Monday, February 23, 2009

Mobile Security Update: Configuration Management Becomes a Greater Issue for Smartphones; 81% of Manufacturers Worried about Mobile Payments, & More!


Mobile Security Update: Configuration Management Becomes a Greater Issue for Smartphones; 81% of Manufacturers Worried about Mobile Payments, & More!

In the current issue of Information Security Magazine, analyst Eric Orgen opines on the lack of smartphone security in businesses.

Orgen observes that most recent quarterly reports from Apple and Research in Motion trumpet 4.3 million iPhones and 6.7 million Blackberrys respectively. That's a lot of mobile communications and connectivity in a hurry, and much of it involves sensitive business and personal information.

Here are some brief excerpts from his column with a link to the full text --

Smartphones are ubiquitous in corporate life, supplying email and browser access to data whenever and wherever information junkies need a fix. But so far IT has been slow to address the security arising as result of the smartphone phenomenon. ...
IT should be putting smartphone security policies in place to protect the sensitive data, access to corporate applications, and software configurations.:
Disclosure laws, such as CA 1386, apply private information that is stored as "computerized data." ... never allow consumer data to be delivered to a smartphone, clear caches and temporary buffers after a VPN session, or encrypt all data that the smartphone receives.
All connectivity to business applications and networks should require a password and SSL VPN for secure communications. ...
Configuration management will become a greater issue for smartphones as business software becomes more prevalent and malicious code starts targeting these devices. ...
Eric Ogren, Smartphone security lacking at many businesses, Information Security Magazine, 2-19-09

In a related story, McAfee has released another interesting study -- this one is on security issues related to mobile devices.

Here are some excerpts from the press release, with a link to the full report --

Key findings from the McAfee Mobile Security Report 2009 include:
Half of all global manufacturers reported mobile malware infections, voice and spam attacks, third party application problems or incidents that caused network capacity issues
Almost half (48%) of manufacturers agreed that the cost related to patching and fixing affected devices had significantly impacted their business
Concern over the security of mobile device functions is high; 81% of manufacturers are worried about mobile payments; 69% are not convinced by the safety of installing applications and 66% are concerned about devices' WiFi and Bluetooth connectivity
Three quarters (75%) agree that carriers and manufacturers should carry the cost of security and only 12% think that users should be involved with handling security measures
Widespread Increase of Incidents
Despite manufacturers' attempts to lock down security, evidence shows that security issues are growing in diversity and sophistication. Overall, there has been a dramatic upswing in the number of incidents across all the major threat categories ...
Impact on Cost and Future Functionality
... Almost half (48%) of manufacturers highlighted that patching and fixing devices is an expensive business, 36% stated that security incidents have had a negative impact on their brand or public relations and almost a third again (32%) said that security problems have prompted a significant loss in credibility or user satisfaction.
McAfee, Inc. Research Reveals Impact of Security Issues on Mobile Device Manufacturers, 2-16-09

To download the full report, click here.

Wednesday, February 18, 2009

Cyber Attacks Against US Gov Rise Dramatically in 2008; Meanwhile, Total Losses for Cyber Attacks on Business Estimated @ $1 Trillion



Cyber Attacks Against US Gov Rise Dramatically in 2008; Meanwhile, Total Losses for Cyber Attacks on Business Estimated @ $1 Trillion

Along with sharing insight from within the dynamic matrix that is CyLab, CyBlog will also be providing you with news and analysis on issues and trends in cyber security, privacy and mobility.

Two recent stories cry out for some comment --

The number of reported cyber attacks on US government computer networks rose by more than 40 percent last year, USA Today reported on Tuesday.
The newspaper, citing data obtained from the US Computer Emergency Readiness Team (US-CERT), said there were 5,488 tracked incidents of unauthorized access to US government computers and installations of hostile programs in 2008.
There were a combined 3,928 such incidents in 2007, USA Today said, and 2,172 in 2006. ... The newspaper also said the data obtained from US-CERT may represent only a "small sampling" of the total number of incidents because "just one percent of federal agencies have fully developed tracking systems."
Agence France-Presse, 2-17-09

Data theft and breaches from cyber crime may have cost businesses as much as $1 trillion globally in lost intellectual property and expenditures for repairing the damage last year, according to a new study from McAfee.
McAfee made the projection based on responses to a survey of more than 800 chief information officers in the U.S., United Kingdom, Germany, Japan, China, India, Brazil, and Dubai.
The respondents estimated that they lost data worth a total of $4.6 billion and spent about $600 million cleaning up after breaches, McAfee said.
CNET, 1-28-09

In regard to the reported 40% rise in cyber attacks on the US government, I have two observations --

First, year by year, day by day, hour by hour, millisecond by millisecond, we are going deeper and deeper into the Information Age, and as we go deeper and deeper into the Digital Light, we are also going deeper and deeper into the Digital Dark, and just as all commerce, and all culture are becoming increasingly cyber-intensive, and so is all cloak and dagger.

Second, there are many dedicated and talented cyber security professionals in government, but the challenges they confront are both immense and immensely complex. Although there was considerably momentum in the late 1990a, too little progress has been made in the first decade of the 21st Century. Attending an all day briefing in D.C. last year, I found myself hearing the theme music to the Bill Murray film, Groundhog Day in my head. It does seem as if we are going over the same ground again and again. But hope springs eternal, and with each new administration there is another opportunity to make meaningful progress faster; to wit, the Obama-Biden administration has revealed its cyber security strategy. Click here for some background on the plan from Brian Krebs of the Washington Post (and a member of the CyLab Business Risk Forum).

In regard to McAfee's estimate of $1 trillion in losses related to cyber crime and other types of cyber security breaches, I also have two comments --

First, as one who spent most of the 1990s quantifying financial losses in the legendary FBI/CSI Computer Crime and Security Survey, I will venture a prediction that in time -- if we ever come up with a real measure -- this $1 trillion figure, like those hundreds of millions we documented in the CSI/FBI survey, will prove to be on the conservative end of the spectrum of informed guestimates.

Second, the McAfee guestimate takes on a poignant significance in the light of the current financial meltdown and resultant economic crisis: if almost three quarters of a trillion dollars could be reasonably expected to thwart the collapse of the US banking system, and over three quarters of a trillion dollars could be reasonably expected to significantly impact the world's single largest economy, then saying that cyber attacks on business could total $1 trillion dollars is saying a great deal about the importance of investment in both cyber security research and cyber security implementation. It also begs the question, what is the silent, overlooked impact of such losses?

Stay tuned ...

-- Richard Power, Distinguished Fellow, Carnegie Mellon CyLab

Wednesday, February 11, 2009

CyLab MRC's Martin Griss Declares, "I Do Not Want Us to be Just Another Big Consortium, I Want Us to Do Something"



[Image: Martin Griss addresses workshop attendees]

CyLab Mobility Research Center's Martin Griss Declares, "I do Not Want Us to be Just Another Big Consortium, I Want Us to Do Something."

At the opening of the Carnegie Mellon CyLab Mobility Research Center (MRC) Mobile Health Workshop, MRC Co-Director Martin Griss declared "I do not want us to be just another big consortium, I want us to do something."

The MRC's Mobile Health Workshop brought together over forty leaders in the health care, information technology (IT) and education sectors to explore challenges and opportunities in this vital intersection where science, medicine, and IT meet head-on with one of the most poignant dimensions of the human condition.


[Image: Silicon Valley Campus]


In welcoming the workshop attendees to Carnegie Mellon University's Silicon Valley Campus, Dean Pradeep Khosla, drew attention to a recent three million dollar renovation and highlighted the bold vision behind the work of the CyLab Mobility Center, the Information Networking Institute and the other elements of Carnegie Mellon University that make the Silicon Valley Campus a vibrant center of insight and innovation. "We are integrating Silicon Valley and Pittsburgh campuses. We have over thirty full-time students and several bi-coastal PhD programs. Our graduate students can spend two years at the Pittsburgh Campus and three years at the Silicon Valley Campus. The time for change has come at universities."

In articulating the ambitious agenda of the one-day workshop, Griss told attendees their goals were to identify three "shovel-ready" collaborative initiatives (i.e., health care, academia and industry), and gather the will, resources and plans to launch these initiatives. In the course of identifying and developing these initiatives, Griss called on them to identify impediments and potential solutions, as well as to focus on "thinking globally, acting locally" by coming up with local initiatives that "tap into the uniqueness of Silicon Valley."

Griss also articulated the three critical questions that were addressed in the twenty-four position papers submitted by attendees:

1. How will mobile health improve outcomes, reduce costs, and/or patient (and provider) experience?

2.What are the most pressing business, process, organization, cultural and technical issues in mobile health?

3. What are the best opportunities for collaborative university research?

Speakers from Kaiser Permanente, Microsoft, Qualcomm, SAP, Kinnexxus, Helsinki University of Technology (TKK), and Carnegie Mellon framed the core issues and reported on cutting-edge work being done in the space.

In two breakout sessions, the attendees were organized into five groups, with role participants. Each group was led by a facilitator. Each group has a scribe to take notes. The assigned tasks of these work groups was to prepare one or two flip charts and a five minute talk.

The goal of the first breakout session was to "explore space of collaborative mobile health opportunities identify three promising ideas."

The goal of the second breakout was to "identify no more than 3 shovel ready collaborative initiatives to make a significant (local) difference."

At the end of the day, attendees walked away, remarking:

"Do it again." (Several of the groups are planning on re-convening.)

"We have been in mhealth for awhile, but this workshop really opened my eyes to the rich area of potential."

"The people I connected with today, I want to collaborate with tomorrow."

"We are here," promised Griss, "to be a leader in this eco-system."


[Image: Karita Ilvonen, Research Director, Helsinki University of Technology, Reports on Breakout Session]

Related Posts on the CyLab Mobility Research Center Mobile Health Workshop

CyLab MRC Mobile Health Workshop: Helsinki University of Technology on the Known Unknowns

CyLab MRC Mobile Health Workshop: Kaiser Permanente's Naomi Fried Extols Telehealth and Envisions "Home as the Hub"

CyLab MRC Mobile Health Workshop: Microsoft's Oren Rosenbloom on the "Copernican Shift" in Health Care

CyLab MRC Mobile Health Workshop: "Wireless Health Connectivity Collapses Time and Space" says Qualcomm's Don Jones

CyLab MRC Mobile Health Workshop: SAP's Belala asks, "Can wireless patient flow monitoring to provide true patient-centric care?"

CyLab MRC Mobile Health Workshop: Kinnexxus' Vision -- "With" the Elder Rather than "For" or "To" the Elder

CyLab MRC Mobile Health Workshop: Carnegie Mellon's Siewiorek on "Intelligent Systems that Augment Body and Mind"

CyLab MRC Mobile Health Workshop: Faces of Future Technology Leaders, Students with Their Posters

CyLab MRC Mobile Health Workshop: Helsinki University of Technology on the Known Unknowns

[Image: Prof. Paul Lillrank addresses workshop]

CyLab MRC Mobile Health Workshop: Helsinki University of Technology on the Known Unknowns

Paul Lillrank, Professor of Quality and Service Management and Karita Illoven, Director of Research, Helsinki University of Technology, spoke on "The Known Unknowns of Mobile Health."

To view their presentation, click here.

Q&A on Mobile Health Workshop Themes

What is your vision of how mobile health will improve outcomes, reduce costs and/or improve patient (and provider) experiences?

Paul Lillrank and Karita Illoven, Helsinki University of Technology: Mobile solutions break constraints, such as time (asynchronous communication modes), location (no wires), data quality (sensor systems) etc. This provides new degrees of freedom to design service production systems.
By breaking constraints, mobile solutions can be expected to have impacts on output efficiency (technical, economic, and allocative), and outcome effectiveness (coproduction of health outcomes. The effects can be expected to be different depending on the various operating modes, such as visits, cure, care, elective, emergency, preventive, and projects. Patient centricity requires not only process work-flow modeling, but ways to describe and analyze patient health behavior: health events and how they combine into episodes; and interactions that take place in service events.

What are the most pressing business, process, organization, cultural and technical
issues in mobile health?

Lillrank and Illoven: Business -- To develop appropriate performance metrics to enable revenue models and cost-benefit analysis
Process -- Understanding and analyzing the various types of healthcare value chains, producer processes, patient episodes, and the service events where these intersect; and the points where mobile solutions may have an impact.
Organization -- The supra-process (process governance) level, i.e. the power, responsibility, monitoring, and incentive systems required for successful implementation.
Cultural -- Professional corporate cultures suitable to manage exceptions, non-routines, etc. white spaces between / beyond defined processes and protocols.
Technical -- Inter-operability, data compatibility, appropriate technology, easy user interfaces

What are the best opportunities for collaborative university research?

Lillrank and Illoven: Theory-oriented researchers need access to real-world problems and issues; platforms to test various solutions; and ongoing discussion / brainstorming with practitioners. Problem centric research needs to draw on various disciplines (e.g. outcome –based revenue model development would need inputs from business economics, clinical and behavioral medicine, device technology, software development, etc.) and observe implementation.

CyLab MRC Mobile Health Workshop: Kaiser Permanente's Naomi Fried Extols Telehealth and Envisions "Home as the Hub"

[Image: Kaiser Permanente's Vision for the Future]



CyLab MRC Mobile Health Workshop: Kaiser's Naomi Fried Extols Telehealth and Envisions "Home as the Hub"

Naomi Fried, Vice President for Innovation and Advanced Technology at Kaiser Permanente spoke on "Telehealth: Innovations in the Delivery of Health Care."

Kaiser Permanente (KP) has gravitas on any subject related to health care in the US.

KP is the largest nonprofit health plan in the US. It has 8.7 million members, 13,000+ physicians, 156K+ employees, 416 medical offices, and $35 billion in annual revenues in 32 states and Washington, D.C.

KP already had a sophisticated e-mail system in place, through all members can email doctor and get a response back within 24 hours, but Telehealth represents a paradigm shift in delivery of care, and its programs span the continuum of care

"Telehealth," Fried reports, "is a process and system for care that extends beyond traditional walls, bringing health care and wellness into the everyday experience of members and their families"

Touching all aspects of the patient's care, Telehealth leverages communications, information and biometric technologies to extend and enhance patient and care giver relationship.

"With Telehealth, members are met where they are," says Fried. A patient at home can step on a scale, and the reading is sent back to KP electronically. A physician can look into a baby's ear via videoconferencing and write a prescription, without the parent having to bring the baby into the office.

Emergency room visits can be reduced by thirty to forty percent.

Also, KP can get members home quicker, especially by curtailing those last two or three days in hospital, which are usually only for monitoring status. Now that can be done via mobile health technology.

To view Naomi Fried's presentation, click here.

Q&A on Mobile Health Workshop Themes

What is your vision of how mobile health will improve outcomes, reduce costs and/or improve patient (and provider) experiences?

Naomi Fried, Kaiser Permanente: Mobile devices are capable of playing a key role in remote management of our patients with chronic conditions. They would collect data from biometric devices in the patient’s home or office and upload and send the physiologic data back to KP where it could be electronically monitored and triaged. Clinicians would evaluate the data and take action when necessary.
Mobile devices also offer a platform for sharing health education information with patients that are on the move.
We are moving into an age when healthcare will be delivered at the convenience of the patient, outsides the confines of traditional healthcare delivery locations. Telehealth offers the opportunity to deliver care where the patient is for a variety of needs.

What are the most pressing business, process, organization, cultural and technical issues in mobile health?

Fried: For mobile data capture to monitor patients with chronic conditions to be as efficient as possible, the data must integrate seamlessly with the electronic medical record. Clinician workflow and management of patients with chronic conditions can best be optimized if there is a single access point for the clinician to view both home based and office based data. The electronic medical record must contain and provide access to all the necessary home-based data.

CyLab MRC Mobile Health Workshop: Microsoft's Oren Rosenbloom on the "Copernican Shift" in Health Care


[Image: Oren Rosenbloom addresses attendees]

CyLab MRC Mobile Health Workshop: Microsoft's Oren Rosenbloom on the "Copernican Shift" in Health Care

"Healthcare is undergoing a Copernican Shift, with the consumer now placed at the center of various healthcare programs," says Oren Rosenbloom, Microsoft's Director of Development for Consumer Health Solutions.

"Technology," he added, "has changed expectations."

Rosenbloom spoke of Microsoft's two product offerings, Amalga, a unified intelligence system for hospitals, and Health Vault, a health patient applications information platform.

As an example, he reported on the Cleveland Clinic Home Monitoring Pilot, a Microsoft HealthVault pilot undertaken in cooperation with the Cleveland Clinic.

This pilot addresses chronic disease management in the areas of diabetes, hypertension and heart failure. The short-term pilot follows multiple diseases in the clinical delivery setting, using multiple at-home devices including glucometers, heart rate monitors, weight scales and blood pressure monitors.

Cleveland Clinic hopes to increase clinician efficiency, improve patient outcomes, and deliver a better experience for patients.

Rosenbloom cited the critical questions the pilot is intended to answer:

Can we empower patients/consumers to take an important role in managing their chronic disease ?
Will patient outcomes improve with better data integrity and compliance?
Can clinician efficiency improve by having more reliable and up-to-date data?
Can we improve the quality of a patient visit and reduce the length of appointment time with more integrated physician and patient involvement in disease treatment?
Can we reduce cost by using "off the shelf" home medical devices and leveraging patient's existing home computer and Internet connection?

The Cleveland Clinic Pilot includes 460 patients with hypertension (utilizing one device), 30 heart failure patients (utilizing 4 devices) and 30 diabetes patients (utilizing 5 devices).

The devices used are digital weight scale, blood pressure reader, blood glucose reader, peak flow meter and pedometer.

Rosenbloom shared some observations on the pilot so far:

Patient age factors into success (e.g., heart failure patients are an average of 65+)
Installing software and devices varies across configurations
Device industrial design is greatly lacking
Data integrity even controlled by patient is an issue (digital signatures and auditing history are needed)

In concluding his presentation, Rosenbloom shared some further observations:

Mobile health and technology is still in its infancy
Business models are still insufficient
There are lots of information systems "data islands"
There is increasing desire for patient involvement
There is no substitute for human interaction

To view, Oren Rosenbloom's presentation, click here.

Q&A on Mobile Health Workshop Themes

What is your vision of how mobile health will improve outcomes, reduce costs and/or improve patient (and provider) experiences?

Oren Rosenbloom, Microsoft: Mobile Health by definition will become a necessary component of all healthcare. Technology has created the expectation that you can take your office with you where ever you go and you can communicate with anyone anywhere at any time. Increasingly family health managers interact with their pediatricians, their personal doctors, and the health and wellness providers of their aging and often remote parents via secure/insecure email and cell phones. Similarly, there is a growing trend of healthcare being provided outside the normal confines of the clinical environment with provider visits to the home, increasingly provided as a benefit to employees as a means of reducing trips to the ER and thereby reducing employer costs. And there is conjecture and increasing evidence that outcomes improve when patients are within the comfort of their own environment surrounded by family and friends. My definition of Mobile Health is one where providers and caregivers can remain in contact with their patients where ever the patient and the provider reside. Improving outcomes and experiences, and reducing costs begins by defining the right users and use cases and applying technology, processes and business solutions where applicable. Lots of examples, including 1) Finding your right provider based on your requirements, ratings, social networks, etc., 2) Online scheduling of doctor visits, 3) Online access to a copy of your medical records, 4) Remote monitoring of patient data that is collected, validated, stored, analyzed and shared with providers and caregivers, 5) Improved patient experiences when entering clinical environments via online pre-registration and post-care discharge information available online.

What are the most pressing business, process, organization, cultural and technical issues in mobile health?

Rosenbloom: There are many pressing issues in mobile health.
This is a partial list --
1. Business models are still insufficient. Limited/no incentive for providers to communicate with patients outside the clinical environment because they are not paid to do so.
2. Mobile technology is still in its relative infancy and may not be reliable for mission critical systems.
3. Mobile connectivity is partial at best, especially in North America.
4. Industrial design for many devices is lacking; examples include limited/no suitable cell phones for the elderly, difficulty in configuring monitoring devices and ensuring they remain functional and communicating accurate data.
5. Disparate information systems housing patient data are data islands even within a given hospital.
6. The human touch is still extremely important. Technology will never be a substitute for it.
7. The healthcare system as a whole is one of the remaining service industries that doesn't recognize the "consumer" (i.e. patient) as the most important entity in the system.

What are the best opportunities for collaborative university research, and what is the role of university research in this area?

Rosenbloom:
Universities have the advantage of having a broader time horizon than businesses. I'd recommend collaborating on scenarios that may not have an immediate or obvious revenue model but could result in a disruptive change in how health and wellness is administered.

CyLab MRC Mobile Health Workshop: "Wireless Health Connectivity Collapses Time and Space" says Qualcomm's Don Jones

[Image: Qualcomm Presentation Wireless Health, 2-11-09]

CyLab MRC Mobile Health Workshop: "Wireless Health Connectivity Collapses Time and Space" says Qualcomm's Don Jones


"There are four billion cell phones in use in the world today," Qualcomm Vice President for Business Development in Health and Life Sciences Don Jones observed, "three billion more than any other computing or consumer electronic device.

"The phone," he underscored, "is the most personal device."

Qualcomm is working on Body Area Network (BAN) and Wide Area Network (WAN) mobile healthcare strategies and solutions, some are in the commercial market already, others are in clinical trial.

Jones highlighted CardioMEMS in the field of Wireless Implants, CardioNet in the field of Diagnostic Devices, Smart Band-Aids in the field of Fitness, and CHEALCOMM in the field of Home Health.

CardioMEMS features "miniature implantable sensors, which use radio frequency energy to transmit real-time data and communicate this information to the patient’s physician for the management of patients with congestive heart failure."

CardioNet's diagnostic devices "wirelessly and remotely detect cardiac arrhythmias."

Smart Band-Aids will enable people to measure and wirelessly transmit information while exercising.

The CHEALCOMM home health hub enables people to capture and wirelessly transmit vital signs, improving health, and fitness maintenance.

To view, Don Jones' presentation, click here.

CyLab MRC Mobile Health Workshop: SAP's Belala asks, "Can wireless patient flow monitoring to provide true patient-centric care?"

[SAP Research Canada Presentation, 2-11-09]

CyLab MRC Mobile Health Workshop: SAP's Belala asks, "Can wireless patient flow monitoring to provide true patient-centric care?"

Yacine Belala, Senior Research Scientist for SAP Research Canada, spoke on "Optimizing Patient Care In Clinical Units Using Wireless Patient Identification and Tracking."

In his presentation, Belala raised some provocative issues for discussion:

Is it possible to use wireless patient flow monitoring to provide ‘’true’’ patient-centric care ? (Not simply automate paper flow)

What current barriers/challenges could be removed/addressed?

What key process steps, cycle times, backlogs, rework errors could be improved using wireless technologies ?

What measures of quality, productivity, patient satisfaction… need to be accounted for?

What would be key to get medical practitioners and institutional buy-in?

To view, Belala's presentation, click here.

Q&A on Mobile Health Workshop Themes

What is your vision of how mobile health will improve outcomes, reduce costs and/or improve patient (and provider) experiences?

Yacine Belala, SAP Research Canada: Current hospital information systems are not well suited for highly mobile personnel and patients. One significant challenge is the ability to track patient flows in a clinical environment and maintain a link with the healthcare records (EHR) at all times. Wireless technologies would enable, for instance, the creation of a temporary ‘’file’’ when the patient enters the facility and be updated at each step during his/her visit. If the patient is equipped with a wireless device that properly identifies him or her, medical data obtained could be automatically added to the EHR at the end of each step in the care process. Physicians and nurses would also be able to access the patient data from various locations, and hence make more informed decisions. Such an approach would reduce the number of operational inefficiencies such as, for example, the prescription of redundant tests or the need to reconcile medications.
What are the most pressing business, process, and organization, cultural and technical issues in mobile health?

Belala: One of the most significant challenges is to find simple, practical ways to gain acceptance from end users i.e. healthcare professionals and patients. The latter are mostly concerned about security and privacy issues while the former are equally interested in reducing inefficiencies so they can dedicate more time to actual patient care. The identification of patient flow management processes could help solve some of these issues.
What are the best opportunities for collaborative university research?

Belala: As mentioned earlier, we would like to find areas of collaboration that involve healthcare providers and university researchers in order to model clinical patient flows adequately

What is the role of university research in this area?

Belala: We see the university researchers taking a prominent role in patient flow process modeling. This could be achieved by means of case studies and simulations in collaboration with SAP and healthcare providers. We also anticipate that a proof of concept could be developed as part of the research.

CyLab MRC Mobile Health Workshop: Kinnexxus' Vision -- "With" the Elder Rather than "For" or "To" the Elder

[Image: Dara-Abrams and Pan address attendees]

CyLab MRC Mobile Health Workshop: Kinnexxus' Vision -- "With" the Elder Rather than "For" or "To" the Elder

Benay Dara-Abrams, CEO and Chief Gerontechnology Officer, and Wayne Pan, Chief Medical Officer, Kinnexxus spoke on "Improving Health Outcomes Through Collaborative Gerontechnology."

Dara-Abrams articulated a vision of working to provide healthcare "With" the elder rather than "For" or "To" the elder.

She stressed enabling independence: "The more you can support independence the lower the costs," and characterized the current environment as "chaotic, fragmented, difficult to navigate, isolating, dysfunctional, inefficient and costly."

The current paradigm for the healthcare of elders, Dara-Abrams observed, may provide support for the physical and physiological elements of what it means to be an individual, but it is not addressing the spiritual, social or cognitive elements very well at all.

To view the Kinnexxus presentation, click here.

Q&A on Mobile Health Workshop Themes

What is your vision of how mobile health will improve outcomes, reduce costs and/or improve patient (and provider) experiences?

Benay Dara-Abrams, CEO and Chief Gerontechnology Officer, and Wayne Pan, Chief Medical Officer, Kinnexxus: If you look at the healthcare delivery system today, it can be broadly divided into two major areas: inpatient and outpatient. Healthcare of the near future will also need to take into consideration the third and largest area, the personal health space (the sum of an individual’s behaviors and activities). Mobile health, as part of Health 2.0, is at the junction between the personal health space and outpatient areas. Currently, there are very few tools providers have at their disposal to help patients in their personal health space. Providers, in the outpatient setting, can offer advice (e.g., smoking cessation) and maybe write a prescription and then send the patient on their merry way hoping that what they have said and done will actually improve the patient’s health. Mobile health will provide more tools that can help the patient achieve better health outcomes and consequently, reduce the need for acute care (i.e., emergency room visits and hospitalizations). Development of non-intrusive, intuitive appliances that blend seamlessly into people’s lives, including remote monitoring of physiological parameters, can and will provide valuable, real-time information to help patients with their health self-management challenges. After all, patients spend the vast majority of their time in the personal health space, and Health 2.0 brings healthcare to the patient. The added benefit of linking patients in the personal health space to providers through connected support networks will encourage patients to be more compliant. These connections can also benefit the elderly, as it can reduce feelings of isolation and help them feel less depressed. This type of mobile health environment will also enable providers to detect small changes that may occur over time and enable early detection of trends that might otherwise go unnoticed. Other issues, such as patient compliance with medication can, not only be monitored, but support can be offered at the time when the medication is missed. This support can come in the form of reminders to take medications as well as helping patients understand better why they are taking the medications and the possible consequences resulting from non-compliance. In addition, through improved monitoring of patients in the personal health space via an electronic dashboard of sorts, providers can become more efficient using real-time clinical data to help prioritize scheduling of patients for office and/or home visits.

What are the most pressing business, process, organization, cultural and technical issues in mobile health?

Dara-Abrams and Pan: Gaining adoption of new modes of healthcare delivery. Current mobile health approaches focus on physiological and physical health but do not address cognitive or social health dimensions 1.0 approach to home visits lacks critical information to arm physician with data on the patient prior to the visit to be able to prioritize visits. Current technology is not adaptable to decline in faculties among aging patients.

What are the best opportunities for collaborative university research?

Dara-Abrams and Pan: Identify which of the promising technologies is capable of commercialization in a way that is sustainable to rapidly bring theory into practice. Bring together interdisciplinary teams with different viewpoints to create a unique perspective to evaluate feasibility and optimize product development in mobile health applications.

What is the role of university research in this area?


Dara-Abrams and Pan: Promote a broader view of health and wellness, extending the healthcare model, identify and develop adaptable technology to compensate for declining faculties, focus on technologies that can support outpatient services and patient self-management.

CyLab MRC Mobile Health Workshop: Carnegie Mellon's Siewiorek on "Intelligent Systems that Augment Body and Mind."

[Image: Quality of Life Center (Carnegie Mellon/University of Pittsburgh) presentation, 2-11-09]

CyLab MRC Mobile Health Workshop: Carnegie Mellon's Siewiorek on "Intelligent Systems that Augment Body and Mind"

Dan Siewiorek, Director of the Human Computer Interaction Institute, School of Computer Science, Carnegie Mellon University spoke on "Quality of Life Technology Engineering Research Center" (QoLT).

Sieiorek's talk described how the QoLT ERC addresses this core problems of human-centered, holistic design by bringing together robotics and information technology engineers with biomedical and rehabilitation engineers, healthcare professionals working in assistive technology research and clinical practice, and experts in aging.

The project's goal is to "increase employability and productivity across the life span."

Siewiorek reported on the QoLT's integration testbed, "McKIZ," the McKeesport Independence Zone (a.k.a. Blueroof), a 10-acre 12-block area with 12~15 single family houses with a church, a convenience store, a community center and other infrastructure.

To view, Siewiorek's presentation, click here.

Q&A on Mobile Health Workshop Themes

What is your vision of how mobile health will improve outcomes, reduce costs and/or improve patient (and provider) experiences?

Siewiorek, Carnegie Mellon University: The Quality of Life Engineering Technology (QoLT) Engineering Research Center (ERC) envisions intelligent systems ranging from individual devices to comprehensive environments that enhance body and mind. They monitor and communicate with a person and understand his/her needs and task goals, and compensate for or replace diminished capabilities appropriately, safely, reliably and graciously. Such future Quality of Life Technology (QoLT) systems will not be just machines for convenience or saving labor, but intelligent assistants. They will allow people to independently perform valued and necessary activities of daily living so that they can fully participate in society. They will enhance and augment the capabilities of caregivers. They will also delay or prevent the manifestation of functional impairment. The missing element is a basic understanding of how to relate human functions (physiological, physical, and cognitive) to the design of intelligent devices and systems that aid and interact with people.

What are the most pressing business, process, organization, cultural and technical issues in mobile health?

Siewiorek: The QoLT ERC is addressing a large and growing segment of our population - people with reduced functional capabilities due to aging or disability. The number and percentages of people in need of QoLT increase every year. About 60 million Americans have a disability that affects one or more of their major life activities. Perceptive, cognitive and musculoskeletal diseases that impair motor skills dramatically increase with age. A number of subpopulations are of particular interest. In 2030, over 20% of the U.S. population will be over 65 years of age, with one in two working adults serving as informal caregivers. Globally, the number of people older than 65 years is anticipated to double between 1997 and 2025. An estimated $1B could be saved annually in the U.S. if all seniors’ entry into long-term care facilities can be delayed by a single month. As individuals, families, communities and a nation, we are facing new technical and social challenges to attain, prolong, and preserve quality of life.

CyLab MRC Mobile Health Workshop: Faces of Future Technology Leaders, Students with Their Posters

CyLab MRC Mobile Health Workshop: Faces of Future Technology Leaders, Students with Their Posters

The Mobile Health Workshop was not only brought together executives and senior researchers of leading organizations in the health care, technology and education sectors, it also introduced them to the faces of technology's future, i.e., some of our students, who shared their mobile healthcare related projects in poster sessions between the presentations and working groups.

Here are a few photos that are worth a thousand words each.