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June 11, 2016 By e-Patient Dave 8 Comments

#2016ADA day 1: incredible interview with “artificial pancreas” creators Dana and Scott


If you can’t see the video above, click to watch it on Vimeo.

One of my favorite sayings about digital health is “When assets digitize, things change fast.” The point is that once information (or anything else, even fonts) goes digital it can suddenly be hundreds of times faster to develop new things. In health and care, a special kind of liberation becomes possible: if the person who has the problem can suddenly invent things, what becomes possible?

I’m at my first-ever diabetes convention, the American Diabetes Association’s 76th annual Scientific Sessions. I’ve written before about @DanaMLewis and husband @ScottLeibrand of OpenAPS.org, the open-source Open Artificial Pancreas System project. (Most recent was this on this site “When assets digitize, things change fast”: the #OpenAPS do-it-yourself pancreas and this amazing speech last month on e-patients.net.)

Did you know it’s not unusual for a basically health person with diabetes to die in their sleep? I never heard that until I got to know people in the DOC (diabetes online community). (Amazing what happens when you talk to the person who has the problem, eh?) That’s why I want awareness of what diabetes is, and awareness of this amazing project, to spread way beyond the usual diabetes community.

So early in this interview I ask Dana to briefly explain what the pancreas does, why it does it, and what goes wrong if it doesn’t work, which (I assure you) will lead you to understand why people with this disease might say “WeAreNotWaiting.” (If you don’t know that phrase, google it.)

Dana flashes her pocket pancreas while husband Scott grins
Dana flashes her pocket pancreas while husband Scott grins.

[Read more…]

Filed Under: diabetes, e-patient resources, Health data, Innovation, Patient-centered tech 8 Comments

June 7, 2016 By e-Patient Dave 13 Comments

Understand the Blockchain in Two Minutes: Institute For The Future

If this is the first time you’ve heard of blockchain, remember it.

If you’re like me, this will be puzzling and maybe a little bit unsettling, because people are saying it’s going to change the world, but it’s not at all clear what it even is, much less why it would change the world.

But I understand enough about it now to say (with reasonable(?) confidence) that they’re right, but it’ll be years before we all see it happening.

This is not specific to healthcare, but  it will surely show up in health information.

It’s called blockchain, and the Wikipedia article on it doesn’t help much. But that’s why I like the two minute video I found last week (above), from the Institute for the Future…. how? Why, via Twitter, of course – hat tip to @Sasanof (David Grayson) for his tweet! Please click to watch it. (Email subscribers, if you can’t see the video, click the headline to come online.)

Blockchain is as fundamental a change as HTTP and SMTP.

[Read more…]

Filed Under: Health data, Innovation, Patient-centered tech 13 Comments

June 5, 2016 By e-Patient Dave 5 Comments

“Think, think, think”: message to European Cancer Patients Coalition AGM

View mHealth presentation to ECPC Annual General Meeting on Vimeo.

ecpc logoThis is a quick first post to get this online before the meeting finishes. I hope to add more notes below.

I’m in Brussels at the AGM (Annual General Meeting) of the European Cancer Patients Coalition, an association of over 400 cancer patient organizations. They are organized, they’re methodical, they’re action-oriented, working on health policy, drug development processes, patient involvement in clinical trials, and anything else in the patient’s interest. I was invited by Mrs. Kathi Apostilidis, vice president of ECPC and a long-time member of the Society for Participatory Medicine. She is also known as a force of nature.

[Read more…]

Filed Under: Clinical trials, Culture change, Events, Government, Health policy, Innovation 5 Comments

May 20, 2016 By e-Patient Dave 3 Comments

“When assets digitize, things change fast”: the #OpenAPS do-it-yourself pancreas

Dana Lewis on stage at O'Reilly
Click image to watch video on the O’Reilly site

For some reason I’ve spoken about this a lot in speeches for more than a year but I haven’t blogged about it. The time has come.

One of my sayings in Let Patients Help is a lesson we learned in graphic arts, and the music industry learned too: “When assets digitize, things change fast.” This is, truly, an extraordinary example.

Some people with diabetes pretty much do as their doctors tell them and the industry tells them – they wait and hope that things will get better. That’s fine with me – I never say that people should be more like me. But when someone wants to take a more active role, I believe society (including medicine) should not stand in the way: let patients help improve healthcare.

[Read more…]

Filed Under: e-patient resources, Events, Health data, Participatory Medicine, Patient-centered tech, Patient-centered thinking 3 Comments

May 18, 2016 By e-Patient Dave 5 Comments

“The Patient’s Perspective – medicine’s new true north” – essay in PLAID diabetes journal

PLAID Journal coverFor the past year I’ve mentioned this in speeches, but I’ve never written about it here:

In November 2014, a routine blood test revealed that my hemoglobin A1C was slightly elevated, making me what they call “pre-diabetic.” (See lab results below.)

Well, that got my attention.

Why? Because, through social media, I know a lot of really smart, articulate, passionate members of “the DOC” – the diabetes online
community – and I’ve learned all kinds of things about the reality of diabetes that you don’t see in the TV commercials.A1c screen capture

I’ve learned that it’s not rare for a basically “healthy” person with diabetes (PWD) to die in their sleep when their blood sugar crashes; I’ve learned about unfixable nerve pain and amputations; I’ve learned about all kinds of things that can go wrong when diabetes gets out of control. I don’t even know enough to make a properly prioritized list, but I know enough to say you do not want to have diabetes if you can avoid it.

(Footnote: it drives many of us nuts when a TV commercial or news story talks about “diabetes” as if it were one thing. It’s not. Type 1 diabetes (T1D) is medically different from type 2 diabetes (T2D), which I am at risk for; it typically arises in middle age, but has been seen as young as age 3. “Diabetes prevention” is an ignorant thing to say: Type 1 can’t be prevented, Type 2 sometimes can. But that’s a rant for another day.)

[Read more…]

Filed Under: Culture change, diabetes, Leadership, Participatory Medicine, patient engagement, Science of Pt Engmt Tagged With: diabetes, patient empowerment, pre-diabetes, thomas kuhn 5 Comments

May 16, 2016 By e-Patient Dave 10 Comments

What questions should researchers ask about “the weekend effect” in hospitals?

Death rate for stroke patients (red line) is worse as nurse coverage shrinks
Death rate for stroke patients (red line) is worse as nurse coverage shrinks. From wikipedia.org/wiki/Weekend_effect May 16, 2016

Update: I’ve changed the headline, because people kept answering the wrong question.:-) The right question is here:

Attention patient voices around the world: what questions should researchers look at to see if there is a difference between weekend and weekday services in hospitals?

In the UK a major debate is underway about the weekend effect in hospital services: are they less safe, how are they different, etc?  The image at right, from Wikipedia, is one example: the red line shows that death rate for stroke patients improves dramatically when nurse coverage is not close to zero.

I’m on the BMJ editors’ patient panel, and Rosamund Snow, the BMJ’s patient editor, points out that from the patient’s perspective there’s a lot more to look at than death rate.

That’s a pretty crude measure of whether a hospital’s performance is affected, eh? “What are you complaining about? She didn’t die, did she?” What about things like falls, medication errors, access to needed surgery, and on and on and on.

So Rosamund has decided to seek patient thoughts on the subject, hallelujah.

Of course UK experience is important but what are your experiences in any country? Mostly we’re seeking patient experience, but physician experience in other countries could be useful, especially if a system made a change that created a clear difference, better or worse. Both data and anecdotes are welcome.

Most important, though: What questions should researchers look at to see if there is a difference between weekend and weekday services?

Filed Under: Health policy, patient safety 10 Comments

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