Sunday, May 27, 2012

#HealthFoo and HealthCamp - what a week! (@HealthCampRDU and #hcrdu )

Last weekend I was invited to my first HealthFoo. I was really excited to participate. HealthFoo is an invitation only event held over three days, this time in Boston at Microsoft's amazing New England Research and Development (NERD) Campus. I actually got to camp! Then, three days later I was in Raleigh, NC to facilitate It made for a busy and exhilarating week and a warm up for and the Washington DC Health Data and Innovation week that kicks off next weekend (June 2nd)

HealthFoo is organized by the team at O'Reilly thanks to the sponsorship of the Pioneer Fund at the Robert Wood Johnson Foundation. It brings together people from across the health care spectrum for three days of intense discussion and activity. Just like HealthCamp the participants start off the event by building the agenda.

For me it was a renewing experience. It was great to be able to spend time with friends both old and new. It started at the airport in Baltimore where I found myself on the same flight as long time HealthCamper, David Hale (@lostonroute66) who is evolving his work on Pillbox to become a developer evangelist at the National Library of Medicine. This is the type of role that Government organizations desperately need as they liberate the vast amounts of data and depend on innovators in the private sector to unleash the true power of that data.

David and I travelled by public transport to Cambridge, MA and the NERD Campus. Stopping for breakfast at The Friendly Toast - well worth a visit!

On Friday afternoon HealthFoo kicked in to gear. It was wonderful to spend time with more old friends Ted Eytan, Regina Holliday, Susannah Fox, Stephen Downs, Nate DiNiro, Dave DeBronkhart (EPatientDave), Alexander Carmichael, Ernesto Ramirez, Dr Bryan Vartabadyan (DoctorV), Roni Zeiger and more. 

Regina spent the entire weekend painting. You can read about her first HealthFoo experience here.

While the schedule had time for sessions on Friday evening this morphed, as is often the case at these type of events, people were deep in discussions around the agenda wall and just busy catching up with others and making new connections. Consequently the sessions got started on Saturday morning.

I attended a variety of sessions. In the Open Health Data session it was great to hear about the work Nate DiNiro is doing with Code For Health to advance the american health care system. There was also a fascinating discussion about the rise of the Informed Patient. One comment was that this was the worst thing to happen to the medical profession. Now people come in armed with stacks of Google search results. I argued that we don't in fact have "Informed" patients. We have "scared" patients and if search tools had a better insight in to our medical history those searches could be more accurate and insightful. Then we might actually have a more informed patient.

In the next session a small group of campers got together with Paul Levy who no longer runs a hospital but has published a leadership book - Goal Play!: Leadership Lessons from the Soccer FieldIn this session Paul wanted to draw out some ideas to help Dr. Ross Greene in his quest to help troubled kids through his initiative:

Paul led a session to re-think the web experience so that it could serve kids, parents and social workers. Together we ideated over the challenges. Amongst the ideas was the concept that we needed 3 different ways to access the resources on the site. These were from the perspectives of: The kid, The Parent and The Relationship. 

it was important that the parties were not painted as "in the wrong". It was a relationship challenge where the answer is to find ways to communicate effectively.

In the DIY Public Health session it was once again a privilege to hear the insightful views of Tom Meunecke. Tom is one of the original designers of Vista, the system that powers the Veteran's Administration health system. Tom urges us to focus on simple conditions and solutions. On the internet simple has always won out and we need to keep that in mind as we re-think health care.

We need to use positive psychology to change behavior - Fear fails.

We also need to watch the evolution of the Quantified Self movement. Teaching people that they have the power to measure is a huge step forward. If you can't measure you can't change. 

In public health we get a snapshot every two years that is 9 months out of date when published. This is a horrible way to monitor progress. Yet, we have a growing array of sensors, like the Withings scale and the fitbit than are generating enormous amounts of data but this is completely outside the purview of public health. Empowering individuals to share and donate their Health Data is the idea behind the RainbowButton initiative. 

Health Food and Agriculture

This proved to be a fascinating session, partly due to the diversity of participants. Food is a foundation stone of health. "Food is medicine" - Jill Shah. We ignore that fact at our peril. This session was led by Amanda Eamich from the US Dept of Agriculture.

Looking at a global scale. 80% of water consumption goes to Agriculture. We are heading for a global water shortage in the coming decade. Livestock is also responsible for generating 20% of the CO2 - this is equivalent to the contribution to global warming by transportation.

70% of africans work the land but Africa is a net importer of food. 

Education is a critical component. We need to educate our kids, just as we did with smoking. 

Legislation at a federal and state level is also a factor. Adam Noah pointed out how it is allowable to raise chickens in the heart of New York city but state law prohibits this in rural West Virginia. How can we establish sustainable food chains when state law erects barriers?

Roni Zeiger suggested that we should have more information available at the point of purchase so we can make more informed decisions about the food we consume. eg. QR codes with links to educational videos. 

Brita Riley talked about fascinating innovations in Hydroponics for sustainable food. Hydroponics is the fastest growing area for Intellectual Property in the USA today.

Susannah Fox led a session to seek out ideas for evolving the What If Health Care meme.  

ideas at the session included:

- Spark a grassroots movement
- Create a speech
- Get industry and community leaders to give their spin on each idea.
- Connect to policy Initiatives
- Pin examples
- Strategic Initiatives for this cadre of thinkers - then challenge them with new questions.

This session was also shared with Carolyn Lawson from the State of Oregon Health Authority. This was Carolyn's second HealthFoo. Last year she attended after just taking her CIO role at the authority and had used HealthFoo to ask for help on what she should do.

Carolyn recounted her experience of the last year where she adopted a lot of the recommendations she received and her organization is now recognized as one of the leading innovators in State-based health care. Oregon is establishing Coordinated Care Organizations that integrate non-traditional health services. Every CCO must have a Community Advisory Board and must offer dental and mental health services. The population served is medicaid eligible and no one can be refused. There have been 50 applications to become CCO and the first round of 14 will cover 90% of the State's Medicaid population. The OHA is moving from being a delivery organization to being an enabling agency.

The transition is moving towards a capitated model with quality measures driving incentives for service providers.

Later I stepped in to a session led by Jonathan Briner on Health Insurance. I found myself to be one of the few people in the session with a background in the Health Payer world. In thinking back on the session it starkly exemplified that challenges with Health Care and the insurance model we have today. 

How do you incentivize people to be healthy and reward them for good health behaviors without discriminating against people who may have genetically driven health conditions that present them with severe challenges. Obviously with many of the chronic health conditions being derived from lifestyle decisions we have a lot of scope to encourage healthy behavior. 

In a session led by Alex Tam of Frog Design the question was: How do we connect Innovators with the people with needs?

This discussion involved representatives from Kaiser Permanente and the Mayo Clinic. Project Health Design was also represented. Stephen Downs pointed out that Blogging about success and failures in the Project Health Design process is a pre-requisite for payment. This is a great way to spread the knowledge.

It is clear that there are many approaches being attempted. HealthCamp is just one of these avenues. We need to look for opportunities to bring people together from across the health spectrum - including patients. 

Saturday evening was an exciting time at HealthFoo. A dozen or more 5 minute Ignite presentations were given. David Hale rocked the house with the tale of his genomic journey of discovery. Dr. Alan Greene unveiled his latest TICC-TOCC initiative to make a minute change in the birthing process for new born babies, one that could dramatically improve their health.

I also took my chance to present my first Ignite presentation. For those not familiar with the format. You have 20 slides that advance automatically every 15 seconds. It is a challenging format to deliver against but the presenters did an amazing job. Even when PowerPoint threw in unscripted pauses!

Here is my presentation: Fight DPS. I have loaded it on Slideshare:

Sunday morning began with Tim O'Reilly leading a session on Value Creation v. Value Capture

Can we think about Health Care differentlyif we focus on value Creation.

One of the points raised was that the existing Health Care system puts no value on the time of the consumer/patient. We build systems that expect patients to queue for service.

A fascinating alternative was given as an example. Dr. Jason Cunningham (Northern California) has equipped a corps of traveling nurses with iPads to visit patients. He conducts Doctor consultations via Facetime. The Nurses are roving professionals. This approach has seen his team of nurses expand and Dr Cunningham can see more patients than by having them come in to his office.

It is clear that we need to shift health towards prevention and this needs to be led by monetizing the prevention approaches. 

"Disruptors don't make deals - they circumvent."

The big disruptors are free. They grow up in to a paid economy.

Jamie Haywood: "We live in the myth of a market economy." 

Market economy requires transparency. In the USA 60% is not a market economy. The USA is a protector of captured value that is stifling innovation.

in one of the final sessions I attended we focused on HIV and AIDS. Ben Sawyer of Games for Health demonstrated an early alpha of a game aimed at youths at risk. 

This led to a discussion that revealed the remarkable level of iPad adoption in schools and low income families. There are already 3 million iPads in use in schools. 

The mobile platform is a great one for delivering education because the platform is perceived by the user as more private. You don't tend to be overlooked by others in the same way as when using a desktop computer.

After a busy weekend at HealthFoo I headed back to Baltimore to make the final preparations for HealthCampRDU. On Tuesday we drove down to Raleigh, NC for a one day at the Marbles Kids Museum. This was the first time the HealthCamp un-conference format had been experienced in the North Carolina area. We brought together about 70 people from across the area (and beyond) to discuss "innovating the care culture"

While HealthFoo brings together thought leaders from across HealthCare that are familiar with the un-conference approach HealthCamp typically finds itself reaching out in to the traditional health care world and introducing people to the inspirational nature of the "un-conference".

We started the day with Fire starter talks from Susan Helm-Murtagh of BlueCross BlueShield North Caroline (the major sponsor of HealthCampRDU) and Derek Zabbia and Henry DePhillips of Audax Health. Their short 10 minute talks got the participants thinking. Then participants faced their first decision of the day. We held three tracks of 4x4 presentations. These were four slides in four minutes. I will post the presentations in a separate blog posting. 

After the 4x4 sessions the participants were drawn back in to the main room in order to create the agenda for the remainder of the day. It was great to see the discussions ignite and the agenda wall fill up, changing and morphing as people merged sessions because they had common interests.

What followed was an intense day of networking and discussion and we ended the day with a report back from each of the sessions. 

What a Week!

It was an incredible non-stop week! A week interspersed with job interviews and software development. HealthFoo was an experience I will carry with me for a long, long time. A chance to re-charge the innovation batteries and re-connect with friends. it was a perfect pre-cursor to HealthCampRDU and HealthCampDC where we take the un-conference experience to new areas of health care around the country and open people's eyes to the potential of partnering with other passionate innovators to drive change in health care.

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