Beyond the Stage 1 Criteria for Meaningful Use

The policy goals of meaningful use will be most fully realized by building on findings from Stage 1 and by making full use of the greater proliferation of certified EHR technology and supporting HIT infrastructure that will take place under Stage 1.  CMS intends to propose through future rulemaking two additional stages of the criteria for meaningful use.

Stage 2 would expand upon the Stage 1 criteria in the areas of disease management, clinical decision support, medication management, support for patient access to their health information, transitions in care, quality measurement and research, and bi-directional communication with public health agencies.   CMS may consider applying the criteria more broadly to both the inpatient and outpatient hospital settings. 

Consistent with other provisions of Medicare and Medicaid, Stage 3 would focus on achieving improvements in quality, safety and efficiency, focusing on decision support for national high priority conditions, patient access to self management tools, access to comprehensive patient data, and improving population health outcomes.

Additional information can be found at www.cms.hhs.gov/Recovery.

CMS provides a 60-day comment period on the proposed rule.  The proposed rule may be viewed at http://www.cms.hhs.gov/Recovery/11_HealthIT.asp.

Notice "support for patient access to their health information" happens in stage 2 of the meaningful use criteria.

Good news, it's included in some capacity...and this gives all of us consumer-centric co's time to build.

Bad news, the NHIN will march onward focused on stage 1, which means we'll be scrambling for simplification when it comes time to integrate patient capabilities to access data.

Buckle your seatbelts boys and girls - it's gonna be a loooong trip to 2013....

Posted via web from Jen's Posterous


Personal Responsibility for Health = Patriotism 2.0? Take Some Responsibility for Your Own Health. If Not For Yourself, Do it For Your Country.

"If you eat too much, exercise too little, drink too much, smoke, take drugs, fail to wear a seat belt, or ignore gun safety, there's only so much a doctor or hospital can do for you. And Americans do all those things, more than other people. And many are uncomfortably aware that self-destructive behavior is most often found among the poor and among minorities. Public policy can achieve only a limited impact against these problems. We'll have to rethink the deeper structure of American food policy: subsidies to corn and soybean growers, the paving over of exurban land that might provide nearby cities with less expensive fruits and vegetables. Ultimately, though, these are decisions that individuals must make for themselves. The present concept of medicalized health care sends some unwelcome messages. By outsourcing the concept of health as something that doctors, hospitals, and now government do for you -- rather than something that depends considerably on your own choices and efforts -- we ask the medical system to do more than any medical system can do. As you consider your new year's resolutions, remember: better habits will benefit not only your family and yourself -- but all your neighbors and countrymen as well."  

From: "Wednesday, December 30, 2009 | DCPCA Health News Alert."

Posted via web from Jen's Posterous

What to do When Moving Sucks: Make A Single Healthy Action Aspirational

I've read you're on the right track with developing a software application if it solves some wicked problem in your daily life.

For me, getupandmove.me is just about the only system of outside accountability for healthier behaviors I've got.

Without the motivation factor provided by folks who know and love me on Twitter, there's no friggin' way I'd tear myself away from my laptop, business cards, and whiteboards to exercise between 15-30 minutes a day on any sort of regular basis. 

Today my personal savior was @mklemme, who challenged me yesterday afternoon to run for 20 minutes.

20 minutes. Doesn't seem like a lot, does it?

But I dithered. I procrastinated. I told myself it was too cold last night. Then it was too wet and dark when I woke up this morning.

Finally, that unfinished challenge just SITTING there (like me) was too much to take.

I laced up the New Balances and off I went for a sloooow jog through the Los Altos Hills. 

You know how some days you have those kick-a@# runs where the wind kisses your cheeks, the sun smiles on your scalp and forearms, and all the world is right and good in your eyes? 

Well, I can tell you, today's little journey was NOT one of them. 

I was huffing and puffing. I was sweating. I think I was running at about 82 minutes per mile pace. I'm pretty sure a pair of septuagenarians passed me on the trail near the Highway 280 exit. 

But, because Myk was counting on me, I finished the run (barely). 

And it hit me like a ton of bricks - THIS is the reason why getupandmove.me has so much promise. 

It makes a SINGLE healthy action aspirational. 

It's quite a challenge to debate the merits of a socially oriented, n=1 approach to health improvement, but working out with my guammies is proving this kind of thing can work - at least for some. 

I wanted to finish Myk's challenge. Bottom line. So I did. I could have done a million other things with that 20 minutes.

If Myk had asked me to lose 7 pounds, or not eat junk food all week, or cut back my coffee consumption, it would have been too broad a goal, and I would have wondered why the hell he was nagging me in the first place. 

When I'm trying to explain the concept of how microchoices are so important for personal AND public health reform, I get one of two reactions:

1. Duh. 

2. What the heck are microchoices?

I'll use a comparison here to illustrate why incentivizing individuals (I, you, everyone else - one at a time) to make healthier 'entry level' 'every day' choices is the only thing that I think will save healthcare. 

My cofounder Andrey Petrov, along with Shinyoung Park, CEO of Funji.me, both helped me get over my fears related to launching Get Up and Move with what I considered an extremely anemic feature set (and no instructions! no about us page! oh the agony!).

It was Shingyoung who explained for me, patiently, the value of launching with a "minimum viable product."

Well, God bless him, Andrey gave it his best shot too :). 

There are several big benefits to doing this...

First, you confront head on the fear that you will not succeed with your big dreams and just boot the product out the door. 

Second, this means that you then become near-addicted (ok, addicted) to rapidly iterating improvements so your friends don't un-friend you on Facebook when you start singing the siren song of your new app. 

In health, microchoices are the rough equivalent of the agile development, rapid iteration, minimum viable product approach. 

GUAM (getupandmove.me) was the minimum viable product, and despite my empty fears and protestations, Andrey was strong enough to meet both head on and launch. 

In getupandmove.me, we focus on what is the minimum viable ACTION that a person can take, in the near future, to get healthy. 

Each getupandmove.me challenge equation or statement has not one, but TWO viable actions coded into the algorithm.

Like DNA base pairs in a double helix, you can't just do ONE minimum viable action to complete a challenge (which is where GUAM differentiates itself radically from other 'personal' health, fitness, and wellness apps). 

In getupandmove.me, TWO users have to complete TWO minimum viable actions...User 1 (challenger) will do X action for X quantity if User 2 (responder) will do Y action for Y quantity. 

We're literally coding social contagion into individual decision-making. 

It was after completing Myk's challenge, despite the awful quality of the run itself, that I realized we've got a platform, not an app, on our hands here. 

It's the behavioral patterning, the social economics of that algorithm that matter most here.

We've known 1 is the loneliest number for some time now - why haven't we coded platforms that enable the addition of 1+1 for better health outcomes before now? 

Unfortunately, I'm not a sage. I can't answer that question retrospectively. 

Fortunately, I am an optimist, and, now, a founder. I can say that from here on out, in every area Andrey and I touch, health is social. Health can be contagious too, and getupandmove is helping spread the epidemic. 

To your health-


Posted via web from Get Up and Move!


Going on the Calendar - Body Computing

At the Body Computing conference we explore ways to expand the ability of technology to deliver information to consumers and get better outcomes. Can you put entertainment in? With the Internet, the draw is entertainment, and that can be very motivating. So the Beating Heart is totally for your kid to play with. You stick a patch that looks like this cool glowing heart on your chest, and it communicates the heart rate to the phone. It gives kids insight into what the heart rate is. They can send a photo of the latest teen idol and see what effect it has on their friend's heart rate. We will have increasing capability of monitoring ourselves this way.

From: "Implant Wizard - Health Data Management."

Fall 2010.

Posted via web from Jen's Posterous

Jam Wif What U Got - What's Next for Getupandmove.me?

This guy is workin' it riffing on Smule's Leaf Trombone app - I want to be in THAT number.

Speaking of numbers, Getupandmove.me is now just about a month old.

A peek at our stats and what we've learned so far:

* 254 users
NOTE: This number = sad face + a big challenge for your creator team - How do we get new friends to move with us? More on how we plan to gain user traction anon, but if we were speaking in Pig Latin our answer might look something like "Acebookfay."

* 463 challenges
NOTE: Confirming, again, initial 'superusers' or hyperactive 'parent' nodes in our social graph really like to tell other users what to do, cough cough, motivate each other.

We figured out there are 2 basic species of "guammies" - those who like to be told what to do, and those who like to boss others around. Ahem. Guess which I am :). Even more interesting, however, as we begin to track the spread of contagious challenges from an initial user 'node' is that sometimes Guammies who like to 'be told' LEVEL UP and become Guammies who motivate. Fascinating future implications for UX design.

* 208 completed challenges
NOTE: Another sad face. We want to stay above 50% completed challenges (where BOTH challenger and responder complete challenge by clicking on "Done my part"). I want us to hit 75%.

In looking at our insanely detailed weekly internal report card, we figured out our open challenge format (challenge anyone on Twitter without making sure they're 'logged in' or signed up for GUAM) means we have a lot of 'ghosts,' or Twitter users who have been invited but haven't logged in to GUAM. We're working on an enrollment loop to reduce this.

In keeping with our Open Sesame commitment to conversing with you, our users, about where we're all headed together, Andrey and I figured we'd offer a more basic, FAQ type update on what we think this strange trip is all about.

Please to excuse the 'yelling' in subheads...


A: We specifically targeted the preventive/wellness end of the PHI spectrum that we feel is not currently addressed by CRM systems in place nor in direct-to-consumer personal logging or biometric ("me-tric") tracking applications like DailyMile.com or LiveStrong.com.

There are a ton of apps out there that help you track things - but NOTHING out there (that we've seen) that successfully harnesses existing energy in your social networks.

In 140 characters: There are a ton of apps and services that track activities but none that really motivate you to do the things you want to track.

Some try to mask this by giving you graphs and stats. Graphs and numbers are not motivation. Your friends and family are motivation.

We want to connect you to them so you can make 'healthy' contagious, one microfitness challenge at a time.


The goal of Getupandmove.me (speaking like a true amateur scientist) is to motivate users to move by harnessing the cascade effect of 'hyperactive' or frenetic super user "node" individuals in existing social networks. I just learned this is called 'sociometrics.' Woo hoo for continuing ed...


One of the most fascinating things about guammies is that you're not only taking responsibility for your OWN health by committing to a small act of fitness, but you are, in essence, *also* taking responsibility to 'coach' or 'mentor' another user to get up and move it by 'bartering' your fitness for theirs.

I've heard a lot of chatter from the bigwigs in healthcare this year about "getting consumers to take responsibility for their own health and wellbeing" blah blah blah.

You, my dear guammies, are not just talking or tweeting about this - you are DOING it. One challenge at a time.

It's important here to look at how current health and wellness apps fail to use the most motivating things in your life - friends and family you ALREADY connect with in your social graph - to help you make better choices.

Motivation isn't a set of instructions about how to do a pushup in perfect form.

Motivation is someone getting you interested in doing a friggin' pushup in the first place, and we think meaningful, personally relevant motivation structures are the most critical element missing from the current wellness spectrum of applications.


We rely on our lead users to incentivize responders, at least for now. If you are a lead user - wow. Our hats are tipped to you.

Send the funniest or weirdest #getupandmove challenge (keep it clean people!) and we may get you a nifty tee shirt :).

Our early lead users ("challengers") provide social motivation not only to move themselves, but also in effect take responsibility for getting other users ("responders") motivated and stay on track in that 'space between' home and work where you may choose to do things OTHER than go for a run or go to the gym.


Frankly, we don't have a GD clue.

Well, I'm being modest, we have a few ideas, but nothing concrete at this early stage.

We're examining all kinds of analytics and graphing APIs.

At minimum, we're trying to see if it's possible for your social graph to help inject small bits and bytes of microfitness into your daily life by tracking the 'path' of a challenge from user to user to new user etc, but even we aren't sure yet how to track the contagion of movement motivation from 'parent' node users to 'child' responders.


Although we're kind of relying on the strong backs of frenetically active challengers to motivate the guammie community, we are also very deliberately targeting responders usually are not initial or early adopters with our easy to use challenge formats.

If a challenger's challenge fell in the forest, and nobody heard it, would it still make a sound? Nope.

Responders - you are the heartbeat of #getupandmove. You're going out on a limb. You're doing a favor for a friend that asks you to move. And you're motivating others in return.

We salute you!


We're keeping challenges small and simple - users don't have to be a pro athlete or marathoner to use Get Up and Move.

We're not competing with sites like DailyMile.com and Skimple or RunThere to log what you've done...

We're big fans. In fact, eventually we want our users to move from 'microfitness' at the daily level using Get Up and Move to larger macro challenges like training for a marathon using DailyMile.com.

We aren't enabling logging functions - instead the most primary function of GUAM is that "guammies" (getupandmove.me users) are motivating each other to move...if there are psychological or behavioral stages to working out, we're in the "pre move" category.

And in the "pre move" category (as opposed to the "actively moving" category and the "I want to move MORE" category addressed by other apps and communities), the most important thing is someone providing that motivation for you to simply get up and do SOMETHING.

That's where Getupandmove.me comes in.


At the most basic level, Getupandmove.me enables users to challenge friends and family to 'microfitness' challenges, in real time using simple preset options like "dance to 2 songs" or create your own using our free web app.



For PHI (personal health information) tracking, the sky's the limit.

Deploying something like Getupandmove.me for medication adherence, physical therapy exercise tracking, telehealth/home monitoring and self reporting of critical biometrics for, say, diabetes treatments would be awesome.


We haven't yet integrated with personal biometric trackers like FitBit or WakeMate (for sleep), but are considering it in the future - as well as telemedicine integration for challenges and self-reporting on metrics important for preventive health in conditions like diabetes, etc.


Planned future features include Facebook Connect integration (version 3.0, mid-January), group challenges, export activity to calorie counters, etc.


Our ambitious B2B enterprise market plan includes:

* gyms (reminders for new clients)
* events/conferences (onsite fitness challenges for attendees and exhibitors)
* colleges/high schools (for sports teams training in the pre or off seasons)
* hospitals/clinics (community wellness programs)
* medication/pharma reminders
* and employer wellness programs

There are a few other sectors we're in the early stages of exploring viability.

Plus at some point soon we'll be doing mobile schtuff.

That's about it for now guammies.

Til next time, may the force be with you.


PS - Be on the lookout for a new "Stealth Mode" feature release on Monday that protects your privacy to an uber-degree.

Posted via web from Get Up and Move!


Interested in e-Prescribing? Keep an Eye on Scotland's CMS Program this Spring...

The CMS offers patients with LTCs the chance to benefit from ‘pharmaceutical care planning’ with their community pharmacist as well as shared care and repeat dispensing.

When a patient signs up for the CMS the pharmacy’s patient medication record will send an electronic notification to the GP’s IT system which then allows the GP to choose whether to enter into a shared care agreement with the option to generate serial prescriptions for up to 48 weeks.

The pharmacist draws up a pharmaceutical care plan with the patient and if a shared care agreement is in place relevant information shared between the pharmacy and the GP with informed patient consent. At the end of the serial prescription time period the pharmacist sends an electronic end of care treatment summary and a request for a new serial prescription.

From: "E-Health Insider Primary Care :: Scotland's CMS to go national in April."

Posted via web from Jen's Posterous

Introducing #getupandmove at Quantified Self Meetup!

Jen McCabe and Andrey Petrov on #getupandmove from Kevin Kelly on Vimeo.

Posted via web from Get Up and Move!


To Our First 236 Users - A Love Letter

Happy Wednesday to all!


December 23rd. We're almost at Christmas. Today is a big day for many reasons. 

On this day last year, a chance meeting in Southern Maryland led someone who is now very important to me to suggest that if I really wanted to make a go of starting a health software company, I had no other choice but to move to Silicon Valley. 

Check that one off the list...

That starting a company thing? Yeah, me and @shazow are workin' on that. 

At http://getupandmove.me, we've got a major version release planned every two weeks. To say it's gettin' hot in here would be an understatement.

We're looking at how challenges, aka "activity agreements" in the words of guammie @ppeach, may be useful for:

  • medication reminders
  • occupational and physical therapy ("do your exercises @home!")
  • running clubs
  • High school sports teams in the hot summer preseason
  • club sports groups at the collegiate level 
  • event planners (wedding weekends, conferences)
  • personal trainers
  • gyms! (especially to help those New Year types keep coming back)
  • Yoga studios
  • hospital community wellness events
  • employer wellness programs

But here's the bottom line: We could NOT be doing any of this without you.

Thanks to you, we are learning things about what motivates people to go from sit-->stand-->MOVE. The data from our community is showing amazing things about how people can help each other make healthier microchoices contagious. 

236 users may seem like a small sample size for a super early, minimum viable product beta, and it is.

When we launched almost a month ago, I told @shazow if we got to 350 users who were ACTUALLY moving every day I'd be thrilled.

What we've discovered: 236 users may *seem* like a small sample size, if, that is, you're any other kind of applicaiton. 

You, our very first batch of guammies, are doing something that is completely new.

You aren't playing around here, and neither are your designers, although we hope we're making moving around  easy and fun.

This isn't a social app, or if it is, it's one with a fierce little purpose.

You see, you, our first users, aren't just reading content, or sharing links. 

You are actually stirring each other - single-handedly - to live healthier lives, minute by minute. You are heroes on a small scale, for me for yourselves, for others to whom large 'getting in shape' or 'losing 20 lbs' resolutions are overwhelming. 

You are helping us start small. Later this week I'll share some stats that help us take a look at your big impact.

Our gift to you today: 

  • improved home and public profiles - you can now share your #getupandmove challenge profile if you'd like. 
In my case, the public accountability helps me ensure I fit in some time to move every day.
  • functional hide/unhide - you can choose to 'hide' for awhile if you're on vacation, etc. 

There's no shame in falling off the wagon for a bit here, then starting right back up, a little bit at a time. 

If you've got friends and family who you know want to 'get healthy' in the New Year, steer them over to where you're already getting up and moving. 

We'll all be here, waiting to help. 

A happy and healthy holidays full of small movement to all 236 of you. We big puffy heart you :)



Posted via web from Get Up and Move!


The "Always On" Web, Status Updates, and Health

The reason status updates - short real time mesages about who an where I am and what I'm thinking or doing - are so populr and hold so much promise for health is that 'status' broken down into smaller parts allows users, ie people like you and me who will all someday be patients- penumtinate control and choice over our identiites. On the status-obsessed, update NOW now NOW here HERE here web I get to reinvent myself as many times as I want. I can be the genetics geek, the brainy sister, the cyber babe I never was in high school, naughtier in online phraseology than I would be in the real world.

Persona creation a la avatars and profiles is imprtant, but, once created, that identity or doppleganger lives on only through the multiple and repeated status updates (and links and photos etc) that I provide.

The 'survival,' valuation and propagation of my online identity requires frequent care and feeding, and this maturation (or lack thereof) doesn't happen in isolation. For the same reasons we love heroes and villians, David and Goliath, impossible odds, star crossed lovers, the concept of Lotto tickets and the big win for a small spend, America's Funniest Home Videos and sports bloopers on YouTube, and- sometimes in our deepest secret hearts, watching our friends fail (or succeed beyond their wildest dreams) - we love watching people self journal on the web, living out the minutiae of our lives in encouraging and embarrassing micro episodes, 140 characters at a time.

On the web, our status updates are within our hands, and their individual recordation - in addition to the cumulative personal narrative they represent - is aspirational.

I'll say it again because it bears repeating - our web identities are aspirational.

And thus using these social micro status updates, with their sometimes seemingly painful mundanity and silly monotony, represent perhaps our best chance to create platforms that make "health" aspirational.

If we provide micro updates, make daily microchoices and microchanfes to our behavioral patterns it's like the start of another year at high school where the geek can be reinvented as homecoming queen.

She probably didn't change much over the summer...contacts instead of glasses. Highlights. A haircut. New boots. Going to the gym. A vacation where she met a group of kids from France.

But come late August, all those small things add up.

Microchoices, status updates, personal identity, and control. Personal reinvention via a steady stream of micro updates across distributed social networking platforms. If you can't follow the analogy above regarding how status updates and microblogging platforms relate to health, keep plugging away on the technically driven, rather than behaviorally targeted, programming.

I'm sure you'll get somewhere really big - just not really soon. In health consumer software, if you build it they will come just ain't gonna cut it. It's more like if you give me the framework to build simply, without having to enter too much stuff myself, I will come, and bring a couple thousand of my closest friends. Which approach do YOU think will make health more contagious?

Sent from my iPhone

Jen McCabe
CEO, Founder
Contagion Health

Posted via email from Jen's Posterous


Sex Ed, Teen-to-Teen Style: Peer Health Promotors in Rural Ecuador

What if I told you that Juan, a community health worker in rural Ecuador, is providing injectable contraceptives outside the clinic setting to indigenous community members?

What if I told you that Juan is actually 15-years-old and the clients he's reaching are also youth?

Juan and 30 other young people, aged 11-19, are the first group of peer promoters to use a peer-to-peer community based model to deliver injectables and other contraceptives to rural and indigenous youth in the Chimborazo region of central Ecuador. The program is born of a partnership between Planned Parenthood Federation of America (PPFA) and CEMOPLAF, a major Ecuadorian reproductive health NGO.
Ecuador has the highest adolescent fertility rate in Latin America, and this skyrockets when we're talking about rural or indigenous youth. Among community members in the region here, just 6 percent of women and 12 percent of men reported contraceptive use, while less than half of all women reported any knowledge of sexually transmitted infections (STIs).

This program meets the needs of a particularly underserved and hard-to-reach group, with a new contraceptive method, in a new way. The peer promoters hail from 15 different small communities within the region and are providing a brand new range of services to their peers. They meet weekly at a central clinic location to discuss challenges and attend trainings. There, CEMOPLAF also provides lunch, transportation costs and job-skills training.

Absolutely fascinating program.

Another socially contagious approach to public health. This time, it's teens literally innoculating each other against STDs.

Posted via web from Jen's Posterous

The World's Girth Keeps Growing, and Growing, and Growing - Even in Places You May Not Expect

Obesity is becoming more common among poor city dwellers in Africa because of easier access to cheap, high fat, high sugar foods, scientists said.

Researchers looking at data from seven African countries found the number of people overweight or obese increased by nearly 35 percent between the early 1990s and early 2000s and the rate of increase in obesity was higher among poor people.

"Given the chronic nature of most diseases associated with obesity and by extension the huge cost of treatment, the prospects look grim for the already under-funded and ill-equipped African health care systems unless urgent action is taken," said Abdhalah Ziraba, who worked on the research with the African Population and Health Research Center in Nairobi.

From: "Global Health Council - Studies Show Obesity Taking Hold in Africa and ."

I wonder how long we have until obesity will be the number one cause of death worldwide?

Posted via web from Jen's Posterous

Study Shows 96 Percent of Doctors Concerned About Losing the Unique Patient Story with Transition to Electronic Health Records

When physician respondents were asked how concerned they are “about losing the unique patient story with the transition to point-and-click (template-driven) EHRs,” 96 percent voiced concern, reinforcing the need for patient health records to be created using a combination of structured and narrative information.

From a Nuance study of almost 1k docs.

Fascinating. Those who've seen the Contagion platform stuff - ahem. :) Right track, ho!

Posted via web from Jen's Posterous


Leave Your Assumptions At the Door, 'Cause They Don't Belong in the Hospital

"My husband almost died from a ruptured and infected bladder, while in the care of hospital staff, because nobody read the record."


Excellent ePatients.net post on medical literacy, patient/caregiver engagment.

Posted via web from Jen's Posterous


Patients meet donors from largest-ever kidney swap

A hospice nurse who handed homemade cookies to her operating team. A retired stockbroker who had volunteered with the National Foundation and decided to walk the talk. And a woman inspired by President Barack Obama's call to volunteer. They all donated a kidney with nothing to gain - they didn't have a friend or loved one in the marathon chain of transplants that they helped make possible.

"It feels wonderful," Sylvia Glaser, 69, the hospice nurse, said Tuesday at a news conference where most of the donors and recipients met for the first time. "You are giving someone a life, and there is no substitute for that."

"It's not like I'm doing anything courageous," Bill Singleton, 62, the kidney foundation volunteer, told The Associated Press before his surgery. "If I don't volunteer, who will?"

From: "Patients meet donors from largest-ever kidney swap."

Sometimes you despair about the future of healthcare reform and healthcare delivery in general...

And then you read about something like the largest 'step' or 'stair' kidney transplant, done at Georgetown.

13 people giving of selves on a level you and I can't even begin to contemplate.

Tis the season people. Do something good with your resources, anatomical and otherwise.

Posted via web from Jen's Posterous

It's Christmas - Have a Heart! Or, If You Don't, We Soon May Be Able to Grow You One

It was very exciting to observe engineered heart cells behave on a tiny chip in two dimensions like they would in the native heart in three dimensions," Kim said.

From: "Heart cells on lab chip display 'nanosense' that guides behavior."

Korean colleagues and Hopkins w00t!

Posted via web from Jen's Posterous


Glimpse Into "FounderBrain:" Analyzing Emerging "Guammie" Behaviors

From an email Andrey sent Jen last week:

"Out of 334 challenges:

121 (36%) were symmetrical (same vs same).

80 (24%) were default (run vs walk).

6 (2%) were reverse default (walk vs run). Huuuge difference.

29 were dance vs dance
28 were walk vs walk
29 were run vs run

Funny how close all the symmetrical types are.

We can definitely draw some observations here..."

Funny observations:
1. We actually seem to *like* being told what to do.
2. There's a strange 'mirror' challenge effect occurring, with symmetrical challenges. 

Posted via web from Jen's Posterous

Size Matters...

Abstract Models reveal that sexually antagonistic co-evolution exaggerates female resistance and male persistence traits. Here we adapt an established model by including directional sexual selection acting against persistence. We find similar equilibria to previous models showing that sexually antagonistic co-evolution can be limited by counteracting sexual, as well as, natural selection. We tested the model using empirical data for the seaweed fly, Coelopa ursina, in which body size acts as a persistence and a resistance trait. Our model can generate continuous co-evolutionary cycles and stable equilibria, however, all simulations using empirically derived parameter estimates reach stable equilibria. Thus, stable equilibria might be more common in nature than continuous co-evolutionary cycles, suggesting that sexual conflict is unlikely to promote speciation. The model predicts male biased sexual size dimorphism for C. ursina, comparable with empirically observed values. Male persistence is shown to be more sensitive than female resistance to changes in model parameters.

From: "Sexually antagonistic co-evolution: a model and an... [J Evol Biol.] - PubMed result."

Red Queen theory fans should enjoy this short summary :).

Posted via web from Jen's Posterous

So Sickly Awesome I'm Gonna Stop Typing Now and Drool...

From: "adidas - Star Wars Stormtrooper Tee - Short Sleeve Shirts."

Thanks @caparks for the heads up...

Posted via web from Jen's Posterous

Get Up and Move - Your Rx for Preventive Medicine

The term preventative medicine should mean discovering a disease process before it manifests itself through its complications. After discovering the disease it should be treated in the best possible way available.

From: "Repairing the Healthcare System: Dont Listen To What They Say. Watch What They Do."

Take one http://getupandmove.me challenge, 1x daily to protect against titanic girth expansion.

Welcome to our new blog! We're glad you're here.

Look for the mobile version coming soon...

Now, get up off your a^% and MOVE it!

Posted via web from getupandmove.me


Health Data Management - Is it a Woman's World? (Agree? Disagree?)

Good, bad or indifferent, health information management (HIM) is made up of women.

From: "Hospital Impact - Understanding health information requires an understanding of women."

Posted via web from Jen's Posterous

Why The Redefining Patienthood Project Matters: Sometimes, Naming *REALLY* Matters

One thing I am still getting used to, though, is when patients call me by my first name. There seems to be a void in this area of etiquette: How does one address one’s physician? It is almost always an older patient who will use my first name, in a friendly, offhand way. And, I have observed, these patients are usually men. It might seem natural if I have had a long-term relationship with these people, caring for them over the years, but often these patients seem to make a decision at the outset to be on a first-name basis with me. I wonder about these people. Are they trying to be chummy? Is it a power thing, making them feel less vulnerable while they sit half naked on the exam table? Do they just call everyone by their first names?

From: "Cases - Etiquette of How to Address Someone in the Exam Room - NYTimes.com."

Look out for more on the Redefining Patienthood project before this year closes: http://myhealthinnovation.com/blog/archive/2009/11/redefining-patienthood.>

Posted via web from Jen's Posterous


Cart Before the Horse: The Coming Biometric Sensor Wars

Personal biometric tracking ("me-trics") is growing like a gremlin hitting a swimming pool.

Ok, so maybe that's an overstatement of the small, tight sector's early strength, but not by much.

Wired Magazine 'legitimized' the segment with a #quantifiedself themed article.

There's even a Quantified Self meetup group in San Francisco and Silicon Valley (where @shazow and I recently demoed early lessons learned from building and launching http://getupandmove.me).

Big business is getting involved: Qualcomm has been showing all kinds of promising iPhone wireframes with external biometric sensor feed integration (at TEDMED and Telecom Council of Silicon Valley's mHealth meetup for a start).

I know of at *least* 3 Bay Area startups that are working on customized biometric sensors for health and vital sign tracking and constant data feeds.

And while all of this has to happen, and we SHOULD be evolving quantitative leaps and bounds beyond the current constraints of a wired heart monitor the size of my Eames kitchen table, we may be putting the cart before the horse here.

Where will all this wonderful always on measurements of the biorhythms that make me, well, me GO? 

Where will we import them? Track them? Manage and measure anomalies? 

We're still missing the viable software platform (which I think is a personal health record-esque animal) that will make USING this wonderful datastream possible.

Examples of this kind of simple platform are all around us.

We're lifestreaming on Twitter. Granted, that's just text-text conversions, so to liveblog we don't face the same data translational programming human-machine interface challenges we face with live biometric tracking. 

And now some early startups are testing interfaces and how this might look reflected in a consumer-oriented software platform using something most of us want more of and something most of us can't get enough of (no, it does NOT require two people to accomplish - keep your minds out of the gutter here people)...

I'm talking about - sleep. 

Zeo and YCombinator startup WakeMate (cool guys, good product, check it out) are both bare-knuckling it for an early lead in this market of tracking zzzs. 

Brad Feld is starting to use the service, and like most biometric tracking, finds that the following elements are critical:

1. Use the thing regularly. Seems like a moot point or worthy of a Captain Obvious award, but when you consider how many people don't take their meds you begin to see the psychosocial challenges that will occur when we try to get a mass market biometric device in use.

2. Establish a baseline.

3. HAVE GOALS. Also seems like a blindingly obvious point, but chances are you aren't tracking sleep/wakefulness biometrics unless...you have issues with getting enough good sleep. 

How will we transition the needs of wider health and wellness metrics into concise, easy to articulate goals that inform integrated human-machine interface design?

4. Sleep around. Try different devices. Like Goldilocks, some of us will need a big chair with tons of data, some of us will need a smaller serving of info in our breakfast bowl. 

But all of this is a big of playing with a market that's still got nothing pulling the traces of the wagon. 

Wherefore art though personal health platform? I'm waiting for you to be built and help me get a good night's sleep, among other things...

Posted via email from Jen's Posterous


Why Programming Microchoice and Microcontrol into the Healthcare System Will Lead to the Equivalent of the Microprocessing Revolution

Yesterday at TEDxSV Thomas Goetz, executive editor of Wired Magazine and author of The Decision Tree, talked about a concept where individual decision-making will become paramount in health.

For the past year, I've been working on a concept that explains how we might harness individual decision-making choices, and the control someone has over them (real AND perceived). I realized as I looked back through emails and blog posts that I've failed to clearly define this so others can get to work using it.

I'll keep this blog post clear and concise in style, rather than verbose and metaphorical, in the hope that it will lead to an acceleration in how we talk about healthcare reform and 'meaningful use' of individuals' health data.

The theory is something I'm calling Choice/Control Aware Care, and I believe it is the second generation of Participatory Medicine.

It was born on the floor of @susanlindsey's kitchen when @mdbraber was visiting Maryland over a year ago. He and I were talking about how people make choices as patients, and what we might feel like we have control to decide when we're stuck in the hospital.

My argument, which was illuminated using a whiteboard and some fruits, veggies, and tubs of markers (hey, I work with what I've got), is that people have far more choice and control over things in the healthcare system than we currently let on.

For one, a person can always choose NOT to adhere to treatment...to refuse medicines, refuse a transfusion, etc. This is the 'null decision,' or 'do nothing.'

WHY a person chooses the 'null decision,' for personality reasons, due to religious beliefs, or just plain old fear doesn't really matter (although it's an interesting research question for later) - what really interests me here is that people who choose the 'null decision' in health KNOW or perceive that they have some sort of limited control over what happens to them in the process of care delivery, if not over the outcomes themselves.

This brings me to the second important tenet in Choice/Control Aware Care: we have more control (real AND perceived) in the healthcare system than is currently communicated to us by care providers.

In addition to the "null decision" or 'do nothing' approach (which often happens in palliative care and end-of-life medicine including Hospice programs), there are a whole host of potential decisions - a smorgasboard of personal choices - that a person might make if the care conversation illuminated them.

I have come to believe over the past year designing software programs that a more robust conversation and analysis of choices and control is absolutely necessary in order to incentivize healthier decisionmaking and measure how our connectivity in social networks helps illuminate choices others have made (as well as their 'contagious' influence on our own lives as detailed in the book "Connected").

I've grown very, very tired of hearing policy makers and healthcare executives, in addition to healthcare bloggers, spout platitudes about how we get people to 'get healthy.'

The short answer is this - we don't.

They do. WE get them to be 'not sick' (hopefully).

If we can accept our OWN lack of control over outcomes, then we may begin to accord individual decision-making (cognitive reframing and all those other nifty neuroscience tie ins we currently discount in health) the import it is due.

This focus on individual, EVERY DAY decision making (and how these small microchoices add up over time to health or the lack thereof) is ABSOLUTLY necessary in order to revolutionize our healthcare system from one focused on 'sick care,' or the singular distribution of resources we bring to bear to encapsulate and 'cure' or 'fix' an episode of illness or injury, to 'well care,' or preventive medicine, which connects these currently disparate episodes across a person's lifeline and illuminates their past decision-making history to elucidate future potential solution sets from which they may choose.

While that sounds a bit complex, the truth about Choice/Control Aware Care as a theory is almost embarrassing - it's so blindingly simple someone, surely multiple 'someones' in the healthcare system should have thought of it before, and burnt midnight oil to bring it into practice in strategic planning.

And maybe they have, but if so, I haven't heard them actively building processes and products and connecting people to measure individual decision-making in health and how it impacts a person inside and outside the healthcare system.

This is not a stroke of genius. Not even close. The Choice/Control Aware Care theory is based upon a concept so small (literally and figuratively), so clear that IT IS ALREADY present in our everyday lives. And it's not hard to use.

To the contrary. It's so blindingly easy to understand that when I talk about it at events, peoples' response is often "yeah, but doesn't everyone already know that?"

I'm talking about "microchoices."

As soon as I explain it using a few analogies, it becomes apparent that everyone understands the concept of making small choices in the now, choices like "should I eat the cookie or the carrot sticks? Walk or drive the kids to the bus stop this morning?"

Everyone also seems to understand that there are many of these microchoices we have control over, and that we can bend the potential set of choices based upon our subjective desires about how we wish to live (and die).

I'd like you to think for a minute about the micro 'set' of decisions you've already made today - a rainy Sunday here in San Francisco - that add up to macro impact your health.

Here's an example of what I'm talking about, using what I've done so far today:
1. Slept in. Decided to grab 5 extra hours of shut eye instead of working on http://getuapandmove.me business plan, Kisaut Fellow "Redefining Patienthood" project, or going for a run (although I'll probably do some of those later today). I needed to help correct the deficit, and so granted myself this luxury.
2. Ate a pear and drank some kefir for breakfast. Not the french toast smothered with maple syrup I wanted using leftover french baguette dad @litomikey left behind when he drove to the airport this morning. Feel light, good.
3. Washed breakfast down with some black tea and honey instead of coffee and Splenda.
4. Cherrypicked the bits of semisweet chocolate out of the bag of trail mix dad left in the fridge. Resisted, however, the chocolate dipped biscotti. Threw that bag away.
5. Made conscious effort to drink 2 whole 8 ounce glasses of water.
6. Brushed teeth. Felt guilty for not flossing. Put floss on store list on fridge.

And so on. See what I mean? And that's just for the 2 hours I've been awake today. If I took that list into my docs office she'd think I'm absolutely nuts.

But those decisions, and how I make similar or different ones day after day this week, this month, this year, and so on, has a GREAT impact on my overall health and happiness.

Our only challenge is to learn how to harness the cumulative effect of small, everyday choices - "microchoices" - for incentivizing healthier decision-making in each individual, n=1 sample size.

The great news is that we *can* absolutely measure these sorts of things. One Eureka moment for me was joining the #quantifiedself Meetup group here in San Francisco. There people meet to talk about tracking personal biometrics - or "me-trics" they find relevant like sleep quality, REM, food intake, stress, etc.

And it is interacting with these personal tracking pioneers that drove me to explore my own solution sets of potential health decisions on a daily basis.

Make no mistake - health isn't just about the decisions you ACTUALLY make. It's also about the delta between the decisions you COULD make, or the things you THINK about doing, and what action you choose to take.

As Yoda says, this is about "Do or do not, there is no try."

And speaking of scifi, now let's talk about why moving from a focus on macro population health approaches to individual microchoices will lead a revolution akin to what happened in computing in 1971 when ex-Fairchild Semiconductor engineers Marcian Ted Hoff, Stan Mazor, and Federico Faggin created Intel's "computer on a chip" microprocessor.

(Sorry, I'm reading David A. Kaplan's book "The Silicon Boys And Their Valley of Dreams", which I highly recommend as a holiday gift for those in health tech).  

The analogy is almost too strong to be borne. When talented and visionary startup teams in the Valley catalyzed the evolution of microprocessors, computers evolved from closet sized machines like ENIAC locked deep within the bowels of research institutions to smaller buffet-sized affairs.

This miniaturization process - as well as an installation of silicon chips into 'smart' calculators - led some to start wondering what would happen when computers could be carried around with us (gasp!) and the brains of the computer would be open to users commands via software interfaces accessible by keyboard command.

1971 is when things got *really* interesting in computers because we acknowledged the power of putting a common chip inside to lead to wireless translation and manipulation of data for task achievement.

We are so close in health it's painful.

We've already got some wireless health initiatives that are allowing "users" (ePatients) to "interface" with personal health data computations via sites and services like CureTogether.com, Patients Like Me, Daytum.org, Twitter.com (using hashtag/username tracking as variables in our 'me-tric' algorhithms) even a spreadsheet file in Google docs.

But we're still missing the programming equivalent of "Intel inside." Where's our health microprocessor?

Maybe we won't ever have one. Maybe an individual data bank repository that lies within each individual person is as close as we'll come. But I don't think that's the case.

First, we need to establish the 'language' of circuitry for health, the flow of data and rules about how that data transfers and travels. This means, for HIT to have a common 'processing language,' we must create ontologies that translate data to be processed. hData and OMHE are some of the more interesting examples of brilliant engineers working on this problem.

That is the health equivalent of the microprocessor.

Once we have data standards that let health data be interfaced with via code, we can write software programs that allow 'everyday' users to 'interface' with their own terminal and ask the program to do things like display potential health choices based on their past decision making. NOTE: Believe it or not, the programming solution to organizing this decision-history information is far simpler than anyone's thinking, and yes, Contagion Health is working on it.

Those programs are the health equivalent of the keyboard.

Then it will get *really* interesting as users start requesting easier access, sharing of information outside their own networks. Oh wait, they're ALREADY DOING THAT.

This brings me to my next point. Instead of being at the head of the health computing revolution, Silicon Valley is chasing after the trailing wires ePatients and others are dragging behind us as we flee a closed system with a near uselessly complex interface.

So why aren't the best and the brightest working on this?

I'm dismayed every time I hear brilliant engineers demonstrate a lack of interest in healthy as a problem to solve. This doesn't mean it's actually boring, but rather that it seems like something we should just let the gray-hairs (sorry to all my gray haired friends for that one) solve or fight over amongst themselves.

But this is underestimating the siren call of a problem so audacious that none of the superpowers (Google, Microsoft) have figured it out.

First, if greed and rampant ambition drives any of us, then health is the place to let that ambition loose. We have yet to see a personal health software superpower emerge. Imagine what options as employees 1-20 in a company like that would be worth.

Second, if hacker humanitarianism drives any of us, then health is the place to let that idealism loose. We have yet to see a personal health company that takes human-human connectivity and control into account during the design phase. Imagine what giving each individual person the access to his or her health and wellness decisions in an easy to use format like viewing a photo album on Flickr.com would do.

The next healthcare revolution will not be about macro-machines or population initiatives like broad spectrum antibiotics.

Instead, it will be about personalized medicine in it's truest nascent state - what matters to an individual person in his or her daily life?

What accounting does each of us need to do to make health/wellness decisions?

We need - as so many here in the Valley have told me with little understanding of the issues - the "Mint.com" of healthcare. Yes, that's a vast oversimplification, but a health 'bank' is hardly a new idea, although it *is* a small step in the right conceptual direction. 

If I haven't grabbed you to whiteboard out choice and control aware care and the Aristotelian evolution of patient activation, this is probably blowing a few circuits.

So I'll leave you with a simple question about the choice and control YOU have over your health and how it might impact you when you're inside the healthcare system.

How do the things that happen to this person OUTSIDE the hospital setting matter once that person is INSIDE it?

Because make no mistake...as my mentor and friend Carlos Rizo says, at some point, every one of us *will* be a patient.

The microchoice here is whether or not you will find and join and fund and fight with the companies who will take healthcare from a closet-sized behemoth to something we can use and hold in the palm of our hands.

The 'micro-ization of care' is on its way, and the only decision you need to make today is whether or not you will be part of it now, early on, or whether you'll wait to read about it in biographies 20 years out.

I suggest you answer 'yes.' Now is the right time to start thinking small.

Jen S. McCabe

CEO/Founder: Contagion Health 

CoFounder: NextHealth (NL)

LinkedIn: Jen McCabe 
Skype: jenmccabe

iPhone: 301.904.5136 
Dutch Mobile:  +31655585351


Posted via email from Jen's Posterous


Why You Should Find a Place for Your Kids to Practice Coding Along with Soccer...

"This isn’t some big VC-backed play hoping to take over the world,” says Schnitzer. “We’re two guys who spent a month and a half building what Facebook should have built a long time ago."

The guys from Mobcast, Nikolai Sanders and Jason Schnitzer, just became my new heroes.

There are a ton of services in healthcare that I look at and think "D$%@, they should have built this a long time ago."

A way to challenge and motivate each other to move is one of them. This is the whole reason we built Get Up and Move.

But now there are new frontiers to explore for microfitness challenges. We're going to boldly go where no health/wellness app has gone before.

For example...

Would you like to *see* where other guammies are doing their http://getupandmove.me challenges?

Join a 'local' challenge? I sure would....

Also, some yummy goodness on our 3 week Bday - we're now 134 completed challenges! Woo hoo!

You commented, we listened - @shazow coded up some language to show your Twitter friends that #getupandmove isn't spam.

Check out http://getupandmove.me/accept to give it a look-see.

Posted via web from Jen's Posterous

Learn How to Apply for an HHS Beacon Grant

ONC to hold Beacon grant assistance Web meeting
The Office of the National Coordinator for Health Information Technology at HHS will host a conference call Monday from noon to 2 p.m. ET to provide technical assistance to those organizations interested in applying for federal contracts under the new Beacon Community Cooperative Agreement Program.

On Dec. 2, HHS Secretary Kathleen Sebelius announced her department was launching the three-year, $235 million Beacon Community Program, including $220 million to contract with up to 15 not-for-profit and government organizations that are leaders in health information technology to "generate and disseminate valuable lessons learned that will be applicable to the rest of the nation's communities."

It is a Web meeting, but a dial-in phone line also is available at 800-369-1863. The participant pass code for the call is 4530396. More information about the Beacon program is available at HHS’ Web site. Joseph Conn / HITS staff writer

From: "HITS - Modern Healthcare's daily IT e-newsletter 12.12.09."

Posted via web from Jen's Posterous


Seppukoo » About

About Seppukoo

The invisible Committee -
--> This is the end. My only friend, the end.

You are more than your virtual identity
«Virtual life» is an - often - abused term used to describe the whole of one person online activities. But as media communications let our second/online/offline identities overflowing into real life - and vice-versa - the distinctions between the real and the virtual are becoming, more and more confused. Which is virtual? And where's the real? Beyond all those questions only a fact remains: that our privacy, our profiles, our identities, our relationships, they are all - fake and/or real - entirely exploited for a sole purpose: to be sold as a product. But are those lives really worth to be experienced?

Pass away. Leave your ID behind.
Rather than fall into the hands of their enemies, ancient japanese samurai preferred to die with honor, voluntarily plunging a sword into the abdomen and moving the sword left to right in a slicing motion. The name of this form of ritual suicide is Seppuku (切腹, "stomach-cutting"). Among the important people who committed seppuku there are Azai Nagamasa, forty-six of the Forty-seven Ronin (1703), Takijirō Ōnishi , and, of course, Luther Blissett.
As the Seppuku restores samurai's honor as a warrior, in the same way, Seppukoo.com deals with the liberation of the digital body from any identity constriction in order to help people discover what happens after their virtual life and to rediscover the importance of being anyone, instead of pretending to be someone.
Hacking and parasiting one of the most popular social networking website, Seppukoo.com deactivates one's user facebook account, driving people into one of the most radical chic user-experience: the vir(tu)al suicide.

Suicide networking. Infecting the social.
As viral marketing strategies have been exploited by corporate media to make profit connecting people all over the world, Seppukoo playfully attempts to subvert this mechanism disconnecting people from each other and transforming the individual suicide experience into an exciting"social" experience.
With Seppukoo in fact it's not important how many friends you have, but how much you may influence them. Induce your friends to commit suicide and rise up the Seppukoo Rank!

Resurrections. There's no death where there's no life.
Suicide is a free choice and a kind of self-assertiveness. Unfortunately, Facebook doesn't give to its users this faculty at all, and your account will be only deactivated. This means that any information regarding you and your friends, will be strictly preserved by facebook authorities in order to keep your virtual life alive for the eternity.
That's why you won't need any superpower to come back to your virtual life after death: just a simple login, and your life will be completely restore back.
Still hesitating? Let yourself be conquered by Seppukoo as you have an honour to save yet!
Don't waste this opportunity.

Strangely compelling and disturbing.

Seppukoo.com lets you 'fall on your sword' and commit social network suicide.

From: "Seppukoo » About."

Posted via web from Jen's Posterous

FastCompany Recommends iPhone App Rx for Healthcare Providers

ePatients like whoa...

From: "8 Medical iPhone Apps You Should Prescribe to Your Health-Care Professional | All Up in Your Business | Fast Company."

Hat tip to Brian Dolan, @mobilehealth, from MobiHealthNews, for the great link.

Posted via web from Jen's Posterous

Merry Christmas! WTH!!! HIT Hotness...

From: "http://www.chipchick.com/wp-content/uploads/2009/12/VITAband1.jpg."

More info: "http://www.chipchick.com/2009/12/vitaband-tap-technology-bracelet.html."

"VITAband can be this generation’s Medical ID bracelet. It’s a digital identification bracelet with two key functions: it stores personal health records to give first responders access to critical information in the event of an emergency, PLUS gives access to tap payment technology through a RFID chip – and this is all on your wrist, just like in Japan where this technology is extremely popular.

So the VITAband works out great if you end up in the hospital. All your medical data is on your wrist, and when you are done just tap your wrist and pay your bill.

To get started it will cost you $39.90 for the bracelet and an annual subscription. For every year thereafter it will cost you $19.95 a year to store your data and be able to use it to pay for purchases. You can easily replenish your VITAband with funds through various sources."

Posted via web from Jen's Posterous

Happy Holidays! WTF? HIT Lamesauce...

Holiday shoppers looking for that perfect last minute holiday gift have a new option this year that could literally save the recipient's life. The new 911 Medical ID card provides the security of personal medical information that can be carried as easily as a credit card, and is a great present for travelers, seniors, caregivers, parents, students, the chronically ill, and many others.
If you’re severely injured in an accident, suffering from a severe allergic reaction, or impaired due to a medical emergency such as a stroke, heart attack or seizure, you can't possibly speak for yourself. The new 911 Medical ID™ was created to relay your important health information to first responders, emergency room doctors, or other medical personnel.
Approximately two millimeters thick, the 911 Medical ID™ is the world’s thinnest USB medical information storage device, fitting in your wallet as easily as a credit card. This new Portable Personal Health Record (PHR) provides a simple way to store and carry important medical information such as health history, allergies, and prescriptions, in a format that is easy for medical personnel to access. The information carried on the card will reduce misdiagnoses, save valuable time, and even help cut the cost of medical care as the healthcare industry moves more toward electronic records.
911 Medical ID™ has been in development for three years by MEMI Tech, LLC in Louisville, Kentucky. It can be purchased for $39.99 from http://www.911medicalid.com .
“The 911 Medical ID™ card would be a perfect gift for anyone,” said MEMI Tech CEO Mark Weiss. “It is an easy way to create a Portable Personal Health Record (PHR) that gives you the ability to better control your medical information, and can save your life in an emergency.”

From: "New Portable Personal Health Record (PHR) Card is a Life Saving Last Minute Holiday Gift - AOL Money & Finance."

I think this is worse, definitively, than getting coal in your stocking.

Posted via web from Jen's Posterous

New Health Geoinformatics Lab for Undergrads at Loma Linda University

Loma Linda opens health ‘geoinformatics' laboratory
Students interested in public health and wanting to learn how computerized mapmaking and data analysis software can be used to improve the health of populations around the world will be able to take training at the newly opened Health Geoinformatics Laboratory at Loma Linda (Calif.) University.

The lab was opened in partnership with ESRI, a Redlands, Calif.,-based developer of geographical information systems software, according to a news release Tuesday by the software developer.

The lab “will provide undergraduate and graduate students with hands-on experience in applying modern information system technologies that combine maps and satellite imagery with data about the geographic locations of diseases, healthcare resources and socio-demographic characteristics of communities,” according to the release.

Undergraduate students will be able to earn Bachelor of Science degrees in public health, health geographics and biomedical data management while students with graduate degrees will be able to add certificates in health geoinformatics, environmental health, global health and development, and spatial epidemiology. The lab is part of the recently completed, $85 million Centennial Complex at the university. Joseph Conn / HITS staff writer

Posted via web from Jen's Posterous


You. Yes, You. Participate in TEDxSV This Saturday!

TEDx's are locally organized mini-TEDs that have traditionally had closed attendee lists.

But TEDxSV is breaking new ground supporting social change. 

We're opening the kimono. For the first time, you'll be able to participate WITH us live, on the day of the event!  

TEDxSV partnered with Ustream to deliver a live video stream on Saturday, Dec. 12th, LIVE from Stanford University, starting at 10am Pacific Time.

Ustream is the leader in live video on the web, and if you haven't watched an event yet, they make it easy and painless. 

Set up your user account ahead of time so you can chat as soon as we go live...

Then tune in here on Saturday: 

Also, think about organize a group or Tweetup to participate via our TEDxSV(satellite) program....


http://www.tedxsv.org/?page_id=10 - we are looking for remote groups around the world to watch UStream.com's coverage of our video with us and interact with our audience and other groups. TEDxTokyo, Singularity University, Stanford University, SF State, and others have already agreed to attend. 

And if you've got something to say, TED-style, say it on our YouTube.com video channel...it's your 3 minutes to tell us how the next generation of social innovators will evolve social change. 

TEDxSV Video Contest http://www.tedxsv.org/?page_id=98 - we are seeking the next generation of TEDxSV speakers and TED speakers with this 3 min video contest. Winners will have a chance to speak at the next TEDxSV event and possibly be reccomended to big TED.

See you online! 

Posted via email from Jen's Posterous


AT&T Reinvents the Wheel, Creates "Wireless Enabled Health Device." Yeah. It's Called the iPhone.

From: "Scientists at AT&T Labs in Florham Park have created wireless-enabled medical devices."

Whoops. Someone wasted a ton of grant money on this bad boy...

Posted via web from Jen's Posterous


Shocker: Computers+Healthcare Doesn't = Instant Improvement (Now There's a Harvard Study)

There is a widespread faith, beginning at the very top of our government, that pouring money into computerization will lead to big improvements in both the cost and quality of health care. As this study shows, those assumptions need to be questioned - or a whole lot of taxpayer money may go to waste. Information technology has great promise for health care, but simply dumping cash into traditional commercial systems and applications is unlikely to achieve that promise - and may backfire by increasing costs further.

From: "Rough Type: Nicholas Carr's Blog: Throwing computers at health care."


Posted via web from Jen's Posterous


PHR Report Card from Patient Privacy Rights - Google Health Gets D/F, No More Clipboard Gets Only A?

A "PHR" is a Personal Health Record.  PHRs can collect and store official records, labs, tests, and claims data directly deposited by providers.  They can also store other health-related data such as heart rate, glucose levels, medications, allergies, exercise habits, lifestyle, sexual history, personal notes and other data you create.

The term 'PHR' implies you control this type of electronic health record - because its 'personal,' it's yours.  But that is simply not true of all PHRs.

How much control do you really have?

Think twice about who you allow to see, use, or control your most sensitive, personal health records, from DNA to prescriptions. Patient Privacy Rights (PPR) did our best to decode PHR privacy policies and spell out what control you have over your information.  PPR makes no recommendations on specific PHRs.  The Report Card is our opinion based on the information available on these companies' websites.

From: "Patient Privacy Rights: PHR Report Card - Home."

Worth a detailed read. Some PHRs, as noted by the study, are really EHRs or EMRs (electronic health or electronic medical records) reskinned as 'personal.'

In short, this sector is a long way from maturity. There are still huge problems to solve in the space.

Mixed feelings = both sad and energized by these reviews; upset because it means we've still go so far to go and energized because it means Contagion is on the right track.

Posted via web from Jen's Posterous

Where Mobile Social Health is Headed - Realtime "I am here doing this" Updates

That means Rummble users can geotag tweets with their current location (if they choose to share it) and any venue in the world. This real-time geo-data is consumable by everyone on Twitter, regardless of whether they are signed up to Rummble or not.

This is one of the first social apps (outside of twitter clients) to use geo tweets. It adds geo lat/long into tweets for Twitter’s Location-api for status updates posted out of Rummble. This covers the user’s location, check-ins and tweets posted of Rummble reviews of a bar or cafe etc. Tweets from the Gowalla and Foursquare aps are geotagged if the setting has been switched on in twitter settings.

From: "The Latest from TechCrunch - Spam - Yahoo! Mail."

@shazow, yes sir, right space, right time.

Posted via web from Jen's Posterous


Lessons Learned: From a Health Tech Startup So Early Stage It's Still Got a Vestigal Tail

**Note to fellow early stage founders - when you can't sleep, spooling up a new Posterous is a great cathartic way to slow the mental gyroscope. I wrote this post pre-counting sheep last night.**

1am and all is well. And quiet. 

This isn't insomnia. My eyes feel like they have hidden fishing weights rooted to the sockets. I could probably start drooling and twitching upright in my chair. 

Now I see why programmers really get rolling between 11pm and 4 or 5am, despite the never-quite-conquered desire to snooze. There's no one around. It's like the external world is giving you a pillow of silence and stillness, gently, like a doting parent tucking you in tight. Anyone who wants to be up and moving at this time *really* wants to be doing, well, whatever it is they're doing. 

And so do I. And so I'm awake.

It's day 5 post-launch of Contagion Health's first web app,
 Get Up and Move (#getupandmove). 

Andrey and I decided to go out on a limb and show you a snapshot of our admin stats panel so you can see *exactly* how we're doing.

After all, this is your community of micromovement. You generated this data - you own it. 

As my Get Up and Move co-creator Andrey said when he read the draft of this post: "Feel free to put up a screenshot of the admin panel, if you're alright with the tongue-in-cheek Funding. I always wished more companies put up a glimpse of their "secret" admin stuff."

Two things to note as you view the panel...

1. "Completed Challenges (far right)" = challenges where BOTH the initiator (user 1, or U1) and the responder (user 2, or U2) have done their part. We don't count a challenge as finished until it's a 2-for-1 done deal.

2. Yes, we are looking for funding. Our B2C biz model for the web app = who the hell cares. Our B2B model = enterprise/white labeling for inclusion in employee wellness programs we think are so cool we'd actually use them (and of these we've only found 1 so far). We're using the DM model AmericanWell employees ($ per user/year). But more about that fun stuff later.

Back to the #getupandmove narrative. I have a feeling it's going to be an epic...

I'm going to tell you about this journey in occasional, lengthy posts framed in typical blunt-force-trauma style. I'll use the collegial tone, even though it's a risk, because most of the assumptions 'pre-founders' have about launch are complete horsesh&t. 

This whole startup tech blog world talks a lot of smack about what works and what doesn't, but the big secret is that we're all just sitting scared sh*&tless and tharn in front of our screens before we pull the trigger. 

One founder friend who is very successful told me he used to hide in the closet with a sleeping bag and flashlight for launches. 

This is orifice-clenching, teeth-grinding stuff. And that's CODERS talking about the feeling of launching - these are the folks who actually build and test the stuff in the wee hours obsessively, and thus have some significant control over it's developmental stages. 

It is, unfortunately, not a very different experience for someone who has no coding control, for someone who has gone from patient, to patient advocate, to nonprofit healthcare administrator, to healthcare tech startup analyst, to Health 2.0 blogger, to health+social media consultant, to hax0r wannabe, to health tech startup founder bootstrappin' it for all I'm worth - and then some. 

I certainly don't recommend a similar trajectory, unless you've got balls of steel and brains of Jello. Or probably both. 

Unless, of course, you are seeing something, or things, burnt onto the insides of your retinas before you sleep. Unless there's something, or things, you want and need to see built so badly that you would sacrifice anything to try and birth them. 

Then, by all means, go forth and build, young Jedi. 

I want to share some of the stuff we've learned thanks to your open and honest feedback (via 
our UserVoice forum
). And I want this sort of embarrassing gutcheck postmortem to become part of other early stage tech startups' journeys. 

Disclaimer: If you don't know what the hell I'm talking about, you probably haven't tried Get Up and Move
 yet. If not, follow @contagionhealth
 on Twitter, then mosey on over to getupandmove.me. The app uses your Twitter login information (it's built using Twitter's API) so there's no signup or profile creation. You'll notice it's free, and there's no ad-assault going on. 

So give it a try, and come on back and tell me what you think. Honestly. Like I'm going to share some lessons learned with you. 

Andrey and I have discovered some really amazing things in the past 120 hours. About ourselves, about Twitter, about each other, about you. 

Yes you, dear reader, dear alpha and beta users, dear masters of the microfitness universe who dared to try out being 'guammies' at this early, squalling infant stage. 

Without further ado...

Lesson 1: You've got a teensy weensy little SM streak in ya! 

Supporting Evidence: You *love* issuing challenges. My arms feel like wet spaghetti noodles. I'm doing between 2 and 5 minutes of pushups per day. I've had to start doing 'girl' pushups again, along with interesting versions of wall pushups (for triceps) and finally dips on the counter edge. 

And I'm loving every elbow-wobbling moment. This is *exactly* what I wanted. Exactly what I needed. Someone, well, several someone's actually, to push me further than I'd otherwise permit myself to go. 

Lesson 2: Some of you really, really like to be told what to do. 

Supporting Evidence: You *love* completing challenges. Quick, fast, and in a hurry. Sometimes I've just barely clicked "Done My Part" and then started the timer before you respond with - whabam! - a notification that you've completed the challenge. 

Lesson 3: If I have met you face to face (in addition to being buds on Twitter and/or Facebook), I'm more likely to finish your challenge (and immediately or near immediately after you issue it), unless you sh&^ talk me on Twitter and shame me a lil' bit in the public square. 

Supporting Evidence: Some of our guammie friends may not like the are-you-ready-to-rumble approach, which is why Andrey and I designed the app to deliver challenges via safe, dark-corner, agoraphobic-friendly direct message rather than via public tweet. 

Interesting point here...my mom @susanlindsey is now bugging my friend @ePatientDave and Los Altos startup pal @alexdmoore for challenges. She likes knowing the people I work with (and guys, if she starts asking questions about whether or not I'm eating well or brushing my teeth, the answers are always "yes" and "you betcha."). 

My dad @litomikey said flat out that he doesn't really need the motivation to work out. This is a guy who's a former Navy SEAL, taught my younger sister @kbluey and I to poke someone's eye out using a thumb and a dirty look, and just kicked my butt at the gym on Friday (and that of my younger, Jacob-buff cousin Jack). He is NOT going easy on me just because his semi-sweet daughter launched her first app. 

Instead, he pointed out that he's sending me challenges (and accepting mine) not because of the movement aspect, but because it's *me.* 

This is more than random acts of microfitness. This is more than 'instant' exercise. My dad feels closer when he thinks of me being happy and healthy, even for 2 minutes of pushups where he probably doesn't know I'm cursing his name (ahh, whoops, sorry about that Pop!:).  

This emotive connection is fascinating, and emergent in a ridiculously simple 1:1 Twitter app. That leads me to our next revelation - although we can't take credit for this one...

Lesson 4: Location, location, location. You want to share WHERE you're moving.

Supporting Evidence: An interesting number of GUAM users are already adding 'addendum' tweets with location-based data, which you are typing as free text and then sending as a SEPARATE and independent DM or public tweet or email or Skype chat or text or message in a bottle. Just kidding about that last one, although that'd be a damn awesome way to get user feedback. 

Anywho, you're telling us things like how you just closed the door to your office, squirreled out of your desk chair, and busted out 2 minutes of crunches on the floor. Or that your 5 minutes of running was to the 7-11. To get a Nutty Buddy ice cream cone. <crickets/> 

Point is, a certain subset of you seem to *want* to make the initiator of a challenge aware of your surroundings, so we can get a nice mental picture of where you were when you moved it for us. It's like returning a favor or something. 

But we didn't ask for that at all, and that's another nifty emerging norm that we'll do something about programmatically to easily allow you to 'check in' Foursquare style if you so choose. 

When Andrey and I talked about this, we went back and forth about the utility and privacy risks related to allowing personal geolocation (although I'd planned to do this from the beginning with the #getupandmove mobile applications). 

I explained that I like to get a smell of the Blacksburg VA air and see my sister Kate's thoughtful look over the horizon when I challenge her to 15 minutes of walking (with my niece or nephew onboard in utero). 

It's this personal and sensory connection that matters most to me with Get Up and Move, this weird and wacky deepening of ties enabled by something as stoopid simple as a Twitter-based challenge. 
For some reason, it just works to create a picture in my mind's eye that reminds me of the people I love most and miss most (and that I should probably return their phone calls more often). 

So we'll work on how best to allow you to set the scene for your Get Up and Move friends. If you've got druthers, send em this way. I give you permission to be harsh. And speaking of permission...

Lesson 5: You maybe want us, or the app Gods and Goddesses, to give you permission to RT the challenge, and maybe to add a little additional incriminating info. 

Supporting Evidence: Although tons of you asked for a public RT button, we expected that if you want to call someone out on Twitter - slash - motivate them to #getupandmove, you'd just take the initiative and copy/paste and RT that way. 

But almost no one's done that. It's like the community of Twitter users who are also using Get Up and Move are awaiting permission, aka us programming in the RT button on our app. 

Andrey disagrees with me here, as the best startup teams do...He doesn't imagine you're waiting for permission, but rather that the "culture of Twitter discourages blind copy/pasting, people feel as if they have to add a 'taste of themselves' into each message to justify sending it out." 

That's why plain RT turns him off. (Note to healthcare brands trying to negotiate the Twitter landscape - Andrey's just told you everything you need to know, and while responding to a message at 5am no less). 

Relax, my movement loving friends. We shall deliver. Andrey's got something really nifty up his sleeve.

Lesson 6: You want to be able to respond to a challenge later. Even if it's a tiny time commitment and easy to finish, you want control over *when* to respond.  

Supporting Evidence: Maybe work isn't really the type of place where shaking your groove thang to 2 Taylor Swift songs is the type of thing management smiles upon - especially right before those holiday bonus checks are cut. 

Andrey and I talked about this for a bit pre-launch, but then decided that we wanted to keep the 'micro,' 'random acts of fitness' mantra intact. 

We firmly believed (and I still do, actually) that challenges should be able to be done just about anywhere by just about anyone, with no special equipment or training, and completed in less than the time it takes your barista to whip up that limited edition Peppermint Mocha (no whip). 

But here's the bottom line: Calendaring or 'snoozing' a challenge is better than you refusing because you can't do it instantaneously. Far be it from us to stand in the way of your progress. So look for something nifty in this area soon.

Lesson 7: You want control. I know. I should be ashamed of myself for getting this one wrong. So I'll issue an apology. We underestimated you.

Supporting Evidence: I thought that if we gave you the ability to create your own challenges with no constraints (just user/user, open A variable for activity and open T variable for time in the Get Up and Move equation) you'd mess something up and alienate people, or create something too complicated, or, even worse - not use the app at all.

Andrey maintains a healthy dose of skepticism about what will happen to the ecosystem if we let loose the constraints on activity and time. As he says: "I'm still suspicious about this but we're here to experiment, right?" 

How very paternalistic of us. Indeed we are here to experiment. But so are you. You are the early adopters, the innovators. The people who try the next big thing before it's the next big thing, when it still may *never make it* to the next big thing (although mentioning that to a startup founder is like naming The Scottish Play). 

Although our motives were noble - to launch with just 3 challenges just about anyone would look at and say "Oh yeah! That's so friggin easy! Of course I can do that..." - we may have messed up badly here. I'm not sure yet, but we'll see next week when we start building the big feature push for version 2. 

I hope you can wait that long for some new stuff....and that brings up...

Lesson 8: Founders - launching an app is like the end of year 1 in a marriage, where you can say objectively your spouse still looks pretty good first thing laying on that pillow next to you hogging the covers, but you're over the morning breath. 

You will have to harness both boredom (with yourself, with your app), a lack of confidence (will we make it through this together?), and prioritize in real time (LAN party or movie night with the significant other?). 

You have to fall in love with some small, newly unearthed or rediscovered part of your app EVERY. SINGLE. DAY. If you can't, it's only a matter of time til the divorce happens (and hopefully someone gets a fat successful-exit settlement before you look for spouse/startup #2). 

Everyone I've met in the Valley BS's about iteration, iteration, iteration. They say it's to keep the users from getting bored and searching out greener pastures. That's horsecrap.

So-fast-you-can-barely-code-it-and-debug iteration keeps BOTH sides from getting bored - programmers and participants using the app. With our always on, instant gratification world, it's iterate or seek amusement elsewhere. 

But, the good news is each one of us has control over our responses. No matter how cool Andrey and I make Get Up and Move, you'll always have millions of other options about what to do with your time. 

Speaking of responses, the cool thing about this early Get Up and Move community that both frightens and excites us is that we're trusting each other. There's no way to verify if I'm actually weeping on my stained concrete studio floor doing the 8th crunch challenge of the day. It's working on the honor system. 

For the mobile application, we'll use the accelerometer and some other nifty stuff including timestamping to VERIFY that you're at least moving when you're logged in, but for now, it's tell the truth.

And who'd try to scam a system like this? There's no gain for misdirection or untrustworthy behaviors. Ahem. I have to admit, since we created the app, I tried to cheat. I really did. 

I challenged my dad (sorry Pop, you're getting all the fallout today) and then lied. I said I'd danced for 2 songs when I hadn't done it yet.

You know what happened about 5 minutes later? I felt so damn guilty seeing my dad doing pushups on 2 repaired shoulders *for me* *because I'd asked him to and for NO other reason* that I got up and danced to 2 Beatles songs. 

I'm not encouraging cheating the app before we have a way to verify your movement and location. But you could do it if you really wanted to. 

Or, you could take the easier route and just move your a^% for a minute or so.  

We just hope you'll move it with us, and each other. 

Bottom line: No one controls your boredom, or decision paralysis (or lack thereof) or your 'adherence' to a healthier lifestyle but you. Lesson learned. 

We're looking at ways to let you create your own challenges and let loose the real exponential power of self motivation turned outwards and traded for the movement of others. 

And while we're talking about control, I'm going to exhibit some and get some shut eye. There are many more lessons swirling around in the brain pan, but frankly I'm worn out from a day of moving and shaking. 

Plus, I have a feeling I'll be moving a lot again tomorrow, thanks to all of you...

Jen S. McCabe

CEO/Founder: Contagion Health 

CoFounder: NextHealth (NL)

LinkedIn: Jen McCabe 
Skype: jenmccabe

iPhone: 301.904.5136 
Dutch Mobile:  +31655585351


Posted via email from Jen's Posterous