Upcoming Conferences: International Medicine and Medicine 2.0

•17 March 2008 • 2 Comments
Wonderful news! Two of my favorite topics and explorations, International Medicine and Medicine 2.0 are currently accepting registrations for their respective conferences.
 
On May 30th to 31st 2008, the Institute for International Medicine would be hosting the 3rd Exploring Medical Missions Conference at the University Center on the Main Campus of the University of Missouri-Kansas City, Kansas City, MO.
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Most health professionals contemplate international service and are inspired by the prospects. Yet few are confident about where to begin.

 
Medical missions are closest to the heart for me, be it rural areas or urban neighborhoods. The human experience is just invaluable. The strength and insight one can gain from various medical missions experiences will be truly the most treasured learnings in the practice of medicine. This endeavor addresses many dimensions of our lives—personal, the society that we see and observe, the people we visit with—those we touch, those who touch us, those we work with, and many many others whom we are blessed to meet along the way.
On September 4th till 5th 2008, the Journal of Medical Internet Research, the International Medical Informatics Association, the Centre for Global eHealth Innovation, CHIRAD, and other organizations will be sponsoring the Medicine 2.0 Conference: Web 2.0 in Health and Medicine at the MaRs Center in Toronto, Ontario in Canada.
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For those who are curious or currently exploring and enjoying the possibilities of Medicine 2.0, this conference is going to be very interesting, if not exciting.

Who should attend?

    * Academics (health professionals, social scientists, computer scientists, engineers)

    * Software and Web 2.0 application developers

    * Consultants, vendors, venture capitalists, business leaders, CIOs

    * End-users (health professionals, consumers, payors)

 You may go to the above websites for more conference details.

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Media in Medicine: Bertalan Mesko’s Scienceroll and More Medicine 2.0, an Interview

•10 March 2008 • 3 Comments

I am very excited as I type this. I will be deferring the supposed post for today, Media In Medicine: Sprinkle Some Imagination, for later. Alternately in some of the days to come, I will be posting about some interesting proponents of media in medicine. I have written about them here at some point. This time, I will be trying to interview some of them via e. Ah, happy day!

In May of 2007, I wrote a post about Medicine 2.0. It dealt with my own exploration and understanding of the interesting place of medical and health care professionals, medical students, academics, researchers, medical leaders and learners, and patients along the arteries and veins of Web 2.0. I then proceeded with exploring further focusing more on its soul—media (focusing on the gifts of the new media) than its intimidating surname—2.0. However, I do not dislike the geeky appeal of the numeric assignment. It has a been a wonderful ride since—one of very open learning avenues and exchanging thoughts with so many interesting folks behind the writings and blogs. I am delighted to have expressed my humble voice this way about a discipline that is a lifetime endeavor. Though 2.0 is just one amongst its expansive collaterals, I speak and write proudly and with ever more curiosity about this revolutionary means of communicating and sharing medical knowledge.

Please welcome, one of my favorite reads on the medical web, Bertalan Mesko. mesko.jpgHe is a medical student at the University of Debrecen in Hungary. He is one of the active proponents in educating the rest of us about the endless possibilities of Medicine 2.0 among many other interesting things that he shares about in his blog, Scienceroll. Recently, he travelled from Debrecen to Los Angeles, New Haven, and New York and gave a presentation in a conference called Medicine Meets Virtual Reality and another one at Yale University. I am honored to share about this interview here today.

1. How did you get started with your takes on Web 2.0 in Medicine?

In January, 2007, I came across the online presentation of Vesselin Dimov who is a physician in Cleveland. I think he is the first person to write about this subject on his blog in the blogosphere and that presentation opened my mind. I knew these tools, services and websites provided by the realm of web 2.0 could change the way medicine is practised, so I started to write about this special field of medicine and launched a blog carnival under the name of Medicine 2.0 later in 2007.

med320.jpg2. Who coined the term Medicine 2.0? Do you consider yourself one of its pioneers?

I have no idea who used this term for the first time. Anyway, it’s a hard question. I consider myself as a member of the „second generation”, because it wouldn’t be fair to call myself a pioneer. If someone has mentors, he obviously cannot be a pioneer and I do have mentors like Ves Dimov, Attila Csordas, Scott Shreeve and Bob Coffield.

3. You recently presented at the Medicine Meets Virtual Reality Conference, would you care to share that experience from a professional, cultural, and general standpoint?

Wow, it should be quite a long answer. From a professional standpoint, it was good to see physicians and scientists are really open to these new opportunities of web 2.0. They tend to create a new form of medical practises (e.g. Jay Parkinson), they know how much these tools can ease their own job. And that’s why they liked my presentation and the live Second Life simulation. From a cultural standpoint, that is a different world. The system of health care or medical education is totally different from ours. Your medical education is based more on clinical practise. And generally, the main difference, according to my experience, between the USA and our region is that if you have new ideas, you can go further more easily than your competitors.

4. How was the Yale University presentation experience? Can you share with us a sample question raised by your audience there?

I’m humbled to spend some days around Yale and to give a presentation at the School of Medicine of Yale was probably the best thing I’ve ever done. Sometimes everything works. I think I gave my best slideshow ever at Yale. The questions raised by the audience were focused on search engines. A major concern of the residents was that it’s quite hard to find relevant and useful information in Pubmed in seconds. And when they have a patient and have to make a decision fast, they need to have a great tool with which they can get the right information in time because getting tens of thousands of results after making a search for a medical condition cannot be efficient. That’s why we’re currently working on a personalized medical search engine for medical professionals which I will present soon on Scienceroll.

5. What difficult issues (if any) have you encountered in developing your Second Life in terms of sharing medical information?

The medical exercises organized in Second Life by the Ann Myers Medical Center will never be as realistic as real medical education. But educating or learning without geographical borders is just fantastic. I especially enjoyed learning from US physicians and discussing medical cases with Brazilian, German or English medical students. In this virtual world, we have all the tools to educate interactively (descriptions, animations, simulations anbd reliable websites). The only concern I still have is about credibility. We have to ensure all of the visitors that we’re real physicians and medical students. That’s why I will construct soon a page for listing our credentials and any kind of data regarding our professional life.

6. In your opinion, does SL have an imminent future as a tool or even a venue for medical education?

Second Life was centered around casinos and entertainment in the past. But as casinos were forbidden, we have now the space and opportunity to focus on education. I think the virtual world has an educational golden age nowadays. So yes, even if most of people think it has no future, I’m absolutely sure about it’s future role in medical education.

7. Do you have anything to say about the tide of social media (networking sites like within3, iMedix) in relation to medicine? Can you share a personal thought or two regarding the role of this new media (digital, web, internet) in medicine at present? And your thoughts about the future?

I’m pretty sure this new kind of media will play a major role in the future of medicine. With these community sites, not just the physician-physician interaction becomes easier (e.g. Sermo.com), but doctors can communicate with their patients in a more efficient way. It’s not about making a diagnosis on-line, but making contact faster with patients. I plan to work as a geneticist probably in a personalized genetic company and I hope I will not only be able to tell my patient about their own genetic background but to show them some reliable and useful resources where they could find even more information. Web can be the best friend of a physician if used in the right way for the right purpose.

8. What do you hope to achieve in the long run or advocate for with your work at Scienceroll?

It was only a blog with 20 readers, now it has more then 1500 readers a day. My aim is to become one of the most reliable resources of web 2.0 and medicine. I would like to present my slideshow at more and more conferences to show physicians this new world of web. That’s why I have already given slideshows at several local clinics and departments and I took a journey to the US. I also would like to be a good genetic blogger to become a good geneticist. I have a more than normal passion for personalized genetics and I’m pretty sure my future will totally be dedicated to this field of medicine. So blogging or writing about web 2.0 and medicine is just my hobby.

10. How do you balance your time as a medical student and as a successful medical blogger?

First, I’m not a good sleeper, second I’m enthusiastic about my blog. I just love blogging and informing my readers about the most recent improvements of web 2.0 and medicine or genetics. I also like interacting people from around the world and getting many e-mails, suggestions and tips. Blogging can totally change your career. I feel lucky and try to encourage others to start their own blogs. So back to the question, during the day I’m a medical student and this is my top priority, of course. But during the night, I browse the net, organize my web projects, etc. Writing blog posts became one of the most important tasks in my daily routine.

Wonderful!

Here is his most recent slideshow presentation. In a few clicks, you will be provided with awareness and some brilliant synthesis of knowledge snippets from many roads, scattered points, nooks, and crannies.

[splashcast MPWF5381CE]

Thank you very much, Berci, for your time and generous attention to this interview. All the best in your endeavors!

Media in Medicine: Collaborative Aim and Reach of JovE, WorldVistA, PLoS Medicine

•27 February 2008 • Leave a Comment

Not a long time ago, open source advocates were pushing a little farther to forward and expand their cause. We have been witnesses and fortunate end-users to this web evolutionary development. From our street corners, we have observed a waterfall of resource and journal sites free of charge open shop like market day. As I started exploring Medicine 2.0, I blogged about 2 sources, WorldVista and PLoS Biology. Let me share more about them here again in a short while.

First, here is something close to the heart, an open journal site that presents experiments in video format. JoVE.

Journal of Visualized Experiments (JoVE) is a peer reviewed, open access, online journal devoted to the publication of biological research in a video format.

For a sample, view this experiment on “A Craniotomy Surgery Procedure for the Chronic Imaging of the Brainby clicking on the screen shot below. Have I mentioned that I love film? Woot! Have fun!

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Thanks, Gaurav Parikh for sharing this site.

WorldVistA is an open source, low cost software that handles electronic health records. It was originally created by the U.S. Department of Veterans Affairs for use in their hospitals and facilities. Now, the rest of the world can use it too.

WorldVistA’s mission is to improve healthcare worldwide by making medical information technology better and universally affordable.

WorldVistA seeks to help those who choose to adopt the VistA system to successfully master, install, and maintain the software for their own use. WorldVistA will strive to guide VistA adopters and programmers towards developing a community based on principles of open, collaborative, peer review software development and dissemination.

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Here are excerpts of Thomas Goetz article on the New York Times, “Physician, Upgrade Thyself,” when this software was first introduced to the public.

Health care providers have been dreaming about electronic records for so long that the idea has begun to seem like vaporware, a never-to-be-realized fantasy similar to flying cars and jetpacks. But there is already a clear software standard, an open-source system that’s low-cost, easy to use and readily available. It could be the key to the health care system we ought to have already.

Want to see the best knee surgeon in the country? If he’s using WorldVistA, he can check out your online records at his house or office. If you switch jobs and move to a new insurance plan, you won’t need to build a new medical history and FedEx old records around. With your permission, your files will be accessible to your new providers instantly. In this way, electronic medical records generate better care and lower costs.

WorldVistA isn’t perfect. It isn’t as customizable as some proprietary systems, and its graphical interface isn’t as intuitive or as polished. Worse, its back-office functions — staffing and billing — aren’t all that strong. Major hospitals and health maintenance organizations in search of a Cadillac are free to spend the dollars to buy one.

But for the vast majority of health care providers, WorldVistA is what they’ve been waiting for: a low-cost, simple-to-use system that makes it easier to provide quality health care.

I end today’s post with another personal favorite, PLoS Medicine or the Public Library of Science Medicine.

PLoS Medicine believes that medical research is an international public resource. The journal provides an open-access venue for important, peer-reviewed advances in all disciplines. With the ultimate aim of improving human health, we encourage research and comment that address the global burden of disease.

PLoS Medicine…is an open-access, peer-reviewed medical journal published monthly online by the Public Library of Science (PLoS), a nonprofit organization.

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Here is a message from the PLoS founders,”A Medical Journal for the Internet Age.”

The Internet is awash with medical information. Eight hundred million people have direct access to the Internet [1], and in the United States over 60% have searched for health or medical information on the Web [2]. Go to any search engine and type in the name of a disease or drug, and you will be directed to hundreds of sites, ranging from the sound and useful to the quackish and dangerous. Google “medical” and you get 85 million pages, “drug,” 40 million, and “health,” 230 million.

But something is conspicuously missing. The most reliable medical information on the Internet—the contents of peer-reviewed medical journals—is hidden from the public and most of the world’s physicians. Although most medical journals are available online, their publishers limit access to those who choose, and can afford, to pay for access. This should not, and need not, be so.

I agree!

Grand Rounds 4.22 is now up at Scienceroll!

•26 February 2008 • Leave a Comment

gr422.jpg For the general reader:

What are Grand Rounds?

…are a ritual of medical education, consisting of presenting the medical problems and treatment of a particular patient to an audience consisting of doctors, residents, and medical students. The patient is usually present for the presentation and may answer questions. Grand rounds have evolved considerably over the years, with most current sessions rarely having a patient present and being more akin to lectures.

In the medical blogosphere, the tradition of Grand Rounds continues. The virtual Grand Rounds were brilliantly founded by Nicholas Genes in 2004. This “weekly compilation of the best medical blogs” is “hosted by a different blogger each week.” The first Grand Rounds subsequently debuted at his medical blog, Blogborygmi.

Today, Grand Rounds Volume 4 No. 22 is up. This week’s showcase of the best of the medical blogosphere is hosted by Berci Mesko at Scienceroll. It wonderfully highlights The Future of Medicine!

The number of submissions, the learning value, and the diverse content are truly worth the while. It shows the many many interests and issues of medicine. Truly a ton of somethings for the curious or the voracious.

The Story of Healing’s post, Media In Medicine: More Than Mending The Broken, is featured as one of the editor’s choices.

Media in Medicine: The Big Guns Are On It

•25 February 2008 • 9 Comments

Before I share the main course for today, let me first touch base with the chosen labels for our endless babble involving technology’s role in potentially enhancing or carrying medicine and health care to the next better level—Media, Medicine 2.0 and Health 2.0. I initially have veered away from the latter term in my previous posts as I would like to apply my time more on Media (being mostly new media) and Medicine 2.0. These are more tangible to my focus at this point. I wanted to alleviate the great confusion these digital surnames bring us all. Though further on, I also realized that I too have to be educated on what these terms entail. The differences in detail between the two are also important. We could all learn something new everyday. That said, what is Medicine 2.0 and Health 2.0? Ms. Frankie Dolan, creator of MedWorm shares her understanding with us in her blog, Frankie Speaking Frankly.

…Health 2.0 is the application of Web 2.0 technologies in the area of health, whilst Medicine 2.0 is the use of Web 2.0 technologies in the area of medicine. Some examples can be seen in the Medical 2.0 Directory. I have come to think of Health 2.0 websites as being those that provide services geared towards the consumer, and Medicine 2.0 those geared towards services for the medical professional

Now that that is in place, on to our dish.

It seems like big web corporations such as Google, Microsoft and AOL are all on board the Health 2.0 caravan in pitching in their share of the possible solutions (or possible market share) in the seeming broad revamp, evolution, and even revolution of health care. This could begin an effective model in technologically advanced societies that have an electronic medical system of some sort in place or that are actively transitioning (or have transitioned) their medical records to e— such as the U.S. This could eventually spread across the globe.

Let us begin with Google. According to CNN,

Google Inc. will begin storing the medical records of a few thousand people as it tests a long-awaited health service that’s likely to raise more concerns about the volume of sensitive information entrusted to the Internet search leader.

The pilot project to be announced Thursday will involve 1,500 to 10,000 patients at the Cleveland Clinic who volunteered to an electronic transfer of their personal health records so they can be retrieved through Google’s new service, which won’t be open to the general public.

Each health profile, including information about prescriptions, allergies and medical histories, will be protected by a password that’s also required to use other Google services such as e-mail and personalized search tools.

Here is a screen shot cropped from the Liquidmatrix Security Digest.

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The original beta page itself has apparently been taken down. Google has not officially announced this new venture. This project, code named “Weaver” according to Mashable, is evidently made possible with the participation of the non-profit hospital, Cleveland Clinic, which by the way publishes medical e-books that are available free to download in some e-book sites such as Wowio. From the same article in CNN.com,

Contacted Wednesday, a Google spokesman declined to elaborate on its plans. The Associated Press learned about the pilot project from the Cleveland Clinic, a not-for-profit medical center founded 87 years ago.

From a technology and development standpoint, it is exciting. However, I have questions of my own regarding assurance of privacy. Communicating medical and health information on the web is helpful in many ways in streamlining the jungle we call health care. However, the world wide web containing detailed medical information about patients, about us, about you, raises the big security question. Currently, our records are stored in computers in hospital networks and clinic systems. HIPAA issues, anyone? Here is more from CNN,

But the health venture also will provide more fodder for privacy watchdogs who believe Google already knows too much about the interests and habits of its users as its computers log their search requests and store their e-mail discussions.

Prodded by the criticism, Google last year introduced a new system that purges people’s search records after 18 months. In a show of its privacy commitment, Google also successfully rebuffed the U.S. Justice Department’s demand to examine millions of its users’ search requests in a court battle two years ago.

The Mountain View, California-based company hasn’t specified a timetable for unveiling the health service, which has been the source of much speculation for the past two years. Marissa Mayer, the Google executive overseeing the health project, has previously said the service would debut in 2008.

Either way, this is something to look forward to. Hopefully the security bases are, in fact, securely covered.

The other 2 big leaguers who are having their own new hits are Microsoft and AOL.

Here is Microsoft’s Health Vault.

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According to Mashable,

HealthVault is a web-based personal health record tracking data such as blood pressure, cholesterol levels, surgical procedures, etc. Centralizing medical data for physician access alleviates problems in both personalized care and also insurance.

Microsoft does not expect a flood of users to immediately populate the site and is instead looking to existing healthcare institutions for help. Ideally patients will permit hospitals, doctors, and clinics to insert information into their HealthVault records. Early partners of HealthVault include the American Heart Association, Johnson & Johnson, the Mayo Clinic, and seven hospitals throughout the Baltimore-Washington metropolitan area.

Last but not the least for today is AOL’s Revolution Health and Health Talk.

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Here is a report from CNet News.

AOL co-founder Steve Case announced Wednesday his online health and wellness company, Revolution Health Group, has acquired HealthTalk, pushing his company into the ranks of the second-largest health information site on the Net.

HealthTalk will operate as a site within the Revolution Health Network, which includes CarePages.com and RevolutionHealth.com. The Revolution Network is also affiliated with drugstore.com and SparkPeople.com.

More and more examples add to our pages as we continue to explore the important role of media in medicine. The more we know about what is out there and which way we are heading, the more we empower ourselves to participate in our very own process and quality of health care as patients. Thus, we might improve our choices and strengthen our voices about what really matters to us in maintaining our health. As doctors, including other medical professionals, who are abreast with technology can also broaden our reach in terms of understanding, communicating, and ensuring the quality of care we are giving. The important bottom line, as we have emphasized again and again, is the need for effective communication among us all.

Media in Medicine: the Reality of the Digital Divide

•22 February 2008 • 3 Comments

Two quick reads to munch on tonight about the imbalance in the accessibility to health information created by economic disparities and lack of infrastructure, among other reasons, in developing countries.

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Allen Cheng of The Next Generation shares his point with us.

An established information infrastructure in the developed world has made accessing health information a facile task. In a span of minutes a patient may coddle his curiosity by self-diagnosing an illness, investigating the origin of the disease, reading on different treatment options, and checking the background of relevant doctors and hospitals, all tasks simplified by the wide availability of the internet. Recent medical information and research journals can be disseminated to doctors, describing current trends in disease or new treatment methods. Colleagues can consult each other across the country instantaneously, ensuring the best treatments for their patients. Electronic medical record systems allow seamless sharing of patient data among different clinics, documenting histories, drug regimens, referrals, and existing conditions. These capabilities save time and reduce mistakes.

In contrast, health workers in impoverished countries are starved of the relevant information typically accessible to their colleagues in other places. Hospitals in remote areas with virtually no roads, electricity, or basic communication means often have to function almost autonomously without access to medical information or colleague support. In turn, the hospitals are difficult to monitor, making assessment of healthcare standards difficult. While improving conditions in a developing country will eventually spill into its healthcare sector, a host of obstacles currently hinders physicians who desire the best for their patients.

Finish this important and insightful article here. Apparently, according to the same article, some solutions implemented have failed and may have wasted valuable resources in these countries. The above perspective was published just a couple of months ago.

We go back to an article about 7 years back by the Bristish Medical Journal similarly wailing on this seeming great divide.

Information and communication technologies have not been harnessed systematically to improve the health of populations in developing countries.

These technologies empower those who use information by providing them with a choice of information to be accessed in their own time and by allowing them to put their own information on the web.

The current digital divide is more dramatic than any other inequity in health or income .

The quality of health information available on the web is inconsistent, and the visibility of research from developing countries is limited.

The way forward is to exploit the full interactivity of the internet, which allows rapid feedback and change to continuously mould information into useful knowledge.

I may have a very simplistic notion of this problem. I do recognize the enormity and the complexity of these issues once in the field. But my take is this, start small. Perhaps if we aim to start implementing solutions at a more manageable and affordable level, with strong measures of sustainability and maintenance in place, we might just move a step forward. As with many solutions offered, many intents would be noble. But there is a difference between intents and carrying through. One way to ensure this is to see it in as many possible dimensions and angles as possible, looking closely or moving far from it, including even the simple intent and theory. And the working button for this might I suppose could mean in the same spirit, boldness, and starting cost as those of the green, small, and handy? 😉

Media in Medicine: I Love Film

•20 February 2008 • Leave a Comment

This New England Journal of Medicine article is another one worth sharing about the use of media in medicine. Today’s plate is film. This medium of communication is a personal favorite of mine. It is also my favorite learning tool.

It is not uncommon to use video as a medium to communicate medicine, to educate, to share knowledge, to present theories, report breakthroughs. Though most commonly, the point of view is that of the professional, student, or authority on health issues. But this time Dr. Gretchen Berland of the Yale University School of Medicine aptly rotated the camera sharing with all of us a stark portrait, “The View from the Other Side—Patients, Doctors, and the Power of a Camera.”

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As an internist, I was disturbed by the contrast between those two scenes, the second revealing the depth of Buckwalter’s concerns and fears, none of which were apparent during the conversation with his doctor. In the later tape, Buckwalter’s struggle is palpable. If such stark contrasts are common, how much do I really know about my own patients? Probably far less than I care to admit.

I learned that participants generally need more than a few days or weeks with a video camera to record their experiences adequately; the unfurling of one’s life requires time.

film is a medium conducive to exploring the smallest details that make up a life. These details are often overlooked, or missed, in clinical research conducted in more traditional ways. As nuances of a patient’s experience are compressed into standardized responses, statistical power is achieved, but depth is lost.

Perhaps a first-person perspective, recorded from the wheelchair, would reveal a world rarely seen by most nondisabled persons. Buckwalter had been the first to volunteer for the project, followed by Vicki Elman and Ernie Wallengren. All lived in the Los Angeles area and had heard about the project through the UCLA medical community. Buckwalter used a wheelchair as a result of a cervical spinal cord injury, Elman because of multiple sclerosis, and Wallengren because of amyotrophic lateral sclerosis.

You may click on the following screen captures, on the left to view the video and on the right to listen to the interviews done on Dr. Berland, the researcher and Dr. Buckwater, one of the volunteer participants in this study.

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This again is one other example of the use of media in medical advancement, an important one at that. Here it was used as a witness and reminder to be vigilant in improving the quality of patient care. It promotes awareness in many respects about the daily struggles, both inward and outward, of patients and people with disabilities having to deal with those who are supposed to help them and work with them but end up adding to their unrelieved suffering.

I love film.

Related—Media In Medicine: Dr. Stark, ZocDoc, iMedix

Media In Medicine: What of the Insurance Companies and Other Issues?

“How Web 2.0 is Changing Medicine”, an addendum

Media In Medicine: More Than Mending The Broken

2.0 in Medicine and Definitely Beyond

Upcoming—Media In Medicine: Sprinkle Some Imagination