This document summarizes a presentation on how information technology and social media will change healthcare through the concept of Health 2.0. The presentation aims to convince the audience of this importance, introduce concepts like Web 2.0 and the wisdom of crowds, demonstrate existing Health 2.0 resources, and discuss how this could impact both medical practice and patients' lives. Examples of current IT uses are reviewed as well as potential Health 2.0 applications and some challenges or unintended consequences.
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
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. 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. 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. 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. 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. 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. 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?
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. 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
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.
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. 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. 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. 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?‖
28. 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
29. Google Flu Trends
This is the result:
Ginsberg et al (2008) Detecting influenza epidemics using search engine query data. Nature (ePub Nov 18, 2008)
30. Wikipedia / Health Wikis
Not definitive, but excellent. How?
http://en.wikipedia.org/
http://www.ganfyd.org/
http://www.AskDrWiki.com/
Or…
Create your own:
36. 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
37.
38. 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.
45. 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
46. 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?...
47. 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?...
53. Access
Critical to obtain information &participate
SmartPhones
Windows Mobile
iPhone
Google Android
Palm Pre (soon)
Netbooks
Web access (firewalls)
Installed System Applications
54. 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
57. 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.