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How Location Services Could Impact Health Care

I showed my dental hygienist who else was checked-in there on Foursquare last time I went to the dentist's office and she was quite taken aback. But we consumers willingly shared our presence at and feedback about that medical facility. That's only the beginning of what's likely to happen.

If health insurance agencies track your location and charge you more for insurance, you're probably not going to appreciate that. There are some possible upsides to the intersection of location and health care, however.

For the Patient

"I would love to see HospitalCompare.com and Health and Human Services (HHS) data mashed up with mobile location apps for health care consumers," says Brian Ahier, Health IT Evangelist at Mid Columbia Medical Center in the Dalles, Oregon. "Helping me find the best pediatrican or orthopedic surgeon would be a great application. And once I'm there, I want to want to lodge a positive or negative complaint on the same service."

"This is all about is the patient," argues Mark Scrimshire, founder of the HealthCamp movement of healthcare unconferences around the world and an employee at a large healthcare payment corporation in the US.

"The one person who is not by their computer during a medical transaction is the patient. They are in the hospital or in the pharmacy. As smartphones take off, there will be tremendous potential for really suplementing the patient and bringing them data that's relevant. Location services could recognize that you are going into a pharmacy, for example, and remind you what your prescriptions are and of anything you needed to talk to your pharmacist about regarding those prescriptions.

"When you walk into the doctor's office, your smartphone should configure your data and prompt you to transmit your health measurements from home quickly and easily, because it knows where you are. I think there's a lot of potential for augmentation of the patient to let them monitor their own health. That will happen through a wide variety of sensors and location is one important factor that will provide context for that sensor data. 'Blood pressure up? Well, he was at work again.'"

Scrimshire also sees location data being served up to Augmented Reality style apps to help patients navigate their way through the maze-like halls of big hospitals - and providing the kind of in-home tracking that would help the elderly stay in place, instead of being institutionalized.

"Putting a few thousand dollars of monitoring equipment into a home, if it prevents someone from visiting an emergency room, it pays for itself with the avoidance of one visit," he argues.

These kinds of strategies may be less far-fetched than they seem. Medical providers are already offering Google Maps of the best facilities to seek appropriate care. A University Medical Center in Holland has even built an emergency Augmented Reality display that allows you to look through your mobile phone's camera view and locate the nearest automatic external defibrillators (AEDs) located in a public place.

For the Doctor

There are already systems in place in many hospitals to track medical equipment, but what about tracking the medical professionals themselves?

Brian Ahier works in the same small Oregon town where Google recently built a big data center, The Dalles. Earlier this year Google gave the town a grant to build a free city-wide wifi network. Wifi is just one of several ways that the locations of mobile devices can be tracked.

"If there's an emergency and we need to call up all hands on deck, it would be really handy to be able to pull up a map and see where everyone is," Ahier says. "It would need to be secure, and probably for people who are on call only. It would have to be an opt-in situation by the physician."

Inside the hospital, location data could prove very useful in tracking updates from devices located in various parts of the institution as well.

"At some of the HealthCamps there have been conversations about secure Twitter-like conversations in a hospital environment, even between devices," Mark Scrimshire says.

"Imagine if every bed and device could send and recieve Twitter-like messages. Imagine if you come onto duty and you get the feed of all the updates from all the patients and devices.

"Because of the life or death nature of the industry, it doesn't move that quickly and thus hasn't adopted technology like this. 'Meaningful use' in healthcare right now is about whole-record interoperability, this would be about real-time mashing together of data feeds from different devices and building filters and context. If a patient has a device on them, where are they and how does that relate to other things you're tracking? That makes for better management of the patient. Is a health care provider doing something out of sequence? Location becomes a factor that helps to add context to all these things we could monitor."

Obstacles to the Vision

Some location technologies will likely impact health care sooner than others. There are obstacles to the kind of future that Ahier and Scrimshaw describe. Ahier, for example, says that GPS signals on phones vary too much in accuracy today. And the iPhone is too proprietary for many corporations to build on top of. "Almost all the doctors have iPhones, too," he says. "Even if we give them BlackBerries, they go out and buy their own iPhones."

"Ultimately, I think we're going to need to be platform independent, even device independent," Ahier argues. "We're going to need to be able to use an Ubuntu netbook, an iPad, etc. Our EHR (electronic health records) are going to have to run on all those."

Scrimshaw believes that location technology providers in healthcare will go Google's route and build HTML5 mobile web apps, which nearly every smartphone on the market will soon support.

Scrimshaw believes that the bigger issues are cultural. "The whole industry is very conservative because of privacy," he says.

"HIPAA [the Health Insurance Portability and Accountability Act of 1996] is used as an excuse not to share, but the P is for portability. The big trap door is that we as patients can demand our data, people may want to charge us for us, but our information is our currency. We can decide when and with whom we want to share it.

"Security is going to be the issue the industry is going to through up as an excuse to not do anything. It's been a minefield to get quality data published about doctors and hospitals, it's a minefield to go through. The healthcare industry is still one where there's a lot of advantage to a lack of transparency. You don't realize you could save $200 by going down the road for the same treatment because the information isn't available.

"But some trends are coming together, in part because of the recession. Employers are putting more of the responsibility for paying for health care on the shoulders of employees, through high-deductible insurance plans, for example. When they start feeling the cost more, then they start asking questions and asking if there are other steps they can take. When the onus is put on the consumer, you'll see them demand a change in the healthcare industry. The consumer can demand their information and be more on par with the physician and make decisions. Then you'll start to see the innovators really coming into the picture."

Will location data be a major disruption of the balance of power between the various stakeholders in the healthcare industry? Will it make shopping for health services, or staying healthy, an easier casual activity for more and more people with smartphones?

Will doctors and medical devices be instrumented, tracked, analyzed and more effectively managed to reduce cost and improve the quality of care?

These visions of location-based health care may be a ways off, but they could also be fast approaching. Just today the FCC and the FDA signed an agreement to jointly develop technical standards for wireless-enabled medical devices and services. Location technology and healthcare could come together sooner than we might expect.

via readwriteweb.com

Fascinating discussion with Marshall Kirkpatrick. WE haven't even scratched the surface of Location Based Services in HealthCare.

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Inception Theatrical Review,Inception Synopsis, Should I Watch Inception?| FlickDirect

Reviews > FlickDirect™ Staff Review

Inception Theatrical Review

Marco Duran

7/17/2010 9:17 AM EST

I did not intend to write a review for Inception.  I didn't want to.  If I plan on writing about a film, I take my notebook and write my notes by glow of the silver screen.  However, when I entered the midnight showing, I went empty handed.  I just wanted to sit back and enjoy the ride.  The lights dimmed; the film played; the curtain closed and something was planted in my head that has since festered and grown, taking over my dreams and my waking mind.  I was compelled to write on what I saw and experienced.  I sit here now, needing to share what I experienced, needing to tell as many as I can to run and have the same experience I did.  A film has not haunted me so much in quite a while.  It is the second of Nolan's films to make me question reality and have me chattering like a gibbon as I left the theater - Memento was the first.  They both messed with my head.  Inception is so well tuned, so well structured, the world it creates is complete and nearly perfect.  I not only understood, but I could easily manipulate the concepts it showed me so that I could see them every day around me.  This is what film is about.

At some undetermined time in the future (or maybe happening now in the present right under our noses) people are able to jack into other's subconscious and invade their dreams.  Dom Cobb (Leonardo DiCaprio) is the best at doing this and at finding the secrets hidden within those dreams.  He is hired by Saito (Ken Watanabe) to place an idea into his business rival's, Robert Fischer (Cillian Murphy), mind.  The request is impossible, the stakes, high, but Cobb needs to do it to gain access back into the United States in order to see his children again. A heist. One last job.  So, Cobb puts together a team of people to help him accomplish this task.  Ariadne (Ellen Page) is the architect; Yusuf (Dileep Rao) specializes in sleeping potions; Eames (Tom Hardy - stealing every scene he is in) has connections and munitions and Arthur (Joseph Gordon-Levitt) is Cobb's right hand man.  However, what none of them realize is that Cobb has a demon in his head in the form of his ex-wife, Mal (Marion Cotillard) that may materialize and wreak havoc while they are working.

The first person that must be praised is writer/director Christopher Nolan.  He has proven himself time and again to be the best director working today.  Is there any other director whose track record is so clean?  He makes films that are great for film geeks and casual filmgoers alike.  The critics love him with great reviews and the audiences love him with great box-office.  Besides the misstep that is Insomnia, I am hard pressed to think of anyone else who is so prolific and still so successful.  Some will say Tarantino but I would argue that Nolan has broader appeal.  I really don't know why more isn't being said and written about him.  He is a master storyteller.  No one else would have been able to cram so much information, at such breakneck speed, into two and a half hours without confusing me, and keep me on the edge of my seat.  Each piece of information is given at such a time that it either connects to what happened not so long ago, or so that we can use it to unlock the mystery that is about to come.  Other directors would have had pity on the "incompetence" of the audience; they would have watered down the plot to help us understand all the information.  Nolan drops us in the middle of a story and trusts us to keep up.  He doesn't bother with details that would weigh down the exposition (How can they jack into other people's dreams?, Who discovered it?, How does it work?) but instead offers it up for us to buy into if we are to follow him. 

The editing is the second thing that must be praised.  The editing room is the final place that a director "writes", and as such Nolan's cutter, Lee Smith, (the one he's been working with since Batman Begins) is a genius.  For thirty to forty-five minutes in the second act of this film there are between four and six different storylines that are going on simultaneously and interrelate with each other.  The deft work done here is like juggling chainsaws.  If one of the storylines is botched and left behind, the whole movie is ruined.  And someone may lose a limb.  Added to that is the unbelievable score that Hans Zimmer, three-time Nolan collaborator, produces.  It is as unrelenting as the editing.  Looking back, I don't recall more then five minutes tops that did not have music behind it, pushing it forward, raising the tension.  There are a few spots in the film where I wished the movie would have slowed down some in order to let us feel the weight of an issue or a decision, and therefore I feel it lost something special in those moments.  However, on the whole, it is a dizzying display of expert editing.

DiCaprio does better here then he has done in quite a while, perhaps because he's not butchering some accent.  His guilt ridden scientist is very similar in tone to the guilt ridden cop he played in Shutter Island.  He is perfect in this role.  After discovering Tom Hardy in 2008's Bronson, I have found every role he's been in mesmerizing.  I'm glad he's going to be getting a chance soon to be a leading man, I just wish it wasn't as Mad Max.  Joseph Gordon-Levitt keeps choosing amazing material to be in, although I do wish the costume crew didn't always place him in the same dapper-looking clothes – shirt and tie with a cardigan again?  Switch it up a bit, huh?  And Marion Cotillard is an unrelenting force here.  The inside joke of having the music that wakes everyone up be Edith Piaf (Cotillard's Oscar winning role) was, I feel, inspired.  Through it all, nothing was regretted by these dreamweavers.

Finally I want to discuss a scene that was in the trailer – guys floating around a hotel hallway.  For some of it, I am still confused as to how they did it.  There are two segments to the scene.  The first is the fight, a fight that goes from floor to wall to ceiling to wall to floor with such ease and fluidity that even Fred Astaire, in all his dancing glory, couldn't have dreamed that film would have come this far.  That was incredible and I can't even imagine how the fight choreographer wrapped his brain around the logistics of bringing that all together.  The second is the zero gravity portion, long profound stretches of time where lots of people are suspended in zero gravity.  That's where I get confused.  I suppose it could be CG, erase the wires that the actors are hanging from, however it appeared to me to be more of what they did for the Apollo 13 film in NASA's KC-135 reduced gravity aircraft.  But how would they have been able to build an entire hotel hallway, room and elevator into one of those aircrafts?  It cooks my noodle, but I love it for doing so.

There are a couple of places where the visuals don't quite work, where the CG lets the filmmakers down.  There is a bit more of The Matrix (people being jacked in, not knowing which is the real reality, heck they even had a hot girl that was a complete fabrication of someone's imagination) and of Vanilla Sky here then I would have liked to see.  And though the ideas may not be completely original, the execution is.  How you react to the ending and your interpretation of the entire film is more a reflection of your personality and your outlook on life.  It's awesome for a piece of art to mean so many different things to so many different people.  Nolan has given us yet another a film that we will be watching for decades to come.  

-- Marco Duran

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Go see Inception. It will play with your mind. It is an incredible movie.

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