Analytics & Social media impact on Healthcare
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Analytics & Social media impact on Healthcare
A view on how analytics and social media is used for shaping the healthcare industry
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Don't Let Fears About Healthcare IT Mire You in the Past | Healthcare Information Technology

Don't Let Fears About Healthcare IT Mire You in the Past | Healthcare Information Technology | Analytics & Social media impact on Healthcare |

The decision-makers in hospital C-suites have healthcare information technology on their minds these days, but what they are thinking is not all warm and fuzzy. In fact, I detect a certain amount of dread about how it will fit into the future. Even with generous federal incentives for meaningful use of HIT, many hospitals still have not committed to an electronic medical record. Just this past September, HIMSS Analytics, the research arm of the Healthcare Information and Management Systems Society, estimated that only 41 percent of hospitals were ready to meet Stage 1 of meaningful use.

Of course, the high price of implementing EHR has put off a lot of executives, but I believe their concerns run deeper than that. In a Dell Computer survey of hospital executives last March, only 47 percent thought EHRs would be a positive step, and almost 80 percent were anxious about the need to train physicians and staff to use the new technology.

That is not exactly a stunning endorsement of EHR. Hospital executives seem to regard EHR implementation as a long and difficult slog, with uncertain results at the end. We have all heard the horror stories when EHRs' promised magic somehow went horribly wrong. Sometimes physicians and clinical staff had major problems navigating the system and had to stay late to fulfill their new data-entry responsibilities. Clinical care was disrupted, physicians were up in arms and the hospital did not expect a return on its investment for many years to come.

It's time to step up to the plate
All of these problems can happen, but I strongly believe we need to move ahead with EHRs and other technology. Potential problems should not take us off our goal. Rather, they should be instructive examples of how we need to handle EHR implementation better than others did in the past. The advantages of EHR are obvious by now. It can reduce medical errors, improve patient services, increase efficiency, improve workflow and reduce readmissions. A recent study of Philadelphia hospitals, for example, showed that it even reduced readmissions by an average of 7 percent.

Those who ignore EHR will miss the train as it is about to leave the station. The evolution toward advanced healthcare informatics may have been slow in the past, but it is speeding up. The HIMSS Analytics survey I mentioned before found that while still only a minority of hospitals are ready for Stage 1 of meaningful use, that number rose 16 percent from February to September 2011. Healthcare IT is coming sooner than many in this industry care to think!

Put yourself at a competitive advantage
Hospitals and physicians are going to need to adopt EHR and use it, or else they will lose patients to other systems who successfully make the transition. There are all kinds of ways that healthcare IT can help make your hospital more competitive. For example, having a good EHR system in place can help make you eligible for new programs, such as pay-for-performance and accountable care organizations.

Healthcare IT can also help with recruitment of physicians. In a recent survey by Epocrates, maker of point-of-care medical software, 70 percent of current medical students said EHR technology would be an important factor in deciding where they would practice medicine. And last but not least, you can lure more patients to your hospital with a robust healthcare IT system with features such as patient portals. The Dell survey found that 83 percent of hospitals are favorably interested in patient portals and other ways to do business online. While only 18 percent had partially or fully implemented a patient portal, another 62 percent were planning to do so.

Some steps to keep you safe
If you are still deciding whether or not to implement EHR in the near future, there are ways to keep your institution safe from the perils of healthcare IT. Here, culled from the experiences of other hospital executives, are some steps to take.

Take time to do the groundwork. Most major health systems underestimate the amount of time it takes to implement EHR. You need time to get input from physicians and staff, choose a vendor, plan implementation, train staff and test software extensively before you go live.Involve physicians and other clinical staff. These key groups should be involved from the beginning, when you are just starting to plan. The EHR system you choose has to fit their needs and be easy for them to use. If they are not on board, your system is likely to fail.Find the right vendor. The vendor you choose should be responsive, and the system should be flexible enough to allow for improvements and modifications that your primary users identify. Your groundwork should involve performing a workflow analysis.Hire experienced IT personnel. Seasoned IT personnel can make a huge difference in a successful implementation, but as more hospitals implement EHR systems, the growing demand for them makes it harder to find the right personnel. You may have to pay more to find the right people.Don't skimp on training. Recognize that people who will be using the system have very different digital abilities and learning styles. Give them as many ways as possible to learn the ropes, including standard classroom training, one-on-one sessions, manuals and online exercises. This rich menu may cost extra, but it’s worth it.Plan for post-implementation snafus. No matter how well you plan, understand that there will be problems. After your go-live date, meet with physicians and staff to evaluate problems and deal with them head-on.

The transition to healthcare IT may seem daunting, but don't be discouraged! EHR is not something you can put off if your want to be a viable player in 2012 and beyond. It's time to move ahead and be part of the future

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BodyMedia and IBM Collaborate to Give Personal Weight Loss Advice using Analytics

BodyMedia and IBM Collaborate to Give Personal Weight Loss Advice using Analytics | Analytics & Social media impact on Healthcare |
BodyMedia has announced a personalized feedback system called BodyMedia FIT coach, which makes use of analytics software from IBM to give customized weigh loss advice. This will help people better understand how they progress and help them to accomplish their fitness goals.

The FIT coach will analyze user input, historical and current BodyMedia data to provide personal feedback. The BodyMedia FIT Armbands have already tracked a lot of data of many people up until this moment: using all this information to make a personalized advice can improve the success of consumer’s weight loss plans.

The feedback system is based on IBM Decision Management platform. It makes calculations to assess the users’ current status and compare it to the long-term goals. Down below you can find the key features of the FIT coach.

“The new FIT coach component of the BodyMedia FIT Activity Manager software is the first solution of its kind that can calculate and deliver information on:

Whether users are missing, meeting or beating their targets for burning calories daily
Multiple activity options for making up shortfalls in daily goals for burning calories (e.g. “Hop on the treadmill and walk for about one hour at a speed of four mph and you should hit your goal for burning calories today”)
Nutritional analysis of each day’s eating patterns, along with relevant recommendations for correcting problems such as excess fat intake
Overall progress towards the users’ weight loss goals, along with advice to stay on course”

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Why Social Media? – Andrew Spong Shares His Thoughts With H2onlinehu (Part 1)

Why Social Media? – Andrew Spong Shares His Thoughts With H2onlinehu (Part 1) | Analytics & Social media impact on Healthcare |
With this post we would like to start our first interview series on H2ONLINEHU. Our aim is to discuss the idea behind pharmaceutical online communication and the recent trends of the field with experienced professionals and influential experts. And what better way to start, than to talk about the importance of social conversations in pharma with one of the founders of #hcsmeu, healthcare social media Europe, Andrew Spong.Anyone that is involved in the field of health and social media knows you mainly from your key role in healthcare social media Europe. Could you talk about the idea behind building this particular community and having the weekly Twitter chats?

I think the story behind healthcare social media is quite well-known now, so I will just re-cap it really briefly. I was looking in the Summer of 2009 for health conversations on the social web, and I didn’t find that many at that time. What I did find however was a lady called Silja Chouquet (@whydotpharma). We found that we were using the same key words, searching for the same sort of health-related things and, as a consequence we found each other. However, what we didn’t find at the time (although the case is very much altered now) were the sort of regular conversations about social health that we were looking for. Or rather, we didn’t find any systematically organized or regularly held contexts for those conversations to take place on the social web in Europe.

We therefore decided to launch a tweetchat. We thought we’d call it Healthcare Social Media Europe, and use the hashtag #hcsmeu following the example of #hcsm, the healthcare social media conversations started by Dana Lewis (@danamlewis) in the US. Within 10 days of our initial conversation we had the first #hcsmeu chat. We promoted it quite widely through our own networks, and were delighted when a dozen or so people turned up at 1pm CET on Friday 7th August 2009 on the #hcsmeu hashtag. And that was in August 2009, and now of course we’ve had two real-life hcsmeu conferences, we’ve had a healthcare social media global conference, and nearly 120 weekly events now which take place every Friday as you know at 12:00 UK time, 1 o’clock European time.

To an outsider, how would you describe health conversations on the social web? Why social media, what are the advantages of this platform compared to other channels for health-related conversations?

The advantages of social media in connecting people are numerous really, but let’s just focus on a few of them. First is the instantaneous nature of the connection. To find and identify people – assuming that their bios are properly formed and feature the relevant keywords – and immediately connect with people across the world, but also with people in our own geographies around Europe who share our interest in the health conversation on the social web. So in terms of building community, social media has been I think crucial for all the healthcare stakeholder groups. What has been also very interesting is the way that social media has enabled those different stakeholder groups (patients, healthcare professionals, the industry, public health providers and so on) to find new ways to interact and new spaces to interact in, to share and to address some of the issues which we consider when we ask „What does improving the quality of care look like?”. Immediacy, speed and also availability of one-to-one connections is something new and something that social media fosters very effectively, I think.

You mentioned a couple of key words that stood out to me: interact, share, address issues. Why are these crucial? Why is it important for pharma companies especially to be involved in social media when it comes to health conversations?

While there are similarities across the different stakeholder groups, there are clearly differences as well. From pharma’s perspective, for example, the opportunities that social media offers include the rebuilding of its reputation, the building of a level of trust in its activities, and to credential itself in such a way as to offer tangible evidence of its commitments to patients and providers rather than some of the more abstracted and esoteric claims that pharma companies are prone to make on their websites along the lines of ‘wanting to make the world a healthier place’. That’s great, but really: who doesn’t want that? In short, you are far more likely to be convinced by a company’s claim to want to do that if they can actually demonstrate to you that they are doing it rather than just telling you that they’re doing it.

Thus perhaps the biggest opportunity possibly for the industry is to reach out, to credential itself, to build trust, and build credibility. However, that is also its biggest challenge, because when levels of trust in the pharmaceutical industry are as low as they currently are from an observer’s perspective, it is always going to be difficult for any given company to make that first step. It can be problematic for companies to find the most appropriate context within which they can begin to build all those adjacent benefits that we just identified. Being a heavily regulated industry as it is, pharma has not always found an easy route into this conversation. It is noteworthy that the companies that have succeeded such as Roche, Pfizer, and Boehringer have been those that have been most willing to put themselves out there. Not in an irresponsible way, but clearly, these companies understand that this is an experimental environment, and that unexpected things can and will happen. Let’s not forget that the conversation on the social web that Twitter drives has only been happening for five years. Twitter as a platform is only five years old, and whilst it is only the first generation of real-time information networks, what’s qualitatively different about the interactions that it creates and about what the industry is consequently having to learn to do in order to participate effectively is to get involved in a dialogue rather than merely making pronouncements, although at this time there is still far too much push messaging taking place.

Within European online health communication how do you see the position of pharma companies and agencies located in Eastern-Europe? Based on your past experiences what kind of advice would you give them?

I think from a Western European perspective we’ve seen evidence of interest arising across stakeholder groups including pharma, but on an individual level it hasn’t been a great deal of evidence, at least among English-speaking circles – obviously language is an issue – of affiliates within Eastern Europe coming online in a systematic way at a corporate level. So whilst individuals are beginning to mobilize, there hasn’t been a great deal of evidence of wider initiatives. Coming back to language issues, it is note-worthy that those conversations are conducted in English. However, I think that encouragement should be taken from the fact that companies like Pfizer, Boehringer and Roche are beginning to attempt to support their affiliates by supporting the bringing together and launching of local-language social media presences. And I think Pfizer is probably the leading example of this at the moment. They developed best practices from the head office in the US which have been expertly filtered out to European affiliates and they have been really supporting local colleagues in their desire to connect with the customers that matter to them in their geographies.

We know that the internet has no boundaries, so effectively everything they publish could be theoretically read by everybody. If they take it upon themselves to identify a need within their own territories, within their own geographies, in their own language then the more progressive companies are seeing that they have a responsibility to support those affiliates and help them grow those presences themselves. So, there’s not a massive amount of evidence thus far, but you get a sense that the conditions of possibility are being created to support the development, the emergence, and the blossoming of pharma social media in Eastern Europe.

And finally, how would you evaluate 2011 in terms of health conversations on the social web? What do you foresee for 2012?

I wrote a blog post about this subject recently. I believe that we are in this three-stage process of identifying trends that are slipping away, trends that are dominating, and trends that are emerging so it is interesting to watch this organic process take place. I’ve only been paying close attention to and participating in the social web since 2008, it was my third Twitter birthday in November. So I’ve personally been on Twitter for 3 of 5 years of its life, and do not possess a complete contextual framework from which I may speak to this question with any more authority than anyone else who has been using the platform. However, it is my observation in the three years that we have seen what were considered fundamental issues for the industry, when it was more focused on trying to orient itself rather than participating, we have seen these issues like listening and engagement becoming less important. That’s not to say that you don’t need to listen and you don’t need to engage, but it’s a prerequisite of maintaining an effective presence on the social web: that one listens, and listens well and continually refines one’s listening strategy. So it’s pointless to talk about that, you have to be doing that anyway. And similarly if you’re not engaging on the social web than what are you doing? So these are trends that I think are disappearing.

I’m hoping that we will talk rather less about mobile next year because it is beginning to seem superfluous. Almost everything is mobile now and therefore to have a mobile strategy is a redundancy. You should be taking Google’s lead by looking to serve the interests of the mobile user first and allow everything else to follow on behind this. So we need to focus on mobile, but we don’t need to separate it from everything else that we do on the basis that is becoming the core focus of the consumption and therefore (ideally) the publication of content. Hopefully we’ll just take it for granted that mobile is integrated and incorporated in everything that we do.

I’m also hoping gamification and anything game-related will prove to be rather less fascinating for us next year. There was a fantastic paper by Chia Hwu (@chiah) who delivered a paper entitled ‘Three Major Trends in Healthcare: Social, Mobile and Games‘ at an Ideagoras conference recently. She made some great points about games – gamification doesn’t work, games do work, she was saying. You don’t want to be taking game elements and trying to integrate them into a user experience or user interface but if you can find a way of conveying a message through a game that’a appealing then maybe you’re on to something.

Search remains important as the way that we are searching and what we are searching for and the environments within which we are searching for the information is changing constantly. We all saw that statistic last year about effectively Facebook being the world’s biggest search engine because more searches are entered to Facebook than to Google because Facebook, although it does link out into Google it links to its own content first. People are looking for health information for example within Facebook. And the quality of information that they’re going to find more often than not at this point of time is very poor. So if we believe that the whole purpose of healthcare is to improve patient outcomes, then there are issues there regarding search. So search is critical, the question of where patients, healthcare professionals are looking, the environment in which they are searching for information, to inform their practice and to inform their shared decision-making and the co-creation of their healthcare.

The things that I think are important in 2012 are two-fold. I’m really interested in influence. By which I mean I’m not interested in whether Klout is better than PeerIndex or Kred, and that shouldn’t matter to any of us. Rather, what is important is the fact that secondary services are appearing now which are harvesting and processing social metadata, ‘Big Data’ analyses of the totality of our activity across the social web and they’re doing something with it. Now in the case of Klout they are just putting a big number on it, but if Klout for example becomes a trusted measure of influence – it has done a great job making itself untrustworthy recently – but let’s just say they managed to have done that, then it becomes an issue for the industry. People’s opinions of brands and companies will increasingly be informed in part by the way that the platforms harvesting, analysing and discussing their social metadata present them.

The industry therefore will need to be growing importance of presenting itself consistently through the content that it publishes all across the web. This is not going to be easily achieved, but it needs to be something which senior employees or those with a global perspective begin to look upon as a pressing issue: to make sure that data and messages are consistent. A great start from the point of view of your readership and your geography is just to make sure that everything that they do within their own geographies is consistent. So they don’t have many different people tweeting things from different accounts. It’s not a complex matter, but there has to be a plan that everyone is aware of, takes ownership of, and that is coherent. Big Data is another emerging trend. Patient communities are – like CureTogether, like PatientsLikeMe – beginning to have access to relatively significant numbers of pieces of patient reported information which allow us to say interesting things about symptoms and treatment options for patients.

Finally, the industry has to be absolutely transparent about the reason why it is using social media. If it’s trying to represent itself in such a way as to simply redefine how it believes it may be able to control messages – which it cannot – then it will be found out and made to look foolish. Pharma needs to take a new approach to the way in which it represents itself within social web environments. Credibility is another trending issue in 2012. Direct messages are the last thing patients want to see. The social web is not for pushing messages, and it’s also not for selling. I’m hoping 2012 is going to be the year within which some of my fundamental questions – which underpin the financial planning and the growth of companies – around marketing are interrogated because to me it seems that an expectation endures that ideas forged in the offline world of the last century can simply by transposed onto the social web as if they had some sort of universal value, significance and bearing upon the fundamentally different dynamics of the social web. It is my opinion that they do not, and that they do not belong there, and that is why I advocate discussion about the subject via the #postmarketing hashtag. I think we are in a post-marketing era – people don’t want to be sold at on the social web, neither do they want to be tricked, or cajoled or persuaded. They want to converse, to be informed and they want to be heard. But they do not, for sure, want to be sold at. The transition from monologue to dialogue and all the expectations that inhere within it from the perspective of the way hitthat businesses need to present themselves and think about their customers’ perceptions of their activities are key characteristics of the social turn in communication.

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30 Social Media Predictions for 2012 From the Pros

30 Social Media Predictions for 2012 From the Pros | Analytics & Social media impact on Healthcare |
How will social media impact businesses in 2012?We sought expert opinions from a wide range of pros you’re likely familiar with.

We are grateful for the dozens of social media professionals who have written over 600 articles for us since we started Social Media Examiner in October 2009.

To give you a glimpse of what we can expect in the next 12 months, we decided to tap their knowledge and expertise. Here are their predictions of where social media is headed in the next 12 months


#1: Businesses consolidate social media activities

#2: Photo and video social networks will blossom

#3: Brands embrace real time

#4: Strategy takes center stage for social media

#5: New apps help with content overload

#6: Businesses outsource content creation

#7: Advanced analytics are coming for the masses

#8: Regularly creating unique content becomes essential

#9: Businesses learn to choose the right channels

#10: Facebook’s growth inspires unique Facebook marketing experiences


For the all the predictions and their detail please click the title and read at source....

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IBM Watson: The Science Behind an Answer- Interesting easy to follow video

After Watson's groundbreaking performance on Jeopardy!, see how this incredible smart technology processes data. In this video, the four steps of Watson's qu...
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The Trouble with Treating Patients as Consumers

The Trouble with Treating Patients as Consumers | Analytics & Social media impact on Healthcare |

To be a patient today is to be treated as a consumer. But treating patients as typical proactive, in control, well-informed consumers can backfire. Asked to take on increasingly complex decisions and digest ever-larger amounts of information, patients find themselves placed — often by design — in the driver's seat. High-deductible insurance plans aspire to make the cost implications of care more transparent and implicitly shift decision-making to members. The "empowered patient" movement encourages patients to become hyper-informed and to take control over their care. But providing greater information, access and autonomy — so often successful in consumer settings — does not necessarily drive better care or experience. Consider these cases:

An unexplained black-out sent a 61-year-old Boston woman to the emergency room and set off a flurry of visits to specialists to uncover the cause. Each doctor needed records of the diagnostics from previous visits. Hospital policy, however, required that patient data be released only to the patient, meaning she had to return to the hospital prior to any new specialist visit. Requiring her to control the information flow burdened her in the midst of a medical crisis.After years of struggling with her weight, a New York mother underwent bariatric surgery. She was inundated with information from her medical team about how she would need to change her behavior. Guidelines around when, how, and what to eat or not eat — the rules were overwhelming and constraining. Before long her weight had jumped again. For this woman, an excess of information (along with an assumption that she was prepared to absorb it) was part of the problem, not the solution.In a New Jersey health clinic, patients were calling 911 for minor illnesses and injuries, rather than the clinic's 24-hour line. Even when clinicians asked patients to program the clinic's number into their cell phones, 911 calls remained constant. Expecting patients to be proactive in this case was unrealistic; it took clinicians programming the number into patients' phones for them to change their behavior and reduce 911 calls, saving money and resources.

We see three main reasons why treating patients as consumers can create problems.

Patients don't want to be there: People don't seek out healthcare without a reason. Something is wrong and patients want to solve it and get back to normal. When patients are required to be proactive decision-makers, the health care system is often casting a very reluctant hero into the role.Patients aren't equipped to be there: Even when patients are willing to be decision makers, they may not have the tools. At a time of unusual stress, the system asks them to absorb technical information and make difficult decisions that require specialized expertise.Patients aren't in it alone: To design for patients alone is to forget that they are part of a complex system and aren't often independent decision-makers. Decisions are shaped by other stakeholders: friends and family who support the patient, the insurance company who foots the bill, practitioners who provide care and expert advice, the hospital administrators who inform system-level protocol, and so on.

When the people who design health-care delivery understand the difference between a patient and a consumer they can create more effective experiences.

For example, a series of diabetes decision aids developed by the Mayo Clinic Center for Innovation exemplifies how to design for patients as patients. Treatment decision cards use plain language and clean graphics to represent costs, risks, side effects, daily routines, weight change, and other considerations for common diabetes treatments. The tools help to align expectations around the many facets of treatment and provide a metered amount of information pertinent to the options at hand.

Most importantly, the intent is not to saddle the individual with the burden of the decision, but to help patients and providers work together to make decisions about treatment. The cards are designed to provide a mechanism for discussions around trade-offs and lifestyle considerations, providing an avenue for conversations around weight, blood glucose testing, daily medication regimen and behavioral changes that are fundamental to learning to live with diabetes. They are tools to enable a dialogue, meant to be used by the doctor-patient team, rather than guidelines or directives handed off to the individual.

The program acknowledges that treatment needs to be doable, rather than ideal. A clinical trial piloted the decision aids in a randomized group of clinicians; a second group provided usual care with an educational pamphlet. The six month trial demonstrated that patients who used the cards were more knowledgeable than usual-care patients, and more involved in the decision-making around diabetes medications.

As health-care delivery undergoes a profound transformation, the reflex to put patients in the driver's seat can result in poorly designed delivery systems that don't necessarily improve care or reduce costs. Health-care systems, providers, policy makers and designers need to take a step back and assure that in their eagerness to "consumerize" the medical experience they don't undermine the quality of care by demanding more of patients than they should be expected to deliver.

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AZ taps electronic patient records for real-world evidence collaboration

AZ taps electronic patient records for real-world evidence collaboration | Analytics & Social media impact on Healthcare |
AstraZeneca is to use anonymised real-world data from European electronic patient records to gain a better picture of how its medicines perform once they reach the market.

The pharma company has signed a three-year deal with IMS Health for access to existing anonymised electronic health records - which include clinical outcome, economic and treatment pattern data.

The records will provide "real-world evidence based on observational and retrospective studies throughout Europe," according to AstraZeneca

The company said the information would be used to "inform the delivery of effective and cost-efficient healthcare."

In addition to broadening its understanding of its current product portfolio, AstraZeneca also hopes to use the information to inform its future discovery and clinical development programmes.

Greater understanding of how existing drugs perform in real-world settings could also help it to position new drugs favourably in reimbursement and health technology assessment (HTA) discussions.

AstraZeneca and IMS plan to develop a customised research and analysis tool to interrogate the data, which will be used to identify gaps in existing treatment that could be addressed by new medicines.

The main focus of the collaboration will be on chronic diseases, spanning several therapeutic categories.

AstraZeneca’s president of R&D, Martin Mackay, described the alliance as "a key milestone in our commitment to understand the impact of our medicines in the real world, beyond what we see in controlled trials."

The deal recognises that tightly-controlled protocols in clinical trials cannot take into account variations in doctors' prescribing habits and the way the public actually take medicines.

AstraZeneca said the information gained would paint a picture of unmet needs in the current standard of care and treatment patterns across a number of therapeutic areas, with an emphasis on chronic illnesses.

Pharma companies have understood for some time that there is a benefit from the inclusion of observational, non-international studies in drug development programmes - even if the concept is not universally applied in practice.

The company’s latest collaboration with IMS Health complements this emerging trend.

Jon Resnick, IMS Health's vice president of real-world evidence solutions, said: "This joint initiative reflects a shared perspective on the transformative power of real-world evidence on global health systems."

The IMS Health agreement builds on AstraZeneca’s existing ‘real-world’ data and research partnership with WellPoint’s health outcomes research subsidiary HealthCore in the US.

The February, 2011, deal also had a chronic disease focus and saw AstraZeneca and HealthCore partner on real-world studies to determine the most effective and economical treatments.

Under a four-year deal the firms are conducting studies analysing electronic medical records, claims information and patient surveys.

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Healthcare proffesionals should be carefull with what they share on social media

Healthcare proffesionals should be carefull with what they share on social media | Analytics & Social media impact on Healthcare |
On the 31st of October 2011, the General Medical Council in the UK launched a consultation to produce guidelines for doctors and healthcare professionals when using social media. Why is this needed, and why now? The simple answer is – to stop you from getting into hot water when using Twitter and Social Media!

Top time for Hot Water in 2012?

“Personal profiles on Facebook and other social-networking sites are a trove of inappropriate and embarrassing photographs and discomfiting breaches of confidentiality. You might expect that from your friends and even some colleagues — but what about your doctor?” Time Magazine

This is current news in 2012, but if you look at the date of publication of this time article, it’s September 2009. Although this was published over two years ago, we think medical students are going to be coming under increasing scrutiny as the year unfolds.

It’s happened before, in the UK…

Remember people playing the lying down game? Roll back to Swindon, UK. A number of junior doctors were suspended for what many medical students and doctors considered hijinks: posing for photographs whilst lying down in unusual places. See our example of the latest MRI-PET scanner here: It’s happening now…

A research paper from 2010 looked at a small group of medical students in Liverpool, UK. Over half had witnessed unprofessional behaviour by their colleagues on social media.

Dr Amy Cunningham, a lecturer from Cardiff University recently highlighted on Twitter and her blog about doctors using slang on social media, e.g. referring to ‘mad-wives’ instead of midwives. For her efforts, both she and the doctors in question were both applauded and criticised by healthcare professionals and different elements of the national press.

Help is at hand…

If things seem a bit blurry and you dont know who to turn to for advice, fear not – as we have compiled a handy list of references:

From Your Institution – Check if you have guidelines at your University, and follow them!From Professional organisationsFrom the MPS: The pitfalls of social networkingFrom the BMA: Using social media: practical and ethical guidance for doctors and medical studentsFrom the AMA: Social Media and the Medical Profession: A guide to online professionalism for medical practitioners and medical students.

Help From Within – We think ‘use your moral compass’ is a great adage. See the moral compass example of one experienced GP below.

Advice from an experienced user of social media

One of our medical professionals says this:

“I use this principle. If I wouldn’t be happy with any of: my mother, friends, work colleagues, peers, nurses, receptionists, patients, friends of patients, children of patients, professional licencing bodies, line manager seeing it, don’t post it. Do not post anything relating to your workplace, patients, or patient care online. If you have a grievance, use formal channels.”

What about anonymity online, protected tweets, protected postings?

“Just be careful. Is it worth risking your professional status over such minutia? The security of these areas is becoming increasing difficult to police. Don’t go there.”

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A study encourages people to take the doctor’s notes home after exams.

A study encourages people to take the doctor’s notes home after exams. | Analytics & Social media impact on Healthcare |
In an old “Seinfeld” episode, Elaine goes to see a dermatologist about a rash, and is left sitting on the table in the exam room, alone with her medical chart. She opens the folder and almost immediately makes a sour face.

“ ‘Difficult’?” she says, reading aloud.

Let’s face it: We’ve all tried to imagine what the doctor’s been scribbling during our visits, what is to be found in that intimate record of frailties and phobias that we never see, even though it is all about us.

“The medical record is information that really belongs to the patient, but it’s treated like a classified document,” said Susan B. Frampton, president of Planetree, a nonprofit organization based in Derby, Conn., that promotes patient-centered approaches to health care. “It’s symbolic of the power differential in health care.”

Patients have a legal right to their records, though access can prove difficult. What would happen if patients were encouraged not just to see their medical records but to take them home, study them and really own them?

A research collaboration called OpenNotes has set out to answer this question, publishing the first results of a study on physician and patient attitudes toward shared medical records last month in Annals of Internal Medicine. For patients, at least, this seems to be an idea whose time has come.

The goal, said Dr. Tom Delbanco, a principal investigator of the study, is to engage patients more fully in their own health.

“That’s the great challenge in medicine: getting patients to be more active in their own care,” said Dr. Delbanco, a professor of medicine at Harvard Medical School. “What we’re doing is opening the black box and letting you look inside.”

Ultimately, he and the study’s lead author, Jan Walker, a member of the research faculty at Beth Israel Deaconess Medical Center in Boston, envision a record that is jointly written: with physician and patient input information, with some negotiation about the details and an agreement on how to proceed.

Dr. Delbanco and his colleagues recruited more than 100 primary care doctors who were already using electronic health records to volunteer to share their medical notes with patients. The researchers asked both participating doctors and doctors who declined to join the project about expectations and concerns, and surveyed nearly 38,000 patients.

The patients were from three very different communities: Beth Israel Deaconess, Geisinger Health System of Danville, Penn., and Harborview Medical Center in Seattle.

Doctors were ambivalent about opening their records, concerned that patients would demand more of their time as a result, or be worried and confused, said Ms. Walker, the study’s senior author. But patients were enthusiastic: 90 percent thought they would be more in control of their care if they saw the notes. They weren’t worried about being confused. Most said seeing the record would help them take better care of themselves: They would better remember the treatment plan, understand it and take their medication.

“Knowledge is power,” Ms. Walker said. “A patient goes to the doctor only once in a while, but in between visits, you’re making all kinds of decisions that affect your health every single day.”

Candice Wolk, a 39-year-old mother from the Boston area who just gave birth to twins, is a good example. During her first pregnancy checkup, her obstetrician noticed a dark spot on her back and suggested she follow up with a dermatologist. But in the excitement about her pregnancy, she forgot — until she read over the notes from her visit.

Even before M. D. Anderson Cancer Center in Houston started using electronic medical records, administrators gave patients their paper files to carry from doctor to doctor.

Now, cancer patients say having password-protected access to their electronic records helps them absorb complex information about treatment and follow lab tests.

“It never upset me, except the first time I read about my bones,” said Paul Grabowski, 60, of Houston, who has two forms of blood cancer and has developed bone loss that causes severe pain. “I heard about it from my doctor, but it’s different when you read it in black and white.”

Open medical records can help H.I.V. patients track viral loads and other disease markers, and motivate patients to take their medication, said Dr. Bob Harrington, a professor of medicine at the University of Washington in Seattle who is medical director of the Harborview Madison H.I.V. Clinic.

For indigent patients, access to records may help even more because they move frequently and their care is often fragmented, said Dr. Joann G. Elmore, professor of medicine at the University of Washington School of Medicine and one of the study authors.

Weight is a particularly sensitive topic in records, the researchers have found. Doctors who use the word “obese” in their notes may risk alienating patients.

“It might be better to say the patient is ‘20 percent over ideal body weight’ rather than ‘a jovial obese man came into my clinic,’ ” said Dr. Thomas W. Feeley, head of the division of anesthesiology and critical care at M. D. Anderson, who co-wrote an editorial accompanying the new study.

Further, experts worry about notes being shared with patients who have mental illness or substance abuse problems.

Most doctors do not think that showing patients their records will increase lawsuits; patients may even be able to point out mistakes or omissions. But other concerns remain.

Will physicians’ notes change if they know patients are reading them? Will patients withhold information they don’t want recorded? Will they be more likely to seek a second or third opinion?

The shared medical record, Dr. Delbanco said, “is a new medicine. It’s designed to help more people than it hurts, but invariably it may hurt some patients. Medicines are never perfect.”
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The Human Anatomy, Animated With 3-D Technology

The Human Anatomy, Animated With 3-D Technology | Analytics & Social media impact on Healthcare |

PEOPLE wear 3-D glasses for new movies like “The Adventures of Tintin.” But for medical school? The answer is yes at the New York University School of Medicine, which is using 3-D technology to update a rite of passage for would-be doctors: anatomy class.

In a basement lab at NYU Langone Medical Center in Manhattan last month, students in scrubs and surgical gloves hovered over cadavers on gurneys, preparing, as would-be doctors have for centuries, to separate rib cages and examine organs. But the dead are imperfect stand-ins for the living. Death — and embalming fluid — take a toll.

So, in an adjacent classroom, a group of students wearing 3-D glasses made by Nvidia, a graphics processing firm, dissected a virtual cadaver projected on a screen. Using a computer to control the stereoscopic view, they swooped through the virtual body, its sections as brightly colored as living tissue. First, the students scrutinized layers of sinewy pink muscles layered over ivory bones. Then, with the click of a mouse, they examined a close-up of the heart, watching as deep blue veins and bright red arteries made the heart pump.

Compared with the real cadavers in the lab next door, the virtual one seemed as dynamic as Imax.

“It’s like a living digital textbook,” said John J. Qualter, a research assistant professor of educational informatics at the medical school who helped design the 3-D installation.

The virtual human body is the creation of BioDigital Systems, a medical visualization firm in Manhattan that Mr. Qualter helped to found. It develops animations of the anatomy for drug makers like Novartis, medical device makers like Medtronic, television shows like “Mystery Diagnosis” and medical schools.

The virtual body, introduced last month at N.Y.U., represents an unusual collaboration between industry and academia. The companies, which originally paid BioDigital to develop medical animations of certain body parts for commercial purposes, agreed to let the design firm freely use the digital models for educational purposes. In recognition of N.Y.U.’s involvement, the company has pledged a small share of future revenue to the medical school.

But the medical students were merely testing an early incarnation of an ambitious project.

BioDigital plans to develop the virtual cadaver further on its new medical education Web site,, with the aim of providing a searchable, customizable map of the human body. Right now, Mr. Qualter said, the site is available only in a beta version. But in the coming months, the company plans to offer its code to, say, health Web sites that want to embed images of the respiratory system, or to doctors who want to show animations of prostate cancer surgery to patients.

“We wanted to use our data visualization to improve knowledge of complex health topics,” Mr. Qualter said. His firm hopes to position the virtual body as the health education equivalent of Google Maps — available as a free, easy-to-use public Web site and in an upgraded, fee-based professional version.

“We want to become a scalable model,” Mr. Qualter said, “a Google Earth for the human body.”

Mr. Qualter and his business partner, Frank Sculli, a software engineer, founded BioDigital Systems in 2002 to help companies and institutions use 3-D storytelling to make medical topics more comprehensible and compelling. For instance, the firm created an animated heart to demonstrate how an implant from Medtronic could fix a prolapsed heart valve. At N.Y.U., the firm worked with the medical school to develop animations of operations for surgical education.

Those kinds of commissions helped make BioDigital successful as a small business. But its executives concluded that its growth potential would be limited if they remained focused on one-off projects for limited audiences. Last year, they decided to combine all of their commissioned medical illustrations into one virtual human.

“As a private company, as a service business, we can make a couple of million dollars annually,” Mr. Qualter said. But, as a product firm with a searchable map of the human body to market, he said, the company has greater potential to increase revenue and improve health education. “Once the BioDigital Human is really being used by a lot of people, we can leverage that.”

IT is too soon to tell whether studying a digital human model will help medical students understand anatomy more deeply than they can by dissecting cadavers alone. But the virtual body certainly offers some advantages.

In the N.Y.U. lab, Chana Rich, a 21-year-old first-year student from Fairfield, Conn., dissected an older, female cadaver. But the dead woman had undergone a number of surgeries during her lifetime, and her body was now missing its appendix, spleen and right lung.

“She’s skinny and female,” Ms. Rich said, “so sometimes it’s hard to visualize the smaller vessels.”

A few minutes later, Ms. Rich was in the projection room, isolating the liver of the virtual cadaver and examining the blood vessels connected to it.

“In a cadaver, if you remove an organ, you cannot add it back in as if it were never removed,” she said as she adjusted her 3-D glasses. “Plus, this is way more fun than a textbook.”

But her colleague, Susanna Jeurling, a first-year medical student from Washington, disagreed. Dissecting a real cadaver, she said, gives students a unique, tactile understanding of the body.

“I don’t think this will ever replace cadavers,” said Ms. Jeurling, 24. “There’s something about being able to hold it and turn it in your hand.”

Administrators at the medical school say they have no plans to phase out dissection, an educational method that dates back to the Ptolemaic era. The 3-D digital human body is merely a complementary teaching method, said Dr. Marc M. Triola, associate dean for educational informatics.

“It’s an amazing blend of one of the oldest medical education techniques and the absolute newest,” Dr. Triola said.

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Reference for becoming an empowered patient.

Reference for becoming an empowered patient. | Analytics & Social media impact on Healthcare |
I help build open source software tools that patients can use to have greater control and influence over their own healthcare (like the Direct Project and Your Doctors Advice). As as result, I've become quite familiar with other tools that do the same sorts of things. There is a community of patients who are deeply interested in the ways in which they can become more engaged and how they can specifically use technology to achieve this. This community calls themselves epatients. The epatient community asked me to write a short collection of resources for "becoming an epatient."

The "e" in epatient is intentionally obscure. The initial assumption is that the "e" stands for "electronic," as it does in "email." But in fact, the "e" stands for "engaged" or "empowered." Nonetheless, reference to email is intentional: The epatient community recognizes that leveraging data is a critical part of empowering a person who happens to be sick. Patients must be "electronic" to become fully "engaged." I think of epatients as the healthcare equivalent of makers and hackers. More importantly, they are the people I have in mind when I write software.

Engaged patients get better healthcare. Not just a little bit better. Much better. This is not a thesis I am prepared to defend here, except to drop a link to the Journal of Participatory Medicine, which is a good resource for those seeking a full chronicle of this engaged effect (the benefits of engagement have been documented in the healthcare literature for years).

Let's go over some simple concepts that the rest of my epatient advice and resources are based on:

Your doctors are probably not managing your healthcare information. You should assume it is your responsibility. Otherwise, the people involved in your treatment process will often presume that this information simply does not exist.
Other patients, with similar conditions to yours, can have better information about your health problem than your doctors have.
Like the highway system, the healthcare system is generally beneficial, but there are dangers, and you need to learn to avoid them.
And here are two things you should keep in mind:

Whenever I say "patient," I actually mean "the patient/caregiver team." Often, the patient will not have the energy to do what is necessary to be fully engaged. It is critical that when the patient cannot be an epatient, that at least the patient's team be an epatient proxy.
In regard to the "better information" I mentioned above, I don't mean that your doctor is typically wrong and another patient is typically right about your diagnosis or treatment options. While that does happen on occasion, it is not the norm. Another patient's information is "better" because your doctor typically does not have the visceral experience of being a patient. Your doctor doesn't understand which lotion can make all of the difference or what position might let you get some sleep after a rough procedure. There is simply no substitute for experience. Sometimes that experience can make your life a little easier, and sometimes it can help you get the right treatments that literally will save your life. (This is the gist of epatient Dave deBronkart's story.)
The first thing an epatient needs to do is find the right epatient community. For any common illness or group of symptoms, there is a community of people who are already connecting with each other over the Internet. For people with a recent cancer diagnosis ACOR is probably the right place to start. This is one of the oldest, largest and most active epatient communities. Sometimes, the tools that a particular community of epatients choose might be a little old school — things like traditional forums, or even list-serves. Do not judge a community by its adoption of technology, judge it by its activity level.

There are efforts to create technology solutions that are specifically designed to enable patient communities. For a good example, check out PatientsLikeMe, which is representative of patient communities drifting more toward "patient social media." I am happy to say that epatient tool makers like me are coming up with cool stuff constantly. But the mature epatient is not impressed by new and shiny. Remember, it is the relationships and insights that matter here, not the technology. Whenever possible, you want the right information delivered over the wrong technology medium, rather than the other way around.

For any serious common healthcare condition, there are probably several different communities of patients online that you can meet with. For common conditions, you might also be able to find a specific meetup in your area, or at least some kind of epatient meetup. If you have a rare disease, you might have trouble finding local resources, and you might only have one or two online communities to choose from. But for rare diseases, the online patient community as a whole is typically better informed than the average primary care physician on a particular condition. Sometimes a physician might not understand or recommend treatment options that are offered outside their local healthcare community, an issue that can be compounded when they are unfamiliar with a particular type of diagnosis. It is even more critical for rare disease patients or caregivers to find a patient community and listen to them. For rare diseases and conditions, it is critical to understand what treatment options are offered in other areas and to be fully informed regarding sham clinics that often operate in under-regulated areas.

How do you know you've found the right community? Here's a good rule of thumb: If you can't get a real response to a simple health question from the community within 24 hours, you should probably move on if there are other options. Healthy epatient communities are vibrant and alive.

You should also consider joining the Society for Participatory Medicine (SPM). The mailing list for the SPM is one of the most important cross-condition meeting places for epatients.

If you are interested in the technology side, also pay attention to Health 2.0 (#health20), which has a Patients 2.0 (#patients20) community that is concerned with the "electronic" part of epatient. Generally, I find that Health 2.0 is the right place to find out-of-the-box thinking on healthcare information systems, especially those offered directly to consumers. I go there to get the down-low on my competitors and to find collaborators. Matthew Holt from Health 2.0 cross pollinates the healthcare blog, which is also worth adding to your RSS reader.

The cross-disease epatient community uses Twitter more than Facebook or Google+ (for the time being), and the #epatient hashtag is your friend. I also recommend following @epatientdave, @reginaholliday, and @hhask as good starter accounts. If you care about the tech aspects of epatients, then check out @NateOsit or myself (@fredtrotter). And if you're interested in the activist portion of the epatient community, then look at the Occupy Healthcare roster.

Once your healthcare information gets past a certain basic level of complexity, it becomes important that you have a personal health record (PHR). Your doctors should, eventually, be able to update your PHR. That means you need a PHR that supports the Direct Project. Right now, that is a short list, with Microsoft's HealthVault at the top. As a FOSS advocate, that is not an endorsement I make lightly, but Microsoft's health IT team has been surprisingly supportive of open source (i.e. patient empowering) technologies and they have relatively mature Direct support. Indivo is pretty much the only one to consider if you want to run your own PHR (it's open source), but its Direct support is lagging. Something you should keep in mind: If you have only one doctor at a time, you do not need to obsess about the coordination of your own healthcare information; if you have more than one doctor, you do. You can manage this information with a PHR, or a notebook, or even an infographic. What matters is that you need to do it, and do it carefully.

Some of the people in the Quantified Self movement are patients who are trying to use data about themselves to improve their health. If that interests you (if you have a chronic condition, it should), then take a look at the Quantified Self website.


There are two types of patients: those who are in crisis mode and those who are in maintenance mode. If you are in crisis mode, and you feel like your whole world has been turned upside down, then I recommend you read Dr. Carolyn Oliver's book "Cautious Care: A Guide for patients." The newest edition of this book is also available as a series of free PDF downloads from the Cautious Patient Foundation website. Here are direct links to the hospital part and the outpatient part. Dr. Oliver's book is like a "defensive driving crash course" for the healthcare system. If you are going to be staying up all night at the hospital (as a caregiver or a patient), and you have no idea what you should be paying attention to, this is the book that you should be reading. (Disclosure: I work for Dr. Oliver at the Cautious Patient Foundation.)


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HealthTap University allows med students to answer patient questions online with physician guidance

HealthTap University allows med students to answer patient questions online with physician guidance | Analytics & Social media impact on Healthcare |
As medical students, we learn countless facts about the human body, mechanisms of drugs, and physiologic pathways, in hopes that one day we will use this knowledge to help patients—perhaps provide a better understanding of their disease, ease their fears, or offer a cure.

Patients, especially now in the age of Google, come to their doctors with many questions about their various pathologies. Undoubtedly one of the most crucial skills for a budding physician to develop is the ability to anticipate and address patient concerns.

HealthTap University allows medical students to practice this, at their own convenience, online. Students even receive the guidance of established physicians.

HealthTap is an innovative new social network that improves the way doctors and patients communicate. Via HealthTap, patients can ask medical questions online, free of charge, and quickly receive a credible response from more than 6,000 licensed physicians. Upwards of 500 reputable healthcare groups are also on the site, including renowned organizations such as Cleveland Clinic and Mount Sinai Hospital.

Now, medical students can assist in answering patient questions through the HealthTap University program. While not exactly the same as visiting with patients in the hospital or clinic, exposure to patient questions on the site gives students an idea of the kinds of questions they may be asked by patients on the job, and experience answering them.

HealthTap U students write responses to real-life questions and submit them for review. Physicians may then evaluate the answers for accuracy and edit as necessary. Physician-approved answers are published with a line under the answer that acknowledges the medical student’s contribution. It’s a creative, win-win situation, since having medical students write the bulk of the answer can save time for busy physicians. In turn, medical students actively learn how to answer patient questions and start building their online credibility. I have had the honor of being involved with HealthTap U alongside a group of esteemed student colleagues from several different medical schools. I answer questions in my free time, and I truly believe it has strengthened my medical expertise and helped me gain experience in addressing real patient concerns.

For fun, I answer questions pertaining to my personal medical interests, such as pregnancy and women’s health, or anything else I feel like learning about at the moment. HealthTap questions have led me to read up on gestational diabetes, Barrett’s esophagus, autism, and pneumonia, just to name a few. But more than being a productive pastime, HealthTap U has been an invaluable supplement to my clinical education. During my internal medicine clerkship, I would come home and search for questions related to what we had discussed in lecture that day, or topics related to my patients’ conditions.

Using a combination of my own knowledge and additional research to answer questions, I was able to help patients and reinforce my understanding of concepts at the same time. Though sometimes my responses are published without changes, physicians often tweak them; they have taught me so much from their feedback. Even after answers are published, other doctors can comment or add their own answers, and I learn from those as well. Several HealthTap University students, including myself, have answered questions correctly both on rounds and board exams because of knowledge gained from HealthTap U.

Deborah Verran's comment, January 8, 2012 12:07 AM
Interesting development in e-learning for medical students. Wonder how long it will be until this type of learning is more widespread
Chatu Jayadewa's comment, January 8, 2012 5:45 PM
Agree, it's very interesting. I think with the increasing trend towards remote monitoring of patients, medical e-learning should follow suit soon after.
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"Big Data" still at early stages- lot more to be done- Bain

"Big Data" still at early stages- lot more to be done- Bain | Analytics & Social media impact on Healthcare |
Big Data has been the hot story in IT for 2011, leading to disagreement over its definition and its importance. (Just today Thomas Friedman cited it in his New York Times column.)

While a few argue that Big Data has peaked in its hype cycle, many practitioners contend it is still in very early stages of development.

Rasmus Wegener, a partner in Bain’s IT practice, says that instances of Big Data are relatively rare and that most Big Data is simply Large Data. And Large Data can be handled with traditional tools.

“It’s a somewhat hyped topic, just as cloud was for years. At Bain, we bridge between IT and the business guys. We find a difference in perception and understanding; even though they use the same words, it may mean something different. Businesses may think they have a big data problem. But often that’s because they don’t understand the tools in the technical organization and the skills sets which can handle a lot of data.”

Bain asks a few key questions:

Do you have a significant amount of data that needs to be analyzed? “Typically they say yes, and then we ask if it all has to be analyzed at the same time.”How complex are the analyses you have to run, the number of computing operations required to transform the data into actionable insights?Critical issue — what’s the speed at which the data must be captured and the solution generated? “This is almost always a knockout criterion. When you walk through the airport and they take pictures of everybody in the security line to match every face through facial recognition, they have to do that almost in real-time. That becomes a big data problem. If I am a bank and looking at a vast number of credit scores and histories, and I don’t need to provide an answer in five seconds but can do it next day, then that is not a big data problem.”Degree of structure of the data. Does it contain a significant amount of unstructured data from video or audio or can it be put into a relational database easily?

Wegener figures only a few industries have Big Data issues — utilities running smart grids, telcos and Internet companies like Yahoo, Amazon, eBay and Google which are analyzing massive amount of traffic in real-time and delivering targeted advertising. Retail, health care and other businesses have vast amounts of data without necessarily meeting the definition of Big Data, he added.

“Tools such as Oracle, SAS and Teradata are out there to handle vast amounts of data. Companies often lack the organizational structures and the talent to ask the right questions, frequently because they have underinvested in top-notch talent to drive their business intelligence.”

Getting the answer right can be worth millions. A cruise line client wanted to improve its pricing. It had 30 ships sailing each week from ports around the globe with about 3,000 passengers per ship. Business thought this required Hadoop which would have involved a $1 million investment. Bain prescribed pulling together analysts scattered around the company into a team and hiring a skilled leader. The company developed some Large Data analytical tools and achieved insights. Just one, a better way to price rear-facing cabins, brought $5 million in additional revenue the first year.

The gap between business needs and IT delivery has grown as data has grown, especially in companies that have failed to invest in the right analytical talent, said Wegener.

“You don’t know what yo don’t know, and if you don’t know, it is hard to come up with the right question. You need to be well-versed in both the business and the data.” A consulting firm like Bain can help develop the questions and set direction, but a company needs its own team to stay together and provide continuing analysis, Wegener said.

It requires someone who understands the business, often an MBA; someone who is comfortable with large quantities of data such as a mathematician or physicist, and someone with computer skills to know what a database or data warehouse can do and what other technologies are available to solve the problems.
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Why Aren’t We Talking About Healthcare-Commerce?

Why Aren’t We Talking About Healthcare-Commerce? | Analytics & Social media impact on Healthcare |

These days everyone is familiar with e-commerce. And our more social media savvy readers are probably all clued up on f-commerce (that’s Facebook commerce folks). I’ve even heard Google’s Adwords and Adsense business referred to as g-commerce. But what about the next letter in the alphabet. How come no one is talking about h-commerce?

Make no mistake; healthcare commerce online is big business (A Forrester research report projects 2012 Healthcare spending online will reach $8.7 billion). And the traffic for online health retailers is pretty impressive, too., a pioneer in the space nets 4.66 million unique users a month (and a not too shabby $416 mm a year in annual sales). But their traffic pales next to more traditional drug retailers like CVS (6.37 mm uniques per month) and Walgreen’s (10.6 mm uniques per month). And then, of course, there is the 800-pound gorilla of health info online, Web MD with a whopping 16 million unique visitors per month (to put that number in comparison, the New York Times website average 17 mm uniques per month). It’s clear that Americans are more than comfortable obtaining health information online and they’re also comfortable with online purchasing of the drugs and other healthcare products they need. So why aren’t we doing a better job of selling those products to them?

Don’t get me wrong. I’m not advocating digital snake oil sales or anything similarly distasteful (or anything that might get anyone in trouble with the FDA). In fact, quite the opposite. As an industry, it’s a real black eye for us that most people associate online drug information with spam e-mails offering cheap Viagra and that most of the discussion of drug sales online revolve around things like obtaining cheap Canadian pharmaceuticals. No wonder the Pharma industry has such a bad reputation with many consumers. While drug manufacturers have sat in their ivory towers doing their best to ignore conversations with consumers, the digital space has been ceded to shady characters who have no interest in preserving brand integrity or serving patient’s needs.

Yes, we’re bound by strict regulatory requirements that preclude us using some of the traditional methods that other consumer marketers use to tout the features and benefits of their products. But that doesn’t mean that we can’t find new and better ways to educate consumers about their health and help them maintain positive lifestyles. Or even just make their lives a little easier.

Consider the plight of a young mother who has just relocated with her family to a city where she doesn’t know anyone. She needs to find a GP she can trust for her family. She needs to find a pharmacist she can trust as well. Maybe one of her children has special needs and she needs to find a local support group. Maybe she just needs to know where that 24-hour drugstore is located. Perhaps she has a prescription that has run out and no one to authorize a refill. What does she do now?

She probably looks at Yelp or one of the many sites that publish HCP reviews. She may type the name of a national drugstore chain into a search engine and find a store at random. And she will spend a lot of time online looking for resources to help her and her family. Not a problem, right? We all know young moms have nothing but time on their hands.

How much better would it be if she were able to go to a one stop portal that contained tons of information about the healthcare resources available in her community? A site that listed HCPs, local specialists, pharmacists and patient support groups. A site that also provided links to educational resources online and e-commerce partners who could help with issues of supply and cost. A site sponsored by one (or several) Pharma companies that provided a real service to the community and a positive representation of our industry online. And, not for nothing, a site that increased compliance and by extension benefitted both the patient and the Pharma company.

The above, is just one example, of ways we can interact with and benefit the end consumer, without violating FDA guidelines. I’m sure our readers could come up with numerous other ideas. The key here is to once again step outside the narrow confines of our traditional industry thinking and to learn from other players in the market. A good start would be for Pharma companies to become more active in the general conversations about online marketing and retailing that take place at sites like INTERNET RETAILER and SHOP.ORG. Ultimately, the end consumer for Pharma is a consumer and we need to realize that despite all the rules that bind us, the purchase funnel for our products is no different than any other.

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Insurance firm BUPA wants to mine e-health data

Insurance firm BUPA  wants to mine e-health data | Analytics & Social media impact on Healthcare |

Insurance company Bupa wants the Federal Government to provide anonymous patient data from the Personally-Controlled E-Health Records (PCEHR) system to companies for research on Australian health.

Under legislation currently before parliament, only the consumer has control over access to information in their own e-health record, and decides which health practitioners are able to see what information contained in their e-health record.

However, Bupa Health Dialog, a subsidiary of the insurance giant, believes that this is far too constrained, and that in the interests of research, all data should be anonymised and made available to research Australian health consumers.

"Access to de-identified health data on the Australian population is extremely useful to identify the needs and risk factors of Australian health consumers," Bupa said in a submission to the parliamentary inquiry on the PCEHR legislation.

"Health and wellness organisations, such as Bupa Health Dialog, are uniquely positioned to develop and implement sophisticated data-mining tools, which can enable the development of accurate and relevant programs that improve the health of the community."

Bupa could, for example, determine what percentage of diabetes patients don't have their annual eye exam, or the percentage of people with heart disease who don't take statin medication.

"This use of de-identified data would lead to the development of more effective, routine, targeted prevention activities that enable healthcare professionals to make interventions within the right cohorts at risk of exacerbation of chronic diseases, as well as enhance the way we manage existing chronic diseases."

In order to allay any concerns about the privacy of this data, Bupa said that "de-identified" information would have all personal information, such as names and dates of birth removed before it would be made available to other organisations outside the scope of the normal PCEHR system.

While Bupa is arguing for access to be extended beyond healthcare providers, the Australian Privacy Foundation in its submission said that the legislation does not define the term "health provider", meaning it is unclear who exactly will be able to access the PCEHR system.

The Privacy Foundation also called for the government to release current costs for implementing the PCEHR system, and said that the Bills do not guarantee that the system will be ready by July 2012.

"It is better to get this government initiative right than to meet an arbitrary deadline. Everyone is a health consumer, so getting a national e-health system wrong could be very costly in terms of public perception of the government, and set our national e-health agenda back several years," it said.

"The Bills should refer to actual deliverables and benchmarks over and above simply enabling a PCEHR system experiment with clinicians and the broader community in living laboratories."

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A Prescription for Prediction- How predictive analytics are used in critical care of premature infants

IBM and the University of Ontario Institute of Technology (UOIT) are using testing System S to help doctors detect subtle changes in the condition of critically ill premature babies. The software ingests a constant stream of biomedical data, such as heart rate and respiration, along with clinical information about the babies. Monitoring "preemies" as a patient group is especially important as certain life-threatening conditions such as infection may be detected up to 24 hours in advance by observing changes in physiological data streams. The type of information that will come out of the use of System S is not available today. Currently, physicians monitoring preemies rely on a paper-based process that involves manually looking at the readings from various monitors and getting feedback from the nurses providing care.

True stories from IBM's First-of-a-Kind (FOAK) program, which pairs IBM researchers with clients to bring incredible discoveries and possibilities into view....
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Transforming Healthcare through Analytics: A Conversation with Bill Rollow and Lorraine Fernandes

We’re swimming in data, but are we transforming it into usable information?

As we embark on 2012, we’re looking ahead at the next steps for transforming healthcare. Josh Constine of TechCrunch got in the spirit with 6 Big HealthTech Ideas that Will Change Medicine in 2012. Constine named Artificial Intelligence (citing IBM Watson and Siri) and Big Data as two of the six.

Both concepts are particularly timely. Mandates require more and more data to be collected and stored in electronic health records. But all that data collection and expense is ill used if it gets trapped in silos.

As Lorraine Fernandes, IBM’s Global Healthcare Ambassador, recently asked, “How do we harness the power of all this electronic data?”

Fernandes and Dr. Bill Rollow, GBS Solutions Leader for Healthcare Value and Transformation, discussed the promise of Watson-inspired analytics in their recent video. Transforming healthcare comes with ambitious goals: improving the quality and safety of healthcare while controlling costs and creating new efficiencies for patients, providers, and payers.

The challenge is that the vast majority of healthcare data is unstructured, whether doctors’ notes, x-rays or other test results. But a longitudinal view of patients and providers paves the way for incredible potential rewards.

Deep analytics – like those powered by IBM Watson – present a world of possibilities. The data previously stuck in silos can be translated into information that underpins better outcomes, best practices and more cost-effective solutions. Patients could save copays or time by avoiding duplicate, unnecessary tests that may create safety risks. Providers gain on both sides of the equation, as they can provide better care while streamlining their interactions with payers.

As Dr. Rollow explained, “The paradox is, there is a relatively large amount of data, or potential data, out there, but the amount of information that we have that’s usable in clinical decision making is small.” Analytics aims to change this.

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More Pharma Firms Entering Deeper Social Waters With Confidence 01/10/2012

More Pharma Firms Entering Deeper Social Waters With Confidence 01/10/2012 | Analytics & Social media impact on Healthcare |
While many businesses have raced to build their presence in the online social sphere, pharmaceutical companies have been typically shielded away from these channels over concerns with liability for monitoring adverse events and entering unknown territory. It’s understandable, as, not surprisingly, pharmaceutical is under greater scrutiny than many other industries. But as social media reached a tipping point in 2011, with mainstream acceptance among marketers, we also saw many more leading pharmaceutical firms making broader forays into social media.

Here are a few notable examples:

Bio-pharmaceutical firm UCB, Inc., and PatientsLikeMe, an online community for people with life-changing conditions, partnered to create an open epilepsy community online to capture real-world experiences of people living with epilepsy in the United States.
Johnson & Johnson established an innovative Acuvue Acuminder Facebook application, which reminds people when it’s time to change their contacts. It is a frequently cited example of social media success in the industry. Johnson & Johnson’s leading social media efforts also expand well beyond Facebook to include a YouTube channel, several Twitter handles and a corporate blog.
GSK was among the first pharmaceutical companies to incorporate social elements into consumer outreach efforts. A few years ago, when social media was really just starting to hit the mainstream, GSK targeted U.S. adults, ages 18 to 34, with an unbranded website and campaign designed to increase awareness of genital herpes—including treatment options for the sexually transmitted disease. GSK earned significant recognition from the medical and public health communities for sponsorship of this campaign, as well as for the social value it created.

In 2011, GSK fortified its social presence with its branded “More Than Medicine” blog. Designed to encourage more open and productive dialogue with consumers in the United States, the blog is used to share news about the company (including coverage in major media outlets) and its innovations, its corporate social responsibility efforts, developments in healthcare reform, and information about chronic diseases, among other topics. GSK also now maintains a Twitter feed.
Another pharmaceutical giant, Pfizer, reached out to audiences across Europe in 2011 with a quit-smoking campaign that included the push of a “Serious Quitters’ Arcade” games site through Twitter activity, video seeding and a Pac-Man-inspired Facebook app. (It is possible this pan-European effort may have helped Pfizer earn the number-one spot in a recently released study by Paris-based Cegedim Strategic Data, which compared pharmaceutical companies' spend on traditional promotional channels to their presence on two leading social media channels – Facebook and Twitter.)
Social channels represent a powerful marketing opportunity for pharmaceutical companies to build and foster relationships with existing customers and new audiences. Seeing the success companies across industries are having with social media, it’s no surprise more pharmaceutical companies are deciding to plunge deeper into social waters. However, what’s also clear is that broadening engagement in social channels makes good business sense, as fostering ongoing and positive dialogue with consumers will only help the industry to better serve patients.


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Infographic: Search & Call Tracking

Infographic: Search & Call Tracking | Analytics & Social media impact on Healthcare |
Are you tracking search-related conversions that come in by phone? Perhaps you should, when 43% of them are estimated to come in that way. Ads that contain phone numbers are also said to have a 10% increase in clickthrough rate.
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6 Social Media Networks to Watch in 2012 + Infographics

6 Social Media Networks to Watch in 2012 + Infographics | Analytics & Social media impact on Healthcare |
The social media ecosystem is now so extensive and encompassing that I thought that it would be best to stand back and reflect on some significant events and evolutionary social networks that could make a difference in 2012 that are impacting how...

1. Google+

Google decided in 2009 that it could no longer ignore the social web as it watched Facebook warp the web into a global community of 800 million plus. On June 28, 2011 Google Plus launched and became the fastest growing social network in history reaching 25 million users in less than 30 days. It continues to grow at over 600,000 users a day and is projected to reach 400 million users by the end of 2012 according to estimates by Paul Allen.

It is now both a personal and business social network after launching Google+ brand “pages” on November 7, 2011. Google plus enhanced the visual aspect of social networks by making its images significantly larger than the photos on Facebook. Facebook has since responded with a revamp of its design that allows for much larger images in its new “Timeline” for personal profiles.


2. Pinterest

This social network is a place to organise and share online images that you find interesting or inspiring and continues to reinforce the trending growth of an increasingly visual social web.

Pinterest has grown 4,000% in the last 6 months and is now threatening to break into the top 10 social networks with more than 4 million unique users.

Its users are extremely engaged, it keeps its users logged on for long periods of time and ranks as number three at 88.3 minutes per user per month behind Facebook and Tumblr respectively.


3. Tumblr

Tumblr is a multimedia rich microblogging platform that allows users to post text, images, videos, links, quotes and audio to their short form blog. It is about ease of use.

The numbers for this platform are too significant to ignore.

900% growth in the last 12 months90 million users compared to only 10 million a year agoAddictive and highly engaged audience with 2% of its audience making up 43% of total visits

The engagement on Tumblr is only second to Facebook at an average of over 141 minutes per month per user.

Ease of use and making it simple to post images plays into a web that embraces high definition and addictive images.


Read in detail at site about the following 3


4. Slideshare


5. Facebook


6. Twitter

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Do We Need Doctors Or Algorithms?

Do We Need Doctors Or Algorithms? | Analytics & Social media impact on Healthcare |
his is Part II of a guest series written by legendary Silicon Valley investor Vinod Khosla, the founder of Khosla Ventures. In Part I, he laid the groundwork by describing how artificial intelligence is a combination of human and computer capabilities. In Part III, he will talk about how technology will sweep through education.

I was asked about a year ago at a talk about energy what I was doing about the other large social problems, namely health care and education. Surprised, I flippantly responded that the best solution was to get rid of doctors and teachers and let your computers do the work, 24/7 and with consistent quality.

Later, I got to cogitating about what I had said and why, and how embarrassingly wrong that might be. But the more I think about it the more I feel my gut reaction was probably right. The beginnings of “Doctor Algorithm” or Dr. A for short, most likely (and that does not mean “certainly” or “maybe”) will be much criticized. We’ll see all sorts of press wisdom decrying “they don’t work” or “look at all the silly things they come up with.” But Dr A. will get better and better and will go from providing “bionic assistance” to second opinions to assisting doctors to providing first opinions and as referral computers (with complete and accurate synopses and all possible hypotheses of the hardest cases) to the best 20% of the human breed doctors. And who knows what will happen beyond that?

Assessing Current Healthcare

Let’s start with healthcare (or sickcare, as many knowledgeable people call it). Think about what happens when you visit a doctor. You have to physically go to the hospital or some office, where you wait (with no real predictability for how long), and then the nurse probably takes you in and checks your vitals. Only after all this does the doctor show up and, after some friendly banter, asks you to describe your own symptoms. The doctor assesses them and hunts around (probably in your throat or lungs) for clues as to their source, provides the diagnosis, writes a prescription, and sends you off.

The entire encounter should take no more than 15 minutes and usually takes probably less than that. Sometimes a test or two may be ordered, if you can afford it. And, as we all know, most of the time, it turns out to be some routine diagnosis with a standard treatment . . . something a computer algorithm could do if the treatment involved no harm, or at least do as well as the median doctor (I am not talking about the top 20% of doctors here—80% of doctors are below the “top 20%” but that is hard for people to intuit!).

So what’s wrong with this situation? This is by no means an exhaustive list, but it sets up a nice springboard:

Physically having to go to your doctor’s office makes sense for the most part, except that a lot of the basic tests are either visual (tongue and throat check) or auditory (listening to the breath and vibrations in the abdomen). Time plus cost will often discourage people from taking that first step to visit a doctor. Most of the time a Dr. A could at least advise you when it is worth visiting based on your normal body functions, your current indications, and your locality’s current infections and other symptom trends.
A lot of the vitals being tested for (e.g. blood pressure, pulse) can now be routinely done at home or even with the help of an iPhone and an explosion of additional possibilities will emerge in the next decade.
You are the one telling the doctor your symptoms.
The doctor has to inquire (probably every time) into any possible history of each symptom, test results, and illnesses, except when he does not have time for you in that village in India.
The prescriptions are still done on paper, requiring you to, again, physically go to a pharmacy and pick up what you need there. So compliance is an issue.
Looking at this, I cannot help but think that this is a completely antiquated system (regardless of whether it is healthcare or not)!

Going down the list, we find a pretty negative assessment. The vital signs could all be determined with the help of mobile devices, the operation of which do not require years of training and a certification. You will be able to do this by yourself—Philips already is using the iPhone camera to try to measure vital indicators, others will be even more innovative and as an insurance company it would be cost-effective to give them to every insured person for free. Skin Scan is measuring your risk of skin cancer from a photograph of a skin lesion. Telemedicine is accelerating and a Qualcomm company is measuring heart rates using an iPhone. Cell phones that display your vital signs and take ultrasound images of your heart or abdomen are in the offing as well as genetic scans of malignant cells that match your cancer to the most effective treatment. Ear infection and skin rash pictures and more will all be mobile phone based, often supplemented by the kind of (fractal) analysis that Skin Scan does, and more than what the doctors naked eye could usually see.

The history of symptoms, illnesses, and test results could be accessed, processed, and assessed by a computer to see any correlation or trends with the patient’s past. You are the one providing the doctor with the symptoms anyway after all!

Any follow-up hunts for clues could again be done with mobile devices. The prescriptions—along with the medical records—could relocate to electronic and digital methods, saving paper, reducing bureaucracy, and easing the healing process. If 90% of the time the doctor knows exactly the right kind of diagnosis from these very few and superficial inputs (we haven’t even considered genetics yet!), does it really require 10+ years of intense education for every diagnostician?

The fault is not entirely with the doctors, though. Most of us don’t know what set of symptoms warrant the full-scale attention of medical personnel, so we either go all the time or we do not go at all (save for emergencies). We also cannot realistically expect any (even our family) doctor to remember every single symptom and test result over the years, definitely not in a government hospital in China. Similarly, we cannot expect our doctor to be able to remember everything from medical school twenty years ago or memorize the whole Physicians Desk Reference (PDR) and to know everything from the latest research, and so on and so forth. This is why, every time I visit the doctor, I like to get a second opinion. I do my Internet research and feel much better.

Identifying Emerging Trends In Healthcare

But I always wonder why I cannot input my specific test numbers and have a system offer me a “second opinion” on the diagnosis since it has all the data that the doctor has and can use all my current and historical data effectively. In fact, it is not hard to imagine it having more data than the doctor has since my full patient record would be at the tip of its digital brain, unlike the average doctor who probably doesn’t remember my blood glucose levels or my ferritin from two years ago. He does not remember all the complex correlations from med school in which ferritin matters—there are three thousand or more metabolic pathways, I was once told, in the human body and they impact each other in very complex ways. These tasks are perfect for a computer to model as “systems biology” researchers are trying to do.

Add to it my baseline numbers from when I was not sick, which most doctors don’t have and if they did 80% of physicians would be too lazy to use or not know how to use. Applied Proteomics can extract tens of gigabytes of proteomics—what my genes are actually doing instead of what they can do—baseline data from one drop of blood. Oh, by the way I have my 23andMe data to add my genetic propensities (howsoever imprecise today, but improving rapidly with time and more data). The doctor uses a lot of imprecise judgments too as most good doctors will readily admit. My very good doctor did not check that I have relative insensitivity, genetically, to Metformin, a diabetes drug. It is easy to input the PDR (the Physicians Desk Reference), the massively thick, small-font book that all physicians are supposed to know backwards and forwards. They often don’t remember everything they read, in med school but it is a piece of cake for computers. The book on your typical doctor’s desk is probably not current on the leading-edge science either. Confirmed science and emerging science are different things and each has a role. Doctors mostly use confirmed science, the average doctor not understanding and pros and cons of each or the expected value of a treatment (benefit and harm). And our 18th century tradition of “first do no harm” dictates that if a treatment hurts ten patients a year but saves a thousand lives we reject it.

With enough examples, today’s techniques for language translation (or newer techniques) can translate from human lingo for symptoms (“I feel itchy” or “buzzy” or “reddish bubbly rash with pimples” or “less energy in the morning” or “sort of a stretch in my tendon” and the myriad of imprecise ways symptoms are described and results interpreted — these are highly amenable to big data analysis) into medical lingo matching the PDR. With easy input of real medical results into a computer and long-standing historical data per patient and per population, which a human cannot possibly handle, and patient and population genetics, I suspect getting a second opinion of my diagnosis from Dr. A is a reasonable expectation, and it should certainly be better than a middling physician’s (especially in less developed countries like India, where there is a dire shortage of trained physicians).

I may still need a surgeon (though robotic surgeons like those from Intuitive Surgical are on the way too) or other specialists for some tasks for a little while and the software may move from “second opinion” (in three years? Or seven?) to “bionic software” for the physicians (in five or ten years, with enough patient data?). Bionic software, again, defined here as software which augments and amplifies human understanding.

But I doubt very much if within 10-15 years (given continued investment and innovation and keeping the AMA from quashing such efforts politically) I won’t be able to ask Siri’s great great grandchild (Version 9.0?) for an opinion far more accurate than the one I get today from the average physician. Instead of asking Siri 9.0, “I feel like sushi” or “where can I dispose a body” (try it…it’s fairly accurate!) and with your iPhone X or Android Y with all the power of IBM’s current Watson computer in the mobile phone and an even more powerful “Nvidia times 10-100” server which will cost far less than med school with terabytes or petabytes of data on hundreds of millions (billions?) of patients, including their complete genomics and proteomics (each sample costing about the same as a typical blood test).

IBM’s Watson computer, I understand, is now being applied to medical diagnosis after handling imprecise and vague tasks like winning at Jeopardy, which experts a few years ago would have said could not be done. “Computers cannot match the judgment of humans on these kinds of tasks!” And with enough data, medical diagnosis or 90% of it is an easier task than Jeopardy.

Already Kaiser Permanent already has 10 million real-time medical records with details of 30,000,000 e-visits last year with caregivers and computer modeling of key diseases per individual that data scientists would love to get their hand on. Already, according to IDC 14% of the US population is using their phones for medical help and 200 million health and fitness related mobile applications have been downloaded according to pyramid research. Fun stuff, though early. They are probably two generations away from systems that are actually useful.

A more elaborate vision, one that is not very useful today because of lack of enough data and enough science, is defined in Experimental Man and websites like Quantified Self. Though they feel like toys today, they are much further along than the mobile phone was pre-iPhone in January of 2007. And data, the key ingredient to useful analysis, and diagnosis, is starting to explode exponentially—be it genetic data, proteomic data or physical data about my steps, my exercises, my stress levels or my normal heart and respiration rates.

My UP wristband or something like it (disclosure: I am an investor in Jawbone)) will know all my sleep patterns when I am healthy and how many steps I take each day and may have more data on my mobility if I ever get depressed than any psychiatrist ever will know what to do with. Within a few years, my band will know my heart rate at all times, my respiration rate, my galvanic skin resistance (one parameter among multiple ones used to measure my stress level), my metabolic rate (should cost about $10 to add to the band by measuring my CO2 in my breath and may detect changes in my body chemistry too like when I get a certain type of cancer and traces of it show up in my breath).

All my “health data” as well as my “sick data” and my “activity data” will be accessible to Dr. A (and location when I was stressed or breathing hard or getting the allergic reaction and what chemicals were nearby or in the air—did toluene exposure cause me to break out in a rash from that new carpet or trigger a systemic reaction from my body?). I doubt I will be prescribed an arthritis medicine without Dr. A knowing my genetics and the genetics of my autoimmune disease. Or a cancer medicine without the genetics of my cancer when the genetic sequence (once per life) costs far less than a single dose of medicine. In fact all my infectious disease treatments may be based on analysis of my full genome and my history of exposure to viruses, bacteria and toxic chemicals.

Constant everyday health data from non-medical devices will swamp the “sickness tests” used in most medical diagnosis and be supplemented by detailed genetic, proteomic and sick data with bionic software and machine learning systems. Siri might even remind me one day that my heart rate while sleeping has gone up abnormally over the last year, so I should go run some heart sickness cardiograms or imaging tests. Obviously, Siri’s children and its server friends will be able to keep up with the latest research and decide on optimal strategies based on patient preference (“I prefer to live longer even if it means all the fancy treatments” or “I want to live a normal life and die. I prefer to spend more of my time with my children than at the hospital” or “I like taking risky treatments”). They will take into account known research, early pioneering approaches, very complex interrelationships and much more.

My best guess is that today a physician’s bias makes all these personal decisions for patients in a majority of the cases without the patient (or sometimes even the physician) realizing what “preferences “ are being incorporated into their recommendations. The situation gets worse the less educated or economically less well-off the patient is, such as in developing countries, in my estimation.

Envisioning Future Healthcare

Eventually, we won’t need the average doctor and will have much better and cheaper care for 90-99% of our medical needs. We will still need to leverage the top 10 or 20% of doctors (at least for the next two decades) to help that bionic software get better at diagnosis. So a world mostly without doctors (at least average ones) is not only not reasonable, but also more likely than not. There will be exceptions, and plenty of stories around these exceptions, but what I am talking about will most likely be the rule and doctors may be the exception rather than the other way around.

However fictionalized, we will be aiming to produce doctors like Gregory House who solve biomedical puzzles beyond our best input ability. And India, China and other countries may not have to worry about the investment in massive healthcare or massive inequalities in the type of physicians they might have access to. And hopefully our bionic software (or independent software someday) will be free of the influence of heavily marketed but only minimally effective drugs or treatment regimes or branding campaigns against generics or lower-cost and equally effective, more affordable drugs and treatments. Dr. A will be able to do a cost optimization too both at the patient level and at the policy level (but we may choose, at least for a decade or two, to reject its recommendations—we will still be free to be stupid or political).

What is important to realize is how medical education and the medical profession will change toward the better as a result of these trends. The vision I am proposing here, though, is one in which those decades of learning and experience are used where they actually matter. We consider doctors some of the most learned people in our society. We should aim to use their time and knowledge in the most efficient manner possible. And everybody should have access to the skills of the very best ones instead of only having access to the average doctor. And the not so “Dr. House’ doctors will help us with better patient skills, bedside manners, empathy, advice and caring, and they will have more time for that too. If computers can drive cars and deal with all the knowledge in jeopardy, surely their next to next to next…generation can do diagnosis, treatment and teaching in these far less uncertain domains and with a lot more data. Further the equalizing impact of both electronic doctors and teaching environments has hugely positive social implications. Besides, who wants to be treated by an “average” doctor? And who does not want to be an empowered patient?

The best way to predict this future is not to extrapolate the past and what has or has not worked, but to invent the future we want, the one we believe possible!

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Anti Drugs campaign uses shocking Facebook pictures on timeline

Anti Drugs campaign uses shocking Facebook pictures on timeline | Analytics & Social media impact on Healthcare |

A new campaign by an agency in Israel uses Facebook’s new timeline feature to highlight what drug use can do to you. The profile features a young man named Adam Barak and his entire profile is split in to two halves with pictures of him being a fit an healthy young man placed alongside images of him as a drug addict. Created by Mccann Erickson in Israel the major problem with the campaign is that it is actually not allowed within Facebook’s own TOS as you are not allowed to use personal profiles to do any sort of promotion. Having said that the campaign is a smart way of highlighting drug use and what it can do to people in a very real way that the target market can clearly understand. Because the campaign uses Facebook timeline it is already getting lots of attention on marketing and social media blogs so even though Facebook will probably eventually take it down it has probably already done it’s job. Check out the images below to see why you should never do drugs…

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Big Data -- Big Money Says It Is A Paradigm Buster - Forbes

Big Data -- Big Money Says It Is A Paradigm Buster - Forbes | Analytics & Social media impact on Healthcare |
Big Data is attracting big money — $100 million at Accel Partners, the VC firm.

“Big data is one of the biggest transformational changes in the data center and IT landscape,” said Ping Li, a partner at the VC firm Accel Partners, which is running a $100 million Big Data fund. “It happens once in a generation,” he told the audience at a Churchill Club panel in Silicon Valley.

Gartner predicts that data will grow 800 percent over the next five years and 80 percent of the data will be unstructured.

And just what constitutes Big Data? After SC2011, the US supercomputing conference in Seattle in November, Addison Snell, an industry analyst, blurred the lines a bit in a podcast with HPCwire.

“There is small Big Data just as there is entry level high performance computing,” he said. Someone who has worked in gigabytes and now has to work in terabytes is dealing with Big Data, added the CEO of Intersect360. “It’s relative to the infrastructure you had before.” It may incorporate complex event processing, data mining and complex real-time analytics. Big Data can have many elements — large files, large volumes and real-time I/O within a short data life span. Every vendor at SC2011 was talking about big data, agreed Nicole Hemsoth, editor of Datanami.

Or to put Snell’s observation another way, Big Data breaks existing systems and ways of working.

“A lot of people know how to work with data,” observed Anand Rajaraman, “but now there is a lot more data so the kinds of things you can do with it and the way you work with it can are very different. The founder of companies which have been acquired by Amazon and Walmart, Rajaraman is now senior vice president at Walmart Global e-commerce and co-founder @WalmartLabs, and a professor at Stanford.

“The tools [for Big Data] are very different. Many of the fundamental algorithms for predictive analytics depend crucially on keeping the data in main memory with a single CPU to access it. Big Data breaks that condition. The data can’t all be in memory at the same time, so it needs to be processed in a distributed fashion. That requires a new programming model.”

This can be hard for traditional data users to understand, He watches students attack Big Data problems by creating a sample, but that defeats the value of Big Data with all its potentially informative outliers.

Businesses are catching on to the promise of Big Data said Luke Lonergan, chief technology officer at Greenplum, an analytics company that was acquired by EMC.

“Every business is looking for ways to get tighter connection with its customers, to improve prediction and and move them along a trajectory. We see a certain urgency around Big Data.”

Traditional users of Big Data — retail, telecom and intelligence — are already comfortable with it, said Lonergan. The next big set of users are in mobile-social, especially incorporating geo-location. Some areas have been underserved, such as health care, which he described as the third rail because it has been too hard and too slow. But now health care is experiencing fundamental change similar to what retail felt when customers came in armed with smartphones and had more information than sales people. Patients are starting to acquire more information and health care providers are developing more analytics.
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What Physicians Can Learn from Pareto | par8o

What Physicians Can Learn from Pareto | par8o | Analytics & Social media impact on Healthcare |

Every day, whether we know it or not, we as a society benefit from the systemic phenomena that Pareto describes ( However, to say that Vilfred Pareto, a 19th century economist turned sociologist (, invented these things would be a stretch, as it would be equivalent to saying that Pareto is responsible for the tenets underlying all marketplaces, market-based industries, and for that matter…western civilization. I think it is more appropriate to say that Pareto described these things in a way that was both logical and broadly applicable to many more industries and challenges.
Above all, Pareto teaches us that efficiency comes from effectively matching supply and demand. A “pareto optimized” system maximizes the benefits that any group of people can receive from a limited amount of resources. For this efficiency to occur, there needs to be as few intermediaries as possible between the reciprocal parties and a clear, transparent understanding of the goods or services being provided. Therefore, ALL markets (and efficient economies) have these two features in common:
Transparency - The ability for the goods or services to be understood by all parties, also known as “price discovery.”
Liquidity - Direct interaction between both parties, which is critical because it allows both parties to adjust relative to one another and minimizes the friction caused by intermediaries.
When a system does not have these features, almost as a rule, opacity replaces transparency and the multiple intermediaries replace liquidity. These outcomes benefit incumbents, rather than the broader good.
Hence, par8o.
As physicians we can see that we have strayed far from Pareto’s insights, which has resulted in the exact opposite of an efficient system (and our patients are suffering for it). There are so many intermediaries in the healthcare system today, that only a small fraction of our nation’s healthcare spending actually goes to the people providing the care. Furthermore, the AMA’s CPT coding system has turned physicians into a commodity. It makes absolutely no sense that my sister (who is just finishing her radiology residency) and my father (who has had an immensely successful 30+ year career as a radiologist), should both get paid the same amount for reading an X-Ray. No law firm pays the first-year associate the same amount as the senior partner, because higher value is placed on greater experience. As physicians we have allowed ourselves to be commoditized.
Pareto principles cannot solve all of the problems facing physicians and the healthcare system. However, they can provide a unique lens for us to look through and understand how we find ourselves (and the entire country) in such a predicament and, perhaps most importantly, provide clues for a path forward. As people have learned the same lessons time and time again throughout history, can we learn from what Pareto principles have been able to accomplish for other civilizations and industries and apply them to help fix our still broken healthcare system?
par8o is the catalyst to help that happen for both physicians and our patients.

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Computers in Biomedical Research: Eric Shadt at TEDMED 2011

Dr. Eric Schadt , Chair of Mount Sinai Medical School’s Department of Genetics and Genomic Sciences and Director of Institute of Genomics and Multiscale Biology, presented a talk at last year’s TEDMED about how computers are continuing to revolutionize biomedical research. Though computers don’t think on their own and have to be carefully programmed, they are able to immensely help us get from data to information to knowledge faster and in many new ways.

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