Neil Seeman is Director of the Health Strategy Innovation Cell. He works to inspire new ideas to try to solve old health policy problems. He has authored over 800 essays, editorials, and journal articles. Neil is the co-author of four books, including Better Medicine: Reforming Canadian Health Care, Psyche in the Lab, and Psychosis: Discovery of the Antipsychotic Receptor. A founding editorial board member of the National Post, his new book is XXL: Obesity and the Limits of Shame (University of Toronto Press, March 1, 2011). His writing and research focus on patient-led change, policies to nudge commercial innovation in healthcare, healthcare governance, mental health policy and information transparency. His research publications have appeared in a wide variety of journals, including Healthcare Papers, the Journal of Affective Disorders, the Journal of Addiction and Mental Health, Policy Options, the Canadian Medical Association Journal, the Journal of Participatory Medicine, Healthcare Management Review, Healthcare Quarterly, and Electronic Healthcare. He is a regular contributor to national and international media and is a weekly essayist for Longwoods Publishing. His research and ideas have been cited in media around the world, including the Harvard Business Review, the Asian Wall Street Journal, the Economist, Business Week, Maclean's, the Sydney Morning Herald, the Washington Times, the CBC, the Toronto Star and the Globe and Mail. He has been a Research Associate for the Hospital Report Research Collaborative at the University of Toronto Medical Faculty, a Research Fellow for The Fraser Institute, a lawyer for non-profits, an advisor to global Web-based health technology companies, and a Research lead in 'health 2.0' at IBM, where he consulted to governments, health regions and hospitals around the world. He also teaches health services management and health law at Ryerson University. In a Cell collaboration with The Change Foundation, Neil is Primary Investigator of the "Using Online Dialogue to Drive Health-care Improvement Project". He is also part of a new collaborative research team studying patient engagement practices in Canada and around the world, funded by The Canadian Health Services Research Foundation, the Health Council of Canada and the Max Bell Foundation.
If you want to find out more, Google him or type in his name into the MIT Media Lab’s Personas project. A Senior Resident in health system innovation at Massey College, Neil holds degrees from Queen’s University (BA), the University of Toronto (JD) and Harvard University (MPH). He has been listed in the Canadian Who's Who (Univ. of Toronto Press) since 2002 for his contributions to public policy. He has co-founded several companies, including the Free Trade Medical Network Inc., Clera Inc., and the RIWI Corporation. Neil is a member of the Patients' Association of Canada and a new board member of the Canadian Obesity Network. He advises healthcare companies and non-profits around the world.
|"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, RateMDs.com(tm), 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 livworld.com, 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 ‘d.school’) 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 d.school 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. http://network.nationalpost.com/NP/blogs/fullcomment/archive/2010/03/19/neil-seeman-how-internet-freedom-in-china-affects-your-health.aspx|
|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 http://beta.innovationcell.com/wiki/About|
|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 myhospitalidea.com. In the spirit of the Excellent Care for All Act, 2010, myhospitalidea.com will harness the power of the public’s ideas to continuously improve hospital quality. myhospitalidea.com 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 myhospitalidea.com 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 myhospitalidea.com. 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 myhospitalidea.com 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: myhealthinnovation.com. 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 myhospitalidea.com||In the spirit of the Excellent Care for All Act, 2010, myhospitalidea.com will harness the power of the public’s ideas to improve hospital quality. myhospitalidea.com 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. myhospitalidea.com will be a social forum to invite new, low-cost ideas from the public to improve the quality of care. Upon release of myhospitalidea.com, 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.|
|… further results|