mHealth, Wearables, and Invisibles on Hilton Head Island

While not quite Fantasy Island, I recently enjoyed a trip to Hilton Head Island, South Carolina where I stayed…at a Marriott. Turns out the island is named after Captain William Hilton. No relation to the Marriott International, Inc (formerly Hot Shoppes!) folks. I was there for the 2015 Annual Meeting of the South Carolina Society of Health-System Pharmacists to speak about the emerging area of wearable technology in pharmacy. It was a nice, tightly run conference with good speakers and active attendees.

Travel note: go ahead and roll the dice to get a flight into the Hilton Head Island airport rather than a nearby regional one. Do not be dissuaded by the likelihood that you will be kept aloft in a twin propeller DASH 8. Don’t think of it as a puddle jumper, think of it as a boutique aircraft.

DASH-8 aircraft

Lodging note: The Hilton Head Marriott Resort & Spa is a cozy beachfront property with a great view and an extraordinarily good customer experience. Every single employee I saw had a face graced by an unforced smile and displayed a naturally pleasant demeanor. Little touches here and there added to the experience. Bacon-wrapped scallop proffered while walking in to check-in? Yep (politely declined, but still a nice touch). Waterside dining that was cool and comfortable despite a temp of 81? Yep. Power outlets on the bedside lamp so that phones could be plugged in next to where you sleep instead of across the room at the desk? Yep. However, it was the always helpful, never obsequious, people working there that made the biggest impression.

Marriott Resort View


X Gonna Give It To Ya

Embedded image permalink

A gentle street poet named Earl Simmons once penned the words, “X Gonna Give It To Ya”. I can’t remember the next line of the stanza, but I think it may have been, “If You Let it”. He may very well have been talking about Stanford Medicine X, because you kind of have to be open to what it has to offer. But if you are, it will deliver quite an experience.

As usual, #MedX started well before the conference proper with the pre-conference which generated an outpouring of tweets and other activities leading up to its kickoff this year and throughout the conference. If there is any doubt, the fine folks at Symplur have put that question to bed.

From the pre-conference, there was a high-utility tweetstream for anyone interested in clinical trial design, particularly those seeking ways to integrate the patient. From afar, it appeared the workshop was very effective in introducing epatients to the complexities and headaches of clinical trial design and execution AND in introducing researchers to what epatients really care and think about with clinical trials.

UMQ (Uncomfortable Moment Quotient)
UMQ = number of total conference sessions/number of instances in which a question or comment makes speaker or audience (in-room + virtual) visibly uncomfortable. One of the things that separates Medicine X from most other conferences I attend is that it has a remarkably high number of instances in which people become visibly uncomfortable as a result of a presentation or (more likely) a Q&A. I had many conversations about this observation in 2014. To be clear, this is a good thing. The truth can be uncomfortable. Health is messy. Health care may even be messier. So kudos to Dr. Larry Chu (@larrychu) and everyone involved for the way Med X is structured to almost cultivate the UMQ as a mechanism for addressing the tough problems we face in health care. Last year the UMQ was high as well, but at times there was an edge to it that was…not helpful. Through planning and design, it seemed this year had another remarkable UMQ, minus the sometimes-nasty edge.

How Quickly the Uninitiated Become The Learned
It is a-maz-ing to me to reflect back on just a few years ago when I saw the first inclusion of epatients, then epatient scholars, then epatient advisors at Medicine X. The same people who blew me away with their bravery in sharing their struggles with their health, were also as vulnerable as an exposed nerve at times. To see what has really been a transformation of some of them over the years has been part of the joy of being a part of this conference experience. (By intent, Stanford Medicine X is a conference experience). I still remember the first time I heard Sarah Kucharski (@AfternoonNapper) speak and was blown away by her voice (her ‘capital V’ voice, although her ‘lower case v’ voice is quite nice as well). To see her grow in her role and  (sometimes quiet, sometimes not-at-all quiet) self-assuredness has been pretty cool. Similarly, seeing others like Britt Johnson (@HurtBlogger) evolve from leader-as-blogger to also taking on the mantle of IRL leader has been encouraging to watch. One other neophyte-to-leader journey has really struck me as well, that of Chris Snider (@iam_spartacus). This is a guy who I thought of as a podcaster who talked about gaming, diabetes, and various tech geekery. I feel like he has really developed this Voice as a curator/narrator hybrid for #MedX and for the broader conversation. Almost like an human-version of Storify. Oh, and he also wields surprising power. I saw firsthand how the power of his tweets could motivate people to walk up to physicians and ask them about their socks. #truestory

400% Increase in Pharmacist Participation
I don’t have the access or authority to release the actual attendance figures for pharmacists at Med X, so I thought I would guesstimate. I mean, if only 10-35% of ACTUAL MEDICAL CARE is based on level 1A evidence (per @drnigam and various other sources, although technically not Cochrane), I can get away with this guesstimation, right?

Whatever the actual figures may be, there was definitely a stronger presence for pharmacy this year. From mentions of the role of the clinical pharmacist at Stanford Coordinated Care by its Co-director Ann Lindsay to multiple panel, plenary, student leadership, and first-time attendee roles by pharmacists and pharmacy students (@kellygrindrod, @rnovak_pharmd, @nicholasvu, @asapola_pharmd), it was encouraging to see and hopefully a sign of things to come. [h/t @nickdawson] Pharmacy has a lot to offer and (unfortunately) is the second best-kept secret in health care.

Poolside Backchannel of the Backchannel
I read a book a few years ago titled, The Backchannel: How Audiences are Using Twitter and Social Media and Changing Presentations Forever. I also use Twitter quite a bit and actually consider it to be my most useful social media tool for professional development and connections. So I thought I had a fair grasp of the use of it as a “Backchannel”. However, one  evening a group of Med X student leaders and epatients taught me that there is such a thing as the Backchannel of a Backchannel. That’s part of the beauty of being in academia. There is no shortage of the steady stream of new ideas and youthful enthusiasm that come in from new students and learners.

Science-y Stuff 
I love the plenary sessions, but I am always going to look forward to the parallel, research-track sessions. I had it narrowed down to my top two favorites for 2014, but couldn’t decide so I am going to mention both. The first is the eHealth and Personal Health Records Panel with Nigam Shah [abstract], Perry Gee [abstract], Anne Townsend [abstract], and Floor Sieverink [abstract]. {by the way, all abstracts also have the Twitter accounts at end} Shah made a compelling case for mining EHRs for practice-based recommendations, and the others had really interesting takes on PHRs and the patient experience.

The Health and Human Behavior session was my other favorite as I believe their theme of health behavior change + technology is at the core of so much of what we are trying to do to improve outcomes. The presenters were John Hixson [abstract], Shiyi Zan [abstract], Sean Young [abstract], and Ken Yale [abstract]. Hixson used  PatientsLikeMe in a population you wouldn’t necessarily expect: 50 year old (average age) US veterans with epilepsy. Zan explored the use of social media for healthcare in adolescents and young adults. Young started with 550 million tweets and ended with a more manageable 2.1 million tweets to evaluate for HIV-related risk communications. And Yale looked at 5 years worth of data on the impact of incentives in promoting health behaviors. You owe it to yourself to check out their abstracts.

Best Poster
The fact that I had followed Paul Grant for years and even have a screenshot of one of his tweets from a 2009 mHealth Dubai conference in a slidedeck legit has nothing to do with this selection. Although I can’t imagine it hurts. More info on his fascinating work here. h/t @engagmentstrat

Visceral Reactions aka The Good Kind of Stomach Punch
There were a couple of jaw-dropping and dusty room plenary presentations I want to share. The first was the E-NABLE system. Basically it’s: 3D printing + goodwill + community = affordable prosthetic hands for kids.

The other was the introduction to the current version of Jerry The Bear. Great cause. Great motivation. Fingers crossed they keep plugging away and have success on Indiegogo. They are trying to “Reinvent diabetes education through PLAY”.

Back to the airport
Today I leave for CTIA Super Mobility Week. I’ve never been to it. It is at the other end of the conference spectrum from Medicine X in that is massive and industry focused. I am uncertain exactly what to expect. I am certain that no other conference has what MedX is gonna give to ya.



Other Perspectives on Stanford Medicine X 2014 (Click on title for link)

(I maintained a list  of these last year, so I will try to do so again as able)

From a medical student and fellow Gunner (@TheBiopsy)

From co-host of #hcldr chat (@Colin_Hung)

From symplur – hashtag analytics (@symplur)

From a family physician (@drmikesevilla) [h/t @GilmerHealthLaw]

From a communications professional (@MichelleLBrandt)

From a medical educator & pediatrician (@MedsPedDoctor) [h/t @wingofzock]

From the artist-formerly-known-as-Pew [Storify] (@SusannahFox)
From the artist-formerly-known-as-Pew on sharing the glow (@SusannahFox)

From a mother of child with Cystic Fibrosis [Storify] (@ekeeleymoore)

From a PhD candidate with MedX bike tips [@jsperber]

From an epatient & paramedic (@prostheticmedic)

From an epatient/podcaster & a Gaggle of Google voices (@iam_spartacus)

From an epatient with T1DM (@txtngmypancreas)

From an epatient with Crohn’s (@CarlyRM)

Stanford Medicine X YouTube Channel (h/t @JBBC)

Identifying and evaluating apps for clinical practice

IJCPCoverArticleRecently I was invited to participate on an article by some of the fine folks at iMedicalApps. While I had done some things with them in the past dating back to a guest post in 2011, including providing early coverage of Medicine 2.0 @ Stanford, I had never collaborated with them on a conventional journal article. In this case, the effort was led by fellow pharmacist Timothy Aungst, PharmD as part of  his efforts to bring a stronger eye of assessment to the unsettled world of medical apps. This particular effort yielded the article, “How to identify, assess and utilise mobile medical applications in clinical practice”, which was published in the International Journal of Clinical Practice. The aim of the article is basically outlined in the title. This was to be a practical paper for a clinician audience highlighting key aspects of the steps for: 1) identifying, 2) assessing, and 3) using medical apps. I believe a good paper came out of this collaboration and it certainly sparked the most creatively titled editorial comment (Battle for the Planet of the Apps).

Source: Aungst TD, Clauson KA, Misra S, Lewis TL, Husain I. How to identify, assess and utilise mobile medical applications in clinical practice. Int J Clin Pract. 2014;68(2):155-62. doi: 10.1111/ijcp.12375.

Stanford Med X 2013: Postcards from Summer Camp

Med X: Now with even more glow sticks and ePatients!

It’s always tough to sum up a wonderful, weekend-long experience like Summer Camp Stanford Medicine X, so I will focus on what stood out the most for me.*


Damn, These Cabins Are Nice
As always, @larrychu and his what-seems-like-a-small-army-of-a-team did a fantastic job of creating a unique conference experience…from the sea of smiling faces to the thoughtfulness put into everything ranging from the weight of the paper to the quality of the video production to the eyebrow-raising badges. I think it says a lot that student volunteers from last year’s Med X traveled back from medical schools like Yale and OHSU to be there this year.

Singing Songs & Roasting Marshmallows
Since its inception, Medicine X has always tried to give the patient a voice in the healthcare conversation. In past years, that voice often took the form of stories they shared. This year was a bit different as those patient contributions expanded even more. I saw patients helping to build research networks (C3N @ekeeleymore ), advocacy orgs (Emily’s Entourage @emilykg1), and apps (Goal Machine @HurtBlogger).


But I have to say, the stories themselves continue to have a substantial impact. Different stories speak to different people and a few this year really spoke to me. Joe Riffe (@DirteMedic) spoke about his journey from “broken biped to Prosthetic Medic”. Coincidentally, a story Joe (from Kentucky) told me about Pappy Van Winkle followed me all the way home, as that rare bourbon had cameos in both a Google-centric movie (The Intern) and on a soccer podcast (Men in Blazers) on my JetBlue flight. (This is also relevant because the absence of WiFi on JetBlue meant I had time to write this). Another story that stood out for me was that of Emily Bradley (@chroniccurve). Her guest appearance on Just Talking will completely open your eyes to what living with chronic pain and disability for a young woman on a college campus is like. Aside: if you haven’t checked out Chris Snider’s (@iam_spartacus) podcast, you should. He has done a great job having Med X lead-in and post-conference guests.

There were lots of ePatient stories that I found compelling, but the last I’ll mention touched me the most. As a father of a young daughter, I listened to Catherine Rose’s (@drcatherinerose) story about the struggle to keep her daughter Alexis alive and couldn’t imagine facing that type of adversity. As an engineer and degree collector, it was amazing how Catherine put her penchant for numbers to work to help her miracle baby. I can’t even begin to do her story and imagery justice. Make sure you check out the Med X video when released! Until then, this will give you a tiny idea about what Catherine has been involved with for AlexisUpdate: Catherine posted her Med X slides and notes here. Check out how meticulous she is with this example.

To sum up, a Southern boy made me marvel at his tenacity, a college student made me marvel at her resilience, and a mother made me marvel at her courage.

Who Made the Best S’mores?
I like research. There. I said it. So I always look forward to the “Academic” part of the “academic conference for everyone.” And while I definitely was digging the #whatifhc panel episode of Scientist Island with @Berci  @michaelseid11 @stephen_friend and @dvansickle, I also really liked the Plenary and Parallel Sessions that let individual researchers shine in cooking up their own science-y S’Mores.

ePatients wearing #S'MoresWalkingGallery jackets in support of @ReginaHolliday's inclusion on Scientist Island

ePatients wearing #S’MoresWalkingGallery jackets in support of @ReginaHolliday’s inclusion in #whatifhc panel on Scientist Island

Research presentations worth writing home about included those by ‘conventional’ researcher Sean Young (@SeanYoungPhD): who presented on the use of social media for HIV prevention – his article was published this month in @AnnalsofIM;  Amy Birney: an industry-based research scientist at ORCAS who presented on the MoodHacker app for depression; and Sara Riggare (@SaraRiggare): a doctoral student/patient with Parkinson’s who presented on her efforts in engineering for self-tracking of chronic disease.

Best Moment of Camp (aka If You Only Watch One Med X Video)
There was an enormous amount of quality presenters and panels at Stanford Medicine X; however, if you missed the whole thing and only watch one panel (or were in a parallel session and missed it) I would strongly recommend the Organic Data panel featuring: Atul Butte (@atulbutte) & Gilles Frydman (@gfry). I felt they represented the conceptual/cultural Alpha and Omega of Stanford Medicine X. Atul Butte discussed the exciting possibilities of research with genomic medicine. I think him a bit prescient as well in reflecting on an older talk he gave in which he suggested than a high school student could perform high level research given what is available online today (I’m looking at you keynoter @jackandraka). The other thing Butte did was present in a way that was accessible to a very broad audience and with a pretty positive message. At the other end of the ePatient spectrum was Gilles. I knew a bit about ACOR and his work with participatory medicine and had even met him once at a conference in Philadelphia. However, I had never heard *him* tell his story. Wow. Patient advocacy, community building, bridging the gap from patient to researcher…he has created a truly admirable body of work.

I’ll come back and update this post with the link to their panel video when it goes up – it is that good. UPDATE: Video has been posted of @gfry video and of @atulbutte video from the session.

Camp pranks and surprises
Was I surprised when I saw a pediatrician from the Midwest quote Pitbull in the #MedX stream? Yes, sort of.
Was I pleasantly surprised when @SeattleMamaDoc overheard and got my back after someone challenged me for “being too pale” to actually live in Florida? (Psst, it’s called sunscreen). Yes, it was nice.
Was I dismayed at the number of articles that were inaccessible related to conference topics. Unsurprised. But yes, a bit.

I had a couple of experiences at Med X that prompted me to think about trying to make it to Doctors 2.0 and You. At one point I was at  a table with @Berci @health20Paris @gfry and @CiscoGiii (almost as the lone American) and it occurred to me that there might be good ideas elsewhere too. It made me think back to Mednet in Leipzig (anyone? anyone?) where I heard a presenter from a Scandinavian country bemoan the fact that only 92% of their hospitals had EMRs. That was 2007. 

Future Is In Pretty Good Shape With These New Campers


I saw a lot of first-time attendees, ideas, and presentations at the 2013 edition of Stanford Medicine X. There were innovative scientists, emerging patient voices, and creative technologists. We have a lot of problems to overcome with healthcare. But I definitely left feeling that we have the pieces to do it.


*Confession: I’m totally stealing the #MedX Summer Camp theme and using it as a device here

Other Perspectives on Stanford Medicine X 2013 (Click on title for link)

From an ER Physician (@DrLeanaWen)

From the Prosthetic Medic (@DirteMedic) Part 1
From the Prosthetic Medic (@DirteMedic) Part 2

From chronic pain/disability patient (@chroniccurve) Part 1
From chronic pain/disability patient (@chroniccurve) Part 2

From a medical student (@TheBiopsy)

From a caregiver (@DrCatherineRose)
From a…great googly moogly, I may not bother to update my compilation anymore (@DrCatherineRose)

From ePatient and Feelalike founder (@AlderBrett)

From a patient with type 1 diabetes (@iam_spartacus) [Storified]
From same patient with type 1 diabetes who podcasts and wore Google Glass (@iam_spartacus)
From same (industrious) patient w/type 1 diabetes [& guest] (@iam_spartacus & @saraknic) [#JustTalking podcast]

From the official Stanford Medicine account (@SUMedcine)

From a kids doc in the Midwest (coincidentally…no, really!) (@DoctorNatasha)

From a Cystic Fibrosis advocate/mother of 4 (@ekeeleymoore) [Storified]

From a pharmacy student (@NicholasVu)

From a patient who experienced an “unnecessary nightmare” (@Riander)

From a nurse/patient/caregiver (@She_Sugar)

From a physician futurist (@Berci)

From a med student/medical journalist (@TeawithMD)

From BestEndings founder who sports a ready smile and a ‘Death Kills’ t-shirt (@KathyKastner)

From a “Professional Patient” (with loads of vid interviews) (@Hospital Patient)

From Hashtag Central (@symplur)

From an ePatient Advisory Board member and fishing line magician (@NickDawson)

From an ePatient who also provides the E of Entourage (@emilykg1)

The potential of mHealth in pharmacy

mHealth_AJHP2013The next frontier in healthcare? The next step in patient-centered delivery of health services? Technology’s next overhyped bubble? There are grains of truth in all of these labels that have been given to mHealth. However, what is beyond debate is that there are opportunities with mHealth. In particular, I am optimistic about the opportunities with mHealth for pharmacists. To that end, I asked several colleagues to help outline the potential of this informatics arena. Those efforts were recently published as an article in the American Journal of Health-System Pharmacists (AJHP). My hopes are that this article serves to increase awareness of these opportunities and perhaps spurs some pharmacists to capitalize.


Source: Clauson KA, Elrod S, Fox BI, Hajar Z, Dzenowagis JH. Opportunities for pharmacists in mobile health. Am J Health Syst Pharm. 2013;70(15):1348-1352.

Kevin A. Clauson, Pharm.D., is Associate Professor; and Shara Elrod, Pharm.D., is Assistant Professor, College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL. Brent I. Fox, Pharm.D., Ph.D., is Associate Professor, Harrison School of Pharmacy, Auburn University, Auburn, AL. Zaher Hajar, Pharm.D., is Fellow in Consumer Health Informatics, College of Pharmacy, Nova Southeastern University. Joan H. Dzenowagis, Ph.D., is Senior Scientist e-Health World Health Organization, Geneva, Switzerland.

What do pharmacy students think about #socialmedia for education?

TLM2013Dr. John Sandars has been looking at the roles of technology in medical education for many years. So when we decided to look at use of social media by pharmacy students (and their thoughts in particular on its use in education and engagement) I sought him out. As with any good collaboration, everybody brings a little bit to the table, and this one was no exception. Our articleSocial media use and educational preferences among first-year pharmacy students” was recently published in the journal Teaching and Learning in Medicine.


Trends in Technology, Mobile, and Education

Mary Meeker from KPCB recently delivered her gallery of “2013 Internet Trends” at the All Things D conference (#D11). I was originally directed to this data marathon from the mobile perspective via Brian Dolan (@mobilehealth). However, Meeker’s presentation is much more than that. It is a sprawling look at the Internet of Things, Traditional Industries Being Re-Imagined, and Sharing Everything. Fortunately, her mammoth 117-slide deck (that was delivered quickly in just 20 minutes; video here) has been placed on @Slideshare.

It is a lot to process, but here are just a few points that jumped out at me from Meeker’s presentation:

  • The average smartphone user reaches for his/her device 150 times a day (what does this hint at for wearables?)
  • Percentage of residents who ‘share everything’ or ‘most everything’ online: USA (15%) compared to Saudi Arabia (60%)
  • offers same day package delivery with real-time map tracking…often by bike…in China
  • Amazon was the third largest provider of tablets in 2012 (behind Apple & Samsung); overall tablet growth has outpaced smartphone growth
  • 77% of academic leaders at 2,800 colleges perceive online education as the same or superior versus face-to-face education
  • Top “Learning Tools” from “learning professionals” worldwide included: 1. Twitter 2. YouTube 3. Google Docs…7. Skype 8. PowerPoint…12. Evernote 13. Slideshare 14. Prezi
  • Mary Meeker is funny, who knew?

Again, there is a lot of information here and some require a deeper dive, but this is a great resource to answer some questions and stimulate more.



Get every new post delivered to your Inbox.