What I learned at Health Foo

Just in case anyone is curious: my notes from Health Foo, a meeting held last weekend in Cambridge, MA. It’s long, so skim for the 9 lessons if you want a shortcut.

What: Foo Camp is an unconference, constructed on the spot by the people who show up, with just a few guidelines set out from the start.

Background on Foo Camp:

http://www.enotes.com/topic/Foo_Camp

Who: The O’Reilly team and the RWJF team collaborated on the invitation list which included a mix of gamers, clinicians, health entrepreneurs, investors, global health activists, federal and state government health officials, patient advocates, designers and [I'm sure other categories I am missing].

Background on how Health Foo came to be:

http://rwjfblogs.typepad.com/pioneer/2010/12/tim-oreilly-to-host-unconference-for-health-tech-leaders.html

A growing list of people I met who also happen to use Twitter:

http://twitter.com/#!/list/SusannahFox/health-foo

Where: Microsoft’s NERD Center in Cambridge, MA, is superlatively cool. The mix of open and closed spaces of different sizes was conducive to great meetings, chance encounters, and a feeling of possibility (including the possibility of falling down the winding staircase – look sharp!).

When: The sessions didn’t officially start until 10am Saturday, July 16, but we all got together for dinner on Friday and breakfast on Saturday morning, with generous amounts of time for socializing (like 3 hours for cocktails/dinner, 2 hours for breakfast).

My notes (warning: I listened and took a few notes but I’m leaving out huge swaths of the experience, including some people’s names, b/c I was so immersed in the Be Here Now.):

On Friday night after dinner and opening remarks (urging everyone to put away their devices, which I did) we all got a chance to nominate ourselves to lead sessions. A grid was printed on huge boards – times down the side, rooms listed across. Large post-its (about 5×8 inches) and sharpies were available. I described my session as “Peer to peer health: Harnessing the power of people who want to help themselves. How to trigger the avalanche?” Paul Levy’s blog post has some great photos of this process: http://runningahospital.blogspot.com/2011/07/health-foo.html

Two other sessions seemed similar so I teamed up with those leaders: Ron Gutman of Health Tap (a start-up by this serial entrepreneur) and Jon Kuniholm of Open Prosthetics Project (a labor of love by this retired Marine who lost his right hand in Iraq). We were originally scheduled for Saturday afternoon but I convinced them to switch to Sunday morning so I could attend a competing session (and b/c I wanted to get more of the event behind me before I led a session).

It was incredibly difficult to choose which sessions to attend. There were 5 going on at once for each time slot, the descriptions were sometimes cryptic, and I didn’t know most of the session leaders. At 10am on Saturday I ran into Linda Stone who urged me to join her in Stephen Bezruchka’s session.

Bezruchka had fascinating slides comparing countries’ health data along various lines, both inputs and outputs. He showed how personal behavior turns out to have little effect on life expectancy when you look at the aggregate. For example, Japan has the highest rate of smoking among men in the world and the U.S. has among the lowest, but the longevity effect is the opposite of what you’d expect just looking at those data points. His thesis is that the community-oriented culture in Japan has a salutary effect that we should take note of – that “caring and sharing is a social determinant of health.” People living in societies with higher rates of social cohesion – being there for one another – live longer. He sharply critiqued American society and its trend toward atomization, disconnection, and inequality. One ray of hope I tried to bring: Pew Internet’s report on social networking sites and our lives: http://www.pewinternet.org/Reports/2011/Technology-and-social-networks.aspx

(Lesson #1: Follow Linda Stone anywhere she’s going – or latch onto someone else who is saying “trust me, this person is amazing.”)

Background on Bezruchka:

http://depts.washington.edu/deptgh/map/people.php?id=3

http://www.youtube.com/watch?v=Q0X2exKyC7k (TEDx talk which closely approximates the session)

For the second session, I followed my instincts up a winding staircase to the Treehouse, a cozy, circular space meant to hold 8 people. A dozen were already inside but I squeezed in and sat on the floor, just in time to hear Eduardo Jezeirski say “nothing I build is half as good or useful as what people in the community could design.” The session was about sparking local innovation in developing countries.

A seminal example was passed around: the Jaipur foot, a vulcanized rubber foot with a stiff heel for amputees in rural India. The developers had noticed that U.S.-made prosthetic feet would break after a few months in rural India, where people walk long distances, with no shoes and through wet conditions – a completely different use case from the typical American amputee. The engineers also noticed that local people had no way to fix the U.S.-made apparatus, which requires tools and some special mechanical knowledge, so the locally-generated design was simpler and could be repaired by the user.

I was so out of my depth in this session that I can’t do justice to most of the rest of the conversation among people like Aman Bhandari of HHS and Meg Wirth of Maternova.net. However, I did take notes on an inexpensive prosthetic knee which includes a pedometer and the guts of a cellphone. It sends an SMS back to a central office with the number of steps taken that week – if none were taken, the local NGO can get in touch with the person to be sure the knee is still working and they’re OK. It’s Quantified Self for appliance maintenance, not personal fitness. And it removes the record-keeping burden from the shoulders of the clinic workers, who couldn’t possibly keep track of each prosthetic’s status.

It was an amazing session in which I stretched my mind, yet felt physically cozy, listening to quiet voices – not presentation-volume.

(Lesson #2: Pick some sessions about which you know nothing. Lesson #3: Architecture can have a significant effect on the experience of a meeting.)

Background on Jezeirski:

http://trackerblog.trackernews.net/2011/06/14/ilabs/

Background and a photo of the Jaipur foot:

http://www.goodnewsindia.com/index.php/Magazine/story/jaipur-foot/

http://instagr.am/p/Hyn0Q/

For the third session I was intrigued by the simplest post-it – something about building a human phenotype, plus a sketch of cut-out paper dolls. Spoiler alert: it was AWESOME.

I walked in to a standard-looking meeting room just as Zack Booth Simpson was diving into a demo of Traitwise.com. My choice to stay was helped by the fact that I recognized some people in the room whose opinion I trust.

I believe Traitwise represents a possible future for survey research and it was definitely the most relevant-to-Pew-Internet thing I learned at the whole event, so go now to the site and answer a few questions since it’s the quickest way to understand what it is about:

https://traitwise.com/

I can’t do justice to the discussion except to say that it sparked a lot of ideas in a lot of different sectors. For example, one person in the room is involved in epidemiology and wants to use it for the sorts of questionnaires used to track outbreaks, such as on cruise ships or among people who frequented a certain restaurant chain. These questionnaires are often long and boring: Did you eat salad? Did you eat fish? Did you eat fruit? Etc. for 120 questions. Traitwise would be able to detect patterns and correlations, sifting the common from the uncommon, and quickly serve up only the most useful questions.

I was intrigued by the way they keep it fresh and amusing, serving up random questions so people stay engaged. Traitwise notices which questions get skipped and which are popular – and then serves up that one popular question more often. Any registered user can suggest a question. People can vote questions up or down. People can rate the correlations (and to quote Zack: “causation is overrated.”)

An example of a custom health inquiry is the yes/no question introduced with the following text: “Scleroderma is a chronic systemic autoimmune disease (primarily of the skin) characterized by fibrosis (or hardening), vascular alterations, and autoantibodies. I have scleroderma: yes/no.” You can imagine how intriguing it would be for a whole scleroderma community to answer 200+ questions, including that one, and then look for correlations. Indeed, they have done so – and so has a Marfans community.

I could spend hours on the site answering questions and thinking of questions I’d like to ask. As I told Zack, I haven’t been this scared and inspired since a Procter & Gamble executive said they no longer spend money on surveys or focus groups. Instead, they “listen more than ask” and monitor the social stream. Survey researchers, get ready to re-tool.

(Lesson #4: Go into any room where Tim O’Reilly, Steve Downs, Gilles Frydman, and Farzad Mostashari are leaning forward in their chairs.)

Update: Since the above lesson is not, um, widely applicable, here’s an alternative: Design research that invites participation from your target group.

Background on Zack Booth Simpson and Traitwise:

https://www.traitwise.com/home/about_us

At lunchtime I grabbed a sandwich and sought out a group of people I didn’t know. My friend David Hale joined us and asked that we go around the circle introducing ourselves by our interests, not our jobs. It turns out we had 3 musicians, 3 dancers, and a snowmobiler!

(Lesson #5: Honor what Sara Winge said at the start of Health Foo: “You are here, not because of your job, but because of who you are” – and talk to strangers.)

As I wrote earlier, I convinced Ron and Jon to switch our session to Sunday morning so I could participate in Abbe Don’s 2-hour IDEO process demo – and boy, am I glad I did. It was exactly the kind of hands-on, brainstorm-y session I needed after a mind-bending morning.

Abbe did a quick presentation about how IDEO approaches their projects, then gave us two case studies to ponder. She split us into two teams and gave us specific tasks – write down one personal health goal on post-its and group them on a board, for example. It was so participatory that I only took one note – that IDEO asks “HMW” questions to help prompt new thinking: “How Might We…” The final project for my team was to create a visualization of health that would motivate someone to change their behavior. We had a wonderful Goalposts of Lifetime brainstorming and then cutting, pasting, taping, and drawing our way to complete “The Goalposts of Life” – a representation of 3 lives, the grandfather’s cut short by a heart attack (with pictures of what he left unfinished), the father’s (with pictures of his new healthy lifestyle and longer life goals), and the son’s (all the dreams he has for the future).

(Lesson #6: Go into any room where arts & crafts materials are laid out.)

Saturday evening featured Ignite speeches – I think there were at least 10 (probably too many, to be honest, but I enjoyed them all). It was a great way to get a taste of the range of expertise and experiences at the event.

On Sunday morning, I hosted a session along with Ron Gutman and Jon Kuniholm about peer-to-peer health and how to spark widespread use of consumer health tools. A great group showed up – probably about 20 people in a small meeting room so it had an intimate atmosphere. Since I helped lead the discussion I didn’t take any notes, but I appreciated how open people were to thinking about consumer engagement in new ways. We talked about challenges to adoption: people who are truly offline, people who see no reason to engage in their health, technology that is simply a pain to use. We also talked about enabling factors: a life-changing diagnosis that prompts engagement, mobile adoption, technology that is easy to use, communities led by people who model good behavior (such as responsiveness), wider awareness that these tools exist (either in mainstream press or word of mouth).

Here’s the gist of what I said:

A majority of U.S. adults are online, have a cell phone, are using social network sites, are gathering health information online. A significant chunk have smart phones, track their own health data, post health related material online, and look for other people who share similar health concerns.

The tools are in place. The culture is shifting to expect that people have access to information and each other. But we are still at the early adopter stage in participatory medicine. What are the elements that must be in place for this thing to break wide open?

My take-away was that I am on the right track, focusing on this phenomenon of peer-to-peer health.

(Lesson #7: Be brave. Everyone is there to contribute and even nurture, so put your ideas on the table.)

Quick sidebar on the nurturing environment: Jamie Heywood brought his adorable 8-month-old son, Miles, on Sunday and everyone took turns holding him. It was that kind of meeting.

It also struck me that the DIY aspect of an unconference creates a start-up feel – leave your job title at home, your ideas give you legitimacy. The one exception was a recurring question I heard: “Are there any doctors in the room?” I didn’t mind at first, but the question grated after the third instance. Nobody ever asked if there were any nurses in the room, or any caregivers, or anyone currently going through a significant medical treatment. Nobody ever asked if there were any designers in the room, or any investors, or anyone who had an advanced degree of some other kind. We all play a role. Why the need to call out MDs?

The pursuit of health, including the improvement of health care, is a mountain we are all climbing together. As my dad, a pretty serious hiker, always says, “The mountain doesn’t care who you are.” I felt like Health Foo was a 2-day climb of a pretty daunting mountain. Some keys to having a good time were: wear comfortable clothes, pace yourself, stop to enjoy the view every once in a while, and bring a buddy. My buddy was E-patient Dave, who stayed with me at my in-laws’ house in Cambridge – our breakfasts on Saturday and Sunday at Simon’s were among the best “sessions” of the weekend. Side note: if you are ever near Harvard or Porter Sq, treat yourself: http://www.yelp.com/biz/simons-coffee-shop-cambridge

(Lesson #8: Approach Health Foo – and maybe any conference – with humility, curiosity, and a sense of possibility. And wear good shoes.)

The next great session I attended was titled Google Health #Fail, led by Greg Biggers and Farzad Mostashari. It was a big, passionate group with lots of opinions on what went wrong, but Greg and Farzad did a masterful job of guiding us toward a discussion of what would make the next entrant get it right (“it” being personal health records or electronic medical records). Again, I listened more than I took notes, but hopefully someone else will write it up since it was a very good discussion. Here’s what I jotted down:

-          Google created a private record, which was off-mission for Google since they do a great job of connecting people and aggregating data.

-          The ecosystem wasn’t ready and Google got “big company disease” so they bailed too early.

-          There are no lightweight solutions for such a broken system.

-          An EMR is the hardest problem to tackle and the least interesting for most consumers.

-          Google failed to make it easy for people to import data and use it.

-          Useful analytics, like Mint.com’s, would have been a saving grace.

-          A counterview: The minimal use case was compelling enough – an easy way to see last year’s test results next to this year’s. Just to see the data is enough for some people.

-          Outside the U.S., EMRs and health data tracking helps trigger vaccination reminders – another simple use case that is compelling to people.

-          Google was late or unable to get the developer community excited.

-          Companies need to come to the game with someone in mind, someone whose problem you want to solve.

-          PatientsLikeMe’s 4 keys: 1) the platform has to be awesome; 2) someone has to care about the individual; 3) understand what is meaningful about the problem being solved; 4) do research, help people take action.

-          This space is not about apps. It’s about a use case, a value proposition like “this will help you save money” or “this will help avert disaster.”

-          A successful future initiative would do well to focus on babies. Pregnancy and parenthood are gateway moments in people’s lives.

-          Let the data flow and the technology will work itself out.

Health Foo ended with a demo of some toys (literally). Jose Gomez-Marquez designs medical devices for the developing world. His lab creates DIY kits for people in the field to come up with their own solutions. http://iih.mit.edu

Here’s me holding a piece of Lego which serves as a platform for modular pieces that lock into place so clinicians in the field can create custom mechanisms in seconds that in the lab would take hours to create): http://instagr.am/p/H5D1F/

Jose hacked a toy helicopter to create a nebulizer. And the list goes on. It was a fun way to end the meeting.

I ended up going for a walk around MIT with David Rosenman, Linda Avey, and Thomas Goetz, ending up at a bar to watch a few minutes of the women’s World Cup match between Japan and the U.S. We ran into Lucky Gunasekara, another Health Foo camper — another happy chance meeting since I hadn’t had the chance to talk with him during the event.

Thomas, Linda & I grabbed a taxi to Logan Airport, newly armed with one chocolate bar each thanks to David.

(Lesson #9: Keep the spirit of the event alive as long as you can.)

Anyone else want to add to this travelogue? Comments and questions welcome.

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Posted in: general | key people | medical records | positive patterns

 

 

 

Comments

26 Responses to “What I learned at Health Foo”

  1. Sarah stephens winnay says:

    Fantastic recap. Thanks for sharing the inspiration!

  2. Wow! Seems like it was a fantastic gathering! I am watching now Bezruchka TED talk – that’s amazing. Susannah, thanks for sharing your thoughts on the unconference and including tons of great links!

  3. Matthew Holt says:

    Susannah–You’re officially busted for not paying attention at the last 2 Health 2.0 conferences’s when Traitwise are on — and yes other survey software guys should be scared. (OK I know you weren’t at the last one, so I’ll somewhat let you off!)

    They’ve also developed a cool integration with Genome stuff–not sure if it was demoed at Healthcamp

    Sounds like you had lots of fun–but someone needs to tell me why this is better than a standard Healthcamp (other than it goes on much longer)

    • Susannah Fox says:

      Hi Matthew,

      I don’t mind being busted (can’t be everywhere) or being late to the Traitwise bandwagon (thrilled to have found them now). You must know by now how much I love the Health 2.0 conferences and how I count on you to ferret out and feature wonderful stuff.

      Your second point is the more interesting one to me and I’d love to get other people’s thoughts on it: Why was Health Foo so excellent? What are the elements of a great meeting?

      You are absolutely right that a standard Healthcamp can be amazing. I attended one in DC that included fewer than a dozen people but totally changed the way I approach my work. (Paging Mark Scrimshire, Ted Eytan, Jen McCabe, David Hale, Anita Samarth – you were there, too: what made that day so great?)

      I’ve also attended large, organized events (with pre-arranged agendas and websites and everything) that have been equally stellar.

      One ingredient is the conference organizers.

      Matthew, you and Indu are lovely hosts with sharp eyes for good speakers, and I’ll never forget the first time I heard AC/DC blaring over the meeting hall speakers at Health 2.0 San Diego (way back when). There was a very clear sense that this was not your grandmother’s health conference.

      BJ Fogg’s Mobile Health 2011 event is another meeting that stands out in my mind as a reflection of the organizer’s personal style: encouraging people to shine, making people smile, giving everyone permission to go up to anyone they would like to talk to.

      I could go on with what I think, but I’d love to hear what other people think makes a successful meeting. It’s in the spirit of Lesson #9, in fact, which is the most important one of all: Keep the spirit of the event alive as long as you can.

      • Re ingredients of a stellar event: I second Susannah’s comment about the organizers, especially their ability to pick a stupendous mix of people. Last year Robert Wood Johnson’s Pioneer people picked a similarly great bunch of people to observe TEDMED and discuss it afterward.

        TEDMED is vastly different from this Health FOO, but they have that in common: the extraordinary range of attendees.

        Last night I met with a couple of people involved in a different event (not sure I can say who, at this point), and they strike me as the “very-well-thought-out” stellar event types.

        Why don’t we have a Yelp-like “rate this conference” feature somewhere? There are some events I’d like to give a minus-5 to :–) in addition to the +10 for things like this.

      • Matthew Holt says:

        I all for that, so long as it’s like Vitals (and, it’s rumored, Yelp) in that you can knock off a review or two you don’t like. That’ll stop Dave from comment on Health 2.0! (just kidding….)

  4. David Harlow says:

    Susannah — Sounds like a terrific unconference, and your enthusiasm about the experience matches that of other attendees I’ve heard from. I was involved in putting together the HealthCamp Boston a while back that met in the NERD space – which is fantastic meeting space – and I’ll second your Lesson 9: Keep the spirit alive as long as you can. We sometimes see the spark of what could be when we are unplugged from the day-to-day and immersed in an unconference. Another key element is one of the ground rules relayed to me by another attendee: Nothing is on the record unless someone says: this is on the record. While I’m a big believer in livetweeting conferences and other coverage, “the cone of silence” can definitely lead to more open sharing and discussion. Thanks for sharing your experience and your lessons.

    • Susannah Fox says:

      Thanks, David – the off-the-record, pencils-down, no-recording-devices policy *was* conducive to more open conversations. But there were definitely times when I was itching to live-tweet :)

  5. Eve Harris says:

    ah, so THAT’s what a Foo is! Thanks, Susannah & commenters. I will keep reading & hopefully keep learning. Lesson #7 is key for me.

    • Susannah Fox says:

      Thanks, Eve! Lesson #7 was a big one for me. I have never been with so many people who were so game for anything. It made for a very open discussion.

      I just updated Lesson #4 to be: Design research that invites participation from your target group. It’s much more widely applicable than the dream-state of being in the same room with O’Reilly, Downs, Frydman & Mostashari :)

  6. J A Ginsburg says:

    Love everything about this (except, of course, that I wasn’t there…) Great overview, Susannah. Thanks.

    Some meandery thoughts for next time:

    Several years ago, before anyone knew from West Nile virus, veterinary pathologist Tracey McNamara badgered the CDC to keep testing, sure that their diagnosis of St. Louis encephalitis (SLE) was wrong. Her freezer at the Bronx Zoo was full of dead crows, which are impervious to SLE, but not to—as was eventually diagnosed—West Nile.

    I interviewed Tracey several times and was always struck by her clear-headedness: “If you wait for the first human index case, you’ve lost.” Well, yes, except we *always* seem to wait. Only when faced with a breaking crisis, such as West Nile, SARS or bird flu, do people start taking about “One Health,” a nod to the interconnectedness of all things.

    As I read your notes about Jose Gomez-Marquez’ stunning work at MIT, I thought, h’mmmm, I know some vets who could really go to town with that. My inner journalist “yenta” can barely contain herself: These guys REALLY need to know those guys…” Traitwise? Oh my gosh – the potential mash-ups using farm animals data and wildlife surveys…oh be still my heart.

    Not only are most diseases zoonotic (affecting several species, including humans), but the health the environment directly impacts the health of everything else (http://www.webdoc.com/documents/C4D58097-0EF0-0001-F91A-1C708DAD15B8).

    I can carry on for hours on this particular soapbox, so I’m going to stop now…

    H’mmmmm… perhaps we should talk?

    • Susannah Fox says:

      What a fantastic comment – this is exactly what I was hoping to do: spread the spark of inspiration.

      Maybe we should talk! Email for me is sfox at pewinternet dot org

  7. Susannah,
    I totally agree with you – that first HealthCamp for me was like yanking me out of the world I’d been living in for 15 years and catapulting me forward. The smaller size, engaging dialog, and the most passionate people were key, but so was the timing. I loved that most of you looked at me and demanded “you need to be on twitter” – I signed up on the spot. I remember walking away realizing, DC can be the #epicenter of healthcare innovation!

    • Susannah Fox says:

      I love that image of a catapult! People talk about breakthroughs in their thinking, or pivot points in their careers, but how about slingshot or catapult moments?

      • As someone who recently used the “pivot point” metaphor, yeah, I think catapult is more apt sometimes!

        I think I said it to you, in fact. And at the moment what I feel is indeed more like a catapult – quite uncomfortable due to rapid and forceful acceleration! :–)

        Your “climb the mountain together” metaphor, including your dad’s comment, gives voice to something I’ve observed but have never identified. Of course, at medical conferences it IS all about the doctors, commonly. But that’s starting to change – I’m at the ONC regional health IT meetings, and there is BUZZ BUZZ BUZZ about consumer engagement, “patient pull,” etc.

        You are SUCH a journalist, SUCH an observer. Thanks.

  8. Susannah Fox says:

    The direction of the discussion here & on Twitter is warming my heart. I had a few goals in mind when I decided to share my notes from Health Foo:

    1) Lift the veil. Let everyone who wasn’t there get a peek at what it was like (at least from my personal perspective).

    2) Create an inspiration contagion. There were so many sparks flying, why not let them set some new fires? Hence the links to more info about a few session leaders I really loved learning from.

    3) Let people know inspiration can happen to them, too – today, tomorrow, anytime. It was an awesome meeting, but it wasn’t The Awesome Meeting. There are other great conferences, incredible meet-ups, chance encounters. That’s why I think Lesson #8 might be the most important and I like Roni Zeiger’s re-wording: Approach every day with humility, curiosity, and a sense of possibility.

    Be ready for the pivot – or the catapult.

    When I tweeted about this, I got some great answers:

    Andre Blackman (@mindofandre): attending APHA/SOPHE in 2004 solidified my jump into public health

    Elizabeth Buie (@ebuie): Yes! First “Human Factors in Computing Systems” conf., Gaithersburg MD, 1982. Start of CHI series. Light bulb went on for me!

    Khadijah M. Britton (@KMBtweets): #140conf and a convo I had with @LizStrauss, yes!

    Anyone else got a story to share about a meeting that changed their approach, gave them new direction?

  9. [...] What I learned at Health Foo | e-Patients.net RT @LindaStone Excellent summary of #healthfoo by @SusannahFox; thanks @sarawinge @timoreilly @pioneerrwjf @paultarini [...]

  10. [...] Fox’s entertaining travelogue about what she learned at Health Foo, an unconference held last weekend, first led me to Traitwise – a survey tool aimed at [...]

  11. [...] post is patterned on a similar post penned by Susannah Fox ( @SusannahFox ) after the first HealthFoo in 2011. She lays out the origin [...]

  12. Do you know if video or audio of the sessions are available? Thanks for all the useful information/suggestions and those links.

  13. [...] we had some great discussions. For a sense of the first and second Health Foo unconferences, see Susannah Fox’s and Ted’s posts on 2011 and 2012, [...]

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