I have been doing quite a lot of work lately on setting up redundant network attached servers and cloud storage systems for what is now about 2TB of data. It has been increasingly clear to me that none of the systems I see would be adequate for the panacea that everyone thinks EMR’s are. I predict we are in for a huge wave of data security breeches at best and total data losses at worst. many docs using EMR’s I’ve seen have woefully inadequate data security and backup plans.
Just reported: another day, another privacy breach. New York-Presbyterian Hospital and Columbia University Medical Center “inadvertently” posted the personal information of about 6,800 patients–including names, clinical data and 10 social security numbers–online, reports the New York Times. While the breach was discovered in July (after a patient’s relative saw the information online), the hospital and medical center didn’t announce the problem until yesterday because of an ongoing investigation.
The personal information was accidentally placed on a server, but has since been removed, the hospital said in a statement.
During the breach, exposed data such as names, ages, surgical status, temperature and pulse became accessible to search engines, Myrna Manners, a NewYork-Presbyterian Hospital spokeswoman told the Times. Patient diagnoses were not disclosed, she noted.
I must say this is an example where the old taboo idea of “economic migration” would end it overnight. That is — have managed care simply make these tests not reimbursable (ie if you order the test the lab won’t be paid for it) and the use of these tests will end overnight. HOWEVER– just the opposite happens. Newly introduced tests of clear benefit languish for months or years (ie MIF/AMH in fertility) being refused by managed care and patients forced to pay out of pocked for them. Interestingly the old bad tests are relatively cheap and the new ones routinely more expensive.
According to the study, “given the current economic climate for medical practices, it is the responsibility of clinical laboratory directors … to review their test menu and … remove tests that do not provide clinical value to a particular medical practice, whether such testing is conducted in-house or sent to a reference laboratory.”
Think that’s bad– how about an old test that frequently gives incorrect false positive genital herpes results?
In fact, a recent paper in the American Journal of Obstetrics & Gynecology found that many US labs are using outdated genital herpes tests that often yield false-positive results.
“Commercially available herpes simplex virus antibody assays that were not glycoprotein-G based demonstrated high false-positive rates (14 percent-88 percent) for herpes simplex virus type-2 antibodies in sera that were positive for herpes simplex virus type-1 antibodies but negative for herpes simplex virus type-2 antibodies,” according to the paper. “Herpes simplex virus serologic testing should be performed with only glycoprotein-G–based tests.”
have just returned from the Maker Faire and have seen the future of medical device innovation, invention, and design– Self-design and rapid home prototyping. For those unfamiliar with the jargon basically technology now exists that can allow the creation of a working prototype of a device from idea to an actual working hand-held version in a physician-inventor’s own home. This has the potential to democratize the process and eliminate previous massive cost and technological barriers that kept the process inaccessible except to large industry or those with substantial capital resources.
One person I spoke with was calling this the Next Industrial Revolution. To me this is clearly the inevitable technological evolution of design and device innovation following in the exact path blazed by desktop publishing, digital video and computer based editing for movie creation to name just two examples. –And once again it is fueled by the exponential progress in computer power –here married to a fanatical base of innovators driving the creation of the raw tools that will be the assembly line of the future.
What is Maker Faire? Maker Fair just had its first NY exhibit and is an offshoot of Make magazine. MAKE brings the do-it-yourself mindset to all the technology in your life. Think of it as technology-hackers. Its like wood-shop for the 21st century hacker who is building his own radio controlled spy drone or augmented reality device instead of oven mitts and hotplate coasters. AS they write “this is a magazine that celebrates your right to tweak, hack, and bend any technology to your own will. For example, in our first volume, we show you how to get involved in Kite Aerial Photography, how to make a cheap but effective video camera stabilizer, and how to build a device that reads the hidden information stored on the magnetic stripes on all your credit cards.”
Homelab laser engraver/cutter. can carve any substance with laser power and precision. cuts out 3D models too.
But that’s just the beginning. The sophistication of the home creation kits is mind-blowing.
This is a beagleboard. It contains all the power of an entire computer. It was running what looked like a normal desktop with a video capture and object recognition on a version of linux. It costs less than $500 and can be the basis for home-made computer intelligent devices. All open source as well.
At the Faire take thousands of people with this mindset, demos, kits, and lessons to “celebrate arts, crafts, engineering, science projects and the Do-It-Yourself (DIY) mindset.” And as usual for my tech crossovers— add one doctor to the group.
What’s The Medical Significance? As usual I search out emerging technologies not yet used in medicine that have the potential to right now change how we do things. What’s struck me with all I saw was the common theme that anything that was a high tech machine now today can be imagined, designed, researched, 3D modeled, and turned into working prototype all in a home workshop on an inventor’s budget. What’s more this now applies to the physical aspects (ie plastic casing and movable parts) and to the electronics being them embedded operating systems or any myriad of sensors. The theme of the day was that you yourself can see these projects through to this stage and there is a thriving community and ground-swell of momentum to build a grass roots infrastructure to help.
Examples of 3D Prototyping/Desktop Manufacturing:
The left image is a makerbot — you build this machine and then it produces 3d models out of plastic from 3D images on you computer. You can anything from an action figure to a device handle to well– the middle images was made on a higher end system like that shown on the right. here the machine first modeled the bones then applied a tissue layer over it. The system right now can take any 3D dataset from an ultrasound MRI or CT scan and reconstruct 3D tissue or organ models. I’ll follow up in a later post how scientists are using such technologies to literally build artificial organs in the lab– they build the structure then seed it with living cells that create the organ. The maker bot replaces a $100,000 fabricator from a decade ago and costs under $1500– and its all open source.
Could You Cure a Disease With a Device Invention? Does Your Child Think He or She Could? You’d be Surprised? The New Inventor’s Mindset for the 21st Century. You probably grew up thinking devices of all sorts and especially electronics were otherworldly gizmos of incomprehensible complexity of design. The workings of a TV, video camera, or electronic medical diagnostic device where the stuff that only biomedical engineer with a pocket protector and a degree from MIT could have created. Your kids think otherwise. They are comfortable with technology and with programming computers when presented with understandable languages. They can make a webpage. They can edit video and retouch photos. They have a myspace page. They may tinker with remote control toys. Many of them with some practice can create 3D computer graphics. Just recently A Russian amateur filmmaker called Alexander Semenov produced this 2.5 minute bootleg Transformers short with a couple of sub-$1,000 cameras, two hours’ of footage and a month in the home desktop editing suite that many think rivals the effects of a million dollar Hollywood blockbuster.
Understand that the next generation of design and creation tools will use these same sorts of visual programming language and are just as accessible. I walked through the exhibits with a 6 and 9 year old. By the end of the day the 6 year old had soldered an LED lit circuit board to make an electronic toy (parts cost $1), both had piloted radio controlled robots complete with sensors, and had begun to design autonomous robotic creatures– and they had never done this before. I was recently asked to give a talk to a group of 4th graders working on the Lego First competition. This is a robotics competition for kids to build working devices. There are more than 10,000 teams competing this year. This year’s theme is biomedical research. They kids were instructed that they have the tools to invent a device that could solve a medical problem. They don’t believe only MIT engineers solve problems. They expect to. Remember who invented youtube and facebook.
home kit for sensor based mobile search and rescue bot. The same sophistication as a military robot and the same technology as in implantable body rovers being developed.
robotic arm prototype- could model prosthetics
home made kit for scanning tunneling microscope for research uses. A scanning tunneling microscope (STM) is a powerful instrument for imaging surfaces at the atomic level. Its development in 1981 earned its inventors the Nobel Prize in Physics in 1986. For an STM, good resolution is considered to be 0.1 nm lateral resolution and 0.01 nm depth resolution.With this resolution, individual atoms within materials are routinely imaged and manipulated. This is now a do-it-yourself kits for under $200 all open source design and technology
Screening all pregnant women for a rare but fatal genetic disease is too expensive, researchers say in a new report that adds to a recent controversy about whether genetic tests are worth the cost. The research is reported in the new issue of AMJOG and reported in summary here.
While scientists can already screen for SMA, allowing parents to seek an abortion or decide against having children, doctors are split on whether or not to recommend routine screening due to cost concerns.
The new study analysis comes to $5 million for each case of SMA avoided by prenatal screening- and decides its too expensive.
“We found it to be too expensive,” said Dr. Sarah Little of Massachusetts General Hospital, who worked on the study. She added that the value for money was a tiny fraction of what is generally considered acceptable by health economists.
While a genetic test for SMA costs just under $500, more than 12,500 women would have to be screened to prevent one case of SMA, which affects only about 1 in 10,000 newborns.The results bolster guidelines from the American College of Obstetricians and Gynecologists, which recommends that only parents with a family history of SMA get screened.
However, another professional association, the American College of Medical Genetics, was not impressed with the study, which was published in the American Journal of Obstetrics and Gynecology.
“They came to the wrong conclusion because they used the wrong tool to do the evaluation,” said Michael Watson, executive director of the American College of Medical Genetics, which recommends universal screening for SMA.The team used the standard method of calculating cost-effectiveness, which naturally favors screening for diseases such as cystic fibrosis in which patients live long lives and require expensive treatment.
When patients die young, in contrast, they don’t incur a lot of expenses, and so the dollar value of preventing such diseases is smaller. “It’s just not a practical approach,” said Watson, adding that “we could save a ton of money in the US if everybody died.” I have often pointed this out to those who criticize fertility care as being too expensive for the health care system. Cancer care and intensive care units are very expensive. If we only use cost effectiveness analysis then we would only offer preventive health, nutrition, smoking cessation, and vaccinations. Much more cost effective then treating elderly sick people!
As a fertility specialist I deal with the SMA genetic screening test on a daily basis. I advise all infertile couples of the existence of the test and the risks of being a carrier and having an affected child. As is the case with cystic fibrosis and fragile X most couples do want to be screened once they know the test exists. For those who test positive in both male and female some have chosen to have PGD where I test the embryo during IVF to see if it is affected and only replace those that are not. I have had couples use this test to successfully have a healthy child unaffected by SMA. Just recently I saw couples who came specifically for PGD having lost more than one child who died from SMA– and they were unaware that testing existed before.
This reminds of when a west coast state (think it was washington) used a cost effectiveness analysis to decide which medical treatments their public health insurance would cover. Treatments were ranked and they went down the list until the budget ran out. This system was very poorly received.
I hate to rock the boat but as advances in genetic diagnosis are exploding this problem is going to go through the roof. I can now test for far more genetic diseases than tests existed for 10 years ago. Using DNA chip technology I can now screen for over 200 diseases. Is this cost effective? Would you want to have it done? When I thought about having children I wanted to be tested for everything possible! Just last week I had a Yale student on a research elective with me. He could not believe we don’t universally screen everyone for everything possible–yet many patients don’t want any test not 100% needed. Others striving so hard to have a baby want to be tested for everything possible. As the number of diseases we can test for heads north of 1000 in the next years our ability to test has outpaced policy decisions and protocols of what should be done for the couple who never had a child. The bigger issue as we enter the future of Obama health care is where does genetic screening for low risk couples for diabling or fatal diseases (the ultimate preventative care) fit into the economic analysis. How much is too much? I guess it depends on who you ask and who’se paying…
I have just received a breaking news update from Astellas regarding risks of using their antibiotic Vitabiv in pregnant women. This is one of the most strongly worded warnings on use of an antibiotic in pregnancy I have seen recently. I received a generic warning update last week from the American College of Ob Gyn that “some warning regarding a drug in pregnancy” was coming today.
As the letter reads:
The purpose of this letter is to inform you of important safety information for VIBATIV™
(telavancin) for injection, a once-daily intravenous antibiotic indicated for the treatment of adult patients with complicated skin and skin structure infections (cSSSI) caused by susceptible isolates of the following organisms.
An informational program for healthcare providers has been established to help minimize the risks associated with the use of VIBATIV; the most important relates to the use of the product during pregnancy. Animal data indicate that use of VIBATIV during pregnancy is associated with reduced fetal weights and increased rates of digit and limb malformations in offspring, although these malformations were infrequent.
Women of child bearing potential should have a serum pregnancy test prior to administration
of VIBATIV. Patients should be counseled on the risks and benefits of VIBATIV. Consideration
should be given to using an alternative course of therapy, if a positive test result is obtained.
The use of VIBATIV should be avoided during pregnancy unless the potential benefit to the
patient outweighs the risk to the fetus. Women of childbearing potential (those who have not
had: complete absence of menses for at least 24 months or medically confirmed menopause,
medically confirmed primary ovarian failure, a history of hysterectomy, bilateral oophorectomy, or tubal ligation) should use effective contraception during VIBATIV therapy. Patients should be
instructed to notify their prescribing physician/healthcare provider if they become pregnant while taking VIBATIV. A pregnancy registry has been established to collect information about the effects of VIBATIV use during pregnancy. Physicians are encouraged to register pregnant patients, or pregnant women may enroll themselves in the pregnancy registry by calling 1-888-658-4228.
Olive Medicalhas developed a single use HD endoscopic camera system for surgical applications. Traditional endoscopic camera systems consist of a camera head with a coupler to attach it to the scope and a camera control unit. Camera head and control systems typically cost in the $30, 000 range. olive’s approach is to make the camera had single use and delivered in a sterile peel pack ready for the operating room. They intend to deliver such a system at under $300 per case — less than 1% of a current cost to purchase a system. What’s more the system is native HD at up to 1080 resolution. I had a chance to speak with them about the system and they claim they are using a native HD imaging sensor chip. if so, they would be the first surgical camera system to do so. All other HD systems available today do not natively sense in 1080 but rather employ post imaging processing to upscale and modify the image. Their camera unit also includes integrated still image capture software eliminating the need for yet another $10,000-$30,000 box – although with obviously less features (no video, printer, etc). Their fulls specs include :
Full 1080p Video Output
2 DVI and 2 HDMI Outputs
Touch Screen LCD Interface
Integrated Storage of 40 Images
Following the disposable razor model, they would provide the camera control box to the facility for minimal (or no cost) and camera heads would be purchased per use. Following the green bandwagon they intend to accept the cameras back after use for reprocessing. Of course the obvious thought would be for a facility to just buy a few $300 cameras and use them over and over again. They have addressed this issue with some novel patented software that recognizes if the unit is shut off and watches and limits use until its factory reset. The team at Olive includes several ex-stryker hardware and software engineers so they know the traditional market well.
The idea of disposable systems is not new. Over the years I have seen many disposable laparoscopes and hysteroscopes and even limited use imaging systems. Many years ago I presented at the AAGL conference the first ever fully digital scope with a cmos image sensor and LED illumination. At that time I predicted that such a set up by eliminated camera control and illumination box requirements would enable the entire thing to become wireless and disposable. More recently more recently an Italian group wrote about such a disposable system viewed through a PC that achieved only VGA resolution. Olive has upped the ante by designing something at a fraction of the cost at true HD definition! They have some video on their website but its not labeled which one is recorded with which camera so I can’t link here yet.
This is a totally logical progression as Moore’s law gets applied to medical imaging in the OR. Chip fabrication follows Moore’s Law with dropping cost and doubling performance every 2 years. The expensive parts of these systems are now basically computer chips and related hardware. Therefore as technology accelerates we’ll see exponential advances in performance and miniaturization for lower costs. Given Imaging and others have produced disposable self-contained pill-cams that have a low cost cmos chip and LED illumination in a swallowable capsule. Chip CMOS sensors with integrated processing leverages consumer-based electronic technology advances (and economies of scale) as well as trickle-down military imaging technology. HD (and beyond) sensors are going to get very cheap in the future for these markets- not to mention the demand for real time HD video imaging on cell-phone cameras as wireless bandwidth goes beyonf 3G. The sensors really are basically the same.
The unit is not yet FDA approved. While I have seen videos I have not yet had he unit in a live lab evaluation so the final grading will ultimately rest of real world image quality, resolution, color fIdelity, and light sensitivity. I know several of the major traditional manufacturers have seen the unit. I can only imagine them buying to squash it. Such a low cost device certainly does not fit in with the traditional low volume high cost + service contract scope camera model used today.
What’s the Sensor?–They obviously would not verify to me the sensor inside the unit– no company ever does. I usually find out once the camera is released and a competitor cuts one open and sends me detailed photos and spec sheets. I did do some hunting around and was able to verify there are now American company produced CMOS imaging chips natively 1080p60. They make a standard 2/3 inch chip imaging max at 2112 x 1188. The ones I saw are 2.1-2.5 megapixel. The same fabricators also produce a 1/3 inch version. Researching this i got quite excited about he prospects for using these chips for consumer electronics in ultra-low cost HD camcorder/still devices. Flipvideo has some competition coming!
Such a device if the quality and reliability is there could be very attractive to many facilities battling down time service and sterilization issues. This could enable higher throughput in the OR with less capital outlay and lower manpower. The other (even larger in my opinion) potential market is office-based facilities which now primarily bag or high level disinfect such systems. This would be a very attractive alternative for them. Until now capital equipment requirements have been a barrier to entry for many doctor’s (and vet) offices. Ob Gyn , urology, orthopedics, ENT, general surgery, ICU’s and the ER among others are specialties are those where there is currently a significant application for imaging in the non-OR setting. This low cost idea is not alone- several companies have introduced low cost integrated camera-view- display units based on cmos- such as the tower-free hysteroscopy system with LED LCD screen and CMOS. The difference with Olive’s approach is single use eliminates the sterilization costs and they are offereing it for less than 10% of the cost of even the ultra-low cost systems coming out. Just look at the price of computer LCD panels and HD camcorders (10% where they were recently) and you can appreciate the technology price advances pushing this model.
Don’t underestimate the difficulty of sterilization. While many current ystems are labelled as autoclavable most facilities have found that significantly reduces the lifespan. In january the FDA shut down the use of one of the most common OR scope-camera disinfection systems from Steris used in 23,000 sites. This whole issue is a subject of an upcoming post but basically the FDA said Steris made too many changes since approval of the device– so it not the same device anymore and shut the thing down! While the issue is being resolved it has been a nightmare for case preparation and opens up the reexamination of sterilization. Up until now disposable of resposable systems have not been attractive because they were priced at >10% of system costs. Now Olive is getting to the <1% price point – and that’s a different story.
You might recognize Jeff who was recently featured on ABC’s Shark Tank where he turned down the shark’s offer of $500,000 for his guitar idea. In the podcast we discussed the unique opportunities and challenges of medical device development- and innovation in general.
I was immediately struck by Jeff’s unique perspective and vision when I met him. He has innovated in so many different areas and has successfully partnered with physician inventors for blockbuster devices.
Topics We Cover in the Podcast:
What’s unique about medical device development and how the potential returns differ from other industries
Advice for the physician/inventor where to go with your idea–pitfalls, how to protect your intellectual property and how to partner and start a company
Is your idea good enough to form a company?
The dangers of big companies and the opportunities of start-ups
All you need is a fantastic idea and where to go from there
What to look for in a business partner
What’s similar between innovation in any industry-medical, music publishing, and internet?
What is the unique opportunity in today economic climate?
Hope you enjoy and get inspired… All you need is a great idea– and as Jeff says- I believe everyone has one.
You can listen to the podcast below or download it in 3 versions — a single file or split into part 1 and 2.
I received this comunication from the American Society for Reproductive Medicine
MEETING ANNOUNCEMENT —The Adequacy of Assisted Reproductive Technology Oversight
Monday, December 14, 2009
8:30 am – 3:00 pm
Mandarin Oriental Hotel
Washington, DC
Given the rather high profile incidents in infertility therapies that came to light in 2009, the leaders in reproductive medicine are asking questions about how best to prevent such incidents from occurring again. While little factual information is available on the specific incidents, we can and should assess where general oversight of the field is, and seek ways to improve it, if necessary
Accordingly the American Society for Reproductive Medicine is convening a meeting in Washington, DC to gather input on this important topic. Information will be exchanged between government agencies, patients, physicians, leading academic experts, and others.
Featured speakers will include:
Maurizio Macaluso, MD, DrPH, Centers for Disease Control and Prevention
James Goldfarb, MD, President, Society for Assisted Reproductive Technology
Jake Mayer, PhD, the Jones Institute, Eastern Virginia Medical School
Stuart S. Howards, MD, American Board of Urology
Barbara Collura, RESOLVE, The National Infertility Association
6 Steps to get more accurate medical diagnoseswas just printed by US News and World Reports along with Newsday. I was interviewed for this segment and asked to share some of the methods I developed and use to deliver the best possible results for my patients with infertility at Gold Coast IVF in Syosset, NY. I provided tip # 1 — don’t assume just because you have been given a diagnosis that it’s complete or accurate and make sure you have a chance to share all the details of what’s happening to you with the doctor. This is the most vital step to start the diagnostic process to help maximize results.
Thea article describes an all too common problem I see in fertility treatments (and medicine in general) - doctors who jump to conclusions and make diagnoses based on assumptions rather than facts- and then lead the patient down treatment paths that may not be optimal – or even correct!
The article goes on to say some doctors mistakenly decide in 18 seconds! I usually spend more than an hour with a new infertility patient asking and listening to determine exactly what the potential issues are. Unfortunately the article says some decide in just 18 seconds.
My Threshold First Step – Make sure you can tell your whole story- insist on an accurate diagnosis before treatments begin. As it states in the article:
If your doctor appears to be in a rush and interrupts frequently, you’re at greater risk of being misdiagnosed. “Don’t assume that just because someone has given you a diagnosis that it’s necessarily accurate and complete,” says Dr. Steven Palter, medical and scientific director of Gold Coast IVF of Syosset, a reproductive medicine and surgery center. “The patient should communicate to the physician all of their concerns and symptoms. . . . There’s rarely only one treatment option, so the patient should ask what are the risks and benefits, and what options does the doctor have experience with and what they don’t.”
The Six Steps:
Make sure you can tell your whole story
Ask your doctor three questionsafter he or she comes up with a possible diagnosis
BREAKING NEWS: First description- full free slideshow with audio of project and podcast
I am honored to share with you on docinthemachine.com my Presidential Report from the CGE of the launch of the Center of Excellence Program of the AAGL CGE. With 38 years leadership in Gyn Minimally Invasive Surgery the AAGL is uniquely qualified to share its educational mission by verifying those Centers that meet these standards.
The AAGL Global Society for Gynecologic Minimally Invasive Surgery Launches Center of Excellence in Minimally Invasive Gynecologic Surgery Program at Annual Meeting November 16-20, 2009 in Orlando, Florida —dedicated to establish and verify standards at surgical facilities and hospitals.
(click green play arrow to hear presentation audio and automatically advance slides)
The primary objective of the AAGL and its professional interest partner the Council of Gynecologic Endoscopy (CGE) is to promote the adoption of minimally invasive gynecologic surgery with its reduced morbidity, shorter post-operative recovery time, less invasiveness, and reduced costs.
OurAnalysis of patient and provider needs worldwide showed that there are widely divergent qualities of practice and that patients and providers have difficulty in identifying excellence. There is a lack of national standards to improve outcomes. While payors seek to control costs/outcomes patients lack access to the educational resources to direct them to the appropriate center to meet their needs in many cases. As I stated in my address:
We recognize in the modern era of health care we have a unique opportunity as well as an obligation to use our educational resources and multidisciplinary expertise to help promote those systems and procedure which can improve patient outcomes in women’s health while reducing costs to both patient, payor, and society as a whole.
The CGE has therefore launched two new programs to address these needs.
First is an individual registry of physicians based upon peer review of operative experience and complications. The CGE, founded in 1996 has over 1100 individual gyn surgeons who have meet its standards. The new program integrates an evaluation based on today’s complexity of procedures in minimally invasive surgery. It is a tiered system with 3 levels of practice (based on procedure complexity) and 4 areas of proactive experience and specialization (General Gynecology Procedures, Fertility Enhancement Surgery Procedures, Repair of Pelvic Floor Defects & Urogynecology Procedures, Gynecologic Oncology Procedures)
Second is a Center of Excellence Program In Minimally Invasive Gyn Surgery. This is in recognition of the modern notion that to achieve best-in classs surgical outcomes requires not only an expert surgeon, but an integrated multidisciplinary surgical facility with systems and procedures in place to maximize quality cost effective safe outcomes for patients.
9 Requirements: Areas of Review To Qualify as a COEMIG:
Institutional Commitment to MIGS
Director of Division
Medical Staff Physician Qualifications
-Dedicated Educational Program
-Formalized Credentialing Guidelines & Systems to Introduce New Procedures
-Procedures for Minimizing Complications
Sufficient Experience with Procedures
A Full Complement of required Non-Surgeon Consultative Staff
Ancillary Staff
-Dedicated Team-Based Concept
-Dedicated non-physician Educational Program
Equipment Guidelines
-Availability & maintenance
Treatment pathways
-Linked to Peer reviewed Practice Guidelines
HIPAA Compliant prospective Outcomes Data Tracking
In my presentation launching this program at the AAGL annual meeting I shared
The AAGL is extremely excited and totally committed to the concept of Gynecologic Minimally Invasive Surgery Centers of Excellence. It represents a unified vision for women’s health that integrates our entire educational mission and expertise over the past 38 years.
First Ever Global Opportunity for Standards of Excellence:I was equally excited to present the concept to the Affiliated Societies of the AAGL which is made of representatives of National Minimally Invasive Gyn Societies from around the World. Our dedication to this concept and recognition of its value was shared by representatives of Partner Societies from South America, Europe, and Asia. We agreed to work together collaboratively to establish a shared Global Standard and to establish a shared program to advance Women’s health under the AAGL CGE COEMIGS program in cooperation with each Nation’s Society.
I will share further details of the program with you here as they are released!
This is a beagleboard. It contains all the power of an entire computer. It was running what looked like a normal desktop with a video capture and object recognition on a version of linux. It costs less than $500 and can be the basis for home-made computer intelligent devices. All open source as well.
