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"Nurse” vs. “Doctor” I’ve been tinkering with a new research tool from Google labs – Ngram Viewer™ – which unravels cultural references inside the 15 million books scanned by the search engine giant. Looking at the proportion of published content that mentions the word “nurse” or “doctor” – over the period 1800 to 2008 – I found the Google application’s raw graphing data reveal some fascinating results. In a nutshell, the English language corpus has historically held doctors in higher esteem than nurses; around 1980, cultural references to nurses and to doctors nearly converged. And after 2000, doctors rose again in importance relative to nurses, and at a rapid clip. What explains the trend?
A Commitment Vows: Accountability 2.0 Commitment contracts have worked for individuals around the world whose aim is to lose weight, spend more time with their family, or quit drinking - but it can also work for hospitals, governments and CEOs who want to stamp out bad habits. Call it Accountability 2.0.
A Patient's Right to be Believed The right to be presumed innocent preserves a higher ethic - the rule of law. Similarly, in business, the "customer is always right" is an axiom of quality service. In healthcare, things are a little bit different.
A rapid, Web-based method for obtaining patient views on effects and side-effects of antidepressants This project was undertaken to develop a rapid method for obtaining a widespread sample of patient views on the efficacy and side-effects of antidepressants. A Web-based method is described for rapidly and objectively obtaining patient views on the effects and side-effects of treatment with antidepressants. The method entails a systematized search of many URLs (Uniform Resource Locators, or Web page addresses), using keywords and phrases to extract the named drug and symptom that are reliably relevant to the medication being taken by the individual reporting the experience online. Unwanted medical conditions (e.g., cancer) are excluded. Three successive searches of thousands of Web pages revealed a cumulative total of 835 "mentions" of patient experience on duloxetine, 756 for venlafaxine, 637 for citalopram, 636 for sertraline, 559 for paroxetine, 457 for fluoxetine, 318 for desvenlafaxine, 289 for fluvoxamine, and 210 for mirtazapine, in association with various symptoms. A comparison of the associated symptoms for each of the antidepressants found that the prevalence of the combined factor of fatigue, drowsiness, tiredness or lethargy ranged from 6.4+/-0.8% down to 2.9+/-0.15% of the mentions, where the S.E. was derived from three repeats of the Web-based analysis. The prevalence of dizziness or vertigo ranged from 7.6+/-0.8% down to 1.9+/-0.3% of the mentions. Given the increasing number of patient narratives about drug experiences on open-access Web forums, this rapid novel method will have increasing utility in post-marketing surveillance and in comparing the effects of psychiatric medications. PMID: 20705344 [PubMed - as supplied by publisher]
Assessing and Responding in Real Time to Online Anti-vaccine Sentiment during a Flu Pandemic The perceived safety of vaccination is an important explanatory factor for vaccine uptake and, consequently, for rates of illness and death. The objectives of this study were (1) to evaluate Canadian attitudes around the safety of the H1N1 vaccine during the fall 2009 influenza pandemic and (2) to consider how public health communications can leverage the Internet to counteract, in real time, anti-vaccine sentiment. We surveyed a random sample of 175,257 Canadian web users from October 27 to November 19, 2009, about their perceptions of the safety of the HINI vaccine. In an independent analysis, we also assessed the popularity of online flu vaccine-related information using a tool developed for this purpose. A total of 27,382 unique online participants answered the survey (15.6% response rate). Of the respondents, 23.4% considered the vaccine safe, 41.4% thought it was unsafe and 35.2% reported ambivalence over its safety. Websites and blog posts with anti-vaccine sentiment remained popular during the course of the pandemic. Current public health communication and education strategies about the flu vaccine can be complemented by web analytics that identify, track and neutralize anti-vaccine sentiment on the Internet, thus increasing perceived vaccine safety. Counter-marketing strategies can be transparent and collaborative, engaging online "influencers" who spread misinformation.
Assessing and Responding in Real-Time to Online Anti-vaccine Sentiment during a Flu Pandemic Traditional communication and education strategies by public health authorities are limited in their capacity to counteract public concerns about vaccine safety. Efforts to counter the arguments of the anti-vaccine movement, to calm fears and to provide accurate information require sustained, effective public health communication. In order to evaluate, in real-time, Canadian Internet users’ attitudes to the safety of the H1N1 vaccine after Health Canada approved the vaccine, we surveyed a random sample of Canadian Internet users from October 27 to November 19, 2009 (Step A). In Step B, we determined which vaccine safety Internet sites were most trusted by the public by deploying a dynamic ‘Internet robot’ that informed us (i) which Uniform Resource Locators (URLs) discussing ‘myths and facts’ about the H1N1 vaccine were being most widely shared and discussed among English-language Internet users, and (ii) which Web sites, blogs, and links were being shared on social media sites.
Autism and the Measles, Mumps, and Rubella Vaccine: Need to Communicate a Health Study Retraction to Patients The public is concerned over the safety of vaccines for children. If such fears translate into avoidance of vaccines, the public health of the community is at risk. The 1998 study by Wakefield and colleagues, which linked the measles/mumps/rubella vaccine (MMR) to bowel disorders and autism, sparked global concern over the safety of the MMR vaccine. On February 2, 2010, the Lancet published a full formal retraction of the Wakefield study.
Back-to-School Health and the New E-parents After Senior Kindergarten, the dominant parental concern voiced by parents online (on blogs and social networks) is health promotion. Does the school support healthy living? Does it offer sufficient exercise, healthy snacks and lunches, and healthy attitudes toward food?
Big Pharma Listens Pharma companies will embrace the Web, real-time communications and social networking. Mergers and acquisitions, joint marketing, and co-promotions can only go so far in propping up the sagging industry. More patients, caregivers and providers will search online for health information in the new decade.
Bottom-Up vs. Top-Down Innovation - and Hot Air Too much focus on the bottom-up/top-down debate misses the real goal: making sick patients healthier faster, or managing and preventing illness altogether. This may happen bottom-up, top-down, or, more often than not in my opinion, by combination or accident. In many cases (as with the hot air balloon) we don't really know why for years to come.
Business News Network interviews Cell director on innovation in obesity policy described in his new book
CBC Radio interviews Cell Director on Healthy Living Vouchers (HVLs) to fight obesity
Cell Director Neil Seeman cited about healthy living vouchers on Yahoo News
Cell Director interviewed on healthy living vouchers idea to attack obesity-related chronic illness Interview begins at 32:30
DSM-Twitter: Are We Happy Or Sad Right Now? Using our real-time analysis of depression surveillance on Twitter, there were 417 tweets - within 15 miles of Toronto - expressing sadness (or what Twitter calls a "negative attitude") during 17 minutes on March 12 (from 1:06pm EST to 1:23pm EST). During the very same time frame, there were 1,500 tweets from Toronto showing happiness or a "positive attitude." This suggests that the ratio of happy comments to sad comments in the Toronto area was 3.6 to 1.
Defining Technology Down Nowadays the word "technology" is associated in our minds with massive capital, or "R&D". As such, people are scared of technology, while in the past they relished it.
Do you work in an Intrapreneurial Company? Take the 1-Minute Test Intrapreneurialism is the route to innovation inside organizations, and in healthcare organizations in particular. A culture of intrapreneurialism is what enables a graduate student scientist in a University lab, or a policy analyst in a government department, to launch a magical product or service to market.
E-Psychiatry: Using Web-Based Communications to Connect With Patients Improving access and quality of care for patients suffering from mental illness
Fired for Performance! Lessons from the Medvedev Management Model Medvedev's reaction offers a case study on how things can go awry when evaluating performance data. Especially in an era of scarce resources, one should set return-on-investment metrics, not simple targets like medal counts.
Forthcoming book by Cell Director Neil Seeman and Adjunct Fellow Patrick Luciani featured in Globe and Mail special on obesity
From ehealth to mhealth: Celebrating the mobile phone at 5 billion This just in: The number of mobile phones in use worldwide has exceeded five billion due to unyielding demand in India and China, Ericsson has shown in a new study. I’m not talking about Smart Phones (i.e., iPhones or Blackberries). I’m talking about basic cell phones. In many countries, such as India, cell phone penetration is highest in rural, poorer regions. In South Africa, cell phone penetration is virtually 100%, allowing healthcare workers to dish out SMS text instructions to millions who are suffering from one of the largest HIV/AIDS epidemics in the world. So: The next time a vendor proposes any tool to improve healthcare, ask her about its applicability for the mobile phone. If she does not have an ‘mhealth’ application, ask why.
Funding IVF in Quebec: Mining the Web to Assess Public Support for Policy Change On March 12, 2010, Quebec's Minister of Health and Social Services announced that the province would be the first jurisdiction in North America to cover the costs of in vitro fertilization (IVF) treatment. Judging by the increase in Internet discussion of the topic, Quebec's decision has heightened the public discourse on allocation of taxpayer dollars. At this time, two million Quebecers are without a regular doctor. This study measured online public opinion before and after the Minister's announcement, using "sentiment analysis." This involves mining open-access content on blogs, online commentary and message boards. No individual identifiers were captured.
Haiti vs. Avatar - and Behavioral Economics 2.0 A micro-campaign on the Web, or behavioral economics 2.0, can present mutually exclusive options that serve as effective messages in healthcare. When opportunity costs are described crisply, people act upon them. They lose what economists call their 'present-focus'.
Handoffs and Fumbles Just as recent academic literature identifies rising concerns about handoffs, so too do patients. Examining the physician rating site,, patients show agitation over the stress of nursing and physician shifts. Patients, especially women giving birth, spend time coordinating their hospital encounters to ensure that their physician of choice is on duty throughout the course of their stay.
Happiness Rising In an eye-popping study published in the Proceedings of the National Academy of Sciences, Arthur Stone and colleagues interviewed over 340,000 people in the United States by telephone to ask about how happy they were. The survey asked each person to rank overall life satisfaction on a 10-point scale and to answer six yes-or-no questions about enjoyment, happiness, stress, worry, anger, and sadness.
HealthCamp Toronto 2009 The Innovation Cell teamed with IBM and organized the first HealthCamp held in Canada. HealthCamp is a global movement pushing change in healthcare to engage participants in meaningful conversations about healthcare innovation. HealthCamp Toronto followed the format of 'unconferences' -- a participant-driven conference centered around improving the patient experience. Impact Achieved More than 100 global “Web influencers” (including patients, providers, policy makers, journalists) from different countries, with different training, and from different ethnocultural backgrounds met face to face, and many more followed the conversation online (via Twitter™).
Healthcare Innovation: An Authenticity Lesson from Barbie dolls “The losers now will be later to win ‘cause the times they are a-changin’.” Bob Dylan could have been singing about healthcare innovation – and girls’ dolls. Beauty queens fade quickly and the late bloomers bloom beautifully. What I call the Barbie dolls of innovation are organizations sun-tanning lazily while deaf to the crashing waves of change. Consider: Did Mattel see or hear the sensational Liv dolls coming? In a recent interview with Fast Company, Nicole Perez of Toronto-based Spin Master Toys described the strategy for their popular Liv dolls: “The dolls needed to be pretty because they’re dolls and that’s what girls want, but we also wanted to make the dolls approachable and real.” Spin Master launched, where girls can register their Liv dolls, play dress-up with virtual clothes, play games, read online diaries, and watch Web videos. The take-home lesson from the doll wars: Authenticity pays. It’s not possible to ginny up authenticity out of thin air: i.e., you create a brand strategy, a social media presence – and, suddenly, you are an exemplar of sincerity. As Idris Mootee has written: “... Stop Botoxing your companies, start changing the core of the organization and start ‘doing’ what is responsible for shareholders, societies and the environment.”
Healthcare Innovation: Extreme Affordability The Stanford Institute for Design (which likes to be called the ‘’) observes that vendors have historically been making products that serve “a tiny fraction of the world’s population”. It's not a bad business calculus when the top 5% hold over half of the world's wealth, but the imagines products that cater to the remaining 95%; and so the concept of American affordability needs to get a little more ‘extreme’ if it's going to apply itself to a global market.
Healthcare’s Unwinnable War against ‘Screen Time’ To many in the healthcare community, allowing young children and teens too much ‘screen time’ is a grievous parental offence. Pity that. Many of the greatest inventions of the last decade – and some of the most dramatic modern pro-democracy campaigns – have come our way thanks to teenagers and 20-somethings sitting for hours a day in front of their screens and tapping on keyboards. If young people had been restrained from screen time exposure, Facebook wouldn’t exist (now worth an estimated $30 billion dollars); tens of millions of dollars wouldn’t have been raised for Haiti Hurricane relief via Twitter; the democracy movements in Iran and China would have never accelerated; and Barack Obama wouldn’t be in the White House.
How China's Threat to Internet Freedom Affects your Health The fate of Google's China policy therefore affects the world's health. Access to less filtered information through Google's PageRank algorithm allows Chinese Internet users to know which research institutes or media or health agencies or public officials to trust. NB: This editorial was reprinted (a version thereof) in the National Post.
How Do You Say Health in Inuktitut? Inuktitut, in its use of metaphor and its capacity to stitch together ideas to form word sentences, can bind people of different heritage and origin. Inuktitut is an ideal voice to use in healthcare settings. It is omayok ("alive"). It is a living language whose very essence is to link one person to another.
I Still Don't Understand What You Do Online conversations on the Web - three billion minutes are spent on social networks every day - reveal that the professional identity class is losing its allure. On Linkedin(tm), the professional social networking site, job-seeking healthcare workers describe themselves no longer by stale professional titles, but in imaginative alliterations - as in, "I dissect diabetes one day at a time".
India on My Mind The Indian healthcare economy is pivoting thanks to money, brainpower and raw ingenuity. The poorest regions of India are leading this bottom-up revolution; they have the most to gain.
Innovation Cell is formed in February 2009 as an independent healthcare innovation think/do-tank Please read more about us at
Inside the Health Blogsphere: Quality, Governance and the New Innovation Leaders Research has shown that "Health 2.0" - that is, user-generated health information often featuring blogging (i.e., self-publishing) or collaborative editing tools known as wikis - is increasingly popular among health professionals, chronic disease sufferers and the general public (Giustini 2007; Seeman 2008). However, concerns persist over the alleged inaccuracy, bias and poor governance of self-published health websites, or blogs, where an author's entries are usually placed in chronological order, much like a diary (Wikipedia 2008a). Prominent members of the lay media have voiced criticisms of blogs. For example, one leading Canadian journalist recently noted in The Globe and Mail that "reporters who are trained and paid to do the often dry work of gathering facts and interviewing people ... provide the news stories, and the news sites gather them up and the bloggers comment on them" (Smith 2008, April 3). This statement implies that reporters are more skilled, credentialed and objective; bloggers, it suggests, are mere commentators. In the context of health information, however, the research presented concludes that health blogs are positive tools that create meaningful, informed news and exchange for consumers and health professionals - at a level that exceeds the quality of popular newspapers. Expert health bloggers, that is, credentialed editors with subject matter expertise (subject matter experts, or SMEs), influence the course of opinion within professional and chronic illness communities rapidly and, as such, are innovation leaders.
Interns Over 40 for Healthcare When former United States President Bill Clinton admitted to having an “improper relationship” with Monica Lewinsky, I learned more than I needed to know about the appropriate duties of an intern. Around the same time, Canada had its own intern scandal: internships at Canadian companies, government agencies and nonprofits were scarce, and the idea of apprentice labor (unpaid or low-paid and stipend-based) was considered unusual corporate practice. Low-paid or unpaid internships for current University students and new grads are a launch pad to a paid, full-time position in a chosen career.
Interprofessional Collaboration Revisited Do people who have no professional titles – many patients may fall in this group – feel sidelined by the enthusiasm for ‘inter-professional collaboration’? What happens if you’re not a ‘professional’? Or what happens if you are a ‘professional’, or were trained as one once, but you’re now ‘just a patient’, or a caregiver, or a retiree, or you’re at home with the children, or you’re unemployed?
Introducing myhospitalidea partership project with the Ontario Hospital Assocation The Ontario Hospital Association (OHA) and the Health Strategy Innovation Cell are pleased to present an interactive webcast on October 20 showcasing the roll-out of In the spirit of the Excellent Care for All Act, 2010, will harness the power of the public’s ideas to continuously improve hospital quality. will track what the public believes are the most exciting hospital “ideas in action” – real implementations in Canada and around the world that are gaining attention for their merit and growing success as measured by web analytics. When is released, it will be a social forum to invite new, low-cost ideas from the public – and a place to celebrate the most exciting hospital ideas that have been implemented in hospitals in Canada and around the world to improve quality of care. Join this webcast to learn about the opportunities for a select group of OHA member hospitals to help steer the evolution of The webcast will explain the process of joining the Collaboration Council, the criteria for Council selection, and timelines and obligations of Council hospitals. The webcast will explain how leverages trends in social media and collaborative open innovation. An example of collaborative health care innovation is the Innovation Cell’s leading patient-led idea generation platform: The Innovation Cell, a not-for-profit think tank at Massey College, specializes in building collaborative innovation tools and capturing and analyzing real-time health information from the web.
Launching The Global Accelerator Award The Global Accelerator Award™, based on an Innovation Cell methodology to capture patient (and wider public) opinion. The Cell's methodology analyzes which organizations or people have put an idea or strategy into action that has generated significant and recent positive “buzz” or “chatter” on the World Wide Web – notably, on patient-led blogs and social networking sites. Impact Achieved The Award, the first of its kind in the world, has recognized 19 organizations or people globally
Listening to Jared Loughner When faced with danger, and Jared Loughner represented danger, the natural human reaction is to either fight or flee. Fighting would have meant wrestling him to the ground when he was obstreperous at Pima Community College and dragging him kicking and screaming to the nearest mental health facility. Many prominent commentators say the College administrators who dismissed Jared Loughner last spring should have brought him to the attention of mental health authorities. Would this have averted the tragedy in Tuscon? Likely not.
Making sense of online patient conversations Neil Seeman discusses how the MOHLTC can capture new voices for strategic planning at the "Lunch and Learn" put on by the Chronic Disease Prevention Management Portfolio and MOHLTC.
Move If U Wanna: Obama and the weight loss nudge
My Rage against the Machine (and what Healthcare can Learn from Steve Jobs) Healthcare’s technical complexity – and stress levels – could benefit a great deal from mimicking Mr. Jobs’s composure. Steve Jobs sells simplicity – even when he experiences a glitch at product launch. So enamoured are we with the power of Apple that we give him the benefit of the doubt. When we reach a point in healthcare IT when product launch snafus are tolerated, we will have succeeded. At that point, we will have reached a stage where we accept imperfection – when the promise of healthcare IT far overshadows its defects. We are not there yet.
Neil Seeman speaks about healthcare innovation to the Canada-India Business Council Neil Seeman speaks to the Canada-India Business Council at "The Future of Innovation".
Neil Seeman: It’s time for the government to pay us to stay healthy
OHA Accountability and Transparency in the Healthcare Sector Listening 2.0: Understanding patient needs and how healthcare organizations can be more accountable and transparent using social media
Ontario Hospital Association and Innovation Cell Partner on In the spirit of the Excellent Care for All Act, 2010, will harness the power of the public’s ideas to improve hospital quality. is a collaborative project between the Health Strategy Innovation Cell and OHA that will dynamically track what the public believes are the most exciting hospital “ideas in action” – real implementations in Canada and around the world that are gaining attention for their merit and growing success as measured by Web analytics. will be a social forum to invite new, low-cost ideas from the public to improve the quality of care. Upon release of, it will be a place to celebrate the most exciting hospital 'ideas in action’ that have been implemented in Canada and around the world
Participatory storytelling online - Innovation Cell publishes new research showing the power of participatory storytelling online Measuring patient satisfaction is an important quality improvement technique. The World Wide Web offers new approaches to understanding patient satisfaction and stories about healthcare encounters. In this paper, we suggest that there is a wealth of patients' stories being told online, in real-time, on social networking and on social rating Web sites. This patient-generated, publicly available information can complement existing patient satisfaction data and can provide insights into patients' values, perspectives and expectations - and can suggest ways to improve the patient's experience along the continuum of care.
Patient led innovation and the speed of change OHA Annual Healthcare Leadership Summit: How healthcare organizations can be more accountable and transparent using social media
Peter Drucker at 100: Wish you were here On blogs and youth-oriented social networks, one of the most commonly associated words connected to recent Wall Street scandals is, simply, "greed". Within days of the insider-trading allegations against Galleon Group, the investors had fled, and the once elite hedge fund slid into liquidation. When the public detects greed or malfeasance, bottom-up blogstorms are highly critical. Similarly in healthcare, the trust that patients and communities invest in any not-for-profit institution can quickly dissolve when there is a want of transparency.
Press Release: Canada Recruits 700,000 Great Minds, Invests $2 billion in Innovation Overseas The federal government today (May 25, 2020) announced the latest annual influx of 700,000 new Canadians from around the world to spur game-changing innovation, creativity and jobs. Most are thrilled to start their own business, with access to new capital and the most diverse workforce anywhere. Canada’s reputation for being an immigrant’s dream shines. Canada is a place where you do not need a fancy University degree in order to build and thrive. “Due to an aging population, it is not surprising that many of these new immigrant entrepreneurs are focusing on the healthcare market,” said Harvard drop-out and multi-billionaire Mark Zuckerberg, 33, who last year moved Facebook’s head office to Ottawa, a city now ranked by Wikipedia as among the most ethnically diverse cities in the world. “While other countries are still boasting about focusing all of their innovation efforts on recruiting superstar academics in niche fields, Canada gets it: innovation is driven by opening more doors to more immigrants.”
Privacy Has Lost its Cool Factor Web 2.0 means social collaboration on the Web. Most "health 2.0" enthusiasts embrace "publicness." "Publicness" is the new ethic of transparency in all things. Social networking sites such as Facebook, Linkedin, analysis Twitter and MySpace trade off people's growing willingness to disclose details about their personal lives, accomplishments...and their failures. Twitter, the fastest-growing Web phenomenon, is completely open source. Every entry is searchable on Google.
Sarah Palin is (Half) Right about Obesity Policy Obesity prevention was a major part of President Obama’s vision during his election campaign: “Childhood obesity is nearly epidemic, particularly among minority populations, and school systems can play an important role in tackling this issue.” On this observation, most politicians agree. But there is a line beyond which a conservative-minded, limited-government philosophy will not cross. Mrs. Palin paid homage to this sentiment – with protestations against a “nanny state gone amok” – in her recent criticism of the First Lady’s “Let’s Move” initiative, which aims to spur children toward healthier eating and living.
Stopping out of School and Work: Innovation leave One disruptive innovation idea and a new set of data surfaced recently. The idea comes courtesy of Peter Thiel, one of the most influential people in Silicon Valley. Thiel has launched a new initiative to pay promising young people $100,000 grants to “stop out” of high-school and start their own companies. Wow. The new data set comes from the US Bureau of Labor Statistics: contrary to popular myth, Gen X and Yers have just as much job loyalty as job-switching baby boomers. When they were 18 to 44, the Late Boomers, it turns out, had an average of 11 employers, or a job change every 2.4 years. Mr. Thiel will offer grants of up to $100,000 for kids to drop out of school. In an offhand remark during an earnest description of the initiative in a Techcrunch interview, the contrarian Mr. Thiel – co-Founder of Paypal and seed investor in Facebook – called it “stopping out of school.”
The Best-Dressed Doctors: No Ties, No Diamond Rings On social networks and blogs, patients and family members routinely express confusion about the role and identification of caregivers whom they encounter when in hospital. Many posts on the popular doctor rating site,, reflect this.
The Change Foundation and the Innovation Cell partner to probe how Social Media can improve patient care "A new quality improvement lens: making sense of online patient conversations in social media to deliver on the promise of patient focused care" is a partnership collaboration between the Health Strategy Innovation Cell and The Change Foundation. The project spans across 12 months and is working with healthcare provider organizations to use online patient dialogue to improve quality. The project consists of 3 phases: * Phase 1: Scanning the horizon – the Innovation Cell, in cooperation with partner organizations will conducting a scan of leading practices using online dialogue and engagement to improve quality in healthcare and other sectors. From this scan retrospective case studies will be extracted and should outline challenges, opportunities and legal considerations of using online patient dialogue information. * Phase 2: Development of case studies – the Innovation cell will work closely with partner organizations to develop and test emerging best practice guidelines on enhancing quality improvement and patient-centred care using social media tools. * Phase 3: Wrap up – Learnings from the scan and case studies will inform the development of an e-Tool kit to share insights and lessons learned from real-time patient and caregiver stories.
The DSM is now Public What is happening at the Website is groundbreaking in the history of clinical evidence: all of us may now have a say in the definition of what constitutes mental illness. As a case study in patient-led change, this symbolizes a critical shift for the culture of psychiatry - and may have ricochet effects across all areas of evidence-based medicine.
The Danger of Safe Ideas A dangerous idea is one that turns status quo thinking on its head. Consider, for example, a gear-shift in cultural norms such that the privacy of health records is irrelevant to the vast majority of citizens; or that the political inevitability of mass immigration (say, quintupling the annual number of immigrants) eliminates the human resource challenge in healthcare and solves the spiraling costs of caregiver burden in this country.
The Electronic Educational Record: Lessons from Healthcare It is fashionable in popular management books to point out that healthcare is a 'laggard industry,' a late adopter in trends like social media or client service excellence. But there's one area in which healthcare has led many other fields (notably education), and that is in the area of electronic health records (EHRs). I'm speaking here of healthcare's leadership in documenting the strategic benefits of a shareable, living electronic record of personal data that can be used to reduce error and improve the client experience.
The End of Healthcare Consultese? When talking about their real healthcare experiences using online networks, people describe themselves as "patients" about five times more frequently than as "consumers"; and people call themselves "consumers" about seven times as much as they call themselves "clients". Most of the objections to the word "patient" seem to come from academics who decry the supposed paternalism associated with the word; or from those who prefer "consumer" on principle - they object to the "medical model" of health. My interpretation: Regular people overwhelmingly prefer "patient".
The Great Grandparenthood Boom, Predictive Irrationality and the Future of Caregiving Will you be a great grandparent? How would you change your behavior if, at age 30, you knew you would live to age 105? In many cultures grandparents take on a primary role in caring for children, providing stability, predictability, and wisdom. They are surrogate parents, keepers of family ties, transmitters of culture. Many grandparents are responsible for raising at least one grandchild. And some are also great grandparents. That is why the discovery of new gene variants that can tell us how long we’ll live is so important. It is important for the future of our great grandchildren.
The Greatest Checklist In The Checklist Manifesto, Atul Gawande’s panorama of complex decision-making in modern medicine, he showcases the power of the checklist to save lives. Checklists fight the fallibility of human memory, even among the best-trained clinicians. Few people call checklists ‘innovations’ – since they sound humdrum. Prominent examples include the routine recording of vital signs in patient charts, or a checklist in the Operating Room asking things like: Do we have the right patient? The correct side of the body planned for surgery? The right antibiotics administered?
The Innovator’s New Dilemma I know a fledgling healthcare innovator; let’s call him Prof. X. Before the World Wide Web gained force as a collaborative tool, Prof. X had co-founded companies and, more important, also had more than a few duds to his name. More recently, Prof. X created one patent-pending idea by himself, published on it, and the idea has spun off into a (small) company with a tiny team he trusts. With this software invention, he hopes to re-invent a multi-billion-dollar industry for 1,000 times better value than what the market leader can deliver, and at a fraction of the cost.
The Latest Developments in Privacy Protection in an eHealth Environment Presentation at the Canadian Bar Association's Annual Health and Privacy Law Conference.
The Myth of the Natural CEO In an analysis of 1,128 mini-essay responses to reader-identified selections of "natural leaders," here were the most familiar answers: Warren Buffet (Berkshire Hathaway), Bill Gates (Microsoft), Lou Gerstner (IBM), Jeff Bezos (Amazon), Michael Dell (Dell) and Steve Jobs (Apple). No hospital or healthcare names made the public's list. This suggests that what the public at large considers great leadership is highly skewed: in favour of male, private sector CEOs, and biased toward the technology and finance sectors.
The Spinoff (Part 2) – Anti-Innovation Awards I’m at cocktail hour for an ‘innovation reception’ of researchers and entrepreneur types trying to seduce venture capitalists. Or so I thought. As I mingled, I saw two solitudes: entrepreneurs (thin and tired) and VCs (well-fed and in suits, huddling by the bar, laughing boisterously). The first entrepreneur I met was a woman from Russia (in Canada nine months). Her English was poor. Above the cocktail din, she tried to explain to me what her company did. All I really understood was that she had a doctorate: The letters, PhD, were italicized and elevated on her business card. After twice struggling to convey what product she was trying to launch, she told me to “just look at her website.” (I did so, the next day, and got a ‘500 error’, telling me the site was broken).
The Spinoff (Part 3): Does Faculty Tenure Harm Commercialization? Tenure is supposed to ring-fence the right to academic freedom, helping tenured professors to challenge the status quo without reprisal. It has been my observation that people who challenge the status quo are those who possess a rare combination of courage and humility; no job can guarantee that. Whatever its original goal, tenure is a quaint economic anachronism, wholly unsustainable in the Great Stagnation. The rafters are falling on post-secondary education in the G20: money is scarce. Health spending as a proportion of gross domestic product is biting more and more out of public education; it is also constricting the ability to pay out-of-pocket for much of private education. As parents increasingly seek value-for-money for their children’s post-secondary education, they will opt for schools like the tenure-free Franklin W. Olin College of Engineering in Needham, Massachusetts. Just a decade old, the engineering school – where each admitted student receives a scholarship that pays for half tuition -- is highly ranked (8th in undergraduate engineering by U.S. News and World Report). Teachers and curricula get evaluated constantly by students and alumni. A culture of entrepreneurship thrives. During senior year, students work with a local company as consultants on real engineering projects.
The Spinoff (Part 4): No, Virginia, We Don’t Need More Innovation Conferences Suppose we stop spending time talking – and talking – about innovation. It is a waste of scarce funds. Entrepreneurs find these conferences absurd. Innovation conferencing is fashionable among academics, management consultants, lawyers and media types, not among people inventing applications to change the world. I believe there is an inverse correlation between countries that hold a lot of conferences about innovation and countries where innovation is on fire.
The Spinoff: Part 1 (Problem Solvers) A new book I’m writing called The Spinoff aims to solve a puzzle: how do you spin out global commercial health ventures from Universities, hospitals and think tanks? I’m interested in the habits of researcher entrepreneurs whose low-cost inventions have dramatically improved global health. To me they are like journeymen boxers who win after 12 rounds – despite punch after punch after punch: legal gobbledygook; academic jealousies; venture capitalists who challenge them on their grasp of ‘unit economics’; institutional administrators whose default answer is ‘no’; and the chorus of critics who think the slightest commercial gain from research is akin to rotting landfill.
Towards a New Model of Healthcare Awards Improving patient engagement in decisions about relevant healthcare information
Toyota and Sumo: A Tale of Two Apologies Quality executives and quality committees of boards of directors - in hospitals, in car companies, in any company - do not own accountability for quality. The CEO is like the grand champion of sumo. He or she symbolizes quality for the enterprise.
Two Seconds for Mental Health It takes two seconds to say "thank you" to someone - in an email or a tweet on Twitter(tm). Expressing gratitude and empathy, the opposite of what some of the 40+ crowd put down to the pomposity of youth, are the twin attributes of Twitter(tm) - the mega-popular micro-blogging tool that lets people write 140 character messages to the world. [Note: This editorial was reprinted in 12 newspapers across Canada via the Canwest News Chain]
US Health Reform and the Opportunity Cost of Rhetoric In life and in public policy and management, there is a real cost to maintaining one's policy convictions as if they are forever righteous and true. There is a dollar cost to showing your constituents that you will go to the wall for Mr. Obama's health reform, or, alternately, that you will go to the wall to fight any and all of his reform endeavors.
Understanding patient needs in the second generation of the Internet Neil Seeman explains how providers can use patient narratives for ethically responsible medical advances at the Massey Grand Rounds Symposium on Responsible Use of Advanced Technologies in Medicine.
Using patient data to fuel innovation Presentation at the India Consul General Meeting
Wall Street Journal cites Neil Seeman and Patrick Luciani's new book in effort to encourage free market solutions for obesity
We are not bowling Alone Reducing the burden of care on unpaid caregivers
What Detroit can Teach Canadian Healthcare Historically, healthcare organizations have run stakeholder engagement exercises, satisfaction surveys, consultations, whistle-blower and ombudsman programs. These mechanisms seldom sustain a dialogue with consumers to nurture innovation. To ensure that real-time corporate governance supports effective leadership strategy, ideas that bubble up from the public could be systematically linked to the Board's vision. Every idea could be mapped to a defined Board goal, such as reducing staff turnover, or improving brand loyalty. Technology will soon enable this better.
What Elinor Ostrom can Teach Healthcare Economist David Henderson has described Ms. Ostrom's Nobel as a victory for "practical economics" as opposed to abstract formulas. Public reaction to her award, as measured by sentiment analysis on Twitter(tm), the social network, has been highly positive.
Who Will Be My Friends? The same rules of friendship should apply online and off. The spirit, if not the letter, of most professional ethical codes would suggest that "friending" a patient or client on Facebook(tm) is inappropriate. It is inappropriate since it can invite miscommunication, disappointment and expectations of favouritism.
Why e-books are good for your health Nostalgic for the good old days of curling up to reading Proust by the fireplace, the “sky-is-falling” opposition to the meteoric rise of e-books is in retreat. As we saw with the quaint devotees of the typewriter, the print newspaper and the landline telephone, there is, it seems, a grudging acceptance among the Chicken Little crowd that the days of physical bookstores are numbered. There are innumerable arguments on all sides of the e-book issue, and I will not debate their full merits here; like all new technologies, some publishers and authors have embraced e-books, others have decried them. In this essay I want to make one observation only: the rise of e-books is good for personal health.
You Changed My Life Small, subtle, low-cost healthcare interventions - a thank-you note; consistent expressions of kindness; discussions about common interests, in other words, connecting - matter greatly to people's health and expectations of care.
“Is Depression a Disease”? An Open Letter to the Editor of the Globe and Mail On the occasion of Father’s Day, I took the opportunity to ask my father, Philip Seeman, about his impressions of an article on depression in the Globe and Mail (June 18) by columnist and feature writer Leah McClaren. Ms. McLaren posed the question: “Is depression a disease?” As of the time of writing, there were 118 online comments concerning Ms. McLaren’s article. She had interviewed psychotherapist and writer Gary Greenberg, author of Manufacturing Depression, which, she writes, “debunks the prevailing notion that depression is a disease and anti-depressants the long-awaited cure.” The print edition of the newspaper published one critical letter. Ms. McLaren’s article contained no Web links to research on depression by Dr. Greenberg; this research is hard to find.
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