OrganizedWisdom Health Blog

Will you trust your health records to Google?

Adam Bosworth, vice president for engineering at Google, has been talking about health information for several months, and the Internet giant's interest in the health field has been widely known. Last week, he spoke at the American Medical Information Association's annual convention in Orlando, outlining a vision that includes:

• Discovery - Consumers should be able to discover the most relevant health information
possible 
• Action - Consumers should have direct access to personalized services to help them get
the best and most convenient possible health support 
• Community - Consumers should be able to learn from and educate those in similar health
circumstances and from their health practitioners 

Then he digs deeper into the technical and human factors likely to pose a challenge to achieving these goals. In the realm of privacy, he offers an existing Google solution, Account Authentication Proxy for Web-Based Applications, also known as Auth/Sub:

When two parties on the web want to give rights to each other, both of them share what are called “public keys,” which is tech talk for a way to be sure that the other side is who they say they are. The first site authenticates the user.... It then redirects to the second site with the URL to redirect back to. The second site then separately authenticates the user..., makes sure that the rights are clear in terms of what the first site can do with respect to the second, and then returns to the first site. There is then an exchange between the two web servers just to make sure no one intercepted some web traffic and tried to spoof this. Then a long magic number known as an authsub token is shared between them that permits the first site (and only the first site) limited rights to data in the second site for a given patient/consumer.

Google's array of products is almost indispensable these days. I use Gmail, Blogger, Google Reader and more, despite feeling slightly creeped out when I notice that my past searches are reflected in the ads served. They're great products, easy to use, and make my online life flow more smoothly. I really appreciate the recent improvements to health search that let me narrow the results to precisely the information I'm seeking.

One question Bosworth did not address is how Google is going to make money from its presumably-forthcoming health products. I bet I'm not the only one raising an eyebrow at the prospect of contextual advertising on my personal health records. What do you think?

PDF of Bosworth's notes from the speech is here.

Health Bloggers as Wisdom Creators

If you've looked at medical blogs at all, you've probably run across Kevin, M.D., written by a primary-care physician, Kevin Pho, who works in Nashua, N.H. He's a perceptive and often funny writer who takes on issues ranging from the Avandia scare to why some people get cravings to eat ice.

Cary Byrd at eDrugSearch has a nice mini-interview with Kevin focusing on the nature of health blogging. "I try to give my posts an air of controversy to spark debate," says Pho. "By doing so, it will bring attention to important healthcare issues that mainstream media may ignore or minimize."

A good health blog, whether it's by a patient advocate or a medical professional, also transmits real information of the sort that doesn't make the health headlines on TV or in your local paper. (Like the ice thing -- apparently it means the person is lacking iron. Who knew?) Kevin Pho is lucky in that his employer has no problem with him using his real name and photo on his blog. Many other health bloggers cloak their identities, either to protect patient confidentiality or their own jobs.

Lynette Has Lymphoma -- And It Could Be a Good Thing

Lynette, the Desperate Housewife played by Felicity Huffman, ended the season on a startling note: She was diagnosed with cancer -- specifically, Hodgkin's lymphoma.

Lynette is surely not the only cancer patient whose diagnosis disrupts an already tense marriage -- though she may be one of a select few who gets diagnosed  after she falls out of bed during a rough encounter with her husband. Lynette is also surely not the only cancer patient whose diagnosis brings family tensions out of the woodwork -- in her case, a domineering mother who intends to help her daughter through chemotherapy, whether the daughter wants it or not. How will it all turn out? We'll have to wait till next season.

In the meantime, the plot line on one of TV's most popular shows may do much to raise the profile of Hodgkin's lymphoma. If this happens, it will be an echo of the effect Katie Couric had when, after her husband's death of colorectal cancer, she underwent her own colonoscopy on the Today show. Researchers found an increase in the number of Americans getting colonoscopies after the show ran. It's a testament to the power of storytelling to change people's behavior -- and health -- for the better.

Hodgkin's lymphoma patients have not been content to leave the storytelling to TV producers. Hodgkin's is one of the most curable forms of cancer (good news for Ms. Huffman's chances of continued employment) and many of those who have it have used the Internet to communicate about their disease and treatment.

Some, like Jenny Goellnitz, are in the first few months of dealing with "the Hodge." Since she is a real person and not a TV soap-opera character, cancer disrupted not a tumultuous sex life, but her career as a lawyer and her hobbies of running and Civil War history.

Some, like Sarah from Journey to Babeland, were already bloggers before they became cancer bloggers. The title of her blog reflects its beginnings as a weight-loss journal, before two years of far weightier concerns (including a stem cell transplant) took over.

I've been reading a lot of cancer blogs lately. Some of them are heartbreaking, like Fight 2 Win, whose author Alese Coco fought but did not win her battle against cancer. Others are uplifting, like the bright side, where Ally has stopped posting very often now that she's two years in remission. Each of them is real. So, in her own way, is Lynette Scavo  -- particularly if her story helps inspire people to learn more about cancer, take good care of themselves and reach out to those in need.

 

Test Our Newest Widget

Web 2.0 and Pharma Marketing? Not as Strange as It May Sound

A few days ago the House killed a proposal that would have prevented pharmaceutical companies from marketing new drugs directly to the public for the first two years after they are approved. Drug makers breathed a sigh of relief at the news, but the larger message may still be the same, regardless of the outcome: Makers of drugs and medical devices will need to find creative ways to get their  message out to an increasingly distracted and suspicious public. (One industry professional who's carrying that particular banner is John Mack of the Pharma Marketing Blog -- read it, it's good.)

I admit it -- I flip past the pharmaceutical ads in magazines and tend to tune them out on TV. Yet even before I started working at OrganizedWisdom, I was passionately interested in new medical developments that affect specific conditions, not just for myself but for my friends and relatives.

At the same time, I know it's important not to take marketing information at face value. I remember when my father-in-law had lung cancer, and some family members wanted me to investigate really sketchy reports they'd seen on TV or on the Internet. Their motives were pure -- they wanted him to be well -- but in that frame of mind it was all too easy for them to be misled.

As a consumer, I want to receive complete and responsible health information, even from people who are trying to sell me something. I'm much more likely to give that information my full attention if I'm already perusing related material -- for instance, reading a health blog, whether it's by a physician advocate like Kevin, M.D. or a patient advocate like The Assertive Cancer Patient.

Is there a role for marketing in this kind of media consumption? Perhaps. As a blogger and patient, I want to be free to say what I think and talk publicly about my experiences with illness and treatment. Marketers, particularly in this realm, are used to having more control over the environments in which their messages appear, and are not used to dealing directly with customers' questions and concerns.

An honest, innovative, patient-focused marketer might well find a way to make this new Web world work. Here at OrganizedWisdom, we're starting out by bringing together information that makes patients' lives better. I can promise that that will always be my first priority.

Waffling on what health studies mean

"Dads to blame for fat kids," shouts a headline from this week's news. "Hmmm, there might be something to that," I think, remembering the waffles-and-sausage breakfast my dad made for me last weekend. Still, I'm suspicious of anything that sounds that easy. And why blame dads?

Turned out the story could have just as easily been headlined "Thin and healthy? Thank Dad." The study found that dads who were engaged with their kids, setting boundaries and acting as role models, were more likely to have children with a healthy Body Mass Index (BMI) than dads who were disengaged or permissive. The parenting style of mothers -- who often get blamed when a child is heavier than normal -- didn't show any correlation to kids' BMI.

Setting aside legitimate questions about the use of BMI to measure obesity, does this prove dads are to blame when their kids are overweight? Of course not. Heredity, culture, available food and exercise options, and the influence of friends, care providers and other relatives all play a role in a child's weight.

News stories and headlines often oversimplify or magnify the results of research. The Effect Measure public-health blog last week gathered up a range of headlines that appeared in response to a release from the Centers for Disease Control on the use of masks to prevent the spread of avian flu -- a Rorschach test for headline writers, as they put it.

As an old newspaper headline-writer myself, I can sympathize with the journalist struggling to sum up complicated information in six words or less while keeping it engaging and fun. Yet the results leave many people struggling to make sense of conflicting information while making good decisions for themselves and their families. OrganizedWisdom continues to look for more and better ways to make sense of health information in a way that ordinary people can understand, trust and share.

Still, ladies, if your kids are chubby, it may not be all your fault. Just to be sure, though, you probably ought to save that Mother's Day chocolate for yourself...

Five things to look for in a health site

The latest news on Medicare's prescription drug program is troubling, on the face of it: More than 3 million low-income seniors who are eligible for the program have not sought the government subsidy or signed up for a plan. One of them is my mother-in-law.

Vivian is nearly 80, one of the nicest people I know, and also one of the healthiest. You can see her dancing at left. (And yes, that's her natural hair color, for which she credits a Native American grandmother.)

Rather than follow the government's advice to sign up for a prescription drug plan, she's decided to keep paying for prescription drugs herself. Why? Because she's only on one regular prescription, and it costs $10 a month. Most of the available plans have co-payments higher than that, plus monthly fees. Like her, quite a few of these 3 million people may have simply done the math and decided they were better off without a government program. They're making decisions for themselves.

When the plan was first introduced in 2005, the choices were confusing enough federal officials encouraged elderly people to have an adult child or friend help them. I did this for my dad -- again, someone who doesn't take others' word for anything regarding his health, but looks at the information and makes his own decision.

Today, everyone is a health care consumer, and a lot of what we need to know, we have to find out for ourselves. It's not always easy. That's why I'm excited that OrganizedWisdom is going to be making it even easier to share and find the wisdom you need to make good health decisions. Look for these changes over the next several weeks, and watch this blog -- I'll tell you more about what's coming up as our plans solidify.

In the meantime, here are five tips for evaluating the health information that you find online:

• Know who is publishing the site and what their interest is in promoting a specific product or treatment. (Check the "About Us" section for clues.)
• Look for evidence that the site's content is reviewed by editors or medical experts.
• Remember that everyone is different. The health measures that work best for you may be completely ineffective for me.
  
• Pay attention to tone of the writing and design of the site. A cautious, scientific style may be less fun than an emotional appeal, but when it comes to your health, information is more important than entertainment.
• If it sounds too good to be true, it probably is.

Health care is confusing. Wisdom can help.

Sometimes, life is just unfair. My friend J is 32, works out at a gym three days a week, eats a heart-healthy diet, is losing weight, and takes Lipitor. Yet his LDL cholesterol level remains stuck at 560. (If you're not familiar with cholesterol, that translates as Way Too High.) I'm 10 years older and I don't work out, watch what I eat or try to lose any of my excess pounds, yet my cholesterol level is well within the normal range at 100, without any drugs needed.

The difference between us is based largely on heredity, and both of us can get a clear message from our numbers. But what if you're on the borderline? In its special section on medical testing, the New York Times profiles George Skouras, who got his cholesterol level down to 140 without taking drugs. Today's guidelines recommend statin drugs to get cholesterol below 125, but Skouras was concerned about the possibility of undiscovered long-term side effects. In the end, he realized, he was taking a gamble either way.

More and more, our health choices lie with us, the patients, and that means we need information. Of course we rely on our doctors and other medical professionals to advise us, even if it's only in 10-minute sound bites thanks to managed care. We pay attention to health news, even though it's often confusing and contradictory. Often, we talk to the people in our lives. My friends helped me know what to expect when I hit perimenopause. Your mom may have taught you what to do about a cold or an upset stomach. I've encouraged several friends to try an osteopathic doctor for back problems.

It's this social network of health information that OrganizedWisdom wants to gather and make available to everyone. As we say on our home page, "Health care is confusing. Wisdom can help."