Worlds colliding…industry vs. academia May 13, 2008
Posted by Hans in : academics, nature of ehealth, opinion , 1 comment so farIt’s interesting to see how differently ehealth is viewed by academics and industry. To one, ehealth is the potential of using new mediums to explore ideas and possibilities, while to the other, ehealth is more of a means to an end.
For the past few years, I’ve been in the academic world exploring the limits of our existing evaluation theory as applied to ehealth innovations. As a researcher (or perhaps more aptly, ‘would be’ researcher), I focused on the concepts of ehealth and how one could evaluate these constructs. The pursuit was academic and intellectual, even though I tried my best to remain grounded in solving, what I perceived to be, real problems. Perhaps that’s why much of my writing and thinking on this topic has been focused on the patient and how users of the technology (health care providers included) can be empowered by ehealth.
More recently, I’ve been exposed to the industry perspective of ehealth. In this world, ehealth is all about programs and projects, about deployment schedules, funding options, and providing the framework to move a health care system along. Here, there really isn’t any time for or value of the rigorous methodological approaches (and debates) surrounding randomized control trials, systematic reviews, or even articulating an epistemological viewpoint on how knowledge is constructed or derived. Ehealth, in this context, is a business matter that requires analysis, forecast, and action.
For me, I feel somewhat stuck between two worlds, not having left the academic/research world, and yet being asked to help address some industry problems. Discussions in the realm of industry hardly mention patients except in strategy/vision documents. Ehealth is big business, dominated by government bodies and vendors.
I’m not saying that one is better than the other. I merely point out something that wasn’t *real* to me until recently. I always knew that industry is different and operated differently than the research world, but perhaps I was a bit naive about how much difference there really is.
WorldPowered by Qumana
Popularity: 66% [?]
A voice against irrational exuberance in ehealth January 23, 2008
Posted by Hans in : academics, analysis, opinion, research , 1 comment so farFor 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:
- Technology companies don’t fully understand the complex, fast-paced, amorphous nature of health care. Health care is not like other industries.
- The concept of using technology in health care is valid, but it must be done right. Today, implementation and the realities of the technologies just aren’t good enough (yet).
- We need to go far beyond "user centered" design. Clinical involvement is mandatory because many systems are designed using incorrect assumptions.
- Governments should focus on developing and enforcing standards.
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.
Powered by Qumana
Popularity: 88% [?]
Is this the future of peer review? January 22, 2008
Posted by Hans in : academics , add a commentCame 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.
Tags: peer-review, open access, blog
Powered by Qumana
Popularity: 91% [?]
Online Evaluation Resource Library January 12, 2008
Posted by Hans in : academics, research, resources , add a commentHere’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.
Powered by Qumana
Popularity: 31% [?]
JMIR a top health services and informatics journal June 23, 2007
Posted by Hans in : academics, research , add a commentFor those interested in publishing their work, you should consider the Journal of Medical Internet Research (JMIR). JMIR is now the #2 medical informatics journal based on the ISI/SCI impact factor ratings, with a rating of 2.9. The “impact factor rating” is a statistical measure of how frequently articles from a specific journal are referenced by other articles. The thinking is that “better” articles will be referenced more frequently. You can read more about this announcement here.
Popularity: 26% [?]
The Imposter Phenomenon June 23, 2007
Posted by Hans in : academics , add a commentI attended a fascinating presentation earlier this week. The presentation was about the “imposter phenomenon” by Diane Zorn (PhD candidate at York University).
The Imposter Phenomenon is when high achievers (e.g., graduate students, professors, lawyers, physicians, etc) are “plagued by the fear that they are not as capable or intelligent as others think they are, that they cannot keep repeating their sucesses, and that they will reventually be found out as frauds”, despite outstanding accomplishments and frequent praise.
What I found most interesting was that this phenomenon isn’t so much an individual’s fault (according to Diane Zorn), but the result of environmental and cultural forces. In graduate school, the university culture fosters unhealthy lifestyles and often unwittingly promotes this imposter phenomenon. Diane Zorn presented data that showed how working to get a PhD is detrimental to your health: loss of hobbies, isolationism, decreased and dysfunctional communication skills, high incidence of depression, high stress, and so on.
One interesting finding was about Harvard. Apparently, Diane gets very positive feedback whenever she runs a seminar/workshop on this topic at universities and companies across North American and Europe. Audience members seem to share about their own insecurities and generally support Diane’s thinking about the imposter phenomenon. The one time she presented at Harvard, she got a completely different response - basically they disagreed with her. When she asked the Harvard audience about their response, they basically said “We’re at Harvard. Why would we feel that way”. As Diane said, Harvard looks like a perfect opportunity for a case study.
Popularity: 19% [?]
To PhD or not Phd? August 12, 2006
Posted by Hans in : academics , add a commentI’ve been asked on several occasions about studying ehealth/health informatics at the graduate level (i.e., masters or doctoral/PhD degrees). Some seem to be interested in advancing their own knowledge so that they can use their new found knowledge and skills to further their career in the workplace. For those interested in pursuing a doctoral degree (PhD), here’s a great resource that may help determine if the PhD/doctoral degree is right for you (http://www.cs.purdue.edu/homes/dec/essay.phd.html)
The information is provided by Purdue University and seems to be written with computer science students in mind, but the concepts seem applicable to other disciplines. Since I’m currently going through the PhD progress, I would have to say that this degree is not for everyone. You may have the skills and talent to complete the PhD, but all of the other aspects of the degree may not be a good “fit” for you. One thing that I’ve learned is that completing a PhD is like a marathon (not that I’ve ever run or completed one). The journey is quite lonely, as you only have yourself to get everything done. Basically, you have to love your topic so much that you are willing to forego other opportunities (a night out, vacations, relaxation, etc) so that you can work on your research. Usually, this means reading the latest journal articles, preparing a manuscript for publication, reviewing your data, or just thinking about your topic.
I’ve been thinking about a post about possible career options for those interested in ehealth/health informatics, so I’ll try and get something written up for the near future.
Popularity: 13% [?]
Reference manager, electronic databases, and other thoughts from a systematic review April 28, 2005
Posted by Hans in : academics , 1 comment so farHere are some thoughts as I work on my systematic review.
Electronic Databases
I’ve been searching Medline and EMBASE and I have as good a search strategy that I’ll get. Since I’m mostly looking for theory-type papers, I think I’m going to get a considerable amount of “noise” - okay, I can deal with that. What I find frustrating is the process of getting the citations out of the databases and into a reference manager (I’m currently using Thomson ResearchSoft’s Reference Manager 10). In my current search, I have close to 5000 hits to sift through (my colleague has a list of over 9000!). What I find frustrating is that I can only save/export 200 citations at a time. What is up with that? For your information, I’m using the Ovid versions of the databases. So, I have to download 200 citations at a time and then load them into Reference Manager. What a tedious process. Oh yeah, and when downloading, there must be at least a hundred different formats - what’s up with that?
On another note, I wonder if GoogleScholar will ever provide the functionality of being able to download the search results into a file or reference manager? Hmm…now wouldn’t that be interesting?
Reference Formatting
Since I’m in a pseudo-rant mode, what is up with the hundreds/thousands of different reference formatting styles? Okay, I can understand that there are some significant differences between body notes (e.g., APA formatting), footnotes, and end-notes (e.g., Biomedical journals), but is there really a need to have more than that? Considering that the differences amount to cosmetic differences? I’m a bit bitter because I spent a weekend fighting with Reference Manager to get my references into a journal’s format when submitting a manuscript - it wasn’t fun. In all fairness, I understand that the biomedical journals are trying to come to some consensus with the Vancouver/Universal Biomedical Journal style. I suppose change has to occur somewhere.
Personally, I like the APA reference format because when I read a body note, I’m more aware of the source than when seeing superscript numbers. The body notes seem to provide more information - I also like the reference list because it’s in an alphabetical format. But, body notes are a real pain when there are several references, or a list of items referenced extensively. The read-ability of the text becomes almost impossible because it’s interrupted with body notes. In this circumstance, I’d have to say that end-notes are probably superior because it’s less obtrusive. But, by using numbers, you lose something. I know that for me, I’m less likely to look-up the reference when end-notes are used because it’s more work to stop reading and find the reference - maybe that’s a bad habit of mine.
Well, back to work on my systematic review. I’ve got to load up some more citations into Reference Manager.
Popularity: 13% [?]
Free thinking Fridays April 22, 2005
Posted by Hans in : academics , add a commentI just returned from one of my regular meetings of the “Monday Morning group” (we now meet on Fridays). Today’s discussion was tentatively about Michel Foucault, using Discipline and Punish as the text. We weren’t able to get into a real in-depth discussion because the group had difficulty understanding the text. Why is it that Foucault (and other philosophers in general) are so difficult to understand? I’ve observed that there is a wealth of literature written about Foucault. I get the impression that Foucault is very influential to much of the social sciences, and perhaps now the “biomedical” sciences.
The discussion lead us back to one of our favourite topics: paradigms and metaphors. It was interesting to see how these two concepts interplayed with the notions of power and living in the present. I’m interested in this notion of post-modern science and what the ramifications are for the future.
On a totally different note, I’ve been asked to start contributing to the Centre for Global eHealth Innovation’s blog (under development) - more to come on this subject.
Popularity: 12% [?]
Thoughts for a rainy Wednesday April 20, 2005
Posted by Hans in : academics , add a commentI’m experiencing “bad” network traffic here at the Centre today. It’s raining outside, and I just got back from a presentation by Anna Gagliardi. Anna was doing a dry-run of her dissertation defence on June 22, 2005. Her topic was “Patient and professional perspectives on performance measurement in oncology”.
I won’t divulge the details of her research (at least until she successfully defends it), but I found the research interesting. Basically, she compared the different perspectives of three stakeholder groups (patients, physicians & nurses, and managers) on performance measurement and its use in oncology. What I found interesting was to see someone else use a similar methodology as mine. Some of the questions and comments by the audience was interesting as well.
I had some other things that I was going to comment on, but I forgot them. I’ll write more later.
Popularity: 28% [?]
