Texting for Diabetes @ Medicine 2.0’11 Stanford

For Medicine 2.0 (#med2) at Stanford this month, I am excited to be delivering a Research in Progress presentation of our study,  “Impact of Texting and Predictive Potential of Health Literacy on Medication Adherence in Type 2 Diabetes Mellitus”. The study, supported by the McKesson Foundation Mobilizing for Health grant program, aims to help a diverse and largely uninsured and underinsured population in South Florida improve adherence to the medications they take for type 2 diabetes mellitus. Our study intervention is designed as a simple series of text messages through treatment targeting one of the primary hurdles to optimal medication adherence – reminders. I will also be sharing our plan for integrating health literacy assessments and disease state knowledge into the clinic EHR as a means to provide more patient-centric counseling and support. Our hope is that we produce an effective intervention to improve health which is also low-cost and thus ultimately scalable. There are a lot of scary numbers being bandied about for diabetes such as its $174 billion annual cost and forecasts that as many as 1 in 3 Americans could develop diabetes by 2050; it would be massive if this contribution could assist in stemming the tide.

Beyond being surrounded by a great study team, I have also been fortunate that providers at our primary care clinic partners have become very enthused about the study. We actually amended our original protocol to account for the fact that physicians at other clinics within the Memorial Healthcare System approached us and volunteered to help recruit participants.

Over the years, Mednet and its offspring, the Medicine 2.0 Congress have been among the most ambitious, surprising, and practically beneficial conferences I’ve attended.  Every year I see new attendees from seemingly disparate areas and sectors that come and then find commonalities that produce stimulating discussions, research collaborations, business ventures, and even friendships. This year will continue that tradition with the pre-conference lineup at the Stanford Summit on September 16, 2011 and the two-day Medicine 2.0 conference proper that follows on September 17th and 18th.  I will be there to share our research to date and eager to participate in the other sessions. I hope to see you there too!

@kevinclauson

Mobile Health 2011: A Look Back at What Really Worked

Stanford Guest House

Mobile Health 2011: What Really Works at Stanford University (#mh11) is over, so it’s time for a quick look back at the conference.  To borrow (steal?) from conference organizer, Stanford Persuasion Technology Lab director, and quick-change artist @BJFogg – I am going to take a retrospective look at my experiences there through the device of ‘home runs’.  For full speaker slide decks, you can click here.

Conference Atmosphere Home Run
I have been to a lot of conferences…pharmacy conferences, medical conferences, informatics conferences, and social media conferences.  However, I have never been to a conference that seemed more along the lines of an ‘event that happens to be interspersed with speakers’.  This is not an indictment of the quantity or quality of the speakers; somehow there were >50 of them smoothly shoehorned into two days.  The comment is more about the carnival-like atmosphere surrounding the conference that made it fun and exciting, and contributed to a very collegial vibe.  One of the best aspects of Mobile Health was the extended breaks.  They were just plentiful enough and twice as long as an average conference.  If you think about the old chestnut ‘the best value at a conference is the hallway conversations’…voila! Those breaks doubled the value of the conference.  Also helpful was Fogg’s “giving permission” to all attendees to go up to anyone there and say hello, reinforced by the speakers largely making themselves available after panels concluded.  I’m still undecided about a few things (e.g., the birds and the bees); however, balancing all the West Coast wackiness was the fact that the conference was timed and chimed down to the minute.  Seriously.

Lodging Home Run
It’s almost like this place is a secret or something.  I stayed at the Stanford Guest House for their conference rate of $109.  You can barely stay at a Roof Rouge near a major city for that.  The rooms and hotel were basic and a little Spartan, but the beds were comfortable, the place was immaculately maintained, and the staff was gracious and knowledgeable.  The deal-maker was that the Stanford Shuttle (Marguerite) had pick-ups ~ every 20 minutes to take you all over the campus.  There was also a Guest House shuttle that could be reserved (e.g., to take you to the Alumni Center‘s conference venue).  The only drawback was that there were no dining options in-house or within easy walking distance.  Definitely will stay here again next time I’m at Stanford.

Almost Made Me Apply for a Job in Public Health Home Run
Sharon Bogan.  You just have to love somebody with that kind of spirit, fighting the good fight, excerpting Monsters, Inc., innovating in resource-limited settings, and inviting litigation (for others).  Everyone I’ve met from King County Public Health going back to the mhealth Summit has been a gem.

Goosebump Home Run [tie]
Green Goose and Proteus ingestible event markers.  Check them out.  Seriously.  They *literally* gave me goose bumps in thinking of potential applications of their technologies during their presentations.
Honorable mention: Google Cow presented by Google’s Chief Health Strategist (@rzeiger).  Technically he was focusing on Google Body, but since I had already seen Body I was pretty happy to see the bovine version.

Reunion Home Run
It was great to see @chiah @EndoGoddess @JenSMcCabe  KarenCoppock  @LarryChu  @SFCarrie  @SusannahFox and loads of others again!

New Peeps Home Run [misc]
If you are worried about our future, know that we are in good hands with people like @hcolelewis coming on the scene
Most likely to isosceles with regarding mHealth, PAHO, & Uruguay @JuanMZorrilla
Most likely to invite for Skype in guest lecture in my Consumer Health Informatics course @QpidMe
Most likely to explore the mHealth studies based out of our campus in Puerto Rico with @MarcosPolanco
Most surprised to find in my back yard Vic Shroff
Note: any conversations that included words like NDA, lawyer, or launch are not listed here for obvious reasons.

Failed to Connect at All Strikeout
I would have liked to have spoken with @enochchoi

Conversationus Interruptus Strikeout
The Keck and and PHI guys

Best Laid Plans Strikeout
Climate control and the janky A/C resulted in groups of attendees going to the outer hall and watching panels on a screen and/or going outside to cool off.
(Dis)honorable mention: minimal power outlets/juice available was surprising.  This problem was offset somewhat by the length of the breaks which allowed for both networking and recharging.

Least Favorite Panel
The Partnerships panel was my least favorite.  It definitely had eye-opening moments for some attendees and there were interesting discussions and placements (e.g., possibly the least and most idealistic two people at the entire conference were seated next to each other).  However, most of the discussions were pretty familiar to me from having gone through many of the processes described.  So my bias/preference would have been to have instead heard more specifics about MedPedia from James, Medic Mobile or Social from Josh, etc.

Overall Favorite Panel
Very tough decision as there were several really outstanding ones.  I considered a tie here but was able to pull the trigger and name “Methods and Measures for Research and Evaluation” as my favorite overall panel.  The moderator and panelists all had great content to share and illuminated a lot of the challenges in conducting research in this space.  Plus the Open mHealth initiative is so encouraging!  I think this panel is a ‘must view’ for everyone as it can help in introducing a common language that could lead to better coordination and scaling of efforts as well as providing guidance for individuals.  Overall, the quality and detail of this panel was exemplary.  I ended up choosing it in part based on the criteria of ‘if I could only have the full video of one panel’ because of its high utility for me and in sharing with multiple audiences.  Many of the slide decks from this panel are here.

Final Verdict
I am definitely happy I attended both the pre-conference workshop by @BjFogg (although it mostly served to whet my appetite for the full Boot Camp) as well as the conference proper.  I have been to some good conferences that were one-offs, but will absolutely figure out a way to make it back to Mobile Health next year.  My two most substantial takeaways were that the construct of this conference was singular in nature and that it was probably easier to connect with potential collaborators here than at any other conference I’ve attended.

@kevinclauson

Update: other perspectives on the conference have previously been posted here by @thulcandrian of AIDS.gov and a take on mHealth by @geoffclapp here.

Update 2. Here is a new conference highlights post by Craig Lefebvre (who I wish I had realized was @chiefmaven when I met him there)

Update 3: ‘Text in the City’ founder Katie Malbon has written the most ambitious mh#11 wrap-up to date

Update 4: If @TextInTheCityNY had the most ambitious/complete post, @geoffclapp has added the most thoughtful and thought-provoking review to date

Update 5: From the ‘people I wish I had a chat with’ file at #mh11, @AndrewPWilson has now provided his main takeaways from Stanford

Update 6: Patient-centric thought bubbles and more from e-Patients.net rep @msaxolotl at #mh11

Update 7: Jeff Kellem (@slantedhall) provided a tech-focused list of quick hits from the conference

Update 8: David Doherty (@3GDoctor) has added the most contrarian view of the conference to the conversation here

Pimp My Poster

Like many colleges of pharmacy, ours added a seminar component years ago. The seminar has since been expanded to include a paper, a poster, and a podium presentation.  The topics range from literature-driven examinations of therapeutic controversies to original research tied to the faculty mentor’s specialty.  This year I was responsible for the recitation on the poster component.  This slide deck is what I used for that lecture.  Two particularly notable resources for me in assembling this lecture included the piece in The Scientist that inspired the name [1] and the site maintained by the Godfather of Scientific Posters: Dr. Colin Purrington [2].  If you want to dig a little deeper, here are my current favorite articles on the topic as well [3-5].  The full-text of all of these journal articles is currently available online for free.

I’ve benefitted from attending a lot of conferences over time and have seen (and continue to see) posters that are masterful creations, along with others that are absolute rubbish.  I posted the ‘Pimp My Poster’ slide deck here in hopes that it may be a resource to others, but am also keen for feedback to improve it for future iterations. 

@kevinclauson

[1]  Westly E. Pimp my poster. The Scientist 2008;22(10):22.
[2]  Purrington CB. Advice on designing scientific posters. 2009. http://www.swarthmore.edu/NatSci/cpurrin1/posteradvice.htm Accessed February 2, 2011.
[3]  Erren TC, Bourne PE. Ten simple rules for a good poster presentation. PLoS Comput Biol 2007;3(5):e102.
[4]  Hamilton CW. At a glance: a stepwise approach to successful poster presentations. Chest 2008;134(2):457-9.
[5]  Wood GJ, Morrison RS. Writing abstracts and developing posters for national meetings. J Palliat Med 2011 Jan 17 [Epub ahead of print].

If this level of creativity could only be used for ‘good’

The 10th annual ePharma Summit was held over the last few days in NY.  I was interested due to some of the scheduled speakers but could not make it, so I dipped in and out of the virtual conference stream as possible and found some pretty worthwhile content in there.  The most convenient way to follow was via #ePharma on Twitter, but the conference site also did a pretty good job of posting videos (although the audio was almost inaudible at times) and other information.

What ultimately prompted me to blog about it was a tweet (via @WendyBlackburn & @pjmachado) about a parody video produced by Kevin Nalty (@nalts) [see below].  It just struck me as creative, funny, and very strong work…and it made me think how great it would be if that kind of creativity could be unleashed to design social media/mobile/any type of health-related content aimed at informing, educating, and empowering patients.  Yes, the creativity behind this video is being used for ‘good’, but minus the shackles it could be used for a much greater ‘good’.  I think that social media, in particular, has a lot to offer on this front and it is unfortunate that the regulatory environment is such that this is largely not possible right now.  There have been some efforts along these lines and there was even a preliminary paper just published on the use of Facebook to deliver HIV education.  However, there remains a long way to go – and I’m not just talking about ‘official guidance’ in a single arena. 

More anon, for now…I hope you enjoy the video.

@kevinclauson

Note: If you click on the video it may say it is restricted on certain sites as it contains content from Universal Music Group and must be played on You Tube…so you can click ‘Watch on YouTube’ to play or go to the epharmify Channel to view it.

Medicine 2.0’11 at Stanford – Call for Abstracts

The Medicine 2.0 World Congress on Social Media and Web 2.0 in Health, Medicine, and Biomedical Sciences is one of the most valuable conferences I have ever attended.  It has been the meeting in this arena with the clearest focus on actual research and evidence for Medicine 2.0 issues and also offers the best opportunity to connect with other researchers, clinicians, e-patients, business and policy people.  In fact, the very first Medicine 2.0 Congress was where I was introduced to (and/or first met IRL) so many people who went on to become research collaborators, colleagues, and friends. 

In the spirit of that original meeting, I am excited for this year’s Medicine 2.0 at Stanford (September 16-18, 2011).  I have always appreciated the fact that Medicine 2.0 has truly been an international gathering, but am happy to see that it is coming to the United States for the first time.  I am also eager to see another first,  the one-day Stanford Summit at Medicine 2.0, which will directly precede the Medicine 2.0 Congress.  The Summit is lining up to have an incredible array of moderators and panelists.

Given the quality of the attendees and the opportunities for discussion/dissemination of your research (and networking), if you are working in this field I would strongly urge you to respond to the Call for Abstracts, Presentations, Interactive Demos, Startup Pitches and Panel Proposals for Medicine 2.0 at Stanford.  The deadline for submission is a (rapidly approaching) March 1st, 2011.  You can click on the link for the Call or start the process by watching the overview below by this year’s Conference organizer, Dr. Larry Chu.  Also, feel free to contact me with any questions and I look forward to seeing you there!

@kevinclauson

Medicine 2.0 Call for Abstracts from Larry Chu on Vimeo.

mHealth Summit 2010 ATF Part 1

I already miss the sound of the techno music from the Walter E. Washington Convention Center at the 2010 mHealth Summit.  Because I’ve seen a number of questions about what mHealth is, here is my preferred definition from lecture courtesy of @mHealthAlliance: “the use of mobile devices and global networks to deliver health services and information”.  One reason I like this definition is its emphasis on the ‘network’ piece.  It allows for a much broader application.  I understand the desire by some for the term uHealth (u=ubiquitous) and others, like one presenter at AMIA 2-3 years ago from Rockefeller, who yearn for everything to eventually just be ‘health’.  While recognizing that the types of labels like mHealth can definitely be problematic in the long-run, they also can be really useful in the short term for conveying a basic context, getting people to the table, and creating rallying points…which brings me to my next point.  One of the oft-parroted comments of the Summit was that there was too much hype about mHealth.  Unfortunately the word ‘hype’ was being used interchangeably with ‘excitement’ in many cases.  Of course mHealth isn’t a panacea and there are serious obstacles to navigate.  But let’s not lose sight of the fact that it is really hard to motivate people, to excite people, and to generate momentum…and mHealth is accomplishing those things.  So please let’s not be so terrified about overpromising and under-delivering that we squash genuine enthusiasm.  Of course there are speed bumps and as @joncamfield noted, there are definitely some mobile parlor tricks to be wary of out there (he also had the fantastic idea of an implementer track for next year).  In the interest of being fair and balanced, here is an example of a public health/mHealth app featuring augmented reality that may mean well but has questionable execution [EDIT: yes, the video below is for an actual app].

Onto the conference proper…David Aylward, Executive Director of the mHealth Alliance, began with a pseudo-demo of wearable body area networking for basic vitals.  Side note: Aylward closed the conference while wearing a Bugs Bunny tie that I speculated was an ode to Ted Turner and his Cartoon Network.  This remains unconfirmed.  Slightly more relevant, the conference was livestreamed and h/t to @planetrussell who noted that videos from the stream are starting to appear in various YouTube channels.

 

The first two WOW moments of #mhs10 for me included the announcement of the 2011 NIH Summer Institute on mHealth Research, which will provide specialized training opportunities for 25 researchers.

 

The second was during a panel presentation by @JoshNesbit in which he shared a word cloud of the tweets from Haiti following the earthquake.  The wow moment was when he pointed out that the second most tweeted word was ‘please’.  That revelation definitely gave me pause. 

End ATF: Part 1

@kevinclauson

 

Part 2 may or may not highlight snarky entrepreneurs, bedsore-preventing robots, keynote Star Wars quotes, and actual data.

Two Billionaires, The White House, The Rockefeller President and mHealth

The title of this post is shorthand for four of the keynote presenters at next week’s mHealth Summit (follow at #mhs10) in Washington DC.  In addition to these four keynotes by Bill Gates (@BillGates), Ted Turner, Aneesh Chopra, and Judith Rodin, there is a great lineup of speakers and moderators.  There is a dizzying array of tracks and talks to choose from, but for me there are a handful that are particularly relevant.  These include  Najeeb Al-Shorbaji, who directs KMS at the World Health Organization, @SusannahFox of Pew Internet & American Life and e-patients.net, who is asking the right questions and always has cool new data right around the corner, Matthew Holt (@boltyboy), who is behind THCB and Health 2.0 [and who will hopefully be bemoaning Chelsea dropping points the Sunday prior], @JoshNesbit whose video about Frontline SMS I regularly use in my informatics course and who presents one of the most compelling cases for mHealth [seriously, you may be dead inside if it doesn’t speak to you on some level].

I am also really eager to hear from @HajovanBeijma from Text to Change and Susan Dentzer, who has been very forward thinking as EIC at Health Affairs, as well as to meet Walter Curioso, whose work I have long admired.  Since some of the biggest issues facing mHealth deal with scalability, policy, and interoperability, the mHealth Summit promises to be particularly useful as this conference brings together most of the stakeholders necessary to enact change.  I am looking forward to it.  I plan to be livetweeting and possibly liveblogging some, but I may very well get caught up in the presentations and discussions so I can’t make any guarantees.

@kevinclauson

ULP Digital Pharma Nine Notables

Two-thumb typing on telephone at twenty to thirty thousand feet while things are still fresh in my mind from Digital Pharma East.

Digital Pharma was the first Pharma-centric conference I’ve attended.  My usual professional meeting haunts are either focused on HCPs or are a blend of healthcare industry and technology.  I wasn’t completely certain what to expect other than I would likely be among the minority as a ‘representative’ from academia and pharmacy.  That’s plenty of preface, onto the Notables

Notable Keynote
As much as I enjoyed keynotes by Ian Talmadge, Dr. Bertalan Mesko (@Berci), etc., the one that completely floored me was delivered by Dr. Ian Morrison (@seccurve).  It was the perfect blend of style (his seamless comparison of Pimp My Ride to the state of US healthcare) and substance (holistic view of drivers of medication non-adherence).  Spot on observations, great timing, and natural, unforced humor.  The clip on his site does not do him justice. 

Notable Conversation
@LenStarnes is just a really interesting cat. I found him to have a fascinating global perspective, wealth of experience, and he is a darn good storyteller in his own right as well as being a fellow ZX81 owner.

Notable Attendee
Phil Cranch (@cranchtweet), MSPharm, MComm at The Crystal Agency.  He was the only other self-identified pharmacist there who I saw and tied for my fave Aussie.

Notable Anniversary
Congrats to the folks at Pixels and Pills who are a very precocious, collective one.  Remarkable energy, nice approach, no doubt headed for great things.

Notable Recruit
You just watch, I am totally going to figure out a way to poach @Shwen Gwee and get him back to academia where he belongs. Academia needs more driven people who are also savvy.  Don’t worry; I’ll still let him help the ExL Pharma folks.

Notable Transparency
None. I detected no transparency of note. I get that it’s canine-devour-canine and all that, but still a bit disappointing.

Notable Mobile Experience
I can’t help but think if I had talked to @CynthiaNorth 6 months ago that it would have cut off about a month of prep time for our mHealth research protocols and that we, in turn, would have added perspective and experience that would have enhanced their patient adherence piece.

Notable Connection(s)
My post. My rules. Multiple parts to this Notable. @PhilBaumann of Health is Social may just end up being the first social media healthcare futurist. I feel like Dr. Mike Sevilla (@doctoranonymous), despite his notoriety, is underrated as a presence especially given his remarkable longevity. Dr. Bryan Vartabedian (@Doctor_V) simply gets the need for rigorous research in this area and authors a thoughtful, relevant blog.  After speaking to Gilles Fry (@gfry) a few times, I finally figured out a one-word descriptor for where he resides on the ‘Rage Against the Machine’ to ‘Endearing Curmudgeon’ continuum: Fierce.

Notable Omissions
See above re: rules and limits. Somehow digilicious by @JaeSelle did not fit into the Nine despite a potent combination of sculptor, visual enthusiast, and embracing the inner geek.  And where was @jonmrich curator of the Social Media Wiki?  Great googly moogly that thing is useful.  I planned to thank him for those efforts and to tell him to cheer up.  Health literacy, while not omitted from the conversation, was limited to cameos.  Civility seemed to be omitted at a handful of sessions.  Barely activated patients and hesitant healthcare professionals would have made fine additions to some panels to give a fuller picture.  I did not omit any of the stargazing targets.  However, I’ve obviously omitted at least one great connection, one great conversation, and one great find.

@kevinclauson

Stargazing at Digital Pharma East

I am really looking forward to the 4th Annual Digital Pharma East coming up on October 18th in Philadelphia.  In addition to presenting, I plan to do some major stargazing while I am there.  I don’t mean ‘star’ in the manner of the cult of celebrity.  I am defining stars as people who have something really valuable and/or interesting to say.  It feels a little mercenary to go with the express intent of cherry picking knowledge from experts given the themes around sharing – but I guess that’s just part of the allure.

I’m also very much looking forward to reconnecting with Berci Mesko (@Berci) who I have not seen in a couple years, talking shop with social media flag bearer Bryan Vartabedian (@Doctor_V) who will likely be pressed for time from Co-chairing the event, having a face-to-face chat with Phil Baumann (@PhilBaumann) whose mind works unlike any other I’ve encountered in this space, meeting Gilles Frydman (@gfry) who is the final piece of the ePatient trinity, as well as Shwen Gwee (@shwen) who has both tweet cred and does great work.

In addition to those folks, I may be most eager to see presentations by representatives from Comscore and Within3, along with Cluetrain Manifesto author Doc Searls and futurist Ian Morrison.  Needless to say, I am planning to see every single presentation on the final day, which is dedicated to mobile/mHealth.  The rest of the time, it’s just a question of which Stream.  Finally, I am curious to see how the unconference activities and #SocPharm sessions play out relative to previous HealthCamp events I’ve seen.

As for me, I’ll be presenting “Social Media Research: Partnering with Academia”.  The link to the slides on the Digital Pharma conference site will be provided here after the presentation and will be available beyond that at SlideShare as per.  I’m curious to see the reception given that the composition of the audience is pretty different than who I have been interacting with recently.  I definitely have a (relatively) longstanding interest in the subject as one of the first articles we published on the topic was “Legal and regulatory risk associated with Web 2.0 adoption by pharmaceutical companies” in the Journal of Medical Marketing.  We’ve also published several other studies on interactions between different healthcare professionals and representatives from Pharma.  Ultimately, I am banking on the fact that I actually do what I will be talking about and have some concrete takeaways for those interested in the topic.  I’m also optimistic that using an audience response system and building in time for discussion will help make it legitimately interactive.  We shall see.

Overall, I am looking forward to reconnecting and making new connections, planting the seeds for future research collaborations, and learning from area experts that are rarely available in this concentration.  I hope to see you there, hear your thoughts, or cross paths via #DigPharm (or whatever the hashtag ends up being)!

@kevinclauson