Thanks to everyone who took part in a lively #HITsm tweet chat this lunchtime - Next stop HealthCa.mp/Boston #hcBos on 9/14/12

Here is the #HITSm transcript: 

( http://hashtags.symplur.com/healthcare-hashtag-transcript.php?hashtag=HITsm&fdate=06-22-2012&shour=09&smin=00&tdate=06-22-2012&thour=10&tmin=15&ssec=00&tsec=00&img=1 )

If you enjoyed this then check out http://healthca.mp/calendar

Join us in: 

- Boston on Friday 9/14/2012 for HealthCa.mp/Boston at the Microsoft New England Research and Development Campus.

- Kansas City on Saturday 9/22/2012 - more details to follow

- San Francisco on Friday 10/5/2012 for HealthCa.mp/SFBay at Kaiser Permanente's world renowned Innovation Center in San Leandro.

We are looking for sponsors who want to support these great events. Our last event in Washington DC (HealthCa.mp/DC) generated more than 3.1 million Tweet Impressions  Be part of one of the liveliest Health Related People Mashup events!

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My first #HITsm TweetChat! Empowering Health Care Engagement

Yesterday Twitter was "all of quiver" going down for more than an hour in the first major outage for more than six months. I don't think that the prospect of me hosting my first #HITsm tweetchat was the reason, but you never know! (smile)

Hopefully the twitter gods will be kind and Twitter will calmly tweet along between Noon and 1pm Eastern time today.

The questions have been posted - check out the HL7 Standards blog.

Here are the topics:

#HITsm T1: Patient Engagement in health — How do we recognize and measure it?

#HITsm T2: How do we break through health’s glass wall to bring wellness sensor data in to Docs’ offices without overwhelming them?

#HITsm T3: How can we use #HITsm to give clarity to a patient’s aspirational health goal in order to guide treatment plans?

#HITsm T4: How can we use consumer wellness devices + #HITsm to engage the general population in their health?

I will be watching the #HITsm Tweetchat.

So come along and join in the conversation. I am not sure what insights I will be providing but I am fascinated to see how folks share their wisdom based on the four topics. I tried to cover a number of different aspects of Patient/Consumer Engagement:

- From the Quantitative perspective

- From the Provider perspective

- From the Patient Perspective 

- From the Population Health Perspective. 

Hopefully a little for everyone!

See you at Noon EST!

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The Washington Post featured #TheWalkingGallery which took place after #HCDC on June 4th.

The Washington Post has a great post about The Walking Gallery which took place on Monday June 4th at the Kaiser Permanente Center For Total Health as the culmination of a patient-focused day at HealthCa.mp/DC. More than 70 of the 160+ jackets were exhibited telling an amazing and powerful set of patient stories. 

http://www.washingtonpost.com/business/capitalbusiness/2012/06/08/gJQAs5NNTV_story.html

My Jacket is #9 in a growing series of powerful stories: 5711410758_b75a1d3bd5.jpg I am proud to be a member of The Walking Gallery. That is why you will often see me at conferences in my favorite brown leather jacket.

My jacket is Half Past Midnight and is related to the BlueButton and Rainbow Button Initiative.

I wear the jacket proudly at conferences. Here is a shot of me with Todd Park and PJ Machado at e-patients last year.

 Regina tells the story of the jacket best:

http://reginaholliday.blogspot.com/2011/05/half-past-midnight-marks-jacket.html 

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After an amazing week at #HealthData Palooza and HealthCampDC (#HCDC) I decided to apply to be a Presidential Innovation Fellow

A week ago I was arriving at the Kaiser Permanente Center For Total Health to take part in a Code-A-Thon to fight Obesity. Since then the week has been an amazing whirlwind. It has been wonderful to meet so many passionate people that want to transform Health Care. 

The week has been non-stop:

• I worked with a great team to create a simple texting app lessbadd.com to persuade people to eat more healthily in fast food restaurants
• We ran HealthCa.mp/DC where over 100 people (with half of them never having experienced an un-conference before) creating a tidal wave of health conversations that resulted in 3.1 million Tweet impressions being generated.
• Regina Holliday's "The Walking Gallery" brought together 250 people to celebrate the power of patient stories in Health Care
• The Health Data Palooza had over 1600 people and 100 exhibitors demonstrating cutting edge applications that unleash the power of health data
• NASA held a workshop at the Center for Total Health that demonstrated the powerful link between space exploration and health through the use of mobile technology.   

It is clear we are at a tipping point. Big businesses like SAP and Aetna are now taking this transformation seriously and joining the effort.

I may go by the title of Chief instigator at HealthCamp but a lot of this tidal wave of innovation can be traced back to the uber-instigator, Todd Park. Todd recently was promoted to the role of CTO of the USA - deservedly so! After Aneesh Chopra stepped down Todd was the only logical replacement. He has instigated a tidal wave of innovation built upon the release of lazy data that had for years been lying around languishing in the vaults of the Department of Health and Human Services.

The tide of Innovation in health care is not abating as Todd moves from Health and Human Services to an office at the White House. If anything it has served to accelerate the pace of innovation. Evidence of that is the call for a group of Presidential Innovation Fellows to help oversee a number of innovation sprints. There are 5 programs:

1. The Open Data initiatives Program
2. Blue Button for America
3. MyGov
4. RFP-EZ
5. The 20% Campaign

The Blue Button for America Program is a critical health innovation program. It is about to see another essential bout of innovative disruption. After seeing over 900,000 Blue Button downloads since it's release in late 2010 the Blue Button has seen an adoption by major private sector health companies such as Aetna and United Health. It is also accepted by Microsoft Health Vault. 

The next wave of innovation is to take the blue button from being a static snapshot that is downloaded by the patient/citizen and enable a stream to be initiated. This will allow a patient to connect one or more services together and have updates pulled from their health record. 

This evolution has the potential to create a marketplace for analysis applications fueling further health innovation.  When this is coupled with the launch of HealthData.gov and the transition of Government Health Data from static snapshots embedded in spreadsheet, text or PDF files to unique addressable data elements via an open source API then we can clearly see that we are at a major inflection point for Health Care innovation.

We will see a move from simple applications that take a single data set and do innovative things with it to a world where we will see Blue Button files enriched with a wide variety of health, environmental, research and other data to empower consumers to take charge of their own health.

The Presidential Innovation Fellows program has been instituted by Todd Park to fuel further innovation. The program is looking for 15 innovators to work in Washington DC for 6 months on these targeted programs. I have been a big proponent of the Blue Button  (Yes - You have probably seen my leather jacket that features the BlueButton - that's me on the left below with Todd Park and Paulo Machado).

Last October I worked with Alan Viars of Videntity to build RainbowButton.com as a demonstration of how we could use BlueButton data to create a patient driven market place for donated health data.

After such a crazy and exhilarating week, which concluded with connecting Hugo Campos with Todd Park, to help in his quest to gain access to the data generated by the defibrillator embedded in his chest (see his TedX presentation here). I was inspired to throw my hat in the ring to be considered for the Fellowship program supporting the Blue Button for America. 

Wish me luck!

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#NASAHealth @Todd_Park closes the day @KPtotalHealth

Todd Park getting people to think about the potential for Health Data in the USA

Big Health Data could add $450B of Value to the economy, regardless of the quality of life it delivers to the citizens of the USA.

Learning from NOAA...

- Put the data out there
- Provide the APIs
- Have a physical meeting

Todd loves the People Mashup - It is what HealthCa.mp does!

Todd has lined up questions to pose to the group.

A little frustrated about applying data and people assuming the answer is an app. It may be a service.

Data may be a method for market transparency and create competition.

Todd wants to know about hardware. Who should he talk to.

I seemed to kick up a storm of discussion when I mentioned the issue of Hugo Campos and his quest to gain access to the data generated by the cardia defibrillator that is implanted in his chest.

Todd is on a quest to spread the NOAA and Health ethos of data sharing to other parts of Government. There is now a green button for Energy and an emerging Green Button for Cars.
95% of entrepreneurs don't know the data that is available from HHS.

And a great point made by a friend about how Maryland prevents Genetic Testing. Basically because individuals shouldn't have a better insight in to their risks than the insurers.

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@todd_park has his jacket off for the closing #nasahealth and #healthdata

When todd has his jacket off you know this is going to be an energetic session with the CTO of the USA...

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

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#NASAHealth SmartPhone Apps workshop. Make Apps eligible to purchase via taxfree Flex spending plans

Smart Phone Apps (
Mohit Kaushal – West Wireless Health Institute;Felasfa Wodajo – iMedicalApps.com)

A discussion evolved around Asthma apps and the business models that are needed to support innovation that reduces cost.

RxMindMe - was acquired by Walmart and had reached 250k users . The company was built to be acquired but had reached significant traction.

We are moving to a phase were people take charge of their own health care.

We are seeing apps that get around time and geography issues.

People don't like ranking Physicians but will rank service parameters.

My idea to turbo charge the Innovators is to make Smartphone apps eligible for purchase via flex spending plans. Then we create a market driven by consumers.

People can be influenced by data. If it is presented in context that is relevant to them.

Let's not underestimate the power of SMS. If we want ubiquitous access we need to keep things simple. Simple works.

#NasaHealth - View of NIH - 1,000 flowers blooming in mHealthNIH is seeing interesting integration with Environmental data.

In 3rd world text messaging is what works. Customize technologies to the environments that they need to operate in.

12,000 consumer health app in the Apple App Store.
Lack of apps for Payers - but that requires them to be more open - like Aetna's @CarePass

Seeing a lot of 1-dimensional apps using HHS Data. Multi-dimensional is the next wave. Social Determinants of health will come in to play when coupled with personalization.

Some work being done using Skype for Diabetes education - this is re-imbursable by CMS.

We need to mature the health data sets. In the consumer space there is very little data.
We should be building platforms and not just apps.

5% of medicaid patients account for 44% of cost.

Can we take lessons from other industries. Do we need a Joe Camel for Healthcare?

Relationships drive behavior change. It's a developmental process.
We should look to private companies like the soda companies. They have enormous global reach. Can we embed mobile health in their products or distribution vehicles?

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#NASAHealth mHealth for social good w/@msWz @caroltorgan @Lostonroute66

This afternoon we are breaking in to workshop sessions. I chose the mHealth for Social Good session.

I felt I had to participate after developing http://LessBadd.com at the Code-A-Thon this weekend.

This is a fascinating mix of public and private organizations. 

21st Century mHealthCommunications for Social Good

(Scott Ratzan – J&J; 

Michael Weinberger – J&J; 

Todd Schlegel – NASA JSC; 

Carissa Vidlak – Wyle)

Michael Weinberger introduced the Digital Health Scorecard.

Can we help individuals understand their health status.

ScoreMyHealth -  An iPad optimized App in prototype.

This is not a Health Risk Assessment. The objective is a "Super BMI score"

"Why do we have to memorize our numbers in the 21st Century?"

We agree - Apps should be able to go get that data from other sources if they are available. e.g. Fitbit, HealthVault, BodyMedia etc.

Underwhelmed by the app. Very simplistic. They need to move around the questions so that stoppers like knowing your BMI don't discourage people from completing the scoring.

J&J need to create an API and widgets. Also add a Share button.

I keep coming back to my mantra: "Health May Be Private, Exercise is often Solitary but Wellness is Social"

Todd Schiegel - 12-lead ECGs and aiming at Social Good.

Proposing open source platform for data collection of 12-lead ECG data.

Looking to lower cost of the 12-lead ECG harness and associated electrnoics.

Enable data collection on inexpensive Android devices.

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#NASAHealth Made it back from #DCHealth to listen to Nate Gross (@ng)of @Rock_Health

I had to skip out of the #NASAHealth Workshop to do a demo for DC Health. However, I made it back for Nate Gross's presentation.

Nate is from Doximity and Rock Health: http://nategross.com/

60+ digital Health Startups received at least $2M VC funding in 2011.

HealthCare and Education are the next industries facing fundamental software-based transformation.

Foundations are getting in to funding of startups.

Rock Health was the first incubator focused on Digital Health and Mobile Health - a Non-Profit.

Objectives:

- Allay Investor hesitation

- Make Healthcare Sexy

- Bring Stakeholders together

This is not your parent's Health IT.

How it works:

- $20K grant, Zero Equity

- Free Office space in Downtown San Francisco

Curriculum:

- Weekly speakers on entrepreneurship, healthcare policy and technology.

- User-centered design instruction series by Cooper

- Office hours with investors

and more...

Big emphasis on general technology. 

"Go Mobile First"

41 Startups in Rock Health (current and alumni)

Examples:

- Pipette

- Medibabble

- Cardiio (use iphone camera to detect pulse through detection of blood pulsing through your forehead)

- BitGen

- Skimble

- WeSprout

Rock Health is open sourcing some of their curriculum. Check out rockhealth.com

Instagram had a valuation of $33/User. This can be good for Health Care when the end user is a Doctor earning $100,000+ per year.

Research for Financial Services: Baby Boomers are the fastest adopting users of smartphones and tablets

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#NASAHealth Panel discussion

Panel Members
        Ramesh Raskar (NETRA, MIT Media Lab)
       William Riley (NIH/NHLBI)
       Todd Schlegel (NASA JSC)
       Bakul Patel (FDA)  
       Jeff Sutton (NSBRI)

eyeNETRA is an amazing innovation. It brings eye care diagnostics to any location.

We are moving towards hardware app stores.

The EyeNetra technology can also be adapted to cataract diagnosis.

This is important for NASA because they have to manage the risk around astronaut vision for long term periods in space.

Bill Riley: NIH

NIH working on implantable biosensors. Almost like tattoos.  This has potential for management of diabetes. Couple the sensor with an insulin pump...

Wearable Chemical Sensors: Moving from fixed sensors to high density measurement via wearable sensors. This very much ties in with the EPA MyAir/My Health challenge.

Mobile Microscope using smartphones.

Cardiac Disease Management.

NIH struggles with the fact that technology outpaces Research processes.

A quick cycle is a 5-7 year process.

They need to streamline the process.

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#NASAHealth More than 110 members of NASA Human Health and Performance Center

DeVenCI workshop generated three new ideas for testing on the International Space Station (ISS). Check out the web site for details about these projects: http://www.nasa.gov/offices/NHHPC

Procter and Gamble have posted a technical need on the NHHPC web site: http://www.nasa.gov/offices/NHHPC/projects/ideas.html

The Health Data Palooza: unleash the potential of lazy data to transform health.

EPA launched MyAir/MyHealth Challenge: http://challenge.gov/HHS/372-my-air-my-health-challenge

Jeff Davis: Why is NASA interest in Mobile Health?

When NASA looks at spaceflight they need self supporting, easily accessible, low power, low weight, small footprint devices.

Ground-based health applications for remote and underserved areas where mobile phones are widespread and can be leveraged to monitor or diagnose.

NASA brings tremendous value because distance absolutely forces a re-thinking of methods/tools for delivery of care/support

NASA is building an Exploration Medical System Demonstration for test in 2014 time frame.

- In=flight (ISS)

- Ground System and expertise

supported by technology.

NASA uses Ultrasound in flight because it is the best suited to space deployment. There is no handheld MRI device.

Remote health and Health support in Space share similar challenges.

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#healthdata #nasahealth @daniellecass kicks off this NASA human performance center workshop

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

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#HealthData #NASAHealth Phil Fasano kicks off mHealth Smart Media and Health Workshop @kptotalhealth

I am at the Kaiser Permanente Center For Total Health for the NASA Health and Performance Center Workshop.

Jeff Davis welcomes the attendees to the workshop.

This is Day 6 of the DC Health Data and Innovation Week. Five of the week's events have taken place at the Center.

Phil Fasano, EVP and CIO of Kaiser Permanente. Phil is the person who was inspired to build the Center For Total Health as a resource for the community.

Mobile is a critical addition to Health Care.  

Consumer-Driven Health Care - Mobile access for mobile patients.

Health Care is a topic that is dominating many conversations. 

Mobile is just table stakes for KP but is aspirational for the industry.

- Mobile Health

- TeleHealth

- Tablets

KP is piloting televisits for Physical Therapy and Dermatology. 

30% reduction in Dermatology referrals. 

Dermatology is number 1 rated speciality for patient access (due to telehealth capabilities)

Allows instant referral during a primary care visit.

1,500 iPads are being piloted around KP.

3.3M visits to m.kp.org in just a few months.

The general Mobile experience, particularly the app experience, are shaping consumer expectations in profound ways.

Digital Health is a convergence of capabilities that empower consumers to manage their health on their own terms. This will profoundly redefine the patient/care giver relationship.

Having your health record available whenever you are receiving health services should be a right and not a privilege.

Digital Health is the convergence of the Internet, Mobile, Social and Voice.

KP Mobile Access: 

- Health Record

- Secure email to your doctor

- Appointments

- Prescriptions

- Health Plan info

- Facility location

- Department and contact info

- Track and share fitness progress

- Health News

295,000 downloads since Feb 2012.

The latest App release in the last 30 days has already had 75,000 downloads.

KP aims for reviews of 4 stars or higher to understand if they have hit the mark with members an consumers.

If you worry about the cost of technology when considering the future of Health - Don't forget Moore's Law

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#Healthdata privacy and security in the new health data ecosystem @fredtrotter

Listening to FredTrotter and others in this session:

3:00—4:30 p.m., Room 102B

The Administration’s initiative to release government data to stimulate the development of innovative health technologies presents important new opportunities to improve individual and population health. At the same time, the increased access, use and disclosure of personal information characterized by the new health data ecosystem introduces risks to the privacy and security of this data. Failure to appropriately address these risks through policies and best practices could jeopardize the public’s willingness to trust and take advantage of new health technologies. The session will explore the current state of the law, new federal consumer privacy policy initiatives, and recommended best practices that will build trust and enable us to leverage data for individual and public benefit.

Facilitator:
Deven McGraw, J.D., L.L.M., M.P.H., Director of the Health Privacy Project, Center for Democracy & Technology

Panelists:
Cora Tung Han, J.D., Attorney, Division of Privacy and Identity Protection, Federal Trade Commission
Marcia Tal, Founder, Tal Solutions
Fred Trotter, Director of Technology, Cautious Patient Foundation; Author, Meaningful Use and Beyond
Colin Zick, J.D., Partner and Co-Chair of Security and Privacy Practice, Foley Hoag L.L.P.

Colin Zick: HIPAA was about Electronic Data Interchange and the Privacy aspects were a sop to privacy advocates.

Watch out for the term: PII (Personally Identifiable Information)

FTC: the question is when information can be linked to a person or device.

Data is not reasonably linkable if:

- De-identifies data

- Doesn't try to re-constitute the data

- Prevent downstream users from re-identifying data.

Principles:

1. Privacy by Design

2. Reasonable collection limits

3. Sound management and disposal rules

Fred Trotter: People don't care about privacy because they don't understand the implications of a lack of privacy.

People equate HIPAA with Privacy. 

The notion of the single doctor is going away as doctors consolidate. 

In the Health Data world:  Accuracy should trump privacy. We should be demanding an ability to correct errors.

All the people who are looking to save costs are incorporated in to the "Team" and therefore have insight to your data.Devin: How do we create an environment of trust.

Marsha:Financial Services has had plenty of experience dealing with privacy.

An industry commitment in Financial Services to protecting consumer privacy. This culture continues today.

Doesn't this create a growing conflict of interest as we see the emergence of mega banks that offer a range of services that can benefit from knowing a detailed background on their customers.

Fair Credit Reporting Act: protects against data-based discrimination.

If in 2012 we still have doctor's practices that are refusing to share a patient's health data with a patient then we still have a big challenge ahead.

Facebook are now asking if you are an organ donor. That is a health decision that is then being shared with friends.

Is location the last bastion of privacy? It is the data that can pull everything else together.

We have to differentiate between Privacy and Security. WE know how to secure systems "relatively" well.

New HIPAA rules could extend the requirements for patients to have access to report that discloses who has accessed their Health Record.

- The access report provision.

The technology can't distinguish between access and disclosure.

Closing Thoughts:

Fred:  We want control but we want data to flow easily.

Marcia: Let the trusted experts take care of it

Colin: Eat your broccoli, don't get sick and ask for a copy of your medical record, 

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#HCDC HealthCampDC - The buzz has been posted on the Healthca.mp/dc site.

I have posted the Tweetreach report and links to Ted Eytan and the Disruptive Women's blogs on the HealthCa.mp/dc/ site. Check out this link: http://healthca.mp/dc/2012/06/healthcampdc-the-buzz/

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#HealthData Food and Health Tech

Panelists:
Shayla Bailey, Web Manager, Agriculture Marketing Service, USDA
Steven Carlson, Associate Administrator, Office of Research Analysis, Communications, and Strategic Support, Food and Nutrition Service, USDA
Amanda Eamich, Director of Web Communications, USDA
Danielle Gould, Founder and CEO, Food and Tech Connect

Andrew Rosenthal, Massive Health

Nutrition Database - 7906 items. 

MyPlate - driving healthy food choices.

FoodSafety.gov has a widget for food safety.

We didn't get to look at the Food Desert Locator.

Steven Carlson

Food and Nutrition Service - $100M budget.

Run Food stamp and other nutrition support services.

FNS is about moving money through state agencies and local government to help people with benefits.

Policy Research and Analytics - Data User and Data Generator

The Food environment Atlas - http://www.ers.usda.gov/FoodAtlas/

Get a spatial overview of a communities ability to access healthy food.

It is disappointing that the USDA Food Atlas has current data as of 2009 with a little data from 2010.

Shayla Bailey

Agriculture Marketing Service. Business focused. Manage USDA Prime logo.

Certifiers of National Organic Products via 3rd party certifiers.

A Farmers Market Directory: http://farmersmarkets.usda.gov

Market News, Wholesale and retail pricing data.

The Datamart will export to XML.

Danielle Gould - Food and Tech Connect

A consumer of USDA data.

"Hacking the Food System".

"Open Food"

"Free-to-use" UPC.

"Fooducate gets a shout out as a user of the USDA Nutrition database.

"Yummly" Food Processor.  Recipe site.

cleanplates.com

RealTimeFarms.com

What is the wishlist for Food and Health Dats:

- Expand coverage of foods, including nutrition

- Incorporate CPG Nutrition data

- Definitive ingredient typing for health

- Farmshed data

- Standardize commercial items

- Update Food Nutrition database

- Update serving sizes to reflect current portion sizes.

We need to link food with health.  Open APIs are critical.

Andrew Rosenthal - Massive Health 

Massive Health is a health engagement company.

Making products that people love to use.

The Eatery - take photos of your food

Crowd sourcing data is a pretty effective mechanism.

Eatery Scores compared to US Obesity Rates

Pretty good correlation between eatery data and official obesity reported data.

Defining what you eat improves your health.

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#HealthData Bill Frist (@bfrist) Keynote address personalized medicine, driven by data for better patient care

Keynote Address: The Honorable Bill Frist, Physician and former Senate Majority Leader

Bringing the voice of a 20 year practicing physician. 

Data in to discovery

Innovation empowered through science.

Heart transplantation is still state of the art. 

Talks about re-activating inert cells in the heart through stem cell injections. 

When we add Data to this we have the opportunity to accelerate innovation. 

Some patients get worse despite what is thought to be the right treatment. Is it really right for you?

We move from how to improve our research to how we map that to an individual. 

virtually every human ailment has some basis in our genes. 

Worth reading: 

The End of Illness - David Agus.

Electronic Medical Records is an essential first step to improving health.

We are still in the early stages.

Vanderbilt has 2M medical records have been de-identified for research purposes. This has been combined with DNA from left over blood samples.

Combining medical and genomic data has uncovered suspected genetic associations. It is also identifying adverse outcomes associated with anti-rejection medicines.

Data analysis has led to processes being modified (changing testing processes).

The eMERGE network - electronic Medical Records and Genomics.

NIH is investing $1.5B in personalized medicine.

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#healthdata Actionbeats Harvey Fineberg - IOM Go Viral to Improve Health congrats to VaxNation!

Go Viral to Improve Health: IOM-NAE Health Data Collegiate Challenge
Harvey V. Fineberg, President, Institute of Medicine
Proctor Reid, Director of the National Academy of Engineering Program Office
 

Great to see Deborah Esterin as a judge for this challenge.

IOM-NAE Health Data Challenge.

3rd Place: Healthy State 

An app that transforms public data in to visualizations for populations of each of the 50 states.

2nd Place: Raise Awareness

An app that uses social media and push notifications to lower the risk of skin cancer from the sun's radiation.

1st Prize: VaxNation

An app that helps organize Vaccination records.

There are enormous benefits to society when vaccinations are maintained. 

www.vaxnation.org

Cool app!

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#healthdata More Actionbeats California Health Care Foundation "Free The Data"

The Picture of Health: A Data Design Challenge
Maribeth Shannon, Director, Market & Policy Monitor Program, California HealthCare Foundation

"Free The Data"

Raise awareness

Develop Tools

Expand Data Resources

Data Design Challenge (March 2012) - $10,000 award.

Watch out next week for the designs on the CHF.org

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#healthdata NY Digital Health Accelerator

New York eHealth Collaborative.

Not for Profit. Improving health care for New Yorkers. through Health IT.

Built SHIN-NY

Fee for Service for Medicaid will disappear within 2 years.

Payment reforms require new innovations: 

- Care Coordination

- Analytics

- Physician Alerts

- Patient Engagement

Health Homes: - Organized Care coordination and team based approaches

Care Coordination across multiple providers requires a different beast to your standard EMR.

A single coordinated care plan is essential.

SHIN-NY network is exposing an API.

http://www.nyehealth.org/index.php/programs/shin-ny-innovation

API Registration: https://nyec.wufoo.com/forms/new-york-ehealth-collaborative-api-registration/

NY Digital Health Accelerator - NTC Investment Fund, NYeC New York Health, Empire State Development, Health Research Inc.

http://digitalhealthaccelerator.com/

Applications extended through June 11th. Use Code HDI in your applications.

Already hundreds of applications. 

Interviews July 19/20th

Winners selected by Early August Results announced in September

Investors take a small <5% stake.

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#HealthData SAS Analytics and Stratsan

More Action Beats, next up...

SAS Analytics

Learn from other industries. Banking, Gaming, Retail, Resorts, Transportation, Manufacturing.

Every industry is dealing with Big Data. Embracing Social media analytics.

"It is not enough to have a site on Facebook. You need to understand the pulse of social media"

Social Network Analytics.

- Current relationships

- Emerging relationships

- Spot relationships

SAS is pitching to the provider community. 

StrataSan

Zip codes are great for getting the mail to you but have zero to do with delivering care.

Wow- our care is a product line....

Deidentified does not mean anonymized. If you have an address for someone they are not deidentified.

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#HealthData ActionBeats, EPA, Archimedes IndiGO, Medgle, Cancer Survival Query System

EPA announces a challenge. MyAir MyHealth Challenge.

Helping those who are vulnerable to air pollution.

http://www.health2con.com/devchallenge/my-air-my-health-an-epahhs-challenge/

Develop a personal wearable sensor that can also monitor environment and health indicators. 

EPA-HHS My Air, My Health Developer Challenge
Glenn Paulson, Science Advisor to the EPA Administrator
Linda S. Birnbaum, Director, National Institute of Environmental Health Sciences, National Institutes of Health; Director, National Toxicology Program

Tom Goetz - My radar goes off - combining personal data, population data, geo spatial data. That's where really interesting stuff happens.

Individualized Guidelines: Indigo

The problem: current guidelines are clunky. Designed for groups and not individuals. 

Designed for one risk factor. 

basically too simplistic.

IndiGO is based on Archimedes Model. Individualized Guidelines and outcomes.

Patient-Physician decision making.

This afternoon the ACO Session will look at IndiGO for Prioritized outreach.

MEDgle - Ash Damle

The world is demanding hyper-personalization. 

How to personalize care decisions at scale.

Personalized Care Decisions: 

140 Million Data points in the MEDgle platform.

Impressive demonstration of hyper-personalized care diagnosis and that this can be delivered via SMS messaging if required.

MEDgle has a restful API.

Cancer Survival Query System (CSQS) - National Cancer Institute

Two views of a patient (but no view from the patient?)

- Cancer specialist

- Internist

Currently covers:

- Colorectal

- Prostate

Kaiser Permanente is collaborating to trial this platform.

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#HealthData Day 2 kicks off - @TGoetz Thomas Goetz introduces the day and Kathleen Sibelius

Thomas Goetz - Todd Park has been dealing with the challenge of Latent Data.

The Data Palooza is about unleashing the hidden power of untapped data.

Kathleen Sibelius - "Thrilled to be part of the Todd Park Road Show"

"Take Lazy data and get it in to the mainstream"

To make the transformation we have to unleash the power of entrepreneurship. We ar enow seeing innovations make a real difference around the country.
We are just getting started. We have massive inefficiencies. The innovation gap contributes to the challenge. We have to close the gap.

Innovation has been penalized. We have to change the way we pay for care. Exciting results already being seen.

ACOs (Accountable Care Organizations) have moved from Theoretical to launch.
HHS is stimulating demand for innovation.

Electronics Health Records are a key component in driving innovation.

Diabetics with an EHR are 6 times more likely to receive better care and better health outcomes.

"Out of 27,000 adults w/ diabetes, those with EHR were 600% more likely to see improvement."
20% of primary care docs & 1/6 of hospitals were using EHRs in 1/2009.6/2012: 2x hospitals & MDs using them

The conditions for Health Care Innovation has never been better.

"If electronic health records are the vehicle, data is the fuel."

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ONC Consumer/Patient stream at #HealthData

I am sitting in the ONC session that is consumer sponsored.

This session has:

- American Nursing Informatics

- Tiffany
- Dr. AlanGreene

How many nurses have a Personal Health Record?

3.1 Million Nurses.

Supporting the ONC in the Health IT Pledge.
The Pledge from nurses will encourage patients to use Personal Health Record tools and lead by example.

Sr. Alan Greene:

It is time for Health Professionals to touch patients as equals.
Patients should be able to give feedback to their doctors without being fearful of the implications.

Seal.participatorymedicine.org is in open beta.

To get the pledge:

1. Health Data in the hands of Patients and their caregivers
2. Get feedback from patients.
3. Resources in the hands of patients.
4. Encourage active participation

Receivers of Care also commit to some viral steps that encourage propagation.

Livestrong: Giving the Patient a Voice.

10,000 patients - They want their providers to be sharing their data with each other - without putting patients in position of jumping through hoops.

97% want to see providers do a better job.
96% want to be able to share data back
87% want to see the same data that their providers do.

58% strongly agree that they be able to donate information anonymously.

Presentation is important.

Coordinated Care is a recurrent theme.

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#healthdata onc bluebutton challenge

ONC

Volume
velocity
variety

The blue button mashup challenge.
$75,000 award

Diversity of data sources to mashup with bluebutton data

Mark Scrimshire
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#HealthData HealthData.gov launched - Key takeaway: Linked NOT Centralized

HealthData.gov is a marketplace. It houses meta data and not the data itself.

George Thomas is looking out over a packed room.

Drupal7 and built on EC2 (for workflow and community engagement)

CKAN (From UK) on demand resources (RESTful API and feeds
Solr for Search.

Github.com/hhs for code repository. This will be a published code base.

Testament to the open source community. The platform they are using was customized by the open source community at minimal cost.

Agile development project.

1st Call January 15th.
Project kick-off in May.
Launched on June 4th.

Agile reduces risk and not increase it. SCRUM-based, What did you do. What will you do today. What is blocking you.

hub.healthdata.gov/api/rest/dataset to find everything (http: GET)

Get individual data as JSON, XML, RDF.

Get data as Atom Feed

Homework: Google Knowledge Graph. GKG provides links between things not strings. ie. How one thing is related to another. E.g. Washington DC is named after George Washington.

Every thing has a unique identity: A URI. URI's can be linked.

Open Health Knowledge Graph:

Sindice Search hospital class: http://health.data.gov/doc/hospital/.....

HealthData.gov has an open knowledge graph that is a fully RESTful API.

6B "Triples" on HealthData.gov

Bringing social curation to create further relationships.

i2 Challenges:
- Improve the integration and liquidity of data made available

Round 1:
- Domain specific
-- Metadata:
Requests the application of existing voluntary consensus standards for metadata common to all open government data.

-- New designs for metadata standards that don't exist.

WebID-based SSO:
- Great to see single sign on being included in the scope of challenges.

Turtle is JSON like. Key/Value pairs. Turtle is the new JSON where value pairs are things and NOT strings.

Big Message. This is not about Standardizing datasets or data structures. It is about relating different datasets and data structures so that we can equate those differing data sets.

The traditional method of taking a long time and a lot of money to define a standard that then takes years to implement is no longer suitable for this fast moving world. We need a decentralized approach.

#Healthdata. @georgethomas: Key message from HealthData.gov approach is "linked" and NOT "Centralized"

"Data is just data. You can't eat it. Data is only useful when it is applied."

The goal is to generate improvements in health - improve people's lives. Data is the fuel for that.

95% of entrepreneurs didn't know what the Department of Health and Human Services did!

There is still an ongoing education process to make people aware of the data that is available.

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#HeathData HealthData.gov has double the datasets. Cool!

HealthCare.gov is the consumer facing site releasing more data - with the insurance finder. Over 1,000 insurance companies are accessible.

Developers will want to look at HealthData.gov.

There will be an API for the Insurer data. Expect a flood of Insurance comparison sites.

West Wireless Health will sponsor providing Fellows to support HHS in identifying innovative data that can be released.

Health Data Affiliates in WA, OH, MA, LA and CO that will promote health data initiatives in their states.

Great to see this commitment to improved access to data. This means moving to realtime APIs rather than fixed, static downloads.

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#HealthData RWJF Symcat wins their $100,000 prize

Symcat and a team of Johns Hopkins students wins a well deserved award. A very slick app that can be invaluable.

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#Healthdata: More Demos inc. Humetrix iBlueButton

Castlight Health: Know the cost before you go.

Humetrix are demonstrating iBlueButton. Download BlueButton health data to your smartphone. 

iBlueButton is a consumer-mediated Exchange of health information.

Very cool import and export of data. Non-proprietary apps can integrate with iBlueButton through importing and exporting.

http://itunes.apple.com/us/app/ibluebutton/id492141530?mt=8

My Cancer Genome

www.MyCancerGenome.org - making cancer data more accessible. Linking to clinical trials from clinicaltrials.gov

flornce.  mHealthCoach.

Cardiac Recovery Kit to reduce readmissions and promote speedy recovery.

Inpatient module.

 Integrates with Pill box and other APIs

A bedside iPad with an app. Answers the most frequent questions from Patients. 

Also an e-reader (nook color) that is pre-loaded with information for the patient to take home.

My Drug Costs.

MyDrugCosts.com - real time drug cost comparison.

Combine National Library of Medicine data with US DFA, Health Plans, Employers data to present relevant information.

Scanavert- Mobile service that alerts consumers to harmful content in food products. 

Fill out a profile to indicate drugs used or allergies.

Scan a product bar code and receive alerts if ingredients conflict with medications or allergies.

Scanavert has a number of prepared profiles. Gluten-Free is one of the top profiles.

Fascinating demonstration of crowd sourced information based upon use.

SymCat 

Craig Monson - Dr. Google is contributing to Cybercondria

Symcat guides people through symptoms to suggest likely problems.

Guiding you from Symptoms to Solutions. 

There is a web app and an API to enable integration in to other Health Portals.

Symcat uses data from CDC, Medline Plus. National Provider Index. Google Places, Aligning Forces for Quality.

Facebook is used to collect data from providers.

There is plenty of data out there you need to be ingenious in stitching it together.

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#HealthData Palooza welcomes Jon @BonJovi

The Health Data Palooza brings former US CTO Aneesh Chopra and Jon Bonjovi to the stage. 

Project Reach - Mobile App Challenge: 

Real time Electronic Access to 

Give ordinary citizens the power to give homeless veterans a roof over their heads.

http://www.jonbonjovisoulfoundation.org/

Project Reach Mobile App Challenge have 5 finalists

Scott Gould runs VA Innovations and coordinated the challenge.

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#HealthData Action Beat: @Aetna Carepass

Aetna is announcing their CarePass developer platform. 

Make things Simple, Convenient, Connected, Secure, Open

Good to see Aetna adopting the recipe for engagement:

iTriage is most successful mobile app - 6M downloads.

Carepass Sync brings together idnetity, insurance, health, nutrition and fitness.

Developer.carepass.com is being announced here at the Data Palooza.

Aetna de-identified pharmacy claims data.

Integration of HHS data

Good Rx providing lowest cost retail cost by drug data.

Aetna is providing a $100,000 challenge for people who create compelling medication reminder apps.

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#HealthData Community Dashboards

A series of demos from Miami, Ohio, North Carolina and New York State.

Dashboards bring together health data, community data and enable understanding of the determinants of health.

Health Landscape, LLC has created the Community Indicators Data Portal.

HealthLandscape.org has a really nice geo app that allows drill down using local data.

In New York State a church initiative tracks blood pressure. The information is tracked on cards.

Dossia was implemented to store Health Data. Piloted in 5 churches.

The Community Dashboard is provided by NexJ. (it was a shame that the demo failed. It would have been good to see the Health Tracker and community dashboards.

University of Rochester is using Artificial Intelligence to monitor Twitter to identify health related tweets and discover people who are sick.

By aggregating and tracking over time they can create heat maps for sickness. 

Interesting possibilities when mapping known pollutants with the heatmap of sickness. 

By tracking social networks they can track the impact of friends of friends on health. 

County Health Rankings and Roadmaps. 

Looking at Maryland - Howard County is healthiest and Baltimore City is the least healthy.

A cool development is the ability to build a roadmap to better community health.

1.7M visitors since 2010. 

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#HealthData Healthy Communities Institute: Dashboards become a catalyst for collaboration

Healthy Communities Network provides a single source of truth. It forces people to recognize the need to work together to solve health challenges.

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#HealthData Palooza kicks off - The Todd Park guide to the Palooza (@whitehousetp / @todd_park)

We have a packed house at the Washington Convention Center for the third Health Data Palooza. The growth of the ecosystem in 3 short years has been astounding. Liberating Health Data is a critical game changer in Health.

The stakes are enormous. 17% of GDP growing to 20%. Competitor nations spend a fraction of their GDP for the same health outcomes.

9:00 a.m.      Welcome & Opening Remarks 
                       [Main Auditorium, East Salon]
                       Matt Miller, Host, Left, Right & Center, NPR
                       Bob Kocher, Partner, Venrock 
                       Dick Foster, Venture Partner, Lux Capital 

Last year the focus was on proving data has power.

This year's objective is to demonstrate how data can create enduring businesses. 

Todd Park has been promoted from CTO of US Dept of Health and Human Services to become US CTO. With that comes a new twitter handle (@whitehousetp)

The inspiration for Health is NOAA and GPS.

GPS: Added a $90B value to US Economy last year.

A short History:

March 2010: 45 people kick off the Health Data Initiative

June 2010. A series of  demos took place at the first HDI Palooza.

June 2012 sees 1600+ people gathering to see a multitude of demos from Non-profits, startups and established companies. 100 demos selected from 240+ organizations. Many of the organizations are recently founded.

Today we see the launch of HealthData.gov.

The BlueButton: over 900,000 veterans and seniors have downloaded their health data using BlueButton in 18 months.

BlueButton is being cloned across the private sector. 

Cajun Codefest - 300 developers gathered for 36 hours in La Fayette, LA. This has spawned 6 companies. 

We are also seeing seed accelerators: StartupHealth, RockHealth, HealthBox and BlueprintHealth.

The Health Data initiative is not a government initiative - it is an american initiative.

Todd's guide to the Palooza:

1. Don't miss the plenaries

2. Check out the Apps Expo and Afternoon demos

3. Developers should check out the sessions on Health Data APIs

Community folks should attend the Wednesday session on using Local Data to improve Health.

So much going on. Keep tapped in to Social Media to tap in to the cool stuff that is going on.

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#hcdc how to utilize social media in healthcare

How do we leverage the many-to-many relationships.

What do we do with the "social exhaust"?

WebMD 100m visitors each month. Health info on 1 in 2 adults.

Jen Dyer @endogodess blog as prescription.

@personiform - differences between active and passive use of social media by medical professionals.

We need to maintain firewall between underwriters and providers.

Look at the convoy model to understand the power of relationships in relation to behavior change.

How do understand correlation and causation.

Also understand the filter bubble.

So think about private browsing to avoid google/bing filter based on friends and past practice.

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

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#hcdc #thewalkinggallery @lostonroute66 warming up to sing gimme my data back

Mark Scrimshire
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#hcdc #healthdata #thewalkinggallery @tedeytan telling the story of his jacket

Mark Scrimshire
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....Sent from my iPhone

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#hcdc healthcare #healthdata @unclenate runs Do It Ourself

Nate DiNiro leads a do it ourself session taking the lead from our HealthFoo experience.

Ideas:
Leonard Kish talks about the need for convergent approach - a care quality framework.

How do we deal with the proliferation of apps.

@dcdsve - balsamiq

Build a mockup toolkit for patient advocates - balsamiq.com Consumer centric semantic inter-operability framework.

Patient- centric life long longitudinal care plan.

A microform at for a patient generated care plan

- capture patient objectives

Equivalent of hrecipe for care plans

Capture aspirational goals. Can be leveraged by doctors to tailor care plans.

Check out trello for collaborative organization.

Aspirational goals are difficult to quantify.
Outcome:

Patient centric
Open enablement platform
Bottom up not top down

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

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#hcdc behavior change and incentives.

Really interesting discussion that span so many different aspects. The sickest folks with multiple chronic conditions are often the hardest to reach.

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

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#hcdc @marcoambrosio talkin about empowering engagement

"what's in it for the doctor?"

@endogoddess kids with diabetes - its not that they don't want to take their meds it's that they don want diabetes.

Built an app to text to kids with diabetes. Create a personal connection before you start "nagging"

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

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#hcdc #healthdata @boltyboy covering the code-a-thon that took place before healthcampdc

Matthew Holt talking about more than $100,000 of challenge money is on the line at the health data palooza.

70 companies demonstrating down selected from more than 200 applicants.

Mark Scrimshire
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#hcdc healthcampdc has a great vibe going.

The day is buzzing.

Mark Scrimshire
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#hcdc Dr Akhter of #dchealth talking about the proclamation by the DC Mayor

Dr Akhter talking about improving health through innovation at HealthCa.mp

Mark Scrimshire
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#hcdc Hal Wolfe firestarting healthca.mp/dc

The start of a great day. Day 3 of the DC health data and innovation week.

Askin for help on applying many-to-many relationships to health. Big data. Social.

90% of the world's data has been collected in the last 2 years. The "social exhaust"

Mark Scrimshire
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A lovely sunny start for #healthdata and #hcdc healthca.mp/dc

Mark Scrimshire
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The judges for #healthdata code-a-thon have deliberated and the results are...

1st: schoolfit
2nd: healthyplace
3rd: sms2live And lessbadd
healthABC and my local place

Mark Scrimshire
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#HealthData #wotn Ideas for the Code-a-Thon

Smackdown Challenge - Food Comparisons. Facebook social application?

- Compare nutritional data of different foods
- Allow tailoring to personal needs (Gluten, Diabetes etc., weight loss, cost)
- Account for history
- search (link to myfitness pal etc.)

Build your plate.
Share your plate.
Get ideas from others.

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#healthdata #wotn 97M Americans are obese. The epidemic of our times.

Mark Scrimshire
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#HealthData #WOTN Dr. Robert Post talking about ChooseMyPlate.gov

Dr. Robert Post, Deputy Director, USDA Center for Nutrition Policy and Promotion.

http://www.choosemyplate.gov

Empowering consumers to build a Healthy Plate.

33M page views since launch last year.

Check out SuperTracker: https://www.choosemyplate.gov/SuperTracker/default.aspx

800,000 registered users on SuperTracker since December 2011 launch.

- increase intake of fruits and vegetables

- Reduce intake of solid fats and added sugars and sodium

- Replace empty calories with nutrient-dense foods and beverages

- Motivate and empower consumers to make better food choices.

Jesse Gibbons - Product Owner for CarePass, Aetna.

Jesse is talking about the CarePass Developer Portal: http://developer.carepass.com This is a brand new site, launched on June 1st, 2012.

Convenience and Quality are absolutely related. 

A major developer challenge is being launched on Tuesday June 5th.

Next up: Dr. Alan Greene

In 1985 many states didn't even track levels of obesity.

1991 was a watershed year.

Today (2010) most states are over 20% obesity and continues to rise.

Today we are now seeing Children with blood pressure problems. 2/3 of middle and High school students have obesity issues.

Obesity is a symptom of how America: Eats, moves and sleep.

in the Age group 2-18 kids are eating 

#3 Soda

French Fries are the only vegetable. 

Apple Juice is the only juice.

Adults: Vegetables are French Fries and no fruits.

We are lacking Nutritional Intelligence

Big space/opportunity to recognize what you are eating. 

Pay attention to the food you recommend.

Food Desserts. Are an issue. How can you recognize healthy food on the run eg. In airports or on the road.

We have to hack food choices.

Alan tells the story of Banana eating cats that influenced their kittens to eat bananas.

Kids change behavior based on images they trust. For adults this influence is driven by Celebrities.

2.3 bites per minute v 3.5 bites per minute. Slowing down our eating can help us lose weight.

Timing for Food Decisions is critical. We plan ahead better but fail at instant decisions (e.g. we get persuaded by the smell of the french fries in front of us.

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#HealthData week kicks off with the Weight Of The Nation code-a-thon at the KP Center For Total Health (#WOTN)

It is Saturday in Washington DC. I am at the Kaiser Permanente Center For Total Health for Health 2.0's Code-A-Thon. The focus for the Code-a-Thon is the Weight of the Nation campaign (#WOTN) - the fight against Obesity. This is part of the Washington DC Health Data and Innovation Week.

There is a great turn out for this 2 day event. There are probably about 40-50 people in attendance - a great mix of developers and other experts.

There will be presentations from Dr. Robert Post (USDA), Jesse Givens (AETNA), Dr Alan Greene from DrGreene.com.

At 10:40 there will be the Idea Pitch session. Then at 11am teams will self-form and begin coding. At noon there will be tech talks over lunch. These include: Tyler Norris of KP.

The event concludes at 5:00pm on Sunday after final presentations and the winners of the Code-a-thon are announced. After that I have to get ready for HealthCa.mp/DC on Monday morning.

Some facts about Obesity:

97M Americans are classed as Obese. This is an epidemic. Estimated Annual Cost of $190B combatting obesity issues. That doesn't include the downstream costs of disease driven by obesity.

Obesity is a challenging issue. It is a cultural, environmental. societal and genetic issue that creates amazing complexity when trying to solve the problem.

The objectives:

Leverage Federal Health Data such as :

- Health Indicators warehouse

- data.gov

Use any available datasets and APIs

Judging Criteria:

- Use of Data (40%)

- Creativity and Impact (25%)

- Productivity (15%)

- Presentation (10%)

- Functionality (10%)

-Presentation Rules:

 - 5-7 minutes

- Live Demos Rule

- 2 Slides Max

- Submit your project

Aman Bhandari now provides some context to the day.

HHS is building an open data ecosystem for Health.

Companies have developed out of ideas at Code-a-thons. 

Data.gov has over 500,000 data sets available.

The objective is to take policy in to action. NOAA is the model for health. HHS to provide raw data and have companies develop ideas in to businesses.

HHS: $892 Billion, 11 Agencies, 80,000 Employees, 100M Americans served by Medicare and Medicaid.

Pubmed has 21M articles published.

ClinicalTrials.gov has access to 120,000 clinical trials in 177 countries.

Some outcomes from freeing data:

- Bing incorporated quality data in to search results (Hospital Compare)

- Blue Button 

- Think about Data gaps...

- Think about making data useful

- Think about making data actionable

There are huge gaps in the obesity space.

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