Pillbox:Innovation - of the people,by the people, for the people<br />David Hale<br />National Library of Medicine<br />Na...
Open<br />data<br />Actionable<br />data<br />
Data Concepción<br />
pillbox.nlm.nih.gov<br />
Pillbox<br />
Mobile apps<br />
Pillbox by Phone<br />Voice-activated pill identification<br />
Thank you for calling Pillbox by Phone. Tell me one attribute you know about the pill.<br />Shape<br />Do you know anythin...
Summer 2011<br />Transformers 3<br />Final Harry Potter<br />Pillbox production launch<br />
NLM’s API Catalog<br />
NLM APIs and Web Services<br /><ul><li>AIDSinfo
Basic Local Alignment Search Tool (BLAST)
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2011 Health Data Initiative

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  • I am honored to be speaking to you this morning as I come from both a nursing and Navy family. I like to think that I am blending both of my parent’s careers. My first experience with a computer was a Commodore P.E.T. at the nursing home where my mother worked. My first practical use of Microsoft Excel was to make a supply room inventory management spreadsheet.
  • I mean this both in terms of pharmaceutical intervention AND the fact that none of these pills are labeled. The problem is, it’s not just consumers who have to manage this collection of meds.http://www.flickr.com/photos/silverlinedwinnebago/1405216080/
  • If I had a dime for every time I’ve heard one of these drug ID stories, I could probably help fund the Poison Centers that respond to thousands of drug ID calls every day. A couple walks into a physicians office. They have had to switch providers due to insurer and coverage changes. They carry a plastic bag holding the pills from the previous slide.http://www.flickr.com/photos/chikawatanabe/244315092/
  • While they wait, the staff must identify the meds and use them to work up a chart. This couple doesn’t have a EMR, EHR, or anything that ends in R.http://www.flickr.com/photos/thenationalguard/3840298584/
  • Here’s anther story. Talking with EMS providers in rural Oklahoma, I learned that they can spend as long as 45 minutes in the ambulance, each way, when making calls. There is no connectivity or cell service in many of these areas. They carry pocket drug ID books as their only medication reference.http://www.flickr.com/photos/foxwall/161356877/Ambulance Demo2001Paramedic Ben Abo (on stretcher) and EMT Damien Bougher demo the interior of the ambulance.
  • Poison Centers are inundated with drug ID calls, with over half coming from law enforcement. Continually living with the threat of budget cuts, or outright closure, Poison Centers struggle to meet this need.http://www.flickr.com/photos/icerunner/87382347/
  • Many of us care for family members and assist with medication adherence.http://www.flickr.com/photos/moregoodfoundation/5138623107/
  • When caring for our children, we are the entire adherence equation.http://www.flickr.com/photos/ransford/2331329787/
  • Many parents equip their cabinets with special locks to prevent children from opening them.http://www.flickr.com/photos/malweth/196058767/
  • Perhaps the most frightening scenario is when a child learns to open this cabinet.http://www.flickr.com/photos/mr_t_in_dc/3098648065/
  • Even for those who are informed and organized, medication management is a complex task. Search online or in the Apple or Google app stores for medication reminder and management tools. An entire industry has formed to serve these needs. The common thread in each of these stories is they each require medication identification and reference information.http://www.flickr.com/photos/thejaymo/4853212149/
  • Once you download the SPL you’ll run into a second problem. How do you know which labels are solid dosage medications? Once you find those, you’ll see that each label has between 1 and 4,000 lines of XML and contains multiple products. And there are two separate schemas in many of the labels, so you’ll have to know which schema to use. We also found there is no standardized nomenclature for chemical names in the labels.
  • http://www.flickr.com/photos/janeladeimagens/166051502/
  • http://www.flickr.com/photos/draconiansleet/275489550/
  • So we went to RxNorm, another freely available dataset, also from the NLM. It links medications by ingredient and product code, creating a controlled vocabulary AND connects branded products with generics. Again, availability wasn’t the issue. It was complexity and required expertise. Unless you double-majored in computer science and informatics, you don’t have much hope of using this data.
  • When we were finished, we had a table with 30 fields. Each unique product has its own record. Just what is needed for drug identification and reference. Instead of information, we now had an answer to a specific question. What is this med and where do I go for more information? But we were still missing product images.
  • NLM is focusing on more than just the Pillbox API. We’ve recently begun cataloging all of the APIs and web services available from the NLM.
  • We partnered with Florida A&amp;M University&apos;s College of Pharmacy and purchased 1,000 medications.
  • Remember I said CTO was a former video game designer? The camera is controlled wirelessly via a video game controller, giving the photographer intuitive control of multiple aspects of the camera.
  • The team spent 12 months photographing tablets and capsules, creating unique solutions to this type of photography, such as the elevated staging area shown here, to create standards and the methodology for creating Pillbox’s images. These images are of a quality suitable not only for visual identification, but also for research.
  • The result of this work is a set of amazingly high-quality product images. This image has been reduced in size to fit in this presentation.
  • Capsules presented unique challenges, such as reflections and specular highlights.
  • On the surface, Pillbox from the National Library of Medicine and the Food and Drug Administration is a medication identification and reference system. Users identify unknown medications based on their physical characteristics. They can search by imprint, shape, color, size, and scoring.
  • This is a Section 508-compliant, HTML version of Pillbox that does more than identify drugs based on physical characteristics. Users can search on drug names, both brand and generic, the manufacturer, and the inactive ingredients.
  • Today there are numerous iPhone applications that are using our data or API for drug identification and reference.
  • Long after the hack-a-thon, another programmer decided to continue developing the original code. Now there is even more open source code that developers can use to create applications based on Pillbox’s API. This all has happened because we open our data and allowed developers to play.
  • Probably the most innovative use of Pillbox’s API is not an app at all. It’sa voice-activated drug ID system. You call and a computer-generated voice asks you questions about the pill you’re trying to identify. You answer by speaking, and the system queries Pillbox in real-time. I’d like to play a recording of a call to Pillbox by Voice.
  • Pillbox by Phone was created by a sophomore at George Washington University in only three weeks. He had no previous Health IT experience. He’s now been hired by a large health information provider. I was told it was because they saw this demo.
  • NLM is focusing on more than just the Pillbox API. We’ve recently begun cataloging all of the APIs and web services available from the NLM.
  • The NLM API portal contains information and links to a wide variety of web services. This portal is a toolkit for Health IT developers wanting to create innovative applications and resources.
  • We’ve got everything from clinical trials to natural language processing tools to toxicology and environmental health information. You’ll notice PubMed/Entrez and MedlinePlus are also here.
  • I am honored to be speaking to you this morning as I come from both a nursing and Navy family. I like to think that I am blending both of my parent’s careers. My first experience with a computer was a Commodore P.E.T. at the nursing home where my mother worked. My first practical use of Microsoft Excel was to make a supply room inventory management spreadsheet.
  • 2011 Health Data Initiative

    1. 1. Pillbox:Innovation - of the people,by the people, for the people<br />David Hale<br />National Library of Medicine<br />National Institutes of Health<br />U.S. Department of Health and Human Services<br />david.hale@nih.gov<br />http://pillbox.nlm.nih.gov<br />
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    16. 16.
    17. 17. Open<br />data<br />Actionable<br />data<br />
    18. 18.
    19. 19. Data Concepción<br />
    20. 20.
    21. 21.
    22. 22.
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    24. 24.
    25. 25.
    26. 26. pillbox.nlm.nih.gov<br />
    27. 27.
    28. 28. Pillbox<br />
    29. 29.
    30. 30. Mobile apps<br />
    31. 31.
    32. 32. Pillbox by Phone<br />Voice-activated pill identification<br />
    33. 33. Thank you for calling Pillbox by Phone. Tell me one attribute you know about the pill.<br />Shape<br />Do you know anything else about the pill?<br />Color<br />Do you know anything else about the pill?<br />No<br />What shape is the pill?<br />Diamond<br />What color is the pill?<br />Grey<br />Your search matched one pill. Shall I list these results?<br />Yes<br />Epivir 300 MG oral tablet. <br />
    34. 34. Summer 2011<br />Transformers 3<br />Final Harry Potter<br />Pillbox production launch<br />
    35. 35. NLM’s API Catalog<br />
    36. 36.
    37. 37. NLM APIs and Web Services<br /><ul><li>AIDSinfo
    38. 38. Basic Local Alignment Search Tool (BLAST)
    39. 39. ChemSpell
    40. 40. ClinicalTrials.gov
    41. 41. DIRLINE
    42. 42. Entrez Programming Utilities (E-Utilities)
    43. 43. Genetics Home Reference
    44. 44. MedlinePlus Health Topics
    45. 45. MetaMap
    46. 46. Pillbox beta
    47. 47. PubChem Power User Gateway (PUG)
    48. 48. RxNorm
    49. 49. Semantic Knowledge Representation
    50. 50. TOXNET
    51. 51. UMLS
    52. 52. Voyager</li></li></ul><li>Pillbox:Innovation - of the people,by the people, for the people<br />David Hale<br />National Library of Medicine<br />National Institutes of Health<br />U.S. Department of Health and Human Services<br />david.hale@nih.gov<br />http://pillbox.nlm.nih.gov<br />

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