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Medical applications leverage Watson compute power.

Technology has an increasingly important role to play in healthcare and medicine, and medical device makers as well as researchers and clinicians are turning to the cloud to assist their efforts.

IBM is making a significant push in this area, having announced in April the establishment of a dedicated business unit called IBM Watson Health, to be headquartered in the Boston area. A key offering of the new unit is the IBM Watson Health Cloud, which the company describes as a HIPAA-enabled secure and open platform for physicians, researchers, insurers, and companies focused on health and wellness solutions.

"Watson Health builds on years of collaborative relationships with leaders across the healthcare ecosystem," added Michael Rhodin, senior vice president, IBM Watson, in a press release. "The groundbreaking applications of Watson's cognitive-computing capabilities by medical clients and partners clearly demonstrated the potential to fundamentally change the quality, efficiency, and effectiveness of healthcare delivery worldwide. We're excited to broaden access to world-class technology and to work with our partners to transform health and wellness for millions of people."

In addition, the company said that to advance its healthcare analytics capabilities it is acquiring Explorys and Phytel. The latter develops and sells cloud-based services that help healthcare providers and care teams work together to ensure care is effective and coordinated to meet new healthcare quality requirements and reimbursement models. IBM announced May 4 that it has completed the Phytel acquisition. Financial terms of the deal were not disclosed.

Explorys spun off from the Cleveland Clinic in 2009; it offers a secure cloud-computing platform used by 26 major integrated healthcare systems to identify patterns in diseases, treatments, and outcomes. It integrates more than 315 billion clinical, financial, and operational data elements, spanning 50 million unique patients, 360 hospitals, and more than 317,000 providers.

At the same time it launched its new health unit, IBM said it is teaming up with Apple, Johnson & Johnson, and Medtronic on health data initiatives based on the IBM Watson Health Cloud. IBM and Apple will expand their partnership to join IBM cloud services and analytics with Apple's HealthKit and ResearchKit to address employee health and wellness management. Johnson & Johnson will use IBM technology to model and apply medical evidence to optimize patient interventions, and Medtronics will develop personalized care management solutions for diabetic patients.

IBM said the partnerships are not exclusive, and it expects other companies to leverage the Watson platform. And indeed, in May IBM announced several additional initiatives spanning cancer research to health records management.

First, IBM said that it is collaborating with more than a dozen leading cancer institutes to accelerate the ability of clinicians to identify and personalize treatment options for their patients, with additional centers expected to join the program later this year. The institutes will apply Watson's cognitive capabilities to reduce from weeks to minutes the ability to translate DNA insights, understand a person's genetic profile, and gather relevant information from medical literature to personalize treatment options. The project is part of IBM's broader Watson Health initiative to advance patient-centered care and improve health.

"Determining the right drug combination for an advanced cancer patient is alarmingly difficult, requiring a complex analysis of different sources of Big Data that integrates rapidly emerging clinical trial information with personalized gene sequencing," said Norman Sharpless, M.D., director, University of North Carolina Lineberger Comprehensive Cancer Center, in a press release. "We are partnering with IBM in an effort to solve this decision problem with the help of cognitive technology and to improve the decisions we make with our patients to maximize their chance for cure."

"This collaboration is about giving clinicians the ability to do for a broader population what is currently only available to a small number--identify personalized, precision cancer treatments," added Steve Harvey, vice president, IBM Watson Health. "The technology that we're applying to this challenge brings the power of cognitive computing to bear on one of the most urgent and pressing issues of our time--the fight against cancer--in a way that has never before been possible."

In addition, IBM announced May 5 that it is collaborating with Epic and Mayo Clinic to advance patient health by applying the cognitive computing capabilities of Watson to electronic health records (EHRs).

As Watson's capabilities are applied to EHRs, patients and providers will benefit from more rapid and thorough analysis of the medical factors that could impact an individual's health and wellness, the company said. Epic makes software for mid-size and large medical groups, hospitals, and integrated healthcare organizations; its customers include community hospitals, academic facilities, children's organizations, safety net providers, and multi-hospital systems. Its integrated software spans clinical, access, and revenue functions and extends into the home.

IBM reports that Epic has more than 350 customers who have exchanged more than 80 million medical records in the last 12 months, both within and outside the Epic community. Interoperability will enable these institutions to apply the cognitive capabilities of Watson to these records through secure, cloud-based services, providing greater clinical insight to help personalize healthcare.

IBM also announced that it and Mayo Clinic are working together to pioneer cognitive computing in clinical-trials matching for cancer patients. Watson allows physicians to enroll patients more quickly in the clinical trials that best meet individual patient needs. More than one million patients are seen at Mayo Clinic each year, and more than 1,000 clinical trials are available to match patients to at any given time.

"Patients need answers, and Watson helps provide them quickly and more thoroughly. We are excited by Watson's potential to efficiently provide clinical-trials information at the point of care," said Dr. Steven Alberts, Mayo Clinic oncologist, at the time of the announcement.

IBM isn't the only tech company working on medical applications in the cloud. As mentioned earlier, IBM is working with Apple, whose HealthKit enables developers to create consumer health apps designed to give users a comprehensive way to manage their health and fitness, and ResearchKit is an open source software framework that gives medical researchers the tools to accelerate medical studies. HealthKit can be used to create apps that monitor health behaviors and help encourage users to adhere to their treatment plan. Participants who opt-in to apps using ResearchKit also can contribute their health information to medical research/science/medicine.

IBM's role with respect to the Apple offerings is to de-identify and store health data in a secure, scalable cloud system that enables researchers to access and share data in an open ecosystem environment as well as have access to IBM's data-mining and predictive analytics capabilities. Health and fitness app developers and medical researchers will be able to draw on data at a scale that until now has never been available. For apps using HealthKit and ResearchKit, IBM will provide a delivery platform through Health Cloud to easily store, aggregate, and model data, combining it with other data sources and types to enrich research findings and identify the next frontiers of medical discovery.

"With Apple's groundbreaking ResearchKit, researchers can easily create apps that take advantage of the power of mobile devices to give them rich data from a diverse global population," said Jeff Williams, an Apple senior vice president, in a press release. "Now IBM's secure cloud and analytics capabilities provide additional tools to help accelerate discoveries across a wide variety of health issues."

In addition, although not specifically a cloud initiative, Johnson & Johnson announced recently that its Ethicon subsidiary will work with Google to create a minimally robotic-assisted surgical platform. Ethicon makes products such as sutures and endocutters and supports a variety of surgical specialties. The goal of the collaborative effort is to integrate medical-device technology with robotic systems, imaging technology, and data analytics. Such collaboration between information technology and medical technology companies is sure to continue.

Getting data from the body to the cloud

If you want to use the cloud to store, process, or communicate your personal health and medical data--about a biomarker like glucose, for example--you need a way to get that data from your body to the cloud.

In April, Nordic Semiconductor described an application that does that: U.S. blood glucose monitoring company Dexcom now is shipping what Dexcom claims is the world's first commercially available diabetic monitoring solution with continuous (24x7) remote monitoring by adding Bluetooth Smart (formerly known as Bluetooth low energy) wireless connectivity to Dexcom's existing G4 Platinum CGM (continuous glucose monitoring) handheld.

The combination is known as Dexcom G4 Platinum with Share. The system now can send CGM data from the G4 Platinum receiver, a handheld that works with the body-worn CGM sensor, to an iPhone, iPod touch, or iPad, which in turn can securely send the data to the cloud. From there, the data can be relayed to up to five followers equipped with an iPhone or iPad touch, who then can remotely monitor a diabetic's glucose information and receive alert notifications from almost anywhere with cellular network coverage.

To save energy, Dexcom is implementing wireless connectivity from a mobile device to Dexcom's existing G4 Platinum CGM handheld receiver using the Nordic [mu]Blue nRF8001 single-chip-connectivity solution.

The Dexcom G4 Platinum CGM System with Share allows blood glucose readings to be measured at a frequency of up to once every five minutes.

"The Dexcom Share represents a new paradigm in diabetic treatment whereby dynamic trends (up, down, and stable) in a diabetic's blood glucose levels can be continuously monitored and shared on a 24x7 basis for the first time," commented Jorge Valdes, chief technical officer at Dexcom, in a press release.

"This will not only give much greater insight and more accurate and timely management of the diabetic's condition compared to traditional finger sticks, it also will give diabetics, their loved ones, and/or their caregivers the peace of mind to know they are safe at any time."

Rick Nelson, Executive Editor
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Title Annotation:MEDICAL TEST
Author:Nelson, Rick
Publication:EE-Evaluation Engineering
Date:Sep 1, 2015
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