HealthCareVox

Obama’s Big Job: Harnessing The Energy Of The Crowd

2008-12-17T19:39:52Z

Please note: This will be my last post for the year, as the holidays are approaching. I'd like to thank everyone for taking the time to read this blog and I wish all of you a merry and bright holiday season and New Year! I'll see you all in January 2009.

I’ve been watching with great interest as President-elect Barack Obama conducts transition-related business while beginning to engage in two-way dialogue with the American people about the future of the country. I’m been paying special attention to the transition team’s focus on health care and their efforts to encourage Americans to participate in the reform process.
Earlier this month, former Sen. Tom Daschle said he read thousands of comments on health reform over a weekend and was impressed by what he found. Now, Daschle is asking Americans to hold discussions in their homes over the holidays about the topics. Daschle has also promised to attend a few in person.

I think this effort is admirable, but Obama’s staff is going to have to quickly figure out how to harness the energy of the crowd they are gathering to discuss health reform. A couple of things concern me:

1. The Danger Of Unspoken Expectations: It is great that Daschle and his team are listening to the public. However but to date I haven’t seen any information about what the administration will do with the data and information coming out of these discussions. How will suggestions be collated and organized? Which suggestions will rise to the top and become policy? People participating in a conversation need to know the rules of the road, otherwise they may be disappointed about its outcomes.

2. The Danger Of Ignoring What Has Come Before: In 2003, Congress created the Citizen’s Health Care Working Group. The Group conducted numerous conversations with Americans (both online and offline) about what they would like the U.S. health system to look like. The Group developed a detailed report, which has numerous suggestions about health reform. How will Daschle’s effort incorporate the results of this initiative and improve and expand upon it?

Hopefully, Obama’s team is thinking about these critical issues and will be addressing them soon.

kmmad

The One Piece Of Safety Information We Can’t Do Without: What’s MY Risk?

2008-12-12T15:23:37Z

A Wall Street Journal article published earlier this week has generated an interesting, but much-needed debate about drug safety information and when it can harm patients. According to the Journal:

“Too much information about drug safety -- disseminated through media, online alerts from consumer watchdog groups and even by the Food and Drug Administration itself -- might overwhelm patients and raise undue alarm, some medical professionals caution. Consumers may forget about the benefits of a medication if they focus only on risk. And the health consequences associated with stopping a medication, particularly for a chronic condition, may be far worse than the possibility of a side effect.”

kmmad

]]> may be increased by antidepressant medications. Prescriptions of these drugs fell and some wondered whether the warnings did more harm than good.

I’ve always believed that people should be provided with more drug safety information. However, it is useless unless it helps people determine their individual risk and takes into account the severity of the illness the medication is designed to treat. For example, some patients with muscular sclerosis believe that the risk of liver and brain-related adverse events caused by Tysabri is concerning, but they continue to take it because the medication works very well. However, patients with diabetes may be less inclined to take a risky medication if they other equally efficacious medications are available.

I think efforts to improve drug safety information by FDA and companies like Wyeth, Johnson and Johnson and Pfizer are admirable. However, I believe that the best information will provide patients with a clear sense of their individual risk. iGuard.org, is a relatively new Website/social network that provides some interesting and very understandable information about drug risks from the perspective of physicians, regulators and patients.

While too much information can be harmful, the right type is invaluable.

FDA Launches Interesting Partnership With WebMD

2008-12-04T15:49:45Z

The FDA announced an interesting initiative yesterday indicating that the agency is getting very serious about providing accurate and – more importantly – timely information to consumers using the Internet. FDA has launched a partnership with WebMD that will enable it to distribute information and collect consumer feedback via the popular Website. According to an agency press release, the new FDA WebMD partnership will involve:

- The development of a new online consumer health information resource on WebMD.

- A new platform where consumers can submit safety information about food and drugs directly to the agency.

This is encouraging news and I expect the agency to annouce more initiatives in 2009. Given FDA's interest in improving its pharmacovigilance efforts, I think we may see some interesting projects focusing on mining online information -- including search traffic -- to highlight emerging food and drug saftey issues.

To learn more about the FDA/WebMD project, please click here.

kmmad

Thinking About HIV/AIDs On World AIDs Day

2008-12-01T21:18:51Z

This post is part of an event focusing on HIV/AIDs for World AIDs Day, titled “Bloggers Unite.” Learn more about this initiative by clicking here.

I still clearly remember when I first started paying serious attention to HIV/AIDs. It was in the mid-1980s and I had just finished reading a great educational brochure focusing on the disease. I decided to read the pamphlet because I was very confused and needed some unbiased and accurate information about the condition.

In those days there was a lot of confusion about the HIV. Would kissing someone spread HIV, many wondered. What about sharing utensils or living in the same home or apartment? Uncertainty and fear caused many unfortuante problems.

There was also the problem of prejudice and hopelessness. Countless people stricken with the illnesses were ostracized by many of their friends and family. In addition, because HIV/AIDs was thought of as the “gay disease,” there were some who argued that homosexuals were getting what they deserved.

I am happy that things have gotten a lot better today. A diagnosis of HIV is no longer considered an automatic death sentence. Partly because a number of celebrities, including Magic Johnson, have reduced the stigma associated with the condition, it is a lot harder to view people with HIV/AIDs as “The Other.”

However, we still have a long way to go. In some communities HIV/AIDs is still a silent epidemic and people who have the condition are heavily stigmatized. The pharmaceutical industry and many researchers in the public and private sectors have helped turn HIV a chronic condition. However, this has resulted in a dangerous amount of apathy. Finally, we pay a lot of attention to HIV/AIDs education and prevention overseas, but not enough at home.

This is why I am happy to participate in the Bloggers Unite project. Through new (and old) media channels, we can focus needed attention on this continuing epidemic and ensure that we do not lose precious ground.

Let us continue the struggle against HIV/AIDs so that we quickly find a cure and that fewer people are lost to this insidious disease.

kmmad

On December 1st Help Refocus The Country On HIV/AIDs

2008-11-25T16:32:12Z

With the CDC reporting that US AIDs/HIV rates are higher than previously reported and key communities (i.e., African Americans) suffering disproportionately from the disease, we can’t afford to take our eye off the ball when it comes to fighting this terrible illness. That’s why I’m urging you to consider supporting the Department of Health and Human Services, the National Institute on Drug Abuse and Blog Catalog on World AIDs day. These organizations are encouraging bloggers to dedicate their blog posts on December 1st to HIV/AIDs. The goal of the project is to “leverage the power of the blogosphere to remind people that HIV/AIDs is still a critical issue in the United States and around the world."

Please take the time to think about what you’ll blog about that day. I’ll be doing the same. To learn more about the project, please click here.

kmmad

The Death Of Web 2.0?

2008-11-20T18:31:10Z

When I first came across this article, I rolled my eyes. “Not another person spouting another buzzword,” I thought. But, then I took the time to read the article focusing on Razorfish’s new focus on solving client’s business problems rather than advertising and I was pleasantly surprised. I’ve been hyper-focused on how social technologies can help companies in the health space understand opportunities and avoid pitfalls via intelligence gathering and other techniques. Given this, I think that Razorfish has the right idea.

It seems that everyone is doing their best to break “down the silos.” It’s refreshing to see that they are breaking down – although it’s going to take a lot of effort before we reach nirvana.

kmmad

Tech Maven In Chief: What Are The Implications For Health?

2008-11-12T19:08:57Z

Whew, what an election! While I haven’t had as much time to blog recently, I have been paying a lot of attention to the recent presidential election. President-elect Barack Obama has demonstrated the power of the Internet to shape politics and forge powerful and lasting online communities. Through direct experience, Obama has likely become a big believer in the Wisdom of Crowds. This is great news for those in government who believe in the power of social technologies to educate on health and change behavior.

Can we expect an Obama administration to support innovative initiatives like the one Google just announced with the CDC re: flu tracking? I think so, especially if former Vermont Governor Howard Dean becomes Secretary of Health and Human Services. Dean famously started the e-revolution in political campaigns in 2004. If he is appointed to the Cabinet, I expect that he will push through initiatives designed to speed adoption of electronic medical records, improve HHS’ online presence and launch a range of other exciting projects. Of course, we can expect Google’s Eric Schmidt to have a significant influence on Obama’s thinking – whether or not he becomes the national Chief Technology Officer.

These are exciting times for those of us who believe in the potential of the Internet to improve health. It's going to be an interesting four years.

kmmad

Today's Word

2008-11-04T19:44:09Z

I've been a very busy bee lately with travel, projects and the like. However, I did take time to do something that I encourage everyone reading this blog to do:

VOTE!

It's a historic election -- on both sides. Take part!

kmmad

Making Sense Of Social Media Data: Visualization Is Key

2008-10-23T22:20:46Z

Recently, I have been increasingly focusing on how health organizations can use the reams of information available to them via social networks, blogs and other social technologies for business critical purposes. While the concept of mining online data is well established, many are still having trouble linking this information to business processes. Specifically, there is a lot of room for improvement in how this data is being used by the health industry to:

-Help executives answer questions that impact business over the long term

-Accelerate decision-making

-Predict outcomes -- especially as they relate to marketing communications initiatives

I believe that successfully utilizing social media data requires one to visualize information in order to quickly identify trends and highlight insights.

Fortunately, there are many tools available for executives seeking to visualize data. One that I have been using recently is Many Eyes. One can map qualitative and quantitative data to identify overall social media trends in real time.

Given that the Health 2.0 conference is currently underway, I decided to cull content from a number of blog posts about the event and analyze them in order to get a better sense of what people are saying about it. Using Many Eyes, I put together a word tree that associates key words and phrases with the term "health 2.0."

The word tree I developed appears below. I'll be discussing information optimization more in the months to come.

kmmad

Understanding How Minorities Use Online Video & Social Networks

2008-10-21T22:10:01Z

A few weeks ago, I had the pleasure and honor of participating in a Webinar conducted by the folks at the US department of Health and Human Services (AIDS.gov) on how minority populations are using various interactive and social technologies. I was reminded of that Webinar (and wished I had this data in my back pocket) when I recently across research conducted by Synovate last summer on how minorities are using video sharing Websites and social networks. There are some interesting differences in usage patterns within these populations. According to Synovate:

“Though approximately one in four Hispanics, African-Americans and general market consumers have visited YouTube.com in the past six months, African-American and Hispanic males ages 18-34 were more likely to have visited YouTube than their female counterparts.”

In addition: “Hispanic females were significantly less likely than Hispanic males to have visited social networking websites recently, with 18% of women and 27% of men claiming to have visited them. This is in sharp contrast to African-American and general market men and women who were equally as likely to have visited MySpace or Facebook.”

This data further confirms what I’ve been saying for a little while now: the digital divide is about income rather than race. For more on this topic, please see this AIDs.gov blog post.

kmmad

Blogging No Longer Niche

2008-10-16T17:13:43Z

Today eMarketer reported on new data from Technorati suggesting that “the lines between blogging and the mainstream media have disappeared.” That’s just one of the juicy bits of data highlighted in an eMarketer article that hit my e-mail box today regarding the growing global blogosphere. While the new Technorati study is a bit skewed because the company’s user-base was surveyed, it still has some great insights.

Most importantly, one-third of bloggers worldwide had been contacted by a “brand or agency” to be a brand advocate. This makes a lot of sense. Many companies are viewing bloggers as ideal people to disseminate their messages. However, there is legitimate concern about whether all marketers are being transparent about their activities. As we have seen – especially in the US – being non-transparent is a cardinal sin.

Read more about the Technorati study here.

kmmad

Consumers Say No Thanks To Metered Internet

2008-10-14T16:22:47Z

In June, I wrote a post focusing on how Internet service providers are looking at ways to curb the use of high-bandwidth Web technology such as online video via metered pricing. I suggested that “the advent of the metered Internet [could] put a damper on efforts to ensure that people with the greatest need have access to the best online health information.”

Now, eMarketer reports that consumers are not very open to the idea of a metered Internet. According to the company, 81% of US consumers said they dislike the idea of ISP service changes "that would eliminate unlimited broadband.” In addition, very few people believe “those who use more bandwidth should pay more.” Finally, 51% of respondents said they would drop their current Internet provider if it capped their Internet use.

eMarketer suggests that “consumers might [come to] resent all forms of Internet advertising, since those ads will consume some of their metered service.” However, I’m not sure about that. Based on what I’ve read about Internet providers’ plans, they would focus most of their efforts on those using large amounts of online video. Banner advertisements and other low-bandwidth online content might not tip the scales much.

It will be interesting to see how this saga plays out. However, as I mentioned previously, it is critically important for those interested in disseminating information via the Internet to understand this issue and think about how it may impact how people use the Web to find health content.

kmmad

Shire Warning Letter Is About Content, Not Context

2008-10-10T17:56:40Z

Over the past few days, much digital ink has been spilled over the warning letter Shire recently received for a promotional video that was uploaded to YouTube. According to Pharmaceutical Executive and other sources, FDA told Shire that the company had overstated a series of claims made by celebrity spokesperson Ty Pennington in a company video.

I have received a number of questions about this event over the past few days. My response has been this: the FDA warning letter focused on the content of the advertisement rather than the context. While it is certainly interesting that FDA asked Shire to withdraw a YouTube video, the medium is less important to the agency than the message. Shire was warned because it produced materials that did not contain adequate fair balance information, not because the video appeared on a video sharing Website.

In a white paper published by my firm Envision Solutions, Cymfony and Seyfarth Shaw last year we made a similar argument. We said:

“Although the FDA has not released firm guidance on pharmaceutical Internet communications, we have many years of received precedent to guide us . . . At minimum, drug firms thinking about communicating via social media should design their programs to be consistent with . . . principles [such as fair balance, avoiding the dissemination of off-label information and reporting adverse events] and be ready to discuss their efforts with the FDA.”

The recent FDA action supports our recommendation.

Overall, the warning letter has not made Shire gun-shy about alternative interactive media. Company executive Matt Cabrey told Pharmaceutical Executive that Shire will continue to utilize these technologies to promote its products.

kmmad

Help Pew Tweak Its Next Internet Survey

2008-09-30T16:26:34Z

This fall the Pew Internet & American Life project will be conducting a new national survey looking at the influence of the Internet on health. Pew’s Internet use survey is incredibly influential and is the study many people cite first when talking about this topic.

Now, Pew’s Susannah Fox is asking for a little bit of help with the new study. Fox writes: “One of the first tasks is to look at our tried and true 'trend' questions and decide which ones we should repeat as is and which ones need to be updated. Since I benefit so much from reader comments on this blog, I'd like to crowd-source some questions for this survey.

The first question I would like to consider is the ‘screener’ question which yields our estimate that 80% of internet users go online for health information.”

Now’s your chance to influence this important study by providing your comments on this question. Click here to learn more.

kmmad

If You’re Conducting Telephone Surveys You Must Include Cell-Only Population

2008-09-25T16:30:58Z

Over the past few years, statisticians and their fellow travelers have been nervously tracking the growth of the cellphone-only population to determine whether omitting this group will significantly skew the results of the polls they produce. Now, data from the Pew Research Center for the People and the Press indicates that it is no longer a smart idea to fail to include cell-only users in telephone survey samples. A few days ago, Pew published a study looking at how the growing cell-only population is influencing polling for the presidential race. Pew concludes that while including cell phone users in the survey sample does not sway the aggregate results overly much, it reveals that cell-only users are much more likely to be young and support Senator Barack Obama. Pew reports that:

“In the pooled data, cell-only young people are considerably less likely than young people reached by landline to identify with or lean to the Republican Party, and even less likely to say they support John McCain. . . Among the cell-only respondents under age 30, there is a 34-point gap - 62% are Democrats, 28% Republican.”*

Pew concludes that: “Even though the omission of cell phones from election polls does not currently make a large difference in the substantive results, Pew's surveys this year suggest at least the possibility of a small bias in landline surveys.”

What does this mean for those conducting telephone-based market research? Well, when studying small shifts in behavior and attitudes where skews on either side can determine whether or not the results are statistically significant, it’s best to be doubly sure that you include cellphone-only users in your sample.

All of this is fascinating stuff. To learn more about US government surveys tracking the growth of the cell-phone only population, please click here.

*If you are of the mind that young people don’t (and won’t vote), see this nugget from Pew’s research: “While 18-29-year-olds reached by cell phone tend to have less experience voting than their landline counterparts, they are just as interested in the 2008 campaign, and express just as much intention to vote this year.”

kmmad