#HCMN HealthCamp Minnesota Kicks in to Gear

Bright and early on Saturday October 24th HealthCampMinnesota kicks off. A massive Thank You has to go to Albert Maruggi (@albertmaruggi) for organizing the event. This will be a slightly different HealthCamp Event. It will follow a similar model that was used at HealthCampNash earlier this year.

Albert has arranged a fascinating set of speakers to lead a series of panels. The objective is to stimulate discussion around HealthCare Delivery, Payments and Medical Devices. So much is up in the air as Washington debates Health Care Reform that these three themes will no doubt intersect during the camp.

One of the leading lights in Health Care Social Media - Lee Aase (@leeAase) is kicking off HealthCampMN. I am thrilled to finally meet Lee. You can follow the Twitter feed for the event using CoverItLive - embedded below - or catch the #hcmn search stream.

If you are planning to be at HealthCampMn you can contribute to the day by registering on the Wiki and updating it with your ideas and contributions. Post links to your blogs, photos and video streams. The Wiki can be reached via a bit.ly short url: http://bit.ly/hcmn_w.

Now, just because there are a series of panels arranged for this HealthCamp don't think you can just sit back passively. We want you to join in. Test the panel, ask the tough questions. Ask a question even if it seems like a dumb one. We all have different perspectives and the value of HealthCamp is in bringing those perspectives and experiences together, sharing and learning together. HealthCampMn is very much "on the record" - Take photos, capture video, blog and tweet about it. Use the #hcmn hashtag when you post content to Flickr, YouTube and elsewhere.

If there are issues that you haven't seen addressed then stay after lunch and we can create discussion groups on the fly - in true HealthCamp style.

HealthCamp is your day. Dive in. Get engaged. You are a participant and not just an attendee. Most of all - have fun. We want you to come away energized.

If you can't be there then check out the Intro to HealthCampMn on YouTube.

Finally don't forget. If you want to run a HealthCamp there are resources available at http://healthca.mp to help you do that. Or drop a comment here. I am always happy to instigate a new Healthcamp that will spread the word about Participatory Medicine.

HealthCampSFBay kicks off the Health 2.0 week in San Francisco

HealthCampSFBay kicks off this morning at the Kaiser Garfield Innovation Center in San Leandro, CA.

220 of the great innovators in HealthCare are coming together to Accelerate HealthCare.

If you can't be there you can follow the event at http://bit.ly/hcsfbay_w or here via CoverItLive:

If you are following on Twitter look for the hashtag #hcsfbay

The Future of HealthCamp is up to al of us

I am often asked what the future holds for HealthCamp. It is a really difficult question to answer because the future is not in my hands.
Why do I say that?
Because HealthCamp is about the participants. Every HealthCamp is different. My role is one of Chief Instigator. I am here to encourage others to set about running a HealthCamp for themselves.
My next objective is to create the HealthCa.mp Foundation that can act as a catalyst for Health Camps around the world. With that objective in mind I want to see HealthCamps spring up in different communities.
The essence of HealthCamp is to bring together people from different backgrounds and with different experiences. These different perspectives bring different approaches and different insights to the major challenges we face in health care.
The challenges we face in Health Care, regardless of where we are in the world, are too complex, too enormous for any single entity to tackle alone.
When it comes down to it each and every one of us has to step up and be accountable for their part in addressing the challenges. That is why at every HealthCamp I lay down a challenge by asking "What can YOU do?"
Many of the chronic health issues we face can be traced back to lifestyle choices that we each make. Therefore we each have the power to create change. Simply being more aware of our own health and making responsible microchoices about nutrition and exercise can make a life long difference in our vitality.

....Sent from my iPhone

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.

#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.

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.

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.

Free is just too high a price to pay

Robert Scoble seems to be on a roll at the moment. His commentary on the the Twitter ecosystem are fascinating. Last week he discovered that the Auto-follow had made him dumber. Now he is being more selective and as a result the quality of his feed has risen dramatically. His latest post is about the demise of tr.im from Nambu and the shortcomings of the Twitter platform. It is well worth a read.

The took two things from Scoble's post:

1. The Network Effects keep pulling us back
2. Put your stuff in more than one place.

When Twitter has a bad day, like the Denial Of Service attacks last week, we just wait. Just like how Scoble can't get thousands of his followers to meet him on FriendFeed, each of us is daunted at the prospect of persuading our tens, or hundreds, of followers to move with us to another platform.

Facebook and Twitter probably both recognize this fact. It is not just the followers but how about all the ecosystem components I have connected to my Twitter account. Brightkite, TwitPic, Bit.ly, Delicious. The list goes on. Every application adopted makes a user more "Sticky." The adoption of OAuth by Twitter and Facebook's Connect feature make the respective networks more essential to us.

The need to put our information in more than one place has been driven home to me when Twitter Search "Broke". It is more likely that Twitter deliberately hobbled search in order to manage their resources more cost effectively. We now have access to only a couple of weeks of tweets. This means that the collective thoughts from numerous conferences, camps and meetups have vanished.

This tells us Twitter may have stumbled on yet another business model option. They could choose to charge us for access to that collective hive mind. Would you pay? I would certainly think about - but only if Twitter let me pick up those searches as an RSS feed and republish them freely on my blog, or other sites I use.

The actions of Twitter warn us that "Free" is often too high a price to pay for services from a startup. It may be too high a price to pay from even established companies, like Google.

Free services on the Internet are a wonderful thing. But be wary. You always need an alternative. Put your information in more than one place.

It also means that, if you are serious about your personal brand on the Internet, you need to invest in a domain and look at the tools you depend upon and purchase or use Open Source code on servers in your domain. There are examples of open source URL shorteners.

I think I need to look at my blog here on blogger and how I can reduce my dependence on bit.ly. I may also have to revisit implementing identi.ca (laconi.ca) on my own platform.

  

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.

Beware - Twitter search is broken!

Something seems to be going on with Twitter Search. ...or more correctly - something is not going on at Twitter Search. Old tweets appear to have disappeared. Twitter search is broken and the digital footprint from events have disappeared. This is really bad news for many people. Twitter search has become our memory jogger - a place we go to to pick up on the threads of past conversations.

As an example HealthcampMd took place on June 19th - a few short weeks ago, yet there is only one tweet in search from 6 days ago.

If you are covering an event this is bad news. The lasting digital footprint is an important outcome from an event. Is twitter just throwing their history away, or are they focusing resources on the real-time part of search? We need to know!

If you are running an event there is something you can do. I have used CoverItLive on a number of occasions. Thankfully I did this for the HealthCampMd event. CoverItLive is a great service that can aggregate the conversations going on at an event. They don't appear to throw away the history like Twitter is currently doing.

Here is their history of the HealthCampMd event.

BTW - Thanks to SocialText for hosting HealthCamp event sites and the site for http://healthca.mp. Thanks to them we are just in the process of setting up HealthCampToronto for September 16th. They create a great collaboration environment and their SocialText Desktop AIR application is a really nice feature as an event gets closer and traffic on the HealthCamp event site increases. Check out the demo here.

HealthCamp - Spreading the word - a call to Healthcamp Organizers

It has been a while since I last blogged. A lot has been happening, including a successful HealthCampMd event on the 19th June at Stevenson University.

I had intended to blog earlier but my Mac needed resuscitation at the local Apple Hospital. Thankfully, he had a health plan (The good 'ol Apple Protection Plan) and after a successful transplant (a new logic board) he has speedily returned home and back in to the fray.

After being cajoled by Jen McCabe (@jensmccabe) I submitted a proposal for a session to Medicine 2.0 which is being held later this year,in Toronto on September 17-18th. My session is about "how to run a successful HealthCamp."

Since I am planning to be in Toronto for the conference I am also working with Carlos Rizo (@carlosrizo) to run HealthCampToronto on Wednesday September 16th. Other HealthCamp events are in the works in New York and San Francisco Bay in September and October.

I have had requests from many parts of the country to run Healthcamps. In response to that demand I am planning an online Organizer Conference. If you are interested in running a HealthCamp event in your area please get in touch. You can leave a comment on this blog or drop me a message on Twitter (@ekivemark).

The online conference will have a limited number of slots and there will be a nominal participant charge in order to cover webinar and associated costs. As with past HealthCamp events, any surplus from the event goes towards the fledgling HealthCa.mp Foundation, a public charity I am organizing to promote HealthCamps around the country and around the world. Those funds are used to promote HealthCamp and help kick start other HealthCamp events.

Enterprise Collaboration at Scale

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

Common Enterprise Collaboration Issues:

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

Most organizations think about technology first:

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

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

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

Design Thinking: Starts and ends with individuals

• Culture
• Behaviors
• Motivations
• Social Interactions

Human Factors link with technology Factors and Business Factors.

Understand these factors, then brainstorm and prototype then develop:

i.e. Understand, Explore and Develop.

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

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

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

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

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

Instead connect brains by creating:

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

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

• Go where people already are
• Build Adaptive systems

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

Prototype early and prototype in context. Then iterate quickly.

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

After five successive attempts at implementation they have implemented ThoughtFarmer

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

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

Getting people to write valuable people and project pages:

To address this utilize:

• Recognition
• Project Staffing
• Career Development

This is leading to input to organizational design.

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

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

Tiers of knowledge Management (from McKinsey)

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

Social Software in the Enterprise

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

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

SLATES:

• Search
• Link
• Tag
• Extensions
• Signals

People play email volleyball with attachments.

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

Search provides results and not answers.

Discovery provides answers sometimes from people and context.

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

Social Discovery enables a different way to work.

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

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

How do employees focus on the important things?

How do people discover connections to get work done?

Online documents solve the problem of sharing.

Social Messaging is new and close to real time.

Web 2.0 Expo - Day Two

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

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

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

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

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

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

"Your most enthusiastic customer is a fledgling employee"

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

Nokia: Anssi Vanjoki - The Next Transformation:

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

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

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

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

Ellen Miller - Sunlight Foundation:

Focused on Government and providing visibility for citizens.

Open Government data Principles

To be useful data must be consumable.

Kevin Lynch - Adobe

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

Impressive Flash Catalyst beta demo.

Will Wright - Creator of Spore.

100M user generated assets in the game.

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

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

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

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

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

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

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

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

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

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

The Open Enterprise

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

Four big factors in the Tag Cloud:

• ROI
• Econolypse
• Leadership
• Tools

Adption of Enterprise 2.0 tools is slow.

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

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

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