Archive for June, 2010
Health 2.0 – a Double Dutch Treat
June 30, 2010
Lucien Engelen of Radboud University, Nijmegen, NL, and his team (Tom Van De Belt is the first author) have struck two goals in the world cup of Health 2.0. In the Journal of Medical Internet Research, they have published “Definition of Health 2.0 and Medicine 2.0: A Systematic Review.” This broad review of published literature and blogs included a post by me and many others. They note no consensus on these definitions but some recurring themes:
- Web 2.0/technology
- patients
- professionals
- social networking
- health information/content
- collaboration
- health care change.
The second publication is “A Little Booklet About Health 2.0“, originally available in Dutch, now in English for the Kindle, soon to have an English paper edition. This modest title provides a good introduction to Health 2.0 for beginners and those who may have concerns about venturing into this growing field. It is a quick read and dives right into the key topics, using the example of MyCareNet, an innovative interactive platform for IVF patients and providers and leads us to the concept of participatory healthcare and bringing in the patient’s perspective on service design.
These two publications demonstrate some of the growing Dutch leadership in Health 2.0 which will culminate in the Medicine 2.0 conference in Maastricht this November and the TEDxMaastricht program.
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Declining Marginal Returns of Complexity
June 21, 2010
Just completed the book The Collapse of Complex Societies by Joseph Tainter, an archeologist. The focus of the book is on civilizations like the Roman Empire and the Mayas but it made me wonder about the complexity of health care and whether we are at the point of declining marginal returns. It is apparent from the health care reform experience that competing stakeholders make any attempt at reform a complex and nearly impossible process. Clay Shirky wrote a blog post in April on The Collapse of Complex Business Models. Just like societies which become too complex to respond to major stressors. While I am not predicting the collapse of health care in the US but one must wonder whether some of the complexity could be simplified by the experience of other countries, such as, single payer systems and an emphasis on primary care (medical home). Would be interested in other opinions, especially from those who have read the book.
Share this:Curing Cancer Clinical Trials
June 17, 2010
The Institute of Medicine has issued another groundbreaking report, this time on cancer clinical trials. An editorial about the report in the New England Journal of Medicine titled, Cancer Clinical Trials — A Chronic but Curable Crisis, makes some bold statements, such as, “the program is bloated, cumbersome, inefficient.” Slow approval processes with multiple layers and poor recruitment levels are symptomatic.
Recommended changes include improving:
- the speed and efficiency of the design,
- launch, and conduct of trials;
- innovation in science and trial design;
- trial prioritization,selection, support, and completion; and
- incentives for patient and physician participation
The full IOM report lays out participation of key stakeholders, particularly patients and physicians. The emphasis on patient participation is strong and reminiscent of the e-Patient White Paper. While the concept of the Lethal Lag Time is not directly mentioned, the overtones can be heard. I recommend this report as key to the future of the conduct of clinical trials including innovative approaches.
Share this:Partnerships with Online Communities – The Long Tail
June 4, 2010
Chris Anderson in writing Long Tail: Why the Future of Business Is Selling Less of More, popularized this concept particularly in viewing markets in the wired world. How does it apply to health care? Probably in many ways. But specifically it came to mind in thinking about the relationship of provider organizations like hospitals and online communities. While many online communities may attract large numbers, for instance, in diabetes and breast cancer, many more condition specific communities are relatively small even though they may have a national or international scope. Gilles Frydman of ACOR recognized this early by encouraging the proliferation of online communities through his listserv.
Provider organizations are moving into social media but struggling to identify meaningful ways to connect with their patients through Facebook and Twitter. Perhaps the struggle has to do with a broad stroke strategy of trying to appeal to all comers. The real opportunity is in the Long Tail of small online communities who know the best hospitals, information sources, physicians for their disease or condition and talk to each other about it all the time. Certainly PatientsLikeMe.com has found this in the specialize community of ALS and others like it have found the value in the long tail. What about groups like Marfan Syndrome or others that fall under the umbrella of the National Organization of Rare Diseases (NORD). Specialist who treat these diseases in the long tail of healthcare have a unique opportunity to become online partners potentially contributing to blogs, social networks or listservs and inviting patients to post blogs about their experiences on the hospital’s blog or Facebook page. There are many possibilities to explore – meetups, suggestions for improving care – hope to see some take up this challenge.
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