See you at the Millennial Week DC Code-a-Thon

Millenial Week Code-a-Thon, sponsored by Microsoft and Kaiser Permanente

I have been known to hang out with Millenials, actually I am almost one if you look at my score on the Millennial quiz 🙂 .

Even if this wasn’t in support of Millenial Week (@MillenialWeek), it’s in support of Washington, DC, which happens to be the best city in the United States to be a millenial (and many other things).

The Code-a-Thon is sponsored by Kaiser Permanente (@KPShare) and Microsoft together at the world famous 1776 (@1776).

I’ll be there in the role of catalyst. Watch out!

More info below, feel free to sign up at http://bit.ly/KPCodeathon


Millennial Week Code-a-thon

Health and Wellness Designed by You

Brought to you by Kaiser Permanente and Microsoft

Washington, D.C. • June 20-21, 2015

Are you ready to shape the future of health care? Have ideas on how innovative technologies can transform how we stay happy and healthy? Join Kaiser Permanente and Microsoft in Washington, D.C., during Millennial Week for 48 hours of coding and co-creating.

Register now! http://bit.ly/KPCodeathon

Using Microsoft Azure and Xamarin (and with plenty of tech support), you’ll join a team to build app prototypes that incorporate wearables, video calls, mobile communications, or other technologies. You’ll have access to Kaiser Permanente physicians and technologists who’ll help identify opportunities for innovation and provide insights into how the nation’s leading integrated healthcare system operates.

Don’t worry if you’re not a coder. We need designers, marketers, entrepreneurs, and folks with big ideas who are willing to roll up their sleeves and show us YOUR vision of the future of health and wellness!

Oh, and there will be lots of free food, and the winning teams will receive cool prizes.

WHEN: Sat., June 20, 7 AM to11 PM EST; Sun., June 21, 7 AM to 5:30 PM EST
WHERE: General Assembly, 1133 15th Street, NW, 8th Floor, Washington, DC 20005
PRIZES: Microsoft hardware and software
Register now! http://bit.ly/KPCodeathon

Questions? Email ricardo@bemyapp.com

Photo Friday: What Innovation in your DNA looks like

I try and take photographs that capture people as they are (I call it “the human spirit”). This week’s photo wasn’t taken by me ( Thank you@erinm81 ) but notice how the silly shot is always more interesting than the serious shot. It’s from this week’s code-a-thon, where we worked with the newly published open data API by Kaiser Permanente. 

Not here because we don’t want to change light bulbs, here because we want to change the world View Interchange by KP Code-a-Thon 25596 on Flickr.com

Laugh once a day

This photograph was taken by me. The people in the photograph are, on a daily basis, dealing with the most vexing problems in health care known. Not just how to provide coverage and service, but to recruit and train the best nurses, doctors, and physicians, with the highest quality and zero (zero) disparities, and not for the purpose of delivering great care either, for the purpose of helping people and communities achieve their goals in life. And yet, they can come from across the country to find new ways to do it better, with humility and humor.

A little plug for my team’s project (which was not the uber winner – that title goes most awesomely to our Kaiser Permanente Georgia colleagues, iThrive C in the photos). We used the new API to create a workflow for physicians/care providers to happily and supportively accept tracking data from your device/app of choice, provide feedback, and use it to change the social milieu of health. We called it “Total Health Connect.”

When Farzad Mostashari, MD (@farzad_ONC) was in the other day, he remarked to us that he was impressed that our organization would bring together people (physicians from not 1, but 4 Permanente Medical Groups from across the United States) across disciplines to create the future. Honestly, though, it’s how we are – not here to keep from changing light bulbs, here to change the world.

Equality, one of the most important innovations

Speaking of zero disparities and changing the world, our week of innovation isn’t over. Kaiser Permanente is a silver sponsor in the Capital Pride parade and festival in our nation’s capital this weekend. Our doctors, nurses, staff, and members, are walking to support the health of our lesbian, gay, bixesual, transgender, and intersex members, staff, and communities who support them.

When innovation is in your DNA you apply it to everything you do 🙂

Interchange by Kaiser Permanente API Launch and Code-a-Thon – enjoy the journey

I have never been in a code-a-thon that took me to a different state during its operation. And yet….there we were in Virginia in the middle of the night (for a good reason, visiting with Lesley Levine, MD’s (@LRLMD)  brother, who provided us the pizzas for the team’s midnight snack). A the title of the post says, enjoy the journey, which we did.

The code-a-thon is the launch of Interchange by Kasier Permanente:

Interchange by Kaiser Permanente is our open API program. This API securely enables internal and external developers to plug into and use approved public Kaiser Permanente data to improve health care experiences in ways that have never been possible and have yet to be imagined. The availability of the API program has the potential to transform health care interactions, drive new models of consumer engagement, enable safe sharing of Kaiser Permanente digital assets and promote the brand promise of total health as a destination.

We have been working with friends and supporters, including Permanente physicians, nurses, developers and other staff from across the United States, as well as a frankly awesome visit from Farzad Mostashari, MD (@farzad_ONC), who stimulated the group with his wit and probing questions, with a dash of humor. Come back anytime, our friend.

I am working with colleague Mark Groshek, MD (@markgroshek) on a team that is leveraging the API to create a world where a tracker (activity, sleep, food) connects patient and care team rather than creating a gap between them. This is what an API can do, if implemented well. Enjoy the photos. Official release about the API is here.

Hacking Community Walking Data with the Arlington, Virginia, Mobility Lab

There are so many things in just the title of this post that is new learning for me. Let’s count them:

    1. There is automated community walking data available, because Arlington, Virginia has installed electronic meters on its walking trails (see: National Bicycle and Pedestrian Documentation Project :: Home)
    2. This data is available for download and via web service (see: Bicycle & Pedestrian Counters)
    3. There is a mobility lab in this region, (@mobilitylabteam) a unique organization in our nation, part of Arlington Department of Environmental Services, that is
      • The home of cutting-edge original transportation research,
      • A convener and engager of top minds on the topic locally in the DC region, nationally, and worldwide, and
      • The leading online source for how we can improve society by offering a better and healthier array of transportation options.

    I learned about this at mobility hack day, which was held at the Lab this past weekend. By the way, “mobility” refers to transportation, rather than “mobile technology,” although the two are commingled in this world…

    This information is a bit of a revelation for me because I have been following all of the amazing analysis and visualizations of Capital Bikeshare (@bikeshare), the nation’s largest (and most awesome) bike sharing service, which has made its data available for download. This is just one example from community colleague MV Jantzen. I didn’t realize that walking could be measured (since I assumed, unlike a bike, you don’t check out your feet at a walk station).

    Well it turns out that you can, via specially designed meters that have different characteristics suitable for measuring walking indoors our outdoors. It seems like there’s as much science behind these as there is for many medical tests we order (sensitivity/specificity, etc). Again, I was not aware, until now.

    Why Arlington?

    Why, do you ask, does Arlington, Virgina have a nation-leading organization like mobility lab? Here’s a clue (from Wikipedia):

    With a land area of 26 square miles (67 km2), Arlington is the geographically smallest self-governing county in the United States and has no other incorporated towns within its borders. Given these unique characteristics, for statistical purposes the county is included as a municipality within the Washington Metropolitan Area by the United States Census Bureau. As of 2012, Arlington County had a population of 220,565 residents. It would be the fourth-largest city in the state if it were incorporated as such.

    Think about the management of growth that this must require, and necessity is the mother of innovation…. 

    Walking and Mondays, my quick little data hack

    My little hack was pretty simple. I just downloaded pedestrian counts from three points in Arlington’s trail system and wanted to visually review what Mondays looked like relative to the rest of the week. This analysis is important, because there’s behavioral science to show that Mondays have special significance in changing behavior and it may be more effective to start a change on Monday, and continue that change on a Monday, for lasting effect. The Monday Campaigns have highlighted this and leveraged it to success in multiple venues/campaigns. Check it out.  and review “The Science behind the Monday Campaigns

    My hack above has significant methodologic problems, most notably that it doesn’t take the weather into account. 

    Let’s assume for a second, though, that it’s correct. If it is, it may show a picture of people walking on trails mostly on weekends with a drop-off during the work week. Imagine that you are an employer then in the area, and could start a Monday campaign, by encouraging your employees to conduct walking meetings on Mondays or walking to work on Mondays.

    First, you could use this data to see impact – since it counts down to the pedestrian.

    Second, you could report this data back and use it to see a smoothing of walking throughout the week. In other words, Monday could be the “The Day All Health Breaks Loose” and over time, there would be more weekday walking.

    And I’m still impressed that walking can actually be counted without expensive pedometers or app installations. Have I mentioned that a few times already? 🙂

    I guess point #3 is that more employers could install pedestrian counters to support walking initiatives across all their locations.

    I’d like a few of these

    And now, just as I joke that I’d like to have a functional MRI to discover the secrets that other industries use to promote unhealthy behavior, I’d like to have one, or 600 of these sensors to track walking where people live, work, learn, and play.

    Thanks again, Mobility Lab, for opening your doors to all. Special thanks to Sridevi Beidha from Redmon Group, who with a single utterance of a URL, made rainbows come into the room. Transportation and Health are really collaborating now.

    Coming in April: Center for Total Health Community Tour, focus on Transportation and Health

    As the heading says, we’re keeping the collaboration going. See you in April. Watch this space for details on time and place.

    A media moment at #healthdata with US CTO Todd Park and The SchoolFit team

    This is how stuff happens around here. One minute you’re sharing stories with a friend whose team happened to win the obesity prevention code-a-thon. The next, you’re watching as the United States Chief Technology Officer Todd Park ( @Todd_Park ) gets a live demo of the app-created-in-2-days by the SchoolFit team, with CBS News looking on.

    What was supposed to happen was that Todd was being set up for a scheduled interview right after congratulating the winning team, who are Jay Nagy > Ryan Duryea, dev > Art Nicewick, lead > Christine Kraft ( @ChristineKraft ) > Amanda Robison. However, he became engaged, and quite graciously so, in seeing how the app worked. At that point, the CBS crew decided to take their camera off its tripod and walk over to film what was happening, which is what I photographed.

    So, this is proof that winning a code-a-thon can bring great visibility for innovation. And, let’s also celebrate that this is the first Health Data Initiative Forum that had a national TV news crew present (that I know of). This health data thing is REALLY catching on.

    Art, Todd, Christine

    Oh, and CTO Park did pose for a photo with Art and Christine, too. The rest of the photographs from the moment are below, enjoy. With great thanks to Todd’s team for their flexibility, sense of humor, and focus on a great experience for all.

    Obesity Prevention Code-A-Thon Finale: From an invididual to a civic mindset

    DC Health Week Code-a-Thon 13141 – The School Fit Team – They won!

    In the weeks leading up to this weekend’s code-a-thon, conversations like this, with respected community organizers like Greg Bloom were happening:

    This is a reasonable question. In some mHealth circles, people feel “App” is a bad word now, because it seems like too simple a solution to complex problems.

    Enter this week’s code-a-thon. As I mentioned in the post about the code-a-thon yesterday, there were more than a few experts in social determinants of health and geospatial imaging present, and it made a difference. By the time we got to presenting the final entries, I definitely noticed that teams had learned, slept on things, and created tools that enhanced understanding of community conditions, not just a person’s day to day activities. Since many people believe that that the causes of behavior lie deeper than individuals having information, this is very important.

    DC Health Week Code-a-Thon 13129 – School Fit

    And the winner is…. School Fit

    The School Fit team, which happens to include amongst its ranks Christine Kraft ( @ChristineKraft ) (who said she would just do a drive by on Saturday and now look what happened…). developed a ruby on rails app that integrates location based information along with school fitness rankings to work at a family and community level to combat obesity.

    This application, like many others at the code-a-thon, relies on layers of community data to guide people either to civic action, or to understand better the causes of the causes of their conditions. The team is mindful of social differences between schools, so have planned the metrics around educational activities as well as outcomes to assign fit scores to schools. From that perspective, I say, yes, this app could bring neighbors together to solve community problems.

    These aren’t the apps that might have been built 1 – 2 years ago, which tells me that (a) people interested in developing apps for health are interested in improving health and are able and willing to learn the most promising avenues to do that (b) the connection to geospatial analysis and social data can change the way people think:

    DC Health Week Code-a-Thon – Gratutitous Hot Sauce Shot 13114

    I’m impressed!

    Alan Viars ( @avairs ) bringing the hot sauce was just icing on the cake. Thanks to Danielle Cass ( @DanielleCass ), The Health 2.0 Challenge Team, Deb Linton ( @pingdeb ), Hemali Thakkur, and the Center for Total Health ( @kptotalhealth ) for the hospitality.

    Obesity Prevention Code-a-Thon – the era of Geospatial

    Yesterday was the first day of DC Health Data and Innovation Week, which started with the HD&IW Code-a-thon: Preventing Obesity. I have actually been at all 3 Washington DC-based code-a-thons, and can say (and celebrate) a paradigm shift, which is really from the individual, to the spectrum of individual, family, and community. Tyler Norris, the Vice President of Total Health Partnerships for Kaiser Permanente said it well, when he said that we have an opportunity to create a new class of applications that change civic decisions as much as individual decisions:

    To help with that development, I counted no less than 4 geospatial experts in attendance yesterday. That’s a first in my code-a-thon history. These individuals have the ability to understand complex mapping and apply it to health and health care, for overall #RxSocial goodness. A great example is the Center for Applied Research and Environmental Systems (CARES), which manages 7,000 GIS layers to help inform our world. Definitely check it out.

    Aetna’s Carepass Developer Portal

    – The other announcement that happened here at the Kaiser Permanente Center for Total Health ( @kptotalhealth ) was the go-live of Aetna’s Carepass Developer Portal, which offers access to API keys to publicly available data as well as data from Aetna’s own datasets. This includes estimates of costs of care, and…de-identified claims. More announcements are expected this week. It was nice to get a glimpse of this resource, offered by the team that brought it into existence.

    Today is Day 2, which is a great thing for a code-a-thon, because teams can sleep on their ideas and figure out how to position then and use data better. I already see a shift from the individual to the civic, from the location-independent to the geospatial. Here are the rest of my photographs from yesterday, enjoy.

    Idea for the Obesity prevention Code-A-Thon: a healthier meeting revolution

    When you take the time to be mindful – View on flickr.com

    How does it feel when you are at an all day or multi-day event either as an attendee or staff, and you feel trapped by the food choices that are provided for you? Oh, I just gave away the answer. It doesn’t feel good. The recent Weight of the Nation documentary showed that this is actually dangerous, because in situations like these where we are not in normal environment and/or working long hours, stress hormones go up, and disregard for caloric quality goes down. Is there a way out? I found out, there is. Read on….

    I have been meaning to write this post since about January, but really since about 2010, when I learned that we can stop this. I alluded to this first in a post on healthy food in health care (see: #greenhealthcare Part 3: Better food in health care makes a difference | Ted Eytan, MD ).

    I’m giving it its own post now because the Obesity prevention code-a-thon is just 2 short days away (are you coming?). 

    I learned when shadowing event planners, and a specifically gastronomically tuned one at Kaiser Permanente, Kimberly Stansell, who showed me how she works with hotel chefs and caterers to change their default menus to menus that are healthy. The most important finding is that is is possible to work with them to change menus – it isn’t “what you see is what you get.” 

    I first picked up on this because I noticed a qualitative difference in the type, quality, and healthiness of food at events planned by Kaiser Permanente staff. I actually heard a rumor that there was a “Thrive” menu that venues in and around Kaiser Permanente facilities were using to cater events, and that this menu was actually being requested by other organizations for their events, too.

    I found out from watching Kimberly, that there is definitely pre-work involved, there is definitely a dialogue involved, and it is definitely important to make it known that people want healthier choices. As I learned at the Bipartisan Policy Center in February, it is not that the hospitality industry doesn’t want guests to be healthy, it is that they don’t know what guests want. This is where a knowledgeable event planner with the right tools changes the course of health history, for a lot of people.

    I found out there is no “Thrive” menu, per se, but there is a helpful, publicly available healthy meeting guide that’s designed for meeting planners, and it’s here: Do-it-yourself programs – Workforce health | Kaiser Permanente BusinessNet California.

    In it is a healthy meetings checklist, a nutritional meeting guide, even a sample e-mail that you can send to meeting planners to take advantage of this resource (here’s the direct link to that).

    Materials are one thing, leadership is another

    The development and availability of these tools was announced back in 2011. What I am emphasizing here is the difference it makes for a meeting planner to visit with a chef or a caterer before an event, empowered and informed by data and the desire to keep people healthy. I have seen how Kimberly attends to this work with extreme care, because she is caring for hundreds of people when she does what she does. I would say what she does on is as valuable to a group of people as having an AED in the facility, if not more, because she’s helping prevent the need for the AED in the first place.

    Is there an app for that? I’m not sure. Could a mobile accessible healthy meeting planner be created? Would it be standalone or would it be part of a caterer/hospitality venue’s mobile offering? An app can’t replace leadership, but it can certainly enable it. There are a ton of other ideas for this week’s Code-a-Thon that people posted on the Massive Health + Massive Ideas for Health Innovation – feel free to bring those, too.

    Take a look at some of the tasty and healthy bites at the January, 2012, Care Innovations Summit, don’t they lower your stress level?

    That URL again is… Welcome to Kaiser Permanente BusinessNet California – Healthy Meetings

    And it’s true, I do like to photograph food. Don’t hold it against me. With thanks to Kimberly and the experts at Kaiser Permanente HealthWorks Exercise and Nutrition for taking the time to teach me.

    #health2dev Code-A-Thon – I am the tofu to the hotsauce

    Obligatory hotsauce shot, hotsauce courtesy @avairs

    I think I am like tofu when it comes to innovation, I take on the flavor of whatever is around me. If I meet and work with people who are passionate about anything, I tend to pick up their passion, because I feel that passion should never be wasted.

    With that in mind, I excitedly transported myself (using an innovation in that area, Capital Bikeshare ( @bikeshare ), see photo below) back to the Center for Total Health (@kptotalhealth) for the last event of DC Health Innovation Week, the Health 2.0 Developer Challenge Code-a-Thon.

    Last time, I was embedded in a team and picked up the passion of my teammates in the area of relevant peer comparisons and personal health record data. This time, I was more “emeritus” in my approach because I knew I wouldn’t be able to stay the whole day.

    This time, Regina Holliday (@reginaholliday) also came to paint, and for the first time I watched her perform her art (or is it practice her talent?). Have you ever watched her paint? Her hands are steady, she is directed, she is quick. She talks to you while she’s painting and brings anyone who walks by into the work. She doesn’t seem to worry about having her flow interrupted. I was reflecting on what I saw and it felt like watching someone who is good at what they do, loves what they do, and brings the world into what they do. And that feels exactly like…the feeling I get when I am around a physician or nurse who love what they do and are good at what they do – you are drawn to these people and you like having them around you.

    Yair Rajwan, DSc, FNLM (@visualmatics) stopped by and gave me great news, which is that the innovation we worked on at the last code-a-thon, BlueMeter, has come to life and is living! He is also having an experience as a caregiver interacting with the health system that he or any patient or family member should not be having. Fueling the passion, growing strong at the broken places.

    While the coding was going on, I was having a wonderful conversation with Gregg Masters (@2healthguru), Jen Dyer, MD, MPH (@endogoddess), Phil Baumann (@philbaumann), Cristian Liu (@cristianliu) was also present. Got to watch everyone meet for the first time, which is like the superglue in the social network, and as they warmed me up (I admit I was feeling a little behind on things), I began to pick up their passion, like the tofu that I am.

    I couldn’t stay for the whole day so I don’t know which team(s) won. It was Washington, DC’s annual celebration of the lesbian gay bisexual transgender community, Capital Pride (@capitalpride), the 3rd largest in the nation. There was a recurring blending of diversity and technology/innovation events throughout the week, which flowed over each other, such as the #healthapps and #NPLunch11 events. I think you can’t have one without the other, innovation and diversity, which is why I will always seek out both, and work proudly with organizations who do the same, which includes Health 2.0 and Kaiser Permanente.

    Photos from the Code-A-Thon are below, click to enlarge, feel free to use any. Thanks again to the Health 2.0 (@health2con) team for another one of those you-look-up-at-the-clock-and-the-day-has-flown-by days.

    Don’t forget the hot sauce! Washington DC’s Health 2.0 Code-a-thon

    The hot sauce (view at Flickr.com)

    If there’s two things I love, it’s walking to anything and applying the best practices of other industries to health care.  Oh, and Health 2.0, of course.

    So I walked to Georgetown to the Health 2.0 Code-a-thon and participated in a cool project that combines what’s being understood about human behavior in the economics world (where, I believe, human behavior is better understood than in the medical world) and leveraged one of the newest datasets made available, Healthindicators.gov.

    The scene itself – people coming together from different disciplines with the need/desire to build a product by the end of the day. I wasn’t really expecting to stay 11 hours, but that’s what you realize when you look up at the clock a few minutes after you start….

    The other industries part is the example provided by OPower, which compares electricity customers to higher-performing relevant peer groups in monthly statements, using social influence to change their behavior towards (hopefully) reduced peak energy use (they even call it “advanced customer engagement”). So they are getting results for electricity use, what’s the analogy for health care?

    Our hypothesis was that a desired health behavior for all (walking) could be influenced both by (a) comparison with relevant peer groups and (b) linkage to a person’s own personal medical information.

    (a) came from the physical activity indicator at healthindicators.gov, (b) came from, for the purposes of our challenge, medical record data provided by bluebutton, and the two were mashed together to provide information about the desired behavior, comparison to relevant peers, and reinforcement with data from the electronic medical record.

    Most electronic health records don’t include a measure of physical activity, so this would require a person’s input for comparison. This is changing though, most notably at Kaiser Permanente, where exercise is now treated as a vital sign and assessed at every office visit in Southern California, thanks to the work of Bob Sallis, MD.

    Photos below, thanks to @drytownlizzie and Health 2.0 for the leadership and coordination, teammates @raseman (corrected Twitter handle, 02/18/11), @avairs, Yair Rajwan, Heather O’Shea, @jess_jacobs, @MsWZ, @jzatzkin, and congratulations to the awesome team from Maya for their first place win! (We were second place…)