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Archive for the ‘Panel sessions’ Category
Trying to find the room for this panel was problematic – for an informatics conference, information and communication has been rather poor. This panel session is titled “Open source eHealth applications and the Millennium Development goals for Africa”. The first speaker (from Columbia University, in USA) talked bout mHealth as an extension of ehealth, and the Global Villages project funded through WHO. The Global Observatory for ehealth has mhealth for health promotion as its first priority action area (PAA). This covers increased demand for health services and preservation of well being, disease surveillance and control, and health promotion through targeted media, eg through SMS for behaviour change communications. PAA number 2 is around supporting the health work force, and addresses telehealth/medicine consultation being migrated to mobile devices, and point of care support tools. PAA 3 is mhealth for service delivery, though emergency response systems, patient tracking and supply chain management. She pointed out that there are more mobile phones in Africa than in US and Canada together as of 2008. Among the challenges:
Other parts of the overall work are around supporting community health workers, eg through birth/death registries (linked to Open MRS). Andy Kanter, from The Millennium Villages project (MVP), Earth Institute at Columbia University. MVP is a partnership between Columbia University and national governments where the project is based. Focus is on lifting communities out of poverty and using affordable, science-based solutions to address Millennium Development Goals (MDGs). 11 countries (inc Senegal, Mali, Ethiopia, Kenya, Malawi). Three of the 8 MDGs are health related, and aim to improve care. The MVP (http://www.millenniumvillages.org/) aims to establish one clinic per 5000 people, with community health workers (1 per 100-200 homes). The MVG-Net information system is a bottom-up initiative, locally-owned and integrated with global reach. Hub and spoke model, collecting knowledge locally in communities; clinics are location for servers (often using solar power), and use Open MRS and paper systems to gather data. Aim to use technology to build on and improve existing workflows, and use standardised data elements, with forms matching what is on the computer screens. Another aim is to make the forms multilingual, drawing on one common data dictionary. Neal Lesh (D Tree International) talked about ‘Open source development of mobile applications to support community health workers (CHW)’. The idea is to develop a range of applications that can help CHW plan their work and collect data to help support treatment. Openrosa (www.openrosa.org) is a new consortium of organisations working on mobile applications to collect data; grew out of efforts to create mobile data collection for Open MRS. Anna Kramers, from Ericsson, talked about their co-operation in the Millennium Village Project. Future growth for mobile operators is seen as coming from emerging markets, and looking at subscribers paying around $US5 per month or less. Among the applications Ericsson (and probably others) are looking into is micro-remittances of money between mobile phones, as well as delivering education via mobile devices. As well as involvement in the MVP, Ericsson has an initiative in the Lake Victoria area to support fishermen, and the Gramjyoti project in India (described as ‘India’s first HSPA village). Ericsson is working with Sun to develop an open source JavaEE telecom application server.
Technorati Tags: mhealth, ehealth, open source, MIE, MIE2008, Africa, Millennium Development Goals 
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It is Tuesday afternoon and time for the IMIA Web 2.0 taskforce panel. George Mihalas, immediate past president of EFMI, introduced and chaired the panel. Peter started the panel session by giving a brief introduction to what Web 2.0 is and the scope of the IMIA Web 2.0 taskforce. Toni Contesti talked about new workflows, ‘Patient 2.0′, and asked whether the technology is ready to support new ways of working in healthcare. He introduced MDPIXX, developed in the Balearic Islands; it aims to address telemedicine, and many other areas. It stores cases and images, as well as YouTube-like videos and uses SNOMED terminology to categorise. Users can comment on cases that already exist in MDPIXX. Site users can create their own areas, and can customise information relevant to their own interests. Toni described the widget that they had created to allow easy upload of materials from the desktop. The MDPIXX tool is also used for teaching; Paz Martinez from the University of the Balearic Islands, talked about how she uses the platform in the School of Nursing and Physiotherapy. She sees Web 2.0-based education and supplementing, not substituting for, other forms of education. She uploads cases to MDPIXX and the students have to then access the materials and search relevant cases to the areas that they are studying. The students also make their own videos of proposed patient treatments, and discuss them in peer review group sessions. The students also upload comments and keywords, and the work is assessed by Paz as the educator. She has found positive and negative aspects from the students’ real-life use of the MDPIXX environment. The students do not feel that they are learning, even though they have good marks; they also tend to feel they have spent too much time on the system. Paz feels that critical thinking and teamwork improve. Ed Hammond talked about his experience of learning about Web 2.0, and how the use of applications like YouTube is natural for his grand-daughter. He introduced the XO computer (cost around $US200), and sees the interaction of such new developments with Web 2.0 as critical. He sees Web 2.0 as the single best up-to-date resource for news , tactics and strategies for health -he sees it as a pathway to the world community. He spoke of how people are using Web 2.0 to share experiences of disease through blogs and such, and how he uses Wikipedia and generally trusts the information found there. HL7 is using wikis to support productivity and different workflows, as itg helps viewing the evolution of the development of documents; he can work as closely with someone on the other side of the world as well as he can with someone in the same room. In closing, he asked questions such as ‘who do you trust?’, how to determine fact from fiction, but also that reputations can be built online that help in answering such questions. Margaret gave the last presentation of the session on her work using iPods and lecture podcasts in education, particularly with undergraduate nursing students. She talked of the need to engage students, and that her students are increasingly fluent in multimedia. She went on to discuss the possibilities of tools such as Second Life in education and healthcare. Among examples she presented were the use of avatars to expand opportunities for high-fidelity simulation. Technorati Tags: Web 2.0, MIE2008, MIE, education, online learning
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After our 3 presentations, we opened the panel up for discussion of issues raised. Q - do Gen X etc have different attitudes to privacy? - will they care? - will this have an effect on healthcare, privacy, etc? - are we moving into a new era on attitudes? One audience member suggested that after the current generation there may be a backlash that values anonymity. We had some discussion of using social technologies to support distance education. Technorati Tags: MIE2008, blog, Web 2.0, Second Life, education, social technologies, contagious media
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Eike-Henner Kluge, from University of Victoria, gave a talk on ‘The need for global certification of health informatics: some ethical issues’. He summarised some of the general contextual points, of global moves towards electronically-based information in health care, with increasing e-health and telehealth. Among the challenges he noted are standardisation (including interoperability), ethical and legal issues, and professional issues. On the need for certification for professionals, institutions and purveyors. Health information professionals are becoming more mobile – technical competence is, he says, easy to certify, but with differing legal and ethical frameworks, ethical certification is much more difficult. Functionality of standards is only as good as the conduct of health information professionals. Principles of information ethics transcend jurisdictional boundaries. He asked how ethical standards are to be enforced, especially if work is undertaken by, for example, outsourcing models, and different countries’ jurisdictions may apply. Institutions have traditional requirements of ‘product liability’, and with increasing telehealth, international standards are needed. He pointed out that the US Patriot Act (section 215?) requires the sharing of source codes on request by US security agencies – and also prohibits notification to anyone that this has been done. This act therefore makes it impossible to guarantee privacy and security of information. He suggests the need for an independent body to establish and adjudicate certification – without this, security and quality are pipe dreams and health care professionals may be ethically complicit in promising privacy that they know they cannot deliver. Technorati Tags: medinfo2007, ethics, certification, health informatics
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I have finally managed to find a gap between meetings, etc. to attend some of the presentations. On the general theme of ‘Emerging technologies’, Jacob Weiss, a student from Vanderbilt University, USA, presented about ‘Blogs, wikis and discussion forums’, a paper co-authored with Tom Campion, also a Vanderbilt student. (Jacob was practising his juggling outside the room before the session began – hopefully he can also be persuaded to do similar at the BBQ tonight)
He talked about the potential to use blogs, wikis, etc for collaborative work in clinical and medical informatics communities. He noted that most of the technologies are text-based – they facilitate personal journalling and collaborative document creation.
He described attributes of each, based in the publication model, display of entries in sequence or other format, how responses to entries differ between each (eg comments on blog posts versus edits on wikis), the display of knowledge (eg fragmentation versus synthesis), participant emphasis (author versus respondent), visibility of author/respondent identity), and tone of voice (degree of formality). So, attributes of each lend themselves in different ways to support clinical applications; social online support might be best provided via a blog, a hybrid system might be developed to match to different informational and support needs.
Jacob provided an interesting analysis of the possible use of wikis as a basis for clinical records. (The session is obviously of interest, as the room is full, with nearly 100 people).
The second speaker is Gunther Eysenbach, from Toronto, talking about ‘From intermediation to disintermediation and apomediation: new models for consumers to access and assess the credibility of health information in the age of Web 2.0′. In terms of Web 2.0, he began by saying that his main interest is in the collaboration and participation aspects of social networking and software; in addition, he is interested in the use of Web 2.0 for user-generated content. He mentioned a six-book series on ‘Digital media and learning’ that will be published in 2007 by MIT Press as open access via a MacArthur series grant. His focus was on credibility of information in the digital environment, specifically the source, trustworthiness, of information and the expertise of the originators of information. He also explored other aspects and views of credibility, which is often a subjective variable, or a perceptual receiver variable, and that it may not always be enough to provide ‘accurate’ or ‘evidence-based’ information to consumers, as personal anecdotes from peers may sometimes be more believable than research studies.
He defines disintermediation as getting rid of the traditional gatekeeper between the consumer and the information, and has created the term ‘apomediation’ to describe new agents who ’stand beside – apo’ and assist the consumer. He went on to explain differences between intermediation and apomediation environments for consumers accessing information, with the latter being much more based in autonomous consumers, who may be co-producers of information. How credibility is seen differs between the two environments, and that the message may be more important than the source in apomediation environments, with also a possible increase in trust as the intermediaries step aside and roles shift to apomediation.
Preprint: hdl.handle.net/1807/9906 Technorati Tags: medinfo2007, blog, wiki, consumer health informatics, Eysenbach, Vanderbilt
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The ‘krew’ panel session at medinfo2007 went very well yesterday. We had a few technological challenges (like unreliable Internet access), and we provided challenges for the AV and tech people, but in true nursing fashion, we did workarounds and it all ran smoothly. We had about 50-60 attendees - which looked a bit sparse in the large auditorium we had, but had a good mix of people from different countries. The session was titled ‘Connections, Collaboration and Creativity: Exploring Web 2.0 Applications in Health Informatics and Professional Development’. On-site, we had myself, Scott Erdley and Rod Ward presenting; I presented an introduction to Web 2.0 and its possibilities in healthcare, Rod talked about blogs, and Scott about wikis. Bill was not able to do the ‘live’ presentation we had hoped - but we ran a powerpoint with voice-over that he had prepared, and it worked very well. The fina part of the ‘jigsaw’ was perhaps the most interesting, and maybe most in the spirit of Web 2.0 mashups - we ran Margaret’s slides that she had used at the Rutgers presentation in June, and stepped through them in sequence with running the podcast she had made at the Rutgers event. It worked really well, so she could be there virtually, even if not in person. I also video-recorded most of the session (before the battery ran out) and will be turning that into some vodcasts, assuming the quality is OK to allow that. Watch out for more news on this. We will put the final presentation materials on the hi-blogs.info website - but perhaps not until we get home. Technorati Tags: medinfo2007, blog, hi-blogs.info, Brisbane
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