The HealthCamp "Repeater"

Tonight I attended the DC/MD/VA Health2.0 meetup at JAckie's Restaurant in Silver Spring.

Great food, Great crowd, and great topics.

I have added the #DCHealth2 tag to my Google Repeater Health Stream. This means that next week, when Twitter conveniently "forgets" at least you can page down through my Repeater page to get at some of the tweets.

If Jackie's had WiFi I would have gone on line and setup a CoverItLive session. Unfortunately I wasn't able to so this stream of consciousness via Twitter will have to do.

It was great to see so many people from prior and future HealthCamps. I am looking forward to catching up with a number of DC/VA/MD HealthCampers at http://healthcampsfbay.com on Monday October 5th.

Anyway - here is the #dchealth2 tweet stream intermingled with other HealthCamp tweets:

http://www.google.com/reader/shared/user/13818672445828037891/label/Repeater?hl=en

Posted via email from ekivemark's posterous

Medicine 2.0® Congress - Official Blog: PatientsLikeMe

The PatientsLikeMe presentation was fascinating. Is the future one where Genomics and other data points move us to a world of personalized medicine, rather than mass medicine. 

Friday, September 18, 2009

PatientsLikeMe

Patients Informing Practice: Post-marketing Drug Data in PatientsLikeMe, a Patient-Centred Online Community
Speaker: Jeana Frost

Jeana Frost, winner of the JMIR Medicine 2.0 award 2009, presented research data collected from PatientLikeMe website.

Noting that drugs are often used off-label with limited clinical data, Jeana Frost presented an alternative approach to understanding drug use and effects using a patient-centred on-line platform called PatientsLikeMe. Using information shared on the social media, Jeana took experiences created in the community to generate quantifiable data.

PatientsLikeMe was started by two brothers who identified the need for a patient resource when one brother got ALS. The tool allows patients to share information on drugs, symptoms, answer patient questions, report efficacy on treatment. Jeana argued that "community knowledge can affect the treatment of the patient".

Using data from PatientsLikeMe, 602 treatment histories and 220 evaluations of amitriptyline were analyzed in five patient communities (MS, Parkinson's, Mood Conditions, Fibromyalgia and ALS). She found that 80% were using the drug for indications other than depression (depression is the drug's only approved indication). Users reported taking amitriptyline for pain, insomnia, excess saliva, depression (rank 4).

Jeanna noted that off label uses of drugs can sometimes be the drug’s side effects. Christine Thoer also made this comment when she presented her research yesterday at Medicine 2.0.

While credibility of user profiles takes effort and time to develop on PatientsLikeMe, according to Jeanna, I am not sure how data gathered from web identities can be used to generate statistically relevant results.

I also question the relevance of reports from five user communities (e.g., MS patients will amitriptyline for pain and not bed wetting). Even if the data was reliable, experiences from five communities creates a selection bias and can not be extrapolated to the larger population.

PatientsLikeMe can be a very useful patient resource and support tool. I agree that this forum could generate very useful information. Reports on patient experiences can be very important in areas where documented research is lacking. It can also uncovered side effects that that patients are less likely to report in clinical trials (sexual dysfunction). It may even inform and stimulate research, particularly if Pharma companies find creative ways to capitalize on the off-label use (e.g., buproprion, an antidepressant remarketed for smoking cessation).

For additional information, please see her abstract.

1 comments:

Plumaletta Berry said...

This was an interesting perspective on the use of social media for research. The credibility of the website is clearly established and would be interested to get the perspective from a representative from the pharmaceutical viewpoint on the viability of using this forum for research for which a boarder section of responses appear to be received outside of selection for clinical trials.

September 27, 2009 6:01 PM

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Link to conference site / program

Medicine 2.0 Congress Website

Posted via email from ekivemark's posterous

The Future of Health Care is not with the Reformers

It has been a fascinating couple of weeks. A trip to Toronto to attend HealthCampToronto and then present at Medicine 2.0 was a great experience. Hearing @ePatientDave kick off the conference was inspiring with his call to "Gimme My Damn Data." As always Dave gets to the heart of the issue in Health Care. Health Care is something that is down with us - not done to us. This is a message I want to promote as part of HealthCamp.

This line of thinking was further reinforced this week when I attended a showing of "MoneyDrivenMedicine" put on by Baltimore's Action Film Series. One of the hidden gems in the movie was a comment from one of the doctors that: "Informed and Engaged patients make more frugal choices." In a system that is currently driven by Pay for Quantity this is a way that we can all have an impact on our own health and on the surging medical inflation. More medicine does not automatically mean better medicine. Indeed analysis of Medicare spending across the country proves that higher spending doesn't mean better outcomes. In fact it can mean the opposite.

I frequently listen to C-Span and throughout the summer the airwaves have been pre-occupied with HealthCare Reform. However, the reason that I titled this post "The Future of Health Care is not with the Reformers" is because the the risk we face is that the entrenched positions lobbying Washington will limit the extent of real Health Care Reform.

So what do we do?

The Future of Health Care Reform is not with the Reformers in Washington - It is with each and every one of us.

We can choose to abdicate the responsibility for reform to Washington, or we can make the commitment to get engaged in managing our own health.

As @ePatientDave proves by his actions getting engaged leads to better outcomes. When our health is on the line we can be a critical source of analysis that we can share with our physicians. Research being conducted by members of the PatientsLikeMe site are proving this.

So, as we prepare for the next HealthCamp event which is taking place in Oakland on Monday October, 5th (HealthCampSFBay) at Kaiser Permanente's Garfield Innovation Center, Let's consider how we can each make important micro-choices that support our long term health and well being.

What sort of choices could we make?

• We could do as @Doc_Rob did and engage colleagues by Email
• You could do as @JenSMcCabe did at Medicine 2.0 and coerce an audience in to an act of micro-fitness
• Next time we are at the Doctors ask them if they accept questions by email, or would review your Personal Health Record if you were to give them access
• If you don't have a Personal Health Record, you can take 30 minutes and sign up for a PHR at Google Health or Microsoft HealthVault
• You could pick up a Blood Pressure Meter from Amazon, or your local pharmacy, and use a service like bloodr.com to keep track of your readings and share this with your doctor at the next visit
• Take the stairs between floors instead of the elevator at your office
• If you have an iPhone, check out the AppStore for mobile health applications, like those from Polka, that might help you manage your health while you are out and about
• Take a break during the day to stretch your legs and also get a break from the stress.
• Un-SuperSize those fries

I am sure you can come up with many, many more "micro-choices." (You can always add your ideas in the comments below)

None of these actions require an Act of Congress, but cumulatively they all can make an impact on our long term health and wellness.

Yes, the future of Health Care is not with the Reformers in Washington - it lies in our own hands by each of us stepping up to take more responsibility and by getting more engaged in managing our health.

The future of health is Participatory Health Care. Are you ready to participate?

Eight Reasons to Sponsor the HealthCa.mp Foundation

In eighteen months 1,000 people will have attended a HealthCamp. To get involved in this high energy movement that is focused on the re-invention of HealthCare on a participatory model check out http://healthca.mp.

There are eight reasons for becoming a HealthCa.mp Foundation Sponsor given in the information video.

Because You...

• Are a Health Care Innovator
• Have a vision that should be more widely heard
• Support your community
• Want to strengthen the Doctor-Patient bond
• Want access to other Health Care Innovators
• Recognize the importance of wellness
• Want citizens to be more engaged in their health
• Want to build good will with local & global influencers

Which reason is yours?

Are you going to join the growing band of innovators in Health Care who have sponsored HealthCamps? Like SocialText, Microsoft, IBM and others.

Health 2.0 - The Compact Definition

My compact Health 2.0 definition is:

Health 2.0 = (Me + MD)^Us

You can get this on a mug or water bottle at CafePress:

#Med2 - Patients informing Practice

Live blogging from Medicine 2.0 - #Med2 - my stream of consciousness from the event.

PatientsLikeMe - A platform to:

• Share (detailed health data)
• Find (Others with similar issues/conditions)
• Learn (new information)

43,000 Patients and 50,000 members

Nine Conditions:

• MS
• Parkinson's
• ALS
• Fibromyalgia
• Primary Lateral Sclerosis (PLS)
• PSP
• Progressive Muscular Atrophy (PMA)
• CBD
• MSA

Interesting research on some drugs. Able to pull data from actual use.

People analyze side effects and burdens and are flipping use to solve issues with other diseases.

A unique data source for understanding use and experience across populations. This can be very useful for off-patent drugs - discovering new uses for existing drugs.

PatientsLikeMe are getting more complete reporting than occurred in clinical trials.

the size of the communities for PLS and PMA are about 4 times that of any previous clinical trial for these diseases.

Q: Does sharing help combat attrition.

A: The more community the more prolonged engagement.

#med2 - usability and human factors on the web

Live Blog from Medicine 2.0

Emily Seto, U of Toronto

Heart failure is a massive problem. 5M people in USA. Expensive

1/3 to 1/2 of hospitalizations are preventable but need to detect worsening health early.

Clinicians have too many patients to follow constantly. Patients don't adhere to care programs well.

Home monitoring reduces cost.

Patient:

• Bluetooth weight scale, ECG monitor and Blood pressure + Blackberry Pearl Smartphone.
• Uploaded daily to central server at hospital.
• Reminders sent if they don't report in.
• Secure Web site to see logs and reports.

Clinician:

• Patient reports and alerts
• Alerts can be sent to blackberry

Decision making is very complex. Differing perspectives on rules and preferences.

There is a tough balance between flexibility and simplicity.

RHM must be individualized for each patient.

Clinician Concern: Clarity of messages

Patient Concern: False alerts. what to do with information.

Iterative development is needed with input from all system users.

Objective is less hospitalizations. Number of visits to ER is not necessarily a metric. System may send people - because it is appropriate. Issue or quality measure is severity of the issue being dealt with in the ER visit.

Tara McCurdie - Mobile Devices for Nursing

Focus of study was on features of mobile devices and applicability for nurses.

Nurses are on the move. Multi-tasking.

EMRs risk tying nurses to a desktop.

Nursing PDA Pilot project:

Devices: Nokia N810, HP iPaq 210, BB 8820, Palm Treo 680.

Applications:

• Lexi-Complete.
• RN Assoc of Ontario - Nursing Best Practice Guidelines
• McMaster PLUS

Research also looked at more devices: Nokia N810, HP iPaq 210, iPhone 3G, BB Bold, Palm Treo 680.

Nokia/Ipaq are wifi PDAs. Apple/BB are 3G

N810 - Heaviest biggest screen

iPhone was lightest

Human Factors:

• Heuristics
• Shadowing
• Questionnaires
• Usability

Weight is critical. Don't want scrubs falling down due to weight.

Devices are wanted by Nurses for communication with each other.

Testing had minimal training to test how intuitive they are.

4 tasks:

• Email
• BMI calculation
• MedLine enquiry (did i get that right?)
• Wikipedia

Nurses had problem with both BB and iPhone in finding create email task.

BMI task not much difference across tasks.

On iPhone Safari icon not understood to be the browser - typically took 72 seconds to find it.

On Medline - Nokia Tablet better than pocket Pc. Page loads are slow on IPAQ over wifi (1min 30sec)

Nokia then iPhone fastest. Nokia size of display helped.

Wikipedia query

Nokia a lot better than Palm. Took 1M 20s for page to render on Palm over 2G. Visual rendering is poor.

Nokia and iPhone fared best. Nokia 1st.

Task completion performance didn't correlate to user preference.

After period of use the Nokias (8/24 selected) weren't being used. Paper weight due to weight.

Iphone selected by 6/24

Nurses wanted tactile feedback on keyboard.

Quick data access wanted. 3G beats Wifi due to general availability.

Large Screen wanted.

BlackBerry Bold and Apple iPhone were most preferred devices.

Pierre Pluye - Information Assessment method to integrate constructive feedback

1 complainer represents 250 silent complainers.

There have been no studies on the integration of feedback.

Constructive feedback - should trigger action.

Incorporating Push feedback model increases level of feedback

#med2 - Social Networking in isolation

"Live" Blogging from Medicine2.0

Paula Hicks - Trinity College, Dublin - Virtual Community for kids with Cancer

Fascinating Irish example of using Social Media for children in Isolation wards. SOLAS - Keeping young transplant patients connected to friends and familiar places while in isolation.

Age range 3-17 although primarily designed for 8-12 years.

Integrated SMS texting to SOLAs platform because they aren't allowed their cellphones - and you know kids use text!

Music composer, audio books - came from kids themselves. may be too tired to read but can still listen.

There is value in extending SOLAS to a wider community of hospitals to help kids find others with similar issues.

Add more medical information. Issues of power and control.

Funding - always an issue.

Jacqueline Bender, Center for Global eHealth Innovation

Facebook - Awareness-rising, fundraising and support for people affected by Breast Cancer

Women, Breast Cancer & Internet

Largest form of cancer among women.

1% of canadians are survivors of Breast Cancer.

Extensive support needs

Information and support from peers is highly valued.

Women use Internet to cultivate relationships.

• 96 breast cancer websites.
• 84 from North America. 76 from USA
• 45 have public or semi-public profiles.
• 20 social network sites.

Facebook: 300 million users. 120M users/day. 2/3 outside college. Over 35 users growing fastest.

Users modify profiles as they transition through life stages.

Can FaceBook be a health resource?

Facebook groups - 637 related to breast cancer. Analyzed 621

• Fundraising 45% of groups - of which 81% for charity walks
• Awareness 38%
• Support-a-site 10%
• Support=7%

Motivations:

Support Groups = 66

• For anyone 49%
• For self/loved one 38%
• For walkers 8%

For anyone - who knows someone who has survived, battled or died of breast cancer.

Altruistic Youth?

Approximate ages (interpret with caution - obtained by deduction):

• 53% unknown
• 26% college students
• 18% high school
• 3% post-grad

Geographic Location:

• 49% USA (group creators)
• 35% Canada
• 2% Australia

Andrea Meier, Bret Shaw, Judy Feder, Eulalia Puig Abril

E-Patients Communities and Chronic Illness

Aim was to understand how people with chronic diseases seek help and support online

What are their preferences for Web 2.0 resources.

Use this information to design future web-based support communities.

60% of people in the room are (or involved with someone) affected by chronic disease.

Health information Seeking

71.7% found health care provider recommendation difficult to find.

Health Insurance information difficult to find 79%

Doctors presentations on the web difficult to find 57%

Social Support - 81% found discovery of people with similar experiences was hard to find.

Health Information on the Web and Building Virtual Communities for Health Pros (#med2)

How 3 international organizations have been independently evaluating the quality of health care news coverage:

• Media Doctor, Autralia
• Media Doctor, Canada
• HealthNewsReview.org

Inadequate access to information to patients. How can news reporting in health improve that?

David Henry, Founder Media Doctor Australia

H1N1 - We are using the media to proactively change the course of a pandemic for the first time in history. Interesting is the role of the Internet and Social Media in that change.

What is quality of health reporting? Journalists say care is needed.

Journalistic need to cover both side of a story can be a barrier to communication. At what point do we accept that A causes B. Is the world still flat?

Care needed for example: Risk Factors does not mean Having disease.

The challenge is that people want to believe. We have to be skeptical.

Media Doctor created more to influence attitude and approach of journalists more than changing public perception and understanding.

Gary Schwitzer, Publisher, HealthNewsReporting.org

Has Personal blog that is picked up by NY Times (via RSS Feeds). This caused traffic to skyrocket.

Alan Cassels, Founder, Media Doctor Canada

What is looked for in a news story?  

• Cost [Ugly]
• Benefit [Ugly]
• Harm [Ugly]
• Quality of evidence [Not so bad]
• Disease mongering [Not so bad]
• Novelty [Not so bad]
• Availability [Good]
• Independent sources [Not so bad]
• Compare with other options? [Good]
• Relying on the press release? [Good]

How do news stories fare - The Good the not so bad and the ugly indicated above.

US News - 70% of stories report unsatisfactorily on costs.

US News - 70% of stories report unsatisfactorily on benefits.

Misleading numbers - Absolute v Relative risk.

Describing benefits in relative terms can be very misleading.

Bottom line - they are seeing improvements in presentation of health information.

Pat Rich - Asklepios and Mydoctor.ca

Connecting doctors with each other and with patients.

Canadian Medical Association - 70,000 members.

Mydoctor.ca - Health Portal.

Manage chronic diseases online.

False Physician Assumptions:

• Patients not interested in online services, especially seniors
• Patient generated readings can't be trusted
• Patients will swamp me with messages
• I will not be compensated for online transactions

Asklepios

Social Networking site for doctors. They chose not to partner with Sermo.

Built their own site:

• Member demand
• Physicians already using Web 2.0
• Key to member engagement and communications strategy
• Facilitates relationships

The site is:

• Physician only - authenticated and not anonymous
• Hosted in Canada for canadian doctors (avoid homeland security issues)
• Private and secure
• Hands Off - Arms length from CMA

Stats after one year:

• 3092 members
• 92 groups
• 1720 comments (many by a small core of users)
• 916 friendships

Built on open source. Plan to extend to non-Canadian physicians, add blogging, polls, and extend to non-physicians.

Lessons:

• A few super-users dominate
• Targeted engagement strategies work
• Resources are essential for adequate support.

Consumer Empowerment, Semantic apps and consumerism at #med2

Real-time on the fly blog notes from Medicine 2.0 (#Med2)

I am looking forward to the Consumerism and empowerment session here at Medicine 2.0. Given that many of the challenges to modernizing healthcare are cultural rather than technical Social Networks have a great role to play in bringing people together.

Paula Hucko of HSAGlobal leads off. In Canada HSAGlobal works through Telus Healthcare solutions.

Trends:

• Rising Health Cost Burden is unsustainable
• Changing perspectives - move to wellness
• Enabling Technologies

Jen McCabe highlighted the "Silver Tsunami" where the age profile of the population is fueling the crisis on the demand and supply side of healthcare.

Mobile Telephony/data is driving change.

Text messaging is being used as a clinical intervention.

Smoking. Weightloss, exercise.

Needs to be two-way one-way doesn't work. SaaS model - reduces barriers to adoption.

STOMP - Smoking Cessation is live in New Zealand. Proving to be effective. 4,000 users. Works for younger target audiences.

TELUS in Canada use for employees. Smoking Cessation for employees. 17% quit rate after 12 weeks. Versus 4% for other programs.

MEDgle - Semantic Health Applications

MEDgle Semantic Health Catalyst API.

JJim Yong Kim - Not about finding new treatments the rocket science is in health and health care and HOW we DELIVER it.

Clinical Decision Support is seen as the key. The medical brain.

CDS1.0 - challenges include personalization and volume of information and multiple unsynchronized systems.

CDS2.0 - The semantics of health/ the semantics of us

MEDgle Catalyst is their semantic API.

Enables people to build applications and connect with other data streams.

Help people understand their options. Without understanding their can be no rational decisions.

Understand the consequences.

CDS2.0 is to help patients, providers, nurses.

eg.

• Differential diagnoses
• Diagnostic suggestions
• treatment options
• personalized analytics
• integrates with CPT/ICD9/10

Google, Amazon, Ebay, Twitter, Facebook have transformed the web though APIs. We need APIs for Health.

HealthyByte uses MEDgle API to filter health related stories.

Personalized Medicine is based on who we are. Genomics comes in to play.

Trevor Van Mierlo, CEO Evolution Health

Good intentions and bad investments: eHealth and the reality of market forces.

There is a law of attrition. Sustainability requires results.

Healthcare is:

• Personal
• Complex
• Revenue-based

Bottom line - You can't just build and deploy. You have to continually refine and change to keep levels of continued adoption high.

Mark Fam - Deloitte - Canadian Health Consumer Survey

2009 Survey findings.

16% of canadians participate in Health and Wellness programs. 56% willing to do so at no cost.

47% diagnosed with one or more chronic disease. 71% say they comply with treatment regimen.

29% consumers interested in Personal health coach and 24% a care coordinator.

20% seek information on quality and service scope. Canadians largely trust their medical providers.

54% concerned with information privacy.

61% are interested in a PHR provided by their doc, hospital or government. 40% v interested.

42% believe quality varies across the health system.

8:1 consumers believe quality varies widely across physicians.

Over 46% would use walk-in clinic vs waiting for a doc appointment

47% take prescriptin meds. 29% don't understand risks of those meds.

68% fill prescriptions. 80% take their meds. 1 in 4 forget to take meds.

Quality, faster access, improved convenience are drivers.

25% use alternative health services.

28% assist a family member or friend. 44% feel it beneficial to have access to PHR for person they assist.

43% of CA give health system a grade A or B. 3% give system an A.

CA people believe 32% of health spending is wasted.

CA People support expanding community care programs. Third most supported health reform.

Q and A session

Any research on incentives?

Personal note: It goes to the fact that we are inherently lazy. We need to provide easy, no brainer interfaces and data feeds so the PHR does the hard work of bringing in data. Vast majority of people will not adopt PHR's if they have to manually input most of the information. At very least PHRs should allow fax input and possibly OCR of captured images to help populate PHR.

Medicine 2.0 (#Med2) Personal Health Records Where are we now?

On the fly notes from session I am attending at Medicine 2.0...

A Large cross-cultural study in US and China. Focus on Chronic Disease Management - Study by Yunan Chen of University of California - Irvine.

How does the management of medical records by patients impact outcomes.

Informed Activated Patients interacting with Prepared Proactive Teams.

In China Patients get their medical record at the end of outpatient consultations. Even if only on paper.

A long established culture of the patient maintaining a life long record.

What do people do with their records?

• Most patients bring medical records. Many records were more than 10 years old.
• Most patients prefer to have their record rather than leave with the hospital/doctor. It is easier when they transfer to another doctor/hospital.
• Medical record is treated like bank account
• Frequently reorganize records to make it easy to share with clinicians.
• Patients rarely read medical records - but do read lab results - for chronic disease patients it is because they are familiar with details or they have low health illiteracy so can't understand what the doctor wrote.
• Patients actively share information with doctors and clinicians
• Records may include X-rays and charts.
• Chronic Patients often include charts for readings taken at home. Patients do work to help Clinicians review their records.

Implications:

• PHR needs to be mobile
• Shared responsibility with providers
• Information needs to be integrated from providers and home care.

Scandinavian research on Diabetes Portal for Children

Modern Diabetes care has a lot of self-care. Cornerstones are:

• Insulin
• Nutrition
• Exercise

Patient education is central to managing disease.

The Portal project (Diabit) was non-commercial with bottom-up collaboration.

The content:

• Patients and Parents Community (message boards, blogs)
• Local Provider pages

Implemented using simple, open source technology.

Median age of patients was 14 years of age.

Three main themes:

As a management tool - source of reliable information from local clinicians. Led to feeling of security and control amongst patients and parents.

As a generator - portal visits generated more info than expected. This led to increased use. Message boards were great for communication and peer-to-peer discussion. Helped parents and patients realize that they were not alone.

As a gatekeeper - Closed, secure access discouraged use. Difficulty changing passwords etc. Usability and password control discouraged use. Users don't like to use systems with logins.

Conclusions:

- Great management tool

- keep it simple

- keep it open whenever possible.

- keep it rocking with fresh content and news

www.diabit.se

They are looking at using Facebook connect/OpenID integration to simplify the login process by allowing use of existing ids.

The Value of Multi-Tenancy Architecture in Healthcare

Dr. Louis Cornacchia

The problem - Siloed data systems , web multi-instance architecture, EMR uptake at 4%, RHIO business model is unsustainable.

NHIN not real time = not sustainable

Google, Microsoft, Dossia PHR's - uptake <6%

Complexity of medical data makes it hard to structure data.

Solution: ePatient - empowered to manage their healthcare

Physician is consultant.

Doctations: Multi-Tenancy Software As a Service.

...but is it scalable?

Multi-tenancy system is more cost-effective on a ration of 16:1.

ePatientDave and Participatory Medicine

We take our pants off for the Doctor - why not share data?

Every patient has a right to save themselves.

Incredibly moving to hear from a patient.

"My doctor prescribed ACOR"

Patient communities are responsive.

In HealthCare technology spend just 1% for the patients. it will make a big difference.

It is humanly impossible to keep up. Patients can help as filters .

Clayton Christensen - Centralization is followed by Decentralization.

This is dependent upon processes becoming reliable and data being mobile.

"Unmanaged data quality produces train wrecks."

The Medical Information Bank (MIB) is a source of data quality risks.

Private insurance industry databank holding your billing data.

HealthDataRights.org published a Declaration of Health Data Rights.

"HealthCamp and Medicine2.0 Repeater" via ekivemark

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Medicine 2.0 lands at MaRS

Medicine 2.0 kicks off today (Thursday September 17th, 2009) at the MaRS Centre in Toronto.

The Twitter feed is being captured on CoverItLive using the #Med2 hash tag.

Just like yesterday's highly successful HealthCampToronto CoverItLive will allow us to replay the Twitter stream after Twitter forgets.

HealthCampToronto and Medicine2.0 are here!

Today is HealthCampToronto (Wednesday September 16th) followed by Medicine2.0 on the 17th and 18th.@rdjfraser

This is another sold-out HealthCamp event. Congratulations have to go to Carlos Rizo and Rob Fraser (@carlosrizo and @rdjfraser) for organizing a great event. IBM is the major sponsor for this event. Thanks go to them for hosting HealthCampToronto at their offices at 120 Bloor St, Toronto.

I know that a number of prolific tweeps will be at both events including Jen McCabe, ePatientDave and David Hale. If you can't make the event be sure to follow the tweet stream. The hashtag for the event is #HCTO.

Twitter is not providing search to terms over a week old so in order to preserve the hive mind of the event we are using CoverItLive. I am including the feed in this blog as well as on the HealthCampToronto CoverItLiveFeed page. You can also follow the #HCTO rss feed indirectly via my public Google Reader Repeater page. I have setup a bit.ly link to make it easier to find: http://bit.ly/ekivemark_Repeater

.h

HealthCampToronto and Medicine2.0

This time next week (September 18th) I hope to be presenting about HealthCamp's at Medicine2.0 in Toronto. This is the start of a busy HealthCamp season. The only fly in the ointment is the British Embassy. Yes, I am waiting on my new passport.

Hopefully it will arrive in time so that I can head up not just for Medicine2.0 but also for HealthCampToronto on September 16th that is being organized by @carlosrizo and @rdjfraser.

You will be able to follow some of the discussions from HealthCampToronto by tuning in to the #HCTO hashtag on Twitter. Remember though that Twitter now only has a short term memory. If you want to get at that history after the event you will need to take the RSS feed and archive it. I use Google Reader for that. To help preserve the #HCTO hive mind I am rebroadcasting the RSS feed via one of my public Google Reader pages.

Toronto is shaping up to be another great HealthCamp event. If you are arriving in Toronto early for Medicine2.0 you can't afford to miss the vibrant un-conference where you get to design the agenda. It is a truly user-defined conference.

If you can't make Toronto, I hope you can make it to HealthCampSFBay that takes place on October 5th - the day before the Health 2.0 conference.

Snow Leopard - Rough around the Microsoft Edges?

I have upgraded to Snow Leopard and after solving some of the glitches it has been running nicely. Then I added the Exchange integration. That has done a great job of slowing Address Book, Mail and iCal down to a crawl again.

I have also been using Word and Excel and find that they crash more frequently under Snow Leopard. I tried printing to PDF from word and kaboom!

Has anybody else been experiencing weirdness?

Certainly the Exchange integration is a cool feature and very, very easy to setup but that 64-bit speediness suddenly seems to lose at least 32 bits of speed. I suspect Apple have some work ahead in refining their Exchange support.

Today Apple released the inevitable software Update for Snow Leopard. It seems to fix some of the strangeness, such as the problems connecting to SMTP servers. It will be interesting to see if any other niggles are resolved.