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ICT standardization and eHealth – a TalkStandards.com forum event February 25, 2010

Posted by Hans in : conferences & conventions, news , 1 comment so far

I was recently made aware of an interesting website called Talkstandards. Talkstandards has a stated goal to be “an active online community where developers, researchers, policymakers and other interested parties can share ideas and collaborate on the global standards system”.

What is most interesting is that will be hosting a live, online forum event titled “ICT Standardization and eHealth” starting at 1100 EST (1600 GMT) today. The forum isn’t open right now, but the topics look interesting:

It’s good to see some community building to tackle the issue of standards and interoperability. While the US has an initiative to address standards in health care, I’ve wondered how having a plethora of options, while practically a challenge to manage, might be a strength in the long-term if we view this fragmentation in terms of bio-diversity. At this moment, I’m a big proponent of coming to consensus on interoperable standards that are used by everyone. The internet is demonstrating (in real-time) that standards allow for the most number of people to participate – and we all benefit from the collective experience.

I’m looking forward to the Talkstandards event. Not sure if I’ll have anything to contribute, but I will be observing and following the comments.

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OHA Health Achieve 2009 – Day 2 Exhibitor Floor January 7, 2010

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

Had a chance to visit the exhibitor floor during the lunch break. Was great to see some interesting booths. No one booth stuck out in my mind, but there seemed to be a subdued sense of energy on the floor with quite a bit of networking going on.

A couple of shout-outs to friends, colleagues, and other good people:

I’m always interested in the different types of vendor booths. This year, there seemed to be fewer medical device vendors which was a bit disappointing. The big firms were there but not too many more. From my stroll through the aisles, the informatics/EHR section seems to be growing more and more.

The "green" health seems to be growing as well. What caught my attention was the number of organizations present who were involved in recruitment activities. The issue of health human resources continues to be an important issue.

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OHA Health Achieve 2009 – Day 2 Keynote: Michael Moore January 6, 2010

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Today’s keynote was Michael Moore the infamous director Sicko, Roger & Me, Bowling for Columbine, Farenheit 9/11, and most recently Capitalism: A Love Story. Here’s a running summary of the topics.

The session started off with a short clip from Sicko about his relatives purchasing health insurance at Sears for a short trip (couple of hours) to Michigan. The clip also profiled some additional Canadian stories from London, Ontario and London Health Sciences Centre. It was a very interesting introduction to his session. I think the clip hit a bit of a patriotic chord.

Moore talked about his experience running a show back in 1998, TV Nation, and a specific episode of a "health race" between Ft. Lauderdale, Toronto, and Havana, Cuba. The challenge was to treat a broken bone case and the participants were evaluated based on the time to treat and costs. Cuba ended up winning because in Toronto the hospital charged $10 for a set of crutches. Apparently, the NBC censor wouldn’t let the show air as is because it was "against policy" to allow Cuba to win. As such, Toronto/Canada won.

Next he talked about the current state of the health care debate in the US given the media bombardment over this issue. Apparently, some in the US portrays Canada as a "third world country with long line-ups and people dying in the street waiting for treatment". Moore offered anyone in the office to trade their OHIP card for his Director’s Guild health care plan card – no-one took him up on the offer even if the person can have the same "health card" as Steven Spielberg.

He then talked about the process of getting an appointment and seeing a physician in the US. Takes three weeks to get an appointment with the GP. First question – what’s your insurance? And then you wait. The physician’s office is fighting with the insurance companies to get reimbursed. Physicians, who Moore calls "Demoralized Doctor Dave" nets about $50,000/year after paying out expenses. After examining Moore, the doctor then leaves the exam room to check to see if they can refer the patient to a specialist.

Moore points out that something seriously wrong with US system. How is government health care so wrong when the government is supposedly "for the people by the people"? Sarcastically, Moore states that the US has government health insurance that isn’t Medicare or VA Health. The real government is the US health insurance companies who buy the laws.

According to Moore, medical bills are the #1 cause of bankruptcy and foreclosure. The sub-prime issue isn’t the #1 cause of foreclosure. The reason is that the health care industry punishes people when they get sick. One example is of a hospital hiring foreclosure companies to go after a person’s home to pay the bill. A Harvard study noted that 46,000 people die in the US because of lack of health insurance.

Moore then went to talk about a Bill Moyer episode with a a former Signa health insurance executive. The executive admitted that what health insurance companies tell you in the US is a lie about health care in Canada. Competing health insurance companies put aside our differences to discredit Sicko and the push for health care reform.

He then started an extended session of stating some startling facts:

Then, Moore started talking about some of the causes of the issues in the US:

He then shared an interesting story of how he plays a game called "Stump the Canadian" when he speaks in the US to illustrate a point. He’ll ask for the "smartest" American in the crowd (someone who gets As) to come-up and also the "dumbest" Canadian (someone who got Cs). Inevitably after a series of questions, the Americans know very little about Canada or the US whereas the Canadian knows more about the US. As a punishment, Moore makes the American sing the Canadian national anthem.

Moore then pointed out some challenges and issues for Canada. In addition to being ranked 30th for quality of health care, the social safety net in Canada has been cut and is eroding. This all started when Mulroney had his "weird threesome with Reagon and Thatcher" [LMAO!] and got out a big pair of scissors and cut the social safety net. Subsequent governments have continued this trend. As a result, Canada has seen the following "American" characteristics:

Moore pointed out that the core Canadian principle is: "We’re all in the same boat and we all sink or swim together". Canada needs to preserve this idea and principle. Shouldn’t allow doctors to be in the public and private program. Parliament can make any law it wants to do the right thing. Moore ended with a few points:

He then went on to address the elephant in the room: How do we pay for this?

Question & Answer session

Very entertaining, passionate, and enjoyable. It turned into a bit of a love-fest for the Canadian system, but I think his main message was clear – private health care does not work. I will definitely have to watch Sicko.

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Health Achieve 2009 – day 1 November 16, 2009

Posted by Hans in : conferences & conventions, news , 1 comment so far

I was fortunate to get a pass to attend this year’s Ontario Hospital Association’s Health Achieve 2009. Wasn’t able to stay for the entire day due to other commitments, but I did enjoy the morning’s opening session.

Before I summarize the opening session, I just want to say that I’m always impressed with the incremental improvements I see year after year with the convention: the staff are better trained and more professional, the graphics and signage gets better, and the overall experience is very good. Today, the atmosphere seemed a bit subdued from years past, but there was still a sense of excitement.

Opening Remarks:
Opening remarks by the Health Achieve chair (didn’t catch his last name) and several awards presentations.

This was followed by a speech by Ken Deane, ADM for Health System Accountability and Performance. Mr. Deane encouraged the people in the health system for their hard work in dealing with issues like H1N1. Apparently some ERs have experienced up to 80% increases in demand. [Blogger's note: What is up with over-using the word grateful? Deane used the word at least five times in a span of four sentences]

Keynote: Dr. Sanjay Gupta
Wow. Didn’t realize all of the accolades Dr. Sanjay Gupta (of CNN fame) has. He started off with his background into how he became a medical correspondent. He was doing some reporting on the medical units of the US military service. Apparently in the first Gulf War, the time to treatment was too long and as such, soldiers and civilians were dying. The military decided to act on this information by creating mobile medical tents that would closely follow the forward lines. Dr. Gupta recounted incidents involving a sand storm and how he was asked to perform an unplanned, emergency (neuro) surgery in one of these mobile medical tents.

The story itself was very touching and I was really keen to hear more about the role of media in medicine. Dr. Gupta noted:

He ended the talk by moving on to the topic of aging. There are some interesting developments in Russia in terms of stem cell treatments. The Japanese (Okinawans to be precise) have a term ikigai which means "sense of purpose in life"and they believe this to be key in maintaining a long and healthy life. Some other tips/findings about aging well:

He ended the session by fielding questions from the audience. Unfortunately, I wasn’t able to stay for the rest of the day. I am, however, looking forward to attending tomorrow.

Some links to past Health Achieve past conferences:

Oh, one last thing. I’ve been experimenting with Twitter for the past little while and am trying out Twitter as a complement to my blogging. My handle is hansmixer and you can follow my Twitter feed at: http://twitter.com/hansmixer

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OHA Health Achieve 2008 – thoughts from day 1 November 4, 2008

Posted by Hans in : conferences & conventions , 1 comment so far

I had the privilege of attending the opening session of this year’s OHA Health Achieve, one of the world’s "premier health care events". As always, the event was packed and the speakers didn’t disappoint. Here is a quick recap with some comments.

Opening Session
After some opening remarks from the OHA Board Chair, the convention was officially started with a plaing of the national anthem. The video montage was a bit over the top and seemed like it was produced in the 1970s/1980s with shots of landscape, wildlife, winter, people in stereo-typical "Canadian" garb. Because of the instrumental embellishments, the audience didn’t participate in singing as they did in the past. Question: what’s wrong with a simple version of the national anthem?

Wendy Messley was the moderator for the morning and she did a very good job. She opened with some very humorous remarks and got the audience in a good mood. It’s too bad that she doesn’t have more opportunity to ad-lib in her role on CBC’s W5 news programming. She seems like she would be a very good interviewer.

Speaker 1: Retired Gen. Rick Hillier
Gen. Hillier was not quite what I expected. Actually, he was a great speaker and reminded me very much of Colin Powell. Perhaps not as sophisticated and polished as Powell, but Gen. Hillier definitely exuded charisma in a distinctly Canadian (if not Newfoundland/folksy) way. Hillier spoke about the Canadian Armed Forces and the role of leadeship. He walked us through the different roles and provided examples and stories to back-up his point. What I found most compelling was how articulate and passionate he was. He is definitely a very good speaker.

Hillier’s main message was that leadership is all about people, and that organizations need to invest in its people in order to be successful. He started by explaining how leaders must communicate directly, honestly, and with sincerity. Coupled with communication is the need to equip people appropriately to achieve success. One very interesting point Hillier raised was the need to achieve the "Vimy Effect". Vimy Ridge is a defining moment in Canada’s, and Canada’s armed forces, history. The goal is to identify such pivotal events to bring people together and to inspire them, and thus the "Vimy Effect". Hillier also talked about the role of strategic corporals who are both the official and unofficial leaders wtihin an organization that step-up to ensure success of the organization. This topic led to the idea of selecting and creating special teams from existing members. He finished with the idea of maintaining and establishing a constant supply of people, first by investing in the people that you have (i.e., creating leaders), and second by being aggressive in recruiting people for the future.

Speaker 2: Rt. Hon. Jean Chretien
Mr. Chretien was a bit of a jolt, but in a good way. His principle message about leadership is as follows:

Trust the people you have to do the work. Let them do their job. If they fail, fire them.

He shared this information and drew a laugh, but he re-iterated the last point multiple times. What was most interesting was the stories he shared from his 40 years of political experience. Some of the stories included his relations with the Clintons, George W. Bush, and other world leaders.

Closing Thoughts:
As always, the opening session was very enjoyable with the speakers being of high quality. The session was quite patriotic in nature and espoused how great Canada is, and in particular, how great the health care system is. While I don’t necessarily disagree that Canada is great, I wonder if thinking the health care system is awesome is such a great thing. Perhaps I’m a bit cynical, but healthy questioning is always a good thing. Maybe OHA Health Achieve is more of a celebration rather than an event to be critical and examine. But, that’s a discussion for another time.

Here are some links to write-ups of my past experiences at OHA Health Achieve:

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Upcoming Medicine2.0 Conference: Web 2.0 in Health and Medicine August 26, 2008

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Just a quick reminder to those who aren’t aware, but there is a very interesting conference being hosted in Toronto, Canada titled "Medicine 2.0 Conference: Web 2.0 in Health and Medicine".

Medicine 2.0® is an international conference on Web 2.0 applications in health and medicine, organized and co-sponsored by the Journal of Medical Internet Research, the International Medical Informatics Association, the Centre for Global eHealth Innovation, CHIRAD, and a number of other sponsoring organizations.

The conference is being organized by Dr. Gunther Eysenbach, a friend and colleague of mine, and it looks to be a great event. Unfortunately, I can’t attend, but I plan to do some writing on the topic in the next few days.

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Interesting conference – Making the eHealth connection August 5, 2008

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I came across an interesting conference site titled "Making the eHealth Connection". The goal of the conference is to "to raise the profile of eHealth, form new partnerships and identify promising new areas of work for the Global South". Unfortunately, this month-long conference is invitation only.

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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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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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OHA Health Achieve 2007 – thoughts from day 3 (final day) November 7, 2007

Posted by hans in : conferences & conventions , 1 comment so far

After an eventful and interesting day 1 and day 2, the final day of the OHA Health Achieve convention drew to a close today.

Keynote Address: Queen Noor of Jordan
I’m not exactly sure why, but I was looking forward to this address by Queen Noor of Jordan. Her session was titled “Philanthropy in the 21st century”. Queen Noor talked about partnership being the key to success, and that philanthropy is the “love for human kind”. Based on her experience, she found that the most effective type of philanthropy is when people are empowered to help themselves. Instead of a patronizing position, we must find ways to provide the capacity, resources, and training to allow people to help themselves. She talked about how global spending on military and weapons is more than 20 times that for humanitarian aid or how the roles of women need to be recognized and supported.

On some level, I was a bit disappointed with the session. While Queen Noor is a very elegant and poised speaker, I found her to be somewhat … stiff. On one occasion, she got a bit animated and her eyes sparkled when she spoke about her times during the civil rights movement and other moments in her youth. But, just as quickly, she reverted back to her “public speaking” persona – somewhat reserved, controlled, and dignified. She definitely has a presence, but I’m not sure that public speaking is her forte. Nevertheless, I think the overall tone and message was inspiring. She tried to play up to the audience by saying that she has a secret desire to become a Canadian because of the leading role Canada has played in putting human development, peace, and partnership above security and greed.

OHA Board Chair’s Address
Mr. Mark Rochon gave an interesting speech. He talked about the continued importance of the OHA and its members in the Ontario health care context. At first, I thought he was suggesting that the OHA itself was important (and perhaps it is), but I think he was trying to get across the idea that hospitals are very important, even with the move toward integrated care/Local Health Integration Networks. He talked about the need for developing partnerships and for being a strategic ally in advocating for change. What was news to me was that the OHA’s #1 recommendation to have a comprehensive provincial ehealth strategy was quickly adopted by both the PCs and the Liberals during the election, becoming an important component of both platforms.

On a side note, Mark Rochon had a bit of a problem with his voice. His voiced cracked several times and he ended up drinking at least three or four cups of water during his short 15 minute address. This became somewhat of a joke during the session, with Mark laughing at himself.

Minister of Health & Long-Term Care Address – Hon. George Smitherman
The convention was ended with the traditional address by the Minister of Health. He opened with a quip about the OHA having a “queen” theme day, and that he was glad he was invited for the appropriate day ;) . I won’t get into too much detail about his speech. Here are some of the highlights:

I was impressed with Mr. Smitherman’s speech. Sure it was a bit election-platform like, but he is a politician. What I found refreshing was that I got the sense that George Smitherman actually believes what he is saying – his passion came across and was felt by the audience. It will be interesting to see what happens in the next little while, but I’m definitely looking forward to the changes.

FINAL THOUGHTS
Just some final thoughts now that the convention is over. As always, I’m impressed by the overall quality of the convention. The speakers, in general, are excellent, and there’s a real feeling of collegiality and celebration. I can see how it’s an important event to attend for the networking. Now that I’ve attended a few of these, I can see some improvements made each and every year. Hopefully more will come next year.

My highlights for this year were hearing Colin Powell and Wynton Marsalis. Those two sessions definitely stick out in my mind. The ehealth session was memorable because of its popularity as there were more people than I had anticipated. Maybe it’s just me, but more people seem to be interested in ehealth than ever before. Perhaps I’m still a bit scarred from past comments I’ve received and still find it surprising to see others finally “come around”. On a grant application, one of the reviewers commented that while the topic of my project was interesting, he/she didn’t think it was *real* research. Maybe subconsciously I’m still looking to find some validation.

One final thought. I just want to thank the Ontario Hospital Association for continuing its policy of allowing students to attend for free. Without their generous support, I definitely would not have been able to attend this year. Too bad this will likely be my last (free) convention as I hope to be working by this time next year.

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