Monthly Archives: March 2016

Telemedicine: It’s Rocket Science.

Two things I want to get out there today: First, I wanted to be an astronaut when I was a kid (come on, so did you); Second, I use the phrase “it’s not Rocket Science” all the time.astronaut on laptop

But, working in the world of telemedicine, I am working in rocket science, as NASA was one of the first organizations to create “links” from their rockets and space shuttles to their mission control in Houston. They developed many of the technologies used in current day telemedicine many years ago…and they are still helping to generate new ideas in this market sector today. Read on to learn more.

As for the astronaut thing, after a few rides on the “whirly bird” at the state fair, you will know why I will never go into space! I like the ground, the stationary feel underneath my feet, way too much!

Imagine you are in a rural area and fall ill. You are just over 200 miles away from the nearest doctor. What do you do? You could drive if you felt well enough, or if it was an emergency you may call 911 for an ambulance or a helicopter to rush you to the hospital.  Now imagine that those 200 miles between you and the doctor are straight down, because you are an astronaut in low earth orbit.

This is the position NASA found themselves in back in the 1960’s at the dawn of manned space flight. In fact, before they sent people into space, they had to develop a way to send biometric data back from animals in orbit to assess how their circulatory and respiratory systems would work without gravity.  This technology was later put to use to monitor the astronauts themselves while in orbit.

Fast forward to 2035, the year in which Matt Damon’s character Mark Watney is stranded on Mars in the new film The Martian. Even though it’s a fictional account, the ability to communicate data like the biometric data Matt Damon’s character transmits back to NASA is very real.  In fact, it only takes from 4 to 21 minutes to send data back depending on the relative position of Earth and Mars in their orbits.  The Mars rovers currently transmit data regarding their Mars explorations back to earth.  It’s a sophisticated relay that starts with the Mars rovers transmitting to the Mars orbiters during an 8 minute window each day as they pass overhead, and then the orbiters relay the data back to earth at a much faster data rate than the rovers themselves can achieve.

Today, in the year 2016, a year firmly planted somewhere in between the history and the fiction referenced above, NASA is using video teleconferencing to connect doctors on earth to astronauts in orbit on the International Space Station. They have continually improved their systems to address the challenges of latency and data loss that a wireless transmission of this great distance can be subject to.  They use their systems to provide real time access to doctors as well as to allow the astronauts to see and talk to their families and to educate students who want to learn about life in space.

Given their history of innovation in this space (no pun intended) it is no surprise that NASA is not content to stop at video alone and is continuing to push the envelope.

“The focus of current agency efforts have expanded beyond the original mandate of telemetry and remote communication to encompass new “smart medical systems” that are designed not simply to communicate and diagnose ill astronauts—but also to provide physicians on the ground with the ability to remotely provide limited treatment options.”

NASA has also worked with the National Space Biomedical Research Institute and a key member of that association, Baylor College of Medicine, to develop advanced ultrasound technology to not only accurately diagnose things like illness and potential bone loss, but they also have the ability to focus and aim the ultrasound in a way that it can even stop internal bleeding in an emergency.

As you can probably imagine, these innovations can all have implications terrestrially as well, meaning that comprehensive remote treatments on Earth are probably not that far away.

Telemedicine will soon enable physicians to perform initial diagnosis, verify that diagnosis with physical patient data collected by remote diagnostic equipment including sensors, perform remote monitoring during treatment and recovery, and finally deliver after care and follow up.

So although telemedicine may have started as rocket science, today it is making remote care incredibly efficient and easy, not only in space, but also right here on Earth. Thank you NASA.

Avidex AV is revolutionizing the way healthcare facilities and doctors are delivering care. Their 20 years of experience is being leveraged to drive down the cost of care while promoting positive healthcare outcomes. Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

Resources:

#1: http://www.nasa.gov/content/a-brief-history-of-nasa-s-contributions-to-telemedicine/#.VvDndOIrLIU

#2: http://www.nasa.gov/mission_pages/station/expeditions/expedition19/earth_day.html

#3: http://blogs.esa.int/mex/2012/08/05/time-delay-between-mars-and-earth/

#4: https://vsee.com/blog/nasa-chooses-vsee-telemedicine-video-conferencing-iss/

#5: http://www.prweb.com/releases/2015/03/prweb12562316.htm

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

Just Browsing: WebRTC for Healthcare

When my kids were younger, we would watch “Finding Nemo” time-after-time-after-time because they thought it was one of the best animated movies made. I used to sit with them and watch too, laughing just as much as they did at all the great parts: Bruce the shark trying hard not to eat any little fish; all the seagulls squawking “Mine, Mine, Mine” and Dora, the fish that has no long term memory, and, when presented something shinny and new, she goes with reckless abandon to see the new thing.WebRTC

I relate to Dora…put something new and exciting in front of me and I am all over it. I love new gadgets, new things that might make my life easier and less stressful. But having been in this technology space for 23 years, new sometimes means not ready for prime time.

So when WebRTC was released, I did what I always do: looked at it, tried it and said to myself, “when it’s been here a while, I’ll buy into it.” Well, I think I was wrong. My normal Dora gave way to the safe, stuffy traditional video modes I so hang on to for the past 23 years!

WebRTC is real, it’s here and it works. If you are looking for ways to get into the Telemedicine space at an entry level, WebRTC might be a good way to start small and grow big. If you have been unlike Dora…doing the same thing year after year because it’s tried and true, look into WebRTC as a possible breakout solution for you.  You might just say “Mine, Mine, Mine” when you are all done looking!

Expensive hardware. Special software plugins.  Application downloads.  Varying system requirements. Limited hard drive space or system resources.  Lack of interoperability.

These have all historically been considerations that technology managers in healthcare had to deal with to successfully implement a telemedicine strategy to provide remote healthcare services to their patients. Quite honestly, for some healthcare facilities, they also acted as a barrier to entry based on the cost or the technical resources of the facility.  The costs of acquiring hardware and developing a comprehensive and secure telemedicine strategy seemingly outweighed the potential benefits telemedicine provides.

Enter WebRTC. Web browser Real Time Communications.

In short, WebRTC is an open source platform that leverages a communication application built into PC web browsers like Opera, Chrome, and FireFox and into mobile operating systems like Android and Apple OS.

This takes the term “just browsing” from a term to describe casual interest to one of serious business. If you have been daunted by the technical considerations of video teleconferencing in healthcare, here is why you should be excited about WebRTC.

It’s “skinny”. WebRTC uses a skinny client software integrated into the web browser.  This eliminates the need for valuable system resources to be used to store large proprietary application files.

It’s browser based.  WebRTC does not require any specialized hardware or require the user to download special applications.  It runs on existing computers and anyone utilizing a browser that supports WebRTC has access.

It’s secure.  WebRTC is subject to existing browser security protocols and data encryption is a mandatory feature. “WebRTC is currently regarded by some to be one of the most secure VoIP solutions out there.”

It’s open source. Interoperability has been a major issue with proprietary teleconferencing solutions, one that has been difficult to solve, so much in fact that many are giving up on it altogether. WebRTC is not a proprietary, branded piece of software. It is an open source project which means many interoperability concerns are a thing of the past.

It works with legacy investments. For those with an existing video teleconferencing solution, many legacy hardware solutions, like those from Polycom, are supporting expansion of their systems through WebRTC. This allows facilities to leverage all the QOS and enhanced security features of those systems while providing easier expansion in new facilities and access to remote patients via WebRTC.

In short, if you’re aware of the benefits telemedicine offers to your facility and are looking for a resource light, easy to implement, and secure solution that will work across browsers and with existing dedicated hardware, you need to look at WebRTC. Then the next time a patient needs a remote check-up or some aftercare, they can get access to it by “just browsing”.

Avidex AV is revolutionizing the way healthcare facilities and doctors are delivering care. Their 20 years of experience is being leveraged to drive down the cost of care while promoting positive healthcare outcomes. Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

Resources:

#1: https://webrtc.org/

#2: http://webrtc-security.github.io/

#3: http://www.excessionevents.com/blog/interop

#4: http://community.polycom.com/t5/The-View-from-APAC/Why-WebRTC-is-key-to-unlocking-mass-adoption-of-video/ba-p/51639

 

 

 

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

Telemetry. What is it and why is it good for healthcare?

Telemetry. It’s a word I had heard many times, but it was usually closely associated in my mind with rockets and space shuttles.  To be honest, the first time I heard it used in relation to healthcare I was a little taken aback.Telemetry photo  In fact, it caused me to look up a word I thought I knew for a formal definition. This is what I found:

Telemetry is an automated communications process by which measurements are made and other data collected at remote or inaccessible points and transmitted to receiving equipment for monitoring. The word is derived from Greek roots: tele = remote, and metron = measure.

In the light of that definition, the immediate impact of telemetry on healthcare, especially telemedicine came clearly into focus. In fact, looking further down the page of search results for telemetry, I noticed several results for a Telemetry Nurse as well, further solidifying an immediate link between the two disciplines.

If you run a hospital, you are most likely already very familiar with what a Telemetry Nurse does, but here is the description as posted by a University that offers degree programs for nurses.

Telemetry nurses work with patients that require special monitoring, including those recently released from the intensive care unit of a hospital. The patients they work with are often at high risk for complications, so RNs in a telemetry unit must carefully review equipment and data to detect potential symptoms of distress or danger.

Given that this type of physical on-premise equipment has been used in hospitals for quite some time, telemetry is not in any way actually new to medicine at all. However as technology advances, the applications for telemetry become wider and wider.

With the proliferation of internet connected devices and sensors, or the Internet of Things (IoT), telemetry extends beyond the on-premise, state-of-the-art equipment inside the nation’s hospitals and effectively becomes available wherever the patient may be. In fact the problem is no longer collecting the data for interpretation. Now the challenge becomes sifting through irrelevant data to find the important pieces, as well as securing that data to ensure the privacy of all that health information as it streams from a sensor through the internet, and to the nurse or physician it is intended for.

Think about the trends in technology today. People are already using telemetry in a personal way to manage wellness. They use Apple Watches or Fit Bits to track their steps and heart rates, track sleeping habits, and even set REM sensitive alarms to assure that they are always morning people. Companies like Google are even going a step further. Currently they have filed several patents on a glucose sensing contact lens, that not only tracks blood glucose levels, but also connects to the internet and smart devices, as well as includes a heads up display for the person wearing it to see the data from the lens right on their eye!

Now imagine taking all of this telemetry data and being able to share or save it right to your Electronic Health Records so that your physician has access to it to help determine the best care to give. Some say it’s comforting, others think it’s a bit scary, but in either case, it is objectively valuable to the care provider on the other end. If you consider for example some of the tragedies we have seen befall collegiate athletes because they collapse during a game from an undiagnosed condition, could it not be argued that telemetry may have reported some objective data beforehand, even though the athlete wasn’t noticing any symptoms themselves?

These are some of the encouraging promises of big data and healthcare. People like to focus on the negative side sometimes; that the insurance companies may get this data somehow and then deny insurance based on the figures. But on the flip side, your physician could be getting the data and proactively address a potentially life threatening condition as well. The risk of the first may be more than negated by the benefit of the second.

The point is that telemetry has in fact been here for a while in the ER and ICU, but now, in the new connected environment, just like a video conferencing system connects doctors and patients remotely for appointments and check-ups, telemetry connects the biometric data your body produces day in and day out to a physical data log. This allows that same physician to prescribe better treatments during those appointments and even to proactively help you manage your health long term.

I heard someone on a medical program state that “the first person to live to 150 has already been born.” IT is definitely something to ponder, and given the state of medical technology, it doesn’t seem like an outlandish claim. I can’t help but think that telemetry will play a huge role in the active management of personal health, transforming the doctor patient relationship from one of “break-fix” to a true collaboration that gives us all the ability to live long and healthy lives.

Avidex AV is revolutionizing the way healthcare facilities and doctors are delivering care. Their 20 years of experience is being leveraged to drive down the cost of care while promoting positive healthcare outcomes. Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

Resources:

#1: https://en.wikipedia.org/wiki/Telemetry

#2: http://www.jacksonvilleu.com/resources/career/telemetry-nurse-job-description-salary/#.VruC_PkrLIU

#3: http://blog.avidex.com/next-stop-the-ioh-will-there-be-an-internet-of-healthcare/

#4: http://blog.avidex.com/the-doctors-watch-just-stole-my-medical-records-and-other-strange-tales/

#5: http://diatribe.org/google-secures-patent-glucose-sensing-contact-lens

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com