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:

• DC Weather is a hyperlink to the hour-by-hour of Washington, DC. You can customize for your city.
• Tipr is also a hyperlink to a web-based Tipping application. It gives you the results in palindromes, so you can check for manipulation. Nifty.
• Remote is Apple’s iTunes and iTV controller. Very cool.
• RSS is a hyperlink to Google Reader. It’s what I use for RSS now. Well optimized for iPhone and the Web (sorry NetNewsWire, I had to switch…)
• Where is a helpful assist for my Starbucks-dar. Maybe also useful for Zipcar (when I have to drive, Metro is really my automobile)
• Loopt and Twinkle are my preferred location aware friendfinders/lifestreamers. Just testing them now.
• Twitterific is where I post to my Twitterfeed. Give it a try. Follow me.
• Urban Spoon, Restaurants, and Yelp are my food finders, except I am not much of a foodie, so I am mostly interested in these for their health promotion potential.
• Mobile News is as it says. I am really not much of a news junkie (Andrew Weil, MD recommended awhile back that too much news is unhealthy, I’d rather just make my own news)
• Cuberunner is just a game to demonstrate the accelerometer functions - for the “Isn’t this device cool” factor. Thanks to Jody Pettit, MD, fellow i-enthusiast for the tip.
• 1Password is useful for storing Web passwords securely. It has a built in web browser so will enter them for you.
• Epocrates is just a cool medical application that shows the promise of the device. Imagine using this as a tool for medication reconciliation and adherence - like how about a patient version, a pharmacist version, a nursing version, that delivers the med list graphically to the patient?
• AOL Radio and Last.fm are experiments in finding music online.
• MyLite is the electronic flashlight. I like the rock concert effect. Works really well in a power outage.
• Google is google. I should use this app more - it does really nice searches of contacts on the phone.

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.

• More on iPhone 3G availability at sharding/blog - For those of us intently interested in this right now. It's interesting that Apple has decided to centralize distribution to just its stores and not take advantage of a more dispersed AT&T retail presence. I think they will look back at this as a mistake.

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:

• Be Well Mobile, Patient Engagement Software that works - cell phone platform for disease management
• Medical Advances—Through Your iPhone? - Portable applications in health care that the iPhone could enable.
• Scientific Misconduct Blog: LSD and the corruption of medicine (Part III): Naming names - A chilling account of experimentation on US citizens without consent
• Texting may help teens remember meds - CNN.com - Cell phones as a tool in medication adherence.
• The Open Secret of Success: Financial Page: The New Yorker - One of the best summaries of what Toyota does well that I've seen.
• ITIF: Explaining International Broadband Leadership - Summary of broadband access in the US and other countries
• Ruthsarian Layouts - Some helpful CSS layouts for blog design

A lot of stuff going on this week…

• Apple Digital Fitness Companion System? - Mac Rumors - It was/is only a matter of time. Hello Health2.0, courtesy of iPhone
• The computer will see you now | Economist.com - A nice biographical piece about Larry Weed, father of the problem oriented medical record.
• EMC, Partners collaborate on hypertension program - Daily Business Update - The Boston Globe - An employer that thinks about population health and sets up a PHR in concert with a health system. Interesting…..
• Subscribe to ringtones via iTunes - Easy way to get ringtones - a ringcast?
• Mashable?s Guide to Upcoming Web 2.0 Conferences - A plethora of get togethers to get up to speed on the latest in Web 2.0.
• leanblog.org | Lean Blog: The Waste of Handwritten Notes | Lean Manufacturing | Lean Healthcare | Toyota Production System - Yes, Leadership. From patients and their families too. The kind of leadership that brings the patient perspective into every conversation.
• Apple - Support - Downloads - MacBook, MacBook Pro Software Update 1.1 - Help with keyboard freezing issues caused by Leopard
• Healthcare 360 -
• GHI - GHI Medical Home Pilot - I think this is very promising for supporting EHR adoption and patient access to their own clinical information. Ties in very nicely with NYC’s PCIP project.
• Public health system struggles to reach gay ?hidden population? - Washington Blade - Another vulnerable population that could benefit from outreach - many are underserved even when well insured.
• Cocoa Programming for Mac OS X - The resource for programming on MacOSX, and iPhone as well

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.