Mobile phone microscope poised to begin trials in Africa

Lensless mobilephone microscope receives 3 major awards

Mobile phones are accumulating a Swiss Army Knife-esqe assortment of capabilities; substituting as cameras, providing internet access, and soon operating as medical labs if Aydogan Ozcan’s plans come to fruition. This month’s cover article of the journal Lab on a Chip features the latest creation by the Ozcan group, a functioning prototype of a mobile phone microscope. The lensless imaging platform behind the mobile phone microscope is nearing readiness for real world trials, after receiving prestigious awards in the past month from the Bill & Melinda Gates Foundation, National Geographic, and the National Science Foundation (NSF).

“Mobile phones present a tremendous opportunity in Global healthcare,” remarked Ozcan, an assistant professor of electrical engineering at the UCLA Henry Samueli School of Engineering and Applied Science and a researcher at UCLA’s California NanoSystems Institute. “We can leverage the fact that eighty percent of the world’s population lives in areas covered by mobile phone networks to bridge the gaps left by a lack of health care infrastructure in developing countries.”

That lack of health care infrastructure includes not only buildings, but also trained personnel. For telemedicine tools to effectively fill in for hospitals, the devices have to meet several criteria. They must be cheap enough for widespread use in poor areas, be simple enough for a minimally trained person to correctly operate, and be able to easily transmit information over existing cellular networks. Optical microscopes, a key diagnostic tool in hospitals, are too bulky for telemedicine applications.

In optical microscopes, one of the elements which limits the miniaturization possibilities and drives up the cost is the lens. Ozcan’s telemedicine microscope avoids both these constraints by capturing an image with a lensless system. This innovative engineering means that the microscope can be miniaturized (it only weighs ~1.5 ounces) to the point where it fits on most mobile phones, while remaining inexpensive enough for widespread use in developing countries, costing only about ten dollars each.

Images are captured through a process called diffraction, or shadow-based, imaging. An ordinary light-emitting diode (LED) from the top illuminates the sample, and the detector array already installed in mobile phone cameras captures the image, recording the patterns created by the shadows resulting from the LED light scattering off of the cells in the sample. Because cells are semi-transparent, enough information is obtained from this type of imaging to detect sub-cellular elements, and to produce holographic images. By using an inexpensive LED light instead of a laser as typically required for holographic imaging, the size and cost are further reduced.

The mobile phone microscope is also easy to use, and versatile. Samples (blood smears or saliva) are loaded into single-use chips that easily slide into the side of the microscope. Because the microscope uses the entire detector array to capture an image and has a relatively large aperture, it has a wide imaging field-of-view. Samples do not need to be precisely aligned for images to be captured, and the chance of debris clogging the light source is lessened. Alternate uses of the technology include testing water quality in the field following a disaster like a hurricane or earthquake.

The lensless imaging platform is an ideal telemedicine tool because it is so easily integrated with mobile phones, which are becoming cheaper to produce while gaining sophistication. Even base models in developing countries often have cameras. Ozcan’s group developed an algorithm that instantly identifies and counts red and white blood cells and microparticles in samples, a time consuming process typically done by trained technicians. The image results are then sent by the mobile phone to centralized hospitals for analysis by doctors. As an alternative for people whose mobile phones don’t have built-in cameras, Ozcan’s group also created a standalone lensless microscope that only requires a USB connection for power and to upload the captured shadow images to either a laptop or mobile phone for transmission.

Field tests of the mobile phone microscope will begin in Africa this summer using funds received from the three major awards. In early May a proposal of Ozcan’s was selected by the Bill & Melinda Gates Foundation for a $100,000 Grand Challenges Exploration Grant; in mid May he was selected as a National Geographic Emerging Explorer, for which he will receive $10,000; and in late May he received $400,000 for a CAREER award from the NSF.

£7.5 million investment in ambulance defibrillators will save more lives in Scotland

The Scottish Ambulance Service (SAS) will install new lifesaving defibrillators on all of its ambulances this year. The state of the art technology will replace existing defibrillators in a £7.5 million initiative funded by the Scottish Government Health Department.

The new Laerdal HeartStart MRX machines were chosen after an extensive procurement process, which included weeks of field trails with ambulance crews around the country. They include 12 lead ECG diagnostic and interpretive capabilities, which provide greater detail on patients’ cardiac rhythm and diagnosis. This allows better quality information to be transmitted to specialist receiving cardiac centres while the ambulance is en route.

Pauline Howie, Chief Executive, Scottish Ambulance Service, said:
“In most instances of heart attacks, ambulance staff are the first response. It is important that our paramedics and technicians have the most advanced technology available to help them deliver the highest standards of care to patients. The new defibrillators will be introduced into all of our 526 emergency ambulances by the end of the year and will make a significant contribution to saving lives in Scotland on a daily basis.

“Our staff were heavily involved in the process of choosing the preferred solution and the combination of portability, functionality and reliability were key factors in the final decision.  Ambulance crews work closely with cardiologists at centres around the country and the increased diagnostic functionality of the new machines will enhance the quality of information available to specialists, improving the likelihood of a positive outcome for patients. ”

Health Secretary Nicola Sturgeon said:
“Getting the best possible treatment, at the earliest possible opportunity, is vital when it comes to saving people’s lives.

“That’s why the Scottish Ambulance Service has fitted defibrillators in all their accident and emergency ambulances to ensure that when people need this potentially lifesaving treatment it is available – wherever they are.

“The rollout of the latest technology will help the ambulance service deliver an even better service to patients throughout Scotland.”

The SAS responds to over 33,000 cardiac related emergencies in Scotland every year and currently reaches more than 80% of them in under 8 minutes, against a standard of 75%.

Holyrood committee raises concerns over financial management in the NHS in Scotland

28 June 2010

Stethoscope. Photograph: Deliormanli /  iStockphoto A Scottish Parliament report published today raises concerns that “fundamental weaknesses in NHS management” may be influencing decisions on spending, budgeting and staff resources.

The Parliament’s Health and Sport Committee has completed its review of NHS board revenue allocations for 2010-11 and has raised questions over how budgets have been managed.

Read the Committee’s report

Committee Convener Christine Grahame MSP said: “More staff have seemingly been appointed without any comparable rise in productivity because of the way budgets have been managed in the past. This raises a number of questions, including what criteria are being used to approve new spending and what standard of evidence is expected to support a spending plan.

“The committee is concerned that mechanisms in place for holding NHS boards to account don’t adequately address efficiency within the service. We’re also concerned that reductions in budget growth, against a background of continuing rises in demand and inflationary pressures, will place the NHS under great strain.”

Other key findings of the report include:

• The need for NHS boards to inform and involve local stakeholders in increasingly contentious decisions about where savings can be achieved based on evidence they have gathered.

• A call for reassurance from NHS boards that savings can be made without damaging the quality of service.

Wi-Fi Adoption in Healthcare Growing at 60%

LONDON – June 22, 2010
The uptake of Wi-Fi within healthcare has grown at more than 60% over the past 12 months in both wireless local area network and Wi-Fi RTLS (Real-Time Locations Systems) deployments, and high double-digit growth is expected to continue for at least the medium term.

Other wireless technologies being adopted and deployed in healthcare including cellular M2M and wearable wireless sensors have also seen significant growth over the past 12 months.

Wireless communications continue to be adopted in healthcare applications ranging from Wi-Fi networks to wearable sensors that wirelessly transmit a patient’s condition to monitoring applications.

“Wi-Fi adoption has helped overcome initial concerns about complexity and reliability of wireless within healthcare,” says ABI Research principal analyst Jonathan Collins “The growing number of wireless technologies and wireless applications being developed, piloted and deployed within healthcare further underline the level of interest in using wireless to improve the flexibility and efficiency of healthcare services around the world.”

The technologies tracked by ABI Research’s Wireless Healthcare Research Service include Wi-Fi, Bluetooth, Low-Energy Bluetooth, ZigBee, 802.15.4 and proprietary low power RF offerings across applications such as WLAN, personal monitoring, disease management, assisted living and telepresence.

The market trends for these technologies are documented in “Wireless Healthcare and Fitness Market Data,” a database which tracks adoption of remote patient monitoring, telehealth and telepresence, as well as “body area networks,” voice-over-Wi-Fi and chronic disease management.

Encouraging initial findings from a medication adherence study

The Center for Connected Health, a division of Partners Healthcare, announced Wednesday encouraging initial findings from a medication adherence study

BOSTON, MA, JUNE 23, 2010 — The Center for Connected Health, a division of Partners Healthcare, announced today encouraging initial findings from a medication adherence study, using a wireless electronic pill bottle to remind patients with high blood pressure to take their medication. The ongoing study measured a 27% higher rate of medication adherence in patients using Internet connected medication packaging and feedback services compared to controls.
The randomized controlled study assessed the impact of the wireless GlowCap developed by Vitality, Inc. GlowCaps fit popular pill bottles and signal patients with light and sound when it is time to take the medication inside. An embedded wireless connection enables the GlowCap to respond to the patient with automated calls for any missed dose, weekly progress reports, and refill reminders. GlowCaps also share adherence with physicians and a social network if the patient chooses.
“As healthcare providers, we must find strategies that help patients become more adherent to their medications and care plans,” said Alice Watson, MD, MPH, Center for Connected Health. “We are extremely encouraged by these interim results, showing a high rate of adherence in users of the GlowCap system.”
In total, one hundred and thirty nine patients diagnosed with hypertension and taking an antihypertensive medication were enrolled in a six month study starting in August 2009. Participants were required to have Internet access and an email account to receive reports. Each participant was randomized into one of three groups: those in the control group did not receive any communication or GlowCap services; the intervention group received visual and audio reminders from the GlowCap as well as missed dose reminder phone calls, medication refill reminders and progress reports emailed to the patient, family member and /or their primary care provider. Participants in an intervention-plus group additionally received a financial incentive if they exceeded a monthly adherence goal of 80%.
Three month interim analysis shows study participants in the intervention and intervention-plus group achieved adherence rates of 98% and 99%, respectively. This was significantly higher than the control group, which had an adherence rate of 71%. The study is also measuring blood pressure control and subject satisfaction. Final analysis of the study is anticipated this fall. “GlowCaps use real-time feedback loops to act on a number of behavioral motivators: reminders, doctor accountability, social support and help with refills,” said David Rose, Chief Executive Officer, Vitality. “These are  instructive findings for pharmaceutical manufacturers and payors who have a vested interest in improving patient outcomes with their products and services.”

Each year millions of people fail to take medications as prescribed by their physicians; the World Health Organization estimates that adherence to daily medication averages 50% for those suffering from chronic diseases. Numerous studies demonstrate that poor-adherence reduces the effectiveness of medications, jeopardizes patient health, and increases health care costs. Recent research, including work by the New England Healthcare Institute, calculates the costs resulting from non-adherence at $300 billion annually.

Front-line NHS services already feeling the pressure of economic crisis in Scotland

(issued by BMA Scotland Sunday 27 Jun 2010)


Recruitment freezes and unfilled vacancies mask the true impact of economic pressures on the NHS according to a new UK-wide survey of doctors published by the BMA today (Sunday, 27 June 2010).

Launched on the eve of the BMA’s annual conference, where NHS finances are likely to dominate doctors’ debates, BMA research shows that, despite reassurances that there will be no compulsory redundancies in Scotland, NHS organisations are already taking actions which could have devastating and long-lasting consequences for the NHS.

The survey of Local Negotiating Committees (LNCs) [1] found:

    • Around one in four respondents (24%) said redundancies were planned in their NHS organisation.
    • Almost two thirds of respondents (62%) said that there was a freeze on recruitment. Seventy per cent of respondents reporting a freeze indicated that it covered medical posts and 80% that it applied to nursing posts.
    • Just over half (55%) of those with no explicit freeze indicated that there were unfilled vacancies.
    • Nearly three quarters of respondents (72%) indicated that clinical service or infrastructure developments were being postponed for financial reasons and two in five that access to treatments or therapies was being limited.
    • Just under half (45%) of responding LNCs were being consulted on cost and efficiency savings. The amount of savings being sought varied considerably around an average of just under 6%.

Commenting on the research, Dr Brian Keighley, chairman of the BMA in Scotland, said:

“NHS Boards in Scotland have been upfront in publishing planned cuts to the NHS workforce, however these figures may not tell the whole story. Hospital doctors across the UK report that some NHS employers are freezing recruitment whilst medical and nursing vacancies remain unfilled.

“The Cabinet Secretary, Nicola Sturgeon, has already made a commitment to work with us and the other NHS Trade Unions to scrutinise NHS Board plans and it is in this spirit of partnership that I will be writing asking her to clarify the situation in Scotland regarding the findings of this survey.

“We recognise that there is intense pressure to make savings in the health service and as the NHS budget begins to shrink, Boards will inevitably have to consider cuts to frontline services. However, making indiscriminate cuts is not only short-sighted but could cause irreparable damage to the NHS.

“Even changes to back-room functions or administrative processes have consequences for front-line staff, who in many cases, have to pick up the work themselves; this means less time for patients.”

Although the Scottish Government has made a commitment to protect NHS funding the growth in spending in real terms is likely to be minimal and efficiency savings still have to be made. NHS Boards are already under pressure to make their funding go even further, eliminating waste and improving productivity. The BMA accepts the need to be realistic but says that involving clinicians and local populations in decision making is key.

Dr Keighley said:

“There are areas in the NHS where there is a genuine need to examine ways of working and service delivery to ensure that they are delivered in the most cost-effective manner – without affecting the quality of patient care. But all too often we see indiscriminate cost cutting decisions made, seemingly taken for political and financial expediency rather than because of good clinical evidence.

“Doctors and other health professionals should be actively involved in the decision making processes. I am pleased at this government’s commitment to work with us to scrutinise NHS Boards’ workforce plans but I also urge the urge NHS managers to work with us and focus on identifying areas where they can truly eliminate waste and achieve genuine efficiency savings rather than be tempted to make arbitrary cuts and introduce poorly thought out policies.”

BCS Health Scotland Conference 2010

BCS Health Scotland Conference 2010 NHS Scotland logo

Open for Registrations 22nd and 23rd September 2010

Register now for the most exciting eHealth conference in Scotland this year! Held at the prestigious Glasgow Science Centre you not only have a great programme, wide range of exhibitors, great views over the Clyde and City but complementary entrance to the fun science exhibits as well!

The futuristic building mirrors BCS Health Scotland’s Innovative and Modern outlook See Here

We have an extensive International speaker Programme over both days with three themes held in twin parallel tracks.

Keynote speakers include:

Matthew Swindells, former CIO Connecting for Health, and chair BCS Health

Rikard Lovstrom from Sweden to talk about their National Patient Overview project and eHealth strategy

Dorothy Whittick from Canada talking about the Canadian Health Infoway national developments and a Wellness project in Alberta

Brian Robson from Scotland on the Quality theme and his experiences with IHI in America.

Kathy Dallest from Australia speaking on Clinical Safety Management in eHealth.

New! NHS Scotland eHealth Awards!

An exciting new event will be presentation of the ‘NHS Scotland eHealth Awards!’. These awards are given to winning NHS teams for three categories sponsored by BCS and Scottish Government.

Twin Exhibitions: We are very grateful to our sponsors with 18 commercial exhibitions in a superb bright atrium area and ANOTHER FIRST: 15 public information stands in a separate gallery open to the public. There is plenty to see!

The three main themes to be addressed at the BCS Health Scotland Conference 2010 are Quality, Innovation, and Efficiency. International speakers from Australia, Canada, Sweden, America, Ireland, Wales and numerous UK speakers will position themselves on current relevant issues such as patient safety, the quality strategy, efficiency gains from IT and more.

For the first time, the NHS Scotland eHealth Awards will be presented to eHealth teams in Scotland. These awards will be presented by Scottish Government and by BCS, the Chartered Institute for IT, to help boost the status of the IT profession in NHS Scotland at a time of significant change.

Moreover the new Vidiowiki delegate social networking tool will be used for linking up delegates before and after the event. Users can navigate a mind-map of delegates, speakers and exhibitors to create linkups and watch short clips about presentations and demos. This will help planning and networking before coming to the event.

A selection of posters will be available to view during the conference:

  • A novel security risk assessment model – Napier University
  • Clinical content modeling – NHS National Services Scotland
  • Trans-national exchange of eHealth innovations in northern Europe- Aberdeen University
  • A Study to evaluate the effectiveness of an electronic dashboard – Ulster hospital
  • A Study to evaluate the response times for alerts – Ulster hospital

Around 250 participants are expected to take part in this open event. Online registration is possible here. Details about fees and early bird registration can be found online.

A draft programme for the event can be found online at the event website.

Exhibitors are also leading a fun social evening at 5pm on the first day.

Yet again BCS Health Scotland has been able to produce all this for the incredibly low delegate registration prices starting as low as £30.

So register soon for the early bird rates, find us here BCS Health Scotland Conference

Forth Valley Hospital to use robot 'workers'

Thursday, 17 June 2010

Robot at Forth Valley hospital
Hospital managers say the robots will not replace humans

A hospital in Scotland is to become the first in the UK to use a fleet of robots to carry out day-to-day tasks.

The robots will carry clinical waste, deliver food, clean the operating theatre and dispense drugs.

They are currently undergoing final tests ahead of the August opening of the new £300m Forth Valley Hospital in Larbert, Stirlingshire.

The robots will have their own dedicated network of corridors underneath the hospital.

NHS Forth Valley chairman Ian Mullen said the new hospital would be “packed full of design features to improve patient care and improve the life of staff”.

Members of staff will use a hand-held PDA to call up the robot to move meal trays, or linen, or whatever

Ian Mullen NHS Forth Valley

He added: “Members of staff will use a hand-held PDA to call up the robot to move meal trays, or linen, or whatever.

“The robot will come up in the service lift by itself, pick up the item and go back into the lift.”

Tom McEwen, the project manager for manufacturer Serco, said a series of pre-programmed routes would be set out for the robots to follow.

“The robots will follow the sytem using a series of laser beams which will tell it exactly where it is,” he explained.

Computers on board the robots will be able to tell doors to open, and sensors will tell the robots to stop if anything – or anyone – is in the way.

One of the most valuable aspects of using robots is in controlling infection.

Click the link to read more about robot workers

Health e-records 'struggling to fulfil potential'

By Nick Triggle
Health reporter, BBC News Computer keyboard

Electronic patient care records will require an “enormous effort” and a “high cost” to fulfil their potential, a study warns.

University College London researchers said the project had been dogged by technology problems and tensions which had led to delays.

They said early evidence from users also suggested benefits were limited.

The new government backed e-records, but said it was right to review the way they were being rolled out.

The development of a medical records database for 50m patients in England is a central plank of the £12bn upgrade of the NHS’s IT systems.

The basic patient record – known as the summary care record – includes information on allergies, medication and adverse reactions.

Further details may be added over time and it will be accessible to healthcare workers anywhere in the NHS eventually.

Problems

Problems have dogged the scheme for years with GPs raising concerns about patient confidentiality and safety.

To date, just 1.2m patients have had their records uploaded although 30m have received letters informing them about the system.

The UCL team interviewed patients and professionals involved with the project as well as analysing data from a range of sources during the research.

It found there had been difficulties over what should actually be included in the records, while ensuring GP records were complete and accurate had been a “huge task”.


“This research shows that the significant benefits anticipated for these programmes have, by and large, yet to be realised”

Professor Trisha Greenhalgh Report author

Transferring data had also proved problematic because of incompatible computer systems.

All this meant that extra costs in terms of staff time and financial investment were being incurred, researchers said.

This may even lead to the programme going over the £200m budget, the BBC understands.

The report was also critical of the opt-out system. Patients are allowed to stop their records being uploaded, but less than 1% of those who were written to have done this.

Click the link for more information about Health e-records

Audit Scotland reports on the cost of using locum hospital doctors.

Scottish hospitals could save £6 million a year by more efficient use of locum doctors

Posted: 17 June 2010

The NHS in Scotland could save almost 15 per cent of the money it spends on locum doctors in hospitals – or about £6 million a year – through better planning and procurement.

An Audit Scotland report, Using locum doctors in hospitals, says health boards spend around £47 million a year on locum doctors in hospitals. Locums are doctors of any grade or specialty who provide temporary staffing cover at any time. This spending has doubled in the past decade but, in many cases, health boards are not always clear about why locum doctors are being hired and how long they are using them for.

Auditor General for Scotland, Robert Black, said:

“Locum doctors have an important role in ensuring hospitals are adequately staffed and provide good quality patient care around the clock. In recent years, the demand for locum doctors has risen due to workforce issues such as increased difficulty in filling vacancies and the impact of European legislation governing working hours.

“Health boards need better information about why and when they use locum doctors; the grades and specialties of doctors they are hiring as locums; and whether locum doctors are existing employees or from agencies. With better information, boards could improve their workforce planning and use locum doctors more cost-effectively.”

The report also says the NHS needs to get better at managing the potential risks to patient safety of using locum doctors. This is particularly important for locum doctors who are hired through private agencies as they may be unknown to the board and unfamiliar with the hospital in which they are working.

Health boards across Scotland need to be consistent in the way they screen and induct locum doctors and the way they manage their performance. For example, pre-employment checks are not always formalised, induction arrangements are variable across different health boards, and feedback on locums’ performance is mainly verbal, with few written assessments or records. There are no formal systems for sharing information about individual locum doctors between boards.

Click the link for further information from Audit Scotland