The Creative Scientist

“Yelp” for Healthcare?

Recently I posted a link to Health Tap - A new interactive social network that aims to connect doctors to patients - or rather the general public waiting to become patients. 

Immediately this raised all sorts of red flags for me. As someone who is not directly working in the Healthcare industry but personally related to several critics in this domain, I could feel the negative response as soon as I read the words:

“HealthTap’s free web and mobile applications enable 24/7 access to personalized, relevant and trusted health information from thousands of leading doctors, helping people find the best care and make better decisions about their health and well-being.” 

Why the negative response?

1. Legal issues 
If medical advice is exchanged between a medical professional and person (non-relative or even close acquaintance), there is potential risk for legal ramification. Doctors in our country are trained to exchange medical information in the appropriate legal confines of a hospital or medical office - this way there is some face-to-face interaction between doctor and patient and there is legal documentation that exchange of advice took place.

2. Work load
Giving advice - especially if serious medical advice - is MORE work for doctors. Billing this type of work would create new kinds of havoc in the world of medical billing. Perhaps it is different across the border, but in Canada, doctors do not have extra time to even go online fishing for vulnerable people to divulge advice to.

3. More Legal Issues (and inter professional relations)
How does this affect the relationship between physicians? Does it promote collegiality or competition? Imagine a scenario where one doctor recommends another specialist online! In an online social forum like HealthTap, there is going to be an imbalance of responsibility (again touching on point 1). Physicians will be putting their careers on the line and patients will get to “take shots” at them anonymously.

4. Patient selection
Let’s be honest, doctors don’t want to attract all sorts of super-neurotic, annoying patients to their practice. The more active the physician is on HealthTap, the higher the chance of them being at the helm of these irrational and often sensationalistic attackers. 

So bearing in mind the opinion of a few doctors and my own instinct, there seems to be a lot of sensitive issues tied to HealthTap’s social network for healthcare.

The Positives

I do agree that the concept of a curated participatory healthcare online forum would be very helpful to all of us in the Dr. Google era, it is a very difficult model to maintain. Especially given the different policies on healthcare around the globe. While I did mention the negatives of HealthTap, it’s idealistic positive features include:

1. A way to build a reputation online among other doctors. 

2. A method of attracting new patients (keeping in mind the negatives). This is probably more suitable for the US folks.

3. Saves time for patients as they can access YOUR medical knowledge online. Note, this does not save YOU time as a physician and in fact, may cause more work down the road.

4. Better serve existing patients. Your knowledge is available 24/7 — but are YOU (the physician) available?

5. Achieve awards and recognition for helping others. Hmm… should online credibility be something that doctors strive for? This I am not so sure. I would like to know my doctor is healthy and happy and balanced in his or her life. Not someone who is tweeting medical knowledge. This may hurt the rep of a doctor if they don’t do it right…

6. Maintain peace of mind with the offered “insurance” that covers all Medical Experts for participation - Perhaps this is the golden ticket for all the participating doctors!

All in all, HealthTap is an idealistic concept. I foresee that it will be very difficult to implement as policies in Healthcare are already a sensitive subject and even more so the use of online forums as a means to offer health advice. 

What’s your opinion on this?

Can I guess?

I think it’s a can of worms….
Definitely controversial. If well implemented it might* work but if not it’ll be worse than Yelp for doctors!

HealthTap Uncovers The Secret Knowledge Network Of Doctors, Online
FAST COMPANY | 3 APRIL, 2012
http://pulse.me/s/7JZ1I

Through radical transparency and community rewards, HealthTap aspires to become the default national rating and search destination for patients seekin… Read more

—
Sent via Pulse

Sent from my iPad

A winning game!

The one area that I find fascinating in Medical Education is Simulation. Also know as “Gamification” this trend consists of light-weight simulation training using virtual patients,  interactive case scenarios or may even connect to physical simulators (ALSi). 

One successful medical simulation app is Septris. An app which uses interactive scenarios to train people (medical residents, students, nurses, etc) on sepsis management. 

Some of the features that make this app successful are:

1) This game was developed be academic institution - Stanford
2) This game targets a large need - The identification and management of Sepsis. This infection is said to strike 750,000 people in the U.S. and has a mortality rate of 25-50%. This in turn costs the US government over $17 billion per year. 
3) This game targets a large audience - Suitable for Medical, Surgical, Intensive Care, Emergency physicians and nurses and other learners as well.
4) This game provides real-world incentive: Continuing Medical Education (CME) Credits. If you get a post-test score of 75% or more, you earn CME credits. Pretty cool! 

US Health IT looks at security of data on mobile devices

The US Health wants to inspire confidence and trust in health IT and electronic health information exchange. A roundtable discussion on how to establish protocols for protecting the confidentiality, integrity, and availability of health information on mobile devices. Public comment is open until March 30, 2012!

Medical Apps: A mobile healthcare revolution (at last)

Known for its history of poor UX and change-resistant attitude, the healthcare technology sector seems to be undergoing a major mobile revolution. If its any indication, this year’s 2012 SXSW official mobile ‘hackathon’ hosted by Health 2.0 and AT&T, challenged designers and developers to create and prototype a healthcare app. I did not attend SXSW 2012 but I can only imagine the endless possibilities that could arise when you combine healthcare insight, technical savvy and a room full of creative minds…

The burgeoning frontier of mobile and healthcare is completely unprecedented so the sky is the limit - but is mobile healthcare really ready for take off? 

Having worked in the healthcare technology sector from academic, start-up and industry perspectives, I am excited though somewhat skeptical by the hype known as ‘healthcare experience design’ (HXD). I am excited because there are over 12,000 health-related apps are at the Apple’s iTunes store and that nearly everyone, from patients to doctors, has a smartphone with at least one healthcare-related app.

I’m skeptical because there are still many things that need to change - current healthcare politics and IT policies!

So what type of apps are trending? And what makes these apps stick?

For my next few blog entries, I will classify the medical and healthcare apps into five types. Patterns in each category can shed light on the above questions.

1. Educational
2. Quick References
3. Administration
4. Process & Procedure
5. Personal Health/Fitness/Wellness

Experiences in Healthcare: Slices of the HxD Pie

In my experience with medical imaging and healthcare simulation technology, the healthcare industry has always lagged behind in adopting new technology. Reasons for push-back include fear of the unknown, accountability, time constraints and of course, the cost factor.

Yet, this doesn’t mean there isn’t invested interest in designing technology for doctors. With upcoming conferences such as the healthcare experience design conference @hxdconf and the Mayo Clinic’s Transform 2012 symposium on healthcare design, one can expect/hope for dozens of innovative projects to be undertaken in the next few years - from academia and research institutes to manufacturing industries to consulting firms.

Sadly, I have been disheartened. HxD isn’t quite the lucrative business it appears to be… at least not yet. Having worked in each of piece of the HxD pie, (2 yrs in academia, 2 yrs in manufacturing and now 6mo in consulting), I see benefits and disadvantages of each.  

1. Academia lacks the short-sightedness to consider today’s implementation problems. 
2. Manufacturing lacks the patience (and lest we forget, time = $$) to invest in innovation & research. 
3. Consulting, well that depends on practical experience… and how do you get experience without having some success in 1 and 2?

Going further with the pie metaphor…has this HxD-pie suddenly become cold? Will it poison our ambitions and leave us starving?

For now, I’m not hungry. But I plan on saving my appetite….

Is Virtual Reality going to become a Reality?

Recently, the German Cancer Research Center in Heidelberg had developed an augmented reality iPad app (MITK pille) that overlays the virtual image of internal organs on the real-life image of the patient using the iPad 2’s camera. 

This intrigued me as I had studied the concept of overlaying virtual images on real patient “data” for over 2 years. In 2009, I had defended my Master’s Thesis on “Interface design for a virtual reality-enhanced image-guided surgery platform using surgeon-controlled viewing techniques” (it is a mouthful to describe!) - and oh how similar this is to my topic 3 years ago!

Anyway, it got me thinking… how much has changed from 2009 to now in terms of implementing virtual reality in the operating room?

Problems encountered in 2009

• Potential errors in medical image registration
• Cumbersome nature of magnetic and optical tracking in intra-operative situations
• Sterile environment of an operating room

Problems encountered today 2012

• Will have to wait and see… but it is likely each of the three points I just mentioned are just as relevant today as they were 3 years ago…

Response to Medical Mistakes Video

I would like to revise my previous posting of Dr. Brian Goldman’s video based on some further analysis (i.e. conversations with two very critical minded medicine and surgical residents who will remain unnamed). Here is my take after having some new insights:

1. Doctors are already familiar with learning from past mistakes.

Medical students in North American schools have already begun implementing educational structures that foster a new culture of learning through past mistakes. For example, Morbidity & Mortality Conferences have been recognized for at least a decade and is regularly taught in medical school. Maybe Dr. Goldman is just redeeming himself for his own past errors… or maybe he is just illustrating a picture for old-school doctors…. bottom line: times have changed, this is old news.

2. To compare the performance of medical professionals to a ‘batting average’ is unrealistic and making a mockery of the system.

It is understood that while batting an average of 1000 is unrealistic, any practitioner/resident/student will still aim to achieve better averages at each step of the process. Learning and trying to improve after each patient encounter or case is how you become an expert. There is no sense in beating yourself up over your mistakes. Today’s medical students understand that. You can practice until perfect yet there will always be curveballs and by definition of curveballs, you can’t hit them 100% of the time.

3. Lastly, the perspective that Dr. Goldman presents may be site specific. 

Toronto is a different city with a particular type of attitude. You may have heard the rumours that Toronto is a pretentious city. I wouldn’t disagree having lived in there for the majority of my life. Having said that, it is not accurate to believe that this behaviour and attitude among doctors exists everywhere. We do not need to be afraid. To Dr. “Boldman”, although you are entitled to your own opinion, we will not humour any fear mongering attempts.

Why?

because information is everywhere and information channels are multitudinous.

because the challenge of taking complex information sets and making them simpler is satisfying.

because the consequence that better information management and user experience has on society - in particular healthcare, education and public services - is worth the effort.

because this small webspace allows me to openly discuss my thoughts on:

• user experience (UX) in technology
• technology in UX
• the practice of interaction design (IxD)
• how to organize information (IA) i’m new to this one!
• and the applications of IA, IxD, and UX in healthcare

And because you just might enjoy reading this.