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Social Media Accts Denise Silber, Doctors 2.0 & You, Basil Strategies #doctors20

With Social Media, is the more the merrier? Maybe, maybe not. In any case, here's where you can find more information related to digital health from "us", beyond this blog in English.

And this doesn't include my personal accounts on FB, LI, Instagram, G+
 -- or the French equivalents which you can find listed on



Has the FDA dealt a lethal blow to 23andMe?

1174540_10151833488632552_247981076_nI'm based in Europe, and so it was the afternoon today, when the news of the FDA warning letter to 23andMe surfaced. The FDA have asked the company to stop selling the 23andMe Saliva Collection Kit and Personal Genome Service (PGS), which is basically the only product of the company.

One year ago, I had the great fortune to be the panel moderator at Medicine X, (Stanford Medicine, Palo Alto). Medicine X is a partner conference to Doctors 2.0 & You. Anne Wojcicki the brilliant  and charismatic co-founder of 23andMe described her company's genetic testing service and why she had created it. Here's the video.  

Two reasons for consumers to use 23andMe, according to their CEO: consumers own their data and once they know their results, they can take preventive actions. Everyone must act instead of remaining unknowingly at risk for the inefficacy or intolerance of certain drugs, or at risk for certain diseases. 23andme had tested Sergei Brin, the Google co-founder and then spouse of the 23andMe cofounder and found that he had a high risk for Parkinson's disease.

What can a patient do with the information? This is a different story, and that is where the PGS becomes a device, in FDA terms, a device that is not authorized to be one. Yet, in listening to the video, it sounds like 23andMe makes action recommendations based on  the test results.

When I asked the Silicon Valley audience for a show of hands on how many people had done a genetic test, almost everyone's hand was raised. And genetic testing isn't limited to 23andMe. They have competitors (who must be quite concerned as well).

23andme had dropped its price this year to go to mass market. At $99 a test, 400 000 users had signed up. This growth may well have contributed to the FDA's timing...They couldn't wait any longer with that number of users.

The FDA warning letter is here. It's not news to 23andMe, because the FDA had begun to raise red flags in 2009, two years after the company's launch. The FDA said, "you are a device. Please act like one." Who knows why they didn't heed the warning? Was it impossible to maintain a going business and undertake the investment? Was it lack of experience with the regulatory side of healthcare? Was it some form of internal miscommunication?

I believe that if 23andMe had been managed with strong input from managers with drug and device backgrounds, the business would have taken the FDA requests very seriously and not moved forward in the same way.. I would imagine that there would have been investors to follow them on that solid if slower path.

The story will surely unfold over the coming weeks...




Mobile health without borders at Stanford online: Video by Denise Silber #doctors20 #mhealth

Capture d’écran 2013-06-10 à 00.26.37The new course at Stanford Online, Mobile Health without Borders includes my video entitled "Postcards from Paris" presenting mobile health examples from outside the United States. 


Healthcare Social Media: What Can We Learn from a Fork? Or 8 Reasons for Slow Control to Succeed.

Capture d’écran 2013-01-09 à 02.30.18In the first few days of the New Year, we are always smothered in summaries, insights, and perspectives on the year past and the trends to come, especially in the fast-moving area of digital communication.  What and who will succeed on the web, in Social Media, in Mobile Apps? What's going up? What's coming down? You get the picture. But, to my mind, there is only one question? When will healthcare "get it" in a major and concrete way?  When will digital healthcare play as much of a role in as many people's lives as say e-commerce ? The answer is Marketing 101: when what people want, the products, and the business models are aligned. We aren't there yet.

Where I'm going with this, is that some innovations do speed forward with less effort than others. And herein lies my story about the potential success of Slow Control, a company -- which in all transparency has been a client since 2012. Their first product, a digital fork branded as the HapiFork, has been unveiled at the Las Vegas Consumer Show. This fork vibrates when the user eats faster than he's supposed to and it generates graphs of the user's eating speed. Why set up such a system? Because eating too fast is unhealthy and conversely "eating slowly" has various health benefits on digestion, metabolism, weight management.

We are seeing an extraordinary amount of interest in this internet-connected fork, the concept of "eating slowly for better health" which it supports, and the story of the inventor, Jacques Lépine. Journalists and bloggers are very present. The exhibit stand is never empty.

And so, we ask ourselves "why this one"? What are the lessons learned? Here is my take. My theory is that Slow Control is capturing everyone's imagination for a number of reasons.

  1. A fork used for eating is an important and ancient tool going back to the Egyptians and Romans. 
  2. It is something that everyone  likes, because it means that serious food is not far away. 
  3. A fork is a three-dimensional object that everyone can easily visualize.
  4. Eating is one of the most positive human activities that people can discuss and food, unending in our interest.
  5. Eating too fast is something that almost everyone thinks they're guilty of at least occasionally.
  6. The concept of the fork has not had a major technological innovation, since perhaps the introduction of plastic, and none as significant as the integration of electronics.
  7. The application of the quantified self approach to the fork is a mindbender. Everyone knows that we can count and graph our steps, calories consumed, weight gained, heart rate, and blood pressure. But no one even knows how many forkfuls we take a day, let alone how to record them.
  8. A new entrant (Slow Control) to the market has brought all of this together in one product and the interest skyrockets...
Generating buzz is  "not simple" as all that. Look at how many valid public health campaigns have failed to interested the consumer. But, develop a way to measure for the first time an important human activity, and as such transform a historic object...and you're bound to stir things up...It's not about trends in general. It's about what makes us tick...Hey, we can count that too.

Interview with Jacques Lepine, CEO Slow Control, inventor of the 1st smart fork

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Have you heard of the digital fork? Jacques Lépine, the man who wants us all to be "eating slowly" is the founder of ‘Slow Control’. He created a concept, a product, and a company, in order to help us manage the speed with which we eat. And many people are listening to him at the Consumer Electronics Show in Las Vegas, where his fork is debuting at the HapiLabs stand. My company Basil Strategies is accompanying this French start-up, that we believe is making its mark on the Quantified Self movement.

DS  How would you describe your invention?

JL  Well, as an engineer, I can say that this is a unique fork containing some lightweight

Jacques Lépine, CEO of Slow Control
embedded electronics  that enables consumers to personalize their rate of food intake. If the user exceeds his desired speed, the fork will either vibrate or light up to let him know. The choice of the signal is up to the user. In addition, the fork will record meal times and the frequency of the forkfuls. The results will be visualized in graphs.

DS  And the "Eating slowly" concept, what can you tell us about it?

JL  "Eating slowly" is an international concept. People often think of overweight as the main problem of eating too fast. But research studies show that eating too fast can cause other medical issues. Eating too leads to gastric reflux, bloating, metabolic disorders such as diabetes...

DS How did you come up with the digital fork?

JL I am an engineer specialized in writing patents for inventions. One day, I found myself in the emergency room of a Parisian hospital convinced that I was having a heart attack. I was wrong. I had acid reflux, because I was eating too fast. Everyone around me had told me to slow down, and I tried but I never really succeeded in eating slower. So, I thought that there could be a technological solution, and there was. But, it was a bit more complicated than I had imagined.

DS How did you succeed?

JL It was not that easy, because the fork ultimately required 4 patents.  From the beginning I thought that movement sensors could help us, but actually they cannot detect "when" the fork brings the food specifically to one's mouth. I had to realize that there could be a way to create an electronic circuit thanks to the user’s body plus the fork. From there, getting the fork to plot the points of the movement on a graph became feasible.

DS What are your plans for this product?

JL Well, the Slow Control Fork is a French invention and is already recognized by OSEO and Cap'Tronic, who awards prizes for electronic innovations. We competed this year. We now have, thanks to the intervention of your company Basil Strategies and the Melcion Company, a first partner, Hapilabs developed from their experience in nutritional coaching and web services.  HapiLabs brings its distribution, a web and mobile platform and coaching. And so we are participating in the CES with HapiLabs, as an innovative company.

On our website, we will share the scientific knowledge that underpins our current and future products. The first digital forks will be available for consumers as of March 2013. Let the adventure begin…And of course, please tell everyone that SlowControl also comes with a spoon ;-).

New News from Berci Mesko

Capture d’écran 2012-11-29 à 21.31.36Berci Mesko and I keep in touch regularly through many Social Media channels and even via old-fashioned email to discuss Doctors 2.0 & You, Webicina, and how all of this can or cannot for patients...You'll see Berci in Paris next June :-).

Perhaps you know through Facebook that Berci recently celebrated his birthday. Well, there is an even bigger bit of news tonight : Webicina has just won 2nd prize in Luxemburg's Social Media Tournament, run by the European Investment Bank. I thought that Berci Mesko's many Social Media fans would love to hear more from him. So, read on.

1. Denise: So, Berci, what was it like growing up in Hungary? Were you a great student from your earliest years?

Berci Mesko:  I always loved living in Hungary even when I started traveling 30-40 times a year and saw many cultures and countries. The one thing I really admire about Hungary is the educational system in which I always felt very comfortable. I was a very good student from the first years and as I decided to become a scientist instead of a football player (because I realized I wouldn't have a chance to play in FC Barcelona) at the age of 6 I focused on my studies in my entire life.

2. DS: When did you decide to go towards medicine and also genetics? Is there a fun story behind this?

TEDmeskobertalanlapozoBM: Science was clear from the early years, medicine became the target at the age of 12-14 and at the same time genetics got into my full focus. I was amazed by the tools and discoveries of genetics and I feel lucky to get involved with research just after the Human Genome Project was completed therefore I eye-witnessed all the modern changes around the concept of genomic medicine.

3. DS: How old were you when you started using computers?  What did you first use them for?

BM: I remember having an Amiga 500 at the age of 7 and of course I used it for playing video games but I was fascinated by computers and I knew even back then that I would have a personal computer soon.

4.DS:  When did you realize that there was another side to medicine, ie, the Web 2.0 and Social Media side, where the human factor, facilitated by technology, brings  better conditions for patients?

BM: My social media "career" started with becoming active in Wikipedia in 2005, but I only realized the potential of social media in the future of medicine, when I came across the presentation of Dr. Ves Dimov who was kind enough to send it to me privately as well. I was blown away and I knew that would be my way, combining two great fields, medicine and digital technologies. After that I started giving presentations at local clinics and departments talking about how they could facilitate their workflows with social media.

5  DS: When did you first realize that there were issues in the relationship between the patient and the health system and within the health system?

BM: It was a perfect decision to launch a medical blog in 2006 because as I came up with my posts and thoughts, I received plenty of comments as feedback therefore I always got a good picture about what patients think of healthcare and the internet. I became a huge supporter of the e-patient movement and I had a chance to see all the important moves and changes in this area. Again, I feel lucky to live through those years.

6.  DS: You've been to two Doctors 2.0 & You conferences. Did they change something for you? And for the future?

BM: Absolutely! I made an amazing number of new contacts and friends; I gave two keynotes with incredible feedback and it changed the way I think about the future of medicine 2.0 as it managed to bring together all stakeholders of healthcare with a clear mission in mind: to improve healthcare with digital technologies together.

7 DS: And on the personal side, I believe you got engaged in Paris right after Doctors 2.0 & You... Do you see the two as related?

BM: A night you can never forget. And of course I owe you one, Denise, for helping me organize that very special night in Paris.

8. DS: You also joined Mensa this year. Have you met other Mensa people? How is that?

BM: I feel grateful for belonging to such a vibrant community. Yes, I met many of them at recent meetings and became even more addicted to puzzles and logical games.

9. DS: And now, you are preparing to be a Futurist?  I love it. Tell us more. And will you tell us even more at Doctors 2.0 & You 2013?

BM: Yes, this is the topic I plan to discuss in details as I'm making a shift in my academic career from genomics to being a medical futurist. This is not a simple career path but I've been enjoying every moment of it so far. Let me reveal the fascinating details in Paris next June! See you there!

Doctors, Social Media, Conflict of Interest: which doesn't belong? #doctors20

Berman Bioethics Institute, at  Johns Hopkins has just published a new article with a striking title, Physicians, social media, and conflicts of interest. If we need to eliminate the piece that doesn't fit, it would have to be conflict of interest.

The author suggests that social media cannot function without the elimination of conflict of interest, because, in his opinion, Americans are already wary of online doctors. The wariness stems from the news of fraudulent studies published by doctors in the US, and growing information regarding conflicts of interest. The use of pseudonyms, while fortunately not universal, is a hindrance to the establishment of trust with doctors online. Additionally, the author reminds us that the brevity of web articles and microblogging make it practically impossible to ensure that specific conflict of interest information reaches readers.

Although the good news is that various professional organizations in the US, have published guidelines for social media, Johns Hopkins notes that these guidelines are ineffective. They may be voluntary or not even mention conflict of interest.

We can only concur. Consumers must know the real identity of physicians they contact online and whether they have conflicts of the Dollars for Docs initiative. The question remains of course, to define "conflicts of interest."...Isn't "fee for service" a conflict of interest in itself.

New Survey on Telehealth in France: consumers are favorable

Numerous scientific articles have demonstrated the efficacy of telemedicine, in its many user scenarios, whether linking professionals or professionals and patients, synchronously or asynchronously. Mobile apps on smartphones and iPads have significantly increased the potential. However, practical application generally remains small-scale, with a few exceptions around the world.

Quite often, the reasons for the low adoption rate are considered to be economic and organizational. How can telemedicine be financed? Where does one start to put these processes into place? What do physicians and patients think about it?

Mondial Assistance in France published a consumer survey of 1006 French adults in October, 2012. Key results are as follows:

--62 % think that a distance medical advice service can replace a consultation at a doctor's office

-- 28% have realized afterwards that the consultation they have just undergone was not necessary .

-- 79 % would like a 2nd medical opinion, in case of doubt regarding a diagnosis or a prescription 

-- 58 % would like to have an immediate medical opinion whenever they need one

-- 60 %  manage their own medical situation, when they do not have access to a physician, (39 % indicate that gaining access to a doctor is a problem)

This survey was undertaken by Mondial Assistance in relation to their introduction of new tele-health services in France. A French healthcare professional will be able to answer medical questions at a distance and orient the person, if needed, to an expert able to provide a 2nd opinion. Mondial Assistance, being a well-known brand in France, it will be interesting to see how this develops...Perhaps largescale telehealth will be in place sooner than we think...


Shopping for an online patient forum? Read about the Francophone online diabetes community poster presented at Doctors 2.0 & You

Capture d’écran 2012-06-03 à 22.24.12How would someone choose an online community to join, in for example, diabetes? We applied this question to the Francophone web world as a study theme for one of our two poster entries at Doctors 2.0 & You 2012.

To download the poster, click here.

Using Google to search for active online diabetes communities, we found 4 dedicated sites and 9 portal sites that include a Francophone diabetes community. 10 of the 13 are based in France.

While portal sites including diabetes communities were generally established as businesses and dedicated sites, the work of volunteers or not for profits, this did not lead to quality differences per se.

One portal site, based in France, does present a distinguishing feature, the offer of self-monitoring web tools to community members.

No generalizable distinguishing characteristics emerged from our study, which lead us to the (obvious) conclusion that forum and community managers should make a greater effort to differentiate their "offer" and explain to potential members why that community should be of interest. 

Also, at a minimum, forum producers should provide easily accessible activity data to members.

Copenhagen eHealthWeek Mobile Health Symposium May 7: will we see you there before Doctors 2.0 & You Paris?

IMG_3065The title is almost longer than the post. I'll soon be in Copenhagen, hosting a panel on Smartphone Apps I've put together with Jorge Juan Fernandez Garcia (San Juan Dios Hospital) and David Doherty (3GDoctor) from Ireland. So we'll present a European overview of smartphone apps,  the hospital perspective and the use of smartphones for distance consultation between a patient and a physician around an electronic health record. Looking forward to seeing the eHealth crowd at the mHealth symposium.

(left: Denise and David at a recent conference in Spain) 

Paris, international capital of web 2.0 & social media in Health, May 23-24, 2012

Basil Strategies announces the 2nd edition of Doctors 2.0TM & You, the conference (Paris, May 23-24, 2012). This year will focus on emerging trends in Health Care Social Media Communities, Tools, and Apps in Europe, the Americas and Asia

Paris, France, December 9, 2011 - Paris France will be the world capital for Web 2.0 and Social Media in Health and Medicine, when the 2nd edition of Doctors 2.0TM and You convenes on May 23-24, 2012, at the International Residence situated in the elegant Cité Universitaire campus. Doctors 2.0TM & You will shed light on strategic issues for all of Health Care. The exciting program will examine: how doctors and other professionals, patients, hospitals, government, pharma, and payers use Social Media, mobile apps, and Web 2.0 tools to connect and the best practices that emerge for each.

One of the unique features of Doctors 2.0 & You is that

Continue reading "Paris, international capital of web 2.0 & social media in Health, May 23-24, 2012" »

2.6 Social Media Accounts per Engaged US Hospital #hcsm #hcsmeu

Capture d’écran 2011-10-28 à 00.38.18

A good number of hospital social media and communications people follow "Found in Cache," whose author Ed Bennett (@edbennett on Twitter) is a health care social media blogger who has been painstakingly following hospital use of social media on major platforms such as Facebook, YouTube, Twitter, LinkedIn and blogs. Thank you Ed! I also like your pedagogy in response to those asking about social media's ROI:"What is the ROI of my red plaid pants?" asks Ed,"since I can't go to work without pants." Anyway, regarding statistics, I decided to make a numbers chart out of Ed Bennett's latest bar charts, and play with the figures, in order to provide my analysis.


Capture d’écran 2011-10-28 à 00.34.24

1) Facebook has clearly affirmed its lead in 2011, with Twitter coming in second and YouTube third. So, if a hospital is only planning on managing one account, Facebook would seem to be the one to choose at present.

2) If YouTube is lagging to Twitter, the practical difficulty of producing videos versus producing tweets is undoubtedly the reason here.

3) LinkedIn is gaining popularity quickly and at 566 could overtake YouTube's 575 in 2012, despite the fact that YouTube is third most popular site in the world.

4) The increase in number of hospitals adopting social media is slowing, from 200% to 140%...Hmmm, will end 2012 see only 15 or 1600 hospitals? Could be.

5) And finally, for the past two years running hospitals are averaging 2.6 accounts each, Facebook and Twitter, being the most frequent couple.


iPads reveal hidden capacities of autistic children

The iPad "opens windows into children's minds." Discover the amazing progress in communication for people with autism, thanks to the iPad and learning apps. I am sure we are only at the beginning of a new world.;storyMediaBox

Steve Jobs: Larger than Life, Best-Seller in Death. Let's talk medical choices.

Capture d’écran 2011-10-23 à 23.30.47

As you can see on the left, Steve Jobs was present with us at Doctors 2.0 & You 2011, in a larger-than-life image, with an amazing caption : "Apple announces the iPad, changes the course of history." Click to enlarge the photo even more!

The iPad taught us that the killer app  for physicians is in fact a killer device: doctors, hospitals, med schools have snapped them up as never before--hopefully ending some of the persistent skepticism around professionals and computers. But, Steve Jobs' legacy will not be limited to technology. It will be about the man, the man with a will to do things on a big scale, perfectly, a will to change not only IT but music as well and maybe other fields had he lived on.  I, like many if not most of you, knew very little about the personal experiences in his early years that helped shape him into the person he would become and certainly little to nothing about his medical choices during the final chapter of his life.

Steve Jobs' authorized biography will be launched on October 24th, 2011, in the US. The book is above all Steve Job's legacy to his family, his desire to tell them his innermost thoughts in a structured way. But there is every reason to believe that the biography will be a runaway best-seller for perhaps millions around the world who will be interested in knowing more about this visionary --  which is why I want to focus here on the medical side as did the New York Times in an article entitled "Jobs tried exotic treatments to combat cancer, book says."

We learn through this article two things of major importance. Steve Jobs first learned of his pancreatic cancer in October, 2003 and refused to accept surgery and medical therapy for around nine months,  

preferring "fruit juices, acupuncture, herbal remedies and other treatments — some of which he found on the Internet — and that infuriated and distressed his family, friends and physicians".

"When he did take the path of surgery and science, Mr. Jobs did so with passion and curiosity, sparing no expense, pushing the frontiers of new treatments (DNA sequencing to determine personalized treatments). According to Mr. Isaacson, once Mr. Jobs decided on the surgery and medical science, he became an expert — studying, guiding and deciding on each treatment."

So, some questions :

Continue reading "Steve Jobs: Larger than Life, Best-Seller in Death. Let's talk medical choices." »

Thoughts from Medicine 2.0: Going Full Circle or the real story of SoMe #med2

There's an amazing conference going on in Palo Alto at the lovely Stanford Med School campus, organized by the no less amazing Larry Chu under the supportive eye of Gunther Eysenbach. The weather is sunny and crisp. We're a stone's throw of some of the US's if not the world's most amazing tech companies and medical institutions. But, I am not going to talk to you about "hi" as in tech and the latest sensor or app or mobile tablet.

I am going to talk about "hi" as in the way we greet one another, because that's what all of this is about.

We have gone from a pre-technology world, where man/woman survived by living in communities, at a time when it was impossible to do otherwise. And with that community came not only food, clothing, and shelter, but also belonging, a place, a role, a natural support group, a spirtuality.

And then, thanks to technology, we could progressively travel greater distances and ultimately live on our own thanks to the advent of electricity, mail order, frozen food...I think you get what I mean. 

And with each invention, we went one step further -- unwittingly-- in making that distancing possible...In the 21st century, our ability to satisfy our individual needs has led us to live with almost no consideration for "the other". Those who are not able to support themselves are not automatically attended to, whether ill, old, need.

But, and this is the key point, technology has also enabled man/woman to come full circle to what we are meant to do.  We are all seeking at least moments of happiness. We all know that real happiness doesn't come from material gain, even if the promotion, new home or expensive object are momentarily fabulous. It comes from "feeling good about yourself".  And when do we feel best about ourselves?

It's above all when you're doing good. And we all know what that is. I may sound Pollyanna-ish, but I've been interested in the "study of happiness" for sometime. And so I was even more attentive to keynote Jennifer Aaker and her happiness lecture, where she talked of the contribution of thousands to potentially help a stranger with a bone marrow graft.

And now in a subsequent session, we've just heard 10 patient voices -- all people with medical challenges. Not only are they each examples of courage, we can see how that courage is multiplied by coming together with others.

And how is this all achieved? This is the Full Circle. We have for the past number of 2.0 years invented ways for technology to bring us all back together again. And that is the real story of Social Media. It's about putting people together as we were meant to be biologically and that is why in this room as we've heard this morning first from Jennifer Aaker and now from the epatients, there is an extraordinary sense of well-being and endorphins flying around. I don't need to measure it. I know they are there. Thank you all!

Shifting GeoPolitics of Online Physician Communities (purchase of Doctors.Net) #doctors20 #hcsmeu

How would you describe the universe of online physician communities? Up until today, there were two historic categories, those  launched within the borders of one country and those, generally more recent, that were launched with a global perspective. This of course can change through acquisitions, and one such acquisition was posted today.

One of the first communities to think beyond borders was DocCheck who created a multi-country network in Europe. This was followed by Medting  from Spain which integrates Google Translate,  Doc2Doc from BMJ in English, and most recently VoxMed which operates in 8 languages.

We could also talk about specialties. Specialties tend to think more globally and work in English, even in non-English speaking countries.

Amongst the national communities, Sermo in the US has generally been cited as "the" example, because the US is the most common eHealth reference. Yet, Doctors.Net  of the UK, the object of the acquisition,  had been created prior to Sermo and counts more physicians (186k) both in the absolute and as a per cent of the number of practicing physicians in the country than Sermo. The email domain is also cited as the primary email address for many UK physicians. In addition, Doctors.Net  developed a working relationship with other important physician communities on the Continent, in France, Germany, Spain, in the past 12 months.

So the August 23rd, 2011 acquisition  of Doctors.Net Uk by M3 USA is no minor event. M3 USA  manages MDLinx, an English-language medical news publisher of physician-recommended online bibliographies, itself a subsidiary of the Japanese corporation. By placing in one hand, a significant physician presence in Japan, the US, and Europe, this sale most certainly represents a seismic shift in the geopolitics of online physician communities.

Many questions remain. What will  physicians gain from this greater proximity with other communities? Will some of the content assets of the acquiring company be applicable to Europe? Will British physicians be comfortable as a subsidiary of a multi-national corporation? Will all of the various partner companies get along in this new constellation? Will multi-country programs be able to work smoothly despite legal and regulatory differences? M3 USA's announced objective is to be able to interface with global companies such as pharma and health investors. Will the new company be able to deliver on global promise? In the current climate, will this put too much emphasis on pharma's rôle?

I am sure the team at Doctors.Net tested out their hypotheses before the sale, and that we'll be seeing some interesting developments in 2012.


Yes, favorable internet evaluations be purchased.

While internet rating sites for physicians in the US have been around for a number of years and a number of specialized sites are now part of the online health landscape (HealthGrades, RateMDs, and others), this is not the case in Europe in general, and France in particular, despite the presence of Yelp, GoogleMaps, and other US-based sites that allow for physician ratings. Health care professionals in France believe that physician rating will lead to either a) friendly reciprocal reviews amongst professionals (I'll evaluate you, you'll evaluate me, and we'll all evaluate each other) or b) unjustifiedly negative patient reviews. There is simply insufficient trust in crowdsourcing re docs. While French sites such as Le Guide Santé and Hô do allow patients to rate hospitals and clinics, they don't provide for ratings of the individual professional. What's the latest on this front?

Continue reading "Yes, favorable internet evaluations be purchased." »

Clinicians, fear the e-patient no more ; read this scholarly publication. #doctors20 #hcsm

Are e-patients, -- as for example, online patient bloggers or members of an online patient community -- attempting to serve as "amateur doctors" for other online patients? Those who read this blog know that that is not my perspective. I welcome the engaged, expert patient and wonder why it is taking us so long to give them their rightful place in health care. But many people are still uncomfortable with the online patient, even simply seeking information on the Web, let alone engaging with other patients. The Journal of Medical Internet Research has just published a very interesting research paper entitled "Managing the Personal side of health: How patient expertise differs from the expertise of clinicians" by Hartzler and Pratt at the University of Washington.

Continue reading "Clinicians, fear the e-patient no more ; read this scholarly publication. #doctors20 #hcsm" »

The Physician-Patient Partnership, an interview with Catherine Cerisey

Capture d’écran 2011-08-11 à 00.25.59 For today, Silber's blog presents Catherine Cerisey, a French patient advocate and author of her blog "after my breast cancer", « après mon cancer du sein ». Since we launched the health 2.0 chapter meetings, community, and blog in France, Catherine has been present  IRL and virtually via Twitter and tweet-ups #health20fr  #hcsmeufr #doctors20. This June, Catherine Cerisey participated in the French-language Doctors 2.0 workshop about patient expectations.

Catherine and I had a rich exchange recently about the rôle of patients and I want to share with you her insights on "patient partner". Have as a well a look at this brief video animation called "Communicate" about the before and after of the Internet and its impact on the physician-patient relationship.

And here is the interview with Catherine.

Denise Silber : What is your perspective on the cancer patient's rôle? What has the Internet changed?  

Catherine Cerisey :   In a chronic disease such as cancer, in my observation, the patient has always known when and here it hurts, which drug brings relief, where the nurse can inject with the least pain;  it is often the patient who sounds the alert of an abnormal pain that may lead to a series of tests, for example.

Continue reading "The Physician-Patient Partnership, an interview with Catherine Cerisey " »

How interconnected are we?

At Doctors 2.0 & You, the "& You" referred  to the fact that the health care system is (or should be) a very, if not fully, interconnected world. However, this is still a work in progress. To connect  people within their own country, as most health care is still local, is already a challenge and to go beyond national borders presents an even greater challenge given language and travel requirements. Personal and collective resources both play a rôle. The advent of healthcare social media will help accelerate the connection, where basic resources are available. But much more needs to and will be done!

However, the international language, despite  the improvement of automatic translation tools, tends to be English (or globish ;-) and, given as well, the early start that the US had both on the internet  and in the demonstration of the need for eHealth, many of the most-known protagonists, whether patients, physicians, start-ups have tended to be based in the US while much is happening around the world. We can salute to this end, the hashtags developed by @andrewspong and @whydotpharma in the  #hcsm... series.

Nonetheless, Sermo is still often cited as "the" physician community, because of its rôle in the US, whereas Doctors.Net in the UK has more physicians both in the absolute and as a percentage of UK doctors. Doctissimo in France has a higher proportion of internet users in France, than any health site to my knowledge around Europe or North America. Various countries, organizations and individuals are doing amazing things. The list would be too long to place here.  But we have previously posted on this blog articles in English about both Gilles Frydman of Acor, a Frenchman in the US and Dave de Bronkart  an American in...the US and author of the remarkable Laugh, Sing, and Eat Like a Pig. I highly recommend a re-read of thoseposts.(And for the Francophones, there are other articles on the French version of Silber's Blog --use the search box-- and the Santé 2.0 Blog.)

At Doctors 2.0 & You conference in Paris, one of our key goals is to highlight the best in healthcare and social media and web 2.0 tools with an international perspective. While we could not of course cover all continents, speakers represented many countries and participants even more, a total of 22. And  amongst the patient advocates present were (by alphabetical order) Kathi Apostolidis (see her bilingual blog), Catherine Cerisey, Gilles Frydman, Jan Geissler who prepared a video for Doctors 2.0, (See also this link to an interview of Jan by Silja Chouquet).

Our next blog post presents Catherine Cerisey, a first in English. 

Infographic about Doctors' Use of Technology

++ Click to Enlarge Image ++
The Doctor's Tech Toolbox  | Infographic |
Image Source: Spina Bifida

Your Next Consultation?


Here is the scenario of your next consultation. 
You call a unique national phone number and explain your problem to someone who is specialized in managing this type of call and who can provide a pre-diagnosis. Conscious of the importance of your problem, he or she gets you a same-day appointment in the town where you live. The appointment is confirmed by email during the phone call.
When you get there, a first person with an iPad greets you, checks off the appointment and lets everyone who could be following up with you know that you're there. The Center is very busy, but you are taken within 10 minutes of your appointed time. That person performs a very quick examination, confirms the earlier diagnosis, and notes the result in her iPhone.
She goes off to get just what you need. And you are already starting to feel better.
While she's gone, you get on the Web, thanks to the Center's great wifi. You look at your online file and see that everything is already noted. You'll enjoy recollecting the event, because all of the people you dealt with were so competent and welcoming.
 No, this was not a medical appointment, but the replacement process for my iPhone that suffered a major dysfunction and was replaced the same day. Congratulations to Apple and the Apple Store (I went to one in Paris) for their own use of IT to improve service.


Have you read "The Case for eHealth"? #ehealth #hcsmeu

Capture d’écran 2011-04-02 à 14.27.01 The Case for eHealth is a publication I had the great fortune to write at the request of the European Commission (Ilias Iakovidis, Petra Wilson) unit in charge of eHealth, in 2003.

It is now referenced in publications in many languages, although there have been no translations.

I thought it would be interesting to circulate it again now, thanks to Twitter and Facebook, as we ask ourselves about the best way forward.

Here are 2 quotes from page 36 :

Capture d’écran 2011-04-02 à 14.34.25





Capture d’écran 2011-04-02 à 14.29.51

Please feel free to download the report via this link.

Téléchargement Case_for_eHealth03.

PatientsLikeME introduces new rules for recruitment #health20fr

What self-respecting health on the internet fan doesn't know PatientsLikeMe  the site that enables English-speaking patients to create their online profile, generate dynamic graphic representations of their data and-- most important of all, meet up with people "like them"? For many, myself included, PatientsLikeMe is the icon of the Health 2.0 movement. Two new changes to PatientsLikeMe rules inspired this blogpost 1) the PatientsLikeMe site will henceforth apply the principle of cooptation. A member can invite another patient, whatever his or her condition 2) a patient can create a new condition, if one is lacking. People with multiple conditions will be able to follow all of them on PLM.

Capture d’écran 2011-03-15 à 20.48.35

A final but important question at this time: Why does PatientsLikeMe (with its 80k patient database) represent such a small fraction of the English-speaking internet health-concerned population?  If it's the narrow selection of diseases, that may change with the new rules. But, what if the reason comes from the fact that not everyone wants to create and follow their profile and meet with others? To create and manage a detailed online file is work and revealing of one's vulnerabilities whether as an avatar or visibly. As everyone in the field of EHR's knows, not enough individuals are committed to creating one...


Video regarding launch prostate robotic surgery Rambam Hosp Israel #ehealth

Doctors 2.0 & You Conference to Examine Impact of Web 2.0 in Healthcare from Physician Perspective

First event of its kind to be held in Paris, France June 22-23, 2011; agenda will address results to-date, impact and business aspects of social media and tools in healthcare delivery.

PARIS--(BUSINESS WIRE)--Doctors 2.0 & You, a first-time conference examining how doctors use social media and Web 2.0 tools to connect with patients, colleagues, pharma, payers and hospitals, will be held on June 22-23, 2011 at the Cité Universitaire Internationale in Paris, France. Organized by e-health specialist Basil Strategies, co-organizer of the 2010 Health 2.0 Europe conference, the two-day Doctors 2.0 & You event will gather experts from across Europe, the U.S., and Israel, to examine physicians’ professional use of new and social media and its practical, societal and business impact on healthcare delivery.

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Interview with Dutch founder of Meamedica, drug rating site #health20fr


The recent Dutch-origin consumer drug rating website appears in Germany and France as and It was created by a Dutch pharmacist Wendela Wessels.  Publishing a new rating site in healthcare in France, for example, is not easy to succeed. Private rating sites  are not forbidden by French law, but so far, there are no comparative healthcare professional sites, other than for hospitals and of course Yelp, Google directories. No French company is devoted specifically to rating drugs. It is interesting to note that as a result, novelty comes from an entrepreneur in another country, in this case, the Netherlands.  Having heard various rumors in France about Meamedica, its "secret" investor and various problems, I interviewed  Wendela Wessels and found a more or less typical start-up founder trying to bring a solution to a problem. This article will be translated to French shortly.


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CardioCam or medical mirror, a gamechanger for healthcare ? #ehealth #health20fr #telemedicine

The short video below demonstrates the basics of CardioCam, developed at MIT. Cardiocam enables accurate detection of heart rate, blood pressure, and other basics by looking at a technology enhanced mirror. Will this lowcost, accurate technology lead to permanent monitoring of everyone, in order to optimize our various parameters? A whole host of scientific, practical and ethical questions to think about...Will today's blood pressure monitor go the way of the buggy whip?

This invention came out in mid 2010 and was noted in December by the NYTimes in their annual idea recognition article. Here is the citation: Ming-Zher Poh, Daniel J. McDuff, and Rosalind W. Picard, "Non-contact, automated cardiac pulse measurements using video imaging and blind source separation," Opt. Express 18, 10762-10774 (2010)



Launching Mayo Clinic Social Network #doctors20 #health20fr #hcsmeu

By alphabetical order, the following institutions are charter members of the Mayo Clinic Social Media Health Network:

    * Inova Health System, Reston, Virginia, USA    * Mission Health Care, Asheville, North Carolina, USA    * Mayo Clinic, Rochester, Minnesota, USA    * Swedish Medical Center, Seattle, Washington, USA    * Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands

Congratulations from here in Europe to all, and in particular to Lucien Engelen. @zorg20

How do u say eHealth in French? e-santé ! #health20fr

Capture d’écran 2010-11-09 à 19.27.05

Here is the link to the English part of the official eHealth web site of the French government.

Only a select number of articles are in English, but it will give you a good idea of what's going on and who does what. 

You see  on the left

a photo of the French pharmacists' president, whose 10 million electronical pharmaceutical records (shared by pharmacists) are impressive.

and mention of the DMP which is France's national EMR, expected very shortly.

The Chilean miner rescue, # telemedicine, and the philosophy of life

As one of the many following the Chilean miner rescue, it occurred to me, beyond the incredible human interest story, that this event highlighted various lessons beyond the courage of the miners themselves. As you can see from these 3 points, given the extreme situation, the rules of the game changed.

a) telemedicine was embraced  (read about the Zephyr Physiological Status Monitoring system)

Capture d’écran 2010-10-17 à 22.16.00

b) there was delegation of medical responsibility to non-physicians 

c) cost of $10 to 20 million was apparently not an issue in the saving of human life (several hundred thousand dollars per person) - although the mining company is being asked to reimburse 2/3 of the cost.

Hmmm. I'll leave you to ponder the above.

Tweet-up #health20fr with @epatientdave & @oxyvet (Ginny) Loving Life !!

Téléchargement 4 Oct 2010 Transcript for #health20fr - What the Hashtag

Capture d’écran 2010-10-04 à 21.21.02  Tweetup today with @epatientdave & @oxyvet (Ginny) on #health20fr

True to life examples are unpredictable and highly original and so were Dave & Ginny, our tweet-up guests. Dave deBronkiart has mostly been invited to speak at patient empowerment conferences alone. But, in reading between the lines of Laugh, Sing, Eat like a Pig, one realizes the massive importance of Ginny, Dave's wife, in Dave's life...sort of like the wedding vows to be your faithful partner in sickness and in health, ... And Dave regularly reminds us that he and Ginny honeymooned in Paris...So, how fitting for the French and English bilingual tweet-up that they both joined in and told us how much they are loving life.

What are the takeaways from the tweet-up with Dave (three-years after the big battle) and Ginny?

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Miguel Cabrer presents Medting, global doctors' case-sharing platform #health20fr

Founder Miguel Cabrer presents, at Health 2.0 Europe 2010, Medting, a global doctors' case-sharing platform with extranet capabilities.

Social Media: Avandia report chronicles patient observations on cardio issues. #hcsmeu

Social Media: Avandia report chronicles patient observations on cardio issues. #hcsmeu

The question comes up regularly -- what does social media conversation bring to medicine and health? Is it just an echo chamber or do things happen thanks to it ? One of the best and possibly most-cited example of Social Media's "efficacy" so far has been Patients Like Me, who, amongst others, enables patients to not only find other patients with similar issues but also to review data patterns thanks to the observations of hundreds or thousands of people. So, PatientsLikeMe goes beyond conversation by providing a concrete Health 2.0 toolkit.

Introducing Woollabs whose self-styled description is "Business Intelligence through Social Cognition." The company's new independent  report on Avandia, based on analysis of comments and conversations taking on place social media platforms, is very clear.  Capture d’écran 2010-09-04 à 19.00.30

Using technology that enables Woollabs to provide what it considers to be a complete review of what is being said on the web on a given subject, their researchers were able to chronicle, year after year, the growing awareness by patients of the cardiovascular problems posed by Avandia. 

As the report's author noted, conversation topics on the web showed "dramatic change." After having been very positive regarding the drug, by 2005, patients felt that physicians were downplaying their observations about overweight and oedema. By 2006, patients began to see a link between the drug and congestive heart failure...Over the following years, patients' concerns intensified and the report shows that their anger moved progressively from the drug to the pharmaceutical company producing it to the FDA.  What no individual patient or even physician may see, can be understood through the confrontation of multiple experiences and conversations over time...

Should the report have been called: what social media can bring to the quality of care? That would have been my choice...

How will pharmaceutical communication with physicians evolve? #pharma #hcsm #hcsmeu #health20fr #hcsmeufr

Capture d’écran 2010-08-15 à 23.07.23 How will communication between the pharmaceutical industry and physicians evolve? Various forces are at work to reduce the numbers of sales reps deployed in the field: the economy, the excesses of recent years, reduced access to physicians by the doctors themselves, the internet.

 The article referenced on the left describes the case of AZ in the US who eliminated its 850 person Nexium fieldforce and replaced them by a call center of approximately 300 people, coupled with a web site from which doctors could order materials and samples. The articles concludes by saying that AZ will continue to reduce costs in this manner.

However, in the 3 months since the article was published, there have been 21 comments -- thank you social media-- a number of which make the conclusion less clear. 

  • The main point is that "Do not call requests" are growing.
    •  Only 30% of US physician practices receive the calls freely, according to one of the telemarketers who commented. 
    • Another one notes that to get a doctor to call back, he leaves information about a party being organized. I don't know if this is tongue-in-cheek, but it seemed serious.
    • A fourth commenter suggested that calls should only be made at lunchtime when doctors are available and not during patient appointment hours
    • A fifth and sixth person plug e-detailing after hours (or without accompaniment) instead of telemarketing by phone.
In any event, the bottom line is that contacting physicians to provide information that is not needed or wanted at the moment that it is being offered must quickly become a thing of the past. Just in time information on the web combined with access to a personalized company representative who could link the physician to a colleague, if need be, would seem to be the way to go. Comments?

Health Care Social Media EU #hcsmeu celebrates 1st Birthday Aug. 6 2010

Who said that Europe closes up in August? Today is the 1st Birthday of the Health Care Social Media EU community and it's an active time all around with birthday parties this evening in various capitals as each chapter makes its national identity better known. For France, the party is announced on Facebook and there will be more surprises announced during the party by @tiphainemf, @xbrochart and myself @health20paris.

Capture d’écran 2010-08-06 à 11.41.42 

At the risk of adding  one more definition, HCSMEU is about the use of social media in healthcare in Europe to bring people together in a way that contributes to better health. The HCSMEU community has been built by its founders @andrewspong and @whydotpharma primarily through a series of weekly Tweet-ups or written chats via Twitter since last Aug 2009, on Fridays from 1 to 2pm. They are visible by following the hashtag #hcsmeu on Twitter, Tweetdeck, Hootsuite etc,  Capture d’écran 2010-08-06 à 11.32.47
 The hashtag stream can be seen by clicking on the blue and white image. The tweet-ups bring people together to answer 3 questions that have been posted by the participants. They begin and end promptly and typically Andrew pushes us along from one question to the next...Hmm. The 3rd question is not the best spot to have. 

There are also numerous posts on many blogs, a wiki, a daily twitter paper, unconferences.

And for today, Andrew (assisted by Monty) has made a brief birthday speech.


A Global French company in the US EHR / HIT market : CEGEDIM #health20fr

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Pulse Systems based in Wichita Kansas with 2010 revenues of US$16 million and certified CCHIT 2011, was the recent site of an important international announcement.

I am not referring to  its homepage banner indicating that its electronic health records solutions will meet the US stimulus package requirements, in keeping with the package proposed by Obama and enacted by Congress in Feb. 2009, providing $30 billion in incentives for physicians and hospitals to implement electronic health records EHR's.

I am referring to the fact that on July 28, 2010 Pulse Systems joined Cegedim Health Systems, a division of French-based CEGEDIM, thereby receiving $13.5 million in cash and a potential additional payment for a total of no more than $58 million over the next two years.

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HONCode survey on Internet use: final days to reply #health20fr

Final days to reply to latest HONCode survey: Survey about the evolution of Internet use for health purposes

Podcast: Susannah Fox summarizes research on health internet use in US #health20fr

Capture d’écran 2010-07-14 à 00.34.20 Catch an audio podcast with slides by Susannah Fox of the Pew Foundation, reviewing some of her most important research regarding use of the Internet, chronic conditions, the changing way in which we gather news, social media, and more.

PS Susannah herself thinks this is one of her best overviews!

Interview of France's public policy eHealth portal webmaster #health20fr

Silber’s Blog  published the first interview of Matey Karassimeonov, Capture d’écran 2010-06-30 à 23.15.06 webmaster of the recently-launched French government eHealth portal whose purpose is to inform interested parties about eHealth programs in France. This is the English version of the interview. Matey was trained in law and new technologies and worked previously for the French Overseas and Sports Ministries. He can be described as an internet fan since his teen years.

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