#livenotes

Helllooooo good morning sweeties!! You must think that I’ve got nothing better to do than watching series and such.. Well yeah, I don’t. My school is on a break so I'm home ‘till 02/08/2017. I have to confess it isn’t easy watching this show knowing what's gonna happen. 

S01E04

Haha the secret stash of vervain. I love it. It’s like a stash of weed nowadays. By the way do you know that vervain had a healing and protective use in the early days. History says that vervain got his healing powers when it was used on Jesus his wounds after he got off the cross. Also, it was said to protect against vampires. I just love history. 

Oh I love Stefan and Elena in de slow dancing scene. If only I could find a man that loves to dance. 

Haha it’s so funny to see the grown ups think they know everything. 

S01E05

Okay, it’s not logical to wake up so beautiful! 

Haha, Vicky and Jeremy are so cute together. 

No don’t go into the basement!!!! Why are you so stupid!!

OMG! this is way too cute!!! Stefan making dinner for Elena!!! Oh I’m so in love with the two of them!

Haha Jeremy refusing to get high... That’s a first.

S01E02

There it is again. The typical scene doomed for someone to die.

Seriously get a room already! 

I love Elena’s eyeshadow! If only I could hear as well as vampires.. be as strong as them. 

That teacher is getting extremely on my nerves 😒!!!!!

Haha Jenna.. you’ll get the hang of it eventually. 

Uh-oh.. the confrontation between Elena and Damon.. he’s gotta stop doing that with the bird. It’s creeps me out every single time!

Really Stefan... You really gonna let her walk away like that? You should’ve ran after her!  Finally!!!! Such a beautiful kiss! 

Oh Damon, you're so full of it! Will you ever get sick of hurting people?

S01E03

Haha really Caroline.. Throwing a pillow at a vampire? 

HAHAHAHAHAHAHAHA I loooooooooooooveeeeee the scene with the rugby ball!!!  Tyler’s totally getting his ass kicked at football! 

And there’s the vervain.  That slap in his face was so worth it! 

I’m going to bed, my loves. 

‘till next time! 

Xoxo

A Dr, Patient & Insurer Walk into a Social Network http://schedule.sxsw.com/2012/events/event_IAP12497

Sunday, 5pm

How bad is it?

Haywood (patient): There's a crazy gap between what makes sense, and what we really can do. 

Doctors legally can't reply to emails!

Swanson (doctor): How bad is it? It's really bad. We know pts are learning in the space, and the example we showed is probably not as bad as it can be. The fear culture is much stronger than actually encouraging.

I had two clinic employees get fired for HIPAA violations this week. So you can imagine how my other staff feel when I try and to encourage them to talk online.

We want clear communications about how to pay for services. When I do a review, or a YouTube video, somebody needs to pay me for it.

Golinkoff (insurer): When I think about how bad it is, I think of the costs. Insurance in threatened becuase of the costs. And pts are getting more unhealty. And there's a lot of people who can't get care. It's hard to get care to people who would benefit from it, but they don't want to participate.

So we see these trends, and it feels frustrating.

Haywood: It's hard to talk about a system that is incented in murky ways. Doctors want to prescribge anitbiotics to make their pts happy for good reviews, or they want to do a particular surgery to make more money. And none of these things are clear.

How good could it be??

Swanson: The opportunuity we have is to not use pts for vessels for billing. We can't ask our docs to do more, but we can use technologies to stop the repetition of easy educational stuff on bedwetting, exercise, car seats. So that when I get time with patients, it takes full advantage of my specialized doctor skills. And too, then the parents can take it and share the information with each other.

But it has to be paid for. And that's what we're trying to figure out.

Golinkoff: how good could it be? Well we all want the same thing, but it seems like we are in conflict. ONe way to do this is to make the flow of infomaiotn timely accurate and useful. We need to help and empower the pt brvcome more expert in what they need to do, and be an active participant. Create communities that are curative. ANd we can help guide people to those communities.

Haywood: We could think about this as one integrated human information system, so we could pair the right level of expertise for the right level of problem. 

I don't want a company whose bottom line is better for me to die. I don't think any insurance company thinks this way, but just think about it. If you get MS, it's better if you die, they make more money.

I don't know why a doctor is doing everything from health to complex disease mangemtn. Why is there one set of buildings for me, and someone who is incredibly ill.

I want to change these roles from insurance roles to take cases, and docs job is to take your medical knowledge and apply it in a clinic visit. 

Swanson: Parents trust me. They don't trust vaccine experts. They hear a lot from the media. So what I need to figure out is how to get good information to them, who I only see when they're sick.

Ultimately I didn't understand that Aetna could actually help get me information -- we've been bullied into not working together.

...

Golinkoff: we do send out information and have the ability to warn if certain patients haven't had certain tests, or are on contra indicated medications.

Haywood: I am confident that you have the information power to make those connections. But there's a question now about what does it mean to be in the healthcare business? ...

If we move away from chronic diseases that we can mange pretty well, like MS or hip replacements, or bipolar. As good as our EMRs are, they don't know jack about how healthy people are. A great interview by a doctor can be amazing -- and find out completely unendcoded infrmatoin. And an insurance company can know massive numbers on many pts. 

We're aligned because we could all benefit from the mixing of these two types of information sources. But it has to be open.

What comes next??

Golinkoff: we look at health as an episodic thing. The focus shouldn't be on traeating illness, it should be on generating wellness.

The medical system is great at treating acute problems. We need to try to also provide integrated and healing care from generalists.

Swanson: what I need from payers is new pilot models now. Pay for e-visits, pay for a library of information. If we fail, we log why we fail. If we succeed we try to spread the models. Right now I'm staying in the system to fight for change, but at some point I will leave to be the pediatrician I always wanted to be.

Adapting New Technologies for Humanitarian Aid

http://schedule.sxsw.com/2012/events/event_IAP8656

Sunday 3:30

De Rivero: huge rise in mobile changing everydy life but also emergencies.

Importance of information during crises, info on familiaes. 

Lots of applications coming out: iCow in Kenya is used by farmers to manage livestock. Ushahidi mapping out emergency and live information. MoTech in Ghana have applications like Mobile Midwife [sort of like Text4 Baby]. But these are audio messages because of high illiteracy rates. Tailored with local dialects. Mpesa transfers money using SMS.

Ideal situation for us: Hooked up with Microsoft HealthVault to work within an SMS gateway in Senegal. Mother goes to a helah centre during vaccination, she sends an SMS to retrive vax history, and the health worker proceeds accordingly. So now it's a technical issue to implement this.

Much of the current mHealth issues are taking place for just one project. But this could be carried out across countries 

This stuff will work if the users find it useful -- they have control over the health record, they'll have PHRs which is key. 

The other thing about the mobile boom in Africa, is that there is a tendency to blame cultural issues -- they don't go to the health centre is because it's "part of their culture". But it's not cultural to use mobile phones either, but they do.

The reason they don't got to the health centre is because it doesn't work for them. People use things that work.

Gayton: MSF. In Haiti after the earthquake. Haiti is a strange place for the Western world, because its health indicators are akin to sub Saharan Africa. 

MSF is a private emergency humanitarian org. We have a great reputation in the community for being arrogant standoffish bastards. Our independence means that we don't play well with others.

First we had a earthquake response. Then we had a cholera response. Treatment is easy, but it can spread like wildfire. Because Haiti is surrounded by healthy countries, cholera hadn't been there before. We treated 110,000 cases in 2.5 months.

So can we contact Google and import some cholera data? 

Mayrgundter: we were contacted to work together with MSF and we went down there to take a look. All our assumptions were wrong about how to do this project. 

Gayton: The first thing we asked him to do was that we had an issue about the water systems. The key is cholrination. This will kill cholera, which is why you can have a raging epidemic 2 hours from Miami, and only three cases make it over.

Mayrgundter: So we made this map with a bunch of GPS units and pool testing kits. We taught some guys who knew the neighborhoods, and sent them out with these two things on bikes and mapped the cholrine levels.

Gayton: Then we hacked up a choolera register from a spreadsheet and were able to map it out. We took it to UNICEF, we screamed and yelled, and they ended up starting to pay for the trucks to repair.

Then we realized this would be a visceral tool for advocacy. Immediate utility. 

This wasn't that complicated -- these aren't really "new" technologies, but they are being used in new contexts.

And now we're firing through other data into Google Earth, cholera treatment centre locations and they're real-time capacity. Making spreadsheet data visual and useful.

Mapping all of MSF's cholera patients over time, and we can animate its spread on Google Earth. Again, we've had this data in spreadsheets but you couldn't see it.

Everyone's a cyborg!

Tools are the extension of the physical self 

But now we're extending the mental self -- these tools don't stay the same shape over time. 

Shape of the tool and its function are the same. Computers are evaporating into thin air. So I'm interested in learning about the evolutions of interfaces. What's the next step after the liquid interface?

Regular anthro goes into a differnt culture and studies them. Always from the perspective of the other.

Cyborg anthro is the opposite -- these devices we use get hungry, they grow up and beg for money. Ambient intimacy -- you at one click can contact your whole village. This audience is really not just 3500 ppl,it's more like 50,000. Plus you can pack more and more information into your device, and it doesn't get any bigger. If your computer crashes, you lose like 2,000 pounds of stuff.

It's also easier to hoard. It's a crisis when grandma does it, but we can't tell if ppl are doing it on computers.

Printed out FB news feed. Like the egyptian hieroglyhs. But when FB goes out of style, there's no more wall. But hieroglyphs are still there.

So we may enter a digital dark age?

Hyperlinked memories / Persistent Peleontology -- your computer is an external brain. WE have to search and dig through emails. (Email garden, 2011, Nick Rodrigues.)

Information jet-lag -- people are everywhere, we have ot account for time zones. And then you Panic. (Panic Architectures)

Temporarily Negotiated Private Space. Cell phones are the new cigarettes. 

HISTORY

Steve Mann 1981. Wearble computer apparatus. Hacked MIT building to install an antenna and lifestream this. 

He made WearCam. He was frustrated by having to conform to technology to use it (crouching over a laptop). His camera eye would cancel out advertisements and plug in other images (early AR).

Also invented contextual reminder/notification system. Virtual post-it notes with image processing. 

And face recognition!

He also invented Twiddler, one handed keyboard played like a guitar.

WearCam is now much lighter and laser projected onto his eye.

---

This is crazy stuff -- but still people use old metaphors to describe new technologies. I.E. page turning in reading apps. This is a "persistent architecture" that blocks innovation.

Instead we need superhuman interfaces. Like Flipboard.

Kelly Dobson: why do we teach machines our languge? We should learn theirs. She made a blender you growl at and it turns on. Mika Satomi inveted a vest that gives a massage when someone pushes buttons on a video game controller. I want Farmville to be like this, clicking on your FV would actually do farming somwehere.

70s Xerox PARC: Calm Technology

Actions as buttons, invisible interfaces, trigger-based interactions.

Haptic compass belt, you wear this and it always buzzes when you face north. As the inventor wore it, he developed a sixth sense for directions. You could hook this into your GPS in your car and give you a buzz right or left, instead of staring at atiny distracting GPS box.

With location based data, you can make invisible buttons -- leave messages for people that are triggered when you near them. Or automate your house, turn lights on and off. Your phone then is a remote control for reality. ANd it reduces your screen time when you automate.

GeoLoqi. Takes bus data and sends you the next bus when you get to a bus stop. It brings up geo-located wikipedia articles near you. The interface disappears. Your actions on the computer are reduced, and you have to ask less questions.

Reid Beels: Don't eat that! Warns you about health violations.

Pinball machines: we're used to the web, and it's great. But you have to look things up, and its hard to do when you're walking around.

Real-life gaming: real life pacman walking around. Map Attack!

PROBLEMS: Battery Drain. Storing data. Sleeping and waking up.

How STDs can be good for your health: http://schedule.sxsw.com/2012/events/event_IAP9610

Sunday, 11:00am

David Hale: let's create a community around this type of data. Want the data to be used in meaningful ways.

NLMs mission Acquire, organize, presesve biomedica data. Now that citizens can create health data, the citizen's mission is Generate, Organize, Act.

That middle term: organize. We overlap there, so the NLM can play a role.

We're exposing a lot of our data through APIs. A service or a programmer can help add significance to your health information -- you might say "I'm coughing" and a service could run that through our data APIs to provide some machine context [to what "coughing" means].

NIH Social and New Media Policy -- "with respect to personal information, the presumption is in favor of openness." So the default is OPEN. This is a huge shift.

In the policy there's even stuff baked in about using social media to do clinical trials and recruitment. Now we're going to actually recruit -- there's issues here, but we're working on them.

Check out "Rock Talk" blog, extramural research director. 80% of NIH budget goes to extramural research. This blog discusses where that money goes.

Mark Dredze from JHU: Why do social media and health go together?

How does Twitter inform our understanding of health. If we aggregate over millions of tweets, we can get useful signal from the data.

Statistical language processing. Twitter flu trends tracks the real flu rate well. Allergy season. Smoking. Lots of examples of this.

What else can we track? How people use meds. Discovering pt safety issues. Mental health disgnosis. Drug and alcohol use (esp. in young ppl). Stopping medical misinformation.

Deven McGraw: Privacy and security  -- Edelman report, people are concerned about privacy of health data and don't trust health institutions to protect their data, and would switch servicers if there were a breach.

Not all health data is protected by HIPAA. If you share health data openly on the internet, none of that is covered by HIPAA. And people don't necessarily equate their concern about health data with what they practice online. We assume people think what they're doing is more private than it really is.

There isn't anything in privacy policies of social media that stops them from saying "we're going to sell your data if we want to" -- and most people just click through them. I don't do a lot of data sharing on the internet -- I am on Facebook but I don't click on anything and I don't do FitBit and I don't trust a privacy policy to tell me what they're doing with my data.

So is everyone going to be able to benefit from these data tools, even if they're squeamish about privacy? Or only people who are more cavalier going to get those benefits?

Hackel: Let's turn to opportunity. 

Anmol Madan: The ownership of data is important. We have a privacy philosophy. We have to get consumers to opt-in. Second, giving pts value from the data. Third, recognize that the pt owns the data and if they want to leave, they can.

Dredze: I'm really excited about the opportunity. Sickweather will look at what your friends are saying and tell you who's sick. Healthmap being used for public health.

But to give you an idea of how murky it is, the data is public -- it's OK to look at it. But if we start predicting things -- we can predict your gender, your political leanings. You put the data out, but you never agreed to have it used in this way. Like the Target ad controversy.

Facebook status updates on people who are suicidal. Imagine the ethical things here, if FB knows someone is suicidal, do they have to do anything? Should they even be "reading" you in this way?

------

Audience Qs

Social networks don't replace human interaction. It's not FBs job to be your mom, your mom is your mom. And you don't have to shop at Target. So there's personal choice involved.

McGraw: Maybe -- but do you as a consumer have real control over what data you're sharing. I don't have a way of buying something online and not get ads servicing me about similar prodicts. So right now the choice is don't use the internet, or suck it up and deal with targeted ads.

Dredze: I don't think we're talking about replacing people, doctors. But let's say FB could predict suicide. Should they do something?

I'm a pediatrician, and I work for an organization that does social media. We've established relationships with my pts. I want to be able to use data like that to provide better care -- but right now there's no way for me to make them feel secure about sharing data with me... [I can't really remember the point of this person's question[

Dredze: Good point. Who emails? [everyone] Who emails their doctor? [some] Why hasn't everyone emailed a doctor? All these ethical issues pop up right away.

Hale: lots of stuff is happening in the startup community. The data initiative, that's where all this conversation is happening. There's an opportunity for the startup community to be supported 

Madan: yeah this isn't a tech problem. It's a systems problem.

[different doctor] It's important to understand that the pts at these conferences are not typical. I have pts contact me all the time on social media, and they have no idea that the contact is not private.

Hale: totally, we have a lot of concern and effort behind health literacy and education.

I'm a statistical NLP guy. We haven't talked about clinical records -- I think this is huge, as big as the genome. We could encourage orgs that have HIPAA clearance to do R&D around clinical data.

Dredze: this is huge, but HIPAA orgs are terrified of clinical data and sharing information with people. 

McGraw: and you can't connect dots with aggregate data. You have to be able to personalize it.

-----

Closing remarks: what's next??

Hale: big data mashups

Madan: do you remember phone apps from 2005? They were impossible. Helth care is like that now. I hope soon we'll be able to do development on a fast 1-yr cycle.

Dredze: methods and techniques will start to catch up to the amount of data, so I hope we'll catch up and do good things.