Archive for April, 2011

The Rise of Social Media & Participatory Medicine

April 28, 2011

Read my latest iHealthbeat Perspective on this topic. The rise of the ePatient feeds off of social media tools.

Two points I would like to reinforce:

  • every patient with a chronic or life-threatening condition is a member of an online community – they just need to join
  • social media sites are become a routine source of information on managing one’s disease and engaging one’s physician.

The members of the Society for Participatory Medicine are taking the lead in this area. To read a more extensive treatment, read the e-Patient Whitepaper and the works of Susanna Fox, Jane Sarasohn-Kahn and others. This movement is very dynamic and making strides into the practice of medicine.

This opinion piece was inspired by attending TEDxMaastricht – the videos tell the story of how social media technology is enabling participatory medicine.

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Adoption of PHRs – Where are we going?

April 22, 2011

Two recent articles on PHR adoption caught my attention this week:

  • From ComputerWorld -Consumers remain wary of personal health records – reporting on the IDC survey which shows that 23.4% reported that they were somewhat comfortable or very comfortable with Google or Microsoft collecting their health information. 28% of the respondents indicated that they would use a PHR system if their physician recommended doing so. 10% indicated that they did not use one because of infrequent need for medical care and 10% indicated they did not trust the security of Internet sites.
  • Can genomics encourage use of personal health records? An extended report from a presentation by John Halamka about PHRs and genomics. He notes two things that will drive PHR adoption:
    1) health plans that require more patient interaction and shared decision-making with the provider
    2)  features such as the ability to securely email physicians, pay bills, refill prescriptions, get specialist referrals and make appointments, that is PHRs tethered to EHRs will be the consumer’s preference. He also sees a future opportunity to integrate personal genomics into PHRs. He talks about his own experience with personal genomics.

Based on these two articles, there is reason for optimism about growth in adoption of PHRs but may be conservative growth. Drivers of that growth will be: recommendation by providers (participatory medicine), tethered to an EHR so much of the data is already there, and being future rich.

Two additional features I think will be useful for patients are: connection with social media (such as, sharing one’s data selectively with private disease and condition communities, such as, organizedwisdom.com or patientslikeme.com) and connection with wellness apps and mobile devices both of which are offered by Google Health and Microsoft HealthVault).

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Book Review: Data Source Handbook

April 19, 2011

Data Source HandbookThis new book from O’Reilly Media, written by a former Apple engineer, Pete Warden, is a catalog of code for connecting to publicly available APIs for all kinds of sites. It shows data sources by websites (whois, delicious), people by email (Amazon, FriendFeed), people by name (white pages, LinkedIn), search terms (Bing, Google), location (Google geocoding, US census), companies, IP addresses, books, films, music, products.

The brief reviews and code for each source includes those which use REST/JSON, YQL and other languages.

Overall the book is a very practical guide for programmers wanting to integrate public data into their websites or creating mashups. However, the book lacks any data sources related to health although many existing on the web from PubMed to ClinicalTrials.gov.

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Prevention and Lifestyle Changes – Potential for Health Care Reform

April 19, 2011

Dean Ornish

Dean Ornish

Today I heard Dean Ornish speak and came aware more convinced that prevention of disease through lifestyle changes can have a major impact on the future of health. Particularly, the potential impact on the epidemic of diabetes in the US is huge. We all have heard about how more and more of our population is becoming obese and the subsequent increase in diabetes and metabolic syndrome. If lifestyle changes can prevent even 10 or 20 percent of the progression to these serious conditions, imaging the impact on quality of life, work productivity and healthcare costs. This Thursday, Cleveland Clinic and Slate magazine will co-host a summit on Childhood Obesity.

Not only that, but he notes research on his website, Preventive Medicine Research Institute, that there is a potential impact on cancer and telomerase activity.

On a related note, a new interview with Daniel Kraft is posted on the TEDxMaastricht website. He talks about how mobile apps are just beginning to become available and used for lifestyle change but predicts that access to medical records and other patient empowerment tools will become common.

How can we get the word out, shift from unhealthy foods and lifestyles and move toward a healthier country?

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Appropriate Use of Social Media in Healthcare Organizations

April 14, 2011

A question during a presentation on social media in healthcare about the appropriate use of social media in patient care areas. Social media can be an effective tool for engaging patients online. But what about the use of social media in patient care areas. Should nurses, physicians and other healthcare providers be online interacting with colleagues or family during active patient care? With busy clinics and busier hospital units and greater concern about patient safety, is there time for what administrators might view as a distraction? Would you want your nurse to be updating Facebook while you are waiting for post-op pain medication? Yet there may be some advantages to direct caregivers utilizing social media. How about the oncology nurse interacting with the cancer patient discharged last week? Or nurses within a hospital exchanging ideas about improving patient safety? Yet stories of abusive use of social media in health care persist.

Clear answers are  hard to come by. Each hospital will need to develop its own policy and implementation of that policy in the use of social media in patient care environments. But when face time with the patient is the highest priority, social media may need to take a back seat.

Slides are here:

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How about a Motivation App?

April 12, 2011

There is some evidence that although there may be a lot of downloads of health related apps to smart phones, they are underutilized. Especially apps for diets, food monitoring, exercise and walking.  Is this a usability problem or lack of complete features?

At one of the breaks during TEDxMaastricht, I had the idea that it may come down to what motivates each person individually. Are you motivated by some kind of rewards (financial or “chance to win…”) or by a social network or by being able to chart your results or receiving regular reminders, etc. What about a chance to win coupons (Groupon integration)?

What about developing an app which would take you through a series of questions to understand what motivates you to exercise or watch what you eat and then matches you with the apps which provide these types of motivations.

If anyone knows of such an app or is developing one, let me know.  If you develop one based on this post, give me some credit. Thanks.

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TEDxMaastricht – Hope in technology and participatory medicine

April 7, 2011

MaastrichtApril 4 in Maastricht, Netherlands, was an event full of optimism but not simply about how technology can transform healthcare.  Lucien Engelen envisioned this conference as about health, not healthcare and full participation by the patient as an equal partner. To what extent was this accomplished?
The answer is in much of what was said:
- health as homeostasis rather than disease and cure
- you can’t outsource your health
- inforgs -by Luciano Floridi
- society has seen the separation passion and profitability
- in education ere are too many questions for faculty to answer, students must be full participants
- use of a flight simulator as a safety team building tool
- add travel history to your personal health record
- singularity – artificial intelligence, nanotechnology, implantables, genomics, robotics, regenerative medicine
- the shock of the possible – unexpected connections
- doing the impossible – climbing a mountain six times, curing cancer in 10 years
- everyone with a chronic disease is part of a community, they just need to be invited and join
- integrate Google Body with personal health records
- Recognizing healthcare failures and learning from them
- reducing fear of disease, hospital, blindness, etc. As a major goal of a medical practice
Although these quotes may not be exact or make up a coherent whole, the point is that creative optimism gouged by new, openly available technology like social media, can be transformational now.
This was no less true than the patient stories heard throughout the day of facing disease but triumphing over it through community (often online) and hope.
As I process this event, watch for more posts on these themes.

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TEDx Maastricht – The Future of Health

April 1, 2011

In anticipation of the International event on April 4, I wanted to share some links. Although many conferences which claim to be futurist meccas for healthcare, this one is bringing together a group of people including a very strong patient perspective which all are thinking innovation. Also, it is completely full and is being simulcasted to several countries.

Follow tweets at #tedxmaastricht

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