Andre Elisseeff leads a research team at IBM’s Zurich Research Lab that in September demonstrated a prototype system that will allow doctors to view their patients’ electronic health record (eHR) using three-dimensional images of the human body. Called the Anatomic and Symbolic Mapper Engine, the system maps the information in a patient’s eHR to a 3-D image of the human body. A doctor first clicks the computer mouse on a particular part of the image, which triggers a search of the patient’s eHR to retrieve the relevant information. The patient’s information corresponding to that part of the image is then displayed, including text entries, lab results, and medical images, such as magnetic resource imaging. The doctor can zoom in on the image to retrieve selective information or narrow the search parameters by time or other factors.

“The 3-D coordinates in the model are mapped to anatomical concepts, which serve as an index onto the electronic health record. This means that you can retrieve the information by just clicking on the relevant anatomical part. It’s both 3-D navigation and a 3-D indexed map,” explains Elisseeff.

Elisseeff makes clear that the mapper engine is not just a 3-D imaging system. In addition to connecting to a patient’s eHR, the images displayed are linked to the 300 000 medical terms defined by the SNOMED (Systematized Nomenclature of Medicine) international standard, a copy of which the mapper engine accesses from a local database. “It is impossible for doctors to remember all these terms, and they will need some assistance in the near future. Medical standards are at least as complicated to doctors as normal medical terms are to patients,” Elisseeff notes.

Furthermore, Elisseeff says, “The SNOMED terminology is also a knowledge repository. It is how we include the medical knowledge into the mapper engine, how we tell the computer that a finger is a part of the hand or that flu and fever can be related. The glue between graphical objects and the electronic health record is fundamentally based on this computerized medical knowledge. This is the core of our work. The visible part of the application is the 3-D model. But the most challenging part is building the links such that they are clinically relevant.”

“You can think of it as being like Google Earth for the body,” is how Elisseeff frames the mapper engine. “We see this as a way to manage the increasing complexity that will come in using computers in medicine.”

Visualizing Electronic Health Records With "Google-Earth for the Body"

The Food and Drug Administration (FDA) released a draft risk assessment saying meat and milk from most (*) cloned animals or their offspring is safe for consumers to eat. The agency is expected to approve the sale of products from cloned livestock in 2008.

(*) Don't go trying to eat lab mice or anything.

FDA Declares Cloned Foods to Be Safe for Humans

Laurence Kotlikoff takes on healthcare. Pair this book with Intern, by Sandeep Jauhar.

The shocking statistic is that forty-seven million Americans have no health insurance. When uninsured Americans go to the emergency room for treatment, however, they do receive care--and a bill. Many hospitals now require uninsured patients to put their treatment on a credit card--which can saddle a low-income household with unpayably high balances that can lead to personal bankruptcy. Why don't these people just buy health insurance? Because the cost of coverage that doesn't come through an employer is more than many low- and middle-income households make in a year. Meanwhile, rising healthcare costs for employees are driving many businesses under. As for government-supplied health care, ever higher costs and added benefits (for example, Part D, Medicare's new prescription drug coverage) make both Medicare and Medicaid impossible to sustain fiscally; benefits grow faster than the national per-capita income. It's obvious the system is broken. What can we do?

In The Healthcare Fix, economist Laurence Kotlikoff proposes a simple, straightforward approach to the problem that would create one system that works for everyone--and secure America's fiscal and economic future. Kotlikoff's proposed Medical Security System is not the "socialized medicine" so feared by Republicans and libertarians; it's a plan for universal health insurance. Because everyone would be insured, it's also a plan for universal healthcare.

Participants -- including all who are currently uninsured, all Medicaid and Medicare recipients, and all with private or employer-supplied insurance -- would receive annual vouchers for health insurance, the amount of which would be based on their current medical condition. Insurance companies would willingly accept people with health problems because their vouchers would be higher. And the government could control costs by establishing the values of the vouchers so that benefit growth no longer outstrips growth of the nation's per capita income. It's a "single-payer" plan--but a single payer for insurance. The American healthcare industry would remain competitive, innovative, strong, and private.

Kotlikoff's plan is strong medicine for America's healthcare crisis, but brilliant in its simplicity. Its provisions can fit on a postcard -- and Kotlikoff provides one, ready to be copied and mailed to your representative in Congress. We're electing a new president in 2008; let's choose a new healthcare system, too -- one that works.

The Healthcare Fix: Universal Insurance for All Americans

Last month I recommended Michael Pollan's article in the NYT magazine. Now his book is out.

Not all scientific study of Mars is about extraterrestrial exploration. Some of it is about chocolate.

This is Janet Maslin's review. See also the first chapter of Michael Pollan's new book.

In Defense of Food: An Eater’s Manifesto

This is Michael Pollan:

We’re asking a lot of our bees. We’re asking a lot of our pigs too. That seems to be a hallmark of industrial agriculture: to maximize production and keep food as cheap as possible, it pushes natural systems and organisms to their limit, asking them to function as efficiently as machines. When the inevitable problems crop up — when bees or pigs remind us they are not machines — the system can be ingenious in finding “solutions,” whether in the form of antibiotics to keep pigs healthy or foreign bees to help pollinate the almonds. But this year’s solutions have a way of becoming next year’s problems. That is to say, they aren’t “sustainable.”

From this perspective, the story of Colony Collapse Disorder and the story of drug-resistant staph are the same story. Both are parables about the precariousness of monocultures. Whenever we try to rearrange natural systems along the lines of a machine or a factory, whether by raising too many pigs in one place or too many almond trees, whatever we may gain in industrial efficiency, we sacrifice in biological resilience. The question is not whether systems this brittle will break down, but when and how, and whether when they do, we’ll be prepared to treat the whole idea of sustainability as something more than a nice word.

The Way We Live Now: Our Decrepit Food Factories

Authorities suspect that drug cartels are sending a grisly message after a major cocaine shipment was seized.

...

Decapitations have become more numerous in the last two years.

Officials and analysts say the gruesome killings are, in part, an attempt to bring the methods of psychological warfare to the drug trade.

It's no country for old men ...

5 mutilated bodies turn up near Mexico City

Atul Gawande:

If something so simple can transform intensive care, what else can it do?

(See companion thread for additional comments)

Annals of Medicine: The Checklist

Follow-up on Walk Score. See also, from February, Neighboroo.

The post-World War II era has witnessed the nearly exclusive building of low density suburbia, here termed “drivable sub-urban” development, as the American metropolitan built environment. However, over the past 15 years, there has been a gradual shift in how Americans have created their built environment (defined as the real estate, which is generally privately owned, and the infrastructure that supports real estate, majority publicly owned), as demonstrated by the success of the many downtown revitalizations, new urbanism, and transit-oriented development. This has been the result of the re-introduction and expansion of higher density “walkable urban” places. This new trend is the focus of the recently published book, The Option of Urbanism: Investing in a New American Dream (Island Press, November 2007).

This field survey attempts to identify the number and location of “regional-serving” walkable urban places in the 30 largest metropolitan areas in the U.S., where 138 million, or 46 percent, of the U.S. population lives. This field survey determines where these walkable urban places are most prevalent on a per capita basis, where they are generally located within the metro area, and the extent to which rail transit service is associated with walkable urban development.

The first section defines the key concepts used in the survey, providing relevant background information for those who have not read The Option of Urbanism. The second section outlines the methodology. The third section, which is the heart of the report, outlines the findings and conclusions of the survey.

Footloose and Fancy Free: A Field Survey of Walkable Urban Places

Publishers Weekly:

This unique first-person account offers a window into the mind of a high-functioning, 27-year-old British autistic savant with Asperger's syndrome. Tammet's ability to think abstractly, deviate from routine, and empathize, interact and communicate with others is impaired, yet he's capable of incredible feats of memorization and mental calculation. Besides being able to effortlessly multiply and divide huge sums in his head with the speed and accuracy of a computer, Tammet, the subject of the 2005 documentary Brainman, learned Icelandic in a single week and recited the number pi up to the 22,514th digit, breaking the European record. He also experiences synesthesia, an unusual neurological syndrome that enables him to experience numbers and words as "shapes, colors, textures and motions." Tammet traces his life from a frustrating, withdrawn childhood and adolescence to his adult achievements, which include teaching in Lithuania, achieving financial independence with an educational Web site and sustaining a long-term romantic relationship. As one of only about 50 people living today with synesthesia and autism, Tammet's condition is intriguing to researchers; his ability to express himself clearly and with a surprisingly engaging tone (given his symptoms) makes for an account that will intrigue others as well.

Born On A Blue Day: Inside the Extraordinary Mind of an Autistic Savant

This is the first history of public health surveillance in the United States to span more than a century of conflict and controversy. The practice of reporting the names of those with disease to health authorities inevitably poses questions about the interplay between the imperative to control threats to the public's health and legal and ethical concerns about privacy. Authors Amy L. Fairchild, Ronald Bayer, and James Colgrove situate the tension inherent in public health surveillance in a broad social and political context and show how the changing meaning and significance of privacy have marked the politics and practice of surveillance since the end of the nineteenth century.

Searching Eyes: Privacy, the State, and Disease Surveillance in America