PHR's: the Apple Newton of our Times

Personal Health Records (PHRs) have been around long enough now that utilization studies are starting to emerge and the data isn’t good.  While we have increased physician adoption of EMRs and PHRs by offering incentives (soon to be disincentives) healthcare consumers are not participating.  A recent study conducted in the US highlighted that only one in 10 American’s had a personal health record and only about 50 percent of those questioned even knew what a PHR was. 

If the current offering of PHRs were a commercial product aimed at consumers (rather than healthcare professionals) they would have been pulled off the shelf ages ago.  Think Apple Newton (circa 1993). The problem with the Newton wasn’t any physical or technical problem. The problem that broke the Newton was that nobody was prepared for it.  There was no mental slot in people’s heads that the Newton could glide into.  Consumers are willing to overlook technical glitches if they have a firm grasp of what a product is and what it’s supposed to do. 

Why aren’t consumers taking advantage of all this development in the PHR world?  Healthcare Global looked into why patients are reluctant to embrace PHRs. 

Technological issues include

• Concerns about personal health record privacy
• The availability of personal health information in an emergency situation
• The notion that the health care industry's adoption of information technology lags far behind industries such as insurance and banking

Philosophical issues include

• The process of gathering personal health records is a complicated and cumbersome one that could take years
• Healthy patients who infrequently visit a doctor have little ePHI to begin with and, so the argument goes, have no interest in managing ePHI
• Physicians are not promoting them

 All of these issues make sense and Healthcare Global concluded from this information that that “the real spur in adoption will have to come from physician engagement and encouragement”.

Does this make sense to anyone?  With all the incentives and physician engagement, the solution to the issues identified by consumers is to engage with physicians more?  From what I can glean from the above issues, the focus needs to be on patient engagement, not physician. 

 Let’s try incenting consumer uptake by giving people a simple format to handle their personal health information that provides value and is actually fun and rewarding.   One approach is through gamification.  Carwyn Jones and Faisal Ahmed recently published an article in Pharmaphorum on gamification and defined it this way, "Gamification is an approach to learning, not a technological initiative in itself. True, gamification is a way of using technology to be more engaging; but it does this by giving the user certain actions to complete in return for rewards." 

Andrew Cantella a student at the University of Denver wrote a forward looking piece Playing for Your Life posted on the NaviNet Website last year. In his article he theorizes that gamification used to increase patient engagement should improve outcomes.    “If a progress bar, point system, or even simple animations were added to one’s treatment plan, an increase in engagement–subliminal or conscious–should result.”  This is the same logic being applied to the quantified-self movement flooding the market with physical activities trackers (and other monitoring devices). 

There are lots of interesting approaches out there to engage consumers.  Let’s stop focusing on the healthcare professionals and start engaging consumers, because without consumer participation, personal health records won’t accomplish anything. 

It’s your health.  It’s your health information.  Manage it well.  

Public Safety in the digital age - Responding to Terrorists and Viruses

Does it matter if a terrorist is ‘homegrown’ or ‘foreign born’?  When the threat is in our community the risk they pose is the same, and the impact they have on society is equally real.  We rely on officials to recognize and monitor these threats and create strategies to reduce or eliminate the risks to us.  When it comes to public safety, a terrorist threat and the spread of a  potentially fatal virus are both concerns that require constant monitoring and preparation to ensure a quick response when required. 

   

As public health officials watch the H7N9 virus developing in China the emerging threat to our own country is being monitored and measured.  Our public health officials are preparing strategies, opening up the lessons learned from H1N1 and SARS and working to alleviate some of the negative impacts if this virus lands in our country.  But like the Boston Marathon terrorist attack, they cannot plan for everything; we can only hope that the public health response is as immediate and well-orchestrated as that shown in Boston this week. 

Are we ready if H7N9 arrives?  There are a few things that our public health officials could take from this week’s events in Boston. 

Mobile Technology.  Individuals capture an incredible amount of data and images on their mobile devices; we are constantly recording our lives.  Following bombing at the Boston Marathon, a ’flood of digital evidence’ was received by the FBI that contributed to the identification of suspects and photographs that could be circulated.  When it comes to the tracking of viruses through social media, the effectiveness has already been measured.  Trending Now: Using Social Media to Predict and Track Disease Outbreaks identifies some of the opportunities and challenges for using social media for surveillance of infectious diseases.  As the FBI openly appealed for support through social media to help track suspects, so too could Public Health officials appeal to the public to self-track through established tools like Google Flu Trends.  While the information may not prevent an infection, it can be used to improve response times and contain the spread of a disease when an event occurs. 

Reliable Sources on Social Media.  In an emergency situation citizens are hungry for information.  Events in another country that we blithely scanned in the news a week ago become acutely personal when it is happening in real time in our backyard. Social media is where individuals will go and reliable sources need to be on top of the rhetoric and misinformation being circulated.  During the lock down and search for the 2^nd suspect the hashtag #manhunt was broadly used and the url for the Boston Police radio scanners was circulated so people could hear first-hand from police what was happening.  The first report on twitter that the suspect was apprehended came from the Boston Police.  This is the new age of information access, if officials don’t provide it, individuals will hack into it and share it.  Public Health should be preparing for this and plan to provide accurate information via social media frequently in real time 

Voice of Authority.  Law enforcement does this exceptionally well.  “Stay in your homes, close your business and shut down all public services”.  As I watched the barren streets of Boston on the news last night and how citizens voluntarily evacuated, I was reminded of the power of our Public Safety (Canada) legislation.  In Boston we saw the full force of a voluntary order for people to stay in their homes and close their businesses and cancellation of public transportation and schools.  That same authority can be used in the case of a dangerous communicable disease outbreak but as we saw with SARS in Toronto, it was met with tremendous challenges. Will people comply so readily to a threat they cannot see?  The unanimous compliance by 1,000,000 Boston residents to voluntarily confine themselves to protect against the 19 year old suspected terrorist provides an interesting comparison to confinement challenges during the SARS outbreak in Toronto in 2003.  In her article Rights and Quarantine During the SARS Global Health Crisis: Differentiated Legal Consciousness in Hong Kong, Shanghai, and Toronto, Dr. Lesley Jacobs examines how we reconcile the individual’s claim to autonomy and liberty with the community’s concern with safety…How are individual rights and the public good pursued simultaneously?.

Appropriate Compensation – Following the arrest of the 2^nd suspect in the Boston Marathon attack, it didn't take long for the discussion to turn to compensation for the enormous costs of a lockdown that only lasted 15 hours.   If we believe that quarantine or confinement is necessary to protect the public from increased risk then we need to compensate them for loss of income.  In the same way we compensate people for government imposed jury duty we need to recognize that quarantine or confinement results in loss of civil rights.  If staying home means others will not get sick there is an anticipated benefit to the healthcare system on the backs of cost to individuals and businesses.  The time for that decision is before an event occurs, not after. 

The events in Boston shine a spotlight on a significant factor in dealing with public safety concerns, the public’s acknowledgement of the severity of the threat. How do we educate and raise awareness without unduly frightening citizens.  How do we galvanize public attention and an appropriate prevention and protection response that is proportionate to the identified risk? 

When a public safety event happens the public relies on officials to guide decision making and advise the public on appropriate measures to stay safe.  In 2013 we are living in a more connected digital world than we were 10 years ago when SARS arrived killing 44 people in Canada, and we rely on social media much more than we did in 2009 when H1N1 was emerging.  Are public health officials going to work with or plan against social media as we strategize for a potential spread of H7N9?

Look to Boston, to the quick response and engagement with social media that supported officials.  Work with individuals to track and respond to the spread of disease, empower the highest officials and organizations with social media tools for reliable communications, use social media and official voices to clearly articulate risks and let citizens know that if officials must impose restrictions on them, they will be compensated. 

It’s your health.  It’s your health information.  Manage it well.  

Privilege is deeply rooted

Dr. Becker-Schutte is blogging about an interesting concept she calls Healthy Privilege and it’s inspiring some healthy dialogue.  She explains that ‘healthy people enjoy the privilege of bodies that work in the ways that they expect, free from regular pain or suffering, without extraordinary effort.  Healthy privilege allows healthy people to assume that their experience is “normal,” and to be unaware that coping strategies that work for them will not work for someone dealing with illness’.

Privilege is a tried and true concept with no quick solutions.  Peggy McIntosh’s seminal work White Privilege: Unpacking the Invisible Knapsack  is 25 years old this year.  Her analysis of White Privilege provided a framework for feminists to discuss Male Privilege.  Today, a quarter of a century later we are still debating whether Male Privilege exists, as icons like Sheryl Sandburg and Marissa Mayer make headlines for being a female in male dominated corporate boardrooms.  Privilege is deeply rooted. 

Does Healthy Privilege exist?  Heart Sisters is a blog dedicated to helping women who suffer from cardiovascular disease (it’s a great read) and its author Carolyn Thomas is one of many who have entered the discussion.  She eloquently provides an account of her experience with Healthy Privilege and her attempts to provide real advice and input to 'hypemeisters' who create and promote digital/mobile health devices for those suffering from chronic illnesses.  “It’s been said that coping with a chronic illness every day can in itself feel so overwhelming that being expected to embrace an extra task like self-tracking is simply too much. It’s what Dr. Victor Montori and his Mayo Clinic-based team call “the burden of treatment” in their important work with chronic illness and Minimally Disruptive Medicine. But this reality must sound foreign to those living with the luxury that healthy privilege provides.”

This is a great example that resonated with me as a promoter of digital health solutions and believer in the empowerment of ownership of personal health information.  But does it illustrate Healthy Privilege?

I’m a bit at odds with the term.  While I completely agree that there is a lack of understanding in both the healthcare system and society at large towards individuals who suffer from chronic  illnesses, does ‘Healthy Privilege’ describe the issue?  As opposed to our skin colour or gender, our health will change throughout our lives and it is an extremely broad term that is shaped by multiple determinants.   The majority of us are born healthy and as we age our risk of becoming ill increases.  Most of us, at some point in our lives will experience what it means to be ill, in pain or unwell. 

The lack of empathy described by Ms. Thomas is one I can relate to.  After being diagnosed with malignant melanoma fourteen years ago I experienced one of two reactions from those I chose to confide in.  The first reaction was one of overwhelming concern and belief that the cancer was a death notice; the other was a shrugging dismissal that skin cancer isn’t really Cancer, and that I look "just fine".  The most damaging experiences were those of blame, not just from uneducated friends, but knowledgeable healthcare providers who responded to my need to understand “WHY?” with accusations of sun worshiping and other unhealthy behaviours that I did not participate in and could not defend.  I confided in very few people. 

Where I did find comfort, empathy, support and information was on the Melanoma Patients Information Page.  Despite being told by my doctor not to seek information online, I did.  There I found a community of people who understood what I was going through.  For me, this was enough.  My illness, like the colour of my skin and my gender are only parts of my whole, none define me.  Heart Sisters provides an equally valuable service by connecting women with a common illness and providing an understanding, knowledgeable and comforting community to share their experiences.

Identifying Privilege requires self-assessment.  While everyone could benefit from this, it is important that those who manage the difficult task of informing us when we change from Healthy Privilege to illness take the time to reflect on the concept.  The term ‘bed-side manner’ used to be used (maybe still is) to refer to a doctors manner, attitude and decorum in front of a patient.  Let’s revisit that as a starting place.  Why not a mandatory class in medical school, Bedside Manner 101?  As a second step let’s see some performance measures attached to healthcare providers that measure patient satisfaction with their service.    

In Canada, the CBCs Fifth Estate just released as show called ‘Rate My Hospital’ that examined over 230 hospitals across the country using some traditional indicators and some satisfaction surveys.  Similar to the American CNN movie ‘Escape the Fire’, this exposé focused on educating healthcare consumers and engaging them in the dialogue on solutions. 
  

I can accept the concept of Healthy Privilege as a component of our society, as Ms. Thomas herself stated “until I survived a heart attack in 2008, I too had been fairly bursting with that sense of healthy privilege myself.  I knew nothing about what it might be like to live with a chronic and progressive disease every day of my life – and why would I?”  

What I cannot accept is an autocratic healthcare system, the use of blame to shame healthcare consumers, and poor service when my 50% of my tax dollars are funding a multi-billion dollar system.  Let’s bring the concept of Healthy Privilege into our discussions on how to improve our healthcare systems. Let’s start there.

It’s your health.  It’s your health information.  Manage it well.   

Time for healthcare to get a Pep Talk!

We all need a pep talk from time to time.  This week Kid President gave me one.  If you haven’t seen his Pep Talk, watch it now. 

Robby, is age 9.  He has Osteogenesis Imperfecta (OI) a brittle bone condition which has resulted in him having over 70 breaks since birth. What's inspiring about Robby isn't his condition, but the fact that his condition doesn't define who he is. In spite of all he's been through he not only keeps going - he dances.

All those working on improving the healthcare system should take note of his good advice and healthy attitude. 

1.       Stop being boring!  The healthcare system is not working, it’s messed up.  It’s time for a creative solution!   Change is tough but it’s time to change the status quo, even if it’s only a tiny bit.  Our bodies are complex systems, supported by a healthcare system that is even more complex.  There are no easy simple solutions.  Stop waiting for someone else to fix this.   Stop complaining about it and finger pointing that’s boring and a waste of time and energy! 

2.       Are we on the same team?  Healthcare professionals, governments, insurance companies, pharmaceutical companies, healthcare consumers and self-described saviours of the healthcare system.    It doesn’t always seem like we are on the same team, working towards the same goal.  Providers putting profit ahead of care, drugs that cause more harm than good, policies that are too short sighted to achieve any positive change, consumers that don’t take personal responsibility for their decisions.  If we are all on the same team we should be working towards the same goal.  All of us living with optimal health.  Let’s each take some personal responsibility to make one small change for the better. 

3.       This is life people!  It’s short and it’s fragile and we should make the most of it while we are here.  Our health has a lot to do with how long we get to live and the quality of that time.  There are lots of factors that will impact our health so pay attention to all of them.  Good health relies on more than a good healthcare system … lots more.  Lifestyle behaviours, education, social connections, environment, employment, culture and gender all play a role in how healthy we are.  Manage what is within your control and work with those factors that other people control.   

4.       What will be your Space Jam?  Maybe it’s a lifestyle change that will help you live longer and healthier, or opening up communications with your patients to engage them more in their care, or maybe you have an idea that will improve the system or make life easier for people.  Don’t give up.  Believe in a healthy you, a healthy community and a healthy world. 

It’s your health.  It’s your health information.   Manage it well. 

Put technology in it's proper place

What do I expect from my healthcare providers?  Simple, I want them to use their skills at diagnosing and treating to fix me when I am unwell.  Will technology enable them to do that job better?  That is a complicated question. 

Let’s take a look at diagnosing.  A diagnosis is a ultimately a decision about what is causing a person to be unwell and that decision informs the treatment.  A recent study by Paley, examined the accuracy of diagnoses in an emergency department.  Residents were correct in their diagnosis 80.1% of the time, and senior physicians were right 84.4%.  Inversely 2 people out of 10 were misdiagnosed.  The study went on to validate the contributing factors to a successful diagnosis and confirmed that classic diagnostic tools such as reviewing patient history, physical exams and lab tests are critical.  It was identified that older clinicians rely on the history and physical to a greater degree than younger clinicians.  As a result, many recent graduates can only make cardiac diagnoses by echocardiography, relying more on technology for their decision making. 

This study reminded me of the discussions that emerged following Captain Sullenberger’s successful landing of Flight 1549 into the Hudson River.  The experts identified the primary reason for the successful ditching was the decision making of the flight crew members during the accident.  Captain Sullenberger’s years of experience with multiple aviation systems, including low tech gliders, directly influenced his decision making ability. 

I found it interesting that Captain Sullenberger, a safety expert was a proponent of building a balanced environment of learning and accountability to enhance safety and he even had a copy of A Just Culture in the cockpit.  A Just Culture is an environment where learning and accountability are fairly and constructively balanced and is critical for the creation of a safety culture. Without reporting of failures and problems, without openness and information sharing, a safety culture cannot flourish. 

Technology can be an important enabler to a just culture but it is only one part of a learning environment.  Technology provides skilled practitioners with a tool to do their job more accurately and faster, it does not replace the interpersonal skills and human judgement required to effectively diagnose and treat patients. 

A recent New York Times article The Face of Future Health Care  speaks to the role of technology in helping healthcare providers track patient care.  When Dr. Jennifer Slovis recently saw a patient, she was able to spot that the patient had an abnormal blood test several years ago. By reading through the patient’s medical history, she determined he was now overdue for an M.R.I. to check the status of a growth in his brain. She was able to e-mail his endocrinologist and schedule the necessary tests without the patient having to make an appointment with the specialist or her having to make her own diagnosis. “It saved a lot of starting over,” she said.

In measuring the value of technology in healthcare we need to focus on the practical 

applications not the hype. 

Forbes Magazine reported on the President’s Council of Advisors on Science and Technology who have concluded that “the impact of IT on health care over the past decade has so far been modest.” But, don’t underestimate what’s coming. It is nothing short of an explosion in innovation and creativity, facilitated by open systems and connectivity.  Here is where the real value lies.  Technology allows for a connected system that will help patients take responsibility for their health. Strong teams of physicians, nurses and caregivers will use an intelligent network to make their results better and their jobs easier. 

Sorry Watson, while we anxiously await your contributions to healthcare, you can’t replace the decision making skills of our healthcare professionals that are honed in a continuous learning environment. After all, your decision-making algorithms are informed by those of learned professionals and that learning, is constantly evolving.  Let’s all take a moment and think about the role of technology and how it can be used to build a just culture that encourages learning and rewards accountability in healthcare. 

I want technology to support my healthcare provider’s decisions, not the other way around.  After all, if my health stopped functioning and I needed an emergency landing, I’d put my trust in a medical version of Captain Sully any day of the week to guide me to safety. 

It’s your health.  It’s your health information.  Manage it well.  

How to fix healthcare? Start with carrots for consumers!

This week the Harvard Business Review took a stab at redefining the healthcare business model in What is the Business of Healthcare?   It was suggested the focus should be on health rather than healthcare, an honourable ideal.  Far be it for a simple goat to butt heads with HBR but I’m going out on a limb (goats actually can climb trees – google it) and take issue with this seminal magazine and its lofty school of higher learning.  The challenge with HBRs concept is, there isn’t any profit to be made in ‘health’ and healthcare in the US makes up 17.6% of GDP at a cost of $8,233 per person per year (highest per capita cost in the world). 

The problem is, if people don’t get ill, the economy will and that is simply messed up. 

Too much of our economy is built on profits derived from an ill population and not enough is built on profiting from a healthy population.  And, since money is in the driver’s seat, we won’t see significant change until consumers change their spending habits. 

North America has created the gold standard for a business model that profits from illness.  We have a society with relatively high longevity rates for a population as unhealthy as it is which means people are living a long time with chronic illnesses.  The North American food and transportation industries create products that negatively impact health and market them as lifestyle necessities.  Consumers adopt these unhealthy consumption behaviours and inevitably develop risk factors that lead to chronic illnesses such as diabetes and cardiovascular disease.  The healthcare industry then steps in to manage illnesses at great cost while continually improving interventions that allow citizens to live longer with their illnesses.  It’s insane.  Incentives are continually thrown in the wrong direction.

Why do we as consumers put up with it?  We have the power to change this unhealthy cycle with our purchasing power and lifestyle decisions.  But we need help; we need a little carrot to incent us in the right direction. 

 

In a recent article Patients need pay for performance too, Matt Patterson, makes the sensible case for incenting the consumer to achieve positive health goals.  “We need to build models that show patients the impact of making good health decisions now.”  Governments have spent years and millions on incenting healthcare professionals and institutions to create efficiencies and what we have to show for it is staggering growth in healthcare costs and record rates of poor health outcomes.  The reality is consumers have to participate in creating the change needed … so why have we not provided incentives to them? 

This is not rocket science, its common sense.  First, start at the source, we know that there are a handful of risk factors that increase our chances of developing a chronic disease and they are ALL avoidable and they are all measurable.  If we all maintained the following behaviours we would save the healthcare system billions:

• Consume a healthy diet of whole foods
• Participate in daily physical activity
• Reduce or quit tobacco use
• Moderate alcohol consumption
• Maintain a healthy weight

How do we incent people to adopt these behaviours?  Start by encouraging individuals to measure their behaviours in order to track participation and allow a reward based system.  We have to start somewhere and the early adopters are providing an environment to test an incentive program. 

The timing couldn’t be better for consumer engagement and incentives.  The digital/mobile health industry is rapidly growing with an estimated 1.7 Billion to download health apps by 2017  (that’s a lot of people tracking health indicators and governments didn’t have to spend a dime).  Why can’t we encourage more of that, why can’t we offer individuals incentives to meet their healthy lifestyle goals and maintain them.  Let’s encourage people to consume health products, and avoid consuming healthcare and let’s reward those choices.    

Wouldn’t it be great if a portion of the GDP currently spent on healthcare was spent instead on healthy food and active transportation?  Or what about a realignment of personal consumption from those unhealthy options (tobacco, processed food, alcohol) into healthy options (fresh foods, active transportation, fitness activities and even mobile devices to monitor our health behaviours).  We can succeed if we shift even a small portion of our economy to benefit from a healthy population rather than an ill population?    Let’s start with carrots.

It’s your health.  It’s your health information.  Manage it well. 

They are Women, hear them Roar!

Wednesday March 8^th is International Women’s Day. 

In celebration of the enormous contributions that women around the world are making to science and technology I bring you my favourite female contributors to the empowered healthcare consumer dialogue.  These are just a few of the female voices that the Fainting Goat follows and there are  many more inspiring, teaching, living and learning how to improve health through technology that I have yet to encounter.    I salute you, learn from you, seek inspiration from you and follow you (in a twitter way).  You are journalists, physicians, policy wonks, politicians, industry leaders, patient voices, students of healthcare, advocates for social justice, technologists, bloggers, developers and entrepreneurs.  You are also mothers, daughters, sisters and friends.   Happy International Women’s Day, may your efforts and voices stay strong for years to come.

Esther Dyson – Self-proclaimed “Internet Court Jester” – I first heard her speak recently at a broadcast of an Economist interview with Dyson and Dr. Daniel Kraft about Healthcare in 2013 and I was drawn to her refreshing voice and have been following her ever since @edyson on Twitter.   Esther Dyson is an achiever; she is an active angel investor in a variety of start-ups, for-profit and otherwise, around the world.  And, she seems to be having fun with just about everything she does.  I love that she has already published her epitaph on her business website EDventure “I wasn't done yet! There is still more to learn and to fix.”  Oh, and she has written a book (on my to-read list) Release 2.0 A Design for Living in the Digital Age.   

Regina Holliday – artist, advocate and brilliant visionary. What an incredible person, such an inspiration. Here is a link to  Regina Holliday's Medical Advocacy Blog.  If you haven’t heard of Regina, please do yourself a favour and read her blog then follow her on twitter @ReginaHolliday.  Regina is the brainchild behind The Walking Gallery (I hesitate to summarize this project for fear of not doing her work justice).  She creates beautiful works of art that represent the patient experience in healthcare or an aspect of ‘The System’ that would benefit from discussion and she reproduces them on the backs of business jackets and gives them to notable attendees at medical conferences.  The jackets stimulate discussion and beautifully illustrate how difficult it is to turn your back on the patient when their voice is always present.  Her personal story is vividly described in her blog and depicted in her own jacket, I leave that with you to experience. 

Jessie Gruman - author, epatient (4 time cancer survivor) and founder of the Centre for Advancing Health.  The Institute provides pragmatic resources to encourage all consumers to be a Prepared Patient.  She has authored a few books, check out After Shock.  What to do When the Doctor Gives You a Devastating Diagnosis.  Jessie tweets @jessiegruman and is a knowledgeable voice bridging the personal experience with her extensive understanding of healthcare and policy. 

Michelle Petersen – journalist and champion of innovation of health in pharma.  Michelle is founder of Health Innovations – A Platform to Enable All Sectors Within the Health Industry.  She is a prolific tweeter and brings a wealth of information on clinical trials and news from the pharmaceutical side of the industry.  Her blog is Health Innovations.  Follow her on twitter @shelleypetersen.   

Dr. Leslie Saxon – Lelsie works in the coolest place, the USC Centre for Body Computing – The CBC (not the Canadian Broadcasting Corporation) believes that technology solutions are not the problem (or the drivers of our terrific and ever rising health care costs), they are the solutions, and they represent the very best achievements in modern society.  The CBC is an innovation incubation center that commercializes wireless health products that will transcend policy and politics in the future.  She gave a great Ted Talk in 2010 on the need for technology in healthcare and provides a plain-speak explanation of why we shouldn't put patients in ‘information purgatory’.  Leslie is working in this rapidly emerging environment and her tweets highlight how quickly technology is driving the future of healthcare.  Follow her @DrLeslieSaxon. 

Jane Sarasohn-Kahn  - Healthy thinker – Jane is a health economist who works at the intersection of health and technology (my favourite corner).  In her most recent blog The future of sensors in health care – passive, designed, integrated, she explores how sensors will help consumers monitor and manage their health conditions.  Love the infographic too.  You can follow Jane @healthythinker or check out her website Health Populi . 

As my final shout-out in honour of International Women’s Day, I would like recognize the recently launched project, Chime for Change.   Despite the glossy celebrity endorsements, I’m optimistic that some awareness and good work may emerge from the effort.  The six women that I've highlighted are all North American women (Esther is Swiss born but a native of NYC now) a fact that does not escape me and I believe highlights the global aspect of gender inequality in science and technology.  We are so fortunate to live in a time and space where the contributions of women in science and technology are celebrated and their voices are heard, but not all women and girls have the same opportunities.  View the video, and if you see value in the effort, give them a follow @chimeforchange.  

As Hillary Clinton said  “It is past time for women to take their rightful place, side by side with men, in the rooms where the fates of peoples, where their children's and grandchildren's fates, are decided.”

It’s your health.  It’s your health information.  Manage it well.