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Upcoming: The World of Health IT conference & exhibition (Oct. 22-25, 2007) August 31, 2007

Posted by Hans in : conferences & conventions , add a comment

Scheduled for October 22–25, 2007 in Vienna, Austria, The World of Health IT Conference & Exhibition looks like it will be a big event.

The goal of the conference is to “bring the key stakeholders in healthcare delivery through technology together for the first time”. Many of the keynote speakers are either national or international directors of health systems. I suspect that there will be some very interesting sessions with plenty of networking. For anyone interested in the macro-level of health care delivery, this conference looks like a must-attend event.

Popularity: 43% [?]

Podcasting in healthcare - 2007 update August 30, 2007

Posted by Hans in : analysis, opinion, podcasting , 1 comment so far

As some of my readers might remember, I ran a series of posts on examining the potential role of podcasting in healthcare. At the time, I wasn’t too keen on podcasting in healthcare:

Recently, I came across a post titled “Will Podcasting Survive?” on a blog that I follow (Read/WriteWeb). In this article, the author, Alex Iskold, examines podcasting as the evolution of radio. Even though the technologies available to create and distribute podcasts are more widely available than ever, this medium of podcasts seems to have stagnated. He presents some data/graphs to highlight and support the idea that podcasting is stagnating. He gives four main reasons for this trend:

  1. Competition with video and blogs
  2. Limited applicability
  3. Monetization is a challenge
  4. Competition from big media

He concludes with:

It appears that podcasts are not picking up steam, and rather, podcasting is actually slowing down. There is not enough incentive for people to jump exclusively into podcasting because of tight competition from video, blogs, big media and a lack of clear monetization methods. However, it does not mean that podcasts are not here to stay.

Iskold’s conclusions seem to support my thoughts about podcasting in health care, albeit his conclusions are a bit more general in nature. Specifically, podcasts are “something you need to specifically listen to. They typically consist of a discussion you need to be able to focus on to follow”, making podcasts much like listening to a lecture. For some, it will be great, but for others (the vast majority, in my opinion), podcasts will not have much value, other than to be another resource that can be accessed.

Well, a year has passed, and I ran an update using Apple’s iTunes media software (v7.3.2.6) and was surprised at some of the results.

Table 1: Podcasts by topic using Apple’s iTunes on Aug. 30, 2007 (1200 EST) from Canada

Topic/ Keyword 2006 2007 Notes
health 105 150 Mostly health and fitness offerings and a few educational offerings. E-health Insider has a podcast.
medicine 105 150 Seems like a hodge-podge of podcasts focusing on specific conditions. From the descriptions, I get a sense that these are styled like “talk-shows” or something like the CNN offering “Your Health with Dr. Sanjay Gupta” (he has a podcast available from the CNN’s health page)
healthcare 84 141 A wide variety of topics covering improvement, education, self-help, and business. An interesting podcast by CDW talks about technology/IT management issues in healthcare.
doctor 105 150 Not really health focused, as the search returns anything using “doctor” in its name.
e-health/ehealth 1 6 Some very focused and interesting offerings including conference proceedings, e-health insider podcasts, an Australian industry publication podcast, and an individual podcast focusing on issues for Latin Americans.
telemedicine 1 3 Recordings from symposia.
telehealth 0 1 Weekly podcast from Canadian Society of Telehealth
informatics 5 139 Wow - what a surprise! I haven’t had a chance to go through everything, but there seems to be quite a range of podcasts here ranging from comedy, education, careers, and topical listings
cancer 105 147 A good variety of podcasts, mostly related to education and self-help with a few personal accounts of living with cancer. I was a bit surprised by the small increase in numbers, as I expected this section to grow much more than the other topics.
patient 105 150 Again, a wide variety of topics focusing on self-help, education, and general health.
cardiovascular 20 39 Some very focused topics.

I was very much surprised by the significant jump in informatics and the few new ehealth podcasts. I didn’t expect those numbers at all. My expectation was to see more health topics (i.e., health, ancer or cardiovascular), when in fact there wasn’t quite as many - granted 40–50% increases are significant.

Given Iskold’s comments about the slowing trend of podcasting and increasing video content, I wonder if video will supplant podcasting in healthcare. Granted, there may be considerably more podcast offerings on the Internet that are not hooked-up with Apple’s iTunes software.

In my own personal experience, I stopped listening to podcasts on a regular basis. I can’t say exactly why I stopped. All I know is that I didn’t find listening to podcasts to neither particularly enjoyable (even for purely entertainment podcasts) nor efficient. I was always irritated at the slow pace of the discussion, or irritated at the difficulty in jumping to the topic of interest. In the end, I decided to stop altogether.

Popularity: 81% [?]

Now coming to a theatre near you: Capital Health is recruiting… August 26, 2007

Posted by Hans in : opinion , add a comment

I don’t know about you, but I generally don’t like to watch advertisements, especially the 10–20 minutes of paid advertisements just before the start of show at the movie theatre. Normally I pay little attention to the ads, but I almost fell out of my seat when I saw a recruiting ad for Capital Health, “one of the largest integrated health regions in Canada” (it’s located in Edmonton, Alberta). I don’t know about you, but I don’t expect to see recruiting ads for “health care careers” when watching the late showing of actions movies like “The Bourne Ultimatum”.

I was curious about the ad, and so I did a quick check of the Careers & Training section of the Capital Health site. For those interested, there are some interesting postings ranging from clinical, corporate, and even academic/research.

Popularity: 53% [?]

Upcoming: Consumer Health Informatics Conference (Oct. 30, 2007) August 24, 2007

Posted by Hans in : conferences & conventions , add a comment

For those interested in empowering consumers and patients, there’s an interesting upcoming conference: Consumer Health Informatics Conference. The goal of the conference is:

to focus on the technical, social, ethical and professional issues arising from consumer empowerment using information technology.

The conference is a one-day (Tuesday Oct. 30, 2007) event held at Ottawa’s National Arts Centre. The program seems very interesting and based on my knowledge of the speakers, should be a thought-provoking and challenge filled day.

Popularity: 33% [?]

A prescription for Google Health? August 21, 2007

Posted by Hans in : analysis, opinion , 11comments

About a year ago, Google indicated that “health care information matters”, with little to report since then. Google seemed to have formed a health board comprised of physicians and some patients to guide its efforts. Recently, I’ve read a few pieces speculating about Google’s efforts toward building a health care product/service (here and here).

In 2005, I had an idea for how Google could potentially disrupt health care. I even shared it with my supervisor, who thought it was an interesting idea and mentioned he would mention it during a meeting he had set-up with some senior execs at Google. Unfortunately, the meeting never took place, and I sort of forgot about it because of my studies.

My idea was that Google develop a personal health record using basic Web2.0 technologies already in its portfolio. Google has several services that could potentially be re-organized into a functional health information product:

This idea of Google developing a consumer oriented electronic health record was based on the theory of disruptive innovations described by Clayton Christensen.

Currently, efforts are underway to develop electronic health records (EHRs) by governments, regional authorities, hospitals, health information companies, and pretty much everyone else in health care. EHRs have been somewhat of a “holy grail” in the health informatics community since the 1970s, promising an assortment of benefits. Currently, there is no standard EHR product available, and so vendors have been pitching integrated solutions for the last little while. In recent years, hospitals (at least in Canada) have been examining the possibility of assembling EHRs based on “best of breed” technologies - basically taking one component from company A and another component from company B etc. With more governments getting involved in setting an agenda for ehealth/eletronic health records, the vendors seem to be more open towards adopting standards for sharing information between systems and with other organizations (a push for a more regionalized model). Needless to say, these efforts are quite costly in terms of purchasing hardware, building-up an infrastructure, training, and licensing costs. Physicians and other smaller medical groups have been largely left alone to purchase products from vendors - which isn’t necessarily a bad thing.

So where does Google fit in? Well, Google could release a “free to use” personal electronic health record – here are some reported “screen shots” of the would-be Google product (looks like my suggestion might be pretty close). How would it work?

For patients
This product would be a central place that a patient could record and store health information. Information could be found on the web and then recorded for future reference (search). Patients could record some thoughts and questions about the information they found (blog or docs). Alternatively, patients could keep a “health diary” recording responses to medications, daily activities, food eaten, difficulties with activities, etc (blog). Some specialists have mentioned that patients don’t remember enough detail about past events to be helpful when first noticing symptoms, leading to delays in diagnosis/treatment and additional tests. Basically, all of the functions of a personal health record freely available to patients. The “home page” (or “about page”) could list pertinant information (age, existing conditions, allergies, etc). Basically, the patient version is an easy way for patients to view their own information, add additional information, and link to family members (social networking), and share with health professionals.

For providers
While patients can create large quantities of data (usually in text format), this isn’t so great for busy health professionals. Health professionals could be provided a “dashboard” that summarizes the information contained in electronic health record – things like charting medications taken with responses. Obviously some development of appropriate applications would need to take place. Ideally, lab data could be either imported or linked to provide a full picture of the patient. The best thing would be for Google to pitch this type of service to small physician offices who don’t have the expertise to set-up and maintain their own systems. All a physician would need is an internet connection and a few computer terminals. Scheduling could be handled either by the patient using the calendar service and monitored by some administrative staff. No more lost charts!

But wait…
Some will mention that this Google health product will not be “good enough” to meet everyone’s needs. You’re right. But it doesn’t need to be. Google can simply release this product and develop it by adding new features and functions along the way and go “up-market” (following the classic disruptive innovation curve). Of course, Google would need to insure security and privacy and be cognizant of any reglations and laws.

Others might point out that the existing vendors will not sit still. True, but most vendors are interested in making money, and thus they focus on selling to hospitals, HMOs, or other health care groups. Patients aren’t a lucrative market (yet). Vendors might release a product aimed at patients, but that’s more to ensure that hospitals will keep buying their products. Google has an inherent cost advantage here because its services are free to the users because it’s paid for (presumably) by advertisements. Google stays happy because it maintains its user base, and thus increasing its potential ad revenue. At first, the product might not have all the features, but new ones can be added quickly by opening up APIs so that developers can add new features, putting pressure on existing vendors to provide services at Google’s price points and pace (yikes – how do you compete against free?).

Another potential snag is that hospitals and lab companies will not want to share their data with Google. Yeah, that’s true. But, as more standards emerge and governments push for sharing of information, getting other players involved (like Google, Microsoft, or another firm) should be easier. It’s not a question of whether existing players want to, but more a question of when will they be forced to start sharing information.

As Christensen predicts, we’ll soon enter a stage of “commoditization and modularization” where standards allow for components to be swapped interchangeably (we may be closer than we think). If that’s the case, then vendors will need to switch their efforts at providing integrated products to focusing on specialized components like decision support modules, data visualization, or other applications that can “plug” into a larger framework.

I’m interested to see just what Google has up it’s sleeves. The idea that I’ve just described would also follow in Google’s current practice of releasing “beta” products, getting feedback and gaining market share, and then monetizing the product with new releases (see their history with their office products). In one scenario, Google could provide a suite of EHR products for physician offices for free, or with some basic support for an annual cost, slowly moving up the value chain. It’s unlikely that large hospital corporations will ditch the investments they’ve made in the near future. Besides, large corporations have much more demanding needs that Google probably can’t match initially. But, things may change. If enough patients start using Google’s services for Health, maybe there could be a radical shift in power from the health professionals to patients.

I don’t know about you, but I’m very curious to see what Google releases.

Popularity: 54% [?]