Category Archives for Health
Slides to a presentation I gave to a course on social media in public health. They encapsulate some to-be-published synthesis research on how the relationships we establish with mobile devices (smartphones, specifically) lend themselves especially well to behavior change initiatives in mobile health care.
Slides to a presentation that I gave to the BC Ministry of Health regarding recent developments in the sharing of health information on social media. Introductory in nature, but the talk was tailored to address conerns of administrators and policy makers; specifically, how best to characterize the activity of the public on social media sites that is happening in health, and how to account for health professional activity on these sites as well.
Presented as part of the “Retool for Research” lecture series hosted by the BC Ministry of Health Library.
Yesterday I had the pleasure of talking to a group of PhDs and post-docs at the UBC Faculty of Medicine career day. These are the slides I used (I clarified the title in the talk itself; I didn’t come up with the eCommunications title originally, but they released the poster before I could have them change it — not a big deal by any means, but here, I’ve used “social media” to make it a little more descriptive.)
Some rough notes are messily attached to the Slideshare if you click through, and, after the session I followed up with an email saying this:
Hi everyone, I really appreciate the time you all took to come to the session on communications and social media for research today. I hope that at least some of it was useful or inspiring in some way. If you want to follow up with me with ideas or other questions, please don’t hesitate to send me an email.
I’ve posted the slides from today on SlideShare: http://www.slideshare.net/danhooker/using-social-media-to-advance-your-research While you’re there, search for presentations relevant to your research. You never know what you might come across.
In response to the question about further training, I mentioned there are free introductions to lots of social media at Social Media University, Global (SMUG). The name is tongue in cheek, but it’s produced by the Mayo Clinic director for social media, Lee Aase, and the content is tops. http://social-media-university-global.org/curriculum/ (If you hover over the curriculum tab, you’ll see a drop-down menu with different topic options like Twitter, Facebook, blogging, etc.)
Also, someone asked me about where to find a list of conferences in specific fields, which I didn’t immediately know the answer for. This site, Research Raven, looks promising: http://www.researchraven.com/ They’re based in the States, though, so they may not have as much Canadian content as we’d like them to.
Finally, I heard from one of the students over email tonight that there is some deal of concern about the time issue. We didn’t touch on that much after my talk, but recently there was a series in Scientific American called “Social Media for Scientists” that you may find helpful. Part 2 directly discusses spending time on social media, and the whole series goes to some lengths to demonstrate the value proposition of participating in social media: http://blogs.scientificamerican.com/science-sushi/2011/09/29/social-media-for-scientists-part-2-you-do-have-time/ I hope you find it helpful.
Let me start right away by saying: this presentation is not to suggest that patients cannot be involved in the promotion and sharing of high-quality health information. In fact, I believe patients, particularly those living with rare diseases, are often the ones armed with the highest quality information and the networks through which to share their stories and experience.
This presentation came out of a specific question that was posed in the brief survey that our friend and fellow health warrior Alissa sent out in advance of the Vancouver #hcsmca tweetup. The survey respondent was looking for information on how to connect, as a health professional, with various networks. Because I am a librarian and very interested in the types of information that we use to make decisions about our health, I decided to marry these two concepts in this presentation.
To sum it up: there is a lot of questionable health information out there on the Web. As we (health professionals, activated patients, and health communicators) are the ones armed with the ability to distinguish good information from questionable, I feel it is our duty to share and promote this content as much as possible through our various networks and channels on the Web.
The five examples (though there are many more) I used specifically in this presentation are:
- @HealthyRT. The HealthyRT project is a group Twitter feed that shares “peer-reviewed” health information. In other words, all tweets are monitored and the content that is shared has been approved by one of the health professionals with access to the account. My impression is that you, too, can join this group, by emailing the moderator.
- Health News Review. A must-read site that applies 10 quality criteria to news articles (HealthDay, USA Today, New York Times, etc.) about contentious health issues, such as screening tests and innovative treatment options. All reviewers are health professionals, and the editor in chief, Gary Schwitzer, writes a blog that summarizes the issues, and shares other content as well.
- Grand Rounds. A blog carnival highlighting the best of medical blogging from across the web every week. A great way to share your own content, as well as find the best bloggers writing about health and medicine day-to-day.
- #vaxfax. By far the least structured resource, vaxfax (“vaccination facts”) started out with a few people interested in sharing evidence-based information about vaccination safety. Becuase this is such a hot-button topic, I am a little unclear on how successfully this hashtag is meeting that goal. But to me, this is the perfect example of where health professionals are needed to help balance the fear-based and pseudo-scientific information that is otherwise being shared on channels like these.
- Finally, your website. Each and every organization or individual should have some sort of online presence now (this means you). The more you can create, promote and share high-quality health information the better.
The last point I made there has to do with privacy issues, and patient-provider interaction online. I use the phrase “Connect, don’t advise” to mean that it is OK to point people to the health information that you know is best, and to build a network of other professionals, patients and interested parties. What you cannot do, under any circumstance, is attempt to treat a medical issue or divulge information about specific people and health problems.
In 1948, around 5,000 people in Framingham, Massachusetts responded to a call for participation in a study on health and lifestyle habits. They underwent physical exams and in-depth interviews about their health every two years. A generation later, 5,000 more of their adult children agreed to join the study. The results of this ambitious project are one of the largest and most successful health research projects on the books, identifying all of the major risk factors for heart disease that we know today: high blood pressure, cholesterol, smoking, obesity. In fact, the very concept of identifiable “risk factors” for heart disease (let alone other conditions) is due in large part to the astounding results of the Framingham Heart Study and the vision and ambitiousness of the project.
Something similar is happening in Canadian cancer research today with the Canadian Partnership for Tomorrow Project, known locally as the BC Generations Project. Their goal? Enroll 300,000 Canadians over the age of 35 to attempt to identify risk factors for developing cancer and, along the way, creating a massive research database of health information that stretches across all strata of Canadian provinces and lifestyles.
Participants are followed for decades, building layers of information that will create a rich database. Researchers will have access to data and can propose analyses that will identify patterns and information that will potentially explain some of the causes of cancer and other chronic diseases such as diabetes and heart and lung disease.
There is remarkable potential for the long-term, large-scale perspective of this population laboratory to improve our understanding of cancer and other chronic diseases. The development of these diseases is often shaped by multiple factors over a long period. [link]
In BC, the goal is to enrol 40,000 people by 2012, and they are apparently about the third of the way there. They joined Twitter not too long ago and I have been trying to put my finger on the public health parallels ever since. Their enthusiasm and ambition is infectious. They need your help. I’m too young to join, but why don’t you go in my place?
Limited time only offer! Provide feedback to British Columbia health authorities on drugs under review [definition - PDF]. Specifically:
Through this website, patients, caregivers, and patient advocacy groups can add their voice to the BC PharmaCare drug review process. It is part of our commitment to give British Columbians a chance to share their perspectives on drug decisions that affect them.
The collection of information and personal input is a vital portion of the review process. The website gives eligible patients, caregivers and patient advocacy groups the opportunity to provide their input into the PharmaCare review of several selected drugs.
This is a great way to get patients involved in their care plan, and it is a great sign that pharmaceutical policy makers are taking note of the patient experience. This is obviously not yet a commonplace occurrence; indeed in the Press release, the BC Ministry of Health Services acknowledges that they are the only jurisdiction in Canada that is taking patient and care provider feedback directly.
In a related effort of transparency, I got word via the twitter feed for #amia2010, the conference chatter for the American Medical Informatics Association Symposium, that someone from OpenNotes was presenting. That project, you remember, is the pilot study that got 100 primary care physicians to agree to create and share their notes with their patients in a secure online environment. What a venture!
It is of course a shame that projects like these that promote feedback from and collaboration with the people whom medical services affect the most (ie the PATIENTS) seem so strange and require so much explaining and convincing. But as slow as ardent patient advocates might feel things are going, it doesn’t mean we can’t encourage those who are on the right path. So today I’m proud to live in BC, and work alongside the great team at the BC Ministry. Keep up the engagement!
A new paper was released yesterday from the Annals of Internal Medicine that caught my eye: Telephone-Based Self-management of Osteoarthritis.
This randomized trial assigned primary care patients with hip or knee osteoarthritis to receive telephone-based health education support, health education materials, or usual care. At 12 months, the intervention group had more improvement in some pain measures than did the control groups.
The paper’s findings are not so surprising to those who have ever had a positive experience with a knowledgable health care provider: talking over a problem and receiving encouragment from an expert helps motivate you to stick to a care plan. But the results aren’t exactly what grabbed me.
Take this recent Lancet Neurology editorial, “Neurology at a distance,” for example. The author states: “The provision of clinical care via a communication system is nothing new, but advances in communication technologies and computing are bringing new and exciting innovations into the realm of remote medicine. The day of modern telemedicine is dawning.” This is certainly true, and the exiciting advancements that video calling, webcams, iPhones and iPads are having on remote clinical delivery are real and beneficial.
But in this article, what was the intervention that helped manage the pain in osteoarthritis patients? A phone call. As in, two people talking to one another. Well, there was also some educational materials and video involved, but here’s the meat:
The health educator called participants monthly for 12 months to discuss key points from the educational modules and provide participants with an opportunity to ask questions.
Just something to keep in mind the next time you pick up your smartphone and launch Epocrates. The thing’s still a phone, you know.
Allen, Kelli D., Oddone, Eugene Z., Coffman, Cynthia J., Datta, Santanu K., Juntilla, Karen A., Lindquist, Jennifer H.,Walker, Tessa A., Weinberger, Morris and Bosworth, Hayden B. Telephone-Based Self-management of Osteoarthritis: A Randomized Trial. Ann Intern Med. 2010 Nov;153:570-579.
PS: for those of you doing telemedicine literature reviews in MEDLINE, don’t forget about EMBASE and CINAHL… you might be missing 9 – 18% of the relevant citations.
Self-Tracking for Behavior Change
I just invested in a Nike+ Sport kit, which, though they have been around for a while, just peaked my curiousity thanks to my reading of The Decision Tree. The author of that book, Thomas Goetz, points out that one of the most effective ways of motivating people to change their behaviour is to get them tracking their habits. For Weight Watchers, it’s points. For Nike+, it’s the distance and pace of your running.
All the Nike+ system is is a little doo-hickey that plugs into your iPod nano, and another little one that you stick in your shoe. I wasn’t too excited about switching shoe brands, so I hacked my Mizuno shoes that I know and love. But you can read about that elsewhere.
Once calibrated, the system is pretty slick. You can select a workout based on time (eg. 30 minutes), distance (5k, 3 miles), calories or free form. Then you pick some tunage to listen to while you run, and off you go. I have mine tracking in kilometers, and a kind voice pops up every once in a while to say “.5 k completed” or “300 meters left.”
When you’re done, you go home and sync your iPod and it zaps you out to nikeplus.com where your data is waiting for you to review. You can log a couple things yourself like how you felt, what the weather was like and the surface on which you were running. A graph of your pace shows how inconsistently fast or slow you were gadding about.
Other cool features:
- Goals: Set personal goals for distance, pace, etc.
- Nike+ Coach: training programs for you to follow to prepare for a race distance. This is hands-down my favorite feature of Nike+ so far. I have wanted to train for a half-marathon and went looking for a program but came back disappointed in the price and questionable quality of the programs online.
- Challenges: Other users of Nike+ create public goals and challenges for you to join and run along with them. Probably not for me, but a nice way to “socialize” the system.
I hope that Goetz is right and Nike+ gets me out a little more often. He argues that systems like these are often effective for getting people to change to healthy behaviors (link  to the AJPM study mentioned in that post) because they serve as personal motivators. Being able to systematically record your runs and easily watch your progress over the lifespan of your exercise program is certainly motivating for me.
23 and Me, Navigenics and personal genomics: Empowering or Frightening? Continue Reading →
So I know I’m a little late talking about MedlinePlus’s new design but I had just one or two things to say that I hadn’t read yet.
Michelle Kraft pointed out that the link to the mobile version of the page is at the bottom, so you have to scroll down to a) find it, and b) mash your screen to make it go. Agreed: annoying. But to me, the solution is not moving the link from the bottom to the top of the screen, the solution is adding some code and making the website detect mobile browsers automatically.
This technology is not new; in fact, many sites do it to say “Hey, you can’t use Firefox to login to this government page, use IE.” (ed. note: this can go awry: I recently tried to log in to an account at Government Canada and, because they require old versions of browsers, I literally did not have an approved version installed on my computer.) But anyway. Even my blog detects mobile browsers and redirects my viewers to the mobile theme.
There is a Google index literally full of solutions to this problem. Feeling lucky? Here’s one: http://detectmobilebrowsers.mobi/
Mobile issues aside, I am happy to see these changes. The huge buttons for the three major categories are great and the new look compartmentalizes the would-be overwhelming amount of content and makes it a little easier to parse.
Related to the “compartmentalization” of content, I am glad to see the links between sections (the information architecture, if we can be so formal) improved. Time was, Health Topics were one place, Encyclopedia was another, Directory, Video, News, etc and they were mostly cordoned off from one another (saved somewhat by the beauty of the faceted search engine). Those links have been improved, and most sections now allow for quick travel between other areas of the site, while remaining on a topic of interest. Widgets are also available for embedding in your own site, helping to spread the word about the MedlinePlus resource.
It is great to see such a wealth of consumer health information get an excellent facelift. It just gets easier and easier to recommend.
Other, better reviews:
In the face of the ongoing World Cup and the recently completed Wimbledon tournament (not to mention some extraordinarily early start times on this side of the pond), the Tour de France may be getting short shrift today with casual sport fans. But, the Tour is nonetheless getting underway, and there has never been a better year for those interested in health technology to take note.
Tracking athletes’ heart rate and telemetry isn’t new for sports, really, but with the recent rise in popularity of real-time search and GPS-enabled or “locative” applications (Foursquare, etc), not to mention health tracking applications for amateur athletes (Nike+) and those with chronic diseases, this year is just ripe for this stuff.
That’s where Google comes in. Not only can you drive through the Tour route using Google Earth, but you can also follow the riders of Team HTC-Columbia in real-time on Google Maps. Even better? The team’s telemetry data including speed, pedaling cadence, heart rate and how many watts they crank out going up a mountain, is all presented right along side.
This is made possible by the riders’ health and workout data being tracked anyway by SRM — but Google is taking it a step further by mashing up that data with two of the hottest trends in web media: real-time and GPS tracking.
This sort of technology is already moving into the personal sphere; we can track our runs and cycling routes, as well as our speed and heart rate in a manner very similar to this. But even though we know we should exercise, behavior change, as Thomas Goetz points out, is one of the most difficult aspects of improving public health. It is a great shift to see the augmentation of sporting events with this kind of health data: turning idle spectator events into something that engages directly with the actual health and fitness of the athletes involved. (Isn’t that why we look up to athletes anyway?) As these tracking technologies become more mainstream, I hope it will serve as a true motivator to get out and try tracking a workout for ourselves.
If you’re up early this week, you can follow the riders here.