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On the Clinical Frontlines: IEEE HealthCom 2015 LSTC Standards Panel

by Shannon Fischer

IEEE HealthCom 2015 wrapped up Saturday morning with a panel on standards, hosted by Life Sciences Technical Community (LSTC) Standards Committee chair, Carole Carey, with co-chair Bruce Hecht of Analog Devices.

Discussions began with an update on the LTSC’s progress in its first two years—it now encompasses seven IEEE societies, has appeared at several conferences, including the recent SEED conference, and has plans to host its own conference including the upcoming Life Sciences Grand Challenges Conference in January in Abu Dhabi. Carey provided an overview of the IEEE Standards Association and of the application of standards in the context of life sciences technology development, where they serve as crucial building blocks in development and promote consistency and interoperability.

Several speakers including Nirmal Keshava of AstraZeneca, and Joel Rodrigues of the University of Beira Interior, Covilhã, Portugal, highlighted areas where these concepts are particularly needed. This included the accumulating health information and electronic health records, where inconsistencies in data collection have made data mining a challenge at best, and the integration of the growing number of mobile health devices and cloud-based services, where efficient communication and interoperability is becoming increasingly important for developers to consider.

The highlight of the panel came from the final speaker, Meghan Dierks, a Harvard Medical School professor and clinical informatician at the associated Beth Israel Deaconess Medical Center, who presented cases from the clinical front lines to drive home why this matters. Drawing from her past experiences as a surgeon, she explained the realities of hospital life, where older technologies are rarely thrown away, new tools are just layered in atop the obsolete, and caregivers will, as a general rule, overestimate a technology’s capacity. In such environments, crucial information can easily slip through the cracks without rigorous interoperability standards.

• In one example, Dierks presented a scenario in which a hospital acquires a new pathology analyzer capable of assaying a sample and supplying results on 30 identification/susceptibility tests to the laboratory information system (LIS). That LIS takes that information and sends it to an output device read by the doctor—but that output device is an older piece of machinery that can only handle 20 results, a fact long forgotten by hospital workers. Now that doctor has no idea that he is potentially missing ten pieces of information with every sample analysis.

• In a second example, a surgeon requests a hard copy of a diagnostic image taken of a breast, in order to have a manipulable image for measurements during a biopsy surgery. A nurse prints the digital image via an FDA-approved lab printer—but neither she nor anyone else remembers that the printer defaults to a “fit to size” setting, and that the image in the surgeon’s hand is no longer accurate.

“Standards got them part of the way,” Dierks explained, “but not all the way.”

She echoed a call to action made by Carey earlier in the session, who emphasized the need for more involvement in standards development by all sectors of the life sciences community to avoid exactly such situations. “It is difficult,” Dierks said, “but there is tremendous need for these kinds of things.”

Shannon Fischer is a freelance science writer living in Boston, Massachusetts.

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