Ticr - December 2009

November 2009 Vol. 1 Issue 8

TEKTIC HOLIDAY WRAP:

WHAT DO THESE ICONS REPRESENT?

IN THIS ISSUE:

Page 2 -FOREWORD FROM THE STEERING COMMITTEE - Page 3 - TEKTIC UNWRAPPED - Page 4 - INTERVIEW WITH DR.ANTOINE GUIESSBUHLER - Page 6 - NEW MEMBER PROFILE: YOLANDA LIMAN - Page 7 - NEWS in eHEALTH - Page 7 - CLIP OF THE MONTH - Page 7 - THE 2.0 FACTOR: MUSINGS OF A HYPERCONNECTED WORLD - Page 7 - ELLUMINATE - Page 8 - FOCUS OF THE MIND: WHEN MEDICINE GOT IT WRONG - Page 8...

The TEKTIC Steering Committee would like to wish everyone Happy Holidays. It is our hope that during this holiday season, you will have the opportunity to sit back, enjoy the company of your friends and loved ones, and reflect on what a great year 2009 has been. Similarly, this theme of reflection is also echoed with this issue of the TICr as we will be looking back at what we have accomplished as a group in 2009 and where we will head in the coming year. The cover illustration (right) is a representation the key themes that appear in the projects we have undertaken since the conception of TEKTIC three years ago; more specifically, these icons represent the 8 top used words that have been used in our projects. These words resonate what we have set out to do. Can you guess what the 8 images represent? (see answers below) Have a Great Holiday Season and see you in the New Year! Answers from Left to Right: Health, Collaboration, Knowledge Translation, Evaluation, Innovation,Information and Communication Technologies, Information, Community

TEKTIC Unwrapped

By Jennifer Cordiero & Andrea Polonjio

Over the past four years, TEKTIC has developed from grant proposal on paper to an active research collaborative. Made up of academics, health professionals, educators and policy makers, TEKTIC has contributed to B.C.’s eHealth research landscape in numerous ways. In this article, we reflect on the past few years to highlight what we have done and where we might go.

Membership: TEKTIC’s membership represents a diversity of perspectives and professional training. Original members came together to build a strong human infrastructure to house and support TEKTIC’s multifaceted research program. There were 16 founding members with expertise is technology-enabled knowledge translation (TEKT), health informatics, eLearning and education, Aboriginal health, pharmacology, interprofessional practice, and eHealth policy. Over this past year TEKTIC has welcomed new members into the group. The new members have been co-investigators working on TETKIC projects, partners interested in becoming more involved and students working with TEKTIC researchers. In

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total 13 new members have been introduced to the TEKTIC group resulting in new partnerships and exciting ideas.

Research Projects:

As a research unit, the foundational base of TEKTIC has been developing projects within each of its objectives: ‘humantechnology interface’, ‘technology demonstration’, ‘research synchronization‘, ‘eHealth evidence based policy translation’ and ‘capacity building.’ Over the past four TEKTIC Call for Proposals, 34 individual projects have been supported. Many of these projects cut across the five TEKTIC objectives and have spurred new directions. In the work done over the past three years, the two new predominant themes to emerged in this portfolio are: 1) engagement with the public and Aboriginal communities with regards to awareness of health issues and the use of information communication technologies (ICT) in the area of health care, and 2) the use of electronic communities of practice for purposes of collaboration between health care providers, health authorities, medical students, and academics.

Communication and Knowledge Sharing:

In Year 3 time and effort was dedicated to start sharing some of the work our members had been doing over the previous two years. In January 2009 we hosted our first of a series of regular online presentations highlighting TEKTICfunded projects. Supported by Elluminate, these online rounds were open to all members and external partners. Each session opened with a 20 minute presentation followed by a discussion period involving the audience. Session attracted between 7 – 21 participants. Keep an eye open for new details about the upcoming session in January! The TICr was also introduced in Year 3. This online TEKTIC newsletter has become a strong communication piece for both TEKTIC members and external partners. Profiling projects and new members, along with articles and YouTube clips of the latest eHealth trends, the TICr has quickly become a legacy piece for TEKTIC, providing a snapshot of what we are doing month-to-month.

Solid Directions and Next Steps:

And, as the TEKTIC funding period comes to an end, there is still a lot of activity going on. In the next few moths as wrap things up, we will be focusing on publishing pieces from some of our past accomplishments and looking toward the future. We thank you for coming on this journey with us and look forward to where we end up next!

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I completed my medical studies and my specialization as an internist, I was able to combine my medical experience with my computer skills in order to develop tools that aim at helping clinicians and patients improve the quality, safety and efficiency of care. What was defining moment in your career which led you to where you are today?

Why eHealth/Health Informatics? How did you end up working within this area? I have been punching computer cards since I was a 13 year-old nerd, using computers as tools to learn and develop activities that could not be done otherwise, first in astronomy, then in computer games, word processing, and medical imaging. Eventually, once

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Working as a young physician in a clinic in the slums of Calcutta, in India, and being exposed to the reality of the world for a majority of the humanity. Do date, what do you consider your biggest professional accomplishment? In the 1990’s, the development and deployment of the WizOrder computerized provider order entry system (CPOE) at Vanderbilt University Medical Center. In the

2000’s , the creation of a large SouthSouth network for distance education and telemedicine for hundreds of care professionals throughout Frenchspeaking Africa, with the RAFT network. What was your biggest professional hurdle? Having to learn, without training, to manage a multidisciplinary team of 100 professionals in charge of designing, developing, deploying and supporting the medical information systems at our 2’200-bed Geneva University Hospitals, and all the politics that comes with it. Somehow, this is not what you learn as a physician or as a software engineer. But it can be fun... If you weren’t a researcher/ physician/ educator, what would you be/ what profession would you be in (ie, what are your other areas of interest)? An ethnographer or a photographer, travelling around the world and getting to meet different people and cultures. What is your one (or two) favorite technological development from the past 10-15 years? Mobile connectivity is really changing the way we can use information technology, and enables new forms of what I call “man-man-machine” synergies: fostering better interactions between groups of people and computer-based systems, delegating to these systems what they do better than humans.

Where do you see technology fitting in with healthcare 20 years from now? Technology will be everywhere and will have therefore disappeared. Many of the healthcare transactions will be dematerialized, hopefully leaving patients and care providers able to focus on what technology will never be able to provide: empathy, common sense, and good clinical practice. Tell us about RAFT. In 2000, I was invited by medical students at the University of Bamako, Mali, to brainstorm about ways to de-isolate care professionals sent in the remote areas of the country, disconnected from their professional networks, and unable to continue learning and get support for dealing with difficult cases. The idea to use the internet, then just arriving in subSaharan Africa, became obvious. The network is now deployed in 15 countries in Africa, providing weekly continuing education sessions that are followed by hundreds of care professionals, many of which in remote

What was your first job? In the mid 1980’s, working on an early and somewhat clumsy PDP-based word processor, as a junior software engineer for the now defunct Digital Equipment Corporation, in their fabulous research center in the French Riviera.

areas, sometimes from a small cybercafé. obvious that web users would need Most of the courses are now produced some guidance in order to sort out and webcast from Africa, by experts the good from the bad and the ugly in most of the major universities and on health and medical websites. The teaching hospitals. Teleconsultations HONcode was then created: a label enable isolated care professionals to attributed to websites that respect eight access virtual communities of experts ethical criteria, which, when all present, to help solve difficult cases and make increase the trustworthiness of the better clinical decisions, and helping to information. coordinate the evacuation of patients With 6’500+ websites accredited, and towards reference hospitals. various tools to improve access to We aim at scaling up the project and trustworthy medical information in deploy it in many of the 1000+ district 100+ countries and 30+ languages, hospitals throughout Africa, in order to HON has become the major player further support and de-isolate the care in promoting good practices for the professionals, and bring innovative tools publication of health information, as an to better support clinical practice (e.g., international NGO, and now mandated portable ultrasonography with remote by some governments to perform supervision), and also, in collaboration nation-wide accreditation campaigns. with the World Health Organization, With the development of Web 2.0, new to develop public health activities in challenges arise and the tools developed order to better coordinate preventive by HON are evolving to meet them. At medicine and coordination of care. the same time, HON is tackling issues What about HON? related to globalization, by creating outposts of its activities, in French- and The Health On the Net foundation was English-speaking Africa and in Arabic created in the early days of the Worldcountries. Wide-Web, in 1995, when it became

If you were stuck on a desert island with only three things (inanimate objects), what would they be? My cello, and one of these solar-powered satellite internet link that we deploy in rural Africa.

PC or MAC? Agnostic. Whatever works best for a given task.

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New Member of the Month:

YOLANDA LIMAN

Yolanda earned a Master of Arts in Environmental Studies from UBC and a Bachelor of Science in Microbiology and Immunology from McGill University. Her interests include working with rural and Aboriginal communities to: improve their access to relevant, culturally appropriate health information; application of research findings towards improving social determinants of health; and promoting community-university partnerships to improve health education. Yolanda is the Aboriginal Community and Engagement Coordinator at the UBC eHealth Strategy office. The focus of her research is on improving Aboriginal health through the exploration of technology enabled education and community engagement. Specific topics of interest include cross-cultural knowledge exchange between academia and communities, capacity building for digital literacy, research skills training, and youth engagement. The Ktunaxa Community Learning Centres (a TEKTIC funded project) is one of the cornerstone projects under her portfolio. This project explored how technology can enhance rural, remote and underserved populations. The findings of this project have brought a different perspecitve and have informed many TEKTIC and UBC eHealth Strategy Office initiatives.

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CURRENT EVENTS

How Your Cell Phone Can Diagnose Disease To picture the next-gen microscope, don’t picture a microscope at all. Aydogan Ozcan, an assistant professor of electrical engineering and member of the California NanoSystems Institute at UCLA, is adapting cell phones to sample biological images. This is no iPhone app. Ozcan, who formed the company Microskia (on the heels of the UC Berkeley team that developed CellScope), has built a prototype whose cell phone camera sensor can detect a slide’s contents at a cellular level--reading, for example, an increase in white blood cell count that might indicate a new infection or injury. That information can then be forwarded wirelessly to a lab or hospital. The brilliance of Ozcan’s design is that magnification is done electronically, requiring no lens. (CellScope, on the other hand, takes a more conventional approach as a miniature microscope with expensive lenses.) Ozcan simply added LEDs to the phone, and those diodes direct light over the sample, which is analyzed in front of the camera sensor. The resulting hologram is recorded by the camera as a collection of pixels, and can be reconstructed through Ozcan’s software into highly detailed images. The applications for this kind of affordable and mobile device abound. Screening for malaria is a big one, or monitoring someone’s white blood cell count throughout chemotherapy.

Viruses such as HIV and H1N1 are currently too small to detect at this point, Ozcan told me by phone: “They are so small compared to the wavelength of light that their scattering is not going to help. But there are ways to get around this through optics, that we are working on.” When the technology does get there, he says, you could “photograph” your own nasal swab, upload it to a Web site that compares images for diagnosis, and know whether you have the flu without ever leaving bed. Because let’s face it: the last place someone with a compromised immune system should be is a crowded emergency room.

Source: http://news.cnet.com/8301-27083_310393466-247.html

CLIP OF THE MONTH

Have a Holly Jolly Christmas!

Source: http://www.youtube.com/ watch?v=NywZ70yqtp0t_from=PL&index=5

THE 2.0 FACTOR: Musings of a Hyperconnected World

by Francisco J Grajales III Topic: mHealth or Telehealth: nexus of the future

One of the biggest perks of being hyperconnected is experiencing technologies before they massively pick up (or fail!). Last month, I had the privilege of attending the ITU’s* World Telecom Forum and Expo in Geneva ( http://bit.ly/zpKIi ). Held every three years, this event (twitter hash, #WTC09) is the largest ICT multilateral stakeholder trade show in the globe. For gadget lovers, you could find anything from Saudi Arabia’s date yummy-looking USB sticks, to city-wide wifi infrastructure plans, or 4th Generation (4G) and 5G biodegradable mobiles. These phones are the future of medicine, the nexus of mHealth and telemedicine. Here is why... At present, both developed and developing member states have a shortage of healthcare workers, particularly in rural areas. With low access and mobile penetration rising at an unprecedented rate, these next-generation gadgets provide the key to telehealth delivery- bidirectional video broadcasting (5G allows high definition video). Long gone are the days of the purse-size mobiles; these slick connectivity pieces, come in waterproof, solar-cell-embedded models where 10 minutes of sunlight will get you 1 minute of talk time. If I asked how to use YouTube, you would probably answer that it is as simple as googling** an artist. Now, imagine a rural village in Malawi or the Yukon. With the right infrastructure, and the eminence of the late start, we can have illiterate, untrained personnel, learn and perform procedures with instructions from a different continent. As if that was not enough, 10 dollars of hardware can provide a no-lens light-microscopy kit*** that allows the phone’s built in 8 megapixel high-resolution camera to recognize pathogens or even, with remote assistance, diagnose malaria, anemia, or TB on the spot. Where to next? Our imagination is the limit! Sadly though, healthcare delivery is not only about the technology, it is about the strategic deployment of ICT. * ITU stands for the International Telecommunication’s Union. The United Nation’s body responsible for telecommunications, electromagnetic spectrum and standards, www.itu.int . ** In case you were wondering, Googling is a verb in the Oxford English Dictionary. *** Far from Lab? Turn a cellphone into a microscope NYT 2009-11-07 http://bit.ly/25TgTE Note: If you have comments or suggestions, please visit http://e-publichealth.com and leave a note :o)

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Would you like to have your project profiled in t h e T I C r, present your project at an upcoming Elluminate session, or have an announcement to make? Please email Jennifer Cordeiro at [email protected] for more details.

Check the January TICr or www.TEKTIC.ca for the Next Elluminate Session!

Frames of Mind is a monthly film event founded by Dr. Harry Karlinsky, TEKTIC member, utilizing film and video to promote professional and community education on issues pertaining to mental health and illness.

When Medicine Got it Wrong Wednesday, December 16, 2009 - 7:30pm

USA 2009. Directors: Katie Cadigan, Laura Murray VANCOUVER PREMIERE! Director Katie Cadigan’s name will be familiar to longtime “Frames of Mind” patrons from People Say I’m Crazy, a film about her brother’s struggle with schizophrenia, which we presented in 2004. Her heartbreaking encounters with elderly parents after screenings of that earlier film prompted Katie to make When Medicine Got It Wrong, a hard-hitting documentary providing historical context for our contemporary mental health care crisis. In 1974, when it was still accepted medical practice to blame parents for their children’s schizophrenia, a small group of parents in California were the first to publicly challenge this belief. They formed Parents of Adult Schizophrenics (a forerunner to the National Alliance on Mental Illness), and openly challenged the medical establishment to recognize the medical nature of the ailment. Their committed activism led to increased research into the physiological origins of mental illness and significant changes in how schizophrenia is understood and treated. These battles were waged during a time of deinstitutionalization; mental hospitals all over North America were being closed, but the community care meant to replace them never materialized. Many of the severely ill ended up on the streets or in jails. Although these activist parents helped build an important new awareness of mental illness, a visit to Vancouver’s own Downtown Eastside serves as a strong reminder that government and society have yet to fully catch up. Colour, Digibeta video. Post-screening discussion with Joan Nazif and Susan Inman, members of the Family Advisory Committee of Vancouver Community Mental Health Services, and Dr. William MacEwan, Clinical Professor and Director, Schizophrenia Program, Department of Psychiatry, University of British Columbia. “Director Philippe Falardeau explores detention-worthy existentialism.” - Eye Weekly “The film elicits a wonderful mix of emotions ... a poetic tale of an outrageous artist-as-a-young-boy.” - Macleans For more information, tickets, full reviews, and trailers, visit www.framesofmind.ca.

The TICr is Made Possible Through the Partnership of the Following Insitutions: