I am thrilled to share the news that I am the new Chief Technology Officer at the U.S. Department of Health and Human Services. Grateful for the opportunity to serve under the leadership of Secretary Burwell — truly an extraordinary person.
A community colleague recently asked me where he might find the latest numbers on the percentage of U.S. adults who participate in online patient communities.
In the spirit of “public Q&A” I’d like to share my answer and ask people to add tips about other resources in the comments.
Public opinion polling about a rapidly evolving field is a challenge, to say the least. We constantly talked at Pew Research about how to capture a behavior early, before it morphed into something else, and without naming a certain platform (see: The Twitter Question and Changes to the way we identify internet users.) Continue reading
We can’t let misinformation—or worse—go by without comment.
I think it’s time for more people to speak up in health care.
More pediatricians should express their measles outrage.
More people should chronicle the reality of living with chronic conditions.
What if every conference displayed it on a screen, so that every public conversation in every industry was framed by the context of the coming age boom?
What if we look at this data and ask, as Ai-jen Poo urges us to do:
What joys could getting older and caring for one another bring?
How else might we prepare?
- The Next America, by Paul Taylor and the Pew Research Center
- The Age of Dignity, by Ai-jen Poo of Caring Across Generations and the National Domestic Workers Alliance
- Valuing the Invaluable: The Growing Contributions and Costs of Family Caregiving, by Lynn Feinberg, Susan C. Reinhard, Ari Houser, and Rita Choula of the AARP Public Policy Institute
Join the discussion:
- White House Council on Aging (hosting regional forums across the U.S. and on Twitter: #whcoa)
I hunkered down at the library this week, working on a couple of long-term projects.
I kept one eye on Twitter, though, as I always do, and wanted to share what distracted — and inspired — me this week:
Radiolab: Worth — what would you pay for another month of life? How about a year? They get into the debate about Solvadi, which I find fascinating, and wind up talking to patients, “the people who aren’t at medical conferences.” Thanks to Mike Evans, MD, for tweeting the link.
Pew Internet: Social Media Site Usage 2014 — 81% of U.S. adults use the internet and, of those, 71% use Facebook, which is really pretty astounding (and is an opportunity for health intervention and support). Continue reading
Take a deep breath and then look at this data about HIV in the U.S.:
I have seen these numbers before, but never laid out so clearly and so beautifully. Thank you, Jeff Guo of the Washington Post, for breaking my heart. Thank you, because I think we all need our hearts broken anew from time to time. We need to face the reality of the epidemic. We need to look in the mirror, wipe away the tears, and see ourselves clearly in order to start making plans for change. We need to visualize health in order to communicate and pursue it.
“We’ve known for over 50 years that providing information alone to people does not change their behavior.” – Vic Strecher, quoted in a fabulous article by Jesse Singal titled, “Awareness is Overrated.”
So what will? What can make people change their behavior?
I think advice and information delivered by a “just-in-time someone-like-me” holds promise. And we have the ability to connect in our hands.
We are all asking secret questions online — even more so when we use our phones. People who search the AIDS.gov site on their phones, for example, use much more specific terms than those who search from a desktop or laptop.* Mobile seems to make things personal, immediate, and specific.
What if all the knowledge and insights being found privately could be shared more widely? Not everyone is ready to have words like “vagina” and “anal” pop up on their Facebook page, but what if there was a way to bring frank, truthful talk about sex to people’s phones, one-to-one, one-to-many, or many-to-many? What if we could unleash the power of science, storytelling, and sharing? What if we could make health information relevant, in the moment, when we need it, like a heartbeat, a deep breath, or a caress is relevant?
Who knows better than someone like me how to break my heart, make me laugh, and get me to change?
Other sources of inspiration, which I need today after seeing that data:
- Love Heals
- Harm Reduction’s videos
- Metro TeenAIDS
- Kicesie’s Sex Ed videos
- Remarks by Gina Brown of the Office of AIDS Research at NIH, including the immortal question: “When a woman stands up, which way does her vagina point?”
* Source: Cathy Thomas of AIDS.gov, at a meeting of the Federal HIV/AIDS Council in 2012.
In this talk at the Quantified Self Public Health symposium, I argue that we must respect the context of people’s lives while designing health interventions, tools, and research projects. Not everyone is ready to stand naked in front of the bright light of numbers on a screen. Let’s be gentle in our approach, especially to those living with chronic conditions or caring for loved ones.
Believe it or not, 14 years ago, the idea of using the internet for health was a novel concept. That’s when Pew Internet published its first report about the social impact of the internet on health and health care, raising eyebrows across the U.S. Our data was cited in mainstream news outlets, in JAMA, and, most important to me, drew the attention of Tom Ferguson, MD, an online health pioneer who became my guide to the world of e-patients.
I will always be grateful for the incredible latitude I was given to explore and experiment at Pew Internet, thanks to Lee Rainie and our sponsors, the Pew Charitable Trusts and the California HealthCare Foundation. We fielded six national surveys devoted to health and five major fieldwork projects in online patient communities. We were explorers in uncharted territory – areas that would become the most important real estate in the industry – and we were breaking glass on a daily basis, always trying new things. It has been my honor to translate that research into storytelling that benefits decision-makers of all kinds.
For me the new truth is that the most exciting development of the connected health era is not access to information, but access to each other. The implications are enormous for us all: consumers, clinicians, policy makers, and business leaders. The power of community in health can revolutionize the way care is experienced and delivered. It is our job as an industry to bring that to life, to legitimize and formalize the very real and quantifiable role that community plays in our health. I am called to pursue that mission. So I’m writing a book to drive the idea forward (more on that in another post) and leaving the Pew Research Center to commit to this idea full-time.
In September I’ll also start as an Entrepreneur in Residence (EIR) at the Robert Wood Johnson Foundation, the largest philanthropy in the U.S. devoted to the public’s health. Led by Risa Lavizzo-Mourey, RWJF’s focus on building a culture of health overlaps with my vision; RWJF is uniquely positioned to execute on this audacious goal.
By taking on the EIR role, I’m following in the footsteps of Thomas Goetz, who inaugurated the position and wowed us all with initiatives like Flip the Clinic and Visualizing Health. I can’t wait to get started, taking this definition of entrepreneurship to heart: “the pursuit of opportunity without regard to resources currently controlled.”
The power of community must be unleashed on health if we are to achieve the vision we all hold so dear – a world where empowered individuals and families make informed choices that result in living as well as they can for as long as they can. The wisdom people have about themselves and their loved ones is as vital to their health as the insight they gain from clinicians. Simply put, my goal is to help people understand how powerful they are.