The Baycrest Center for Geriatric Care in Ontario, Canada has published the strongest evidence yet that a smartphone training program specifically designed for individuals with memory impairment, can result in “robust” improvements in day-to-day functioning, and boost independence and confidence levels.

“The goal of our study was to demonstrate the generalizability of our training protocol to a larger number of individuals with moderate-to-severe memory impairment,” said Dr. Eva Svoboda, a clinical neuropsychologist in the Neuropsychology and Cognitive Health Program at Baycrest, and lead author of the study.

“Our findings demonstrate that it is possible to harness powerful emerging technologies with brain science in an innovative way to give people with a range of memory deficits some of their independence back.”

Memory impairment, particularly when it is severe, can impact virtually all aspects of everyday life. Individuals are unable to readily acquire new information making it difficult or impossible to keep appointments and stay on top of changing personal, social and occupational responsibilities.

Two decades ago, Baycrest pioneered a theory-driven training program that tapped into preserved implicit memory systems in people with amnesia to teach them to use assistive memory devices. Implicit or procedural memory is a type of memory that supports learning but does not require conscious executive control. Common examples of this type of memory include riding a bicycle or brushing one’s teeth which doesn’t require conscious remembering of where the procedure was learned in order to perform it.

Commercial technologies such as smartphones and other mobile electronic devices have immense potential for individuals with memory impairment as they offer high storage capacity, auditory and vibration alerts, rich multimedia capability and high user acceptability.

The Baycrest study involved 10 outpatients, 18 to 55 years of age, who had moderate-to-severe memory impairment, the result of non-neurodegenerative conditions including ruptured aneurysm, stroke, tumor, epilepsy, closed-head injury, or anoxia (insufficient oxygen to the brain) after a heart attack.

Participants completed two phases of training on either a smartphone or another personal digital assistant (PDA) device. Prior to the training, all participants reported difficulty in day-to-day functioning. Some required ongoing supervision and regular assistance from family members due to their forgetting to pay bills, take medications or attend appointments.

In the first phase, instructors from Baycrest’s Memory Link program taught participants the basic functions of their device, using an errorless fading of cues training method that tapped into their preserved implicit /procedural memory. Each participant received several one-hour training sessions to learn calendaring skills such as inputting appointments and reminders.

In the second phase, participants took the device home to apply their newly-acquired calendaring skills in real-life situations. This included setting alarm reminders to take medications and attend future appointments, charging the device, and remembering to keep the device with them at all times. They also learned how to use other software functions, such as phone, contacts, and camera.

As part of the outcome measures, participants were given a schedule of 10 phone calls to complete over a two-week period at different times of the day – to closely approximate real life commitments. Family members who lived with participants kept a behavioural memory log of whether real-life tasks were successfully completed or not by their relative. Participants and family members completed a “memory mistakes” questionnaire which involved rating a list of common memory mistakes on a frequency-of-occurrence scale, ranging from “never” to “all the time”.

Participants and family also completed two additional questionnaires. One measured confidence in the participant when dealing with various memory-demanding scenarios (e.g. dentist calls to change appointment dates). The other examined the participant’s use of the device to support traveling back in time (e.g. searching activities and events from preceding days, weeks and months), traveling forward in time (e.g. planning ahead, entering future events and appointments), and technical ease of use of the device.

All 10 individuals showed “robust increases” in day-to-day memory functioning after taking the training, based on results from the functional and questionnaire-based measures. Participants continued to report benefit from smartphone and PDA use in short-term follow-up three to eight months later.

“People whose depression is being treated by primary care doctors often don’t do very well, partly because patients don’t take their medications and partly because the doctors don’t follow up as frequently as they should to optimize the medication and dosage when necessary,” said psychologist David Mohr, director of the new Center for Behavioral Intervention Technologies and a professor of preventive medicine at Northwestern’s Feinberg School. “This pill dispenser addresses both issues.”

The bottle is part of a MedLink system, which will include a mobile app that monitors the patient’s depressive symptoms and any medication side effects and will provide tailored advice to manage problems. The information is then sent to the physician or health care provider with a recommendation, such as a change in the dose or drug, if necessary. The MedLink system also will be used to improve medication adherence in patients with schizophrenia and HIV.

“It’s a next-generation technology,” said Scripps Research Associate Professor Peter Kuhn, PhD, senior investigator of the new studies and primary inventor of the high-definition blood test. “It significantly boosts our ability to monitor, predict, and understand cancer progression, including metastasis, which is the major cause of death for cancer patients.”

Kuhn emphasizes that this basic setup can be easily modified with different cell-labeling and image-processing techniques.

Anything that can take the burden and frustration off of patients from the healthcare industry’s hardly navigable morass of bureaucracy and costliness is a welcome change. Building on existing offerings from both companies, Microsoft and GE believe that they can ultimately improve the quality of healthcare given to patients. Quoted from Microsoft’s press release, Jeffrey R. Immelt, chairman and CEO of GE, explained the goals of the partnership:

The complementary nature of GE Healthcare’s and Microsoft’s individual expertise will drive new insights, solutions and efficiencies to further advance the two companies’ shared vision of a connected, patient-centric healthcare system. The global healthcare challenges of access, cost and quality of care delivery are creating a new focus on the performance and accountability of healthcare delivery systems — in every country, at every level of care. This venture will demonstrate what is possible when leading companies with complementary capabilities work together to meet a common goal.

Microsoft CEO Steve Ballmer added:

High-quality, affordable healthcare is one of the biggest challenges facing every nation, but it’s also an area where technology can make a huge difference. Combining Microsoft’s open, interoperable health platforms and software expertise with GE’s experience and healthcare solutions will create exciting opportunities for patients and healthcare providers alike. Working together, GE and Microsoft can help make healthcare systems more intelligent and cost efficient while improving patient care.

Some of the platforms planned by the joint venture is a software suite that will include Microsoft Amalga, Microsoft Vergence, Microsoft expreSSO, GE Healthcare eHealth, and GE Healthcare Qualibiria. The two companies hope that their endeavor will address many of the problems they have identified in the current healthcare system, such as healthcare associated infections and chronic disease management. Michael J. Simpson, current vice president and general manager of GE Healthcare IT, will serve as the company’s CEO. The two companies also project that the venture will produce job growth within its first five years of existence.

Despite the fact that the new company has not yet been christened with a name, it is slated to launch sometime in the first half of 2012.

Do you think Google’s search results are better now? Tell us what you think.

While quality is often in the eye of the beholder, there are certain kinds of queries where the information being retrieved is simply more important than others. We’ve talked about this before, as it’s been a problem in some Google results.

One example we’ve looked at a few times is where an eHow article written by a freelance writer with no clear authority on cancer (and whose body of work includes a lot of plumbing-related articles) was ranking at the top of Googe’s results for the query “level 4 brain cancer” above numerous other sources that would seem to be of greater authority on such a subject.

In fact, the article did get bumped down after the Panda update, but it does still rank number 2, followed by another result from eHow. Granted, this is just one example, and Demand Media has efforts in motion to improve its own content quality, but you get the point.

Queries related to things like health or law demand authoritative advice. Not SEO’d content.

We had a conversation with Mark Britton, founder and CEO of Avvo about this subject. Avvo is a site that offers Q&A forums where consumers can ask medical or legal questions and get responses from qualified doctors and lawyers. It provides apparently authoritative content in these two areas from certified professionals.

This seems like the kind of content that should be ranking well for a lot of these types of queries. Does it not? Britton thinks it’s “very important” for commentary from experts in the medical and legal fields to surface high in search results for relevant topics.

“There is a lot of noise both online and offline regarding health and legal issues,” he tells us. “This comes in the form of lay people, professional commentators and even celebrities who often offer advice that is well-intentioned but inherently inferior to that of a doctor or lawyer trained in the area. However, it is not always easy to get doctors and lawyers to speak. Some still look down on the Internet as a publishing or marketing vehicle. Others just downright fear it, as they have seen too many movies where someone says something on the Internet and they are subsequently hunted and killed by terrorist hackers.”

“There is always room for improvement — especially with our newer pages,” he says of Avvo’s own search rankings. “We just launched our doctor ratings directory and our free medical question and answer forum in November, and it will take some time for those pages to rank as well as our legally related pages.”

Look at the results for a query like “Does type 2 diabetes shorten life expectancy?” Avvo’s page on the subject ranks on the second page, while eHow ranks at the top of the first. The Avvo result has actually fallen since I began writing this article. It used to be right below the number one result from eHow and the number 2 from Yahoo Answers.

eHow’s is an article (not very long by any means) by a guy whose bio says he “has been a freelance writer since 2007. He writes extensively in the fitness, mental health and travel sectors and his work has appeared in a range of print and online publications including Scazu Fitness and USAToday Travel Tips…[and] holds a Master of Arts in community psychology.”

Keep in mind that USA Today has a deal with Demand Media for travel tips. So that presumably means his Demand Media content is simply published by USA Today. Does “Master of Arts in community psychology” indicate more authority to answer a life/death question about type 2 diabetes than say a licensed and practicing MD? That’s who provided an answer on Avvo’s page, which just got pushed further down in the search results.

If you change the query to something simpler like “type 2 diabetes life expectancy” eHow still ranks close to the top, and Avvo’s result slips to….get ready for it….page 18! That’s with various articles from places like eHow, EzineArticles and Suite101 (all victims of the Panda update) ranking ahead of it. Now, I’m not saying that Avvo’s result is necessarily the one ultimate result for this query and should necessarily be the highest ranked, but come on. Interestingly enough, the result was on page 3 for this query when I started writing the article (yesterday) and it’s slipped that much further into obscurity just since then. I wonder where it will be in another day.

Google has given publishers a list of questions to ask themselves about their content, as guidelines the company goes by as it writes its algorithms. The very top one is “Would you trust the information presented in this article?”

While neither of the articles provide any helpful links to sources of information, the Avvo article comes from a medical doctor. I think most people would find that slightly more trustworthy, even if the article isn’t as long or as well SEO’d. Here’s the eHow article. Here’s the Avvo one.

The second question on Google’s list is, “Is this article written by an expert or enthusiast who knows the topic well, or is it more shallow in nature?”

While Google makes it clear that these questions aren’t actual ranking signals, they must be used to determine the signals at least, and you have to wonder just how much weight authority on a topic carries.

Britton maintains that ALL of the site’s advice comes from qualified professionals, claiming that this is one of the site’s “greatest differentiators.”

“We CERTIFY every doctor and lawyer offering free advice on the site in two principle ways: First, we verify with the state licensing authorities that the answering doctors or lawyers are licensed and in good standing,” he explains. “Second, we rate the professionals from 1 (“Extreme Caution”) to 10 (“Superb”), which was unheard of prior to Avvo’s entry into the professional ratings arena. We are big believers that not every doctor or lawyer is ‘Super’ or ‘Best’ which was the steady-state in professional ratings for decades.”

“This was really just an extension of the Yellow Pages model, where the ‘recommended’ professional is the one paying the most money to advertise,” he continues. “But consumers are getting wise and demanding greater transparency regarding the qualifications of their doctors and lawyers.”

“We have three ratings that speak to the expertise of our contributors: The Avvo Rating, client/patient ratings and peer endorsements,” says Britton. “For the Avvo Rating, we start with the state licensing authorities and collect all the information we can regarding a professional. We then load that information into our proprietary web crawler, which we call ‘Hoover.’ Hoover goes out and finds all the additional information it can regarding the professional. We match the licensing data with the Hoover data and then we score it. The scoring is based on those indicators of the professional’s reputation, experience and quality of work.”

Britton says Avvo was not really affected by Google’s Panda update. “We saw a small dip, but things came back fairly quickly.”

“While I understand the intent of Google’s latest update, I’m not sure they entirely hit their mark,” he says. “We noticed a number of pure lead-generation sites – i.e., sites that are selling leads to the highest bidder — jump ahead of us in certain key terms, which is not good for consumers.”

Avvo encourages people to ask questions on the site, claiming it its Q&A boasts a 97% response rate.

Avvo asked us to let readers know that in support of Skin Awareness Month, it is donating $5 to the Melanoma Research Foundation for every doctor review during the month of May.

Should authority and certification of expertise carry greater weight in Google’s search rankings? Comment here.

This means if you keep your profile up to date with any medication and medical history, you can share it with your loved ones so they can answer questions for doctors or other medical professionals in times of emergency.

For example, "Just a few years ago, my father suffered a minor heart attack and was sent to the ER," explains Product Management Director Sameer Samat on the Google Blog. "I arrived on the scene in a panic, and was asked what medications he was taking. To my surprise, I had no clue. If my father had a Google Health account, and had shared his profile with me, I would have been up-to-date on his current medications."

When you share your profile, it sends the email addresses you specify a link to your profile. Only users with said email addresses will be able to view the profile. In other words, if they forward it to someone else, it won’t work. If you are concerned about the safety of your info, here are some things to keep in mind:

- The link to view your profile expires after 30 days

- Viewers can only see (not edit) your profile

- You can review a user activity report to see who has viewed your profile

Google has also added a printing option for your Google Health Profile. A hard copy might be of use for Doctors or relatives without computers, printers or Internet access. There is a convenient wallet format that prints the necessary information at the size of a little wallet-sized card.

Another new feature launched for Google Health is a graphing option, which can help users track trends in their health based on regular tests.

As usual Google is calling for feedback on the service. Samat says there is a lot more work to do. If you have suggestions for improvements or features, you might as well let Google know. If it’s a good enough idea, it could even play a role in saving lives in the future.

Sites like TauMed, Revolution Health, Kosmix RightHealth, and Microsoft’s HealthVault came into existence to address what some see as a growing need for centralized and portable health information. Google aspired to do more, ambitiously aiming for a much broader reach into medical records.

We may finally get a look at what’s been happening at Google Health. The service experienced some drama when its leader, Adam Bosworth, ditched Google in favor of a startup with similar health record aims. Since then, there has been little of substance about it beyond the occasional Marissa Mayer interview.

But with SMX West in full swing practically in Google’s backyard, it appears they will use the event to announce the opening of Google Health’s doors. The Wall Street Journal thinks so, claiming this will happen; Google did not comment.

They have a chicken or egg question to answer about the Google Health service. People will be invited to plug their health details into Google. In turn, Google will try to get healthcare providers and their myriad record keeping services to supply information about those patients.

The main idea focuses on having all the relevant health information, including treatments, prescriptions, and medical histories, in one place. This helps people who may be referred to specialist doctors or surgeons for assessments of conditions beyond what a general practitioner can determine.

Much has been made about the potential for accessing medical information in an emergency. The scenario of an unconscious patient being wheeled into an emergency room, someone who could benefit from one treatment over another due to pre-existing medical conditions, appeals to those who favor easily accessible histories.

The problem there comes from letting the doctors know such records for a patient exists. How would they be able to find this out from someone who’s unconscious and possibly without their ID on them?

That’s just one of many complexities a health record keeping service might face. The daunting task of assimilating patient data from healthcare professionals in multiple formats might be the most difficult, next to getting people to trust such a service.

Google Health will need to attract a lot of people willing to put their information in place. That way they can go to doctors and hospitals and say, look, all of these people want to be part of this, will you be part of it too?