Health 2 F2 Workshop

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Health 2 F2 Workshop

  1. 1. Colin Mitchell SpR Geriatric Medicine / GIM HEALTH 2.0: How IT and the Social Web Will Change Healthcare
  2. 2. Objectives  Convince you that this is important  Convince you that spoonfeeding you information about… SLE or something is unproductive  Briefly review existing technology used in Medicine  Introduce Health 2.0  What is Web 2.0? Some general concepts  The wisdom of the crowds  How Health 2.0 can affect our practice …the way we learn and keep up-to-date  …and our patients‘ lives   Demonstrate some 2.0 resources that are already available  Show you how to use them yourselves  Fiddle about with my iPhone
  3. 3. IT in Medicine – The Future? C
  4. 4. IT in Healthcare - The Future?
  5. 5. What did IT ever do for us? C
  6. 6. IT in Healthcare – The Present  Communication  Organisation / Team-working  Robots  Advanced imaging & image distribution  Patient tracking  Electronic records  Simulation / e-training  Knowledge access / sharing  E-prescribing with decision support  Diagnosis support  Mind reading
  7. 7. IT in Healthcare – The Present  Communication  Organisation / Team-working  Robots  Advanced imaging & image distribution  Patient tracking  Electronic records  Simulation / e-training  Knowledge access / sharing  E-prescribing with decision support  Diagnosis support  Mind reading
  8. 8. IT in Healthcare – The Present  Communication  Organisation / Team-working  Robots  Advanced imaging & image distribution  Patient tracking  Electronic records  Simulation / e-training  Knowledge access / sharing  E-prescribing with decision support  Diagnosis support  Mind reading
  9. 9. Mentalism Presented contrast pattern Reconstructed contrast patterns Mean of reconstructed contrast pattern MiyawakiY, Uchida H, Yamashita O, Sato M-a, MoritoY, Tanabe HC, Sadato N, KamitaniY (2008) Visual Image Reconstruction from Human Brain Activity using a Combination of Multiscale Local Image Decoder. Neuron 60(5):915-929.
  10. 10. Decision Support  E-prescriptions, Electronic health records  Knowledge-based DSS  Uses an ―inference engine‖  Outputs suggestions based on existing knowledge  eg E-prescribing:  Suggests generic medicines  Identifies drug interactions  Asks how long a course of antibiotics is for
  11. 11. The Problem with Decision Support Hi! I see you’re looking after a patient with a history of chest pain! Would you like my help? Sod off Yes please
  12. 12. Medicine – 20 years from now Technology and access to information is already changing how we work What will medicine be like in the future? For Patients? For Doctors?
  13. 13. What is it? HEALTH 2.0
  14. 14. Web 2.0? Wikipedia: “The term „Web 2.0‟ describes the changing trends in the use of World Wide Web technology and web design that aim to enhance creativity, communicat ions, secure information sharing, collaboration and functionality of the web.” http://en.wikipedia.org/wiki/Web_2.0 & Image under CCL from http://hello.eboy.com
  15. 15. Web 2.0? Wikipedia: “The term „Web 2.0‟ describes the changing trends in the use of World Wide Web technology and web design that aim to enhance creativity, communicat ions, secure information sharing, collaboration and functionality of the web.” http://en.wikipedia.org/wiki/Web_2.0 & Image under CCL from http://hello.eboy.com
  16. 16. Some non-medical examples… WHAT IS THE INTERNET FOR?
  17. 17. FAIL
  18. 18. Politics 2.0 http://www.barackobama.com
  19. 19. Organizing without organizations A Tale of Two Planes Northwest Airlines Flight 1829, 1. 3rd January 1999. Lands in Detroit at 14.45. Passengers finally disembark at 21.42. American Airlines Flight 1348, 2. 29th December 2006. Diverted to Austin TX. An 8-hour delay before disembarking. • The difference? • A discussion in the comments section on the American- Statesmen‘s website, an online petition, national media, and the US Congress.
  20. 20. OK, enough about Web 2.0, what about… HEALTH 2.0
  21. 21. Dr. Google  Googling for a diagnosis—use of Google as a diagnostic aid: internet based study (2006)  2 Investigators armed with Google  vs  26 Case Records of the Massachusetts General Hospital  Blinded to the diagnosis, investigators extracted 3-5 key features of the case and Googled them  The 3 most prominent/ appropriate diagnoses were then selected from the search results Tang & Ng. BMJ. 2006 December 2; 333(7579): 1143–1145
  22. 22. NEJM Google Google diagnosis Final diagnosis Case correct? 5 Infective endocarditis Infective endocarditis Yes 6 Gastrointestinal bleed Linitisplastica with bowel obstruction No 7 Cushing's syndrome Cushing's syndrome secondary to adrenal adenoma Yes 8 Eosinophilicgranuloma, osteoidosteoma Osteoidosteoma Yes 9 Extrinsic allergic alveolitis, tuberculosis, BOOP Hot tub lung secondary to Mycobacterium avium No 10 Amyotrophy Ehrlichiosis No 11 Tuberculosis, lymphoma Lymphoma Yes 12 Neurofibromatosis type 1 Neurofibromatosis type 1 Yes 14 Uveitis Vasculitis No 15 Amyloid Amyloid light chain Yes 16 Hyperaldosteronism Phaeochromocytoma No 17 Acute chest syndrome Acute chest syndrome Yes 18 Tuberous sclerosis Endometriosis No 19 Aspergillus Aspiration pneumonia, brain abscess No 22 Graft versus host disease West Nile fever No 25 Cirrhosis Pylephlebitis No 26 Hypertrophic obstructive cardiomyopathy Hypertrophic obstructive cardiomyopathy Yes 27 Spongiform encephalopathy (Creutzfeldt-Jakob) Creutzfeldt-Jakob disease Yes 28 Churg-Strauss syndrome Churg-Strauss syndrome Yes 29 Polymyositis or dermatomyositis Dermatomyositis secondary to non-Hodgkin's lymphoma Yes 30 Cat scratch disease Cat scratch disease Yes 31 Henoch-Scholeinpurpura Cryoglobulinaemia No 33 juvenile polyposis + HTT, links to MADH4 mutation MADH4 mutation (HTT plus juvenile polyposis) Yes 34 Toxic epidermal necrolysis syndrome Toxic epidermal necrolysis syndrome Yes 36 Encephalitis MELAS No 37 Long QT syndrome, Brugada syndrome Brugada syndrome Yes
  23. 23. Reaction to Dr. Google  A spokeswoman for the Patients Association:  quot;Doctors have a very wide knowledge when it comes to diagnosing conditions. But we would be concerned if they were using websites to diagnose people. What would happen if they gave the patient the wrong information?‖
  24. 24. Reaction to Dr. Google  A spokeswoman for the Patients Association:  quot;Doctors have a very wide knowledge when it comes to diagnosing conditions. But we would be concerned if they were using websites to diagnose people. What would happen if they gave the patient the wrong information?‖
  25. 25. Wisdom of the Crowds • An experiment...
  26. 26. How many…  Blue diamonds?  Green circles?
  27. 27. Google Flu Trends Sarah Palin: Flu (aggregate): ILI: Influenza-Like Illness – CDC data on presentations with flu symptoms from ‗sentinel‘ outpatient facilities http://www.google.org, http://www.google.com/trends
  28. 28. Google Flu Trends  This is the result: Ginsberg et al (2008) Detecting influenza epidemics using search engine query data. Nature (ePub Nov 18, 2008)
  29. 29. Wikipedia / Health Wikis  Not definitive, but excellent. How?  http://en.wikipedia.org/  http://www.ganfyd.org/  http://www.AskDrWiki.com/  Or…  Create your own:
  30. 30. MedBlogs& RSS
  31. 31. Social Bookmarking  Users rate stories / websites / videos / papers  More recommendations = higher ranking  Choose a channel by  Topic  Bookmarker Reddit – http://science.reddit.com/   Delicio.us - http://delicious.com/bengoldacre  Biowizard  Digg (with recommendation engine)  All this can be channeled into your RSS feed
  32. 32. Twitter, Flickr and tagging CCL: Markus Angermeier @ Aperto.de
  33. 33. Podcasts, iTunes &iTunesU
  34. 34. Doctors.net.uk Email, CPD and forums
  35. 35. Health 2.0 – What does it change?  For Doctors  Up-to-date knowledge ‗pushed‘ to you  Diagnosis support  Personal support  Connected learning / teaching  ‗Expert‘ patients  Remote / Virtual care
  36. 36. Using Web 2.0 now Split into 3 groups then we‘ll go to the library computer lab. Objectives for the next hour (* = difficulty level) The 3 groups (40 mins): 1. Create an F2 blog*** 1. Find a hot-topic medical article, comment on it, then post 2. it on a blog* Set up Google Reader and subscribe to some Medical 3. RSS feeds** Explain what you did to the rest of the group 2. Discuss if this is useful or all high-tech hot-air 3.
  37. 37. HEALTH 2.0 FOR PATIENTS
  38. 38. iMedix
  39. 39. Electronic Records My Google Health: https://www.google.com/health/p/
  40. 40. SugarStats
  41. 41. Relief in Site
  42. 42. RateMDs.com
  43. 43. Health 2.0 – What does it change?  For Patients  Potentially better informed  Access to knowledge and expert opinion  ‗Ownership‘ / Individual responsibility  Chronic care load distributed  Support – clinical and social
  44. 44. Problems / Unintended Consequences  Poor comprehension of the new media  Wikipedia controversy Blocking ‗social‘ websites   Cyberchondria  Access to records  Consumerist patients Will NHS patients finally ‗choose‘?   Can we trust the internet with our medical history?  Can we trust the government with it?  What about trusting our careers to the crowds?...
  45. 45. Problems / Unintended Consequences  Poor comprehension of the new media  Wikipedia controversy Blocking ‗social‘ websites   Cyberchondria  Access to records  Consumerist patients Will NHS patients finally ‗choose‘?   Can we trust the internet with our medical history?  Can we trust the government with it?  What about trusting our careers to the crowds?...
  46. 46. IWGC
  47. 47. IWGC
  48. 48. IWGC
  49. 49. Patients in control – a good thing? Should we trust our careers to the wisdom of the crowds?
  50. 50. (Literally) at your fingertips PORTABLE MEDICAL IT
  51. 51. Access  Critical to obtain information &participate  SmartPhones  Windows Mobile  iPhone  Google Android  Palm Pre (soon)  Netbooks  Web access (firewalls)  Installed System Applications
  52. 52. iPhone  App Store currently has 131 medical apps  But dwarfed by Windows Mobile  Podcasts  Web access through Safari  Many apps are free  All (except PubSearch – 59p) in this demo are free applications
  53. 53. iPhone Apps
  54. 54. iPHONE
  55. 55. In summary…  IT and the internet are changing how we interact, and allowing us to act together.  Web / Health 2.0 is about the power of crowds, without hierarchy.  Doctors have to be part of the crowd, as contributors and evaluators as well as moderators.  Having an understanding of all this is important to be able to practice medicine in the information age.  Using it could make you a better doctor, now.
  56. 56. Questions? http://obamicon.pastemagazine.com

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