Amazon #FAIL in the recent storms. Failover needs to be part of your cloud-based product design

Yes the recent storms in the Mid-Atlantic were bad. 100 mile an hour winds and heavy rain. Here in the Baltmore DC area there are still many people without power. But Amazon suffered a failure that took out some major services.

David Linthicum puts it really well. 

No excuse: Storms should not take down your cloud

I agree. Somebody at Amazon has been failing. May be the services are "over sold" or "over committed" and losing part of the capability leaves some customers with insufficient resources. However, if major players like NetFlix and Pinterest can't get the resources they need then there must have been something seriously wrong. These data centers should be designed to withstand severe weather. It is not an unusual occurrence. 

Amazon must have been making some serious trade-offs (aka gambles) in managing costs and profitability and they have obviously come back to bite them.

Taking things in to our own hands

This latest incident has underlined that cloud providers are not bulletproof. As such it is incumbent on cloud users to consider redundancy in their designs - right from the outset. As always the challenge is often cost.

If you want to use Amazon services you can configure to operate across multiple regions. The challenge with this is that moving data between regions has a bandwidth cost that you don't see if you operate within a single region. Replication between regions can be technically challenging, depending on your technical configuration but it can also get expensive. 

Using multiple Cloud providers is not simple and straightforward either. Rackspace is promoting OpenStack and Microsoft has indicated some intention to work with OpenStack. 

While it is feasible to configure your platform on different cloud platforms the challenge is managing demand across the different platforms, particularly if you want the ability to load balance or have instant failover.

In these days where there is a strong urge to shorten the time to market it can still pay dividends in ongoing operational costs to think about scalability, resilience and fail over as part of the initial design of your product. Failure to do so can lead to embarrassing outages that are not of your own choosing.

Posted via email from ekivemark: pre-blogspot

Why Microsoft’s Skype purchase means a Face-off with Apple’s Facetime

Microsoft’s purchase of Skype for $8.5 billion in cash is a massive bet for the tech giant.

Although it look like it may well have over-paid by $4.5 billion, and bid against companies who weren’t seriously in the running (Google and Facebook), owning Skype means Microsoft has a much better positioning in mobile.

But that’s not all.

The implications of this deal for Facebook are actually far more interesting. Since Microsoft is an investor in Facebook, the latter will now have deep access to its investor’s assets.

Being able to Skype from within Facebook means Mark Zuckerberg will not have to build his own VOIP communications platform – a seriously complex affair for 600 million users. Plus, the social network already has tie-ins with Skype.

But it also means both Microsoft and Facebook now have a stick with which to beat Apple and its emerging comms platform, Facetime.

With Facebook integration Skype will not be so heavily linked to an actual device – as Facetime is with Apple devices. Note that Microsoft has pledged to “continue to invest in and support Skype clients on non-Microsoft platforms”.

This means Apple is going to have to really pull of the stops on its communications strategy. Perhaps that’s what the new server farm is for?

via eu.techcrunch.com

Posted via email from More pre-blogspot than pre-posterous

Health is Private. Wellness is Social.

On Friday I am attending a round table event in Washington DC. There is an amazing list of attendees and I am honored to be involved with such distinguished thought leaders from across the health care spectrum. The theme of the event is patient engagement. A topic near and dear to me and a subject of many discussions at HealthCamps around the country and around the world. Thinking about this topic led me to a recent post by Stowe Boyd - one of our leading thinkers on the impact of social tools on society.  

I have long admired and respected the work that Stowe Boyd (@stoweboyd) is doing in the Stream. He is someone who really understands the Social Flow that is far more than the individual platforms that represent what we refer to as Social Media or Social Networking.

Stowe's latest line of research is around "Social Cognition." Two observations from his Defrag presentation caught my attention:

"Reynol Junco conducted a study at Lock Haven University that required a group of students to use Twitter as part of their class work: tweets on others’ presentations, or as a social note taking tool when researching. This led to higher social engagement and a GPA increase of one half grade on average. Imagine if they used it in all classes? Or if the whole school used it?"

"Damon Centola has undertaken research that shows that behavioral changes are transmitted more quickly in denser networks. A company or a community where the members in general have more connections to others will be more likely to adopt new behaviors than in more  loosely connected networks." 

Social Cognition and Health Care

This got me thinking... Does this make a case for Participatory Medicine? Where medical professionals, their patients and fellow sufferers of chronic conditions pool their experiences and knowledge to achieve better outcomes. 

The health care Tsunami, where rising costs threaten to bankrupt our nation while fewer and fewer people can afford basic care will force us to rethink how we care for ourselves and each other.

The transformation of health care demands that we become more open. Chronic disease sufferers are already forming networks to share information to help them live with their condition. Each of us needs to establish not just a Personal Health Record but a Life Record. We need to break down the glass walls between the patient and medical professionals. Patients and their personally collected data needs to be put on an equal footing with clinical data. This is where Technology can really play a transformational role.

Transformation Through Life Technology - Not Health Information Technology    

Technology and connected platforms offer us an opportunity to gather information at a level of granularity and accuracy that has been impossible, or at least unaffordable, up until now.

Health Information Technology is needed to be able to filter and correlate these enormous volumes of data to look for anomalies and trends that can assist in early diagnosis of conditions.

Presenting this information back to consumers in a form that can be easily understood and acted upon is crucial. Enabling us to share and compare with others will help to reinforce behavior change that leads to continued vitality. 

The real challenge for the health care industry is to develop affordable, easy to use, consumer oriented solutions that are connected and fit in to the "rhythm of life." 

In conclusion, once again I will make this request to Google Health, Microsoft HealthVault and any other Health IT vendor that cares to listen:

Connect your Health Record to Twitter, Facebook and Text Messaging. Make it easy for people to have data pulled in to their records. Why shouldn't my Health Record follow me on Twitter and determine my mood or my level of exercise from the messages I am sharing with my friends.

On the other end you need to build the tools to make it easy to compare, filter, chart and export different data sets that are being collected. Medical professionals will never have the time to manually pore through the vast flow of data from each patient. They will need tools to summarize, highlight trends and help them act on anomalies.   

Cognition is social. We need to build tools that leverage the social fabric of our lives. This is indeed the next big challenge for Health Care Technology - to create tools and platforms that integrate easily in to the social fabric of our lives. 

Health is private. Wellness is social. 

Posted via email from More pre-blogspot than pre-posterous

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.

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.

Health Reform is up to us - The innovators and consumers

I find myself regularly listening to C-Span and the machinations going on in Washington to reform the Health Care system. I hesitate to call it a Health Care system because the current system in the USA is a Sick Care system.

President Obama is right to be tackling Health Care reform. The current growth in medical spending is unsustainable. The problem comes in the execution of the reform via Congress. The challenge is of such magnitude that the solution will be complex. When that is expressed in legislative terms we end up with a bill of more than a thousand pages and it is destined to grow as amendments are added to accommodate different interests.

The process is frustrating and difficult to understand by outsiders.

What are we trying to accomplish here? We have to stay focused on the prize. What is that?

We want a Health Care system that is focused on keeping us healthy. A Health Care system that enables us to afford preventative action to keep us health for as long as possible. A Health Care system in which the consumer/patient is an active participant (or who can nominate someone to act on their behalf).

The current system is largely geared towards paying for quantity, not quality. There is no incentive in the industry to spend less to get better care. More tests means more money. The Pharmaceutical companies are complicit in this too. A cure is not good business. Far better to stabilize and have patients on a lifetime supply of medications.

There are two groups that can change this:

1. Innovators/Entrepreneurs
2. Consumers/Patients

HealthCamp has proven to me that there are real innovators out there. My professional role has also shown me that there are innovative thinkers inside the Health Care Industry. It is a source of hope. Yes, people are working to make a real difference in health care.

The Health 2.0 Accelerator meetings bring together dozens of entrepreneurs and really drives home the vibrancy in the Health 2.0 arena. New applications are emerging and the Internet is unleashing solutions that are leveraging the wisdom of the crowds and the ability to aggregate vast amounts of data and put those new insights to good use in enabling actionable change.

HealthVault and Google Health are providing un-tethered Health Records that we can take with us, regardless of who we work for or which medical benefits plan we have.

Sites like PatientsLikeMe are providing help to disease sufferers. Change:healthcare is helping consumers spend their money more wisely on health and a growing array of other innovators are building applications that plug in to the Personal Health Record "ecosystems" that are emerging.

The next step is for us, the consumers and patients, to stand up and get involved. We can become more active in our own health care. The tools are out there. This is what HealthCamp is all about. It is about providing a grass roots platform for consumers, patients and professionals from across the industry to come together and discuss the issues and generate ideas that can address the challenges we face in Health Care.

You can get involved. There are HealthCamp events taking place in the next few months. Check the calendar. Register on the HealthCamp site and join in the discussion.

If we want to live healthier, longer lives we can't afford to be illiterate when it comes to health issues. Health Illiteracy can kill you. We need to track our Body Mass Index, to take our Blood Pressure regularly. These simple steps can help us become more aware of our general health.

I am increasingly fearful that Washington will produce a health care reform bill but it will not achieve what the President set out to achieve. It will not make us healthier. It may just make Health Care more complicated and more expensive to deliver.

If we want to see a real Health Care, rather than the Sick Care system we have today, then we, the Innovators and Consumers, have to work together to create the Participatory Health Care system that we want to be a part of. You can take the first step by getting involved in a local HealthCamp.

HealthCampMd is taking shape. Come and join in

We are a month from HealthCampMd. But it is a busy month ahead before we get to HealthCampMd on Friday June 19th.

HealthCamp is becoming an international movement. One event I can't get to happens next week. That is HealthCamp Azerbaijan which takes place in Baku, Azerbaijan on May 23-24th.

One event I am planning on attending is HealthCampNash which happens in two weeks time, on May 30th. I am looking forward to my first trip to Nashville. This should be another great HealthCamp event. It will be a chance to meet up again with some of the amazing innovators I met at HealthCampBoston, the Health2.0 Accelerator and the Health 2.0 Conference in Boston (Including Chris Parks and the folks at Change:Healthcare).

People are already signing up for HealthCampMd which is taking place on the Owings Mills campus at Stevenson University.

We are planning to make Friday June 19th a very special day in the HealthCamp Calendar. Three HealthCamps are in fact taking place that day:

• HealthCampMd
• HealthCampSanDiego and
• HealthCampUK.

If our plans work out we hope to be broadcasting video from each event and arranging a three-way link up between them.

This is going to be a great way to celebrate the first anniversary of this amazing HealthCamp movement. It is inspiring to see how far HealthCamps have progressed in one short year. It is also fitting that HealthCamp celebrates the first anniversary at Stevenson University. HealthCampMd took place in June 2008 at Stevenson University. It was the first public event to take place there for the former Villa Julie College as it transitioned to a full university. Since then events have been growing as the word spreads. HealthCampPhila in March 2009 saw over 100 people sign up for an event hosted by Jefferson University. HealthCampBoston built on this inertia and had nearly 150 people attend an event hosted and sponsored by Microsoft at their New England Research and Development center.

HealthCamp UK 2009 is gaining a lot of coverage by being part of the UK Department of Health's NHS Innovation Expo, "a unique opportunity to catch up with the best in healthcare innovation from the public, private, voluntary, academic and scientific communities".

The HealthCampSanDiego event is gaining a lot of attention since it was featured on BlogTalk Radio.

If you are a developer and want to know how you can get involved in the HealthCamp movement then please come along to the HealthCampMd event in Owings Mills. I am planning to hold a session to plan the evolution of a central HealthCamp network site. Progress is already being made on that front. SocialText have offered their platform as a home for HealthCamp and the http://healthca.mp domain already points there. The social tools in the latest version of SocialText's platform offer a great base on which to build the on-line healthcamp community. My sincerest thanks go out to Ross Mayfield, Eugene Lee and the SocialText team for their generosity in supporting the HealthCamp movement.

If you want to get involved in HealthCamp then go to http://healthca.mp and register. Join the HealthCamp workspaces. You can help us create a great resource that supports future HealthCamps.

I am also working on some ideas to further enable the HealthCamp movement. I hope to announce some of those plans at HealthCampMd. The June events are a springboard to even greater things happening later in the year. Plans are afoot for events in New York, San Francisco and Toronto.

If you are planning to go to the next Health 2.0 Conference or Health 2.0 Accelerator in October, 2009 in San Francisco then you will also want to plan on attending HealthCampSFBay which is being hosted by Kaiser Permanente in their world renowned innovation center in Oakland, CA on Monday October 5th.

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.

SocialWeb at Web 2.0 Expo

What has been happening with Data Portability on the Social Web. ie. OpenID, OAuth, etc.

The workshop is being run by @chrismessina, @daveman692 and @jsmarr

I will twitter comments from this session using the tag #w2e_sw

If you want to build new and innovative services you don't want to frustrate your users by asking for a bunch of account related data. If the data is out there go and get it. Don't Re-Key!

You need standards to enable mashups. Alternatively, you need consistent formats.

If standards exist - use them!

http://www.oxyweb.co.uk/blog produced a world map of popular social networks. This struck me as a great parallel to the HealthCare world with incompatible/competing health care players.

Functional sites, like Friendfeed, Twitter, last.fm and Dopplr represent specialist services. They have the opportunity to create combined value but they need a social graph to create this.

Facebook solved this for many, as long as developers were prepared to live inside facebook.

Activity streams are an emerging standard. No logo yet.

XMPP is not that popular yet, although it is one of the pipes that Twitter implemented and search.twitter.com leveraged.

Partuza is an Open Social - social Network site that uses Apache Shindig.

Pinax is a platform for rapidly developing websites using social tools such as IM, chat,

The emerging theme is "Connect"

Facebook Connect, OpenSocial Connect.

New building blocks:

• Who you are
• Who you know
• What's going on

These are aspects of the social ecosystem. These create the virtual circle of sharing/knowing.

The anatomy of "Connect":

• Profile (id, accounts profiles)
• Relationships (friends, followers)
• Content
• Activity
• Goal (search and discovery)

Most sites are building on the Open Stack:

• MySpace
• Yahoo
• Google
• Plaxo
• Microsoft

Supporting:

• OpenID
• XRDS-Simple
• OAuth
• PortableContacts
• OpenSocial

Facebook is different but is matching these standards.

Why do this?:

- Why do people have to:

• Create a new account on every service
• Re-create their profile
• Give away their password to every site that asks
• Re-discover their friends
• re-friend their friends
• Learn new ways to share and communicate

Why do developers have to?:

• Deal with forgotten passwords
• create another profile form
• Support every new service API that emerges
• Force members to invite everyone they know
• Implement and unsafe method to import contacts
• Create widgets for incompatible social networks
• Manually interpret feeds for activity streams

Industry trends:

• User control of data
• User centric web services
• Locatin based services
• Real time content delivery ubiquitous connectivity
• Interoperable app platforms
• content aggregation and syndication
• increasing quantities of data to work with
• democratization of digital media creation tools

How do customers benefit:

MySpace has built login with OpenID and OAuth to compete with Facebook Connect.

OpenID popup extension is being developed to simplify the user interface, ala facebook connect.

The emerging issue is that once an item has been made "public" on a social network it can't be withdrawn. If you withdraw an item it may still exist in other places that were connected to the original publishing location.

Demos:

• Eventbox

Now for the technical stuff:

OpenID Demo:

Mapquest (owned by AOL). You can sign in to mapquest with OpenID.

In 2009 there are over 30,000 sites that let you login with OpenID (Relying sites). Growth from 20,000 in August 2008 and 10,000 in Jan 2008. (source: http://blog.janrain.com)

Implementing OpenID as a relying party (ie. accept OpenID)

Internally you need to map one or more openIDs to an internal account.

The OpenID User experience

Directed Identity is emerging as one solution to avoid need for users to know URLs.

At least there aren't too many major providers so the button option is still feasible.

Once people have become known to a site it is possible to tailor re-sign in based upon where a user has come from. eg. If they arrive from Gmail then assume a gmail account.

Personal Discovery standard is emerging, driven by EU demands.

The browser knows who you are so this may be a way to simplify login. This moves away from web sites trying to guess which accounts you use.

The Popup extension is emerging as a technique. The challenge is to avoid spoofing. People don't look at the URL bar.

Remember - you can use email address as an indicator of which OpenId providers to support.

Different sites have different account preferences. This leads to sites supporting multiple standards. eg. OpenID + facebook. At least supporting OpenId means you automatically support Yahoo, AOL, Google, MySpace and other popular sites.

Microformats are also important.

Microformats enable webpages to be an API.

Semantic information can be embedded in a page. Some of the oldest standards are hCard (vCard in HTML)

Use CSS classes to markup and style the data. Very simple way to markup information in existing web pages.

This is ideal for database driven sites because you can edit one output web page and apply a microformat to every database record that is displayed through that web page.

Twitter supports hCard and includes the rel=me setting. If you want your blog to be the top search result on your name in Google then add this value to your blog. Simply add rel="me" to a relevant link on your blog.

Discovery

The more you publish the more you need a way to identify what you are publishing as yours. Our desktop is moving out in to the cloud.

Identity enables discovery. XRDS-Simple "the name is more complex than the concept"

XRDS - defines services.

eg. OpenID, PortableContacts

eg. OpenID points to one service. PortableContacts points to Plaxo.

WordPress OpenID plugin supports creating XRDS file.

XRDS-Simple can be used for a personal discovery or for sites to publish their service endpoints

LRDD - Link-based Resource Descriptor Discovery (emerging work)

Authorization

Authorization is important so you don't have to make data public to make it portable.

Will OAuth work in a mobile mode? Yes!

iPhone example is FlightTrack Pro works with Tripit. The iPhone app uses OAuth and Safari to authorize the app on Tripit.com.

OAuth is a protocol for developing password-less APIs.

Plaxo was recently bought by Comcast. Comcast saw a 92% success rate with login using OpenID in collaboration with Google.

The Plaxo-Google connection uses a hybrid. They do the OpenID dance and also handle the OAuth token acquisition at the same time. They also collect and notify user on the basic information that will be used. eg. name and email address.

The Comcast-Google test worked so well that the business folks at Comcast wouldn't let them turn the experiment off!

OAuth can be used asynchronously to allow one user to give permission to someone else to gain access to their information. eg. Dave allows Chris to see his phone number in his contact record.

Relationships and Contacts

Rather than have to support writing to address book APIs for each major service they instead implement a standard protocol. That is PortableContacts. This builds on OAuth and vCard standards.

GMail now supports Portable Contacts. ie. No Google specific code is required to use information from the Google Addressbook.

OpenSocial REST People Protocol is now PortableContact compatible.

vCardDav compatibility is coming with IETF.

Linking Accounts

The XFN Microformat is being used to link accounts and services.

Add a Rel=Me link to connect pages on services..

You can also use Rel=Contact to identify friends.

Google's Social Graph API does this in a simple form. A demo is available.

Activity Streams

Activity Streams are in the realm of "LifeStreaming"

Friendfeed support approximately 59 services. Each was hand coded by Friendfeed.

Activity Streams is about creating a protocol that can be leveraged across sites.

Social Discovery. eg. Plaxo Pulse, LinkedIn network updates, Facebook status updates.

Messaging: Twitter, Yammer, Eventbox (desktop app)

Brand/Personal Monitoring: GetSatisfaction's Overheard searching Twitter.

Primitives: Active, Verb, Object

Actor, Verb Object (context)

Build on Standards

Use ATOM for lists. (aka feeds)

Activity Stream is using a derivation of ATOM to share streams.

Activity Streams is targeted to go in to OpenSocial.

Check out http://activitystrea.ms for the latest info.

Gadgets and OpenSocial

Allow applications to be added tomultiple sites. Write a gadget once and allow in to run on multiple sites. Over 700M users acorss multiple sites support OpenSocial from Myspace to Plaxo to Ning oor Orkut etc.

Shindig is an Apache incubator project for gadgets in OpenSocial.

You can also build OpenSocial apps in the Google AppEngine.

This standard simplifies Engineering integratin and allows developers to focus on PRODUCT integration - ie. How to fit in to the target environment. eg. Ning is different from MySpace.

Next Steps - Homework:

1. Markup existing Data

2. Stop leaking passwords

3. Support OpenID and OAuth

These tools are mature enough to enable simple integration across sites and business partners.

Check out theSocialWeb.tv for the latest news in the space.

HealthCampPhila is nearly here!

There is just over a week until HealthCampPhila kicks off on Saturday 28th March at Jefferson University. There may be a few tickets and sponsor slots left - check on eventbrite for the latest status (http://healthcampphila.eventbrite.com).

The event is primed to generate some fascinating discussion. If you are planning on attending the event then do come up and say hi!

On a separate note I wanted to follow up on my last post where I addressed the issue "Will Google and Microsoft resell my health data?" This question caused some re-tweeting and commenting on Twitter.

I want to thank David Harlow (@Healthblawg) for creating a "connect the dots" moment for me. His comment about health data being valuable took me back to posts I wrote over a year ago for AOL when I was considering OpenID, AIM, identity and portable reputation. The investment that we have made in instant messenger screen names that we have held for years represents a powerful element in building identity. However, that identity is virtual. The PHR is different.

The Ahah! moment for me was the realization that as Microsoft and Google enable us to store our health data they are in fact creating an incredibly valuable tool for trusted and credentialed identity.

Think about this. Facebook is creating a trusted identity system based upon our use of real names and the verification that a circle of friends know us. The online Personal Health Record (PHR) is subtly different from the trusted Facebook identity. The online PHR is being built with data linkages in mind. It is a resource that is, or will be, incredibly rich in transaction and linkage data based upon real world encounters. The PHR becomes like an online fingerprint.

What Google and Microsoft are building is a mechanism that they could leverage to validate that the person behind a LiveId or google health account is really the person that they say they are. This is not a binary true or false value, it will instead be a variable level of certainty - A level that is based on the depth of real world encounter information such as clinical history, claims information, family history and other data collected in the record and the number of authenticated touch points that link to the PHR.

Google and Microsoft could get incredible value from this information. Not from selling the information. Not from analyzing the information to push more ads. No, the value could come from the fact that this pool of data could become more valuable than our credit histories. The difference between the PHR and our credit history is that we, as consumers, have control over our PHR but only visibility in to our credit history.

Without releasing any contextual data about us Google and Microsoft could create the equivalent of a credit score that represents the level confidence in the authenticity of an account.

With the PHR sitting firmly at the intersection of the real and electronic world it is no wonder that these two giants are locked in a land grab battle for consumer mindshare.

Will Google and Microsoft resell my Health Data

A question that seems to be bubbling around on the Internet about the Personal Health Record platforms from Microsoft and Google is

"Will Microsoft or Google sell my Personal Health Data?"

The reality is that Microsoft or Google do not need to sell our personal health data. Microsoft's push in to health is a way to push the Windows monopoly. Adopting HealthVault is going to lead to hospitals, practices and software developers acquiring servers and software to connect in to the ecosystem that is being constructed. As devices become inter-connected we will probably also see the "Works with HealthVault" licensing program take off.

From the Google perspective a revenue model may be different. We will certainly see some linkage back to their Search and AdWords platforms. Google Health helps to keep eyeballs focused towards Google properties. On the developer side Google could easily provide open access to health data through APIs that preserve the consumer-managed privacy controls and generate revenue by throttling the API. They might for example allow developers to access thousands of API calls per day, week or month but require licensing to tap in to higher volume feeds. It is the developers that then create the business models to profit from these data feeds, but all the while the consumer continues to control what data they are releasing to which applications and services.

Microsoft has a dirty SharePoint secret

At work, like probably a lot of people I am running Windows XP with Office 2003 and Sharepoint 2007. I have been battling a problem with Sharepoint and Excel for some time now. It all centers around the Datasheet view in SharePoint. This seems like a useful feature that lets you manipulate Sharepoint lists as if they were a spreadsheet. If only it would work reliably.

When I try to use Datasheet View I get an error telling me that "The list cannot be displayed in Datasheet view for one or more of the following reasons:

• A datasheet component compatible with Windows SharePoint Services is not installed,
• your browser does not support ActiveX controls,
• or support for ActiveX controls is disabled."

It seems I am not alone with this problem. Microsoft Help and Support does tell us that you have to use Microsoft Office 2003 or 2007 Professional edition. That is the first open dirty secret. With all the differing versions of Office that were sold you have to use the Pro edition to get the necessary activeX components to enable this functionality. So, if you are a small business and purchased Office Small Business Edition for your desktops and then went and bought the Microsoft Small Business Server with SharePoint then you are probably going to be stung for some upgrades.

The other dirty secret is more difficult to fix. It appears that SharePoint can't cope with you running multiple editions of Office. So, if you upgrade to Project 2007 or one of the other newer versions of Microsoft's Office productivity suite but don't update the core Office 2003 Professional version then you will probably find that the datasheet view in SharePoint stops working for you. It appears that latest owssupp.dll file (and possibly other dll's) are not backward compatible. This hybrid situation where part of Office 12 (ie. Office 2007) gets installed alongside Office 2003 is a situation that Microsoft can't cope with. I also saw this when I installed a trial version of Sharepoint designer. When the license expired the datasheet view stopped working and when I uninstalled Designer it didn't fix the problem.

With a growing dependence on web-based applications the datasheet view error is a nasty one because it actually causes Internet Explorer to crash. If you use Firefox with IE Tab it will also crash Firefox.

Right now I am running with Outlook 2007 and Office 2003 and I am wondering if this hybrid setup is a continuing cause of the problem.

I know it is in Microsoft's best interests to push us to upgrade to everything 2007 but they should be able to support their own stable of products that span across versions. Maybe this just indicates that not only is the Windows platform creaking but the Office System has also got to large and unwieldy.

It is going to be a common situation, particularly in this economy where organizations may upgrade parts of the suite in order to access enhanced functions but leave other parts of the Office suite in place on the prior version. I think Microsoft's decision to radically change the user interface in Office 2007 may make more companies reluctant to change because of the retraining costs that they will incur.

Telling us to upgrade everything to 2007 is not an acceptable answer. However, when Microsoft tells their customers who bought 30Gb Zunes to just wait 24 hours to fix their the leap year bug that stopped the devices working on December 31st, you know that we shouldn't hold our breath waiting for a fix. All this just confirms my thinking that simpler, browser-agnostic, web applications have a bright future.

UPDATE - I may have worked a fix for this problem. This is what I did:

I did a search on my C: drive for owssupp.dll.

I found two versions in these directories:

• C:\Program Files\Microsoft Office\OFFICE11
• C:\Program Files\Microsoft Office\Office12

Since I am using Microsoft Office Excel 2003 (ie. Office 11 Pro) I renamed owssupp.dll in the Office12 folder to owssupp.dllx.

I then restarted my PC. So far I seem to be able to get the datasheet view working. It will be interesting to see if anything is broken in Outlook 2007.

Battling with SharePoint

Some consider SharePoint 2007's key competitive advantage to be "the breadth of integrated collaborative and community-based applications that are provided out of the box or can easily be developed with SharePoint rich platform services". It was certainly the point Lawrence Liu was making on his blog.

In practical use SharePoint 2007 leaves a lot to be desired. It may be the way it is implemented in some environments but it seems to get used primarily as a "souped-up" shared drive. Actual solutions built around SharePoint seem to be either disjointed or require custom configuration using Visual Studio or Frontpage's successor - SharePoint Designer.

The Wiki functionality in SharePoint 2007 is basically unchanged from the 2003 version. It is pathetic in comparison to other Wiki products. Have you tried adding attachments to a page on a SharePoint Wiki? It is a multi-step process that involves uploading files to a shared document library and then getting the shortcut and posting it in to the page you are editing on the wiki. This is not something your average user is going to want to do. Trying to find workarounds for these weaknesses seems to give further proof that SharePoint is not a collaboration platform. It is a development environment with a set of collaborative components that require professional development resources to configure to make usable solutions.

Trying to implement workarounds reveals other weaknesses. I would love to find solutions for these challenges that can be implemented by a site owner and not require system administrator privileges. If you have suggestions please let me know. Here are some of my attempts at workarounds:

Modify the wiki page to add an extra web part with a document library.

Now this works. You can go to site actions for an existing page and modify the page to add a web part. Choose a document library and you can have an add document link. So far so good.

The downside to this approach is that you are only modifying the configuration of that individual page. There does not appear to be a way to modify the default wiki page layout that all pages use.

Modify the Edit Wiki Page

This does not work. The Site Actions drop down does not let you modify the edit page. This means you can't add a web part to add a document library list.

Let's Forget the Wiki and create a Document Library

In this scenario I want to create a library with a multi-line text field that can have a file attachment. If you start with a standard document library you get all the upload functionality but there seems to be no way to add a record without uploading a file.

If I want to upload a link to a web page I can't do that. Using a URL instead of a document gives an "Error on Page" in the status bar. The record refuses to be created.

Other limitations also show up. For example, if I add a description field to the record it can be a multi line text field but you can't use enhanced text. Consequently font, formatting and hyperlinks are out.

Ok, so let's create a custom list instead

So there are problems with using a document library. Let's start with a custom list. Yes we can create rich text multi line fields so we can use fonts, formatting and hyperlinks. However, attaching a file is an extra step. What's more, once you have attached a file there appears to be no way to launch the attachment from a list. You have to open the record and select the attachment.

At least with the custom list solution I can include URL links and attach files but the user interface is not consistent with the standard document library. There is also no option, as far as I can tell, to add the document information that matches the standard document library.

Designed for Developers

My trials and tribulations attempting to do simple things that have been available for years in wikis and even in Lotus Notes seem to confirm that SharePoint is not a collaboration platform. It is a development platform with collaboration components.

Are You choosing sharePoint?

If you are thinking about using SharePoint in your organization. Yes, it is better than a shared network drive through the use of it's simple version control features. However, if you are looking for a collaboration platform then either look at one of the wiki platforms, like SocialText, or be prepared to invest significantly in additional third party web part components for SharePoint, or in maintaining a team of development resources that can customize SharePoint to meet your needs.

CITIH - Trendsetters talking about Personal Health Records

The Trendsetters talking about Personal Health Records include:

• Dan Pelino, General Manager, IBM Healthcare
• Bill Paschall, Healthcare Applications, AT&T
• Clay Marsh, Director, Center for Critical Care & Sleep Medicine at Ohio State University
• Bill Crounse, Microsoft

AT&T is a founding member of Dossia

An interesting session but the power ran dry so I had to resort to twittering the session from my iPhone. You can follow the tweets by using the #CITIH hashtag at search.twitter.com.

Consumerism and HealthCare IT Innovations

It is snowing in Columbus, Ohio, and I am here at the Consumerism and HealthCare IT Innovations summit.

The Keynote speech is being given by Bill Crounse, MD and Sr Director Worldwide Health at Microsoft.

The context of US HealthCare:

• Labor Shortage - we can't continue to import trained professionals
• Reduced reimbursements - Less incentive
• An Aging Population - increasing demand for services
• Increased regulation
• More use of technology

What do Healthcare workers need:

• Best Information worker tools
• More intuitive user interface
• Better data input options
• Mobile solutions
• Interconnected and interoperability
• Lower total cost of ownership

Health Trends:

• Increasing personal responsibility
• "Retailization"
• Commoditization
• Information everywhere
• Globalization of HealthCare

By 2015 15% of Americans will use medical tourism.

HealthCare is becoming Consumer Centric.

Some of the examples of change:

• Myca.com
• HelloHealth.com which grew out of JayParkinson's work
• MediKiosk
• Telemedicine and Robotics
• The telephone is becoming the telemedicine device

The growing capability of the basic desktop with unified communications integrated video and voice services allows commodity services to be used everywhere. This fits with the Health 2.0 mantra - "Use Simple Tools To Do Great Things"

Microsoft HealthVault

• Providing customized Health related search tools
• Online electronic health record

The game changer in all this is putting the consumer at the center. This is the whole point of the HealthCamp initiative. Empower the patient. With the patient at the center they become the glue for the Health Care system.

HealthVault is not a PHR. It is a platform to enable multiple applications to leverage a consumers health data. We are already seeing a growing ecosystem of health monitoring devices that will publish to HealthVault.

Microsoft are tackling the Enterprise HealthCare space with their Amalga platform.It is an integrated clinical information system.

Microsoft has a Health Common User interface.

The De-Construction of AOL

In the last few weeks AOL has done some serious house cleaning. Techcrunch leaked these plans back in July. AOL Journal, XDrive, AOL MyPictures, MyMobile and Bluestring have been or are in the process of being shuttered.

The business reasons behind this move seem perfectly sound but it will be interesting to see the consumer reaction. Will this withdrawal of service offerings leave people questioning the dependability of the remaining services? Will the shutdown cause their customer base to fragment as members go elsewhere in looking for equivalent services.

Would AOL have been better off linking with other services to transition the users to alternative services. For example, encouraging AOL Pictures users to upload to their recent acquisition, Bebo.

How difficult a position is AOL in? Their core service is arguably AIM and not email. However, I don't think I am alone in using AIM on a daily basis via meebo, adium or iChat or other third party chat applications where none of the eyeballs get to AIM.

It is certainly getting to be an interesting time with Yahoo's share price plummeting and AOL jettisoning services. It is looking like a Google-Microsoft Duopoly will emerge where those two giants provide a full suite of web-based services in order to maximize the attention of their users. The game in that situation is to provide good enough services where the network benefits of one environment outweigh the individual features offered by a specific service. This is the area that Google understands really well. When you look at Google's Documents suite the individual word processing, spreadsheet or presentation capabilities are a pale reflection of the rich Office suite form Microsoft. However, the power of the sharing capabilities provide a massive counter to the formatting features of the Microsoft products. The easiest way to demonstrate this argument is to look at the use of digital cameras and camera phones. I often carry both a 7 megapixel digital camera and my iPhone. However, I find myself using my iPhone and Twitpic far more often than the digital camera. The reason is that I will sacrifice the detail that the digital camera provides for the ease and speed of taking and posting a picture from my iPhone. It is this same richness versus speed and ease of use battle that is shaping the delivery of online services.

OpenId closing in on the big One Billion

This week has been a busy week for OpenID. At the Microsoft Professional Developers Conference Microsoft announced that Live ID will be OpenID compliant. I am estimating that this will add about 380 million accounts to the approximately 500 million existing OpenID capable accounts courtesy of Yahoo, AOL, France Telecom and others. Google has been providing limited OpenID support but this week also announced their adoption of OpenID 2.0 support. Interestingly they are also moving to support OAuth. That is a big move.

It could be that the Google announcement is a knee jerk reaction to Microsoft's news. It seems that they are still developing some pieces of the service offering. What is interesting is that Google seems to have take a slightly different approach and some are claiming that they are breaking the OpenID standard. What they are doing is using the gmail email address as the key. This requires sites adopting OpenID to make changes. This is where the shouting is taking place. For an interesting assessment of the implications check out the Neosmart blog. They claim that Google is forking OpenID. Try to take this in your stride. Take a breath and scroll down to the comment left by David Recordon, one of the leading players in the world of OpenID. I have copied David's comments are here:

"Google is taking advantage of a feature in OpenID 2.0 known as "Directed Identity". This allows an OpenID 2.0 Relying Party to start the OpenID protocol flow using a known URL (Yahoo!'s ishttp://openid.yahoo.com/) to allow for "one click" style login dialogues. By performing discovery on this URL, using the XRDS XML format, the OpenID Provider advertises the OpenID Endpoint URL for the Relying Party to make a request against. Google is doing this correctly with the URL to perform discovery against being https://www.google.com/accounts/o8/id.

The piece that Google is currently doing differently is requiring pre-registration of each OpenID Relying Party before users can login to a given site. This does break the common deployment of OpenID on the web today, but Eric Sachs of Google has said on the OpenID mailing list (http://tinyurl.com/562mec) that this is temporary as they work to stabilize their OpenID Provider: "We just need to do the standard scaling, stability, translation quality, etc. evaluation to make sure there are no major problems. If we are lucky, that won't take much time. However it is more then likely that we will need to tweak things in our user interface to make it easier to understand, and unfortunately translating any such tweaks into 40+ languages takes awhile."

As for using email addresses as OpenIDs, this is something the OpenID community is talking about quite a bit right now; Google included."

I think it is clear, As Microsoft noted, OpenID is recognized as a maturing De Facto standard for authentication. The major Internet players are all supporting OpenID. Now it is time for enterprises to recognize the advantage of adopting a global De Facto Authentication standard. This was part of our discussion at Health 2.0 and HealthCampSf last week.

I have been pushing the idea of using OpenID and OAuth, and other elements embraced by the DataPortability initiative, across the Health Care industry. It is now time for the industry to take that leap of faith and make it happen.

HealthCamp goes international

Earlier this year, at the Web 2.0 Expo in San Francisco, Health 2.0 made the agenda for the Web2Open un-conference track and the Birds of a Feather sessions. This generated a tremendous amount of interest. As I flew back from the event I wanted to make sure the enthusiasm didn't vanish. That lead to creating HealthCampMd then HealthCampDc and HealthCampNy. The enthusiasm seems to be catching. One of the attendees of HealthCampMd is now in the UK and is kicking off HealthCamp UK.

About 20 people participated in a Health 2.0 discussion at the recent BarCampRDU in Raleigh, NC. One of the consistent themes that comes across at these events is the bad experience people have when a serious medical event occurs. That experience manifests itself with a feeling of isolation.

One of the challenges of BarCamp is that conversations just get started and the next session kicks off. It can be a problem getting momentum established. Yes, there is an element of consensus building that needs to take place but it is important that we get a forward momentum and take action. But how do we take action? The problems are so massive and structural they appear as an insurmountable challenge.

This brings me back to a great session I participated in at BarCampRDU where Jim Meyer's "Leap of Faith" talk led me to this idea:

"Being part of a high performing team starts with ourselves"

"...So often in large organizations people feel helpless. They feel that they can't make a difference. Posing the question "What can I do to make a change?" is the first step to achieving exceptional performance.

We must stop worrying about how we can get the world, or our company, to change. Instead focus on the steps that we can personally take. By doing that we have taken the first critical step to becoming exceptional. Success in small ways becomes contagious.

Lead by example."

I need to remember this as future HealthCamps take place. Each article published and presentation made adds to the public consciousness. It all helps to build the wave of change.

I will challenge each attendee to consider what they can do to make the change they want to see happen. You have been warned!

We need to tap in to our social networks and use them for more than just poking and throwing sheep. Let's work out how to use social networks to encourage change. Let's band together and encourage each other.

We are not alone.

I encourage you to promote change in HealthCare. Let's work to make HealthCare more participatory. Let's network so that we know we are not alone.

There is some great technology emerging that can change HealthCare, not just HealthVault or Google Health but some of the open initiatives like Project VRM and the Higgins Open Source Identity Framework.

If you uncover a fascinating technology that is relevant to the HealthCare industry then point it out. Encourage the vendor to get involved with HealthCamp.