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Health 2.0 – The Next Wave
The document discusses the rise of social media and its impact on health care. It notes that people are increasingly using social networks like Facebook and Twitter to find health information and connect with others. This has led to new models of care delivery using mobile technologies. Social media allows for more collaboration between patients and providers and helps address isolation issues. However, many blogs have been abandoned as users migrate to other platforms like Facebook and Twitter.
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Health 2.0 – The Next Wave
- 1. Change and Reformin the American Health Care System Kent Bottles, MD ICSI [email_address]
- 2. ICSI Online www.icsi.orghttp://icsihealthcareblog.wordpress.com/ ICSI on Facebook Twitter ICSIorg Kentbotttles Norskedoc
- 3. Dr. Alan Greene’sHealthcare Bubble Trade at high volumes Prices at variance with intrinsic values Market prices are unsustainably high Misallocation of resources into non-optimal uses Destined to come to an end
- 4. Adam Bosworth ofKeas “When the consumers all leave, sooner or later the laggards have to follow or die”
- 5. Health 2.0 “Community is the killer app in health care” Steve Case, Revolution Health Web 1.0 users search for and read information Web 2.0 regular people create content on line Photo-sharing Video-uploading Music downloading Personal blogging Podcasts Tom O’Reilly 2005
- 6. Health 2.0 Theuse of social software and its ability to promote collaboration between patients, their caregivers, medical professionals, and other stakeholders in health California study showed people with lowest levels of social contact had mortality rates 2 to 4 times greater than those with strong social networks Supportive social networks improve outcomes in patients with heart failure, post-partum depression, preoperative pain, and anxiety
- 7. Flowering of Pro-AmsCommitted, networked amateurs working to professional standards with new technology Rap music Blogs Podcasts Linux The Sims: 90% of content is from Pro-Ams The Grameen Bank barefoot bankers $4 bil Astronomy: Dobson, CCD, Internet
- 8. Nielsen Online: Timeon Social Networks http://www.physorg.com/news163254287.html Number of minutes Americans spent on social networks grew 83% from 4/08 – 4/09 Total minutes on Twitter 7.9 million to 300 million Total minutes on Facebook 1.7 billion to 13.9 billion 700% increase
- 9. Nielsen Online: Timeon Social Networks http://www.physorg.com/news163254287.html Russian internet company invested $200 million in Facebook valued at $10 billion Friendster and MySpace are declining “ Consumers have shown that they are willing to pick up their networks and move them to another platform, seemingly at a moment’s notice,” Jon Gibs, Nielsen Online
- 10. The Social LifeOf Health Information Pew Internet and American Life Project, June 2009 2000: 46% American adults had internet access, 5% households had broadband, & 25% Americans looked on line for health 2009: 74% go online, 57% have broadband, & 61% looked on line for health
- 11. The Social LifeOf Health Information Pew Internet and American Life Project, June 2009 Where do you get information about health: 86% ask health professional, like doctor 68% ask a friend or family member 57% use the internet 54% use books 33% consult insurance provider
- 12. The Social LifeOf Health Information Pew Internet and American Life Project, June 2009 “ Just in time someone like me” 41% of e-patients read someone else’s commentary on blog, website 24% of e-patients consult rankings of docs 24% of e-patients consult rankings of hosp. 19% of e-patients receive updates 13% of e-patients have listened to health podcast
- 13. The Social LifeOf Health Information Pew Internet and American Life Project, June 2009 Creating new health content themselves 6% of e-patients have tagged online health content 6% of e-patients have posted comments in online group discussion 6% of e-patients have posted comment on blog 5% of e-patients have posted review of doc 4% of e-patients have shared photos, videos, or audio files about medical issues
- 14. Doctors and Twitterhttp://www.33charts.com/ Follow and listen Goof around, think about how you want to use it. Follow whoever you darn well please Your patients and hospitals are listening What happens on Twitter stays on Twitter Exercise intelligent transparency
- 15. Twitter http://www.time.com/time/business/article/0,8599,1902604,00.html CliveThompson’s ambient awareness “Social warmth of stray details” Twitting during a conference Public record of ideas Continues dialogue well past end of conference Wider audience Second layer of discussion
- 16. Twitter Tips forHealth Executives http://www.nonclinicaljobs.com/ Follow back Twitter has follow limit Followers plus 10% 2000 followers can follow 2200 people Retweet, Interact, and Reply Follow Friday: #FF, #followfriday
- 17. Online, ‘a Reasonto Keep on Going’ Stephanie Clifford, NY Times, June 1, 2009 “I was dying of boredom. Eons, all by its lonesome, gave me a reason to keep on going.” Paula Rice, 73 “One of the greatest challenges…we face as older adults…is actually about our social network deteriorating on us.” J. Coughlin
- 18. Online, ‘a Reasonto Keep on Going’ Stephanie Clifford, NY Times, June 1, 2009 “ The new future of old age is about staying in society, staying the workplace and staying very connected. Technology is going to be a very big part of that, because the new reality is, increasingly, a virtual reality. It provides a way to make new connections, new friends and senses of purpose.” Joseph Coughlin, MIT AgeLab
- 19. Online, ‘a Reasonto Keep on Going’ Stephanie Clifford, NY Times, June 1, 2009 MyWay Village in retirement homes Eons (online community for Boomers) Facebook, Twitter One third of people 75 years old and older live alone
- 20. Cell Phones andMedicine http://ow.ly/cB41 “ When the iPhone launched, it was a $500 piece of crap. Now, with apps, it’s a minicomputer.” Ryan Gravitytank Surveyed 804 smartphone users Ethnographically studied 20 app-phones users Interviewed 20 app developers
- 21. Cell Phones andMedicine http://ow.ly/cB41 Spend two hours per day on phone Interact with phone 30 times a day Average of 21 applications How many apps do you use everyday 1-2: 26% 3-4: 24% 5-6: 21% 6 +: 29%
- 22. Cell Phones andMedicine http://ow.ly/cB41 Mobile productivity used to mean email and calendar access Now applications for nutrition, exercise, finance, shopping, hobbies, access to media content
- 23. Cell Phones andMedicine http://ow.ly/cB41 25% of apps are paid 69% purchased an app in last month Send about $6 a month for apps “Paying is a no-brainer if you think it’s going to make your life better.”
- 24. Cell Phones andMedicine http://ow.ly/cB41 50% of app users: apps are essential tools to get more done and stay organized Gender balanced and highly educated Use computers, TVs, MP3 less and less Time pressed 78% never enough hours in day 77% always looking for ways to manage time
- 25. Cell Phones andMedicine www.personalpediatrics.com/ “A national network of dedicated physicians who are reinventing the lost art of pediatric house call medicine using wireless technology and state-of-the-art recordkeeping software.”
- 26. Cell Phones andMedicine http://mobilehealthnews.com/2401/interview-dr-hodge-the-first-iphone-doctor/ Natalie Hodge, MD (first iPhone Doctor) 3 years of experience in St. Louis “ We intend to be an entirely mobile platform – there is no need for an office, at least for pediatricians.” “ Everything I need for my practice could fit in the trunk of my car.”
- 27. Cell Phones andMedicine http://mobilehealthnews.com/2401/interview-dr-hodge-the-first-iphone-doctor Hodge’s office had 5 employees $200,000 a year in overhead $50,000 a year in overhead for Personal Pediatrics new model of home visits “Revenue is about the same”
- 28. Health 2.0 ToolsBlogs Online forums Podcasts Really Simple Syndication (RSS) Social networks build online communities Wikis enable community to record, edit, and verify knowledge on a particular disease
- 29. Health 2.0 ReasonsWhy Connect with Others See what others say about treatment 36% To research others’ experiences 31% To get education that helps me 27% To get emotional support 17% To build awareness around disease 15% To share my knowledge with others 14% To get recommendation about hospital 13% To get recommendation about doctor 10% To feel I belong to a group 8%
- 30. The State ofthe Blogosphere October 2008 Technorati indexes 133 million blogs 7.4 million blogs in last 120 days 1.5 million blogs in last 7 days 900,000 blog posts in last 24 hours
- 31. What is ablog? Weblog, Web log, blog Online publication made up of postings Credited with enormous influence Resignation of Trent Lott Resignation of Dan Rather as anchor of CBS Harriet Miers nomination withdrawn Jeff Jarvis blogged “Dell Sucks”
- 32. Scott Adams onBlogs The world sure needs more of ME Maybe I’ll shout so others nearby can experience the joy of knowing my thoughts No, wait, shouting looks too crazy I know – I’ll write down my daily thoughts and badger people to read them
- 33. Scott Adams onBlogs If only there was a description of this process that doesn’t involve the words egomaniac or unnecessary What? It’s called a blog? I’m there
- 34. The blogger’s philosophy“Everything that I think about is more fascinating than the crap in your head.” Scott Adams
- 35. Comment on MedicalBlog “ These medical blogs are just fantastic. I think all too often patients and the Public at large have a strange notion that doctors are somehow almost non-human in the sense of not having ordinary, everyday feelings and concerns common to all humans. We expect them to be miracle workers and superhuman, totally clinical yet warm and caring at the same time.”
- 36. Blogs Falling inan Empty Forest Douglas Quenqua, NY Times, June 5, 2009 Technorati: only 7.4 million out the 133 million blogs updated in last 120 days. 95% of blogs are essentially abandoned Why? Migration to Facebook, Twitter Lack of reader interest Blogger want to regain privacy
- 37. Blogs Falling inan Empty Forest Douglas Quenqua, NY Times, June 5, 2009 “There’s a joke in within the blogging community that most blogs have an audience of one”
- 38. Health 2.0 SearchEngines Microsoft Health Search Praxeon Kosmix/Right Health Healia Healthline Networks Organized Wisdom
- 39. Health 2.0 ConnectingPatients to Doctors Angie’s List Medical Emphasis Search American Well ZocDoc Health World Web
- 40. Few are usingHMSA’s Online Care http://www.honoluluadvertiser.com/apps/pbcs.dll/article?AID=2009905210310 Fewer than 10 people daily using in April 800 consults in 3.5 month period 4,000 have signed up to use service (0.3%) 85% of those who used say excellent or good “ I have grave concerns about the safety of Online Care,” Dr. Josh Green
- 41. Patient Social NetworkingSites Diabetesmine I’m Too Young For This! Foundation Patientslikeme Resolution Health Daily Strength Sophia’s Garden iMedix Disaboom MedHelp HealthCentral Network
- 42.
- 43. Physician Networking SitesSermo MyPACS.net Ozmosis MedicalPlexus Within3 iMedExchange
- 44. Online Medical CareHelloHealth American Well Dr Pod ISIS (Deb Levine and text messaging for at risk teens)
- 45. Health eGames MarketReport Douglas Goldstein, et. al. HumanaGames.com Kaiser Permanente’s Amazing Food Detective HopeLab’s Re-Mission cancer fighting Archimage’s $9 million NIH grant and Escape from Diab
- 46. Health eGames MarketReport Douglas Goldstein, et. al. Exergames Brain fitness Condition management Healthy eating Professional training
- 47. Health eGames MarketReport Douglas Goldstein, et. al. Nintendo Wii and Wii Fit exergames 29.6 million Wii consoles sold in 19 months at $300 per unit www.wiialerts.com
- 48. Health eGames MarketReport Douglas Goldstein, et. al. Social acceptance of video games West Virginia Dance Dance Revolution in 1500 public schools Health eGames are Mainstream Pogo.com 18 million users 63% over age 35 61% women
- 49. Health eGames MarketReport Douglas Goldstein, et. al. Clinical research Physic Ventures whitepaper Debra Lieberman of RWJ $8.25 million Re-Mission improved young cancer patients’ Knowledge Self-efficacy Adherence to prescribed treatment plan
- 50. Health eGames MarketReport Douglas Goldstein, et. al. Health Plan Involvement Humana (HG4H) Inland Empire Health Plan exergaming CIGNA and HopeLab’s Re-Mission CIGNA Virtual Healthcare Community (a patient education island within Second Life) Aetna Foundation funded Archimage Kaiser’s The Amazing Food Detective
- 51. Health eGames MarketReport Douglas Goldstein, et. al. Second Life Heron Sanctuary CIGNA Virtual Healthcare Community Ann Myers Medical Center
- 52. Medicalization of CyberspaceAndy Miah & Emma Rich, London: Routledge, 2008 Controversy and moral panic Auctioning of a kidney on eBay Bidding reached $5,750,100 69% of respondents to online poll thought should be legal Pro-Anorexia online movement Von Hagens’ Body Worlds exhibition and public autopsy www.ronsangels.com (ova and sperm for sale)
- 53. Medicalization of CyberspaceAndy Miah & Emma Rich, London: Routledge, 2008 “ Information obtained from the Internet may conflict with recommendations provided by physicians, thus leading to confusion and uncertainty in the mind of patient. The consequences of this uncertainty may lead to a delay in treatment or the patient turning to inappropriate forms of therapy” Henson, 1999 Anarchic dismantling of established information systems Wikipedia vs. Encyclopedia Britannica Literary prizes for bloggers Physicians losing control of medical information Catholic Church
- 54. Medicalization of CyberspaceAndy Miah & Emma Rich, London: Routledge, 2008 Assessment tools for reliability of Internet information Codes of conduct Quality labels User guides Filters Third party certifications
- 55. Medicalization of CyberspaceAndy Miah & Emma Rich, London: Routledge, 2008 Boundaries between patient and expert are blurred by cyberspace Each category loses some aspect of its distinctive modus operandi New era of collaborative medicine, partnership health, alternative patient knowledge of health
- 56. Medicalization of CyberspaceAndy Miah & Emma Rich, London: Routledge, 2008 Ideal consumerist role Passive patient role Real patients may pursue both roles simultaneously or variously depending on the context “ Belief in hierarchy; somewhere, out at the frontiers of science and engineering…there is a conviction from patients that a solution must exist” for each and every medical problem.
- 57. Medicalization of CyberspaceAndy Miah & Emma Rich, London: Routledge, 2008 “ Unlike the classic sick role relationship where the doctor told the patient what was wrong and what s/he had to do or take to get better, in the information age the patient is just as likely to tell the doctor what might be wrong and outline a range of possible risks, treatments or therapies.” Nettleton
- 58. Medicalization of CyberspaceAndy Miah & Emma Rich, London: Routledge, 2008 Emergence of networks that might be harmful to the patient Eating disorders Self-harm Cyber-suicide Cyber-cannialism
- 59. Medicalization of CyberspaceAndy Miah & Emma Rich, London: Routledge, 2008 Who owns online communities? What legal claims can be made over them? Who should regulate online communities? Does MD consultant to website have ethical/legal obligations to visitors? Can traditional therapy be translated to Internet or is it a new form (e-therapy)? Should MD licenses be by state? At what point is there a patient/provider relationship?
- 60. ICSI Online www.icsi.orghttp://icsihealthcareblog.wordpress.com/ ICSI on Facebook Twitter ICSIorg Kentbotttles Norskedoc