Lessons, home runs and more from Mobile Health 2011 (Stanford)
‘Speakers, What’s your home run? Tell us in 24 seconds, the clock starts now!’
That was how it started. BJ Fogg, who describes himself as an ‘innovator, social scientist and speaker’ played the role of conference host with wit, poise, persuasive technique and ease. He has an immense presence in the room and takes to the stage like a well-rehearsed game show host (but with more serious intent). It all added to what was to be an engaging, eclectic mix of the best of health and mobile technologies.
With 60 speakers in total (and myself being one of them), it’s impossible to mention everyone, although each deserves recognition; it’s a rare thing to go to a conference and feel as if you have learnt/gained/were thought provoked by every speaker on the stage. This conference did just that.
Following the ‘home run’ sequence and further amusing and wise words from BJ, Susannah Fox (Pew Internet & American Life Project) and Patty Mechael (Columbia University) opened the day. As usual, Susannah fed us fascinating figures from Pew Research Institute. The message from Susannah (and backed-up by Patty) which = home run No. 1, ‘bring data, bring my data, bring others data’, and so that thread continued to course it’s way through the next 48 hours.
The sessions were broken down in to panels of 4 speakers, each with an eminent moderator. With great restraint I’m going to (try) to highlight one speaker from each of the panels and my ‘home-run’ from each section.
#1. What Really Works in Changing Behavior.
Jennifer Shine Dire (AKA #Endogoddess), from Ohio State University College of Medicine. described her use of text messaging to improve patient adherence to diabetes management.. A case study (n=3) of text message support showed not only improved self-reported compliance but also a significant drop in HbA1C, a real health outcome.
Home run = the importance of the doctor-patient relationship at the out-set, this strong bond adding to the weight of the text correspondence.
#2.What Really Works in Using SMS to improve Health.
Fred Muench, Mobile Health Innovations inspired us with some great work surrounding the use of text messaging and substance use. His suggestion of patients writing their own text messages to use later in times of temptation, really made me think about how we could possibly get around issues of confidentiality and concerns about parents/family seeing messages on patient cell phones.
Home run = how about getting our own patients to write their own birth control reminders?
#3. What Really Works with Multi-touchpoint Ecosystems.
Roni Zeiger’s (Google) baby, ‘The Body’ works for me! Amazing 3D interactive anatomical model. Having spent 2 years of my undergraduate years in the sickening formaldehyde stench of cadavers, the body is a refreshing and seemingly easy to use tool. I loved the examples of its use both in an educational setting as well as medical. This was not Roni’s only appearance. He moderated other sessions and joined with BJ in imparting some wise words.
Home run = write ‘the body’ url on patient prescriptions.
#4. What Really Works in Mobile Health Partnerships.
This session was a tricky one for me to digest. As a Health Care provider in a non-profit setting it’s something I have thought about but shunned as I feel the equal partnership is problematic. What have we to give back?
I loved the softly spoken words from Josh Nesbit, Medic Mobile, and was absorbed by his description of the lengthy, cumbersome process of getting a clinical trial off the ground. I had great empathy with this. He did show that a non-profit partnership can work if you are prepared to be persistent (his field-worker persisted with ‘Orange’).
Home run = know & trust your partner. Slightly wobbly? Find another one.
#5.What really works in Public Health.
Sharon Bogan, Public Health, Seattle & Kings County opened with a clip from Monsters Inc and the Roz figure, the all to familiar bureaucratic “monster’ who pops up in most institutions. She talked us through the barriers and hurdles to jump when attempting a public health intervention using text messaging. I felt myself nodding in recognition far too many times.
Home run = Keep going! You are not alone.
#6. What Really Works in Methods & Measures for Research & Evaluation.
Ida Sim from the University of California spoke sense and gave us some practicalities of conducting research in the mobile health setting. She also left us with some great resources: http://openmhealth.org
Home run = ‘crowdsourcing for outcomes’, what do patients really care about?
#7. What Really Works in Hacking Mobile Health.
I’m breaking my rule here…I can’t only mention one of these guys. This was both entertaining and engaging, with a real novelty factor. For a few minutes we were taken away from the conundrum of data collection and analysis and opened up to a world of the playful use of web based tools. Aza Raskin, Massive Health , demonstrated with a slick presentation, the broken feed-back loop which underlies the mechanism of learned behaviors. How do we use interventions to complete that loop?
I was intrigued by Brian Kerjcarek’s presentation of the work from Green Goose . The use of feedback sensors to monitor what people do. He showed us how it worked by demonstrating brushing teeth, throwing balls and taking pills. Pretty awesome stuff and got me thinking.
Home run = think about what interrupts the feedback loop and build your innovation around that
#8.What Really Works in Changing Behavior: Commercial Impact.
Again there was a ‘wow’ factor in this session. However it was a fellow Brit who stole the show for me. Jonathan Attwood, Zamzee, described the use of a gaming tool to increase movement by winning points. The gadget has been trialed in 9-15yo from low SES and they found that they increased there walking by us much as a marathon a month. As I have recently been struggling with conceptualizing a technology-based intervention for the clinic population, I got this… and it made me think of a possible solution, learnt form a previous session…
Home run = partnership with Zamzee (?!?). We have the perfect population to see if it really works!
#9. What Really Works in the Business of Mobile Health.
The final session, always a tricky one. But the panelists carried it off with aplomb. And as BJ pointed out, more than 300 people remained in the room. My mention has to be for Eric Leven, RipRoad, the guy responsible for bringing Text in the City in to fruition. He gave a magnificent closing presentation describing his journey from American Idol to health related text messaging, illustrating it with business models along the way. Thinking of ‘Text in the City’ as a business model is quite alien to me (I do not have a business mind), but it made sense in many ways.
Home-Run = I need to look at the cost effectiveness of our up and coming text message appointment reminders
That completes the panelist sessions. But I can’t finish on #9.
#10.In addition to scheduled speakers there were some last minute walk-ons and one particularly resonated with me.
Steph Habif, and ‘check bread’. Before I first started 'Text in the City' (and one of the reasons why I did start it), patients would text me following a clinic visit. For one or two of the more vulnerable patients I would continue a dialogue and check in with them once in a while to make sure things were going ok. Steph talked us through a live demonstration of this on her iPhone; an obese patient who she supported (as a health behavioralist) as she struggled to eliminate bread from her diet as well as negotiate some difficult family relationships.
Home run = simple works, do we need RCTs to tell us this?
Huge thanks go to all the people who made this conference possible. From the incredible line-up of speakers, to the ‘down to the minute’ time keeping, to the great food. The devil was truly in the detail. This was obvious.
BJ’s winning recipe for succeeding in mobile health? Keep it simple, social and fun. Perhaps he applies this to other things in life and it was this recipe that made the whole conference a resounding success. Looking forward to mHealth 2012!
