what google brillo means for healthcare IT

today google announced brillo, their IoT operating system based on android and it’s matching communicating protocol. brillo will be  live later this year and so will weave, the communication protocol. google is now making moves to join apple and microsoft, a timely move.

brillo and weave will work well on light weight devices, like cameras, door locks, etc. essentially home devices. in the growing market of health related devices and monitors, this announcement means another stride in that direction, in the shape of affordable scales, wearables, remote monitoring, telehealth and other means to collect specific and relevant information from patients where they are.

with small computers scaling up, a low memory foot print we should expect a wave of innovation when it comes to healthcare related products.

patient engagement

doctor-and-patientpatient engagement as defined by healthcareITnews.com:

“Patient engagement refers to ongoing and constructive dialogue between patient and practitioner. Within the scope of healthcare IT, patient engagement is driven by technology ranging from patient portals, which enable patients to view test results and records online and communicate with doctors, to electronic data capturing platforms that result in more accurate and streamlined diagnostic information. A high emphasis has been placed on patient engagement in Stage 2 meaningful use.”.

the healthcare system in the US is wonderful in focusing on one thing that has gone wrong and fixing it. it is not so effective in dealing with comorbidities and not so much when it comes to taking daily actions to maintain a state of harmony. mobile devices seem like the right channel to revolutionize the current state. can healthcare be as engaging as our digital social lives? can the same social circle serve as a catalyst to push us in the right direction when it comes to making healthier choices?

why does it seem like we are not getting patient portals and PHR right? to start off, the sicker the patient the less likely they are to use the portal. to put this in perspective, 78% of physicians use EHR while 17% of patients use portals (this data dates back to 2013 by Research Ancker). it is clear that patients do not see the value of the portals yet nor gaining access to their PHR. what is the right model to bond the patient and provider together?

considering that PHR is mostly provider facing, i.e. they are laid out and detailed in a clinical way which makes more sense for the physician than the patient. take clinical notes for example which include terms which do not make much sense to the patient.

but hold on for a second. aren’t the patient already so very much engaged? they suffer the pain, go through the medical procedure, pay the bill… patient are indeed engaged as they fill out the same form multiple times as they visit different departments within the same hospital. as they are expected to accurately name the medications they are taking and the dosage. isn’t it the system that, inadvertently, discourages engagement?
today providers are almost exclusively responsible for deciding a patient’s treatment, next site of care, medications, etc. seeking patient engagement, those key decisions should include the patients and their families, where they can voice their opinion, participate and share responsibility.

consider nutrition and financial wellness as important gaps. patient should know who is responsible for delivering their care. critical data elements can be tied to services rendered to improve outcome in a clear and concise way. regardless of a patient’s spoken language, in order to engage them they should be able to specify clearly and effectively specify what is going on, why they need help and know that someone got their message and is “working on it”. all that within as little clicks as possible.

patient engagement may be the holy grail when it comes to improving outcome and reducing costs. having the patient and their family and friends participate in the process in a meaningful way and be proactive in a timely manner can assist advancing the healthcare system in our country forward.

 

 

scrum 101

scrumscrum methodology is quite popular and i’d like to dedicate this post to making some sense out of it for those of you who are not familiar with it. if you are a development team, scrum could be an interesting fit for you or at the very minimum something new to consider and evaluate.

scrum is a software development methodology that works along the lines of lean manufacturing or agile. to make sure we all speak the same language, agile is lean is scrum in a superficial or high level view point. if you are wondering on the origin of the name, scrum is borrowed from rugby where the players lock up and try to get a hold of the ball by passing it with their feet. small iterations. makes sense?

the methodology assists in defining the development life cycle and stages, the key players and roles and how responsibility is delegated. scrum also assists in figuring out how to stay on top of project and it’s progress, how to address and perform changes/enhancements to the development plan and how to deal with risks. taking a step forward, scrum can help lead development teams, be engaged in drawing conclusions and improve both product and process on regular basis.

if you were a scrum, the world is roughly divided into you and waterfall. “you” means agile methodologies such as kanban and XP. waterfall is a more sequential approach from the 70s that was (probably) influenced by traditional manufacturing, and is similar to the approach of building a house:

  • there are restrictions on the order of operations (one cannot lay the roof before foundation for example)
  • mistakes are freaking expensive so better get it right by carefully planning and quality measuring your work
  • much repetition (many doors, many windows) so consolidating tasks means efficiency

so with waterfall one first gather all the requirements for a product, then architect the solution, then dive into a detailed, technical design of each component, code it up, integrate, test test test, repair/fix and release.

with agile, developing software is more like designing a department store:

  • usually there are loose restrictions on the order of the tasks at hand
  • a wide array of features
  • a detailed and strict planning may fail. small incremental steps and proper adjustments moving forward works better (scrum anyone?)
  • centralizing tasks helps to a certain extent

scrum in action:

  • with agile the team goes on sprints (2w minimum for us) when each run gets us one step closer to our goal
  • effectiveness is key: how many features (stories) were coded into the system. less lines of code in general, more code that does what the end user really needs
  • no elaborate MRD/PRD. with agile one maintains a backlog and direct communication. we hold daily meetings, spring planning and we retrospectively learn from our mistakes and success.
  • flat hierarchy across the team and more responsibilities is handed off to the developers. the team self manages using a structured process
  • a team is comprised with complementing skills, so each team can get stuff done on it’s own accord
so agile is more of a philosophy than rules right?
  • every activity is time measured and they are prioritized from the most important to the least. when time runs out we are hopefully better off than before we started as the product work was done priorly to make sure the most important features are on the top of the list (i.e. backlog)
  • with agile the developers are encouraged to write only what is absolutely necessary and most probably we will revisit this code later on for changes and enhancement. this is where a thought through QA process is essential

think of scrum and agile as a framework for getting the job done. depending on the dynamics of your team and size of company agile maybe what you want to implement. i think it works very well for startups and collaborating with small teams when outsourcing projects. at the end of the day agile/waterfall are all ways to increase productivity and allow developers to make the best of their time.

good luck!

self.brain->reset()

our brains need the time to reset just like the gadgets and computers we use and operate. by experimentation i’ve learned that a minimum of 2-3 weeks vacation twice a year pretty much does the trick. think about it, in today’s day and age we are always on, always connected, always tapping into sources of data to keep us engaged. from the moment we wake up and check our smart phone which aggregates data from multiple social and professional networks, to email, text and voice mail – we are constantly engaging with our peers, families and consume multiple sources of data, easily streamlined for our convenience, easily shared and re-propagated. and this is just the digital disturbance 🙂

the human story for today is our need to focus. the need to do just one thing at a given moment and stick with it for many hours. developers know how to do so (hey nir, can you turn off the music and ask andrew to put his headphones on please?). i know that for me playing music does the trick and specifically practicing yoga. calming the mind is an art that requires constant and un interrupted practice. i cannot imagine the brain enjoying 100% capacity at any given moment, just as much as it enjoys 0% capacity. the truth is pretty much always in the middle. face it, we have learned to respond to these interruptions better than focus, and it goes back to the days where the telephone was invented.

sleeping is the best time for the brain to not consume new streams of data and process all it has been bombarded with, make new connections and archive/store the data. from a quick survey with close friends and family, i learn that sleeping patterns are very much affected and do worsen with time. how many of you out there in the internets sleep with the TV on?

this is why i take two long breaks from my work and focus on relaxing my mind and body, explore new geographical areas of our planet, meet new people, study a new language, and more often then not play/write music and expand my photography skills. this works in phases though and i find that it takes some time to re-adjust the mind and relax – slow down. the longest break i have ever taken from life was a 3 months trip to brasil. no iphone, no laptop, no internet connection. would you be surprised if i told you that it did not take long to re-adjust to the new situation and that i loved it? i took my best photos and wrote my best music while taking these breaks from life.

much like a hard reset, browser cache cleaning and the application of a new style sheet – one may immerge back with fresh energy and a newly re-wired brain. so – for the sake of your career, mental health and own happiness – plan on taking a longer time off. you deserve it.

iPad 3 predictions

the ipad3 is around the corner as apple just announced a media event on march 7th.

ipad3 event invitation what will we possibly get?

  • retina display: 2048×1536 pixels will make pretty much everything more gorgeous and engaging.
  • A6 quad core processor: this means tremendous performance and response boost.
  • LTE support. let’s face it – 4G network is where it’s all heading,
    as the internet will blend better and tighter with the device and our lifestyle.
  • better front and back camera. flash.
  • equal or better battery life.
  • unified GSM/CDMA support.
  • bluethooth 4.0 chip.


what we may get:

  • smart bezel virtual buttons:
    imagine the bezel and back cover of the ipad responding to customized buttons which lit up.
    so you can setup the top left .bezel button to launch maps. more here.
  • NFC chip (not likely IMHO).
  • airdrop feature from ipad to mac.


what we probably won’t get yet:

  • haptic feedback display. the game changer. it will be a great day when it arrives (though the image from apple may hint at it…).
  • solar charging of the device
  • new map system which apple has been working on

final thoughts:

  • how does siri fit in? i am not sure yet…
    will iOS 6.0 be announced as well? if so, developers will a beta by early next week…