care services to the remote areas.- Telemedicine,EMRs, CDSS.
3) To bring about a transparency in public health care delivery system.(e-governance)- Public participation

The three major obstacles to Health Informatics in India.
1) Inadequate Skills of health care personnel/others
2) Inadequate Physical infrastructure
3) Inadequate access to I.T ( Digital divide).

The Three major Post Graduate Health care Informatics courses in India
1) Medvarsity online P.G Diploma in Medical Informatics. , associated with Apollo group of Hospitals
2) Amrita Institute of Medical sciences MSc/ P.G.Diploma in Medical Informatics , at Kochi,India.
3) Post Graduate Programs at BII (Bioinformatics Institute of India), Noida, with good industry integration.

The Three short Online courses for Medical Informatics in India-
1) eHCF School of Medical Informatics, Delhi provides Certificate course in medical informatics
2) IAHI online course on Health Informatics
3) BII provides various online/distance educations courses in Health care Informatics.

In view of the fast changing world of medical informatics, it is essential to formulate a flexible syllabus rather than a rigid one for incorporating into the regular curriculum of medical and paramedical education. Only after that one may expect all members of the health care delivery systems to adopt and apply medical informatics optimally as a routine tool for their services.
Suptendra Nath Sarbadhikari




Nov 15, 2008

- Importance of Digital Pathology ( with Business model)

A California surfer. The surfer is performing ...Image via Wikipedia


Dr. Ajit Singh, CEO, Bioimagene talks of digital pathology.

He is talking to non-medicos and therefore keeps ALL medical terms out of his speech.Without getting into the nitty-gritty,Dr. Ajit simplifies the meaning and importance of digital pathology.Anything i mention on this topic here would only take away from his Talk. So i leave it to you to experience first hand.




The previous part of this talk can be accessed on Youtube.

He is surfing on the edge and i believe he has picked a swell wave.
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Oct 27, 2008

Imaging technologies, Connectivity and the markets.

Let the commoditization of medicine begin! | Trusted.MD Network


I was tempted to read this article, though the headlines(COMMODITIZATION of medicine) don't appeal to the Human rights aspect of my personality. I find the choice of word very cynical and it brings to question the motives of the author. But the services he describes are definitely noteworthy.


I believe the author talks about providing the best radiology service in the most cost-effective manner. Looked at it this way, the services provided by Nighthawk teleradiology services is a boon for patients.It has the potential for bringing down the costs of healthcare. Any measure taken to reduce health costs will benefit the patient, even if the healthcare is being provided via third party ( Insurance) paying for the service.


Telerays.com is a new service allowing bidding for radiology services. You can understand more about the process here.


Since radiology involves interpretation of digital images, it makes real sense to get the best doctors at the best prices (wherever they may be) by making good use of technology.. Simple economics here. And, i dont think quality will really suffer. After a few possible initial hiccups and pruning out of "sub-standard" opiners, I am sure only quality work will prevail.Quality radiologists will always get work, wherever they are. Teleradiology services now being woven into this kind of business model shall definitely be a positive step towards health rights.After all, "TIMELY, best possible quality healthcare for all without discrimination" is what health rights is all about, in essence.


Wonder when will a chunk of pathology services go this way. Very soon, i believe.

Also see http://teleradproviders.com/, a complete radiology diagnostic support from Dr. Sumer Sethi

Oct 22, 2008

- Imaging techniques in Pathology-

Israel's ASI gives pathologists a vital second opinion - ISRAEL21c

-I have written previously about the subjectivity involved in the practise of Pathology. Its difficult to get two pathologists to agree on any one diagnosis if both pathologists insist on looking at the case through the prism of their own experiences.Besides, it is always tough disputing any one"s diagnosis as it is merely an opinion and reflects the Pathologists own "view" of the case.

Now, ASI (Applied Spectral Imaging), a privately held company in Israel has come up with a colorful solution for the problem. Instead of depending totally on the "morphology", ie shape and size, it provides a way to visualize the antigenic proteins present in the tissue. Using their Spectracube family of products, It allows researchers to distinguish between
different materials on a chromosome by highlighting its features with
unique colors, instead of the black dye that had been used previously. This leads to better identification in suspicious cases and the test also lends itself to reproducibility.

The company has already launched " TB Finder" in the market.In addition to TB Finder, ASI is already selling
or planning to market additional tools for pathologists, including
PathEx, as well as for morphologists, who examine protein structures
and alterations in cell structures.


The company presently promotes its products only as a backup / second opinion. But this seems to be more out of its desire not to rub the so-called "Specialists" the wrong way. Being able to corroborate one"s opinion by a scientific and a reproducible test is a tool sorely needed in the practise of Pathology. I shall not be surprised if such corroboration of opinion of a pathologist soon becomes a norm rather than an option.

All in all, a very very useful service to improve accuracy of diagnosis.

Oct 19, 2008

- Telepathology made simple-

MEDTING - MedicalTube, medical meeting; exchange video and image

As a pathologist, I know the importance of collaboration and second opinions. The practice of pathology is sometimes very subjective and its not unusual to get three different diagnosis for the same tissue sample/ histopatholgy slide from three different pathologists.Besides, all pathologists at one institute tend to think along similar lines, further increasing chances of bias. But getting distant doctors to review any one case and histopathology slide has been difficult till date. The best we could do was "store-and-forward" telepathology, where the images of a histopathology slide were forwarded to known experts via email for second opinion. A very primitive means of practicing telepathology, if i may say so!

Enter Medting.

"MEDTING is a clinical web portal that provides a platform for
exchanging clinical cases, images, and videos. Physicians can post
clinical cases with associated images or videos for discussion among
colleagues. In addition, independent images or videos can be sent to
the Atlas space for other to review. Other members of the community can
then vote and write comments on the cases and images posted
."

Medting allows doctors from around the globe to offer their opinions on any histopathology slide (or any other clinical image). Any doctor can upload the facts and images related to any case for second opinions from experts all over the globe.Patient privacy is not compromised as names are not revealed and the site claims to be 100% HIPAA compliant.

The images uploaded presently on the site were of very good resolution. One could easily scan the whole slide, Zoom in on interesting areas of the slide, leave comments, tag images, share them, etc. It provides an excellent collaboration platform and can serve as an excellent educational tool. At present, it boasts of 1840 cases and 15760 images and videos. Cases and images are tagged with keywords using the SNOMED CT terminology.

Medting also offers premium membership and individual institutional support.

I like their service, though it is still very BASIC and has tremendous scope for improvement.

Oct 16, 2008

-Web 2.0 strategy for Business-

Ten Aspects of Web 2.0 Strategy That Every CTO and CIO Should Know [Dion Hinchcliffe's Web 2.0 Blog]

Web 2.0 has changed the way things are or can be done. Organizations need to adapt to these new trends ASAP. A few key points of note for business to survive in the new world-

# It's not about technology, it's about the changes it enables.
# The implications of 2.0 stands many traditional views on their head and so change takes more time than usual.
# Get the ideas, concepts, and vocabulary out into the organization and circulating.
# Existing management methods and conventional wisdom are a hard barrier to 2.0 strategy and transformation.
# Avoiding external disruption is hard but managing self-imposed risk caused by 2.0 is easier.
# Incubators and pilots projects can help create initial environments for success with 2.0 efforts.
# Irreversible decisions around 2.0 around topics such as brand, reputation, and corporate strategy can be delayed quite a while, and sometimes forever.
# The technology competence organizations have today are inadequate for moving to 2.0.
# The business side requires 2.0 competence as well.
# Start small, think big.

Oct 15, 2008

Health wisdom , not just information

I am always on the look out for web services delivering knowledge services in the field of health. I run a non-profit organization, RAKSHA, for exactly this purpose and seek new ways of achieving democratization of knowledge in health.

Organized wisdom is a well thought out web service. This interview with the team at Organized wisdom clearly spells out their views and visions for this knowledge service. The talk with their Chief Medical Officer, Dr. Howard Krein and Esther Dyson , one of the investors was very interesting.




The service claims to be " a free service that provides patients with easy access to the best information available in easy to navigate Wisdomcards, helps patients to prepare for their appointments and helps streamline some to the conversations that must take place."
So, I decided to explore this service logged in as a patient searching for information about my imaginary headache. The first thing i noticed was the cleanliness of the welcome page. Simple, no unnecessary multimedia ( as is VERY often the case with medical information sites) and therefore, fast navigation between pages.

The fonts were friendly, the letters bold and easily legible. It didn't intimidate me, as a patient, with its vastness of information. There was a large search box in a major location with built in prompts via a drop down menu. So far so good.

What really won me over was the neatly laid out information. Not too deep on the first page, just plain English medical speak for an average person.There were links to more scholarly items, but everything i could possibly want to know as a patient was easily available within 2 degrees of separation. There were links to support forums, foundations and drug information ( again in plain English).There were chat rooms, message boards, personal blogs, every useful service i can think of today. They were also initiating a" LIVE chat with a doctor" service, which is now in a beta phase.

All in all, I really liked this service and i am sure something like this will soon be up and running in India, preferably in the Hindi language.
Amen.

Oct 7, 2008

An open letter to the Physicians of the world

Open Letter to the Physicians of the World « ScienceRoll



I am attaching a link to an open letter published on the internet.



That we doctors need to use Web 2.0 applications to ease our burden and improve the quality of our work is given. I have never come across any colleague or senior who disputes the usefulness or necessity of using these applications.



The biggest hurdle is achieving relevant computer skills. No doctor who wants to continue practicing even for next 5-10 years can shy away from regular use of computers and the internet to ease and improve work. But the inbuilt inertia of our seniors is hard to overcome.I should know that. I had this teacher during my pathology post graduation who didn't allow me to introduce evidence based practices in our department. He insisted that HIS opinion was the final and the best opinion and to think of using information retrieval technology for improving diagnostic skills and education was not encouraged ( Frankly, i would say " actively discouraged". He flunked me in my exams a few times after that, from spite or otherwise).



But i sincerely hope and KNOW that there is a vast majority of doctors out there who require and seek appropriate training in the use of the Internet for medical practice. What is required is a method to tap into this enthusiasm and train all currently practicing doctors in proper use of Web 1.0 and Web 2.0 applications like email lists,blogs, social networks, bookmarking, wikis, medical search engines, instant messaging, podcasts, vodcasts.... the list could go on.



Anyways, read this letter here.

Oct 5, 2008

Everyday things i do, put here concisely.

eLearn: Feature Article

Ten Web 2.0 Things You Can Do in Ten Minutes to Be a More Successful E-learning Professional

The following list was inspired by eLearn Magazine Editor-in-Chief Lisa Neal's blog post "
Ten Things You Can Do in Ten Minutes To Be a More Successful e-learning Professional." We'd like to offer the "Web 2.0 Edition" of Lisa's list:

  1. Listen to a conference presentation. When you run across conference presentations while reading your RSS feeds (EDUCAUSE Connect is a prime source, as is OLDaily), save the conference site as a bookmark and revisit it to hear a presentation.
  2. Record a 10-minute presentation about something you are working on or learning about, either as audio (use Odeo) or video (use Ustream), and post it on your blog.
  3. Do a search on the title of your most recent post or on the title of the most recent thing you've read or thought about. Don't just use Google search, use Google Blog Search and Google Image Search, Amazon, del.icio.us, Technorati, Slideshare, or Youtube. Scan the results and if you find something interesting, save it in del.icio.us to read later.
  4. Write a blog post or article describing something you've learned recently. It can be something you've read or culled from a meeting, conference notes (which you just capture on the fly using a text editor), or a link you've posted to del.icio.us. The trick here is to keep your writing activity to less than 10 minutes—make a point quickly and then click "submit."
  5. Tidy your e-portfolio. For example, upload your slides to Slideshare and audio recordings to Odeo and embed the code in your presentation page. Or write a description and link to your latest publication. Or update your project list.
  6. Create a slide on Zoho. Just do one slide at a time; find an image using the Creative Commons licensed content on Flickr and a short bit of text from a source or yourself. Add this to your stick of prepared slides you use for your next talk or class.
  7. Find a blogger you currently read in your RSS reader and go to their website. Follow all the links to other blogs in their blogroll or feedroll, or which are referenced in their posts. Well, maybe not all the links, or it will take hours, not ten minutes.
  8. Write a comment on a blog post, article, or book written by an e-learning researcher or practitioner.
  9. Go to a website like Engadget, Metafilter, Digg, Mixx, Mashable, or Hotlinks and skip through the items. These sites produce much too much content to follow diligently, but are great for browsing and serendipitous discovery. If you find something interesting, write a short blog post about it or at least a comment.
  10. Catch up on one of your online games with a colleague—Scrabulous on Facebook or Backgammon on Yahoo. Or make a Lolcat. Or watch a Youtube video.

Oct 2, 2008

Edutools for medical education

Edheads - Virtual Hip Surgery - Total Hip Replacement Surgery - THR

Follow this link and perform virtual surgery.
A great tool with immense potential in medical education..
Virtual Hip Replacement :


Take on the role of the Surgeon throughout a hip replacement surgery!







Sep 11, 2008

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