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.
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?
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.
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.
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.
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.
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.
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).
Social Media, Quality Improvement
"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.
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.
On Oct. 20, the OHA and the Innovation Cell will co-host a Webcast to describe how myhospitalidea.com leverages trends in Social Media and collaborative open innovation. The Webcast will also explain the process of joining a select group of OHA members to advise on its evolution, and provide the criteria for selection, timelines and obligations. An example of collaborative healthcare innovation is the Innovation Cell’s leading patient-led idea generation platform: myhealthinnovation.com. The Innovation Cell, a nonprofit think tank at Massey College, specializes in building collaborative innovation tools and capturing real-time health information from the Web.
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
Flu, Pandemic, Information surveillance, Real-time web
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.
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.”
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.
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.
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]
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.
“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.”
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.
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.
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.
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.
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.
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.
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?
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.
Unconference, Mental Health, HealthCamp, Crowdsourcing
MHCTO crystallized as an idea at the HealthCampTO organized by the Innovation Cell (http://www.socialtext.net/hctoronto/index.cgi?healthcamptoronto) in September 2009, after the inspiration of Canada’s inaugural MentalHealthCamp in Vancouver.
Semantic Web, Semantic, Media, Wiki
The Cell has migrated it's minimalistic one page website to a Semantic MediaWiki (SMW). SMW is a free extension of MediaWiki – the wiki-system powering Wikipedia – that helps to search, organise, tag, browse, evaluate, and share the wiki's content. While traditional wikis contain only text which computers can neither understand nor evaluate, SMW adds semantic annotations that let you easily publish Semantic Web content, and allow the wiki to function as a collaborative database. SMW's goal is to make Semantic Web technologies usable by the masses. The Innovation Cell's Semantic MediaWiki now joins over 500 public active wikis around the world, in addition to an unknown number of private wikis. Notable public wikis include the Metacafe wiki, SNPedia, Metavid, MetaBase, the Math Images Project, the Sunlight Foundation's OpenCongress wiki and Break.com's Chickipedia. Organizations that use SMW internally include Pfizer, Harvard Pilgrim Health Care, Johnson & Johnson Pharmaceutical Research and Development and the Metropolitan Museum of Art. SMW has especially gained traction in the health care domain for collaboratively creating bio-medical terminologies and ontologies. One example of SMW in healthcare is LexWiki which is jointly run by the Mayo Clinic, National Cancer Institute (NCI), World Health Organization (WHO) and Stanford University. Semantic MediaWiki is also supported on at least three wiki farm websites: Referata by default, as well as Wikia and YourWiki on user request.
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.”
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.
Listening 2.0: Understanding patient needs and how healthcare organizations can be more accountable and transparent using social media
Unconference, HealthCamp, Twitter
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™).
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.
OHA Annual Healthcare Leadership Summit: How healthcare organizations can be more accountable and transparent using social media
Presentation at the Canadian Bar Association's Annual Health and Privacy Law Conference.