Health 2.0 Accelerator and HealthCamp

After an action packed day at HealthCampBoston yesterday this morning kicks off the Health 2.0 Conference with a meeting of the Health 2.0 Accelerator.

Yesterday had over 150 people attend HealthCampBoston at Microsoft's NERD facility in Cambridge, MA.

The Health 2.0 Accelerator is a fast growing non-profit organization that is attempting to coordinate health technology across startups in the Health Care space.

It was setup to deal with 3 issues:

• Consumers need for comprehensive solutions to help them manage their health
• Health 2.0 Companies seeking to expand their offerings
• Traditional Health Care companies are interested in new developments in the Health 2.0 arena.

Matt Quinn from AHRQ (Agency for Health Care Research and Quality) is presenting at the session this morning.

HealthCampBoston and SocialPharmer happen today (4/21)

HealthCampBoston with SocialPharmer takes place today at Microsoft's New England Research and Development Center, One Memorial Drive, Cambridge, MA.

As a pre-cursor to Health 2.0 that happens later this week in Boston, this event has attracted a large group of participants.

You can follow the action using the Twitter Hashtags of #HCBos and #SocPharm.

We are thankful to our sponsors and Friends of HealthCamp that have made this event possible.

You can check out the HealthCamp Schedule using your iPhone or smartphone using Carl Lusby's brilliant Scheduling app. The URL is s.healthcampboston.org.

There should be plenty of people tweeting today. Check out the event feeds on CoverItLive below:

Don't give up on the Personal Health Record

In just a few days HealthCampBoston takes place (Tuesday April 21, 2009). This is happening in conjunction with SocialPharmer at the New England Research and Development campus of Microsoft. This is set to be a massive event and a great pre-cursor to Health 2.0 Meets Ix on April 22-23.

Over one hundred people have signed up for the HealthCampBoston-SocialPharmer event.

In the prelude to this e-Patient Dave's experience in importing his medical claims records to Google Health got picked up by the Boston Globe. This has sparked a fascinating debate. You need to read Dave's post.

At the recent Web 2.0 Expo I had time to sit with Jay Parkinson MD and he also ended up commenting on e-Patient Dave's experience. Jay penned a powerful analysis in the Business Insider of what Dave had written about. John Grohol at e-patients.net described Jay's assessment as "Hitting one out of the park". However, I don't share Jay's conclusion.

Google Health and Microsoft HealthVault are still in the early stages of their evolution. I don't think it is time to give up on the idea. Indeed I think it just serves to confirm that we have to put the patient at the centre of the system and not bet on the Health Care Industry successfully building Electronic Medical Records and Health Information Exchanges in order to efficiently move garbage data about as around the industry outside of our purview.

If we can't trust claims information let's at least focus in on the information we can believe.

How about the medications we are taking, which could be pulled from our prescription records. This is an area where accurate data might actually save our life by avoiding damaging drug interactions.

The moves that the Continua Alliance is taking and Microsoft's device standards for HealthVault are a push in the right direction. I believe consumer accessible telemedicine devices are the next consumer wave. The data these devices collect belongs in our Personal Health Records where we can choose who we want to share that information with.

So Google, Microsoft and Dossia - Don't get dispirited. There will be bumps in the road. Let's tackle the simple stuff first and get value from collecting and sharing basic vital sign, prescription information and family history data that could prove of value to the medical community.

Keeping an open data approach to PHR's will provide the basic for a flourishing ecosystem that will be able to increasingly make sense of the complex data that will eventually feed from EMRs inside the health care industry.

If anything e-Patient Dave and Jay Parkinson's commentary just serves to underline the enormous benefits that are there to be grasped if we put the PHR and the consumer - us - at the center of the Health Care puzzle. The consumer/patient is the one common denominator. Patient Self-Management is not knew and it yields real, positive results. It is just that up to now we, the patients, have been working in the dark with snippets of information of uncertain value.

Rising medical costs are going to drive active consumer engagement and this is going to lead to more patient self-management not less. To my mind this means that the EMRs and Health Information Exchanges that are being planned in order to grab a piece of stimulus cash will be handling an ever smaller part of the patient management puzzle. Outside of chronic disease management, an increasing proportion of health management information is going to be managed outside of these EMR platforms. If the industry doesn't recognize the potential value of the un-tethered PHR then they will be faced with the prospect of operating with less and less of a full picture about the patient. That potentially leads us down a path of practicing more, not less, defensive medicine which will continue to drive medical spending higher.

The patient is at the center of this puzzle.

We are the common denominator.

To the Health Care Industry - Get over it! Give us, the consumers/patients, the tools to help us help ourselves. After all we are the ones that spend 100% of the time living with our diseases and ailments.

Join the discussion in Boston

If you are in the Boston area on Tuesday and are interested in this topic - come along to HealthCampBoston. you can grab a ticket by clicking the link below.

If you can't make it then check out this blog. We will be running CoverItLive to track the action from the day's events. If you are on Twitter, or other social networking sites then follow the #HCBos tag to keep tuned in.

Enterprise Collaboration at Scale

Ideo is presenting their learnings from operating in a collaborative manner at scale.

Common Enterprise Collaboration Issues:

• Sharing between multiple locations is difficult.
• Communications get locked in silos in hierarchical organizations

Most organizations think about technology first:

• Blogs
• Wikis
• Crowdsourcing
• Social Networking
• Telepresence
• Real-Time Collaboration software

The issue is that ROI does not appear because of other factors:

• Rewards
• Culture
• Organization Design
• Knowledge Sharing
• Content
• Achieving Adoption
• Abilities
• Systems Design

Design Thinking: Starts and ends with individuals

• Culture
• Behaviors
• Motivations
• Social Interactions

Human Factors link with technology Factors and Business Factors.

Understand these factors, then brainstorm and prototype then develop:

i.e. Understand, Explore and Develop.

Ideo experimented with Video conferencing by leaving it on all the time. eg. in team rooms and in public places.

Telepresence hasn't worked out effectively. Eye contact doesn't work.

Instead they experimented with adding an iMac on the table in the and a videographer.

May be they should look at Microsoft Roundtable which rpovides a 360 degree panoramic view.

It is hard to get data out of peoples heads and in to Databases. It looses the context that makes it valuable.

Instead connect brains by creating:

• Intuitive interfaces
• Reward individual participation
• Automatic navigation
• No training setup

iPhone - 6.5% market share for smartphones yet 63% of all mobile browsing.

• Go where people already are
• Build Adaptive systems

You can't just deploy a system and be done.

Prototype early and prototype in context. Then iterate quickly.

Create Adaptive Intuitive People Centric systems that reward individual participation and integrate in to their daily workflow.

After five successive attempts at implementation they have implemented ThoughtFarmer

They wrote their own wrapper using Ruby on Linux. The blogging is built on SixApart's MoveableType's platform.

IDEO implements security based upon Trust and a 3 category qualification: Green = Open, Red = Internal only, Black = partitioned due to sensitivity eg. Customer anonymity or conflicts of interest across teams. The Wiki is for Green and Red projects.

Getting people to write valuable people and project pages:

To address this utilize:

• Recognition
• Project Staffing
• Career Development

This is leading to input to organizational design.

The Tools are a natural part of the workflow. eg. a digest of project status rather than dealing with email.

People are bad at describing tacit knowledge. This is what led to a focus on connecting people. People leave so they are working on extending tools through to Ideo affiliates (ie. clients, partners and alumni)

Tiers of knowledge Management (from McKinsey)

• Friction points (new infrastructure to address)
• Behavior change (harder to do but builds on new infrastructure)

Social Software in the Enterprise

Ross Mayfield (@Ross) presented a fascinating insight in to Enterprise 2.0 and the role of Social Intranets and Social Media.

Enterprise 2.0 was defined by Andrew McAfee as having 5 elements:

SLATES:

• Search
• Link
• Tag
• Extensions
• Signals

People play email volleyball with attachments.

The average person in a company spends 1 day/week looking for people and information

Search provides results and not answers.

Discovery provides answers sometimes from people and context.

Social Messaging is an ability to ask questions and get answers without interrupting people.

Social Discovery enables a different way to work.

In call centers 50% of CSR's turn to Google to find answers they can't find find inside.

Even Sharepoint doesn't help because search in sharepoint disconnects the document from the context in which it was created.

How do employees focus on the important things?

How do people discover connections to get work done?

Online documents solve the problem of sharing.

Social Messaging is new and close to real time.

Web 2.0 Expo - Day Three

The final day of Web 2.0 Expo in San Francisco gets underway with Heather Gold talking about Authenticity.

Marketing is selling other people the story they are telling themselves. What is the story you are telling yourself?

The social web connects you to yourself.

If you want people to connect with you - Be Honest.

Our instincts work in the personal world and those same instincts apply in the business world. We are heading for an integrated life.

We make decisions based on relationships. Do you trust the person who is presenting to you?

We make mistakes and are vulnerable. If we do this in public own the mistake and your authenticity grows.

Tim O'Reilly talking with Vic Gundotra of Google:

Vic has a deep passion for mobile. "The world is moving to Mobile"

More intelligent cell phones will be sold this year than PCs.

The challenge is the walled Gardens of the carriers together with the fractured nature of the mobile OS. This is changing with Apple and (Android).

Vic came to Google from Microsoft for a situation. His 4 year old daughter, Tiger, prompted him "where is your phone?" when he didn't have an answer to a question. She already knew that the phone and google could find the answer.

Building apps for phones brings some unique attributes. Location, audio, video and data sources can be combined in unique ways.

Google Voice Search on iPhone has had a 15% improvement in accuracy through improved use of the application on the iPhone.

The web is emerging on mobiles as a viable platform.

Vic demonstrated a technical prototype gMail app running using HTML 5 on iPhone and on Android. This creates the opportunity for a single development platform that could run across iPhone, Android, Palm etc.

Safari, Firefox and Chrome are implementing HTML 5.

Chrome is Open Source so anyone can look at the progress in building Chrome for Mac and Linux.

Google Moderator was developed as a 20% project. It was then implemented on AppEngine. It has been adopted widely outside. It was even used by the Whitehouse for a Presidential town hall meeting.

Netbook innovation is doing wonderful things.

In five years the power of the camera in the phone coupled with intelligence in the crowd will enable amazing new apps.

Voice recognition (as witnessed by Google Voice Search) has reached a usability tipping point.

Google is going to be a leader in creating applications (including offline) using HTML 5.

Google Ventures - The end game is to encourage innovation and enable scaling.

Scott Heiferman - Meetup:

What the internet is representing is that people can turn to each other.

We are realizing the power of each other.

Jen Pahlka talks to Threadless:

Threadless is 10 years old. 250 designs submitted each day. 1m users. 100K T-shirts per month.

Threadless started as an art project but is a great example of crowdsourcing.

The only traditional marketing is the weekly newsletter to their 800k subscribers which lets people know about new designs.

Threadless as a brand represents everything you haven't seen before.

There is a big difference between customers and community.

There is a growing movement where people want to know the back story to the products that they purchase. This is reflected in Organic farming and other market places.

High Order Bit - ChartBeat - Peter Hershberg:

Peter is CEO/Managing Partner of Reprise Media. Need to make decisions in real time on micro-trends.

Web 2.0 has made publishing really simple. People are connected to people that trust them. This gives instant credibility. This gives people access to mass audiences.

"Short bursts of traffic around the "meme of the moment"

Web Analytics fall short.

The Chartbeat demo was impressive. Offering realtime stats. My tweets even became part of the live demo.

Jeff Veen - Small Batch - Designing for Big Data :

Tools to control data and the scale of data are coming together.

The best chart was the Pie showing the percentage of the chart that looks like PacMan.

- Find a story in the data

- Assign different dimensions

- Remove everything that isn't telling the story.

The challenge for designers:

Breaking from Control means moving from Consumer to Producer.

- Enable people to find their own story.

- Give people tools to manipulate data.

- Provide filters to enable clarity

This a shift from storytelling to providing tools for discovery.

Visual clues have moved to providing interactivity

We also move from Editing to Filtering

Enterprise 2.0 Anti-Patterns

Aaron Kim, IBM Senior Managing Consultant, Emerging Technologies - IBM Canada presenting on Anti-Patterns, ROI and Metrics.

Twitter tags: #w2e #antip

• How to go from Hype to productivity
• Enterprise 2.0 Anti-patterns

Anti-pattern is a pattern that tells you how to go from a problem to a bad solution.

Fear 2.0: Fear is not a bad thing but action paralysis is bad. Failure comes with a name tag.

Is innovating less risky than not innovating.

Full control is no longer in your hands.

"Fail often, fail quickly, fail gracefully and learn from it." - Mike Moran

Hype 2.0: I want it because it's cool. I want it because Gartner et al said I need it.

New World, Old Patterns:Knowledge is in people's heads. People are portable.

Email is the knowledge repository. It is hidden to everyone - except you.

Personal Hard Drives hold data but is not typically shared.

People are your competitive advantage:

When you use wikis, blogs, podcasts and other broadcast tools you extend your reach and passively expand your network.

New World, Old Habits: There can be subtle differences between tools. A fool with a tool is still a fool.

Business Week - Taking full advantage of Web 2.0 may require Management 2.0.

Build it and they will come: If Wikipedia works so will mine.

People have limited bandwidth.

Clay Shirky's: Plausible promise, effective tool and acceptable bargain (HCE).

User Adoption Plan + Balanced Incentives.

The World is Flat: Everyone is not the same. Differences will always exist.

Geekness 2.0: Anybody can do it. Laziness 2.0 comes in to play. It has to be easy. Enable gradual adoptin.

Best of Breed: Proven solutions work well but in isolation.

Wikis are good for somethings - but not everything.

Adopt an integrated solution that meets core needs, augmented by best of breed and has enterprise grade support.

Integration is your competitive advantage and may be the innovators edge.

Search and you will not find:

You get a lot of bad with the good. We need filters to surface the good. We need to make sure good content floats to the top.

Data as your competitive Advantage:

Intangible means unmeasurable: Nobody asks what is the ROI for phone and email.

Business Value must discount costs.

Value Creation v. Value Capture

Easy to understand business case

Easy to calculate ROI models.

Measure Supply , not Demand: Bloggers, posts, wiki spaces, authors are measures of supply.

Not all User Generated Content has business value.

ROI and Metrics

If there is not "R" then it is just "C" - Cost.

63% of companies use ROI, TCO and IRR as measures of investment in Web 2.0.

Limited resources means you need to be able to make a case against competing projects.

The Right Metrics

1. What is the business objective
2. Is the metric stable
3. Can a benchmark be established
4. What are the levers to influence the metric

Returns need to be broadly defined:

Revenues, conversions, social capital, cost avoidance

You may need multiple Web 2.0 ROI models.

Control in Social Media is like grabbing water - Pauline Ores, IBM

In the Social Media World the most powerful person is the one who shares the most.

Sharing has more power than holding knowledge.

Web 2.0 Expo - Day Two

Tim O'Reilly preached to the attending masses at Web 2.0 Expo yesterday. The message in a tweet size bite was: The web is growing up. The next wave is the combining of sensor data.

This view fits with my own thinking around Health Care. There is a massive opportunity for us to change Health Care with an imminent wave of commodity health monitoring devices. A taste of this was given to us by Apple at their iPhone OS 3.0 launch. Health monitoring devices can be connected to the iPhone and from their data can be distributed and combined. The logical storage point for this wave of health data is our Personal Health Record.

This was one of the themes at the packed HealthCamp - A Call to Action Birds of a Feather session that took place last night (April 1st).

Today, Thursday April 2nd, looks set to be another jam packed day. The Web2Open un-conference track is once agin proving to be the place to be. A place where the most engaging conversations are taking place. I was lucky enough yesterday to take part in Jay Parkinson's talk about his work with HelloHealth. That session then blended in to a discussion I had tabled as part of HealthCampSf: "Personal Health Records - The centre of innovation in Health Care?"

Those conversations continued at the Birds of a Feather Session last night. It was great to meet a crowd of people who are passionate about Health Care. The discussions confirmed that the challenges we face are complex and wide ranging. They also demonstrate that there are many sources of good ideas that can contribute to solving these challenges.

The key notes were led off by Douglas Rushkoff, Author of "Get Back in the Box""

"Your most enthusiastic customer is a fledgling employee"

Local Currencies can be created through earned value rather than lent value.

Nokia: Anssi Vanjoki - The Next Transformation:

In the 1990's A paradigm change occurred: a phone number refers to a person - not a location.

The same is now happening on the Web: Everything refers to a person and context.

The mobile phone is morphing in to a mobile computer. Nokia has 1.3B of a 4B handset market.

Nokia bought NavTech for $8B. It is the bases of a database that gives every object coordinates.

Ellen Miller - Sunlight Foundation:

Focused on Government and providing visibility for citizens.

Open Government data Principles

To be useful data must be consumable.

Kevin Lynch - Adobe

Demonstrating Flash Catalyst (beta) You can import an illustration and convert the drawing in to an application by defining components.

Impressive Flash Catalyst beta demo.

Will Wright - Creator of Spore.

100M user generated assets in the game.

New group of game players want something more personal. It becomes a tool of self expression.

Spore has an API that allows the game players and/or developers to access the database of content and build new applications. Spore is a platform with data as the valuable core.

DRM created a backlash. There is a patch to remove DRM from the game.

Will Wright points out that on the web we are the centre of our social web.

This comment got me thinking about Health Care. The Health Care Industry is still so set back in outdated views. The industry doesn't put the consumer/patient at the center. We think out members/consumer/patients as populations and groups. We don't view from their perspective. With the complexity of Health Care we will not solve the challenges until we do really put the consumer - as an individual - at the very centre of the view of Health Care.

The Wii represents the best of NON-immersive gaming. Most of the entertainment is happening off the screen in the social group around you.

The Spore and Sims platforms are increasingly being driven by the players. The initial game is there to spark a core community. Then you listen to the community and evolve the platform to meet their needs and wants.

Gaming as re-education tool? Young kids in gaming experiment and build hypothesis. This makes them general problem solvers. Play and Story Telling both are educational tools.

Education is not the filling of a pail but the lighting of a fire.

The issue is motiviation. Motivate and then get out of the way.

Web2Open and HealthCamp

The Web2Open area is already shaping up to be the "Conversation Mashup" place to be. The buzz is building.

@JayParkinson is a great example of creating solutions using the simplest of tools like Google Calendar and a web site. Grew 300 patient practice in 3 months.

HelloHealth a little bit of Facebook, A little bit of Electronic Medical Record, A little bit of zipcar.

A simple tool for connecting with your doctor. Email, IM, Video chat, text messaging. Phone integration too.

eg. Track blood sugar via phone status messages to the doctor.

HelloHealth takes 7% of transactions.

"Low overhead to connect doctor with patients. Like zipcar - rent your doc's time."

In MA universal healthcare means the demand side is fixed. The result is a 52 day wait for a Doctor visit.

HelloHealth is trying to address the supply side.

"Enhancing Communication lowers risks against having a disconnected Doctor."

Is this any different to when the phone was introduced.

Question from the audience: One third of 18-35 year olds have a chronic illness.

Oldest patient is 88 and the youngest is 2. Average age of patients is 35. They do not deal with Medicare. 35% of people over 70 are online daily. 90% of doctors use computers.

HelloHealth will be launched in 2009. The platform will include ratings. It doesn't provide delegation of records - that is coming with the next iteration.

HIPAA is not an issue because the Patient is in control of the record but HelloHealth is a HIPAA compliant platform.

Patients can print their last few visits. A secure PDF can be created.

"Why waste resources integrating with 1980's HealthCare technologies"

An API will become available. Google Health integration

DayDum - super simple way to track everything about your life. Fascinating possibilities to track information about ourselves.

There is a $250B out of pocket health care market. That is the market HelloHealth is going after.

HelloHealth is self-selecting. Passionate doctors are coming because they want to provide better care to their patients.

"Doctors patients come from walk-ins and word of mouth."

Advertising - tried it in New York, Timeout etc. but had very low conversion rates. The best way to recruit patients is to put your name out there and let people talk about you.

HelloHealth provides Doctor profiles - like Facebook that introduce the doctor, their philosophy etc.

"HelloHealth is an EMR with a Social Network."

Existing PHRs are horrible and doesn't give you the data you want. HelloHealth is designed to look like a personal Health Blog. Labels, tagging etc. are provided.

"There is no front desk because you have direct access to your doctor."

"50% of HelloHealth office visits are on-line." The typical patient visits 2.5-4 times per year.

People respect the access when you give access to a Doc's mobile phone. More respect than if calling a 1-800 number.

System allows sharing for second opinions. The patient is alerted when this happens - because the patient is in control they then approve access to their record to enable the second opinion.

HelloHealth Integration

Medgle is integrated with HelloHealth it is a platform that provides information datapoints around a diagnosis. eg. Asthma. This guides the doctor and patient on what datapoints to capture around a particular condition.

Change:HealthCare tracks spending and can associate cost.

Using Twitter feeds to track real-time information.

The Open Enterprise

@StoweBoyd and Oliver Marks are presenting on the Open Enterprise.

Four big factors in the Tag Cloud:

• ROI
• Econolypse
• Leadership
• Tools

Adption of Enterprise 2.0 tools is slow.

Euan Semple: "You can't look to IT for innovation in Enterprise 2.0"

There is insufficient power (make that no power) in the conference rooms. This is frustrating for such a technology centric conference. A major fail for O'Reilly.

As a result a lot of commentary is going on via Twitter. Check out the #oe09 twitter search.

Web 2.0 Expo Day One Proper

Today is the start of the Web 2.0 Expo conference. It is going to be a busy day. I am looking forward to catching Jay Parkinson talking about new business models in Health 2.0.

To warm up I am attending a session by Dave Engberg on Sync-ing between web and client applications. Dave is CTO of Evernote - a hybrid note taking application.

In building a hybrid app Evernote went with full replication and synchronization.
They chose to have one master copy with the option of multiple slaves.
They also chose to use n intelligent update scheme that records an object's state and replicate using update sequence numbers. There is also no locking of records. ie. You don't block the web app from working while a sync takes place.
Their hybrid approach means that they can deal with the disconnected client, eg. while on a plane.
But how do they deal with phone devices when they don't have capacity for a full copy of the client's data. Evernote's Single Master design leverages the IMAP interaction model.The service is the ultimate arbiter.The Replication model uses Update Sequence Numbers. This leverages the Active Directory model.
Time to drop out of this session and head to Web 2.Open.