Archive for 2009

Upcoming Conferences On Medicine 2.0 and Health 2.0

August 31, 2009

I have two presentations in the next two months at conferences full of great content.

  • Medicine 2.0 Congress in Toronto, September 17 and 18 – will be presenting on “Hospital Adoption of Medicine 2.0 – a Culture Shift” Twitter hashtag: #med2
  • Reshape 09 - Second Health 2.0 Conference: Healthcare Communication is Changing in Nijmegen, The Netherlands, October 12 & 13. Presenting as a keynote on Health 2.0 trends. Twitter account @Reshape09
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Cloud Computing Tops Gartner’s list

August 26, 2009

Gartner’s Hype Cycle for Emerging Technologies includes an evaluation of cloud computing. They view cloud computing as being at the Peak of Inflated Expectations. While companies look to the cloud for cost effective solutions, “The levels of hype around cloud computing in the IT industry are deafening, with every vendor expounding its cloud strategy…”
Another post on the Emerge Blog, sees cloud computing as a promise without hype noting three cloud based models:

  • Infrastructure-as-a-Service (IaaS)
  • Platform-as-a-Service (PaaS)
  • Software-as-a-Service (SaaS)

This is a helpful formulation especially since so many platforms are becoming available in the Cloud and specifically in health care: Google Health and Healthvault to mention just two. While there is still concern about security in cloud computing limiting its adoption in health care, these three models should be considered when talking about private and hybrid clouds more common in the future of health care.

Also of note is the expansion of cloud offerings from Amazon. Adoption of Amazon Web Services faces some barriers: “The single biggest barrier to enterprise adoption that exists today is the
reluctance to live with one foot in each of two worlds, the on-premise IT
infrastructure and the world of the cloud. What Amazon Virtual Private Cloud
aims to do is bridge those two worlds.”

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Hype Cycle for Web 2.0

August 19, 2009

Gartner Research has produced its latest white paper on their hype cycle for Web 2.0 technologies. The technology is moving beyond hype into maturity and real value, even transformational. Specifically they note: “we see a number of potentially transformational technologies that will hit the
mainstream in less than five years, including Web 2.0, cloud computing, Internet
TV, virtual worlds and service-oriented architecture (SOA).”
Surprisingly, they see Twitter  and Microblogging have peaked in the hype and will move toward some disillusionment.  ReadWriteWeb is of the opinion that “Gartner may be underestimating the impact of microblogging.”
They note on cloud computing that the hype from vendors has increased (“Deafening”) which may “cloud” the real potential benefit of this transformation. Social Software Suites are also mentioned: “The movement from point tools to integrated suites has brought broader adoption
but also high expectations” which could lead to disillusionment. I wonder if Google Wave will meet or disappoint these expectations.
Health 2.0 is not mentioned. Will Gartner produce a hype cycle for Health 2.0?

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Public and Private Clouds – Health Information Exchange (HIE)

August 13, 2009

In healthcare, there has been hesitancy to consider cloud computing in spite of the promise of funding for electronic medical records and perhaps HIE.  The main issues in cloud computing and EMRs are security and availability. Security is governed by HIPAA including the upcoming regulations on data breaches. Security of EMRs and PHRs is also key in maintaining public trust in EMRs and by implication, medical practices. Availability is key as well as medical practices become dependent on real-time data from EMRs for medical decision making.

  • Can the cloud provide the security and availability/reliabity for EMRs?
  • Alternatively, are EMRs now becoming private clouds which can potentially interact with the public cloud, such as in the case of disease registries and public health initiatives?
  • Are Health Information Exchanges at type of private cloud or would it be helpful to redefine them as such?

Several recent articles give some insight into this issue:

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Simplifying the Complex: Healthcare Reform

August 11, 2009

As the debate heats up on healthcare reform, the Obama administration has now put out a Reality Check to counter the negative campaign against reform addressing both rational concerns like the benefits and burdens to small businesses and some irrational ones. Perhaps what is needed is a way to simplify the message of this complex reform without diluting it or dumbing it down. How about 10-12 areas of reform put into one document (aka, talking points), which summarize the key areas that the reform will take, such as,

  • access to insurance including removing exclusions for preexisting illness
  • consumer protection
  • healthcare IT including PHRs and Health 2.0 and meaningful use
  • cost controls
  • quality outcomes including comparative effectiveness
  • how it helps business and the economy

Such a document should include no buzz words or government 3 or 4 letter abbreviations, such as, ARRA. Some of this is already on the HealthReform.gov website but the President should try to break this down more consistently.

Finally, keep the patient at the center of healthcare reform – see this Health Populi post on the challenges.

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Health 1.0, Health 2.0, Health 3.0

July 30, 2009

In Health 1.0, the ePatient would search the Internet the night before a doctors visit for a serious illness and print out hundreds of pages and insist that the physician address each page.

In Health 2.0, the ePatient goes to to social networking sites to research how others made treatment decisions and coped with their illness. They securely email their physicians for second opinions, and checks the ratings of physicians and hospitals online.

In the future Health 3.0, the ePatient obtains their genetic profiles, sets up semantic agents to monitor for new treatments for the conditions their are at risk for and develops micro-communities of others with similar risk profiles. Health messages to manage the risk profile are delivered to a mobile device which also monitors blood pressure, blood sugar and other vital signs.
Question – where is the physician in Health 3.0?

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What is it Like to Receive Your Genetic Profile?

July 28, 2009

Now that online offerings for genetic testing is readily available, what is it like to order the test and then receive and open the results for the first time? Jen McCabe Gorman, the quintessential ePatient, shares her experience on YouTube as she opens her results from 23&Me. Here experience is filled with excitement, worry and questions – wondering who else in her family might have similar traits, what are the medical implications of mild tendencies, what are the implications for future medical treatment? This personal experience goes beyond anything you will find describing these online genetic testing.

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New Google Health Features

July 24, 2009

Google Health recently announced two new features: upload of scanned paper documents and recording of last wishes.  Uploading of documents provides a useful way to manage legacy paper documents during the transition to electronic records. Since most people still rely on paper records, this move makes sense as an interim solution.
Another scanned document type is advanced directives for which Google Health has partnered with Caring Connections. Advanced directives are important for anyone to have, especially those with advanced disease or entering the hospital. It will be helpful in the future if this could be sent to a hospital directly.
Google Health admits to the limitations of paper documents and the need to move beyond these.
The post is by Roni Zeiger, a physician, and

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The US Chief Technology Office Promotes Innovation

July 22, 2009

A few weeks ago I heard Aneesh Chopra speak at the Cleveland City Club (podcast available). He could easily be called the Chief Innovation Officer – he is looking for opportunities to make changes using existing technology in short term projects. Specifically,
“-Using information technology to transform the way government does business
-Foster private sector innovation
-Reduce administrative costs and errors through utilization of health IT
-Change the way teachers teach and students learn”

Two projects of note are Defense Solutions, a site to submit solutions to be funded by small grants and hear in 30 days, unheard of for government grants.
The other is Data.gov, which exposes existing government data sources for use by developers including raw data, tools and geodata. Part of his approach is to encourage developers in an open source model, to create new tools and mashups which add value.

He spoke today at the Open Government and Innovations Conference. Twitter feed here.

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In Defense of Writers

June 30, 2009

In the New Yorker this week, there is a review of Chris Anderson’s new book, “Free: The Future of a Radical Price”.  Anderson who is known for saying “information wants to be free” continues that theme in seeing all content, music, writing, etc. will be driven by economic forces to be free. He is reinforcing the death of newspapers and their need to find a new business model even if there is none to be had. His argument that the reduction in the cost of transistors and other technology allow for a great business opportunity to offer things for free.

While much of the Internet is free, especially content served up from newspapers to health care organizations, his proposal implying that all content should be free, devalues writers, whether medical writers, news reporters and editors and others. Granted the nature of intellectual property has changed in the Web 2.0 world but not so much as to obliterate the value of good writing and ideas. There is room today and in the future for this IP to be valued and paid for. While micropayments never took off on the web, let’s hope that some newspapers survive and find additional business models to stay alive.

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