Health 2.0

Health 2.0

Data drives decisions? Crowd-sourcing as the future of research

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So, I get back from lounging on the beach in Hawaii to find that two strands of the THCB and Health 2,0 worlds have connected! At the Health 2.0 Conference we’re going to be hearing from 23andme, PatientsLikeMe, Pfizer, MedHelp, Within3 and more about the role that crowd-sourced data has on the future of decisions and discovery.

And then in the NY Times today there’s an excellent article all about this called Research Trove – Patients Online Data. And the author is THCB alumna Sarah Arnquist, who is now in Africa studying health care in Uganda.

Interview with Al Waxman, Psilos Group

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Al Waxman is a healthcare entrepreneur who these days runs the Psilos Group, a venture firm that invests in health care services, health care IT and device and instrumentation companies. Among their better known investments are Active Health Management, Health Hero Network and Definity Health–now all acquired by publicly traded companies. This is a wide ranging conversation about Al’s investment philosophy, his desire to get VCs more involved in health care, his mistrust of politicians and where he thinks health care technology is headed. Here’s the interview.

Al will also be on a panel at Health 2.0 on October 6-7 talking about whether Health 2.0 can make health care more affordable.

IDEO and Ix Innovation Design

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Ionescu_Arna_217pxNext week Matthew will be in a workshop with the folks from design firm IDEO and our friends from the Ix Center. In preparation we’re posting this article from IDEO’s Arna Ionescu who was at the recent joint Health 2.0 Meets Ix Conference on a panel moderated by the Center for Information Therapy’s President Josh Seidman. And if that wasn’t all incestuous enough, this post was originally on Josh’s blog over at Ix.

Thank you to those of you who participated in our interactive webinar last Tuesday. During the webinar we used IDEO’s design approach to tackle the challenge of providing effective Information Therapy (Ix) to a fictional character named Vernon, who has minimal resources and was  recently diagnosed with high blood pressure.

To inspire solutions for this challenge, members of the IxAction
Alliance submitted images of unexpected learning moments in their daily
lives. These images spanned from public service billboards to Snapple
caps and restaurant placemats. In advance of the webinar, the IDEO team
synthesized the images into brainstorm questions.

The webinar attendees voted and selected the brainstorm question,
“How Might We leverage curiosity to prompt Vernon to engage with Ix?”
Following IDEO’s brainstorm rules attendees submitted ideas using the webinar software.

More than 30 ideas were generated in the ten minute brainstorm, and
a second vote allowed the attendees to select which idea to pursue
further. Attendees selected the “High Blood Pressure Club.” We
discussed “$10, 10 minute prototypes” – an approach that allows us to
try out fast and cheap experiments to gain insight before costly design
and implementation efforts.

Health 2.0 NYC Chapter Meetup, July 9th

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Once again we are looking forward to an exciting and packed event on July 9th. So RSVP early and please make it firm.  Before we get to the agenda, I urge everyone to explore and endorse “A Declaration of Health Data Rights.”

Presenters:
1. HandHold Adaptive, LLC, Dan Tedesco –  Dan will present iPrompts – the portable, customizable, visual prompting tool for those with special needs.

Launch! Healogica–Clinical Trials Recrutiment service

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Healogica was one of the companies that presented at Launch! at the Health 2.0 Meets Ix conference in Boston in April. I felt that the quality of the Launch! companies as so strong that they all deserved to be featured to more than the 200 people in the room who saw it.  So on the spur of the moment I offered all of them a spot on THCB to get them a little more visibility. And now there’s a flood of three minute videos headed our way.

First up is an innovative clinical trial recruitment service called Healogica. And yes it’s new (which is the point of Launch). Watch the short video below to get an idea and investigate further over at Healogica

Me & Mr Jones, (Jr.)

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I met Leroy Jones at Health 2.0 Meets Ix in Boston. He runs the Technical Jones web site, and is a veteran of both sides of DC politics (inside and outside of Capitol Hill and the White House). We’re definitely kindred spirits in that we both like technology, politics and health care, we both like explaining stuff and we both like talking! The results of our long and enjoyable conversation (he was sort of interviewing me) are over at his web site — Talking Technology with Leroy Jones, Jr.

How Do We Build Health 2.0 Into the Delivery System?

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The Health 2.0 Meets Ix conference, will take place April 22 and 23 in Boston, Massachusetts. As part of the lead-up to the conference, which will focus on the interplay between the Health 2.0 and Information Therapy (Ix) movements, the THCB, the Health Affairs Blog and other participating blogs will feature a series of posts discussing ideas that will be featured at the conference.

The post below by John Halamka is the second in this series. The first post in the series described the background and main themes of the Health 2.0 and Ix movements. In his post, Halamka offers a vision on how best to build Health 2.0 into the health care delivery system; he will participate in a debate on this topic in Boston. Halamka also recently contributed to a Health Affairs online package on implementing the health information technology provisions of the recently passed economic stimulus legislation. The package was published in conjunction with the Health Affairs March-April issue on health IT.

Over the past few months, I’ve seen a convergence of emerging ideas that suggest a new path forward for decision support and information therapy. I believe we need Decision Support Service Providers (DSSP), offering remotely hosted, low cost knowledge services to support the increasing need for evidence-based clinical decision making.

Beth Israel Deaconess has traditionally bought and built its applications. Our decision support strategy will also be a combination of building and buying. However, it’s important to note that creating and maintaining your own decision support rules requires significant staff resources, governance, accountability, and consistency. Our Pharmacy and Therapeutics Committee recently examined all the issues involved in maintaining our own decision support rules and it’s an extensive amount of work. We use First Data Bank as a foundation for medication safety rules. We use Anvita Health to provide radiology ordering guidelines based on American College of Radiology rules. Our internal committees and pharmacy create and maintain guidelines, protocols, dosing limits, and various alerts/reminders. We have 2 full time RNs just to maintain our chemotherapy protocols.

Health 2.0 NYC Chapter, has meeting, needs a place!

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Health 2.0’s NYC chapter is having a meeting this Thursday 4/2–-around 50 people are due to attend and it’s set to be a great session.

There is one minor problem though. Due to a last minute cancellation by the existing conference room sponsor the meeting needs a new venue. Please contact eugeneATnyhto.org if you can fit ~40-50 people for tomorrow evening from 6.30pm on.

(Eugene does have a back up, but it’s not ideal! And no this is not an April Fool’s joke)

Is Healthcare IT Ready for its Big Coming Out Party?

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In 2001, when my colleagues and I ranked nearly 100 patient safety practices on the strength of their supporting evidence (for an AHRQ report), healthcare IT didn’t make the top 25. We took a lot of heat for, as one prominent patient safety advocate chided me, “slowing down the momentum.” Some called us Luddites.

Although we hated to be skunks at the IT party, we felt that the facts spoke for themselves. While decent computerized provider order entry (CPOE) systems did catch significant numbers of prescribing errors, we found no studies documenting improved hard outcomes (death, morbidity). More concerning, virtually all the research touting the benefits of HIT was conducted on a handful of home-grown systems (most notably, by David Bates’s superb group at Brigham and Women’s Hospital), leaving us concerned about the paucity of evidence that a vendor-developed system airlifted into a hospital would make the world a better place.

Since that time, there have been lots of studies regarding the impact of HIT on safety and, while many of them are positive, many others are not. In fact, beginning about 5 years ago a literature documenting new classesof errors caused by clunky IT systems began to emerge. A study from Pittsburgh Children’s Hospital found a significant increase in mortality after implementation of the Cerner system – a study that was criticized by IT advocates on methodologic grounds, and because “they didn’t implement the system properly.” Studies by Ross Koppel of Penn and Joan Ash of Oregon (such as here and here) chronicled the unintended consequences of IT systems, and urged caution before plunging headfirst into the HIT pool. I raised similar concerns in a 2006 JAMA article, and also recounted the iconic story of Cedars-Sinai’s 2003 IT implementation disaster, where a poorly designed interface, combined with physician resistance to overly intrusive decision support, led the plug to be pulled on the $50 million CPOE system only a few weeks after it was turned on.