Traceable Medicine

This bizz takes elements of several others described here.

 

Medicine has always been defined as part art, part science. Art resists definition and can not be traced, while science is the opposite. As a part-time practicing doctor, I know that Medical care is far from being exact science and the doctor-patient interaction is hardly traceable. We doctors enjoy certain impunity from the fact that not everything we do and advice is recorded, and our errors most of the times, get covered with dirt… Even those facts that get written can be left in paper or in electronic format that is not integrated in larger databases.

 

For instance, let’s compare several parts of patient-doctor interaction, in the old and modern ways of doing medicine:

 

 

Standard-traditional-Old Way

Connected-traceable-telework-New Way

Patient selects Doctor

Word of mouth

Advertising

Managed care org. decides

Whoever is available

Verifiable CV

Knowledge Marketplace

Doctor selects patient

Clinicians accept everyone

Specialists accept patients broadly within their specialty

 

Doctors search for patients in knowledge (medical service) marketplaces, which assure they stay within their proven abilities.

Initial interview

Spoken

Spoken + Audio record + full data entry in EMR. Telemedicine.

Medical Records

Paper or single PC

Electronic Medical Record  (EMR) in a Database

Data collection

Analogical forms (paper, X Ray film, thermo sensitive paper)

Digital forms integrated into the EMR

Medical decisions

Doctor’ call. Hunch. Coin toss. Infrequently, second medical opinion sought. Many times, from a friend or the first doctor who walks around.

Software assisted. Expert systems. Knowledge Marketplace. Telemedicine. Online qualification system for medical acts.

Outcome

Hopefully, everything Ok. Doctor performance is approximately estimated by those few that happen to know the case.

Permanently monitored by the Online Qualification System for Medical Acts.

 

 

Special examples of Traceable Medicine are clinical trials. When companies need to test new products or treatments define tests with extreme control of every variable, write strict protocols and appoint experts that ensure compliance. Everything is traceable. The results are solid enough to allow researchers to extract valid conclusions of general value.

 

Traceable Medicine will push health care away from art and into science. The result will be a less human patient-doctor relationship, but without doubt, success rates will be better and costs lower.

 

The “Online Qualification System for Medical Acts” does not exist and is a business by itself. It requires the EMR, for every participant being able to check patient data. Let’s show some properties:

 

  • can be complemented by Verifiable CVs, because the ratings that doctors obtain in this system can be added (if good…) to their CVs.

 

  • would be a useful Medical Marketing tool for the service providers in the Medical Knowledge Marketplace, because those with a good record can be trusted and sell themselves better.

 

  • will add credibility for those who participate in the Medical Social Networks.

 

  • will be able to run Contests (with many marketing opportunities). Of course, the patient will stay anonymous.

 

  • will be able to provide Certifications (a new business)

 

  • instead of passing tests, obtaining certifications and solving quizzes for free or paying a fee, Doctors will do it and at the same time, get paid for their work

 

  • large amounts of valuable data will be available for Public Health and Epidemiology technicians and experts, which will greatly improve Health Care in general.

 

 

Personal View

I envision huge resistance from doctors to accept traceable medicine. They still fiercely resist using PCs to keep appointments and data. And the pen and paper generation still rules over the young and connected.

We doctors enjoy certain impunity from the fact that not everything we do and advice is recorded, and our errors most of the times, get covered with dirt

Medical Knowledge Marketplaces

Once the patients have an online medical record (EMR) most patients can examined by online doctors, and in many cases those remote professionals can solve the problem. Of course we are excluding many cases in which human contact is necessary for physical or psychological reasons.

 

I conceive the near future of medical care as a connected, distributed space where only a few persons have direct contact with the patient, and a number of consultants examine the relevant data and make recommendations. The eHealth paradigm will make medicine ultra-specialized, a bit de-personalized, faster and cheaper than today.

 

Imagine a situation where a complicated case is exposed to an inexperienced doctor, far from a high complexity centre. Let ‘s assume that this patient has his data online, but physically-present doctor does not have a marketplace where to seek advice. He can maybe bother a friend once or twice, or even pay him. But this friend is no assurance of quality, availability or price.

 

There is not a site where patients or doctors can publish their cases (with the necessary EMR) and seek advice from online doctors. It would be ideal for isolated places where no doctor would visit, for second medical opinion and for 3rd World doctors willing to sell their knowledge in the 1st World.

 

Such marketplace would implement many mechanisms to validate doctors, and to assure quality responses. This concept intersects the Verifiable CV business described elsewhere.

 

In order to sell services online as Telemedicine, doctors will need a little more than a diploma and a license. The competition will be intense, and they will need to demonstrate their knowledge, plus cost-efficiency, availability, response time, technology and marketing. They will need ability to receive payment in many forms, offer guarantee and credit, thinks that they very rarely do in the real world, in traditional Medicine or even in the many popular TV series that depict the medical world.

 

A few forms of knowledge marketplaces within the Health area:

 

– Business-to-Consumer markets, where the patient demands service offers from all the possible providers;

– Business-to-Business markets, where clinics will find complementary institutions across the Net

– Auctions and reverse auctions, where medical services/hours are sold to the best buyer.

– Professional Social Networks, which proved their value in other marketplaces

 

These «medical knowledge marketplaces» should have at least these features:

– access to a reliable online EMR (electronic medical record) for patients

– a doctor’s database, with a critical number of providers in any field. These providers do not need to travel to market their knowledge, because the transactions are essentially online.

– a companies database, ready to buy knowledge on given clinical cases, from doctors online. These companies will be validated in their contact data, and they will be required to pay any services bought thru the marketplace. Or face blacklisting.

– quality assurance service for doctors who want to validate their credentials by any necessary mean

– transaction platform, including bidding, alert mailing and auction.

 

 Other features present in current service eMarketplaces:

  • forum
  • contests
  • tests – quizzes
  • blacklist of those who broke the market rules
  • product offerings
  • group purchases
  • physical meetings

 

This market would be ideal for isolated places where no doctor would visit, for second medical opinion and for 3rd World doctors willing to sell their knowledge in the 1st World. In the near future, it would be nonsensical NOT to have a Medical Knowledge Marketplace

Marketing Médico

Los médicos tienen restricciones éticas para realizar actividades de marketing y, por ese motivo, hay Servicios de Referencia de Pacientes que, con supuesta objetividad, aconsejan a los pacientes a qué médico acudir. Han existido durante mucho tiempo, pero los basados ​​en la web son más fáciles de administrar, más eficientes y tienen un mayor alcance.

El Marketing Médico puede vender los dos negocios médicos anteriores, EMR y Telemedicina. Primero, pueden convencer a los pacientes de que necesitan una EMR para recomendar a un especialista o subespecialista. Para producir el EMR, se necesita un asistente médico y probablemente un médico, por lo que ya se trata de telemedicina. Una vez que los pacientes tienen un EMR en línea, un médico remoto puede brindar algún consejo, tal vez suprimiendo la necesidad original de un encuentro físico con un médico. Actualmente, el marketing médico se aplica a clínicas u organizaciones de salud dentro de un área geográfica determinada. Sin embargo, es probable que algunos servicios se vendan a nivel internacional, como odontología, corrección láser ocular con láser, todo tipo de cirugía estética y cirugías controvertidas como el aborto, la fertilización in vitro, la clonación, el cambio de sexo o la restauración de la virginidad.

Aquí en Argentina existen varias oportunidades para Eso, y el país ya recibe muchos turistas de salud. Hagamos un cálculo simple para encontrar el punto de equilibrio: un pasaje aéreo de ida y vuelta de América del Norte a América del Sur puede costar U $ D 1200 y un hotel de 3 días tal vez 300 más. Los procedimientos que no están cubiertos por el seguro médico y que cuestan más de 2000 en los EE. UU., tienen aquí un costo de entre el 20 y el 30% .

Vista personal

Un paso más allá sería instalar un barco con instalaciones médicas y médicos argentinos u otros médicos calificados. Y acercárselo a las costas de Miami o Londres. El barco podría llevar la bandera de algún país poco estricto, como Ruanda o Etiopía. Para redondear el proyecto necesitamos un país que permita el alcohol y los casinos. La convalecencia no tiene por qué ser aburrida. Si los pacientes no acuden a usted, usted acude a los pacientes.

Telemedicine

Telemedicine refers to any medical action done at a distance. For some tasks this is a very easy, and does not really need the physical doctor-patient contact. Or the contact can be replaced by video cameras and touch-sensitive data gloves.

 

For instance, interpreting EKG, EEG or X Ray images is often done with the hard data alone. Actually, starting a marketplace for those interpretations could be a still virgin starting point. With Medicine going more and more the way of biochemical, electrical or other physical tests, there are always more data to be analyzed. Some of those data can be very complex, like the EEG, and benefit for computer treatment for signal improvement and processing. I am currently advisor in a project for Computerized Polygraph testing for the Federal Police in my country.  Images provided by X Ray, Tomography, Photography, Microscopy or Sonography can also be computer-enhanced, compared and stored, before expert interpretation, all of which can be done remotely. This opens the field of

Telemedicine for almost every medical specialty.

 

The few exceptions are those practices where direct contact is required, like taking samples, feeling, smelling or operating. And still, some of them can be left to nurses, technicians or beginning physicians, with remote supervision by experienced professionals.

 

We are only scratching the surface of the immense, fast-growing medical information market

 

Developing software able to analyze instrumental data is another form of Telemedicine that already started to grow.

 

Health has always been a conservative area, doctors are known to be anti-computing technology, and lawyers are anxiously waiting to take action against every little mistake or data glitch. But still, there is a lot do in this area, with enormous potential for growth and wealth.

 

 

Personal View

 

I took part in a successful project where overweight patients were followed by phone, to ensure they took the medication, followed the diet and lost weight. The phone calls really helped them to comply.

I cannot wait for Telemedicine to mature and allow me to work from home and collect as if I was in a fancy American clinic.

Health eBizz Proposals

 

While generating e-businesses I explored all of the sites that match Entrepreneurs (inventors, web business developers, small business owners) with Investors. There are many, and none of them was of any use for me. However, they have a place in the e-economy and some of them eventually produce transactions. There are a lot of unwanted consequences of entering a project in those sites, including registration fees, spam, fake offerings of capital with a small fee required in advance, fancy services for the entrepreneur like courses and business plan assistance, fake degrees and the like. Once the project gets funded, or when the entrepreneur gives up and stops paying a fee, the project disappears from the site. It would be nice to be able to track the projects for at least 2 years, let several small investors join forces to start a project, see it evolve and measure the success rate of those matching sites. The projects alive in the system could benefit from the distributed knowledge coming from the Problem Solver Marketplace and the Futurologist Arena, two proposals described elsewhere in this book.

 

Investing in a Net project seems to be a all/nothing operation. Of course, nobody expects that a real-life investor will fork 10,000 or more without a lot of expensive research, due diligence requirements, planning and contracts. However, 500 investors could be ready to contribute $20 to a promising project with decent guaranties, achieving the same result in a very short time.

 

This Virtual Shares business needs to be developed to help finance this site and its probable spin-offs. The first step in acquiring shares is to vote (for or against) the proposals in the News Aggregator system located at www.netocios.com. The votes will help other readers to estimate the value of the proposed business.

 

I am sure there will be many readers interested in betting a few dollars in some of these health proposals, but without the obligations arising from a formal partnership.

 

In order to issue shares, most countries have detailed and cumbersome legislation and requirements. For that reason, we keep all the matter within virtual boundaries, meaning that the shares traded here are in no way real. Any transaction arising from investors willing to partner with the author in the development of e-businesses will have to be treated separately, with specific contracts and documents.

Imagine a Reality Show where the participants are entrepreneurs carrying online projects.

 

In the meantime, contributions are treated as donations, and create a moral compromise on our part of further retribution. Moral compromises, I hope, are not enforceable, taxable or likely to create legal trouble. Virtual or moral shares offered in this site are payable as donations to my Paypal address.

 

The Reality Show structure is also an appealing alternative. Imagine a Reality Show where the participants are entrepreneurs carrying online projects. Being public is the price to pay for contributions from viewers and sponsors. Online popularity, traffic and sales are measures of success, and increase chances of participants to climb to the next level. This proposal for a Reality Show is so neat that can be even ported to TV…

 

Some businesses have, or can easily have, an associated domain name. We can register those domains to the name of the best bidder in an eBay.com auction. That provides an initial association between parties with a solid guaranty. A written compromise of keeping the new business within that domain and providing consulting can be a second step.

 

An alternative way to offer virtual shares for Internet businesses is to create a special Domain Register that allows combined registrations, by more than one party. Since all the parties would be needed to transfer the domain, this creates a control mechanism for those domain-based businesses with 2 or more owners. It is the equivalent of business bank accounts that require two signatures on every check. This should be a separate business proposal, but I leave it here for now.

 

Most business can be divided in parts, based on geographic boundaries, on items or type of clients. A contract can grant the rights of exploitation of that part of the business to an early contributor.

 

Another way to implement the virtual shares system is to base the business and website in a permissive country, like the Cayman or Bahamas Islands.

 

If the model turns to be successful, it can be sold to other websites offering business to the public. If most people enjoy picking up winners for a football match or a horse race, why they would not enjoy picking up winners for a business project?

 

 

Personal View

I like the Reality Show on Tv, why not? I sent the idea to a local producer but got no answer. Mr. Trump has the Apprentice show which is close but not exactly the idea. American Inventor is more like it, but they have no continuity and there is little chance for the audience to participate. I could focus on Entrepreneurs at large, or Netpreneurs alone.

I will receive all kinds of objections to my shares project from corporate attorneys. However, there must be a loophole. Venture Capital is fully developed as science and business in the 1st World, but hardly existent in developing countries. So, Virtual Shares are a way for us South American entrepreneurs from to raise seed capital from the Web.

 

 

Health Business Proposals

Netic Infoservices developed a business proposals e-book containing 15 internet health related projects and now these proposals will be available online, here in this blog.

History These writings originated from a series of articles on Cyberbusinesses, requested during 1997-98 by a Spanish language newsletter targeted to business people and entrepreneurs. The articles became an e-book, “Cibernegocios”, widely distributed on the Web back then. The book became a blog called www.Netocios.com , which in Spanish sounds well and could be NetNess.com in English (or something like that but available). The next step was translating into English, to take advantage of the wider and richer audience. Since 2000 I overcame the geographic limitations of a conventional business and have sold consulting to customers abroad.

Sergio Samoilovich, Ph.D.

Implementation Strategies – Resources and examples – Virtual Shares

The latest version of this e-book is kept at this location

 

 

 

Medical Advice Online – This site

Este sitio tiene dos caras. Originalmente comenzó como un foro donde ofrezco consejos médicos gratuitos en línea para pacientes que hablan inglés. Ahora incorporé este blog donde discuto temas de eSalud, principalmente desde el punto de vista empresarial. Una pequeña ventaja de tener mi sede en Argentina es que puedo hacer cosas como ésta, fuera del alcance de los médicos estadounidenses, que tienen muchas restricciones  debido a varias responsabilidades legales, problemas de privacidad y negligencia potencial. Por supuesto, aún podría ser responsable de los daños, a pesar del poderoso descargo de responsabilidad que intento publicar en cada página.

Consulte los servicios alternativos, como mantener un EMR en línea para pacientes / clientes: recopile contenido con fines de promoción web. Los resultados parciales de este experimento en curso se publicarán aquí.

Use of Computer Videogames for Psychological and Medical Purposes – III

Promotion strategy in the academic area
Together with selling software and data analysis services, academic research will be pursued to demonstrate effectiveness of the system. Psychology units in Buenos Aires will carry the initial research. Joint agreements will be proposed to international professional or scientific institutions interested in the new instrument.

Competitive advantages of the Argentina as producing of Software in the psychological field
Argentina possesses a well trained and inexpensive work force, both in the Programming and Psychology areas. Local psychological and psychoanalytical schools have a good reputation around the world.

Most of the professionals in these two areas are located in Buenos Aires, where the initial phases of the project will take place.

Other possible applications of the product.

The software and the statistics could be useful to those studying the mechanisms of attention and learning.

The creation of a tool for creating and measuring ADDICTION can be applied to the research in other types of addiction, psychological or chemical.

The structure created for development and marketing of Psychological Software could be applied to other similar products.

Specific background of the author of this proposal.
Physician. Dr. in Medicine.
Research Scientist in Argentina and USA.
Writer and publisher on computer topics.
Software publisher.
Author of the books «PC Computing for parents and teachers» and «The Art and the Science of the PC games «.
Author of a Scientific publication: «Attitude of Schizophrenics to Computer Video Games». S.R.Samoilovich et al. «Psychopathology», 25 (1992), 117-119.
«Technological Entrepreneur» Workshop, 1996.
Current activity: scientific and technical communication in INTERNET.
Webmaster of the EMPRETEC (Technological Entrepreneurs) Foundation, Argentina.
Secretary-General of the «Argentine Association for Medical INTERNET and Bioinformatics».

Characteristic of the Market for this type of product.
The «parent controllable» games will appeal to a large population of concerned game buyers, with children aged 4 to 10. They will also address those parents that are anxious to measure manual ability and general intelligence of their kids.
Both the ADD software and the remote diagnostic services can be sold to concerned parents of hyperactive children and to mental health professionals. There are no geographic limitations, and the software will run on any PC.
Since the products are unique in its category, they could be relatively high priced.

Use of Computer Videogames for Psychological and Medical Purposes – II

Remote psychological advice.

The unit executing this project will make and sell the module, and keep a centralized data analysis center.
This center will have several roles:

– to collect the encrypted files sent by the users
– to keep statistics on them, taking into account geographical, ethnic, cultural and other factors.
– to inform registered users about their relative efficiency or abilities in the game. Abnormal results will result in a «See your doctor » sign.
– to provide mental health professionals complete reports of their patients’ psychotechnical performance in games.
– to inform game companies about how their products are being used.

Computer games for diagnosis and treatment of Attention Deficit Disorder.

    Infantile hyperactivity

About 5% of the world infantile population suffers of this psychological disorder, also called Attention Deficit Disorder (ADD). These children rapidly jump from a topic to other, have difficulties to concentrate in any type of task or game, and suffer learning disorders.
ADD is the most common reason for consulting a child neurologist. This condition is often attenuated with age, although scholastic lag and social adjustment difficulties can persist.
Diagnosis of ADD is hard to establish, because there is no conclusive single medical or psychological study that defines it. As a result, many children are straddled in borderline situations either at psychological or neurological level.
There is no medical consensus on the causes of this disease, neither on its treatment. Some children respond well to medications (tranquilizers, psychoactive drugs), which must be administered for several years.

Computer games are very effective in capturing child and adult attention. Addiction to them is not usually considered pathological, even when users spend most of their free time at the screen.

Several facts indicate that ADD children could be attracted to videogames:
1) there are a few publications in favor of (but not against) using videogames in clinic situations.
2) the ADD children are normal in the rest of their psychological aspects.

The current literature (Medline and the WWW) does not mention videogames for attention testing (yet).

Advantages of a software with videogame interface that could capture the ADD children attention:

    Diagnosis:

1) the attention span of children could be measured.
2) the software could differentiate the attractive capacity of various stimuli (different topics, standards, colors, sounds, etc.).
4) these collected data can assess the effectiveness of medical, psychological or pharmacological treatments.

    Treatment:

5) since most games tend to increasingly capture users’ attention, the game could become a treatment for the hyperactive condition. Besides, they could be used to reinforce positive behaviors.

Features of the ADD software:
– Game-like interface.
– Reward upon completing levels
– Election between different proposals (puzzle, ping -pong, car race, etc.).

The games can be programmed from scratch, modifying existing shareware or commercial packages with the data collection module.

Games for this purpose do not have to be very sophisticated. Simple games with a few options each can be very addictive, and are best suited for this purpose. (Tetris, Pacman, Pong, Breakout, Aliens).

Either Linux, Mac or Windows platform will be acceptable.

Marketing strategy
The ADD software could be the first product equipped with the data collection module, because it can easily introduce the mental health professionals and the game companies to the «parent controllable» concept.
A simple version of the ADD game will be released as freeware, intended for parents and educators. It will be promoted and distributed thru INTERNET.
A more complete version of the game will be sold with the data collection module. The encrypted file could be sent by e-mail or by conventional methods to the headquarters of the company, together with payment. There, a psychologist will compare the patient’s data with those of the average population.
Mental health professionals will be able to acquire a version of the software that will not encrypt the data, or to subscribe to a complete service of data interpretation.

Use of Computer Videogames for Psychological and Medical Purposes – I

A research and product development proposal

Use of the computer games in Psychology.

Many psychological tests are being implemented in personal computers, and some have a game-like interface. Videogame-like psychological tests are easy to implement in children and in adults with a negative attitude to conventional tests. These tests are currently applied to eye-visual coordination, manual abilities and a few other parameters, some of them related to intelligence, attitudes or values.
Games can be very addictive, and youngsters can spend too many hours in front of them. Standard videogames are not commonly used as tests, because they do not test a single parameter, but a complex set of mental and physical abilities. Videogames usually display a single score at the end of a session that reflects overall performance or completion of levels, disregarding most other parameters that could have psychological value.
A standardized data collection module , like the one proposed in this project, could transform most current games in multivariable psychological tests. These tests could acquire diagnostic value with the availability of a large data base of reference results. This data base would allow each individual to be compared with other players of similar conditions (age, sex, exposure to videogames).
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