HealthTech.PH: Op Ed

Give up your Data to Cure Disease

February 09, 2016 The Mail Man 0

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<footer class="story-footer story-content"><span style="font-size: large;">HOW far would you go to protect your health records? Your privacy matters, of course, but consider this: Mass data can inform medicine like nothing else and save countless lives, including, perhaps, your own.<br /><br />Over the past several years, using some $30 billion in federal stimulus money, doctors and hospitals have been installing electronic health record systems. More than 80 percent of office-based doctors, including me, use some form of E.H.R. These systems are supposed to make things better by giving people easier access to their medical information and avoiding the duplication of tests and potentially fatal errors.<br /><br />Yet neither doctors nor patients are happy. Doctors complain about the time it takes to update digital records, while patients worry about confidentiality. Last month the Association of American Physicians and Surgeons went so far as to warn that E.H.R.s could “crash” the medical system.<br /><br />We need to get over it. These digital databases offer an incredible opportunity to examine trends that will fundamentally change how doctors treat patients. They will help develop cures, discover new uses for drugs and better track the spread of scary new illnesses like the Zika virus.<br /><br />Medicine is famous for serendipity — scientists coming across important findings when they least expect them or aren’t even looking. I’ve often said that we may have all the drugs and therapies we need already to prevent, treat or cure most ailments, but we don’t know which ones can be used on which conditions and at which doses.<br /><br />Case in point: Last year, a team led by researchers at the MD Anderson Cancer Center and Washington University found that a common class of heart drugs called beta blockers, which block the effects of adrenaline, may prolong ovarian cancer patients’ survival. This discovery came after the researchers reviewed more than 1,400 patient records, and identified an obvious pattern among those with ovarian cancer who were using beta blockers, most often to control their blood pressure. Women taking earlier versions of this class of drug typically lived for almost eight years after their cancer diagnosis, compared with just three and a half years for the women not taking any beta blocker.<br /><br />The researchers are now preparing follow-up clinical trials of ovarian cancer patients. My guess is they will confirm the connection.<br /><br />This information was lying in plain sight, no invasive procedures or testing required. We could have found it years earlier if we had had the data.<br /><br />Here’s another recent example. In 2015, researchers at Stanford University and the Houston Methodist Research Institute analyzed more than 16 million clinical documents from some 2.9 million patients and discovered a connection between prescriptions of a certain kind of heartburn drug and heart attacks. One in 15 Americans takes these drugs, the so-called proton pump inhibitors (P.P.I.s) such as esomeprazole (Nexium), omeprazole (Prilosec) and lansoprazole (Prevacid). The study found that they can increase your risk of a heart attack by about 16 percent, regardless of whether or not you have an existing heart condition.<br /><br />This conclusion came from simple data mining, and confirmed earlier research conducted in 2013 and published in the journal Circulation indicating that P.P.I.s could potentially lead to long-term cardiovascular disease by changing the lining of blood vessels. Patients who were prescribed another type of heartburn drug, however, had no increased likelihood of heart attack.<br />I get that patients are nervous about releasing their health records. Studies have shown that even anonymous strings of DNA data can be linked to individuals. Patients understandably don’t want their acquaintances and employers to know all their private health information. But we cannot let these fears suppress the powerful insights medical data can offer us. When I explain to my own patients what can be done with their information for the greater good in research, nobody has ever said to me, “Don’t use my data.”<br /><br />We all go to a machine on the street where we insert a plastic card and cash comes out; we log into our online accounts to check our balances and pay bills; and we give credit card numbers that contain a key to our financial information to retailers without a second thought. But if I asked you to put your de-identified personal health information online, or share it and perhaps some bio-specimens with people other than your own doctors, you might panic. “Health data is not the same as financial data,” you might say.<br /><br />We need to move past that. For one thing, more debate over data sharing is already leading to more data security. Last month a bill was signed into law calling for the Department of Health and Human Services to create a health care industry cybersecurity task force, whose members would hammer out new voluntary standards.<br /><br />New technologies — and opportunities — come with unprecedented risks and the need for new policies and strategies. We must continue to improve our encryption capabilities and other methods of data security and, most important, mandate that they are used. The hack of the Anthem database last year, for instance, which allowed 80 million personal records to be accessed, was shocking not only for the break-in, but for the lack of encryption.<br /><br />We also must block attempts to discriminate based on health information for work or other pursuits with continued legislation, and portray those who participate in the sharing of health data as heroes. In fact, they are heroes: They are part of tomorrow’s cures for themselves and their children. We also need to revisit the cumbersome and obsolete privacy rules enacted by the Health Insurance Portability and Accountability Act of 1996 to make it easier for patients to participate. One idea is to establish a trusted middle “broker,” such as a dedicated nongovernmental agency, that can ensure that every effort is made to keep records anonymous before their release for research studies.<br /><br />Medical research is making progress every day, but the next step depends less on scientists and doctors than it does on the public. Each of us has the potential to be part of tomorrow’s cures.<br />David B. Agus is a professor of medicine and engineering at the University of Southern California and the author of “The Lucky Years: How to Thrive in the Brave New World of Health.”</span><div style="margin: 0in 0in 0.0001pt;">
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<span style="font-size: large;">Source: <a href="http://www.nytimes.com/2016/02/07/opinion/sunday/give-up-your-data-to-cure-disease.html?_r=0">http://www.nytimes.com/2016/02/07/opinion/sunday/give-up-your-data-to-cure-disease.html?_r=0 </a></span></div>
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EMR Innovations News Op Ed Technology Give up your Data to Cure Disease

HOW far would you go to protect your health records? Your privacy matters, of course, but consider this: Mass data can inform medi...

Zena Bernardo : At the helm of the new age of out-patient surgery.

January 25, 2016 Tech Support • 0

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<span style="font-size: large;">MAKATI, Philippines - Zena Bernardo is the COO of The Surgery Center at Centuria in Makati.  By being such, she is at the helm of a new paradigm in healthcare.  What she has is a totally new way of doing out-patient surgery.  <br /><br />There is always that sinking feeling when has to visit the hospital for consultations and checkups with one’s physicians. There is no avoiding the lobby where one sees all sorts of patients and their attendants and it adds to the stress where one is waiting for the physician to attend to you.<br /><br />There is also the increasing cases of hospital-acquired infections that is a cause of very serious concern. All these  for out-patient services and consultations that according to studies last for an average of 11 minutes per patient.<br /><br />It is true that top tier hospitals take serious efforts in disinfecting the premises including “negative air pressure” zones but the sheer volume and human traffic caused by the floor plan of most hospitals make zero infection  efforts difficult to attain.<br /><br />A highly efficient and well planned facility is then needed to serve the healthcare needs of out-patients that expect prompt medical care combined with less intimidating but comfortable facilities.<br /><br />The Centuria Medical Makati answers these needs. It is a 28-storey building with state-of-the-art facilities that includes 600 medical offices, laboratories, operating rooms and other diagnostic services confined in an environment akin to first class hotels. </span><span style="font-size: large;">Centuria Medical Makati is located in the heart of residential and commercial high rise developments called Century City along Kalayaan Ave., Makati City. Centuria Med boasts of the latest in building technology and information and technology such as high speed internet, EMR and Picture Archiving Systems that help doctors to coordinate with other specialists should it be required by their patients.<br /><br />Centuria Medical Makati’s services caters to a myriad of health concerns. The medical arts facility will house clinics catering to general medicine; multi-specialty practice; aesthetics/cosmetic surgery; dermatology; ear, nose and throat (ENT); ophthalmology; cardiology; oncology; neurology; psychiatry; obstetrics and gynecology; fertility; pediatrics; general surgery; orthopedics; urology; dentistry/orthodontics; anti-aging; geriatric medicine; pain care management; and wellness and complementary medicine, among others.<br /><br />Centuria Med is well placed to serve the medical tourism industry that is one of the thrusts of the Philippine healthcare system.</span><br />
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Forensic DNA technology: A powerful tool for judicial reform

January 25, 2016 Tech Support • 0

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<span style="font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;">DNA testing is the most powerful tool for human identification. Since its discovery in the mid-1980s, DNA profiling had caused a paradigm shift in the identification of victims, perpetrators and witnesses in numerous cases. The identification of genetic markers that are highly variable in human populations is a major step toward the establishment of reference as well as criminal databases needed for statistical evaluation of matching DNA evidence, or identification of repeat offenders, respectively. In addition, the chemical stability of a DNA molecule against harsh environmental challenges such as extreme temperatures and high humidity makes it more suitable for criminal investigations which lasts for months, even years in the Philippines. Moreover, the fact that a person inherits one’s DNA from one’s parents, provides an investigator with alternative reference samples, when an individual’s own reference biological sample is unavailable.</span></div>
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<span style="font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;">Recent advances in forensic DNA testing are now paving the way for reforming the manner by which cases are resolved in courts of law through the way suspected offenders are apprehended during a criminal investigation. Firstly, the availability of new markers which are more variable across different populations, adds to the increased power of discrimination once more genetic markers are used. From the time when DNA testing only involved seven to nine genetic markers to evaluate if crime scene evidence matches a suspect’s profile, as well as to determine relationships, to the current battery of 21 autosomal markers and 23 male-specific markers, the capacity of DNA profiling to differentiate individuals has increased significantly. The use of automated and expert systems for large-scale analysis has also been found to reduce manual errors and to increase output per unit time. The use of several dyes in a single multiplex system provides more information from the same amount of genetic material compared to reactions targeting only one genetic marker but requiring the same amount of DNA that was common in the early 1990s.</span></div>
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<span style="font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;">More recent developments involve the use of information derived from mutation rates of a group of genetic markers, known as short tandem repeats, located on the Y-chromosome (Y-STRs), which enables us to differentiate from paternally related male persons. Scientists, including those in our laboratory at UP Diliman (www.dnaforensic.org), are continuing to search for new and better polymorphic markers for purposes of human identification. This work will be undertaken within the Program on Forensics and Ethnicity of the Philippine Genome Center wherein advances in genomics such as next generation sequencing technology (NGS), as well as microarray work, will be used to accelerate the process of discovery of genes which are highly variable in Philippine populations (www.pgc.up.edu.ph).</span></div>
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<span style="font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;">Secondly, the development of more robust reaction mixes coupled with shorter PCR products has also opened the possibility of re-testing old case samples which may have yielded negative results such as in cold cases, or in the re-opening of cases wherein prisoners continue to claim their innocence and relevant biological samples are still available (post-conviction DNA testing). Recently, the Innocence Project Philippines Network was launched at the National Bilibid Prison and the Correctional Institute of Women (https://www.facebook.com/InnocenceProject Philippines). The Network consists of student volunteers in legal aid clinics of the law schools of the University of the Philippines, De La Salle University and Ateneo de Davao; law faculty, lawyers providing pro-bono work, NGOs, private citizens and scientists at the UP DNA laboratory who are working together to evaluate prospective wrongful conviction cases. In its initial phase, the volunteers are tasked to find cases that have become final and executory but that may be re-opened for post-conviction DNA testing following the Rules on DNA Evidence that was promulgated by the Supreme Court in 2007. In the Philippines wherein DNA testing of cases such as People vs. Hubert Webb et al. and People vs. Paco Larranaga et al. could have provided answers to many questions and confirmed or negated witnesses’ testimonies, the use of post-conviction DNA testing, that is now recognized by the Supreme Court, remains to be realized.</span></div>
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<span style="font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;">Thirdly, the US FBI recently reported the development of faster and portable DNA analytical systems that would allow investigators to generate DNA profiles on site, thereby increasing the chances of apprehending the real perpetrator almost in real time. The speed and accuracy of these portable DNA systems are crucial in criminal investigations. In the Philippines where no DNA legislation exists governing the collection, handling and storage of crime scene evidence as well as in the establishment and security of criminal databases, the use of these analytical systems will not have its maximum effect. More importantly, as science, particularly genetics, continues to expand its forensic applications, there is an urgent need for revising the curriculum of relevant courses such as criminology, public administration, political science and law, into incorporating relevant science and genetics topics, in order to improve the education of our future law enforcement personnel, administrators, politicians, legislators, lawyers and judges. Only with an increased appreciation and recognition of science and its numerous uses at the service of society, could we maximize the fruits of scientific research and discoveries that scientists, including Philippine scientists, are making for the good of all.</span></div>
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<span style="font-family: "arial" , "helvetica" , sans-serif;">The author, Maria Corazon A. De Ungria, Ph.D., received the NAST Outstanding Young Scientist Award in 2003 for Molecular Biology. She is the current head of the DNA Analysis Laboratory, Natural Sciences Research Institute of UP Diliman, the director of the Program on Forensic and Ethnicity of the Philippine Genome Center, and a member of the Board of the Innocence Project Philippines Network. She has appeared as expert witness in cases involving disputed parentage issues and in relation to criminal cases.  She provided her technical assistance during the formulation of the Rules on DNA Evidence and her opinion on different bills regarding forensic DNA technology. The UP-NSRI DNA Laboratory continues to offer its parentage testing and DNA profiling expertise as part of its commitment to serve the community. The laboratory may be contacted at (63) (2)  9252965, +639189136284 and updnalab@gmail.com.</span></div>
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Advocacy DNA DOH Global News Movers and Shakers Op Ed Policy Forensic DNA technology: A powerful tool for judicial reform

DNA testing is the most powerful tool for human identification. Since its discovery in the mid-1980s, DNA profiling had caused a paradigm ...

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Give up your Data to Cure Disease

Zena Bernardo : At the helm of the new age of out-patient surgery.

Forensic DNA technology: A powerful tool for judicial reform

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