The Life Ledger

Fitness is a way of life.

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Medical News Today carried a story about a program at Ohio State University where doctors are storing large amounts of medical information on secured USB drives for heart surgery patients to carry with them. Should the patient suffer an emergency, the treating physician could review the patient’s entire history quickly.

“We usually include their most recent clinic visit, ultrasounds of their heart, heart catheterizations and, in some instances, if it’s important, we may have images of their heart,” says Dr. Curt Daniels, a cardiologist at Ohio State University Medical Center.

Dr. Daniels and his staff came up with the idea of using the jump drives. Daniels says the medical history of some heart patients is very complex, and if they ever find themselves needing medical attention in another city or country, every minute matters. That’s where the jump drive can help. Any doctor, anywhere in the world, can simply plug it into their computer to answer any questions they might have.

“What heart surgeries have they had? How should their heart really be arranged, and how strong or weak is their heart? Do they have valve problems? Is that part of their history? Having that information right away, we believe, will improve medical care for our patients,” says Daniels.

I tried tracking down exactly what application, if any, is used to store the data, but couldn’t find anything. I suspect they simply use encryption software to protect the data, and store files in folders. It would be interesting to see someone develop a software application that encrypts the data, automatically runs when the USB drive mounts, and provides a searchable index to all information stored on the drive. Extra points for automatic language translation for patients travelling to other countries.

If you’re interested in creating one of these jump drives yourself, work with your doctor to accumulate the medical information pertinent to you and use a program like TrueCrypt to protect your data. Just make sure you carry instructions on decrypting the data, and don’t leave both the drive and the instructions at the same restaurant in Italy.

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photo credit: e.marie

It’s not every day I read a story on blogging when flipping through health and science RSS feeds. The Science Blog and Science Daily have released articles discussing a study conducted at UC Irvine studying “blog readers’ online habits and experiences, as well as how they perceive their roles in blog-based communities.” Blogging and “citizen journalism” continues to be a growing phenomenon - even the federal government is taking a look at how it can better communicate using Web 2.0 style methods. Recognizing the growing phenomenon, apparently the scientific community is taking a hard look at social interaction and information consumption:

The UCI study examined in-depth the blog-reading habits of 15 participants of various ages to determine how they consume content and interact with blogs and blog writers. The research found that some readers frequently post comments, while in others “lurk,” or visit without commenting.

“With the increased popularity of blogs, various tools like Blogger and Movable Type have made writing a blog easy for a wide audience,” said Baumer, who studies informatics. “But, until the technology embraces the role of the audience, the full social potential of blogging remains untapped.

The researchers hope their work will prompt further studies about the roles of blog readers and how features such as commenting and linking create new ways to interact with authors and text.

This potential change in research approach would be similar to a shift that occurred in literary theory in the 1960s and 1970s, when scholars began taking into account readers’ responses when studying literature.

“This study is really just the beginning,” said Tomlinson, an ICS professor and affiliate of the California Institute for Telecommunications and Information Technology. “With the rapid expansion of online social media such as Flickr and YouTube, understanding how people consume these media will be vital to understanding their broader social impacts.”

It appears the target audience for this study is other scientists - bloggers already study and are intimately aware of how they interact with their readers; blog readers don’t care about the science behind their interaction, they just enjoy receiving RSS feeds and having the opportunity to offer feedback and participate in discussions. Perhaps among those in the social science community, the “blogging movement” represents the same sort of paradigm shift quantum mechanics wrought on the “hard science” community - there is no longer such a thing as an objective observer. Of course, atoms and quarks don’t participate in discussions about what it means to be a quark and how quarks are being denied a voice in the current elections, so there’s possibly even a more thunderous change on the horizon for social sciences - not only is there no such thing as an objective observer, but interpretations and feedback offered by the observed participants have to be factored into the study.

It’s interesting to see the blogging movement through the eyes of scientists. For example, their findings included:

• Some readers frequently post comments, while in others “lurk,” or visit without commenting.
• Readers have diverse opinions of what makes a blog a blog. Academic definitions generally refer to blogs as frequently modified Web pages with dated entries listed in reverse chronological order. But study participants identified a wide variety of characteristics in what they considered to be blogs. These included both technical aspects like RSS (Really Simple Syndication) feeds and trackback links, as well as social aspects, including the presence of conversation or personal content.
• Regular blog reading often becomes more habitual and less content oriented. Similar to e-mail checking, blog reading can become ingrained into users’ online routine. Sometimes, even the usefulness of the blog content itself can be less vital than the activity of reading or skimming the blog to fulfill a person’s particular routine.
• The timing of a blog post is not nearly as relevant to readers as its position among the other entries. Readers are more likely to read the most recent posts at the top of the screen, and are generally less concerned with the exact age of a post. A vast majority of participants said they were not bothered when they were not able to read each and every blog post, challenging a common theory that users tend to feel overwhelmed by the need to remain constantly up to date.
• Blog readers feel a responsibility to make insightful contributions. While past research noted readers expect bloggers to deliver frequent, high-quality posts, the UCI study found readers also place pressure on themselves to produce coherent, worthwhile comments in response to good blog posts.

Sound familiar? If you read “blogs on blogging” like John Chow, this kind of information is frequently discussed. However, my guess is scientists in general don’t blog much, and their fascination and study of the semantic web is proof we are living through a major shift in social science.

If you’re interested in reading more about blogging or semantic web and informatics, here’s some good places to start:

• O’Reilly Radar
• ReadWriteWeb
• iLibrarian
• John Chow
• Dosh Dosh
• PureBlogging

With more people in the science and medicine community jumping on the semantic web bandwagon, it will be interesting to see studies like this one conducted on information consumption, social networking and how it changes our social behaviors.

Do you want your doctor blogging about your checkup? Take our poll and tell us how you feel. Do you, as a blog reader, consume more of your information online than other media? Do you simply go through a daily routine of checking RSS feeds, or do you actually read articles to stay up-to-date on current events and topics that interest you?

photo credit: john-norris

I recently read an interesting article on Medical News Today reporting health insurers will begin covering online physician visits:

Health insurers Aetna and Cigna have announced that they will pay for online physician visits, and patients will be required to contribute a copayment for the visits, the Philadelphia Inquirer reports. Aetna on Jan. 1 expanded a pilot project in California, Florida and Washington state to the rest of the country, and Cigna said it would begin paying for online visits in January 2009. The insurers believe that members will like the service because it can improve efficiency and could prevent more costly problems, the Inquirer reports.

Of course, my initial reaction is - is anyone actually offering online physician visits? Apparently so, if heavies like Aetna and Cigna are getting in the game. Physicians don’t (typically) obtain technology degrees or have the programming skills necessary to open up their practice to an online community, so the first step is supplying physicians a “web visits” framework. Cigna and Aetna both partner with RelayHealth, a company that enables “web visits” through services including online medical chart storage, online appointment scheduling, automated interviews that serve to triage the patient before communication to the physician begins, online prescription center, and a payment/collections/insurance filing center. RelayHealth maintains an entire page describing the benefits and features available to patients, which can be summarized by these two FAQ answers:

What is a webVisit®?
A webVisit is an online consultation between a doctor and an established patient about a non-urgent healthcare matter. When conducting a webVisit, RelayHealth guides you through an interactive interview process appropriate for your specific symptoms, and then builds a succinct message to the doctor based upon the answers you provide.

How do I send a message to my doctor using RelayHealth?
Once you successfully register with RelayHealth and your doctor agrees to communicate with you through the service, easy-to-use, structured templates allow you to consult your doctor about specific health symptoms (we call this a webVisit consultation), request a prescription refill, request appointments, receive lab or test results, ask a simple question, or access health education information — depending on the types of RelayHealth services your doctor offers.

Apparently, companies that assist in enabling physicians to offer medical services online are stating to sprout up. But are any physicians actually offering online services? Recently, ReadWriteWeb reported on the Health 2.0 conference, part of which was dedicated to the “web visit” phenomenon:

Jordan Shlain founded the San Francisco On Call Medical Group, a group of doctors who make house calls almost anywhere their patients want to see them (home, office, even cruise ships) using a souped-up, hi-tech version of the doctors’ venerable black bag.

Jay Parkinson is aiming to be the “small town doctor of Brooklyn ,” using video camming, text messaging, email and chat to help treat his patients.

Both Jordan and Jay showed how different the standard model of health care can be — but also revealed the huge gap between the existing system of health care and the state-of-the art technology that potentially could be harnessed to serve patients at an ordinary level. In the end, this gap is the core dilemma facing the Health 2.0 efforts to transform the industry.

We’ve come a long way from using the Internet to display office hours and send X-rays to other countries for analysis. It appears that soon, patients will have true 24-hr access to non-emergency health care. Add Second Life to the mix, and things get even more interesting - take, for example, this Flickr slideshow demonstrating some interesting possibilities. And soon, with services like Carol getting a start, we may have access to a-la carte style healthcare, where patients purchase “care packages” and receive the care at any participating location.

With all these changes afoot, the real question is - will patients use the services? What about you - are you excited by the possibility of receiving healthcare with an instant-messaging client and web-cam, or will you always expect on face-to-face treatment?

Consumerist has a link to GigaOM’s Joost invite page. Let the floodgates open. Surely allowing super-invite tokens like this to hit the web is the last step before Joost opens its doors to the public?

Now, to see what this fuss is all about. Looks like there’s a couple health channels among some other interesting stuff. Wonder why Bridezillas is worldwide except America? Not that I wanted to watch it…

A friend recently had an interesting problem - he wants to promote the use of podcasts to instructors as a component of courses taught online, and identified the excellent, open-source Audacity as their Windows tool of choice. However, as he began writing documentation for installing and using Audacity, he realized many instructors would be immediately turned off by the complicated installation process required to set Audacity up for exporting projects as mp3 files - many instructors who could otherwise be taught how to record and save projects would not understand how to unzip LAME, copy the DLL file into Audacity’s folder, then point Audacity to the lame encoder. Instead of writing thorough documentation that would likely daunt non-savvy instructors, I suggested an alternative - creating our own installer. It worked so well, I thought others might benefit from the idea.

First, a word about licensing.
I originally wanted to provide the one-step Audacity/LAME installer as a downloadable file, but started reconsidering after looking into license issues. Audacity and LAME are themselves covered by GPL/LGPL and therefore are re-distributable; however, I can’t tell what the SetupStream license terms are, and the patent mess covering the mp3 format may prevent distributing a package that installs Audacity with built-in mp3 output. Since I can’t really tell, I listed the steps required to make your own installer, and you can choose how you use or distribute it.

Step 1
First, I downloaded the tools I’d need. Since I was creating a custom installer, I needed the zipped version of Audacity, not their installer. Additionally, I needed LAME and an installation creator with the ability to insert registry keys. After trying a couple install creators, I chose SetupStream - it’s easy to use, freeware and offers a wide array of features, including all those I need.

• Audacity 1.2.6 - look under “Optional Downloads” for the zipped version
• LAME 3.97 - I used the 3.97 bundle available at RareWares (direct download link)
• SetupStream 2.082

Step 2
Next, some preliminary steps: unzip Audacity into its own folder, then unzip the file lame_enc.dll from the LAME zip file into the the same folder that contains Audacity.exe. Install and start SetupStream, select Create New Setup and click Next.

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