I like this. It demonstrates that our police department acknowledges that this a problem that is affecting a lot of people, and uses a creative way to get the information out.
And PS, if you are coming to visit Washington, DC, take this seriously. Do not use your smart device near a metro doorway or even in a public space, such as seated in a restaurant. You may find its presence in your life a distant memory….
Conditions like this don’t stifle innovation, they ignite it, and it’s one of the several reasons I think mHealth (“the use of wireless communication devices to support public health and clinical practice”) is different than eHealth (which I’m referring to as desktop Web/computer interaction in health/health care).
I credit Susannah Fox, the Internet’s Informant General, for stimulating the thinking. In 2008 at Health 2.0 in San Diego, she said, “Recruit doctors, let e-patients lead, go mobile” and the data she has been generating since has ceaselessly has been pointing to that reality.
More recently, Washington, DC, hosted the mHealth Initiative Networking Conference last week, and this week, Health Affairs hosted a briefing on their latest issue on E-Health in the Developing World (side note, I know I’m behind in noticing this, but I love HealthAffairs new print form factor – less tome-y and more open).
The mHealth Networking Conference was remarkable for me in terms of the spark I noticed on the part of the attendees and the slightly different focus – a little more public health-y, a little more do-great-things-for-society-y. And, I’m going to say it, a little more exciting for someone like me because of the possibilities that go beyond the desktop web. To learn about them in the City where people believe everything is possible, because it is, is just icing on the cake.
So here’s my list:
#1: When we talk about the web, we still worry about the people who are just not online. According to Susannah’s team, its hovering at 26 %. mHealth is different, everyone has a cell phone or is going to get one, relatively speaking. If you compare use visually, the cell phone thermometer shows much greater penetration – all groups are “pushed up” to higher degrees of access.
Wireless internet users’ demographics; this is kind of huge
Speaking of Mexico and the developing world, the parallels are relevant in the United States to vulnerable populaition, and this is another key difference. Desktop web access favors more educated, more affluent people. There’s an inverse relationship when it comes to wireless. Look at this data from December: If you look carefully, you’ll see something amazing. Access statistics for Black and Hispanic respondents are higher for wireless access to the Internet than for Whites. It’s almost as if the “haves/have nots” are reversed. For people interested in reducing disparities, this is…kind of huge. That’s difference #2.
Difference #3 has to do with ease of set-up. When I speak with iPhone developers or people involved in mobile, I hear the words “difficult, challenging,” which is different than what we heard in 1995 when anyone (me included) could code an HTML page and put it up.
Difference #4, when we talk about the web, there’s not a discussion of telecommunications companies and their innovation. When we talk about mHealth, we have to include telecommunications companies. This year at HIMSS10 , in Atlanta, it’s not Sanjay Gupta, MD (whose work I have great respect for) that I want to see speak the most. it’s Dan Hesse, CEO of Sprint/Nextel. People with telecommunications experience, in my opinion will be very important moving forward. In a analogous way, I am as drawn to the CTIA as I am to AMIA .
Susan calls it
Difference #5, Reverse Innovation – Unlike the web, a lot of the “cool” stuff has already been pioneered, outside of the United States. Susan Dentzer said it best at the Health Affairs briefing: ” Clearly the US is the developing country when it comes to mHealth“. The term reverse innovation comes from General Electric (this article from Harvard Business Review explains it) , and it means that a lot of the inventing to be done is happening in India, China, South America, and as the article linked to above points out, in Mexico. What may work best is something that comes from a place with far less resources than we have. Kind of what health care, a resource-poor industry when it comes to innovation at the level of public health and primary care, needs.
ZipHealth: Where would you rather track your health; here, or on a desktop website?
Difference #6, it’s more personal. Some of the apps we saw last week, and others I am hearing about, are things that might not work on the desktop web so well, because a desktop or laptop is not as “personal” a device. The idea of storing information on a web site and forwarding to your doctor seems to make more sense on a mobile phone, because it’s something you hold that’s yours, that you can “share” with someone. Not the same for a web site on a computer.
I want to clarify that this is not 6 reasons why mHealth is better or has more scientific evidence behind it. This is just differences. I’ll report on two great papers in the Health Affairs issue on this shortly.
Comments/additions/subtractions welcome.
Special-Purpose iPhone Accessories: Where Are They? | Gadget Lab | Wired.com – I noticed recently that these things aren't being created (hardware accessories for iPhone). This article shows that I'm not the only one noticing.
iTunes Store – LeWeb Paris 09 – Example of an iPhone app that is custom-developed for a meeting/conference. Could this be the norm for scientific and other meetings in health care?
Police: Robbers Targeting Pedestrians with iPhones « Borderstan (Washington, DC) – Washington, DC Metro Police are now advising people not to use iPhones of an increase in robberies with a specific target, the iPhone, that device specifically, in public. This is a big deal, in a previously-thought-of-as-safe part of the city.
People like me wish Apple would sell a version of its headphones that are not white. These appear to be setting us up as targets.
I was a recent victim of an iPhone snatcher in downtown Washington, DC, and in comparison to some of the crimes detailed in the blog post above, I consider myself very lucky.
It was going to happen eventually that wearing a $600 device would increase personal crime. I can’t help thinking that there’s a way to harness the wisdom of crowds and the very technology being sought after – maybe a "findmyiphone" aggregator that could help communiites and the police zero in on where these devices are ending up.
It’s worth noting that my stolen phone localized itself to the same location on multiple days, near a large Washington, DC, shopping mall, in Pentagon City, before I remotely secured it and wiped it clean (what a great feature – thank you Apple!).
To attest to the seriousness of this issue, even our local gym is passing on the warning:
Attention Members:There has been a report of an increase in robberies over the past week in the Golden Triangle/U Street area. Although not directly related to the club we thought it would be helpful to pass along the following alert from Metro P.D.
Golden Triangle Crime Alert
The Metropolitan Police Department has asked us to pass along the following information. As of late there has been an increase in street robberies around the DC Metro area. The Second District is not immune from these incidents. There is not a specific suspect lookout but there is a very specific target – the iPhone. To help combat this problem, MPD is asking the users of all phones and PDAs to use good street sense when carrying and using your mobile device.
Always be aware of your surroundings. It is a good idea to use your phone while stationary in a spot that will enable you to talk and observe your surroundings at the same time. Keep your mobile device close to your body and make sure it is out of sight when not in use. Please pass this along to reach as many people as possible.
Thank you,
MaryKay MoeOperations Coordinator
Golden Triangle Business Improvement District
As Washington, DC is the #epicenter of many innovations (and health care transformation), it is also a leader in many social issues, some not so enjoyable. Let our experience prevent others from having the same in this case.
From John Halamka, MD’s blog:
Life as a Healthcare CIO: Cool Technology of the Week
I totally agree that the iPod Touch is the underdog device. I actually got the hint of this from several people at once, including ePatient Dave, that they could enjoy the goodness of the iPhone ecosystem without switching carriers. In addition, an organization could deploy these and “own” all the connections without dealing with a wireless carrier.
I was a little worried a few weeks ago when John talked about his Berry-philicity, but now I’m at ease knowing that the magic i-device of the future has a spot in his heart and in his innovation-leading mind.
Details of iPhone 2.0.2 Firmware 3G Connectivity Improvements? – Mac Rumors – An attempt to harness the power of crowds to avoid a tragedy of the commons, 21st century style. I thought this was interesting because of (of course) a parallel to health care. AT&T initially didn’t tell anyone why it was so important that every user upgrade to the latest firmware – now it appears it’s because those who don’t will unnecessarily tax the cell towers serving a specific area. Imagine the behavior this might create – “Are you using iPhone 2.0.1? Would you mind upgrading to improve everyone’s service?”
With that little bit of awareness, maybe this situation might happen. How about someone tapping a colleague on shoulder to say, “Are you seeing a specialist for that condition? Would you mind going to see your primary care physician first to improve everyone’s health care experience?” Those of you in health care will quickly understand why this doesn’t happen due to the incentives out there, but it’s a nice thought.
Let’s see if Apple and AT&T’s foray into community organizing around resource use (intentional or not) provides any lessons for us.
Friends at a very large software company once referred to me in a category they called “influential end user.” I think that means I have no actual authority regarding purchasing decisions (or anything really), but I can convince people to do things (including change health care maybe?).
I think that’s happened recently with the iPhone, as I just received a note from Richard Baron, MD, from the great ABIM Foundation, who said he heard the words “have to” from my mouth echoing in his head about whether he should get one. The “have to” part is about using what are patients are using, and learning about it with them, rather than telling them not to use what we don’t understand.
So, he got one, and maybe a few other people I recommended the iPhone to did, as well. I thought I’d post which iPhone Applications I’m using on my iPhone to give people a head start. Try them out, see what you think. And kudos to all the health care professionals out there who say “yes” to trying new things so they can perform better for their patients.
A little info:
You can get a sense of how I do things from this list, I realized. I don’t have an electronic to-do list, task manager, etc. I’ll post separately about what I do for that. Paper is really good for a lot of things.
What apps am I missing? What do you think of these?
This photograph is from a session using Tapulous’ Twinkle software, which is a location-aware version of Twitter. This exchange is evidence that the iPhone’s most powerful innovation is not 3G, it’s GPS, which Apple, Inc., has now seeded into the mainstream, just as it did with a host of other technologies, like Wi-Fi.
What is shown here is community being created with complete strangers based on location – this exchange happened when my tweet was broadcast to everyone within a 1 mile radius of the San Francisco airport.
Some of you out there have been expressing your reservations about Twitter, Friendfeed, and the like. Here’s a nice article about both. Don’t be reserved, these are important technologies that will have applications in healthcare. Get your Twitter accounts now. Post your ideas in the comments, as well, please!
And San Francisco, thanks for being nice. You never disappoint.
Publishing has been a bit delayed on this blog (but not on my TwitterFeed, I am starting to get how each thing fits together depending on what one is doing), due to the distraction of the beauty of the Seattle summer.
As part of reconnecting with friends who are also iPhone users, I ended up participating in an application-downloading binge. “What does that application with the funny name do? I don’t know, let’s just install it and find out.” I did have the sense to stop and create e-mail aliases for some of them before signing up, but it’s otherwise interesting to reflect on the mob mentality’s ability to modulate concerns about identity exchange. That in itself is interesting – the agility of Apple’s application distribution scheme is going to change a lot about the viral use of software.
What happened next was even more interesting. I have been using Tapulous’ software’s Twinkle for a while now. It’s a Twitter-based application that publishes location information along with lifestreaming events. So, depending on where you are at any given time, it will show you your friend’s tweets, and with the press of a button, anyone who is tweeting around you. The interesting part is that if no one has tweeted recently, it will go back in time, to the location where you are.
520, Big Mountain in background (Rainier)
While driving across the WA-520, pushing the button revealed the tweets of the people who had been stuck in traffic on this notoriously congested floating bridge hours and days prior. As we crossed effortlessly in the evening, I saw the frustrations of many a driver in the past few days while in the same place. It was a sort of a “kilroy was here” – a twitter signature of a place with meaning to Seattleites (this is the bridge that connects many Seattle residents to work for a very large software company in Redmond, Washington) that would persist.
Of course there’s a tie in to healthcare. Think about all of the places with meaning in the healthcare temple – the operating theatre, the waiting room, the intravenous infusion center, the intensive care unit. If a person had used the Twinkle application in one of those places, any future visitor could pick up the tweets/feelings/emotions of that space. Kind of like an emotional geiger counter. If we did a sweep now in these places, what would we find about these environments? Would it be good news or bad? Will America’s hospitals and health care settings create “no tweet” policies for staff within their facilities? Or would they do the opposite….
What if a health care organization used this feature with intention, and asked patients to tweet their feelings during these meaningful times in the lives of themselves and their families while physically located in these places. The tweets would remain fixed to the GPS location and would be retreivable forever in the future. It’s interesting to think how this could potentially connect patients and families to each other across time and place. Imagine if you could ask, “what were the triumphs and the sorrow that happened in this room before I came into it?”
In the meantime, the next time I am in a health care environment, I will have my location aware device “on” and listening…
If anyone else here has used Twinkle or any other location aware lifestreaming application, feel free to post your experiences here.
While visiting with friends recently, I was asked something along the lines of what the expectation for healing should be for a friend who twisted his ankle recently.
There happened to be an Apple iPod Touch on standby with a good Wi-Fi connection, so in a few seconds I dialed this up and said, “Why don’t you read through this and see if it fits what you are experiencing, and then decide what your next steps should be.”
I think the iPod Touch is going to be an underdog in Health 2.0 applications….
Couldn’t wait until Friday for this one. Happen to be in San Francisco while the Apple Worldwide Developers Conference is going on.
Adam’s new iPhone interface.
May 10th through May 13th:
A lot of stuff going on this week…
While in New York City this week, I happened to attend the (first?) iPhone Developer Summit, thanks to a free pass and a little wiggle room in my schedule.
I didn’t go because I am planning to learn Objective C and develop for the iPhone. I went because I wanted to see what the developer community is thinking, and I have to say I was impressed with what I saw. I sat in on a session about the new iPhone SDK and the audience looked almost to me like a group of doctors that are sitting in a room to learn about electronic health records and realizing that their lives are going to change.
There was discussion of the iPhone platform, which has far more computing power and graphics capability than any other handheld that has preceded it, coupled with the fact that Apple, Inc., has made it easier than ever for developers to distribute their applications quickly and efficiently through iTunes. Nothing like this has ever existed on other mobile platforms.
I sensed a tone of quiet resignation coupled with excitement that this will be the next revolution in computing. At the same time, the teaching was about the very basics of developing for the iPhone so it’s very early in the journey. I learned a few things, like the fact that the iPhone you use to develop on will need to be disconnected from the AT&T cellular network, so basically you will need to purchase a phone specifically for development. The SDK requires that you have a Mac running Leopard – you cannot develop on a Windows box. And an interesting revelation that was not well covered previously – the iPod Touch is also a platform for this SDK. This means that an enterprise developer could create internal applications that run off of Wi-Fi, decoupled from phone service. That’s a big deal.
After taking in this scene, I wandered with a colleague over to the Apple Store on Fifth Avenue, which provided more evidence of a transformation coming. The store was packed beyond all recognition. There was a long feeder line of customers waiting to buy things. And yet the store made all of the products available to customers and potential customers to enjoy at their leisure.
There’s something going on here. Click on any of the pictures to see them full size, and the video below to get a sense yourself.
March 14th through March 17th:
Quite possibly.
I didn’t catch the iPhone SDK launch right on March 6, but I did watch it a few days later, and it’s very impressive. It is worth a watch, especially with regard to the possibilities in verticals such as health care. I have met many physicians in the past 6 months who have told me, “I will get an iPhone when…” I think the “when” has been answered. Possibilities such as secure physician-patient communication and patient activity monitoring with direct connect to electronic health records are now possible.
It was interesting to see this right after the Health2.0 Conference, to be sure.
Not to mention that the iPhone is now enterprise-worthy….
Apple Developer Connection – iPhone Dev Center – iPhone Developer Program
Once in a while I read an article that makes an impression on me, and this is one that did.
Why?
» Read more: An Article that Made an Impact: ROKRs, iPhones, and Health Care
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