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136 posts in "Quality of healthcare"

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. 


Interview with Denise Silber at Stanford Medicine X #medx #hcsmeu #doctors20

Thank you Larry Chu and team for the lovely video. The interview is about healthcare social media, the empowered patient, the physician, Europe, the US...


Online physician communities: news from WorldOne + Sermo

Digital healthcare is fascinating. And one of the most fascinating facets is the world of online communities, and within that, physician communities. Why? Physicians have so much to gain from exchanging with colleagues with similar questions. Healthcare organizations have so much to gain if they can target and scale their relation to physicians. Patients have everything to gain if physicians can gain insights and perhaps even professional motivation through communities. And yet, it isn't that simple. The most basic questions remain. Why should the physician join that community? Why should he or she stay? What's the business model? And in every country around the world, the history of online physician communities has evolved in a different way.

And so today we learned that WorldOne  + Sermo (1.8 million healthcare professionals spanning 80 countries, including more than 385,000 US physicians) has received new financing: US$35 million from Deerfield to support the company's physician engagement platform. (Sermo had been acquired in July 2012 by WorldOne). These are not minor events in international digital health.

Nor was it a minor event in August 2011 when Doctors.Net, the British physician community leader was acquired  by M3 based in Japan and the US, and we discussed it here.

Organizing international digital healthcare conferences, such as Doctors 2.0 & You, and speaking at others, such as Stanford Medicine X, I can say that the online physician community space remains very exciting.

You may just want to refresh your memory and watch our Doctors 2.0 & You 2012 panelists here. Stay tuned for even more excitement in June 2013 with our latest physician community sessions, including Sermo,, Dermaweb and several others

... As you wait, I am sure that the words of WorldOne's CEO will surely interest you.

Capture d’écran 2013-04-03 à 21.49.03



Healthcare Social Media Identity Survey to be discussed at Doctors 2.0 & You : Participate now. #doctors20

I've been interested for some time in the role of online identity in healthcare on the social web.

Why? Because on the one hand "transparency"  is key to quality and on the other, the social web has introduced us to the possibility of developing as many identities as we can manage.

So, where do we go with this question? Well, it depends on whom you ask...

To clear the air, we're surveying you, right here and now, if you agree, and around the world The results will be discussed in Paris in June at Doctors 2.0 & You, and online. 

In the meantime, please take 5 minutes to answer here.

Capture d’écran 2013-03-13 à 00.15.10

The Story of the Single Tweet that Cured #doctors20

It took:  Lucien Engelen, Berci Mesko, Larry Chu, Sean Ahrens, Roberto Ascione, myself Denise Silber, and first and foremost the patient herself, but one single tweet did change a life and remarkably so!

Here is the story.

Berci, Lucien Engelen 16.25.21In the fall of 2010, someone in the United States, whom I didn't know of or meet until recently, suddenly developed an inflammatory bowel disease, colitis. Her life was turned upside down as she dealt with this new medical problem that was constantly present. She asked her physician if any food allergy could explain her problem. He said no. And so the colitis went on.

In the fall of 2010, I went to Maastricht in the Netherlands to attend Lucien Engelen and Gunther Eysenbach's Medicine 2.0. There, Dr Larry Chu from Stanford was scouting for speakers for Medicine 2.0 2011 in Palo Alto. Berci Mesko spoke to him about me. (You can see that Berci and Lucien know each other and also enjoyed Paris's Doctors 2.0 & You).

And so in September 2011, off I flew to San Francisco, on my way to Palo Alto for Medicine X.  Larry Chu and I quickly realized that our two events, Medicine X and Doctors 2.0 & You, were based on the same philosophy and would be natural partners. 

Silber Chu 16.18.24
Denise Silber, Larry Chu


Also attending  Medicine X was Sean Ahrens, founder of the Crohnology community. We had a great chat. After the conference, Larry and his team produced a beautiful video interview of Sean, interesting for both its substance and the style.

Back in Paris to prepare for Doctors 2.0 & You 2012, a new partnership came up, with the brand new video platform, Videum that facilitates translation automatically and by volunteers. We chose the Sean Ahren's interview to open the plenary and project it off of Videum for the subtitles. When the video came on in Paris, Roberto Ascione of Razorfish (then Publicis), father of the platform, tweeted the Videum link.  SeanAhrens Chronology 16.12.11


One of Roberto's twitterfollowers from Razorfish was the colitis patient. She saw the link, watched the film, and discovered that a gluten allergy could  indeed explain her symptoms. Two weeks later, she was back to normal!  I did not know the person with "the story", until we met recently, 7 months after the conference to talk about Doctors 2.0 & You 2013. When I described how the conference in 2012 had opened with a video on Videum, she said, "Oh, I have a story to tell you about that video, that "cured me" And so I learned how one tweet had changed a life for the better, with all due thanks to Lucien, Berci, Larry, Sean, Roberto, and, well, me and the patient.


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

Capture d’écran 2013-01-07 à 01.23.17

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 ;-).

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.

Healthcare Social Media Research: how should it be done? where should it be published?

Those of you who are interested in healthcare social media must have given some thought to the questions posed by research regarding healthcare social media.

  • What happens when we use traditional research methods to study Healthcare Social Media  ? 
  • Do we publish the results according to the principles of traditional scientific journals?
  • Do we, given the subject, avoid paid subscriber-only journals ?

 An article* from researchers at U Penn Medical School and which was just published in PubMed demonstrates some of the issues around the above questions. 

The authors' purpose is to analyze the use of Twitter on the topic of resuscitation and cardiac arrest.  62000 tweets were examined on the basis of a series of keywords relating to cardiac arrest and resuscitation. Author profiles, retweets, time of day, were studied. 

The findings demonstrate the difficulty of doing research on tweets. Here are three key results - the issue being that this research was observational and you can only observe the  things Twitter allows us to measure.

  • Only 25% of the examined tweets included specific information on the topic - a fact which merits further analysis...75% of tweets containing keywords do not have information on the topic???
  • 13% of tweets were retweeted...meaning that we can't count on retweeting to diffuse a message.
  • Users with more than 15 resuscitation-specific tweets tended to have 1787 followers (which is a high average number).

The conclusion of the abstract shows the promise of healthcare social media.

Twitter can be filtered to identify public knowledge and information seeking and sharing about cardiac arrest. To better engage via social media, healthcare providers can distill tweets by user, content, temporal trends, and message dissemination. Further understanding of information shared by the public in this forum could suggest new approaches for improving resuscitation related education.


The tweets were published in April-May, 2011....almost a year and a half ago...which is a huge period on Twitter.

The article is published in a subscriber-only journal, meaning that only the abstract is visible. 

I would submit that researchers should come up with new Social Media methodology! 


*Resuscitation. 2012 Oct 26. pii: S0300-9572(12)00871-4. doi: 10.1016/j.resuscitation.2012.10.017. [Epub ahead of print]  Decoding Twitter: Surveillance and Trends for Cardiac Arrest and Resuscitation Communication. Bosley JCZhao NWHill SShofer FSAsch DABecker LBMerchant RM.Department of Emergency Medicine, University of Pennsylvania, Perelman School of Medicine Philadelphia, Pennsylvania.

HealthCare Social Media amplifies French physician grassroots movement

Capture d’écran 2012-10-23 à 11.36.43 The "Doctors aren't stooges" movement in France (les médecins ne sont pas des pigeons) shows that French physicians have come a long way in using healthcare social media. You may recall that the French government had to give them financial incentives in the late '90's to acquire their first computer. 

And now, Dr Philippe Letertre, founder of the movement, has inspired an incredible result in barely two weeks. Please note that almost all of their traffic is from French healthcare professionals, their primary objective at this point in time.

That the emergence of this French grassroot physicians and surgeons movement could not have occurred without the help of Social Media should be food for thought for all of healthcare stakeholders...Some questions to healthcare organizations for example:

  • Are you satisfied with your current web presence?
  • What will you do if there is a major disruption in your communications landscape cia social media?
  • Should you wait and see at present or  maybe encourage more dialogue at the present time?
  • What is the risk of the status quo?


Smith College Conference in Paris Focusses on Advancing Women's Leadership in Public Health

Capture d’écran 2012-10-17 à 22.36.12Am honored  to be a part of this:
Smith College Conference in Paris to Focus on Advancing Women's Leadership in Public Health
Co-sponsored by Smith College and the U.S. Department of State, with the support of the French government and the European Parliament, the event will bring together emerging leaders from francophone Africa, France and greater Europe with experts in public service, global health and women’s education.

NORTHAMPTON, Mass.—Under the aegis of the Women in Public Service Project (WPSP), a joint venture of leading U.S. women’s colleges and the U.S. Department of State, Smith College will host “Women’s Leadership: Public Service and Global Health,” a four-day conference in Paris designed to give emerging public service leaders deeper understanding—and broader professional networks—around issues of infectious disease, domestic violence, nutrition and hunger, and gender disparities in access to medical treatment and resources.

The intensive four-day session, to be held Oct. 17 to 20, reflects the overall goal of WPSP: to increase the participation and influence of women in all spheres of public service. Participants will enhance their skills for attaining elected and appointed positions in the public sector while establishing networks within and outside their nations through which they can share strategies, tools and support.

Participants were selected from the global health arena in countries across francophone Africa and greater Europe. The location and venues of the conference acknowledge the long—and at times complex—relationship linking France and francophone Africa, as well as Smith College’s near century-long presence in France, the site of its oldest study abroad program.

Co-sponsored by Smith College and the U.S. Department of State, with the support of the European Parliament and the French government, this conference reflects the strides that France and greater Europe have made in women’s representation in government and public service.

Admission to the program was highly competitive; more than 170 applications were received for 35 delegate opportunities. More than 15 countries will be represented among the delegates, who are physicians, epidemiologists, health educators, journalists, health policy officials, women’s advocates and NGO officials.

The conference’s opening session will include an address by Nora Berra, former French Minister of Health and Member of the European Parliament. Mrs. Berra spoke at the WPSP launch at the invitation of U.S. Secretary of State Hillary Clinton in December 2011. She will be joined at the opening session by Farah Pandith, Smith Class of 1990, special representative to Muslim communities, U.S. Department of State, a key figure in the development of WPSP.

Among the presenters throughout the four days will be Caroline de Haas, adviser to France’s Ministry of Women’s Affairs; Fatma Bouvet de la Maisonneuve, psychiatrist and women’s rights advocate; Saniye Gülser Corat, director of gender equality, UNESCO; Ambassador David T. Killion, U.S. Permanent Representative to UNESCO; and Denise Silber, Smith alumna, international e-health consultant and recipient of the French Legion of Honor for her work in promoting the use of new technologies in health care.

During the conference, delegates will attend a reception at the U.S. Embassy in Paris as guests of Susan Tolson, Smith Class of 1984, director, AMI-American Media Group, and her husband, Ambassador Charles Rivkin.

Sessions will include keynote addresses, small group workshops, case studies and informal discussions centered on the broad topic of public service in public health. A number of sessions are open to the public.

The program will be directed by Smith professor Robert Dorit, who has published extensively on public health issues. Dorit’s expertise includes the search for narrow-spectrum antibiotics, the genetics and epidemiology of antibiotic resistance, the biology and politics of breast cancer and the interaction between urbanization and human health.

About Smith College

Founded in 1875, Smith College, located in Massachusetts, is one of the largest women’s colleges in the United States. Its graduates are found in positions of public service and leadership around the world.

About The Women in Public Service Project

Developed by a founding partnership of the U.S. Department of State and five leading women’s colleges—Barnard, Bryn Mawr, Mount Holyoke, Smith and Wellesley—the Women in Public Service Project provides vital momentum to the next generation of women leaders who will invest in their countries and communities, provide leadership for their governments and societies, and help change the way global solutions are developed. The Project is a program of the Woodrow Wilson International Center for Scholars.

About the Woodrow Wilson International Center for Scholars

The Wilson Center provides a strictly nonpartisan space for the worlds of policymaking and scholarship to interact. By conducting relevant and timely research and promoting dialogue from all perspectives, it works to address the critical current and emerging challenges confronting the United States and the world.

Office of College Relations
Smith College
Garrison Hall
Northampton, Massachusetts 01063

Kristen Cole
Media Relations Director
T (413) 585-2190
kacole @


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...


Meet up with ePatient AfternoonNapper in Paris at Doctors 2.0 & You (video)

Do you know Sarah Kucharski, AKA @afternoonnapper ? If you venture out into the world of healthcare social media, be sure to look for her...Sarah is a woman on a mission, to accomplish as much as possible, in terms of improving the patient experience and to help the FMD (fibromuscular dystrophy) cause. She took some of her precious time in Paris, while at Doctors 2.0 & You to talk to the camera lens, skillfully managed by @misslondres, Muriel ! The result is simple and elegant. Have a look.

Pat Rich explains how Not to launch an Online Doctors Community #hcsmca #doctors20 #socmed

Every week we hear about yet another eHealth wonder...But, how often do people have the courage to learn from failure and to talk about it so that they can help others learn as well? Hat's off to Pat Rich from the Canadian Medical Association, who came to Paris to do just that at Doctors 2.0 & You 2012. Listen as he explains what went wrong with the physicians' community they called Asclepios (?) Asklepios (?) ...If they can't spell it, it can't succeed!

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) 

Facebook and organ donors: beware of the Maginot line

in Silicon Valley, a med school student whose boyfriend happens to be Mark Zuckerberg comes up with the idea of using Facebook status to signify organ donor acceptance and it is announced on May 1, 2012. Within a few hours, there are 39,000 occurrences of this announcement on Google, in English alone. So, with nearly 900 million FB subscribers around the world,  has the social media giant potentially solved the organ donor problem around the world, just prior to its IPO?

Capture d’écran 2012-05-01 à 23.25.21Not really. First of all, even in the US, individuals must register on their state's donor registry to be sure that their wishes will be respected (Okay, Facebook facilitates the link to the registry). Secondly, while social media breaks down barriers between individuals, it doesn't substitute for national laws. And so, the sun sets on Facebook's empire, as soon as the question involves someone, even temporarily, situated outside of American borders. And fewer than 18% of FB subscribers are American.

In England, where the FB organ donor introduction is happening at the same time as in the US, a patient's family can refuse, after the individual's death.

France, whose famous Maginot line was unable to keep out invading armies, will nonetheless also apply different laws from the US as regards organ donor authorization. Yvanie Caillé, president of Renaloo, the French association of dialysis and kidney transplant patients told Silber's Blog that authorization is assumed in France, unless the person declared their opposition during their lifetime. So, the issue in France is not about authorization by the donor. There are other problems around organ donation.

And there are undoubtedly many variations and scenarios on the theme of these laws in the nearly 200 countries around the world.

But to end on a very positive note, let us remind ourselves that the Facebook announcement is generating tremendous good buzz about organ donation and that is, in and of itself, good for the cause, even if Facebook is not THE solution.


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" »

Doctors Inventing Social Media Apps to help make life better for Patients AKA Jennifer Dyer

Okay, I was supposed to wait until we got the new speaker page up on the Doctors 2.0 & You web site -- but I just saw Jennifer's Tweet go by and we're so excited to announce that Dr Jennifer Dyer, @EndoGoddess is going to be speaking in Paris in the spring, May 23-24, 2012. And here she is today on NBC TV from Columbus, Ohio, where she is mostly! And she is talking about what she talks about mostly: trying to make things just a bit better for patients. It's an amazing app that is for diabetes and it's social.

Good luck, Jennifer! We're counting on you here in Paris to draw the conversation together about doctors and patients collaborating, on diabetes and measurement, thanks to social media, mobile apps, iTunes and motivation. Did I get it all?


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.


Doctors 2.0 & You New Interviews

At Doctors 2.0 and You, there were many conversations, many cameras, all discussing THE movement toward a new physician-patient relationship. And we hope you'll come and contribute your remarks  here to the Doctors 2.0 & You draft Manifesto.

In the meantime, please catch a glimpse of : Catherine Cerisey, Ronan Denoual, Lucien Engelen, Cedric Hutchings, Felix Jackson, Jean-Denis Koeck, Frederic Llordachs, Joris Molenaar, Susan Nicholas, Franck Panaget, Denise Silber, Xavier Simon, Lucie Tesquier. They were all interviewed off-stage by Basil Strategies' partner, MedicalProTV channel by TechToc. The interviews in French are subtitled in English. 

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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!

A Fresh Look at the Cost of HealthCare #CHAM2011

Capture d’écran 2011-09-08 à 23.40.41

 A new look at the cost of Health Care is promised at the 3rd edition of Prof. Vallancien's conference CHAM, convention on health analysis and management taking place on Sept 30 - Oct 1, 2011 in Chamonix.  Get the program here.

You'll be able to attend virtually, by live streaming. It will be the occasion to meet up with a concentration of French health economists and some international guests.

I'll be there, interviewing Joseph White of Case Western Reserve University on an exciting question: is it possible to improve population health? You think it's a given that public health is everyone's hero. Maybe, maybe not.

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." »

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. 

Ireland and UK top two health systems for efficient reduction in adult mortality. US near bottom of 19 countries studied.

Capture d’écran 2011-08-09 à 10.05.29 Capture d’écran 2011-08-09 à 10.05.29 Some surprises from the latest publication of Pr Colin Pritchard in the Journal of the Royal Society of Medicine comparing  health system results of 19 "Northern" countries. The authors examined the reduction in mortality results between two periods of time and created a ratio taking into account health expenses as a percent of GDP. 

The good news is that the study confirms the significant reduction of mortality for those between 15 and 74, the ages studied in this comparison of the period between 1979-1981 and 2003-2005, by the authors. 2005 is the most recent year for which data was available.

First position goes to Ireland, second to the UK, and third to New Zealand. France is 13th and the US trails near the end of the list, for the high cost of saving too few people.The article was immediately picked up by The Guardian, noting that if the UK is doing so well, reforms would be rather inappropriate. (A French  post is available here.)

The subject of the cost of health in France and internationally will be the theme of the next CHAM  conference taking place in Chamonix on Sept 30 2011. Hope to see some of you there. 

Here is the ranking of the number of deaths gained per million on 10 of the countries.

  • Ireland 4941
  • Australia 4328
  • UK 3951, 
  • Italy 3579
  • Canada 2822
  • France 2779, 
  • Japan 2600 
  • USA 2498, 
  • Germany 2395
  • Spain 1586

When we introduce the ratio of expense to gain, we get:

  • Irleland 1:696
  • UK 1:557
  • Australia 1:521
  • Italy 1:436
  • Japan 1:380
  • Canada 1:324 
  • France 1:316
  • Germany 1:247
  • Spain 1:233
  • USA 1:205


Here is the original article.  Téléchargement JRSMpaperPritWall


A Social Media Congratulations to Digestive Disease Week 2011 #ddw11 #doctors20

Let's congratulate DDW11 for a very pro-active social media strategy.

YouTube channel : David Sack, a visiting gastro-enterologist at Digestive Disease Week 2011, did the above video interview, at the "win a Flipcam" contest at the conference.  The DDW organized the video recording of 32 poster presenters and of numerous physicians presenting highlights of the conference here.

Facebook: here is the DDW page  The FB page is another vehicle to tell the story of DDW and be where the audience is. 

Twitter:  1700 tweets approximately tell the story of Digestive Disease Week 2011. You can read the transcript here, gathered on FoxePractice

Téléchargement  #ddw11 - Healthcare Twitter Transcript »

So, if you didn't get to DDW11, you can't get it all online, but you can still get a real flavor for the information and the exchange among physicians, whether they or you were on site or not.

What does it mean for the future of congresses that so much information can be gathered on line. Surely, this is a good thing that gatherings of this nature can go beyond the onsite market. But, not everyone appreciates the transparency of the information and the availability for non-registered attendees...or even for the registered attendees. What will happen to all the publishers of online newsletters, for example?

Anyhow, go AGA, go!

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.


Doctors 2.0 & You Conference: Welcome Greek participants ! #doctors20

Capture d’écran 2011-04-20 à 23.33.10


All Greek participants
will be warmly welcomed by @kgapo and the Doctors 2.0 team !

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 :

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Please feel free to download the report via this link.

Téléchargement Case_for_eHealth03.

Encouraging Organ Donation: Facebook #health20fr

The story of a kidney donation thanks to a Facebook friend whom the recipient had never met was  published on March 31.  The two people met once the volunteer had stepped forward. The tissue compatibility was verified and a friendship began between the 2 people. This is not the first such case. Other stories can be found by googling.

So, altruism exists. Facebook didn't invent it. But it did simplify the means for altruists to meet, and you can even encourage them. Here is a banner you can download.

Once again we demonstrate that the internet is  just a digital image of the people and world around us.... 600 million people on Facebook? Hmmm, who's checking that number?

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Video regarding launch prostate robotic surgery Rambam Hosp Israel #ehealth

#BornHIVFree wins digital engagement award #hcsmeu #hesawards

Having had the pleasure of nominating the #BornHIVFree campaign for the 2011 #hesawards managed by Creation HealthCare, am pleased to note that the campaign is the winner of the 2011 People Power Award.


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Below, please find the title of the poster I presented on same subject at Medicine 2.0 Maastricht, in November, 2010. 

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Mediator (Servier) "bombshell" report by official French inspectors published 15 Jan 2011

On the one hand, prescription drugs contribute to the extension of life expectancy in numerous diseases. On the other, pharmacovigilance or the surveillance of side effects of drugs is imperfect because a) it depends on the central collection of side effect reports, b) a sense of certainty about the specific responsibility of the drug which is not always clear, because patients take multiple drugs and the numbers are low. As a result,  the risk-benefit ratio can be underestimated.  However, on Saturday January 15, 2011, three IGAS inspectors (General Inspectors of Social Affairs) published a 260 page report in French - Téléchargement 33594_mediator-le-rapport-de-ligas - demonstrating a fatal breakdown of the French drug regulatory system over the past decade, as regards the drug Mediator. Mediator can provoke fatal valvulopathies and according to the report, there was not only enough information to take the drug off the market in 1999, the company concealed the true pharmacological profile of the drug since its introduction in 1976. The Mediator report will have far-reaching consequences on the management of "conflict of interest" between physicians and drug authorities, in France, Europe, and most likely the world. What changes will be made to the relationship between the pharma industry and the regulatory authorities, as regards drug registration, post-marketing surveillance, and communication between the industry and physicians? This remains to be seen. 

Continue reading "Mediator (Servier) "bombshell" report by official French inspectors published 15 Jan 2011" »

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.


Continue reading "Interview with Dutch founder of Meamedica, drug rating site #health20fr" »

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