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Conference announcement: HAND-HELD [un] conference – Mar. 20, 2008 @ Toronto, Canada January 29, 2008

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

I came across this announcement for a conference that sounds very interesting.  It’s called "HAND-HELD:  an [un]conference harnessing digital storytelling to improve health".  I’m intrigued by the description of the event:

HAND-HELD is an [un]conference that explores how digital storytelling and new media can be harnessed to improve health care when the tools of creation are placed in the hands of citizens.

The event will showcase the remarkable results of an 18-month participatory media project, I WAS HERE. We put digital cameras into the hands of young mothers who have experienced homelessness to document their lives, and their experiences with the healthcare system.  Their photography and video work will be the starting point for the conversations during the day.

HAND-HELD will bring together a small, hand-picked selection of health-care professionals, academics, media-makers, politicians, decision-makers and young parents who have experienced homelessness — all experts — in a unique open-source day to envision our collective future of health-care in a democratic and digital age.

A while back, I wrote a series on my personal predictions of disruptive technologies in health care.  In my final summary, I identified the patient as the ultimate disruptive force.  Not sure if I’ll be able to attend, but I’m going to try and make it.  The [un]conference is to take place on Thursday March 20th, 2008 in downtown Toronto at the MaRS Centre.

To make things even more ironic, I had an opportunity to catch-up with an old colleague of mine, Dr. Carlos Rizo, and we had a wonderful time talking about our own patient experiences and hopes for transforming health care a system that is actually about the patient.  We hope to do some work together in the future on this topic, so I’m hopeful for some new and exciting developments.

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A glimpse at Google health? January 24, 2008

Posted by Hans in : news , add a comment

Seems like Google is doing things in the background regarding their health product.  Another blog reported a Google Health login page.  Some of the features listed on the login page sound like things I predicted with my "prescription for Google Health".  Definitely something to be on the lookout for, especially given Microsoft’s foray into ehealth with their HealthVault offering.

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A voice against irrational exuberance in ehealth January 23, 2008

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

For those interested in a somewhat contrarian viewpoint about ehealth, I suggest you check out Scot Silverstein.  I just recently came across his site documenting some "common examples of health care IT difficulties".  You can also listen to his interview available via the Government Health IT site – an excellent site.

In his interview, Dr. Silverstein raises some very important points:

My interest in Dr. Silverstein’s work is in our common view on technology:  that there’s great potential to make positive changes, but that success isn’t a certainty – what is commonly referred to as "technological determinism".  I’ve written as far back as 2004 about technological determinism and ehealth, namely to be skeptical about the absolute certainty that the IT professionals have about ehealth (e.g., my post about IBM building computer models to solve health care’s woes).  I think it’s important to have a balanced view on being hopeful of the possibilities, but also being realistic about the challenges (some final thoughts from a 2005 ehealth conference).

I hope to do some more reading on his website to see what other nuggets I can glean from his work.

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Is this the future of peer review? January 22, 2008

Posted by Hans in : academics , add a comment

Came across an interesitng report of how an "author used blog comments to peer review a book".  Before dismissing this report, please consider that the book "examines the study of video games, and the blog in question is Grand Text Auto, an academic blog founded in 2003 that deals with ‘digital narrative, poetry, games and art.’".

Given some of the moves toward open access publishing for all government supported research projects, looks like the academic publishing world may be undergoing some change.

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One step at a time: Pharmacists and physicians exchange patient data electronically January 22, 2008

Posted by Hans in : analysis, news , add a comment

Canada Health Infoway announced a first in Canada:  Pharmacists and physicians exchanging medical data stored in patients’ electronic medical records.

Pharmacists can now “access lab test results, allergies and other vital data from consenting patients’ electronic medical records”, allowing them to “collaborate with physicians and the rest of the provider team and resolve drug-related issues more effectively and efficiently for their patients”.  The physicians seem also seem to be ecstatic about this new development as they are now able to “make better use of the expertise provided by pharmacists, make more efficient use of my time and hopefully, provides a more convenient and effective patient experience”.  This announcement is another sign of increased collaboration between the various health professionals in the system.

On a personal note, I can attest to how difficult this project must have been.  On a few occasions, I’ve been involved with developing “data dictionaries” from within an institution and across multiple institutions.  All I can say is that the task is tedious.  I spent six months reconciling definitions of indicators across a multi-site hospital because each department measured things differently.

Now that pharmacists and physicians have access to the same information about a patient, what’s next?  I’ve been participating in a home care knowledge translation course and a trend I’ve been noticing is exploring increased roles for pharmacists – notably in the area of education and medication checks.  The research that we’ve reviewed suggests that pharmacists haven’t made much of an impact (yet).

Regardless, I think this announcement by Canada Health Infoway is a great first step.  I would have liked to have known how the pharmacists are using this information.  What’s next?

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Guide to program evaluation January 20, 2008

Posted by Hans in : research, resources , 10comments

Here’s a link to a free resource on program evaluation titled, Basic Guide to Program Evaluation.  The guide seems like a great resource for those who need help in getting started.  With some great summaries and tables comparing the pros/cons of different methods and designs, this guide seems like a great, free resource.

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The “Google generation” and some implications for ehealth January 18, 2008

Posted by Hans in : analysis, news, research , add a comment

The findings of a recent report on how the "Google generation" uses technology and searched for information has some potential implications for ehealth (view the full report [35 slides] or read a summary article via ars technica).  In this case, the Google generation was defined as those kids born since 1993.

Kids seem to be familiar and comfortable using technology (i.e., what people would call ‘technologically savvy’).  However, this competence in using technology doesn’t translate into their ability to find information.  Assumptions about youngsters improving their search skills by experimentation and use alone would seem to be false.  What else was interesting was that kids prefer interactive activities (duh!), but they weren’t so picky about visual over text.  Visual was preferred to text, but it wasn’t a huge difference.

For those of us interested in ehealth, I think there are some important things we need to consider.  For example, my supervisor, Alex Jadad, often likes to challenge people by saying that we need to build a system that our kids will use because they are technologically savvy.  They may be more comfortable with information and communication technologies, but we can’t assume they’ll be "experts".  Some things to consider:

What seems clear is that we need to be careful about the assumptions we make about people using technology.  Young people may have a head start in terms of comfort and familiarity, but they aren’t "automagically" experts of finding information.  In fact, according to this study, their comfort and familiarity may lead to a shallow understanding of technology.  Something to think about.

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What can ehealth learn from Steve Jobs, Apple Inc., and Macworld? January 18, 2008

Posted by Hans in : analysis, conferences & conventions, news, opinion , 2comments

As in the past, I watched the 2008 Macworld keynote address by Steve Jobs.  This time, I was a bit surprised by some of the responses of the media and crowd.  Apple’s stock getting hammered didn’t help.  In any case, I think there are some good lessons for ehealth, and health care in general, that can be learned from Steve Jobs, Apple Inc., and Macworld.  Here are five lessons that we can learn:

1.  Focus on the user experience
This one should be a "no-brainer", as Steve Jobs always emphasizes building products that provide an excellent user experience.  You can see this in the design of Apple products.  For whatever reason, health care, and by extension ehealth, hasn’t really focused on the patient experience.  It is, however, getting better.  But, we’re still far away from anything remotely resembling a "patient-centered" system.  The system needs to change its orientation from being health care practitioner centered (i.e., physician) to putting patients first – and I don’t just mean lip-service, but real change.

An analogy of this would be the largely stereotyped caricatures of Microsoft and Apple.  Microsoft is seen as catering to the needs of business, whereas Apple promotes itself as a "consumer" oriented company.  This would translate into ehealth catering either to the existing institutional and professional powers versus patients and consumers.  FOCUS ON THE PATIENT EXPERIENCE!

2.  Demand excellence
Steve Jobs is portrayed as some tyrannical CEO who can be difficult.  However, he is known as a person who does not compromise and demands excellence from all staff and employees.  We can all learn to not compromise and give-in, but push for something better by demanding excellence.  Patients probably know this intuitively, but haven’t really had an organized voice to channel their expectations.  I know that individuals in the health care system all push to be the best they can be, but sometimes the rules, the bureaucracy, and the system just grind people down.  All of us need to demand ehealth to be excellent and not just convenient.

3.  "Think different"
This was a campaign slogan for Apple a few years ago.  I think it’s apt for ehealth of today.  Instead of succumbing to the often cited difficulties and generally accepted ways of doing things, we in the ehealth field have an amazing opportunity to push the boundaries and imagine all of the possibilities of what can be done to make things better.  Normally I hate the phrase of "thinking outside the box", but I think it fits here.  Apple Inc. is known to do things differently.  With so much more at stake, shouldn’t we also "think different"?

4.  Celebrate achievements & build excitement
I think Macworld is a great example of an event that gathers people together to celebrate the past achievements of the past year and also build excitement for the upcoming year.  eHealth needs to do more of this.  I know that there are annual conferences in the US, in Canada, and in other parts of the world, but they sure don’t get much press coverage.  If the Canadian conferences are any example, these are generally attended by industry folks with very little publicity.  A while back, I pondered the idea of having an ehealth or a health Olympics.  Maybe it’s time that we band together to create something bigger that can garner more attention and more excitement.  I don’t know about you, but whenever I talk about ehealth and the possibilities, I get excited.  We have a good chance to be important contributors in helping to make health care better for everyone.  We need to capture this excitement and inspire others.  Macworld does a great job of this for the "Apple faithful", but also generates quite a bit of buzz from non-Apple customers.

5.  Build partnerships
Apple is starting to learn how to build partnerships that are meaningful (e.g., Intel and Google).  Sure, they’re not great at it, but they’re trying.  The ehealth field can learn from this.  Instead of trying to do things on their own, we need to get together and build partnerships.  The problems and challenges are far too big for any one company or group to do it alone.  Governments and private sector groups working together is a good start.  Instead of competing with one another, we should encourage co-opetition so that more can be achieved.  But, don’t forget the patient!  The patient needs to be included in this partnership too.

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Peering into the (ehealth) fog of war … January 16, 2008

Posted by Hans in : analysis, opinion , add a comment

At one point in time, a long time ago (around 2000), I wondered if centralized, government maintained electronic health records was the way to go.  In defense of this position, my arguments revolved around the notions of efficiency and control, in that it was easier for systems to be monitored, maintained, and updated if they were all in one place.  But, as anyone with a technical background could point out, there are significant technical issues behind such a strategy.  It would seem that some people agree: "German doctors say no to centrally stored patient records".

What I find interesting is the proposed "counter" solution:

As an alternative, the German private doctors’ body is suggesting the use of encrypted USB-sticks. These could be handed over to patients and would carry all relevant patient data, including digital images such as radiographs or CT-scans

Wow.  I haven’t heard a call for the use of physical based media in quite some time.  Personally, I thought that this line of thinking was disappearing as the feasibility of cloud computing increases and slowly becomes a realistic option.  In all fairness, there are a few other very interesting points raised by the group representing the German physicians.

After reading this article, I get the distinct feeling that as of 2008, we’re staring into the "fog of war" as no-one is certain as to what strategies or solutions will ultimately prove successful.  Might be interesting to start documenting what ideas people think will work or not work.

From my involvement in this industry in North America, I got the distinct impression that a strategy that mixes personal and public records was emerging.  Basically, health care organizations and governments (depending on their level of involvement in the delivery of care) would maintain an electronic record that is stored and available to authorized parties of the "system" (be it regional or otherwise).  Patients would then maintain some sort of "personal health record" that they can control.  The organizational records are often deemed to be the "electronic health record".  Maybe it’s me, but the title, "electronic health record" seems to have a more legitimate or official connotation than "personal health record".

It will be interesting to see what strategy(s) emerges.

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Online Evaluation Resource Library January 12, 2008

Posted by Hans in : academics, research, resources , add a comment

Here’s an interesting resource for those interested in evaluation, titled the "Online Evaluation Resource Library" (OERL).  The goal of the OERL is to:

the continuous improvement of evaluations used to monitor and judge projects’ effectiveness. OERL provides a rich collection of evaluation best practices, guidelines for their applications to projects, and a forum for stimulating ongoing dialogue in the evaluation community. OERL is designed to support applications of sound evaluation methodologies to projects, not to replace a full course of study for those going into the evaluation field.

I did a quick search for resources regarding ehealth and related topics but didn’t find anything.  Maybe it’s an opportunity.  Nevertheless, for those interested in getting started on evaluations of health related IT projects, OERL might be a good resource for ideas.

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