March 19, 2008

House Robot Developed for Physically Impaired

This is Susan Jacobs' first guest posting for FHIT. You can find out more about her at the end.

People with mobility issues may soon have a more convenient alternative to helper monkeys and dogs. Georgia Tech's Center for Healthcare Robotics has just developed a robot prototype that can assist disabled people in their home. The robot's name is El-E and it is over 5-feet-tall, featuring a large mechanical arm. Though the robot may not have a friendly aesthetic, it could easily become a disabled person's best friend around the house.

The operator of El-E uses a laser pointer to guide the machine. When the laser is pointed at something the person wants, a button can be clicked and El-E moves to the object. There, a mechanical arm extends from El-E's body and the robot literally fetches whatever its operator has selected.

Though El-E was designed with the disabled in mind, this device could have a more widespread appeal eventually. In a Web 2.0 society, people of all kinds may be interested in what the project's director, Charlie Kemp, calls "…a clickable world." Indeed, that is what the El-E creates; a clickable world where anything is available to a person from the seat of their couch.

This robot isn't just convenient, mind you. As I mentioned, many disabled people have found success with the use of helper monkeys and dogs. However, a big draw to that situation is also the companionship. Georgia Tech obviously kept this in mind, as El-E has been programmed to say catchy phrases. It really has its own light-hearted personality, saying things like "Bob's your uncle" when it hands something to you.

Still in a beta phase with this project, the robot's creators will be testing El-E with a large group of disabled patients this summer. No word yet on the cost of this machine for mainstream use, so that could certainly be a big factor in whether people opt to use the El-E in everyday situations. The machine can't be too cheap, as it uses many sensors, cameras and high-tech laser technology.

Another kink that Georgia Tech must work out is the fact that the current prototype only lifts up to 1.2 pounds. It is assumed that this will be improved later. I wouldn't be surprised if every household had a machine like this in the near future, particularly one that is programmed to rummage around the refrigerator.

Susan Jacobs is a part-time teacher, as well as a regular contributor for NOEDb, a site for learning about and selecting an online nursing degree program. Susan invites your comments and freelancing job inquiries at her email address susan.jacobs45@gmail.com

March 02, 2008

Peer Review and Innovation

Picture of woman reading.Lecturers told students on my wife's Physiotherapy course that journals using peer review--like the British Medical Journal--were the gold standard.

But in New Scientist 23 February 2008 Donald Braben argues that we are seriously deluded if we think peer review can lead to innovation. Peer review might work for the mainstream, he writes, but it excludes radical research. Now this chimes with an exchange between Checkland and Jackson I read when researching a Masters dissertation.

Checkland's Soft Systems Methodology is a way of finding solutions to problems that cannot easily be defined and might only be sensed as a vague feeling that all is not well. Predictably Checkland suggests defining the problem and then "identifying feasible and desirable changes". Part of this identification is for the interested parties to generate options and it was here, as I recall, that Michael A. Jackson argued group dynamics meant the methodology was normative, rather than radical. Groups tend to fall into heirarchical working, he suggested, often with one particular individual or group of individuals dominating this meant that radical solutions would often be rejected by those supporting the status quo.

The same limitation may apply to multi-disciplinary review. In a previous posting I wrote about a presentation by Prof Berg in which he argued computers should support standardised pathways of care which would be continually enhanced by review. On the face of it this sounds reasonable. Indeed the idea is not new. I was proposing it at least 15 years before Berg and I doubt I was the first.

But Berg argued that the review would generate innovation. I doubted it and what I have read and heard about the dynamics of multi-disciplinary working supports my scepticism.

Nor is that the end of the story. Peer review may be part of the future of medical practice, but only part. Wikipedia also quotes Drummond Rennie of the Journal of the American Medical Association:

"There seems to be no study too fragmented, no hypothesis too trivial, no literature too biased or too egotistical, no design too warped, no methodology too bungled, no presentation of results too inaccurate, too obscure, and too contradictory, no analysis too self-serving, no argument too circular, no conclusions too trifling or too unjustified, and no grammar and syntax too offensive for a paper to end up in print."

February 07, 2008

Health Informatics and Science

I've been reading Garrick Alder's Mind Bombs which is a collection of short articles designed to galvanise your thinking.

He reports Professor Richard Smith, editor of the British Medical Journal until 2004, said only about 5 percent of the entire planet's scientific papers came up to scratch. In most journals, Professor Smith said, it was less than 1 percent.

I have a comparable view of most of the Health Informatics publications I have read. They fall into two categories: the bean counting variety best kept by the bedside as a soporific and the other weak and subjective.

Health Informatics faces the same challenges as fields like sociology and psychology which also depend highly on the interpretation of human behaviour. At this stage in its evolution, the success or failure of healthcare IT is largely determined by how well users apply it. Therefore, IT must become fully integrated into healthcare, not seen as something separate. This goal is not best served by the creation of another specialty, Health Informatics, in a field already overflowing with them. That just gives practitioners an excuse to continue to pass the buck: "It's not my specialty, mate".

January 26, 2008

Remote Health Monitoring: big brother or big help?

Picture of workers using PCs.UK law firm Eversheds reports Microsoft has applied for a patent for workplace monitoring software. It could remotely monitor a worker's wellbeing, productivity and competence using metabolic measures like heart rate, temperature and movement and relate them to their psychological profile.

Trade unions are concerned that such software could be used to support cases for dismissal, but Eversheds reminds us of its double edge. Workers may equally be able to claim they were subject to undue stress, which might entitle them to reasonable adjustments to their job and working conditions.

I attended a healthcare CIO conference at Microsoft in Reading UK last week. Fellow blogger Dr. Bill Crounce showed a short clip of a vision of future healthcare that made use of remote monitoring and also surface computing. Cabinets next to a patient's bed could indicate to a patient or a carer when it was time for medication to be to be taken by coloured rings around the drug containers, for instance.

January 06, 2008

Secure Health Records: hardware, software and brainware

Further to my recent postings on the essential technical and human aspects of secure and confidential information systems, I was watching the voluble Gyles Brandreth review the newspapers with Carol Vorderman on the Andrew Marr Show this morning. The discussion touched on the recent losses of personal data by various public sector organisations. Mr. Brandreth said the real problem was not hardware or software but brainware. Nicely put.

To add weight to this read this entry on the Joe Public blog.