Health Content in Perspective

The Semantics of Big Data

2012-05-24T21:41:43Z

I had the pleasure of attending the Big Analytics Road Show in Boston this week. The presenters and sponsors did an outstanding job of describing the “big data” ecosystem. They even offered clear descriptions of Hadoop and MapReduce for non-technies, which is quite an achievement.

The most rewarding aspect of the day’s program, however, was its emphasis on how the data can be used to add value to business decisions. Consequently, the focus wasn’t on acquiring massive quantities of data (although zettabytes and yottabytes were mentioned!)—or even on the value of organizing big data sets. Instead, the program provided many examples of how analysis of structured and unstructured data in tandem can lead to new insights that can improve business processes and marketing decisions.

Years ago, at InfoCommerce Group we coined the phrase “data that can do stuff” to describe the advantages of well-designed data products. In essence, a data product that is designed to meet a defined need of a target audience becomes a decision tool when analytics are applied. With the era of big data upon us, even textual data and real-time streams of behavioral data can be leveraged via semantic and pattern matching technologies to obtain data that can do stuff. Furthermore, the different types of data can be overlaid to achieve higher levels of insight into customer behavior or patient outcomes, for example.

The takeaway point: data analysis tools and techniques that used to be available only to big life-science companies and search engines are now entering a phase where the costs make the technologies more widely accessible. However, as someone mentioned at the Big Analytics event, Gartner Group places big data at the peak of inflated expectations on its hype cycle curve. I agree with Gartner because of the level of noise surrounding big data. Nonetheless, with proper alignment between the data, business goals, and execution, opportunities to benefit from big data—or should I say big analytics—exist today.

Between The Lines: Finding the Truth in Medical Literature (Review)

2012-05-20T18:35:01Z

“BTL provides the best critique and comparison of observational vs. interventional (e.g., randomized clinical trials) research studies that I’ve ever read. Even evidence-based medicine experts will find something eye-opening in this book.”

Posting a book review on this blog is a first for me. I am making an exception because this compact volume, Between the Lines: Finding the Truth in Medical Literature, by Marya Zilberberg, MD, MPH, provides an expert’s explanation of many critical issues related to health literacy, evidence-based medicine, and changing models of medical research—all issues that are covered in this blog.

At the highest level, Between the Lines tackles the complex issue of uncertainty in medicine. Dr. Zilberberg presents a framework for assessing the strength of medical evidence in a way that anyone with some basic knowledge of statistics can follow. She uses clear examples that explain, for instance, why a medical test with a 5% rate of false positives could yield a 98% chance of a false positive if the known prevalence of the disease is very low. If these numbers sound irrational, then it’s time you either study Bayesian statistics or read Between the Lines.

In fact, Bayesian statistics are what united Dr. Zilberberg and me. We met via Twitter and our first engaged conversation occurred when she commented on David H. Freedman’s article in The Atlantic: Lies, Damned Lies, and Medical Science. David’s article provoked quite a lot of discussion about the state of evidence-based medicine (EBM), at least based on the type of research we currently consider our ‘gold standard’. His article profiled Dr. John Iaonnidis, who is now chief of the Stanford Prevention Research Center at Stanford Medical School. [1]

When Dr. Zilberberg started explaining the effects of heterogeneity in her blog, I knew I had found someone who had the ability to address important statistical topics in a way that could be understood by a broad universe of readers.

In addition, the book is an excellent resource for non-medical professionals who do have some training in statistics. For me—someone who has experience in econometric modeling and has long been an advocate of Bayesian statistics— but has no formal training in epidemiology, I found the book to be a terrific resource for translating mathematical statistics terminology into medical statistics terminology. All I need now is a self-study guide and comprehension test and I think I’ll feel confident in my understanding of concepts in epidemiology. This shouldn’t be a surprise given that Dr. Zilberberg teaches epidemiology.

I highly recommend this concise volume to anyone involved in peer-review or any aspect of medical communications. I’d even go as far as to say it should be required reading for these groups. And for clinicians and those who determine evidence-based guidelines? Well, I know I’d feel a lot more confident in our healthcare system if I thought that most clinicians could answer the 12 questions that Dr. Zilberberg recommends patients ask before accepting to undergo a medical test or procedure (see Chapter 12).

Finally, I’m confident that Between the Lines will be an important addition to core readings for two groups I highly admire: 1) medical librarians and 2) the Society for Participatory Medicine (http://participatorymedicine.org/).

To obtain a copy of the book, which was published May, 2012, visit the Between the Lines website.

[1] See: http://alumni.stanford.edu/get/page/magazine/article/?article_id=53345 for a recent article about Dr. Iaonnidis’s work.

Secondary Data Usage in Healthcare

2012-04-03T13:42:06Z

I was guest speaker at the March 22, 2012 “Let’s Talk HIT” series hosted by Scratch Marketing & Media in Cambridge, MA. The topic I chose was Secondary Data Publishing in Health. Health Content Advisor’s parent company, InfoCommerce Group, has a long history of guiding business media companies in constructing data products, but increasingly we are finding interesting examples of secondary data products that develop as a by-product of technology companies. Electronic Health Records (EHRs) represents one of the more compelling examples of information technology that has the potential to spawn a new generation of data products.

Scratch Marketing has posted the video of the talk, which was structured as an interactive group discussion, in 8 parts. See their YouTube page for the list of segments: http://bit.ly/H9Wjk9.

See the event recap by Lizzie McQuillan at Scratch Marketing here:

http://scratchmm.com/2012/03/event-recap-let%E2%80%99s-talk-hit-with-janice-mccallum/

Also, for a provocative view, read Marya Zilberberg, MD, MPH’s takeaway from the evening’s discussion:

http://evimedgroup.blogspot.com/2012/03/how-our-healthcare-spending-is-like.html

Thanks again to Scratch and the many Boston-area (stretching all the way out to the Berkshires!) health IT, public health, healthcare publishing, entrepreneurs, and marketing experts who attended and participated in the discussion. Scratch Marketing added Twitter handles to the video, which helps tremendously in identifying each speaker.

Better Security Solutions Build Trust

2012-03-19T20:27:35Z

The importance of building and maintaining trust among entities that are collaborating or exchanging goods & services is paramount. Without trust, markets where imperfect or asymmetrical information exists won’t operate efficiently. Whether we like it or not, “imperfect” and “asymmetrical” define the current mechanisms used to exchange personal health information.

At the same time, new levels of collaboration are being introduced between providers, payers, researchers, and patients within tightly or loosely-defined networks that participate in the care of a patient. All of this collaboration requires multi-directional exchange of data. In a guest commentary post on Health Data Management Magazine, I emphasize the importance of employing appropriate security solutions to help build and maintain trust in the integrity of data partners.

To accompany the post, below are links to recent news on the companies I mention in the article:

Amcom Software Enhances Physician Communication With Release of Amcom Care Connect

http://www.amcomsoftware.com/News/02-28-12.aspx

Imprivata Launches Secure Texting App

http://www.imprivata.com/company/press/imprivata-launches-secure-texting-app

PerfectServe Secures $10.9 Million in New Financing

http://perfectserve.com/aboutus/releases/release020212.html

Samsung Selects Voalté Clinical Communications Solution of Choice

http://voalte.com/NewsPressDetail.aspx?Id=56&title=Samsung-Selects-Voalt233-Clinical-Communications-Solution-of-Choice

TigerText Secures More than $8 Million in New Funding

http://www.tigertext.com/tigertext-secures-more-than-8-million-in-new-funding-adds-veteran-life-sciences-and-technology-investors-to-its-board/

Vocera Introduces Vocera Connect for Leading SmartPhones and Cisco Wireless IP Phones

http://www.vocera.com/index.php/company/pressreleases/120215

See also this video interview with Perficient from HIMSS: http://www.healthcontentadvisors.com/blog/2012/2/28/video-interview-from-himss12.html

Video Interview from HIMSS12

2012-02-28T15:13:31Z

For those looking for the Women in HealthIT video, see:

http://t.co/pfbTB59K.

What has now become an annual event: an interview between Liza Sisler from Perficient and me at HIMSS. This year, I talk about 1the effect of Accountable Care Organizations (ACOs) and value-based purchasing in general on the healthcare industry and the underlying theme of trust and security in health information exchange.

http://blogs.perficient.com/healthcare/blog/2012/02/27/himss-2012-interview-with-janice-mccallum-phi-and-patient-trust-video/

I’ll post more on the topic of trust and security of personal health information (PHI) soon.

Gleaning the Future at HIMSS12

2012-02-10T13:31:46Z

In my write-up of HIMSS11, I summed up the theme of last year’s event by describing how the need to meet Meaniningful Use (MU) stage 1 requirements had produced the foundation for all sorts of value-add applications and analytics. Dashboards that illustrated how providers were ready for population health analysis based on stage 1 MU measures were on display everywhere.

This year, I’ll be on the lookout for higher-level dashboards and will have a specific interest in learning more about health IT software that helps bridge the business and clinical sides of medicine. After all, with accountable care organizations (ACOs) on the horizon, providers will need to establish links between their clinical performance and their financial performance. It sounds strange, but it’s not really a stretch to say that providers have to worry about how clinical outcomes affect their bottom lines for the first time in a long time.

Staying focused at HIMSS is difficult. There’s an excess of topics being discussed in education sessions, too many exhibitors for any one person to visit (approximately 1,100) and so many people to meet up with that it’s impossible to see it all and it’s very easy to get distracted. But, with a core set of meetings and sessions that cover clinical decision support, analytics, and collaboration between stakeholders, I’ll try to stick to my plan.

Please contact me if your company has something new and interesting in clinical decision support or business intelligence solutions that align clinical and financial performance. My schedule is already packed, but I’m prepared for a week of sensory overload!

Realizing the Potential of Personalized Medicine

2012-02-09T20:28:29Z

Imagine a world where we’ve all had our complete genome sequenced and where every individual can receive real-time feedback on how their actions and environment affect his or her body. Drink an espresso and understand the effects it has on your heart rate, endocrine system, etc. With a growing base of genomic knowledge contributed by billions of people (yes, this requires a very large N), this scenario isn’t science fiction. But, it does require that health IT progress at a faster rate in order to meet the needs of predictive personalized medicine models.

The MIT Enterprise Forum hosted a fascinating panel discussion on the future of the personal genome last evening (Feb. 8). Hosted by Kevin Davies, editor-in-chief of Bio_IT World and author of The $1,000 Genome, the panel included Dr. George Church of Harvard, Colin Hill, CEO of GNS Healthcare, Jamie Heywood, Co-founder of PatientsLikeMe, and Dr. Michael Pellini, CEO of Foundation Medicine.

The advancements in treatments made possible through understanding an individual patient’s genome are awe-inspiring. With specific examples from cancer therapies, Dr. Pellini described progress we’ve made in moving from a trial-and-error approach to treating cancer toward models that take the genomic and molecular structure of an individual’s tumor into account before narrowing down the treatment options to home in on the optimal therapeutic “cocktail”.

But the discussion underscored that the continued lack of real-world outcomes data to help build models of what works remains a big hurdle in advancing personalized medicine. Recording and aggregating outcomes data are the domain of EHR and EMR systems, in other words, the world that will be convening at HIMSS in 10 days. (See accompanying post)

The rates of adoption of EHR systems that have sufficient functionality to facilitate personalized medicine are too low and some doctors still complain that they don’t see enough benefit in transitioning from paper to electronic records. Clearly, it’s not the patients’ benefits that these naysayers are considering! Granted, current EHR platforms have a ways to go in improving their usability, functionality, and interoperability. And there’s still too little emphasis on the importance of providing data directly to patients and accepting patient-reported sources of data. But, the failure to recognize benefits of digitized records over paper-based records for advancing the knowledge base in medicine needs to be overcome.

Panelists at last night’s forum also spoke of regulatory hurdles, overcoming privacy concerns, and the need to develop new models for evaluating longitudinal outcomes data to build into predictive models. Changes in reimbursement policies were noted, too.

The good news, however, is that computing power and complex analysis of huge amounts of data are not the factors that are holding back progress in personalized medicine. The field of genomics has experience with big data and Moore’s law is on track to allow for the soon-to-be $1,000 genome to become the $10 or even $1 genome in another generation. All in all, the availability of longitudinal real world outcomes data stands out as the biggest problem.

How long will it take to overcome the remaining barriers to personalized medicine? That’s difficult to predict. But, the panelists presented an optimistic view of the future where a personalized approach to medicine can lead to a data-driven focus on maintaining wellness, not just treating illness.

For more on the Personalized Genome panel, see:

http://www.masshightech.com/stories/2012/02/06/daily37-Personal-genomes-hold-eventual-promise-for-treatments.html

http://www.chenpr.com/blog/uncategorized/stimulating-discussion-and-sold-out-evening-at-mitef/

Event Planning for 2012

2011-12-22T17:15:38Z

At this eventful time of year, I thought I would hold off from sending a long post and instead focus on conference and event schedules. Don’t worry, the year-end review/look ahead post will be forthcoming after the 1st of the year.

There are so many good events to choose from, especially in the healthcare and health IT spaces, that it’s difficult to decide where to devote time-constrained resources. The Events page that we added to the Health Content Advisors site earlier this year lists all major events that I or my colleagues will be attending. At this point, only past 2011 events are listed, but we’ll update the list over the holiday period.

Somehow, I chose a fantastic mix of live events to attend last year and I hope to make a repeat appearance at all of these events in 2012. I’m making plans for #HIMSS12, February 20-24 in Las Vegas now and hope to add the SIIA IIS conference, January 24-25 in New York to the list for 2012.

When we update the Events page, we’ll add links to blog posts, pictures and videos from the events. As a preview, here’s a short video interview I did with HCPlive.com at the Health2.0 conference in San Francisco:

Also, please check out my previous post on Using Game Dynamics that includes a link to a video of my session at Data Content11 that focused on using game dynamics in market research and provides examples from healthcare research, including PatientsLikeMe.

That’s it for now. Happy holidays and best wishes for a 2012 that exceeds your expectations!

Janice

Game On! Enliven Content with Game Dynamics

2011-11-21T22:39:11Z

Anyone remember eWorld? It was Apple’s attempt to create a search engine that was visual and fun. It didn’t work out, but Apple was ahead of its time in the mid-1990s. Now the time may just be right for eWorld-like next-gen visual and fun business information services.

I spoke of the dual advantages of applying techniques from the online game segment to enhance the engagement level of content and to collect more data about audience at InfoCommerce Group’s Data Content11 conference earlier this month. The full presentation with video can be found here (minutes 4:30-12:32).

The presentation includes parallels from healthcare where companies like PatientsLikeMe are matching members of their patient community sites with relevant clinical trials. This is just one example of an online publisher that is serving as a matchmaker between its audience and researchers and creating value to all stakeholders as a result.

I saw eyes light up during my talk when I introduced the topic of applying game dynamics[1] to B2B and consumer health content to increase the engagement level and make the audience more valuable to researchers. A “game layer” for business and consumer health information may seem inappropriate at first glance, but I suggest that borrowing some of the best features of popular games to make content more engaging, easier to navigate, and more personalized can pay dividends. The secondary benefits of collecting more information about your audience and their preferences as they interact with more responsive content are significant, too. Again to use examples from healthcare, if your audience includes the leading experts in a specialty area or a large group of patients with a specific disease or set of symptoms, serving as a matchmaker between your audience and market research firms could represent a new revenue stream, especially if you have compiled data that can be used to segment the audience better than alternatives that currently exist.

I thought of eWorld when I saw HumanaVille, on online resource for seniors who are Humana members. As I mention in my presentation, I’m not sure that a fun visual online interface is the answer to getting seniors engaged online, but it’s worth a try, especially if the alternative is a typical online directory.

[1] For a primer on game dynamics, see this post: http://tomhumbarger.wordpress.com/tag/scvngr-game-dynamics-playbook/

Using Data Content to Build a Patient-Centric Healthcare System

2011-10-28T15:43:06Z

Every healthcare industry pundit seems to be talking about healthcare data: big data, data analytics, patient-generated data, population health data, predictive data, and more. Variations on the theme of: “data, data everywhere, but not a [fill in the blank]” are cropping up all over the place at healthcare conferences. We all agree that electronic medical records, large-scale medical research studies, and devices for recording health and wellness metrics are generating more data, but the expertise for managing the data is in short supply.

At InfoCommerce Group, we understand that data by themselves don’t solve problems, but well-managed data can be programmed to serve any number of purposes. We call it “data that can do stuff”.

Applying best practices for data management requires planning and effort. Quantity without quality will get us nowhere. Join us for the Healthcare Roundtable discussion at Data Content11 next week and participate in a lively conversation about how we can corral the expanding sources of health data, “leverage the liberated data” as I wrote in September, and create a collaborative learning system that establishes a robust base for the next generation of evidence-based medicine and shared decisionmaking between patients, providers and payers.