On May 3, 2010 the New York Academy of Medicine (NYAM) held the Update on Medical IT: What Every Health Professional Needs to Know sponsored by NYAM Informatics Special Interest Group and Columbia University’s  Center for Advanced Information Management (CAIM). The speakers were Dr. Edward H. Shortliffe, President & CEO American Medical Informatics Association and NYAM Trustee; Dr. George Hripcsak, Professor and Chair of Biomedical Informatics, Columbia University; and Rachel Block, Deputy Commissioner Office of Health Information Technology Transformation in the New York State Department of Health. The point of the meeting was

…to address the current evolution of Health Information Technology fostered by the American Recovery and Reinvestment Act (ARRA) of 2009, [whose] goals include reduction of long-term costs by modernizing healthcare through the use of information technology.

Key items covered included

• Federal government investment of $36 billion (in Medicare and Medicaid providers and through government agencies) to drive adoption of electronic health records by 2015
• Development of government-certified systems that achieve meaningful use (more on this later)
• Certification standards
• Reporting protocols
• Compliance with government-certified electronic health records (EHRs)

Sounds great…but, as usual, the devil’s in the details. Overall, the presentations were (admittedly by necessity) rather general – but this led to concerns and questions that the panel sometimes seemed reluctant to address. Ah, politics.

A key challenge: not merely measuring, but defining meaningful use. This turns out to be enormously complicated, as you can see here.  The conundrum lies in identifying a “sweet spot” provides reliable quantitative metrics on ARRA-funded system implementation and use, while considering variations in practice environments. No mean feat.

Another gargantuan challenge is EHR compliance. Again, these reports not only have to be quantitative to be meaningful, but must also account for qualitative data, be compatible with systems from different manufacturers despite developmental compliant, and somehow deal with the proprietary EHR systems already in the field.

Let’s not even talk about security and the Health Insurance Portability and Accountability Act (HIPAA). No, really – let’s not. Except for HIPPA-2, which calls for changes in patients’ procedure payment and insurance notification options that the presenters acknowledged was difficult, if not impossible, to implement.

All this said, however, there’s progress being made, and the effort itself bodes well for an efficient, less costly and possibly universal (yes, international compliance is being explored) EHR system.

You can track the meaningful use discussion at the Meaningful Use Workgroup and review bioinformatics research at the Journal of Biomedical Informatics.

In Technology Review: Cell on a Chip, Lauren Gravitz reports that researchers at Rensselaer Polytechnic Institute in Troy, NY, have created the first artificial cellular organelle. This “cell on a chip” will help researchers understand how our bodies produce the widely-used blood thinner heparin.

This is a critical step. After its discovery nearly a century ago, heparin remains almost impossible to create in a laboratory, and so is still made from pig intestines – a procedure susceptible to sometimes lethal contamination.

Fake cell: This microfluidics chip can replicate the activity of one of the eukaryotic cell’s most important, yet least understood, organelles–the Golgi apparatus. Researchers hope that it can help them understand how to create synthetic versions of important drugs such as heparin. Credit: Courtesy JACS

The central mystery is the process by which a cellular organelle called the Golgi apparatus, converts proteins to sugar-studded glycoproteins. To emulate the Golgi’s workings, researchers created their very own artificial cell organelle – a small microfluidics chip – that acts as a precise, controllable, (eventually) automated Golgi analogue.

Funding and serendipity aligned, bioengineered heparin may enter clinical trials within five years.

Experimental set-up at the FLASH laser used to discover the new state of matter.

University of Oxford scientists have created a transparent form of aluminum (across the pond, it’s “alumimium”) by bombarding the metal with the world’s most powerful soft X-ray laser. ‘Transparent aluminum’ is an exotic new state of matter that previously existed only in science fiction – specifically, in the original TV series, and again in Star Trek IV.

Aa short pulse from the  FLASH laser -  a new source of radiation ten billion times brighter than any existing synchrotron – “knocked out” a core electron from every aluminum atom in a sample, leaving the metal’s crystalline structure intact but turning the aluminum nearly invisible to extreme ultraviolet radiation. Potential applications include planetary science, astrophysics and nuclear fusion power.

A report of the research, “Turning solid aluminium transparent by intense soft X-ray photoionization,” appears in Nature Physics. (Note: abstract only if you don’t have a subscription or don’t purchase access.) The research was carried out by an international team led by Oxford University scientists Professor Justin Wark, Dr Bob Nagler, Dr Gianluca Gregori, William Murphy, Sam Vinko and Thomas Whitcher.

First used in its current sense  by mathematician and scifi writer Vernor Vinge in 1993, and introduced to popular culture by technology futurist Ray Kurzweil 1n 2005, the Singularity is the theoretical future point of hyper-accelerating societal, scientific and economic change made possible by the emergence of machine superintelligence.

The premier dialog on the Singularity, the first Singularity Summit was held at Stanford in 2006 to further understanding and discussion about the Singularity concept and the future of human technological progress. It was founded as a venue for leading thinkers to explore the subject, whether scientist, enthusiast, or skeptic.

Does Bond need Q when there’s real-world computer-mediated telepathy? With its Silent Talk program, DARPA (the Pentagon’s Defense Advanced Research Projects Agency) proudly says nope.

Start by scanning and mapping the brain’s electric signals via EEG. Analyze said signals and convert ‘em into words. Beam these to the soldier of your choice. Voila! Instant telepathy for only $4 million in R&D.

The ghost in the machine is subvocalization - word-specific neural signals that fly around the brain before the word itself is actually spoken. If these are (or can be made to be) the same for more than just the person whose brain was scanned, we’re in business.

But wait – there’s more!

DARPA is also applying the idea to – wait for it – mind-reading binoculars that would communicate a soldier’s thoughts about what s/he was seeing much faster than having to speak (which has now become SO 20th century).

Talk about (no pun intended) the end of privacy….

Everyone’s soooo scared of gray goo – ya know, wantonly self-replicating, nanofabricating killer nanobots run amok and end all life on Earth through an orgiastic wave of ecophagy (literally, “eating the environment”). These pesky critters would be based on the molecular assemblers and nanfabricators envisioned by nanotech pioneer Eric Drexler, which “would join molecular building blocks to make products with atomic precision and unprecedented capabilities.”

While the possibility of this happening is remote and preventable (as described by Drexler and Chris Phoenix), the fact that it is even possible was enough to generate a new batch of fervent end-of-the-worlders. They’re so obsessed, in fact, that nobody’s discussing the next great wave of computer viruses that I poetically call blue goo.

Wazzat?

Allow me to explain: First, we need to take a quick trip to the emerging threat of hardware trojans – intentionally-place, impossible-to-detect defects that would drastically reduce the relibility and life expectancy of processors and memory chips. It’s serious enough that, among others, the Pentagon’s Defense Advanced Research Projects Agency (DARPA) is tracking the issue.

In my view, however, this is a weak hardware trojan (as in weak encryption or weak AI). So, you may well wonder, what would a strong hardware trojan be like?

Glad you asked. By exploiting the software that will control nanofabricators – which, by the way, use basic molecules as feedstock – such future micromonsters would commit technophagy by commandeering computer (or phone, or whatever) resources to create a small army of self-replicating nanonbots that devour the device from the inside out. Like parasitic wasps. (Warning: not for the queasy.)

No way!

Way.

Be afraid…be very afraid. And this time I mean it.