Friday, October 29, 2010

Great #TEDMED summary from @epatientDave on owning death: Sekou/Steve perform, Alexandra Drane on Engage With Grace

TEDMED on owning death: Sekou and Steve perform, Alexandra Drane on Engage With Grace

by e-Patient Dave on October 28, 2010

We talk a lot here about taking, owning, or reclaiming responsibility for our health and its care. If we ever update the e-patient white paper I want to include an area where we’re sometimes robbed of control at the most intimate time: death, and the months and years before.

Yesterday I posted about the Tuesday night opening by lung transplant recipient Charity Tillemann-Dick, who inspired us to a standing ovation. Wednesday opened with an even stronger response to a new performance by poet/performance artist Sekou and his partner Steve. I can best describe it as a powerful jazz poetry duet about our final years and the onset of death. Here’s a snapshot from Martha Stewart’s Tweetstream. (Yeah, that Martha.)

Trying to describe this experience is like trying to describe …. I don’t know, surfing? Swimming? A Rolling Stones song? The words are a feeble proxy – that’s why the TED and TEDMED videos are so great. They’ll be out in a few months. For now here’s my best shot. (Commenters who were there, help.)

They stood side by side. One at a time, then together, they launched a “tic, toc, tic, toc” that conveyed the unstoppable march of time as life goes by. Time after time they brought us to the end of life, then pulled back – to birth, to other stages, then back to the end, to “is this it?” and confronting the medicalizing of death, and wanting some sense of control. At least twice I thought it was over but they pulled back for another cycle, deeper and broader.

I’ve never seen a more emotionally compelling performance, especially in just 20 minutes. They swept up the audience, evoking feelings of being dragged toward death, but pulling back, wanting to own and direct the experience. They tied death to birth – both are natural (“they take care of themselves.” They made clear that our turf as empowered humans is to be responsible for what happens between – and not to let control be taken away.

At the end audience response was even stronger than Tuesday’s ovation: everyone leaped up at once. It was visceral; some cheered.

I was left with a clear, strong feeling that not only is my life mine, my death is too. I recalled Paul Grundy’s story here, two years this week, of his father’s overtreatment – a pacemaker inserted near the end that he’d specifically said he didn’t want. I thought of my own father, who was denied the death at home he’d wanted, because his long term care facility gave us half truths about hospice.

This is wrong. This steals our power from us, at the very end of life, sometimes for paternalistic reasons but too often for profit.

Bravo to Sekou and Steve. And they set the stage for another talk Thursday, by Alexandra Drane of Eliza Corp.

Alex shared the Engage With Grace story. Her sister-in-law “Za” died at 32, and through forceful family action was allowed to go home to die, where her young daughter was able to cuddle with her. Today the daughter, age 9, loves to be told again how she was the last thing her mother saw. She implored us to “have the talk” with family and friends, the five questions about our end of life wishes, and to have it now, long before we think we’ll need it.
_________

This is my first TEDMED, and it’s different from other events this fall. It seems that TEDMED selects speakers who will amaze and compel. Tuesday night Charity did that, with how she defied death; Wednesday morning Sekou and Steve defined our right to own our death; this morning Alex Drane brought it home with a story of a death at an age not much more than Charity’s.

A lot is going on in healthcare, and a lot of people are drawn to different aspects. For me, nothing inspires more than people knowing themselves and being free to express it: “This is who I am, and this is how I want my life to go.” I didn’t expect this at TEDMED, but I’m sure looking forward to the videos.


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One Response to “TEDMED on owning death: Sekou and Steve perform, Alexandra Drane on Engage With Grace”

  1. Annie Stith says:

    Hey, Dave!

    Wow. That sounds SO powerful.

    Having control is precisely why I have my “end of life” legal documents set up the way I do.

    I have seen, too many times, how emotion overtakes a designated Power of Attorney and they make decisions that are against the stated wishes of the patient. My almost-father-in-law just had this happen a year ago. With half a lung taken by cancer years before and a bad heart, pneumonia was particularly rough for him. After going on and off a ventilator three times, he’d had enough. He told the doc he wanted a DNR order, specifically saying he didn’t want to go on the ventilator again. He also told Mom and my ex, named as Co-Powers of Attorney.

    When it came down to it at his next crisis, tho, they couldn’t let go and had him put back on the ventilator. He was SO pissed when he came to! His last days were spent angry and rebellious, pulling off everything he could get his hands on (feeding tube, IV, cardiac leads…) until they had to strap him down.

    My BFF went thru the same thing with his wife about five years ago, giving in to the emotional begging by her relatives and making decisions against her wishes.

    I have no Power of Attorney. In my Health Care Directive, I designate that two physicians must agree that there is no treatment that will be “life saving” as opposed to “life supporting” or “life extending.” One of the docs making the decision MUST be my PCP.

    Then there are four pages of an Attachment, where I specifically answer “yes or no” questions about specific situations that help the docs understand what I consider “life saving, life extending and life supporting.”

    I couldn’t do this without the excellent relationship with my PCP. He’s been partnering with me about my care for years now. I made that clear on my first visit with him, and if he hadn’t agreed I would have gone elsewhere. I’d just been thru a fiasco where my (then) PCP overprescribed both a narcotic painkiller and a muscle relaxer for nearly a year, and I was addicted to both to the point my brain was CREATING PAIN so I’d take the meds all the time instead of PRN. I didn’t find out until I was going to get an epiural and the doc at the hospital caught it. Not my PCP, not my pharmacist, not the neurosurgeon who recommended the epidural.

    At any rate, I’ve been an e-patient ever since. And I will continue to be, even at death.

    Annie

    (DISCLAIMER: Each state’s laws may be different regarding “end of life” documents. It’s best to consult with an attorney about your state’s laws.)

 

 

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Thursday, October 28, 2010

HealthCampDC - when two worlds come together #hcdc10

As I prepare for a week that begins with presenting on Health Plan Innovation at the World Health Care Congress summit in Alexandria, VA and culminates with HealthCampDC on 2010-11-12 I have been looking at how far HealthCamp has come and the fantastic people I have had the good fortune to connect with as a result of HealthCamp. It therefore seems like a good time to look at how these worlds are coming together. To do that I need to give you a little of my history. So come on a little journey with me....

For a number of years I have worked at CareFirst BlueCross BlueShield. I joined CareFirst at the beginning of 2007 and at the time I was deeply involved with Web 2.0 technology and innovation, actively blogging about how these new technologies could transform businesses and industries. 

I quickly saw opportunities to apply Web 2.0 solutions to health care challenges. HealthCamp grew out of the desire to continue the valuable discussions about the junction of Web 2.0 and Health Care. At the time this was the emerging world of Health 2.0. The barcamp concept of un-conferences seemed the natural format to encourage the vibrant and wide ranging conversations around Health Care and Web 2.0.  Hence HealthCamp emerged and first took place at Stevenson University in June 2008. But it was the HealthCampDC event in 2008 that really kick started HealthCamp. 

HealthCampDC in 2008 had a small but very vocal group of participants. Since Twitter has been such an important part of HealthCamp I am going to use their Twitter names here.... The likes of @jensmcabe, @tedeytan, @lostonroute66, @mjchatter, @anitasmarath, @susannahfox @lygeia they created such a vibrant chatter on Twitter that HealthCamp has never looked back. 

I have to give a special shout out to @tedeytan. It is the definition of Health 2.0 that he developed on his blog with his readers that still acts as the inspiration and guide for HealthCamp.

"How can we rebuild health care on a participatory model using social media, open standards, 

open source and the best that the web and mobile internet technologies can offer?" 

HealthCampSFBay took place earlier this month with over 250 people descending on the Kaiser Permanente hosted event at the world renowned Garfield Innovation Center in San Leandro, CA. The Attendees included Todd Park, the Chief Technology Officer at the Department of Health and Human Services gave an amazing key note speech and then led a session looking at the future of the Community Health Data Initiative. You can catch Todd's wrap up of his session here:

So on Friday November 12th, 2010 HealthCamp comes back to Washington, DC. This time CareFirst BlueCross BlueShield is officially sponsoring and hosting HealthCampDC at their DC Headquarters - 840 First Street, NE, Washington DC. For me this is a case of two worlds converging. CareFirst has been busy for the past couple of years deploying new systems and we are finally seeing the public face of those changes as CareFirst launches HealthyBlue, a product that rewards members for following healthy behaviors and building a relationship with their Doctor. On the Physician side CareFirst has been busy developing Primary Care Medical Home as a platform to reward physicians for taking better care of CareFirst members.

HealthyBlue is a product that can benefit from mobile solutions and social media. I would like to see Health Care visionaries, developers and anyone in the National Capital area passionate about Health Care converge on HealthCampDC and join in a conversation about how we can use social media, open standards and mobile technologies to encourage people to engage in managing their health. I am optimistic that we can have a positive, forward thinking and open discussion. My experience at CareFirst has been that there are a lot of great minds applying themselves to big challenges to deliver better solutions and services to members. CareFirst is also very active in donating to community causes in the area. However, when it comes to Social Media only a few tentative steps have been made. This therefore is an opportunity to share your experiences with using Social Media and encourage further initiatives in this area.

There are going to be some fascinating conversations at HealthCampDC on 2010-11-12. You can join in if you go and register at http://bit.ly/hcdc10site.

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Wednesday, October 27, 2010

Day 1 of TEDMED: Charity Tillemann-Dick, e-patient

Notes from a post by @epatientdave - a powerful story that shows the value and potential of an engaged, empowered e-patient:
...She (Charity) moved to Baltimore to work with Johns Hopkins physicians, and chose Flolan. It’s not curative – it only reduces symptoms – and it has serious side effects. Worse, for a performer, it’s a continuous 24/7 infusion, with a 4.5 pound pump. It had to be strapped to her body, even under operatic costumes.
With it, she sang. In the US, Vienna, Israel.
Ultimately, though, she needed a transplant, and got it. It can damage vocal cords, and some patients don’t even survive. Her surgery was rushed – no time to bring her mother to town, to perhaps say goodbye. It was not an easy case – coma ensued – and she described awakening to her mother’s face. She couldn’t talk, couldn’t do anything yet, but she was alive.
When she closed last night with “I Could Have Danced All Night,” my eyes flooded with tears and the crowd rose to its feet.
Oh, the joy of being alive – and having the life we want.
_______
Charity is an empowered, engaged e-patient. What do you want in your life? Who should decide which options you’re told about, and which you choose?
Writing this, I googled pulmonary hypertension and it took me to the Google Health page, where it says: “Your doctor will decide which medicine is best for you.”
Well, bite me: like Charity, I will decide which medicine’s best for me, based on our chosen experts’ advice. It’s my life, it’s Charity’s life. Inform us about our options, and work with us to decide. That’s participatory medicine.

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Saturday, October 23, 2010

Disqus and Google Sites - is it possible?

I have been busy preparing for HealthCampDC on  2010-11-12. To host pages about the event I decided to try out Google Sites (http://bit.ly/hcdc10site). We find Google Docs really useful for creating an online version of the wall at a HealthCamp event so I wanted to test the integration between Google Docs and Google Sites.

One thing I wanted to add was a comment feature to the site. It seems that Google Sites have comments but you have to be a collaborator to be able to post a comment. We wanted something more open than that but still be protected from Spam comments. I have used Disqus on my http://ekive.blogspot.com blog for a number of years. It works quite well. I therefore thought about using Disqus to power a more open Comments feature on the HealthCamp pages. There was one problem. Google Sites disables Javascript embedding. This makes it difficult to incorporate third party widgets.

In setting up the HealthCamp site (http://healthca.mp)I had already attempted to integrate a UserVoice forum. The only downside was having to pre-define a space on the page for the widget. The problem with uservoice is that the at rest widget is a small tab. When clicked it opens a much larger page. I therefore resorted to just using a hyperlink to the Uservoice forum to allow people to post suggestions for HealthCampDC.  

One thing I did learn from reading up about UserVoice and Google Sites is the suggestion to incorporate javascript in to a widget using Google Gadget Editor. The Gadget Editor allows you to produce a custom gadget and host it at Google. One word of warning. On my Mac I found that the Google Gadget Editor didn't run correctly in Safari or Chrome. I therefore had to use Firefox to edit my gadget.

When looking at the Disqus problem I managed to add Disqus commenting to my Google Sites pages by doing the following.
  1. Goto Disqus and setup your site
  2. Grab the generic Javascript code (Disqus Universal code)
  3. Goto the Google Gadget Editor and open the Hello World! example Gadget. 
  4. Replace the Hello World code (between the CDATA[[ ]] sections) with the code in sections 1 and 2 of the Universal Code from Disqus.
  5. Use Save As to save the Gadget with a different name e.g. Disqus.xml
  6. Click on the file name you used in the top right of the editor. It will open the xml in a separate window or tab in your browser.
  7. Copy the URL of the Gadget from the browser window.
  8. Go to the page on your site where you want to add Comments.
  9. Edit the page and go to the bottom of the page.
  10. Choose Insert...More Gadgets
  11. Click on Add gadget by URL and paste the Gadget URL in to the address box.
  12. Set the height of the gadget to approximately 650 pixels and choose "include scrollbars on gadget when necessary"
  13. Save the configuration
  14. Save your page

This is not perfect but at 650 pixels any dialog boxes used by Disqus appear inside the gadget. With the right configuration this combination of Disqus and Google Sites lets you allow comments from anyone. Visitors can even use their facebook, twitter, Disqus, OpenID or Yahoo accounts to identify themselves when leaving comments.

If Disqus would tweak the layout in their code slightly this is not a bad solution. Some of the prompts for the settings and other menus that appear to the top right hand section of the Disqus layout get cutoff but that is really a minor niggle.

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It took 726 steps in and out of the Labyrinth at #Stevenson University

Mark Scrimshire
B: http://ekive.blogspot.com
....Sent from my iPhone

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Friday, October 22, 2010

Friday, October 15, 2010

Today is BlogAction Day - The topic WATER

Petitions by Change.org|Start a Petition »

Today is BlogAction Day. This Year BlogAction Day is supporting the United Nations Initiative on Water. Water is a fundamental element that we all depend upon. Yet in some parts of the world access to clean water is not a given.

Water is so important to our health. Keeping adequately hydrated is an essential part of taking care of your body. 

We are busy preparing for another HealthCamp - This one, HealthCampDC takes place on Friday November 12th in Washington DC. Tickets are available now.

A core focus of HealthCamp is Participatory healthcare. Participatory Healthcare starts with Health and Wellness. That means we have to take responsibility in our own lives for our diet and exercise. For many of us, this is a daunting prospect when we run such busy lives. However, I take inspiration from Jen McCabe (@jensmccabe) and the concept of #microchoices that she promotes. Remember folks, it is not about being perfect. It is about taking it one step at a time and making conscious decisions. It reminds me of the saying "Two out of Three ain't bad"

So on this Blog Action Day in 2010 let's not take the advantages we have in the developed world for granted. One striking fact...  More people in the world have cell phones than have access to a toilet.

Healthcare and water are inextricably linked. Think on this quote from Kofi Annan, UN Secretary-General 
“We shall not finally defeat AIDS, tuberculosis, malaria, or any of the other infectious diseases that plague the developing world until we have also won the battle for safe drinking water, sanitation and basic health care.”

To get involved in creating a better healthcare system come and join the conversation at HealthCamp. Join us for HealthCampDC on November 12th in Washington DC.

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Tuesday, October 12, 2010

FAQ: radical change coming to Net addresses | Deep Tech - CNET News

This puts a whole new dimension on Mergers and Acquisition Strategy. What happens when a subsidiary is sold off? Does the content go away? How would companies handle re-direction to new sites? How will broken links be handled?

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Friday, October 08, 2010

#health2con - The last session

Real time notes from the final session of the Health 2.0 Conference.

The winner of the code-a-thon held at the conference:

Hunter Whitney at First Steps won $2,500.
"Data Data everywhere but not a drop can be used."

http://www.medgle.com/fs

This was built on @ashdamle Medgle platform.

A simple scale viualization to help improve a medical condition.

@ReginaHoliday gave the most inspiring explanation of the painting she has created over the last 2 days. Remember the Patient. that is who we are improving health care for.

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#health2con - the wrap up session

Realt time notes from the wrap up panel at Health 2.0

bob Kocher, Sr Fellow Brookings Institute moderating:

- Don Casey, CEO west Wireless
- Esther Dyson, Chairman EDVenture Holdings
- Mitch Kapor, Kapo Capital
- Lisa Suennen, Managing Member, Psilos Group
- Bryan Roberts, Managing General Partner, Venrock Associates.

We should be focusing on productivity. How can we help doctors see more patients.

Esther - a difference between where money is being invested and where the money will be made.

Lots of people investing in the same area. There will be a lot of consolidation.
Healthcare is a tough place for Product Features. A lot of products are just features.

Success means solving a big problem. then need something that can scale.
Healthcare is a lot of little markets.

Mitch Kapor is not currently investing in HealthCare. It is still early. The eco system is like an arrid desert.

Innovation will take off when payment is aligned with getting people better.

Don C: Who is going to pay? Where is the money? Going to the top of the wellness pyramid.
The large self insured are the ones invested in caring for people for the long term.

Esther: Emerging place where there is a lot of money and diminishing returns is in Pharma. They need to work out how to get to consumers directly. They will shift to selling a lifestyle support program. They need something new to do.

Lisa: The Consumer payment focus won't pay off. Don't rely on consumers. There is a lack of sophistication about payers. How do they fit in to the payment schema.

Esther: Consumers don't want to pay for health care but there are things they will pay for - where it brings pleasure, convenience, lifestyle.
Don C: Capitatin where Consumers have to spend more dollars for health care they will demand more value.

Mitch: If I wanted to make a lot of money today I would do something with medical marijuana
Bryan R: target something on the cost/quality contiunuum.

These discussions vindicate the CareFirst approach CareFirst is taking with Primary Care Medical Home.
Esther: Peer pressure is something to harness. There is a market for good health . Not just sick care.

Mitch: in silicon valley 50,000 is the new $5M. It means investors can take more bets. There is a sub-culture of innovation. This will effect everything including healthcare.

There is a ton of data waiting for people to make sense of. A new golden age of innovation and investment.

Lisa: A lot of new ideas are renamed old ideas.
Esther: huge differences. Sensors and Cell phones. User generated data.
What Mint did in finance someone will do in Healthcare. The industry needs to watch out.

Bryan: Health Reform has set the playing fields for the next few years. People ar eon solid ground for the first time in a while. There is also a lot of aggressive entrepreneurs in the sector. There will be overfunding.
Don: Telecoms and Personal sensors will change everything. The physician community will consolidate in to larger groups.

Lisa: we have to change the culture in the doctors office.
Don: Physicians have shifted in acceptance of the salaried model by a factor of 10%. From 15% to 25% in one year.

What do you need to be successful with an Angel Investor.

- Tell a great story. Why does it matter. How will it change things. Bring data to prove it.

- Read the advice that is out there. Don't be clear about what you are saying . Be clear about what the other person is hearing.

- How will you deal with a setback. Don't believe your own BS.

- You want a great business model then add technology and add a great management team.

- Be careful doing something that can be blocked by Incumbents.


Ron Guttman: How do we incent engineers to build great companies in Health Care.

Esther: Unfortunately it requires someone in their family to get sick.
Bryan: Engineers will come together where Cost and Opportunity meet.

Lisa: Health IT companies seem to take longer to mature and Mergers and Acquisition is the most likely exit.

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#health2con - Wellness 2.0

Demonstrations from the following:

http://www.dailyfeats.com
http://www.cybercise.com
http://www.chizam.com
Health Media Syndicate
http://www.auraviva.com

Chizam creates engagement around the gym.
DailyFeats is a supportive messaging platform with a social aspect to it.

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#health2con

Mobile web traffic is exploding in emerging markets.

Mark Scrimshire
B: http://ekive.blogspot.com
....Sent from my iPhone

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#health2con - more demos

real time notes from the Health 2.0 Conference.

John Moore - MIT asked the question - what if we turn things upside down and the Provider is the one who is privileged to have visibility in to the patient data that the Patient controls.

My conclusion from the demonstration... When the patient is informed and has visibility to their information then they come engaged and proactively manage their health.

"I don't want to disengage from my life to engage with my health"

Cook's Children Physician Network moved to Athena Network for $ of billings. 100 PCP's all .

Athena Health is a cloud based software enabled service for physician's practices. The integration with Microsoft allows records to be moved to HealthVault.

Everyone in the network is engaged in a collaborative deployment.  7 months to transition to this platform  adopted across 1000 users.

WeCare Onsite Clinics

Put Primary Care Back in the Drivers Seat - Will Montoya, Montoya Benefits.

Medical Loss ratio dropped from 88% to 60% after the clinic opened.

20-30% of Total Group Health Care Costs net of clinic cost within 6 months of opening. The clinic is outside of Fee-For-Service.

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#health2con Composite Applications Reforming Healthcare Delivery

More from the Health 2.0 Conference...

Practice Fusion is a web based platform. Offered for Free. Connectivity to 55,000 pharmacies and the major labs.

50,000 users and over 1M patients seen each month.

The open API was used at the developer challenge here at the conference. 

OAuth and what is billed as a RESTful API. However, developers report that it is not straightforward RESt. It is hard to use.

Compare doctors. 

Also providing Appointment booking.

Electronic EMR on the iPad.

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#health2con Launch - 10 new companies and products

More real time notes from the Health 2.0 Conference....

Solving medication non-adherence through rewards programs.

Make it fun, let users choose rewards. Points make prizes. 

Helps negotiate your bill  between the consumer and the health provider.

Bill-Doctor takes a fee + percentage of savings.

This is Health Bartering. 

For providers the benefit is a higher return than when a bill goes to a collection agency.

A question/survey system that  is billed as people-powered search for human health.

Univita Living helps people find the tools and information to allow people to live safely and independently at home.

The site helps plan on the needs to support independent living.

The Independent Living Assessment tool develops recommendations

Service providers are linked in to the assessment survey.
A care Circle can be created for the subject and allows information to be shared.

The site evaluates environmental factors for chronic conditions.

The example used migraine and helped identify potential triggers such as:

- Tomato
- Barometric Pressure Change
- Not sleeping at the same time of day
- Apple

CastLight provides a platform to identify costs for service - especially attractive to people on high deductible health plans.

Compare on various factors: price, education, distance....

uncover shopping opportunities 

The Audience Poll via http://www.polleverywhere.com ranked the companies as follows:

1. CastLight
2. HealthPrize
3. Bill-Doctor
4. Univita

MyTrus is a clinical trials support site. It enables people to participate in a clinical trial from home.

A routing system to connect patients with doctors who are available.

It allows doctors to be paged. notes to be transcribed from audio, No computer access is required.

Provides solution to let doctors know their patient has been to ER.

Doctors can control the level of information they receive when the discharge papaerwork is released.

An iPhone App in the Apps store to measure respiratory efficiency. The Breath Reseach Dashboard online can analyze results from those measurements.

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#health2con Tools and Unplatforms

More real time notes from the Health 2.0 Conference

iTriage - Peter Hudson, CEO - demonstrated their iPhone application to check symptoms and find medical providers.

Limeade - Henry Albrecht, CEO - demonstrated a social approach to health and wellness. http://www.limeade.com

Health Risk Assessment, Social challenges from your friends network.

Google Health - Aaron Brown, Sr Product Manager - Demonstrated new tracker features and custom dashboard in Google Health.

PeaceHealth Laboratories - Brigitte Piniewski, CMO -  How do we get more people to contribute data. http://yesiwell.com

CyPak has developed a disposable card that can collect data and have it uploaded to a phone. Medical devices that are the size of a credit card. http://www.cypak.com/

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#health2con - Launching the Health 2.0 Accelerator Apps Network

Real time notes from the Health 2.0 Conference

Last year the best demo came from the Health 2.0 Accelerator.

This year they are about to do it again.

Erick Von Schweber, CEO Surveyor Health (ex. Pharmasurveyor)
Marlene Beggelman, CEO Enhanced Medical Decisions
Bettina Experton, President and CEO , Humetrix
Jonathan Katz, MedAdherence
Anne Marie Biernacki, Co-Founder and CTO, KnowMyMeds
Brady Davis, VP Business Development & Strategy, Congral and Shared Care Plan
Marc Pierson, VP Clinical Information & Quality, PeaceHealth St. Joseph Medical Center
Steve Luper, Sr. Technical Product Manager, Microsoft

The Health 2.0 Accelerator is about promoting inter operability and an ecosystem for health data.

The Demo has infrastructure Services such as Single Sign On,
Healthvault to provide access to health data, Continuity of Care Record to transfer data using web services. Semantic interoperability via services such as FirstDataBank's Drug Code Lookup Service.

Enhanced Medical Decisions provides a Natural Language Record Coding Service.

Their service can analyze free text and through analysis assign SNOMED, ICD9 and ICD10 codes.
Drugs can be identified and mapped to NDC codes.

The Apps network on the Health 2.0 Accelerator. Uses Google Frebase to identify complimentary web sites.

Humetrix showed how a usb card can be embedded in to a member health plan card  that can access securely online health information for the patient.

KnowMyMeds is used to compile a list of meds a patient is taking. This can be entered online or via a cell phone.

MedAdherence can use the information in KnowMyMeds to interact with the patient and gather readings such as glocuse measures via interaction from aphone.  Since HealthVault is providing the data sharing amongst these applications under the users control.

The overall demo is impressive in the way that data can flow from application to application, under the control of the user/patient. However, at the end of the day - THIS NEEDS TO BE A LOT SIMPLER

However, the composite application concept is interesting and has a lot of potential.

This takes me back to a blog post from HealthCampSanDiego. - Bump my RX - Creating the Virtuous Circle of PHR adoption

The CareGiver is an important player an d one we mustn't forget when developing solutions. The PHR supports the role of the care giver.

Gaming has a lot of potential to addict people to wellness

The Health 2.0 Accelerator Apps Network - Delivers the same coded data to patient, caregiver and provider in user appropriate forms with powerful applications. - http://www.h2anetwork.org

The decision point is with the consumer - that is why mobile is critical to solving the health care challenge.

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#healthcon - instant scan codes http://goo.gl/KEj0.qr

In the last session a demo showed the use of a RazCode that was read by Microsoft Tag Reader.

Google uses QR Codes. An equivalent two dimensional scan code.
If you use the Google Link Shortener http://goo.gl and add a .qr to the end of the short code you get an instant unique QR scan code.

For example to go to https://sites.google.com/site/healthcampfoundation/ you could use the short url: http://goo.gl/KEj0

You can get the QR code shown above by using the url http://goo.gl/KEj0.qr

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#health2con - Data really matters

More real time notes from the Health 2.0 Conference...

Regina Holiday (@reginaholiday) telling a powerful story  about the loss of her husband. check out "73 cents"

This panel will comment on a series of demonstrations:

Roni Zeiger, Chief Health Strategist - Google Health
Phil Fasano, Sr VP and CIO Kaiser Permanente
David Cerino, GM Consumer Health Solutions, Microsoft HealthVault
Wayne Gattinella, CEO WebMD

The demonstrations wil come from:
Jonathan Hare, Chairman and Founder, Resilient Network Systems
Clay Patterson, Managing Director, Personal Health, Cerner
Bob Blonchek, President and CTO, Razoron Health Innovations
Jay Couse, SVP Business Development, Diversinet

Wayne G: The work is just beginning. How do we unlock the value of the Personal Health Records.  

Kaiser - talking about Convergent Medical Terminology. They have made this open source and donated to National Library of Medicine.

Half of Kaiser members (nearly 4M) access their Health Record online.

Microsoft - Amalga is their provider solution. Data is not the entire answer. It has to be transformed to make it more useful.

The consumer is going to start driving how information is  moved around

Google -  Data alone is relatively meaningless. It is about conversations. We should start talking about Participatory Health Records and not Personal Health Records. Google focusing on the core value to the end user/consumer.

On to the demonstrations.....

Resilient Network Systems

We assume the intelligence is in the applications. 

Resilient believes it should reside in the network.

They provide a platform with "Trust Broker", Access Server and Identity Broker

Identity Broker allows 2 different parties to confirm who they are talking with and about.

Trust Broker creates a network of trust services to handle record retention and other capabilities.

The demonstration sowed a fascinating glimpse of the potential to create composite applications without requiring all the interfaces between apps to be pre-defined.

Kaiser and Google agree: Identity and Access Management is a critical element. Probably the most important challenge. For self contained organizations this is easier. you control more of the elements.

Google has open sourced their solution for two factor authentication. They were humbled about how difficult a problem it was to solve and make it user friendly.

WebMD sees some nervousness from employers

Bob Blonchek - Razoron - HealthJive

Razoron have created RazCodes a two dimensional bar code.

The code is scanned using a cell phone to take a picture.  Microsoft TAG Reader was used on a blackberry.

This links through to a web site. The razcode can collect payment and allow the user to post the information from the transaction to a health record. They link to Google, Healthvault, Keas and a numb er of other PHR platforms.

This recognizes that Paper is still part of the process. The tag allows the integration of Paper in to an electronic process.

Googles new URL shortener even generates QR codes (same as tag codes) on the fly.

Jay Couse - Diversinet

Mobisecure Vault.

Allow organizations to data to be repurposed. 

Allows publishing to mobile devices.

Healthcare connected and protected.

WebMD: Plans are not yet ready to share information. 

Clay Patterson - Cerner

Demonstrating their personal health solution and how data can be communicated. 

The demo had a wireless pedometer that fed his personal health record in Cerner Active.

Microsoft: Make sure the data stays open. 

WebMD Mobile Platform

The iPhone App is already used by 2M consumers
The WebMD symptom checker is available on the iPhone.

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#health2con - Day 2 kicks off - 3 conversations with 3 Health CEOs

More real time notes from Health 2.0....
Lindsey Volckmann from Keas introduces the session "A conversation with 3 CEOs"

Keas has a fascinating care Management Platform. Well worth checking out at http://www.keas.com. I have been using the platform for over a year and I love the KEASODL Twitter interface.

The first conversation is between Jane Sarasohn-kahn (@healthythinker) and John de Souza CEO of MedHelp.

MedHelp is 16 years old. Medhelp has 10M users on their site. They grew from 1M users in 4 years.

"Health is too important to fail"

"Side Effects can kill"

Deliver real value - it gets people to keep coming back.

Its Social - get people to talk about you.

Health 2.0 Maturity Cycle:

1. Search
2. Connect Consumers with providers
3. Create Tools

It's not about the patient - it's about every single one of us

Consumers are driving decisions

"Am I normal"  - this is the key question people have.

MedHelp is enabling consumers to answer that question by exposing more data

Medhelp is Partnering with GE Healthy Imagination and producing a range of consumer apps

MedHelp members discovered a problem with Victoria's Secret''s bras from china. In 8 weeks the community uncovered and diagnosed the problem. Formaldahyde used in the materials from bras that came from china.

Claire Cain Miller of the New York Times interviews Cio Collella, CEO Castlight Health

Cost increases in health is the big challenge in Health. New Technology is driving up cost.

Healthcare is the only industry where you enter in to a transaction and have no idea on the cost and quality. It is like going in to a supermarket the lighta are off so you can't see what you pick off the shelves and you checkout and get a bill six months later.

Castlight Health  "gives you a very good seat to a very bad movie"

Trying to create a market by creating transparency.

Cleveland Clinic is one of the groups funding the company. 

We are all going to be paying more out of pocket. The industry has to compete on cost and quality.

Price doesn't matter when you are using someone else's credit card.

Quality is important and is part of the equation.

Calm down - it takes a lot to kill a patient.

The market is changing. 

CastLight provides the shopping experience...

A major social change is happening. but they are working at the pace of health plans. But what will happen with the speed of adoption.

30 years ago the word consumer did not exist.

Consumers now are at the centre.

The Doctors graduating now are practicing online...

Elizabeth Cohen, CNN talking with Jeff Arnold, CEO Sharecare

Jeff Arnold started WebMD in 1998. What has changed...

In 1998 the discussion with hospitals was about email catching on.

ShareCare is about how to build a collective IQ.

How do you turn searches in to questions.

Celebrity Doctors drive consumer awareness

300 partners including some of the largest hospitals. These partners want to be first responders on the site.

They offer a starter kit that converts web and other published content in to questions and answers.

The progression from Q and A to Conversation to Applications 

ShareCare has a knowledge partner concept. Then have Applications to drive transaction revenue.

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#health2con unitymedical deep dive

Unity medical offer a comprehensive platform with video. The Health risk assessment uses video to guide people through the completion of the form. The video guide engages the member in a conversation.

By completing the hra the member gets video guides delivered to them on a regular basis that are tailored to their individual needs

The delivery tool is the wonderbar

The wonderbar is configured by the user to deliver information daily at a time they choose. This can be on a PC or mobile device. It is like having a personal tv channel. Preferences can be set.on a channel by channel basis. On the backend the employer or payer can tailor the messages that are delivered on a daily basis in a channel.

St likes bariatric surgery saw a 237% increase in brand awareness by using this platform.

Question: how do companies wrap this in to an informed consent process.

Doctors can pre-record medically vetted information for their patients. The company needs to wrap their consent process around this education platform.

This is video storytelling. For wellness it covers all the major chronic conditions.

Scalability: consumers prefer video. It is far cheaper than face to face or ask the doctor solutions.

Mark Scrimshire
B: http://ekive.blogspot.com
....Sent from my iPhone

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Health and Wellness should be fun - #Health2con

Dr. Francis Kong has produced an infectious disease battle game and was showing it at the Health 2.0 Conference. Check out the game on Amazon it is called "The Healing Blade"

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Health and Wellness should be fun - #Health2con

Dr. Francis Kong has produced an infectious disease battle game and was showing it at the Health 2.0 Conference. Check out the game on Amazon it is called "The Healing Blade"

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#health2con - remember folks, wellness is about making healthy #microchoices

Mark Scrimshire
B: http://ekive.blogspot.com
....Sent from my iPhone

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Thursday, October 07, 2010

#health2con the voice of the patient

@reginaholiday - 1. connect patients emotionally and analytically

2. Let Patients control their own data (and add to it)

@epatientdave -  3. improve the patient's voice in decision making (care, development, policy)

4. Engage people and provide services wherever they are

@drGreene 5. Recognize all stakeholders - patients, caregivers, and providers - as equal partners with different roles

6. Network everyone, including those who aren't online

 @gfry (an instigator behind getting the patients in to Health 2.0) 7. Here's the real ROI: Recognize Our Impact

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#health2con and the Unmentionables with Susannah Fox - the panel session

The panel on the unmentionables from Health 2.0 Conference.

Alexandra Drane, Eliza

What works with your loved ones probably works with your customers.

Thomas Goetz, Deputy Editor, Wired Magazine - Author The Decision Tree

Feedback loops have been known to work for decades. The issue is how we can get the feedback to people. We are now using technology to provide insight to create action.

We need to unpack the variables.

Jeff Livingston, MD McArthur OBGYN

We use Facebook because we are building a relationship.

Sam Meckey, VP Disease Management, Optum Health

You have to deal with the Unmentionables (sex, Jobs, stress, Money).  you can treat other issues whne patients are dealing with the unmentionables.

Don't be afraid to have hard conversations.

Chris Cartter, GM, MeYou Health

Social Influence - Important to understand how to use social influence

Susannah Fox asked how we create an authentic voice in Social Media

Jeff Livingston - It s the same as the way you talk everywhere else. Behave like you always do. 

Alexandra Drane - Wrapped up Day One

An idea from Roni Zeiger (Google Health) -

The mission to make communities healthier.

SeduceHealth:
"Talk Health To Me Baby"

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#health2con - Behavior Change Health 2.0 and the Unmentionables @susannahfox

More real time notes from the Health 2.0 Conference...

@susannahfox - leading a panel on behavior change....

Live, Love, Life and Care for yourself and others.

Ron Gutman @healthtap.

We know what we need to do but we are not doing it. Why?

We need feedback. How fun is a game with no scoreboard.

Take data, convert to information, transform to knowledge and trigger action.

Richard Tate, Director HopeLab

HopeLab is about using fun to engage in their health. ZamZee is a project - Go More, Get More. 
The unmentionable: Obesity.
Obesity costs us $100B /year

ZamZee online rewards program for teens thats powered by their physical activity.
Activity meter - 

Combines: Lifestyle tracking
Social Gaming
Virtual Currencies

The results: ZamZee creates the equivalent of kids running an extra 3/4 mile each day.

With cash rewards the difference in engagement between $5 and $20 is not great. So small incentives work.

Doug Solomon - CTO, IDEO

This is what Sex Sounds Like....

Challenge: Reduce unplanned pregnancies in teenage women.

Sex isn't science. We keep attacking it with logic. Sex is carnal. Yet we still try to use logic.

We need to design messages that 

use humor.... 

Be Engaging and Helpful....

Be Human....  use plain language.

+ Prototype the tone of voice.
+ Weed out industry jargon
+ Meet people where they are

Use real language to connect with real people..

Ramin Bastani, Founder, Qpid.me

Qpid.me launched today in 50 states.

Qpid.me - Spread the Love, Nothing Else.

An SMS service that can release your STD results to a partner.

Alexandra Krane - Eliza

Poor medication adherence costs $290B per year.

Having perfect health is hard... because we have a life.

Sex, Drugs, work pressures, stress, money concerns

Your systems need to handle these unmentionables.

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@tedeytan and @reginaholiday @dermdoc chatting at #health2con

Mark Scrimshire
B: http://ekive.blogspot.com
....Sent from my iPhone

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#health2con - Health 2.0 tools for employers

More real time notes from the Health 2.0 Conference....

Moderator - Jennifer Benz - Founder and Chief Strategist - Benz Communications

Fred Goldstein - US Preventive Medicine

Demonstrated "The Prevention Plan"

Incentives program for employees. 

Michael Laskoff - CEO and Founder - AbilTo

Provides structured online video chat programs with registered therapists and coaches to help deal with transitions.

The example was Momentum - Return from Family Leave Program.

Amir Kishon - CEO - Wellness Layers

Gave an example of a wellness site produced in conjunction with EHE International. EHE & Me is an evolution of the EHE PHR. 

Douglas Trauner, CEO and Founder , TheCarrot.com

TheCarrot provides a simple tracking environment. There is also an iPhone app. There are programs for things like smoking cessation weight loss etc.

Individuals can define their reasons for taking part. The program makes it easy to reflect back on progress,

Lindsey Volkmann, Director, Business Dvelopment - Keas

Keas provides a Care Management Platform.

Keas has an employer focused solution in conjunction with Healthwise.

Make it simple, make it rewarding, make it easy, make it collaborative.

Employees can join in a team and compare team performance against other teams.

Fred Goldstein: For every $1 in healthcare cost an employer spends they lose $3 in employee productivity.

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#health2con - The Next Generation of online Communities

Moire from Health 2.0..... in real time

Dr. Jeff Livingston from Irving Texas was featured in a film. It showed how they use Twitter and Facebook to reach out to their patients.

They are using social media to connect with their patients.  Their audience of Teen women want to be online. Check out Macarthur Obgyn on Facebook.

The practice found that patients were more comfortable to come to the practice when they could discover their doctor online. They are also referring their friends. The practice found that the more information they put out the more informed their patients are. Better choices result. They have created educated and engaged consumers in a group that is not typically so engaged.

Now for the first part of online communities.:

Part 1. - Data Mining and Discovery Platforms.
Part 2 - Integration with the delivery system
Part 3 - Everyday life platforms.

Part 1 - 

Ben Haywood CEO Patients Like Me
Gilles Frydman, founder , ACOR
Gideon Mantel,, Co-Founder and Chairman of First Life Research

Gilles is well known to HealthCamp. ACOR has a rich set of narratives that originated in the world of listservs. Narratives is another form of data. ACOR has 70,000 members living with cancer. Narratives are just the hardest form of data to analyze. Narratives need to come together with other data streams.

Genomics will have a profound effect on the treatment of cancer.

Patients Like Me has grown alongside Health 2.0. Patients Like Me has become a platform. Ben  Hayward talked about the 80,00 strong network of members. It is representing the Patients voice to the Health Care industry. The experience of members describes their journey in dealing with a critical disease.

Ben Hayward gave a preview of the Patients Like Me Dashboard. The demo looked at Fibromyalgia. 18,831 patients. 1600 patients taking a Cymbalta.

PatientsLikeMe Landscape - allows analysis of the patient experience.
They are able to compare clinical trial results against actual patient results.
Further drill down is available that allows correlation between different feedback. e.g Body Mass v Fatigue.

NIH and other groups spent $10M to prove the same results that the PatientsLikeMe ALS community discovered through their own ad hoc trial.

Gideon Mantel - First Life Research
10Billion user generated posts on medical related issues on the Internet. Growing at 40% per year. 

First Life mines user generated content on English language sites around the Internet.
Converting narrative in to medical insights.

600Million postes from 15M patients. 9,000 medications.
The example has 25,000 posts on Singulair.
These posts can be analyzed from the perspective of Drug interactions, Drug Switching, Drug Effectiveness and Drug comparisons.

This search tool provides the ability to dig in to side effects and provide percentage incidence for comparison FDA approvals don't do comparisons to other drugs. First Life Research through user generated content and self reporting provide that comparison capability.

First Life Research doesn't mine everything.

PatientsLikeMe is excluded from the search because they are balancing privacy. Their site is blocked from scrapers and robots. It is also part of their business model where the data can be sold to companies that want access.

As Gilles pointed out: only 5% of the Internet is visible on the Internet. Many of the rare diseases are discussed in private.  

A big question - How do Communities share with each other - not just inside their community.

Part 2: Integration with the delivery system

MArgaret Rukstalis, Clinician Investigator, Geisinger Health System
Howard Steinberg, CEO dLife
Neil Bacon, Managing Director, iWantGreatCare

First Geisinger and dLife talked about Integration.

dLife is focused on Diabetes. One in every $5 spent on Diabetes

The proposition: Online engagement can improve self management of Type II diabetes.

The population in the study. Over 65, primarily men with High School education. 
In the study patients were invited to a control group or to dLifeG.com

They found that 115  got involved in dLifeG against 53 in the control group.

dLife comes at Diabetes from a consumer perspective.

dLife TV has 0.5M weekly viewers. 
-  Personalized web site.
 - Weekly newsletters.
- IVR outbound calling - linked to themes.

Despite low education levels and low levels of PC Literacy they still had more than 52% moderately to hyper engaged in the program.
The dLife group after 3 months were more motivated with fewer drop outs and still continue to attend appointments.

Neil Bacon - iWantGreatCare 

A UK-based service that aggregates information about measuring the outcomes of treatment:

- Consumers,
- Hospitals
- Doctors
- Payers

iWantGreatCare harness real time information to evaluate quality of care.

The site provides encouragement to doctors that support transparency

Health Care Providers get reporting tools to compare the same information in real time. 

Part 3: Everyday life platforms.

Manny Hernandez, President, Diabetes Hands Foundation
Chris Cartter - General Manager, MeYou Health
Josh Elman, Product Manager, Twitter
Alex Ressi, Founder, TweetWhatYouEat

The simplest food diary that you ever keep.

Post a message: Direct message: d twye Turkey Sandwich, oatmeal cookie, potato salad:300

Why Twitter. Because it was already integrated in to my daily life.

Open Food diaries . See what others are eating

Forums - eg. to find help in losing weight.

A Personal diary

The platform will reference what you have eaten before. OTherwise it uses a crowd source calorie value database.

MeYou Health

A subsidiary of HealthWays.,

A facebook App : Change Reaction
Get people to pledge to doing one healthy behavior each week. Then invite friends to join in. 

HealthSeeker (HealthSeekerGame.org)

Yet another Facebook App. Because that is where the people are. Social Games are a huge fast growing segment.

A social Game:

players choose lifestyle goals. Choose a goal and take on missions.

The idea is to get people to carry out real life missions. e.g. reorganize your kitchen to move unhealthy food out of sight. Your facebook friends become your support team.

Reactions from Josh Elman, Product Manager, Twitter

It is great that people are using Twitter and Facebook to integrate with their daily life. The community you share with provide support and purpose.
It is more public when making a commitment. 

Twitter provides a way to generate user contributed databases.

Chriss Cartter: most People Know What to Do. The trick is getting you to do it.

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#health2con @reginaholiday creating inspiration in realtime while chatting with @healthythinker

Mark Scrimshire
B: http://ekive.blogspot.com
....Sent from my iPhone

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#health2con - The Health 2.0 Developer Challenge sponsored by Adobe

Real time notes from Health 2.0 Conference....

This session at Health 2.0 is focused on the Developer Challenge was moderated by Indu Subaya.

Aneesh Chopra and Todd Park provided the stimulus for this event. June 2nd's Community Health Data Initiative meeting.

A new site was launched after July 4th - The Health 2.0 Developer Challenge.

6 challenges have closed. Two are still open.

The Two open challenges are:
HHS - Visual Quality indicators
National Cancer Institute - community cancer data - make data more actionable.

Aneesh Chopra - CTO, Executive Office of the President
Todd Park, CTO, US Health and Human Services
Peter Levin, CTO, Department of Veteran Affairs

The developer challenge included online challenges and live code-a-thons.

The 6 winners were introduced by the panel.

Aneesh Chopra comments:

- Last year the push was on the open government initiative.

- Innovation - Connectivity
- Market conditions to spur innovation - release government data
- National Priorities - 2 challenges: clean energy, power of IT and Innovation to improve cost and quality in Health Care.

Government can't do it on its own. We need new levels of innovation.

Challenge.gov portal launched to identify activities underway in government.

Todd Park at HHS pushed "Data Liberacion"

HHS is sitting on data. They want to unleash that data for free. "A Tsunami of data liquidity"

Make data available for free. The vision was laid out on March 11. Create an ecosystem of community health data.
within 90 days a showcase of apps were created and displayed on June 2nd.

The Blue Button is announced today:

Peter Levin explained:

A simple idea - liberate data.MyHealthyVet is a PHR for Vets. Over 1Million people already signed up.

The old way was an interoperability standard. Instead they are pushing a new idea.

Let computers do what they are good at "Interpretation"

BlueButton is a download capability. using a common data format.

Over 65,000 users in a soft launch. CMS have 5,000 users without even launching.

Under the Open Government umbrella they are announcing the Blue Button download capability


Blue Button Challenge and the Markle Foundation.

- Let people download their own personal health information.

Public and doctors agree that people should be able to download their personal health information. 65% doctors agree. 70% of the public agree. 20% and 22% are neutral respectively.

The next step is to help make the downloaded information useful.

The people who hold the data don't have to be the ones' who help you make use of it.

Decoupling this stimulates innovation.
What was learnt in the challenge. There were 9 contestants. 4 finalists including Adobe, Microsoft, Medcom, Remember It Now.

The Winner - Adobe Blue Button Health Assistant

Take years worth of complex data and make it secure, presentable

http://health2challenge.org/blog/blue-button-challenge/

Accelerating Wireless Health Adoption:

- West Wireless Health - A group focused on how to lower cost in health care
Get consumers involved. Get a secure low cost way to put data in to the social network world.

The winner is Alan Viars (@aviars) of Videntity.

Videntity built a facebook applicaiton that allows users to share health information with a select group of firends. The information is stored in the RestCat platform - an open source platform.

The RestCat platform connects devices like pedometers to your social network

PracticeFusion: Real time Patient Data Challenge

Practice Fusion - Some geeks hacked a digital weight scale. They added hardware to post the data to the internet. They then integrated this with Microsoft HealthVault. We saw that Todd Park weights 145 lbs. Using Patient Fusion Sync the data flowed through to Practice Fusion.from Microsoft HealthVault.

Practice Fusion has released an application platform to integrate with the Practice Fusion EMR platform.
Health Factor: Healthy Cities Challenge

Create a tool to incorporate community health information in to daily decisions.

Access Interactive built an android application, an augmented reality app that combined real estate listing information and Community health information. What is the health care like, what is the environment like. They used data from Zillow for Real Estate data. This was mashed up with community health data such as

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#health2con - Search and Content - the panel discussion

Matthew Holt moderates a panel on search and content

West Shell - CEO - Healthline
Ravij Raj - GM - RightHealth
Benjamin Wolin - Co-founder/CEO - Everyday Health
Jeremy Shane - President - HealthCentral
Alistair Rock - President Unity Medical

100M consumers / month go to US Health Web Sites.

Dealing with health on the web is very hard. Payers speak billing codes, physicians speak latin, patients speak different languages. The search engines have to translate between them. Searchers are also at different stages of a condition. Is this the ultimate personalized search challenge.


RightHealth launched TweetBeat at TechCrunch Disrupt. It monitors trends on Twitter.
HealthLine demonstrated a 3D visual body map application. Every organ in the body has been mapped to a taxonomy. 3D maps of organs you can delve inside and rotate. This links with symptom checkers and treatment finders.

TV has historically had the lionshare of marketing budgets. But that is changing because the web offers so much more in the way of targeting opportunities. Information /Search sites offer many marketing opportunities because Consumers are searching for specific issues. This offers the opportunity to target niche markets.

We are seeing pharma internet spending focus down to a few high quality sites. We are also seeing spend going to very targeted sites.

Alistair Rock of Unity Medical demoed UM's platform that is being used by a number of insurers.

150M Americans suffer from chronic conditions. Unity Medical is launching a Health Risk Assessment and Wellness platform in conjunction with a health insurer. The WonderBar pushes HD video content to the user and integrates social networking.

Insurers have a lot of data that can be contributed to the search eco system to help consumers find answers.
Data becomes more valuable when it can be associated with others to create benchmarks to allow performance comparisons. ie. How am I doing?

User Experience in Healthcare is about to go through a transformation. Video is becoming a critical element.

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#health2con - Search and content - new models and partnerships - ShareCare

I am at the Health 2.0 Conference (#health2con). These are my real time notes from the sessions.

Chiara Bell of Univita introduced the session.

First up: Jeff Arnold , CEO of ShareCare.

ShareCare is a search engine and Q and A site for health. Keyword search prompts the questions to ask. It brings together content from many qualified sources from celebrity doctors, to health systems and hospitals. There is geo-targeting to localize the results.

May organizations are involved such as American Heart Association, AARP, american Diabetes association.
Johns Hopkins is one of the hospitals represented. They have answered over 5,000 questions on multiple topics. Their YouTube channels are also incorporated in to the site.

ShareCare has an Open API that allows partners to create applications inside ShareCare. A partnership with MDLive allows live video consults.

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#health2con Donato Tramuto introduces Dueling Keynotes from Tim O'Reilly and Jeff Goldsmith

The Keynote is being shared by Jeff Goldsmith and Tim O'Reilly.

Jeff Goldsmith

Health Cost increases are slowing. 2008 was the slowest year of growth. But we will soon overtake Germany as the country with the largest healthcare spend.

There are 1M less hospital admissions than in 1980. Fewer people are visiting Physician's offices. Driven by the recession. Prescription drug spend is recovering thanks to generics. Pharma R&D is on the rise but Pharma Market Cap has declined.
Other Health IT companies are struggling. Are they risk averse? Do they have the wrong business model.
"Gen Y creatives don't want to join the faceless ranks of scientists in the industrial wastelands of New Jersey"

Can Public companies successfully create new knowledge?
- Easier to buy IP and extinguish the creative spark
- Investors want stable growth

Imaging and Pharma are 20% of the Health Industry.

1982 - 2004 Over 85s were becoming healthier with fewer institutionalized. But we are reversing the trend...

USA v UK. 5x the level of diabetes (22.5%) And it is on the rise. Projected to grow 6x in next 40 years.

We are facing an exodus of 80 hour/week MDs to be replaced with 30 hour/week MDs.

Things To Do:
1. Tame the documentation monster
2. Help people find the information they need effortlessly
3. Acommodate the diversity of People's Needs and Styles
4. Equip familities with tools and information
5. Entertain and have fun

Tim O'Reilly of O'Reilly Media

Where is the Health World going?

Tim is the father of Web 2.0. After the dot com bust it was a way to distinguish the companies that survived. All the survivors found a way to capture the intelligence of the crowd. Google harness the information from every click.

O'Reilly watches what alpha geeks are doing....

Where the technology is going:

Data is the "Intel Inside" in the next generation of applications. Applications DEPEND on cooperating data services. Think of Google Maps delivered on your phone.
We are building a data driven operating system for the Internet.

Health 2.0 - we are building a single computer in which everything is connected. Devices are just a part of the system. Health CAre is still an island. How do we want it to be transformed and connected?

The Internet Operating System is a real-time system.

"Would you like to cross a busy street based upon information from 5 minutes ago?"

Google is significant because they teach us the most about the Internet. e.g. Adwords

"We need to turn Health in to a science and not an art."

It will be hard. It will break many existing systems. Look at the pain we have seen in media.
Disruption is called disruption for a reason.

"Healthcare needs an information nervous system. It needs to react in real time."

Web 2.0 is not about hip Web 2.0 companies. Walmart is as much web 2.0. Their enterprise is infused with technology. products re-ordered within 20 seconds of a purchase being made at a checkout.

The iPad will be a game changer. e.g. Interactive EMR on a tablet.

"The Phone is a sensor platform"

Every device generates data and every action creates an information shadow on the internet.

There is a lot of innovation coming from sources outside healthcare. eg. Quantified self movement.

There will be sensors everywhere
There will be collective intelligence

Matthew bringing it all together:

- Healthcare in crisis
- Digital natives taking over will demand new functionality
- Innovation coming from outside

JG: "Many healthcare institutions need to be shaken to their foundations"

The hospital was a place people were supposed to come to in order to meet and receive service. The Internet changes that fundamentally.
TO: "Whenever I talk to Todd Park I become hopeful"

Are we focusing on the right things. There is a lot of trivia that passes for innovation today. We need to work on hard problems.

TO: Hard Problem: can we harness all the health data to do predictive analytics on what works and what doesn't.

JG: Hard Problem: The transactional complexity of the system - billions of transactions that we need to make simpler. We need to be able to exercise human judgement but we currently swamp that with administrivia and data that adds no value.

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