Viewing entries tagged

next up: Patient Centered Technology 4/26

Next week, on Friday 4/26, I'll be speaking at RichTech's Health Forum. I'm talking about the rise of patient-centered technology. More info and registration here


Title: Patient Centered Technology — how smart phones and the web are empowering patients and changing healthcare

In March 2013, Dr. Eric Topol gave Stephen Colbert a complete physical…with his iPhone. The web and connected devices have proven to be disruptive technologies and healthcare is no exception. Today, an increasing number of patients have access to some or all of their medical records through Electronic Health Record systems (EHRs). Smart devices, mobile apps and fitness gadgets also allow people to collect an unparalleled amount of self-generated health data. You can even get a DNA profile for less than than it costs to fill up an SUV.

What does all this mean for patients and the future of healthcare delivery? We’re already seeing a shift. Some call it consumerism, and sometimes it is referred to as mHealth (mobile health) or eHealth (electronic health). Often these terms are spoken about in conjunction with participatory medicine.

We'll will examine where we’ve been with patient-facing technology in healthcare, where we are today and where we are headed. It will include discussions around EHRs, the quantified self movement and the future of the doctor/patient relationship as influenced by technology.

Howto: turn your favorite healthcare journals into audiobooks for on-the-go listening

Last week, I had a twitter exchange with healthcare geek and wonk Emma Sandoe. She was carving out some time to work through the latest edition of Health Affairs.

I’ve always been an aural learner. I find it easier to listen than to read for long periods of time. I promised Emma I’d send her my workflow for turning written text from the web into an audiobook, of sorts, for on-the-go listening.

In college, the educational support lab had a Kurtzweil Reader. The reader was a glorified scanner with a text-to-speach engine invented by Ray Kurtzweil. I’d sit in lab for hours, scanning pages and turning the reading speed up 350 words per minute. At 350 WPM, a 1990s computerized voice sounds a lot like random nose. What’s cool, is that even at that speed, our brains can actually pick out the words. It was cumbersome, but it helped me get through novels and history primary texts when I’d put off reading until the last minute.

Kurtz Reader

My preference for listening versus reading has, largely, stuck. Today, my aural obsession is less driven by a need to cram —although the underlying learning disabilities are still present —and more from how we get written text nowadays. I can’t stand reading much more than 1,500 words on a computer and e-readers aren’t much better. Since printing isn’t a very eco-friendly option, I usually convert things I want to read into audio and take them with me when I commute to work or walk the dog.

I’m a died in the wool Mac user. Here are my work flows for converting web pages, PDFs and articles into spoken text.


In recent versions of Apple’s OS, Apple have made it quite easy, although somewhat hidden to get a spoken track of text.

The built in method In OS X 10.7 (Lion) and 10.8 (Mountain Lion), it’s pretty simple.

  1. Highlight the text
  2. right click (two finger tap, or control+click)
  3. in Services menu, select add to iTunes as Spoken Track add to itunes

The benefit of this method is its extreme simplicity and iTunes integration. Within 90 seconds, you have a new track in your library with the spoken audio of the text in question.

The downside, is it lack of control. Apple’s built in service uses speech settings from your system’s preferences. prefs And, if you are fiddly like me and want something read very quickly, or in another voice, then another method may appeal to you.

The app approach

There are about 5 credible speech apps in the Mac OS X app store right now. I’ve tried them all. You are welcome. None offer a spectacular user experience. Speak It! is the standout of the lot.

Speak It! offers some different voices and enhanced settings. Speak It!’s voices are not as polished as Apple’s, although the british voices are nonetheless enjoyable. Speak It! also has the ability to adjust the speaking rate on the fly.


Speak It! now integrates with Apple’s Services architecture, so moving text into the app is as easy as using Apple’s built in text to speech.

  1. select the text you wish to have spoken
  2. right click on the text
  3. in the services context menu, select Speak It!
  4. within Speak It!, you can listen on the spot via the play button, or output to iTunes.

SpeakIt context

Tips and tricks With whichever desktop method you chose, here are some tips which may help refine the process.

  • If the website offers a print view, it may make it easier to select the entire article.
  • Once you have the files in iTunes, the easiest way to sync with your iPhone is to drag them from the library, onto the icon of your iPhone in the iTunes sidebar.
  • PDFs also work, but be careful not to get copyright and page numbering info, it may require copying and pasting text from each page into Speak It!

iOS Method

If you live on the go with your iPhone or other iOS device, you can whittle this workflow into something even more streamlined. But, it requires a bit of setup first. Voice Dream Reader is a fantastic app which allows users to open a PDF or pull articles from an Instapaper feed, and that’s where the magic happens.

What you’ll need:

For those unfamiliar, Instapaper is a fantastic tool for clipping webpages for reading later. It strips them of ads, flashing graphics and unsightly fonts. You get a very readable black text on white page. The iPhone and iPad clients are fantastic too.

You save pages from the web by clicking a bookmarklet in your browser.

pre clicking my ‘insta’ bookmarklet saves the webpage to my Instapaper feed

post Instapaper briefly paints the page black to indicate it has been saved

Once you’ve signed up for Instapaper, download the Voice Dream Reader app. Voice Dream Reader has the ability to add your Instapaper account.

  1. launch Voice Dream Reader, you may have to add the free Heather voice, which takes a few minutes to download.
  2. after the intro screens, click the settings cog in the lower right settings
  3. select Instapaper and add your account info
  4. refresh the article listing by clicking the refresh button reload
  5. you can control the voice speed and other settings by tapping the voice button settings voicerate
  6. when you are ready to listen, tap to open an article and then tap the play button.

The great thing about either of these methods is how seamlessly they integrate with how you already listen to audio. In my case, whether I use the iTunes/mp3 method or the Voice Dream/Instapaper method, I can play the spoken text back via headphones on a jog or in my care via bluetooth.

what are your employees' trending topics?

Did you watch the Grammys this year? According to Twitter:

  • People sent 10,901 Tweets per second (TPS) as Adele won Record of the Year — the peak TPS moment of the night.
  • “Grammys” was mentioned in more than 5 million Tweets on Sunday between noon and midnight PT.
  • The most mentioned artists (in descending order) during that same 12-hour period were: @OfficialAdele, @ChrisBrown, @NickiMinaj, @Rihanna, Whitney Houston
What about the Super Bowl?
This year, the TPS peak was 12,233 Tweets. The spike took place in the final three minutes of the game, during which fans sent an average of 10,000 TPS. Madonna’s performance during halftime was a big hit, too—there was an average of 8,000 TPS sustained during her performance, with a peak of 10,245 Tweets.

Twitter has this concept of "trending topics". Simply put, when enough people are talking about the same thing at the same time, it is said to be trending. Twitter gives programmers some ability to slice and dice trending data. You can see what is trending in a local area, or at a specific time.

Trending topics serve a few crucial roles. First, they alert us to macro conversations and sentiments. In that regard, they are like instant focus groups on global interests, needs, concerns, and celebrations. The Broncos' inspired over 9,000 tweets per second. People went wild when Tim Tebow threw that winning pass. According to Mashable, twitter users mourned Whitney Houston's passing nearly 30 minutes before the news media shared the story.

The other day, a coworker suggested an idea which knocked my socks off. What if we could see the trending topics inside the organization? What if we could compare what the organization was talking about last year to this year? Could we learn to predict conversations and react to them - employee needs, concerns, excitements, joys?

That may be the single best ROI for an internal social media platform I've ever heard.

Google publishes their zeitgeist every year. It's a recap of the most popular searches. In 2010, the world was looking for information on the World Cup, the BP oil spill, Justin Beiber and iPads. In 2011 it was Rebecca Black, Battlefield 3 and Steve Jobs. Do all of those names or terms sound familiar? I bet your employees are also talking about things you might not be aware of.

Can you pull the same data on your organization? What were employees talking about in 2010? What kinds of information are they looking for today?

Leaders may want to say yes, of course, in 2010 we were going through a merger, I remember the messaging well. Others might point to employee satisfaction surveys. But those ideas are different. The Google and Twitter examples are grass roots data. They are reflective of the larger population, what the front lines are thinking and talking about.

I particularly like thinking about how internal trending topics might impact culture. During the Arhab Spring, words like Egypt and freedom trended. Those topics became more than news, they were rally cries for the feet on the ground. Would employees voice their ideas, creating a new vision for the organization? Trending topics could be a powerful tool for positive change within companies.

Get your HCSM nerd on with ThinkUp

Ever go shopping and see something and think "I have no idea what I'd do with that, but I have to have it?" It happens to me all the time, and almost always in one of two areas: food and tech. Take for instance this Star Trek USS Enterprise pizza cutter- I have to have it! I'm nothing if not predictable. This week, I was blown away when I learned about what the folks at Expert Labs have come up with. They are calling it ThinkUp. In their words:

ThinkUp is a free installable web application that captures the insights and expertise of your social network by collecting and organizing replies to your conversations on Twitter, Facebook and (soon!) other networks.

I grabbed a copy of the code and installed ThinkUp on my hosted webserver - in fact, you can see it here. Like a left handed garlic peeler that doubles as a beer opener you pick up in the check out line, ThinkUp is one of those things that is both immediately full of possibility and confusion at the same time. ThinkUp connects to your twitter account(s), and Facebook account and begins backing up your conversations. Via a sleek web interface, it presents all kinds of data and analtics back to you. ThinkUp shows:

  • Your most replied-to posts
  • a breakdown of clients
  • your most re-tweeted posts
  • Threaded conversations that you have had
  • Links the people you are following have tweeted
  • photos from the people you are following

And much more. Like I said, I've just begun to scratch the surface.

What makes this Healthcare and HCSM related? Nothing special other than it is a great tool to have in your arsenal. Providers should consider installing ThinkUp for two reasons: Firstly it backs up your twitter stream. There are plenty of other great ways to do that, including Backupify, although TweetUp lets you own that data on your own server. Secondly, it helps you produce some dynamite metrics easily - replies, retweets, popular tweets, etc. It makes showing the effectiveness of your posts quite easy.

There are some not so obvious examples as well. For instance, ThinkUp shows your percentage of "conversationalist" vs "broadcaster". Maybe it is time to stop telling and start listening...and responding.

ThinkUp helps you track your conversations and replies. When you ask a question, particularly if you have an engaged set of followers, you often get answers in an asynchronous timeline. That is to say, replies may trickle in over time. ThinkUp remembers your query and presents all the replies in an easy to digest view.

Your experience with the setup process will depend on your comfort level of installing web applications. If you have ever set up a WordPress site on a hosting account, you'll have no problem. If the idea of installing software on a web server sounds daunting, then you may want to wait for hosted ThinkUp providers to pop-up - and that is sure to happen.

If you want to see the user's public dashboard, feel free to check out my install. Or, grab the code and get your HCSM nerd on!