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.

VRM and HealthCamp via Health 2.0 at BarCampRDU

I am writing and posting this from the Carolinian traveling down through Virginia to BarCampRDU in Raleigh, North Carolina. Oh, the wonders of modern technology.

In my last blog I weaved together some of the threads from Vendor Relationship Management and Health 2.0. This has been very much on my mind as preparations for HealthCampDc and HealthCampNy continue.

I have volunteered to talk about Health 2.0 and VRM at BarCampRDU. So, as I sat on the train I pulled together a few slides to illustrate the subject. I have uploaded them to Slideshare and am sharing it below.

Health 2.0- and Vendor Relationship Managmeent

view presentation (tags: 2.0 health healthcamp vrm)

Health, VRM and Open Source - Coming together at BarCampRDU

This coming weekend is the third BarCampRDU, which is being held at the Red Hat Campus in Raleigh. I am traveling down to the event to join 250 others in discussions revolving around Open Source.

So far the proposed sessions include Data Portability, The Semantic Web, Distributed Agile, Rails/Groovy and other developer focused topics. The growing list is here. I have proposed sessions on Vendor Relationship Management and Social Networking and Open Standards in Health Care - aka Health 2.0 - a prelude to the discussions at HealthCampDc and HealthCampNy at the Web 2.0 Expo Web2Open unconference.

Hopefully Doc Searls won't mind me leveraging some of the great ground laying that he and various colleagues have done in order to spread the word on VRM. I will probably start with the VRM Principles:

Principles

1. User control
2. Reduce, Reuse, Recycle (Don't Reinvent the Wheel)
3. Reciprocity & Everybody Wins
4. Leverage network effects
5. Relationships are more than transactions
6. Solve real-world problems

I should probably also steal some slides from Doc's great intro talk on the VRM Manifesto.

Building on the VRM subject I am hoping to get in to discussions about using the Higgins Identity framework to manage federated group access policies. That could be a fascinating discussion that we just barely scraped the surface of, as we touched on R-Cards at the VRM Workshop.

I see a convergence of VRM with Health Care as the consumer becomes more involved in their own health. As that happens scalability becomes critical and the simplicity of Open Standards such as OpenID and OAuth will come in to play to enable seamless, heterogeneous integration. If I understand the principles behind R-Cards and I-Cards correctly these provide a stepping stone to the Personal Data Store that exists for VRM. The pointer-based nature of R-Cards would allow existing islands of information to be leveraged under the direction of the consumer - the real data owner.

The more I think about all these threads emerging, the more I get excited about our ability to make change happen. This week's BarCampRDU is set to be another stimulating un-conference event which should set the scene for HealthCampDc on September 12th and HealthCampNy immediately the following week.

Stay tuned - or better still - sign up and join in making change happen! You can even buy the T-Shirt!

HealthCamp - Get involved!

At the Web 2.0 Expo in San Francisco in April there was obvious and intense interest in the implications for the Health Care industry as a result of developments in Social Networking, Open Standards and Web 2.0 technologies. This prompted me to kick off a series of BarCamp style conferences. The inaugural event was HealthCampMd that was held in June thanks to sponsorship from Near-Time. The next two events are following in September, in close succession. The first HealthCampDc takes place on Friday September 12th in Washington DC at CareFirst's DC offices. A follow on event then takes place the following week as part of the New York Web 2.0 Expo event. That event, HealthCampNy, will be part of the Web 2Open sessions at the Expo. Follow the links to sign up for these events:

• HealthCampDc
• HealthCampNy

Sign up and get involved with the evolution of Health Care where Social Networking, Open Standards and Web 2.0 technologies drive change in the industry. I urge you to become a part of the transformation to a more participatory health care industry.

There is a clear trend in Health Care where the individual has a greater say and a greater role in managing their own health. This is going to trigger structural changes in the industry.

This will be a culture shock for many of the established players. Many of the organizations face significant change. They are facing a world where they are not necessarily in control. Instead individuals will have more control, but with that shift comes changing requirements for the technology that helps Health Care work. Information tools will need to account for the ultimate consumer.

Consumers will look to each other for help and advice. They will need tools to help them assess the quality of information they are receiving. This represents significant opportunity to apply technology in innovative ways. The dynamic nature of this new world will also drive the adoption of Open Standards and Open Source solutions as the demand to connect previously isolated islands of information grows. Proprietary solutions will not have the ability to scale as quickly as the often simpler, open standards can.

I recently attended the Vendor Relationship Management workshop at the Harvard Law School in Boston. It was organized by Doc Searls and is driving strategic thinking about how individuals can be given the tools to interact on an even playing field with the companies they do business with. Attending that conference got me thinking about the application of these approaches to Health Care with the Medical Home concept being an ideal starting point.

Let's continue these discussions at HealthCamp in person and on the web at Wetpaint.

VRM retrospective - making adoption easy

The Vendor Relationship Management Workshop at Harvard this week has been an invigorating event.

During the event I blogged on a question that was on my mind:

"Where do I put all my VRM stuff? "

Some of my questions were answered in the final session on R-Cards.

R-Cards offer the potential for our "personal data store" to be aggregated from the personal data held by companies that we have done business with on the Internet. One thing does need to happen though. We need to establish a VRM data portability policy framework that can be adopted and followed by companies.

What are the elements of a VRM data portability policy?

The basic elements of a VRM data portability policy should include:

• Data retention agreement - How long will my data be retained for? For example - for the life of the relationship plus 30 days.
• Data reuse agreement - Will my data be used for purposes beyond the original transaction
• Data ownership agreement - What elements of the data belong to the vendor such as a Frequent Flyer number
• Data portability agreement - The data that is the subject of the agreement may be stored by the vendor, or it may be held by a data custodian in a Personal Data Store.
• Data access agreement - The data that is the subject, or a sub-set, of the agreement should be accessible to third parties that have been granted access by the user. For example, granting access to my shipping address information at Amazon by a third party vendor I have performed a transaction with.

What other elements are needed?

Enabling evolution of the Personal Data Store

With an agreement around VRM data portability we have the basic mechanism in place to create the VRM Personal Data Store from the information that is already held about us out on the Internet. The R-Card seems to provide a mechanism to enable this.

Embracing the Vendor

This approach is attractive to me because it offers an approach that embraces the vendor rather than excluding them. Forward thinking Internet companies like Google, Amazon and eBay could adopt this as a means of further cementing customer loyalty.

Because the approach acknowledges the existence of our personal data being held by vendors it is pragmatic and leverages the situation. The Personal Data Store and the online infrastructure in the cloud needed to support the Personal Data Store does not become an impediment to adoption. Instead the user adoption curve becomes very simple. If a user has a set of delivery, billing and other addresses they have established and maintained at Amazon or eBay they can begin to re-use them at other sites via R-Card pointers.

As Personal Data Stores become established users can gradually transition their information in to their Data Store seamlessly.

The critical point is that this all becomes a matter of user choice. Users are not forced to adopt the Personal Data Store in order to enter the world of VRM.

Shoot it down

I know this line of thinking needs further analysis but I felt it worth putting out for discussion. Feel free to comment.

What's next with VRM?

The Next Vendor Relationship Management Session will be in 3 months. Another possibility is to hold a concentrated Many-To-Many Webinar.

• A group has been started on iYear for VRM2008 and for RelButton discussions.
• A Face-to-Face Standards meeting for one day on Personal Address Manager and the RelButton
• Need to create the VRM Landing page.
• Need to write the Wikipedia page.

Hopefully a number of the attendees from the workshop will blog and tweet some insightful analysis of the workshop.

R-Cards, VRM and the "real world" Personal Store

An R-Card is a pointer to the data that the user and vendor jointly created.

The R-Card is a super-set of the Info-Card.

R-Cards provide a pointer to data that I, as the user, can edit.

The R-Card represents "Real World VRM and the Personal Store".

The reality is that our data is scattered across the Internet and R-Cards offer the opportunity to re-use data that is held by vendors.

VRM and the Personal Address Manager

This VRM Workshop session covered the concept of the Personal Address Manager.

The scene setting points covered:

• First Assumption - Privacy
• Differences from long running relationships
• - Mutual policy negotiation - pain-free
• - Default policy bucket
• - No identifier
• Easy to produce end of relationship artifacts
• Win-Win for customers and vendors
• - Removing barriers to exit is attractive.

A use case was examined: Single Stop Online Shopping

• With Address
• With Personal Delivery Service (eg. relationship wth UPS, Fedex etc.)
• With Vendor Delivery Service (eg. Vendors own delivery service that respects PAM token)
• With Address from Personal Address Manager

Is the "With Address" scenario a Personal Address Manager (PAM) case? However the PAM might be the place where user relationship policies are stored. "With Address" was eliminated as a policy statement by vendors.

The "with Delivery Service" was selected to analyze.

Roles:

• Shopper (S:)
• Merchant (M:)

Assumption:

• Policy Assurance and Warranty

Scenario:

Step 1.

S: Shop at a compliant store

M: Offer VRM ("use VRM" button on the web page)

Step 2.

S: Click "Use VRM"

M: Endpoint Request

Step 3.

S: VRM Discovery End point - ie. PAM Address pointer

M: Push to provision

Step 4.

S: Provision vendor

S: Give Vendor token (with policy)

M: Policy agreement

M: Use token to get address

M: Use Address

M: Delete

M: Confirmation of End of use

Side notes:

Initiatives are underway to build a policy framework. (SAML and WS-Policy?)

This was a complex discussion to develop the scenario. Edits to refine this discussion can be made on the VRM Workshop Wiki in the Personal Address Manager page.

VRM and Higher Education

I am sitting here at the Harvard Law School for the Vendor Relationship Management (VRM) Workshop and it suddenly struck me. Harvard was where Facebook was founded yet the VRM discussion hasn't touched upon Higher Education as a use case for VRM.

I believe that The Student-Faculty-Institution inter-relationships could make a great field test for VRM. Harvard would be a great place to test out some of the theories. It has the additional advantage of being home to some of the foundational thinkers around VRM.

Could the RelButton be used to engage students and faculty in the creation of course schedules for students? I am not an expert on Higher Education so I would welcome some additional thoughts on potential applications or use cases.

Rise of the Bookmarklet

One of the discussions at the VRM workshop got in to the mechanisms around implementing the RelButton

One of the suggestions was to implement plug-ins. The problem is that plug-ins are browser specific and customers don't all know how to implement and use plug-ins.

An alternative is the Javascript bookmark.

I am not a fan of Plug-ins since these typically don't work on all browsers and also don't tend to work on mobile devices.

My preference is therefore for integration to be based around bookmarklets in any situation where capability has to be incorporated in to a browser.

What are your thoughts?

Is there another solution?

The Next Steps in VRM

This session looked at the next steps in VRM. What are the Requirements and use cases that could lead to bounties being created for Open Source code creation.

The issues discussed in the session included:

• How do we create code that doesn't require plug-ins or installation.
• Intention to relate (on my terms and with trust and courtesy)
• Human readable terms - eg. Creative commons
• Notification to the vendor
• Notification via co-subscribed service(s)
• Linked data model
• Create a bookmarket?
• Don't make user experience worse (consolidate/logins/logging)
• Can we model the real world gesturing
• Phased development (don't make it too big too soon or it will never get delivered but allow the solution to grow)
• Discovery

VRM Workshop - Day 2

Doc Searls kicked off Day 2 of the VRM Workshop.

There are ten principles that he has outlined for VRM:

1. VRM provides tools for customers to manage relationships with vendors. These tools are personal. They can also be social, but they are personal first.
2. VRM tools are are customer tools. They are driven by the customer, and not under vendor control. Nor to they work only inside any one vendor’s exclusive relationship environment.
3. VRM tools relate. This means they engage vendors’ systems (e.g. CRM) in ways that work for both sides.
4. VRM tools support transaction and conversation as well as relationship.
5. With VRM, customers are the central “points of integration” for their own data.
6. With VRM, customers control their own data. They control the data they share, and the terms on which that data is shared.
7. With VRM, customers can assert many things. Among these are requests for products or services, preferences, memberships, transaction histories and terms of service.
8. There is no limit on the variety of data and data types customers can hold — and choose to share with vendors and others on grounds that the customer controls.
9. VRM turns the customer, and productive customer-vendor relationships, into platforms for many kinds of businesses.
10. VRM is based on open standards, open APIs and open code. This will support a rising tide of activity that will lift an infinite variety of business boats, and other social goods.

"Ground zero for Markets 3.0"

1.0 was the Agrarian Age.

2.0 was the Industrial Age

3.0 is the Information Age

Information is not just another word for data. Instead we Inform and Form each other through information.

Where do I put all my VRM stuff?

Today has been fascinating at the VRM Workshop. I held a session on Vendor Relationship Management (VRM) and Healthcare but wished I could be at some of the other concurrent sessions.

Health Care has some great use cases that can demonstrate the value of VRM.

After a stimulating dinner, in which conversations continued, it was time for a walk back to the hotel and a chance to contemplate some of the discussions of the day.

It struck me that there is one question I must ask tomorrow. First, some background for those of you not familiar with the concept of VRM, to set the scene.

VRM puts the consumer at the center of transactions whereas today we are often the outsiders. This is especially true in the health care sector where we often feel like the uninformed observer, yet we are the subject of the tests and treatment.

One of the discussions that came up today was about data portability. The efforts of the dataportability.org collective appears to be to enable data to move between different social media sites. This is different to VRM where it is considered that the consumer owns the information. This is not putting down the essential efforts of the dataportability.org group because VRM depends upon data portability to allow information to be moved from data custodians.

This does raise a significant question. Let's pre-suppose that we as consumers adopt VRM and it is another "cloud" service that we use.

What are the essential characteristics of our VRM data custodian? This is a logical and important question because the average user will not want to be bothered with the information management tasks that go with managing a critical information store.

• So how do we determine the level of trust offered by our VRM data custodian?
• Do we need different custodians for different types of data?
• Does our medical VRM information need to be stored with a HIPPAA certified entity?
• If we have multiple data custodians how is that different from today's situation?

Do we need a service mark for VRM data custodians? Could this be something that pushes forward the identity and data portability agenda's too?

If we could define the characteristics of a VRM data custodian then we could establish credentials and validation programs. The benefit of this approach might be to allow the existing established data stores, whether they are Google, Microsoft or other bricks and mortar vendors, to participate in VRM without shutting off the evolution to an ideal state. The credentials could enshrine the

Another benefit of this approach would be to allow some of the forward thinking organizations to participate in VRM more actively than would be the case if the essential data stores for VRM were outside their purview.

VRM and the Medical Home concept

During the opening remarks to the Workshop Doc Searls asked what areas within organizations might be most receptive to the adoption of Vendor Relationship Management (VRM)?

This question prompted this session. It struck me that the industry initiative in Health Care around the Medical Home concept might be Health Care's sweet spot.

Emerging issues in Health Care will help push the role of VRM. These include:

• The rise in the power of the consumer
• Public policy and the uninsured

In a conservative industry VRM might find a role as an enabler of the Medical Home. Medical Home is being promoted by the industry as a solution to improving the quality and efficiency with which care services are provided, particularly with respect to complex health issues.

The coach, advocate or practitioner that guides an individual through the maze of health care services can be considered a vendor partner of the patient. They can help pull together all of the relevant information to improve the efficiency and effectiveness of diagnostics and treatment.

During the discussion in the session a number of points emerged:

• Google is supporting Continuity of Care Record (CCR). They have also adopted Atom as the standard for sharing CCRs.

some of the participants are already working with solutions in this space:

• MedCommons.net
• Polka.com

Some of the conclusions from the session:

• Information is the bedrock on which Medical Home depends.
• The advocate or coach in a Medical Home program could be treated as "just another vendor" from a VRM perspective.
• The open standards of OpenID, OAuth, OpenSocial and other standards can be used to enable MedicalVRM.

OpenID and OAuth in the Medical Records world

Adrian Gropper of MedCommons presented this session: "The Enemy of Good is Better"

The realization is that the barriers to on-line medical records are not legal or technological. This leaves social acceptance as the primary barrier.

The concept behind this session is that people will use more sophisticated standards as a delaying tactic to avoid adoption.

Healthcare has so many aspects to it. A use case that addresses one specific situation may provide the starting point. But what is that use case?

Informed consent is a challenge in health care. How about a scenario where providers supplied medical information to the patient and they could use that information to seek second and third opinions may be via some type of marketplace.

Do we need a VRM logo that indicates an organizations willingness to provide information on a customers terms. ie. open document formats, openID support etc.

We worked through some use cases:

Information banking standards create trust through VRM via the Rel Button

• Patients Like Me could feature a RelButton on their site
• Employer sponsors medical VRM as an enabler of onsite clinics
• Doctors could feature a RelButton that the are open to assisting with informed consent or partnership with the patient in medical home
• Personal Genome: as poster child for VRM in Science - not healthcare
• Focus on the elderly or severely ill as early adopters
• Doctors could feature a RelButton on their sites that indicate that the are open to second opinions
  

VRM Agenda Making

Be Prepared to be Surprised. The Workshop is being based on Open Space principles. This is similar to the AgileCoachCamp I attended recently and the HealthCampMd meeting I ran recently.

I have volunteered to lead a session on

"VRM and HealthCare - Is Medical Home a stepping stone to VRM?"

1:00pm - 2:00pm in Room 202.

The first session I attended was Kevin Marks of Google talking about Open Social.

One of the emerging standards that seems to be an off shoot of Open social is Portable Contacts. that initiative is being worked on by Joseph Smarr (Chief Architect of Plaxo) and Chris Messina (aka FactoryJoe).

Project VRM

For the next two days I am attending the Vendor Relationship Management (VRM) Workshop at Harvard University's Berkman Center for Internet and Society. There are about 45 people attending this workshop. The tag for content on Flickr and other sites is #VRM08. I may also broadcast and record some of these sessions using Stickam

The premise of Vendor Relationship Management:

"A free customer is more effective than a captive customer"

How do we turn the current state around. The relationship is at the centre. The relationship between people and organizations.

Some interesting discussions are already starting up. For example: How does VRM get traction in the enterprise? This has already got me thinking about the HealthCare industry as I prepare for the next HealthCamp in DC (HealthCampDc). It strikes me that VRM might find an outlet under the emerging Medical Home concept. To quote the opening line of the Wikipedia entry:

"The basic premise of the medical home concept is continual care that is managed and coordinated by a personal physician with the right tools will lead to betterhealth outcomes."

Identity is a critical component in VRM. Building VRM Relationship Services will be dependent upon new protocols and standards in the applications and network layers.

Some of the emerging components of VRM include:

• Personal RFP
• Personal Datastore (this ties in with Data Portability initiatives)
• Personal Address Manager (this becomes a fascinating SocialGraph application)
• Personal Healthcare Record
• Paychoice
• RelButton

Keith Hopper talked about VRM in Public Broadcasting. Kith talked about Money Left On The Table (MLOTT - a Doc Searls originated term). The RelButton becomes interesting to Public Broadcasters as a mechanism to provide additional avenues to collect donations from viewers and subscribers.

R-Cards are one of the components behind the RelButton. R-Card is a trusted channel between two parties - an umbilical cord so to speak. R-Cards is a component of the Higgins project.

Higgins is an open source identity framework that preserves your privacy having been developed from a user-centric perspective.

The Identity Web Services Framework is a key enabling platform for VRM.