M Health Summit 2010 Washington DC – Day One

I’ve just got back from a research trip to the m Health Summit Washington DC put on by National Institute of Health (NIH) in collaboration with the mHealth Alliance. Unfortunately, Obama was out of town in Indonesia and South Korea, but I managed to enjoy a glimpse of his ‘grounds’ during a couple of early morning runs…

The m Health summit – no doubt with great assistance from the UN Foundation partner of the m Health alliance – set a noble tone for the mobile healthcare movement. Scott E Campbell, Executive Director and CEO, Foundation for NIH and David Aylward, Executive Director, mHealth Alliance, introduced the event in celebratory style congratulating the culture of collaboration prevalent in mhealth. They announced an ideas sharing forum in the HUB – healthcareunbound.org where people can register and reach out to one another avoiding the common mistake of ‘re-inventing the wheel’ in this unchartered territory of technological and healthcare innovation in it’s most exciting and fruitful time.

In addition to the GSMA as a new mHealth Alliance member, Hewlett Packard signalled a shift  – it has just signed as a new member to the mHealth alliance in a two year, $1 million aggregate donation to help improve health care and health systems. mHealth is now beyond mobile operators and NGOs and has entered the realm of the big systems integrators, computing powers and the cloud.

Other symbols towards mHealth uptake include an increase in mobile phone related projects by the NIH, with $36 million allocated in 2009.

Todd Park, Chief Technology Officer, US Department of Health and Human Services…

Todd Park gave a fantastic keynote , delivered with electric energy and excitement on the potential of mobile in health. He set the tone by mentioning Text4Baby – a 3 year SMS reminder and prompting service for new mums in the US, and the largest m Health service in the US with other a 100,ooo subs and rising following its launch only this year. Text4Baby received a lot of attention throughout the event – it functions as a collaborative model with all CTIA carriers, and a multitude of maternal private clincs working together to provide the free service. It captures the imagination because people can relate to it, it is a simple service, but with direct hopeful behavioural changes for both mothers and the ongoing healthiness of the newborns having been given the best start.

Park went on to tackle the current unsustainable measurement of healthcare provisioning in the US – based on volume of patients seen, rather than the inherent value of health treatment provided – in terms of the patient and to the overall system in limiting re-admissions. Incentivising financial systems is key and I was hard pushed to find someone who thought that the removal of the 30days obligatory cover for re-admissions, now paid for by the hospital/State, was a bad thing – as it suddenly puts a real financial incentive on administering care which has a long tail view.

Next was data liberacion! Park’s open health data campaign which sets up free online data and total IP ownership of this data, so that those who – Important! – opt in, can allow third parties to develop innovative solutions around this data. One example being the Blue Button Veteran scheme which allows veterans to access their PHR’s easily and intuitively. This scheme was decided upon and rolled out in less than a year, perhaps disproving the groans that regulatory frameworks and approvals are stagnating product development in the longer 5-10 year framework. One can’t help thinking that these systems must now be put in place, so that the patient has a choice between ‘public’ open data platforms for PHRs and those from Google and Microsoft becoming the standard…..thoughts on this?

Next up was a panel discussion on Cross-Sectoral Perspectives on MHealth

I thought that Sangita Reddy, Executive Director, Apollo Hospitals Group, India set it straight when he immediately discharged the idea of developing and developed health markets and economies, stating that India is one of the highest growing markets globally with a 7% healthcare tourist penetration. It did seem apparent that ‘developing’ ‘developed’ was still in terminology much more in the US discussion, and when one astute audience commentator asked whether the introduction of smartphones in mature markets would make obsolete handsets putting health in the hands of those less fortunate many speakers seemed at a loss.

Sanjay Kaul, Business Unit Multimedia, Ericsson put a commercial spin on things when he stressed the need to find sustainable business models (one of the key themes of the event) making mobile healthcare more than pure philanthropy or CSR. Mwenda Mwensi – a leading mHealth figure in Tanzenia stressed the importance of cell phones to feedback 20x more data and more accurate data than paper based field studies – something mimicked in ‘anonymous’ SMS campaigns for with HIV or other disease sufferers providing more honest data via a device as mediator platform.

David H Gustafson, Director, Center for Health Enhancement Systems, University of Wisconsin was pure joy providing sentient and sensical soundbytes and humour throughout a sometimes misguided panel – someone at his age, 234 he said!, had difficulties with touch screens because of shakes, or keys, because of vision impairment – UI at source is key to improving this.  (The exact sentiment reached this side of the Atlantic in September at our Industry Summit). Iconic languages can help where illiteracy is a consideration, and greater education of new systems – including getting physicians involved in work flow changes – is integral to success.

Futhermore trust needs to be established – will this device do me good or do me harm? How can we stamp approve medical apps? And if networks are going to take on this service – with medical sensitivities – then perhaps the service obligations of the carrier is suddenly entirely different and includes safeguarding of life inherently?

After a spot of crab cakes for lunch with a dear MVNO associate nearby, I stopped at another panel discussion on The Business and Economics of mHealth – something central to us all.

Patient-Centric Models are the buzz word, but what does that mean? Well apparently to the panel:

1. To help people live a healthy life  – wellness and prevention

2. To help people get healthy and recover

3. To help people exist with a chronic illness

Frederic Zussa, Director, Worldwide Strategy and Innovation at Pfizer said that the power of ICT should be to increase productivity of healthcare, and that technology should not be siloed as a barrier to this. Peter Drury, Cisco agreed identifying the problem of healthcare as stands as Siloes, Systems and States – with disruptive innovations like m Health going a long way to opening up the market to the disenfranchised in the same way as mPayments has done in Kenya.

First Day Summary:

‘ Global is not the opposite of domestic.’ Julio Frank, former Minister of Health, Mexico

Trust is essential

How to get clinical tests to commercial quickly?

Getting to Scale

Sustainable Business Models

Patient Centric Models

Does mHealth prolong poor life quality for the disenfranchised and the Chronic?

new blog link

just to let you know i have a new blog at http://grannymeowstories.wordpress.com/

thanks x

Sunday April 25th – MARATHON DAY

I can’t believe i’m writing this final entry! Most of you reading this already know how things went, but there may be a few people with only an inkling of the truth so here i’ll give a summary of what is an amazing experience and a set of memories to last forever…brilliant gruelling best-of-people times! 

Anyway, to start at the beginning… 

After much nervous consternation over what was an appropriate time to wake up and leave the house, I eventually woke up about 6.15am (although I  basically lay still and awake in the middle of the night at various stages listening to buses and birds and staring into middle space). 

Mumma Powell had done the trick the evening previous with a MASSIVE serving of spaghetti bolognese and some fruit pie (which I shuffled around my plate in a nervous confusion). We all sat around and ate off of the table previously owned by my old Great Grandmother – Tilly Todd – which has latterly come into my possession and is my newest bit of furniture in the flat. (I am now up to bed, table, chairs and soon to be ‘sofa bed’).  My Ma, Pa and John all got quite tipsy whilst i supped lucozade like a surrogate lamb bottle-fed milk before its short marathon of life, [straight to the butchers]. My Dad talked about playing cards with my great gran around the table in previous eras and also expanded on his theory of Asda’s dairy-produce section, which was very nice of him. John went for the disgrace of simultaneous Greenwich foot tunnel closures. Mum went for the ‘It’s not a race, just do your best’. I went for bed. 

11.30pm ‘WHERE’S MY SPORTS BRA!?‘ 

Usual organisation.  

In the morning I felt rested after a nice bath in the evening before. I was excited to get involved and received loads of text message support – thanks! 

 

I think my Dad had been awake for approximately one second when this picture was taken

Nervous posing

Dad dropped me off at Stratford station, before which I bellowed enthusiasm at anyone with a red marathon bag – my first of many bellows throughout the day! By the time i ascended the Stratford escalators I was very nervous again- I got on the tube, which was packed, and worried about the time ticking away. The carriages were a heavy mesh of amateur athleticism – bodily odour and bananas. 

Got off at Stratford, and my theory was affirmed by this pleasing site! 

NANAS

Had a bit of pre-chat tactics with Granny Meow and then walked up Greenwich hill to find the lovely John had made it over to see me off!! 

hatted boy wonder

Said goodbye and hopped straight into the toilet queue. The ‘red start’ was a heady directional melee of readiness for starting  – people queuing for the toilet, people queuing to hand in their bags, people stretching in bin liners, people putting on their fancy dress costumes, and seemingly everyone asking 

‘Is this your first time?’  

Luckily, a lot of people answered ‘yes’ which led to some hurried back patting and good lucks. After some intimate portaloo time, consideration of the rain conditions, and handing in my stuff, I managed to catch Matt on the phone to say a quick good luck and go get em and then all my nervousness was dispersed by the sight of this man, 

roar

dressed as a roaring tiger, surrounded by several other men in kilts and a scottish ‘weathered lady’ repeatedly saying 

‘Do ya think they’ve gaawt art oonder thar??’ 

I never did find out but, eventually, after lots of panicked scrabbling  I managed to get to pen 5 in the red start and find my way to the front. 

The view

I knocked back a bag of energy jelly beans and before I knew it we were off, with Princess Layla, and a Jedi Warrior just before me. 

 

The first few miles were a bit of a scrabble, but not as bad as I have experienced before in terms of congested running. 

The energy was brilliant in Woolwich, one of my favourite parts of the course(!) The sights and senses were overwhelmed still and not yet normalised to a) priests and vicars with their congregations dousing runners in holy water b)  pubs in full swing with pirates and wenches hanging off of their balconies and bands blasting out music c) mini-full brass bands in terrace house gardens d) loads of kids gasping to give high fives with totally unreserved energy e) jazz and samba bands on highway roundabouts f) evangelist church communities giving out support over full PA systems g) a million different people yelling your name in Sarrrrff London accents, in Caribbean accents, in Indian accents, in Plummy accents, and everything in-between. 

When i first got going, I was in such a state of nervous tension that I couldn’t work out how people knew my name, rationalising that it must have been people from work who had chanced upon me…then i looked down onto my vest and realised and remembered that my name was firmly printed there. It soon became clear that running on the outside of the pack had its advantages: It got the crowd really singing your name which was such a massive pull to get you through. 

For the first five or six miles or so I followed the 8 minute mile pace setter. My maths is fairly post-modern ie. I don’t know how to do maths, so my brain was dually tricking me into thinking, is an 8 minute mile  slower or quicker than usual? I think i opted for slower, when it fact it was two minutes quicker, which made up some good time in the beginning. 

John had cycled all the way down to about mile 3 but this was where the two groups merged and so I was forced onto the wrong bit of the road and we didn’t meet. 

Coming into Greenwich was brilliant -the crowd thickened out and the cameras made an appearance so I made a point of staring determinedly into them in case my grannies could see me. I also stopped fretting about an early ham string tension which I feared was appearing, which settled . Deptford and Rotherhite were a case of getting the head down and a bit bleak (more so than the Isle of Dogs I think). I think i got an energy gel out about here and had to re-tetris my little pocket, including my sole emergency tampon supply, most likely to the horror of my male compadres. Sorry boys. 

Clearly one of the most amazing realistions was the slight incline and corner turn – all of a sudden – up into Tower bridge. At this point I let out a huge shout! Psychologically, this is the first bit of the Marathon ticked off – the South of London left behind. But more importantly than that is the emotion of running over this test-of-time symbol of London, with its current inhabitants and historical descendants cheering you on, running by your side, or going about their business. It’s now!  And it’s huge iron work is flowing over head and you’re turning to the person by your side and all of a sudden screaming, 

‘This is the best f***ing bridge in the world!!’  

And they are nodding sage-like with a massive grin on their face and saying ‘yes it is’ and then you are turning and facing the next 13 and a half miles complicit with the bridge and happy. 

All the while you are getting text updates from the support in the crowd which helps to draw you on. By this point –  after the more sombre parts of South London – I was feeling a bit tired, and the bridge definitely helped to start afresh a bit. In fact, when I passed 6 miles I just thought – ‘well, i’ve done 20 miles before and I’ve done that before’. 

The first people who screamed out my name in a recognisable fashion were Bee, Sarah and Dennis (I think Pudzy and some others were there too). This was such a big buzz and i whipped over and let out a huge primal scream and then set off again all hyped up. Next up around mile 14 was Fiona and her sister and I was so pleased to see them and gave them a quick gallant peck on their hands and then set off again, really hyped up! I’m enjoying myself I thought!! And each ballooned gate that went over was another mile down – and the miles looked ok. 1.48 for a half marathon was the quickest i’d done yet, by 3 minutes. (All personal goals, this is only 16 minutes gap to the men’s whole marathon record). 

As I ran past the Limehouse causeway and the Narrow, there was lots of support and Sophie-shouting. All of a sudden I rounded a corner and faced the descent into the roundabout for Canary Wharf. My Mum and Dad were waiting on the left and I went and gave them a big kiss and drank in their excited faces and then sunk into the underground roundabout. The breathing and padding continued and then snaked its way up towards the crazy traffic light stature, the exact route I’d taken the Sunday previous, minus the cars and the rampant support. 

Up on the left Caroline was aboard Jamie’s shoulders and eagerly seeking me out – looking everywhere but AT ME! So I shouted ‘Caroline, you blind b**tard!’ and ramped up my expletive miles some more. YEY! They saw me and waved and shouted me on and the split seconds were worth it as I charged into the Isle of Dogs… 

Having missed John in south London, I was nervous to see him ‘mile 16-17 opposite a cream icecream van’. And see him I did! In anticipation I tried to quickly re-arrange the nest of hair, doused in several bottles of water, atop my head into a certain distinct shape. And I think I dried my face. There he was, in a sun hat and shirt and with his trusty stead.! So I bellowed…. 

‘JOHHHHHHHHHHNNNNNNNNNNNNNNN!!’  

[read: ADWWWWIIIIIANNNNNNE!!] 

We had a kiss and then he ran along side next to the supporters and shouted something about sub-four which I tried to ignore and lots of other stuff. As we reached another party-fuelled pub on the corner he split off to outcycle me up to mile 19-20. 

By this point, the Adidas app tracker was starting to work and so people were starting to follow my route and egg me on. Between mile 18 and 20 was tough as there was less support and I was starting to go ‘into the abyss’, the mile markers I hadn’t yet passed in training. Running through Canary Wharf was a strange feeling. I remember the city skyscrapers towering asphalt above and the noise and the colours and the emotions bouncing off their sides and down into the valley streets below. The crowd support here was pretty strong as we rounded corner after corner. 

By the time we headed up to Poplar I’d got into a steady routine – at every other mile, accept a water bottle, pour a 1/3rd of it over my head and back, and then sip and drink the rest. About this stage I gnawed my way through a Torq energy bar and psychologically felt like I was re-fuelling for the last stage of the run. 

John mentioned he was now romantically placed opposite a McDonalds on a roundabout just past Mile 20. I came up to the roundabout just when I started to feel a bit woozy. I saw him at the bottom of the hill and chased down after shouting JOOOOOOOHHHHHHNNNNNN again, had a big kiss to rapturous applause, and then powered on….right here we go, into the abyss. No San Francisco run or Finsbury Park Sunday has taken me here. 

Coming past Westferry I knew my Mum and Dad had moved to opposite The Mission building in Limehouse.  Before I noticed them I noticed the huge party ensemble going on in the top floor of Limehouse town hill and a big poster to DAVE/MARY (A satirical biblical reference I’m sure ‘DAVE’ would appreciate). 

Salt ‘N’ Pepa PUSH IT was blaring from the speakers and I shouted the lyrics back out and I found my extra resolve in a late eighties classic [ed. correction]… 

 

Mum and Dad and my bro were happily stood on the left hand side I gave them a wave and a high five each, very generous. I carried on without too much fuss, starting to feel like I needed to reserve my energy. My brother sent me a message saying: 

‘You are on for a sub-four. DO IT!’  

I kept that in the back of my mind, slightly annoyed. The sun was out now for a little while and the heat was constant, though not startling. A mile or so down the road on the right hand side i noticed Caroline, Jamie, and a hungover George Hutchinson. What a classic view! I gave them the cut throat ‘I’m not good’ symbol but apparently they failed to see this and decided I looked ‘strong’, as did my folks! I think this was an area where quite a lot of people started to stop or pull over, and on the opposite side of the road, incoming, were the followers up who had just come off of Tower Bridge and had the whole section of Isle of Dogs to go – many walking, a lot more spaced out. Don’t look at them I thought! Keep looking forward! 

I caught Fiona and her sisters again on my right and then I was on my own for a good few miles (apart from the runners and the amazing general public)! This was a tough stint, but essential just meant keep plowing on, through the showers, and through the bottled water and the hands with jelly babies in them, and through the shouts of strangers, and the London history and… 

…before I knew it, I was passing Tower Hill again and I was on the home straight, starting to think that a sub-four might be possible. At Cannon Street I did an upside down smile and let out a little exhale weep – the sheer exhaustion and emotion kept welling up it was all starting to get a bit much – but i’d pull a hand across my face and keep going. Coming up the tunnel, now little steps, and out onto Embankment I knew i didn’t have far to go. The shouts were echoing and my back hurt and Jenny and John kept ringing me (Er, Hello! I’m running a marathon!!/BUSY!). I got to mile 25 and just after the gate, there on the left, were Lydia and Jenny who went a bit crazy, which was wicked. I powered on round the corner, past Big Ben smiling down on everyone, and into the Queen’s front yard (quite smart digs) and past the final few supporters and the Grand Stand – the feet counting down – and each step so nearly there. And there were the big digital clocks and the finish gates and I was through!! I was through! And my arms were too weak to wave too high in the sky. And there was the time, 3.52: chip time 3.49 – wow!! 

Delirious, I walked through the enervated runner production cycle: de-tag chip, collect runners kit and medal, collect bag and watch in a daze everything around you. People hugging, runners sat cross legged lancing under-toe-nail-blisters with safety pins, people staring into space. The Marathon crew were A-MAZING; the organisation phenomenal and really brilliant support.The hardest part was walking from the finish down to the runners meet, among so many people, each step hurting and so much to take in and wanting to just sit and be found… 

…I managed to creak to a halt in the sun under the tree with the letter P. In the distance, after a while, I saw John come through with his trusty misplaced steed in the crowds. WOWO! And he brought me a cold Polish beer, my actual favourite and the sweet taste of victory!! 

 

I sat and drank that delightful liquid refreshment and in time friends turned up and we negotiated the tortuous tube steps, got to Euston, and got in this amazing machine: 

Lydia makes the dash where I cannot

THE BETSY TROTWOOD – what a marvellous idea, a privately opened pub, replete with friends, family, music, food, drinks, open space,  dancing, flowers, laughter!! THANK YOU for an amazing time, support, and memories!! x x x x x x x x x x x This blog ends here….a new one with writing may pop up in date anon 2010…. 

 

country bumpkins is all im saying

 

  

  

 

Saturday 24th April

Wake up and get on the pasta drip. After a week of not doing any exercise and taking it easy I do a couple of 100 metres to get the muscles going.  It is baking hot and I am scared – shorts or leggings? Shorts or leggings? I am verbosely charged spouting inane running chat at John without breath. Poor John. My nervous energy is through the roof; how many energy bars should I have to compensate? Go to the running shop to look at shorts. Decide to stick with leggings. Get back parents arrive, I sit on my Dads glasses, whilst on the phone to Matt chatting about the marathon, breaking them. Powell arguments break out. I iron on my name to my shirt. I see that more sponsors have come in and I’ve hit my £2k target. I’m feeling more relaxed today than the rest of the week. I cycle to Driffield to get excited again. I come back and have a very long extravagant bath, banana, pasta, pudding: the Powells have sorted out the flat. So, guess now I go to sleep and wake up and run a marathon – that’s weird!! Night, night! x x x Ps. Thinking of Fiona Higgins  – GO TEAM Fiona!! x x

Identification Kit

Friday 23rd April

Wake up feeling totally UP FOR THE MARATHON – COME ONNNNNNNNNNNNNNNNNNNN!!

Last day of work this week. Horrendous day of work; I am emotional and have got too much energy and not enough use for this energy (at this point). Get home, go to bed and sleep for a long time. It’s a good sleep.

Thursday 22nd April – EXPO DAY

Last night I went to a debate between the environmental minister candidates at the Kings Fund arranged by the Guardian. If the environment is a big election factor for you I urge you to find out more about Simon Hughes, the Liberal Democrats who far excelled among the three. Whatever your political fancy, I did find the Tory candidate a bit stuck on substance due to the more climate-sceptic nature of the party he represents. Walking back from the evening, in the evening calm of Fitrovia, I thought about the Marathon coming up and why it stirs the emotions: it galvanises your love of the city, and in this case London, by investing your time on its streets, and in amongst its sights (Regents Park standing still minding me of this, site of many a lunch time run in the snow and in the sun).

I’m finding it very hard to concentrate at work. VERY HARD! Left at about lunchtime and went to an Amazon Web Services Cloud event and nodded off to the CTO – I seem exceptionally tired(!)…after dosing off, left to collect my marathon vest from Survival (completely deranged and overexcited by this point), and then headed to the EXPO to collect my number. Made friends with a Scottish guy and another first runner on the way in, shook hands and said GOOD LUCK. Collected my number, beaming and unhinged, and got LOAF stamped on my shirt – ate more ehergy bars than was necessary picked up shorts and put them down about 30 times ( the shorts vs leggings debate) and eventually left. On way back heard a girl mention how she had drunk a bottle of Vodka just last week (errrr,???) and was running. Then a series of mishaps.

1. Jubilee line delays 2. Bus back from Stratford but I failed to get off correctly and got off at Homerton Hospital 3. Feeling Sad got -50p baked beans for dinner from a Polish shop 3. Walking back with said baked beans, further delayed  by a dog vs dog ruck on footpath, me too terrified to pass for fear of being teared apart by a muzzled animal.

4. Get in no tin opener. No beans. Go to bed.

Wednesday 21st April.

Rest day. WOWOWOWOWOWO

Thanks to everyone who has sponsored me today!! x x x x

Tuesday 20th April – The Mouse

Sudden hysteria sets in. I’m not cycling this week in order to properly rest and so I get the bus. On my 90minute+ journey into work (!!!!) I text frantically and make the snap decision that I AM going to look at the route. Probably a good idea, as I didn’t realise the infamously boring Isle of Dogs bit was way out there at mile 17/18….John’s plan is to see me off at start, cycle down to river side of Cutty Sark to wave then cycle under foot tunnel (open)? to wave again at river side of Island Gardens on Isle of Dogs then dash down to Millwall wave again then Commercial Road and then the finish!! I like! My friend and I at work are frantically emailing eachother. I have as yet not succombed to watching the Youtube clip of last 600 metres in 2009, but it’s meant to be amazing: yesterday, I welled up even looking at the interactive map!! We get free London travel all day, which is nice. After a distracted day at work, got the number 30 back which took nearly 2 hours!! Ran from mine to John’s with back pack and was settling down to nice relaxing evening, safe in the knowledge that I was last ‘run’ away from Marathon (few bits of form training left). Even got to bed at 10pm.

At 3am, awoke. John eerily said in the dark.

‘Sophie. I’m sorry to tell you that we are not the only people in this room.’

Wondering what on earth he meant, it was then revealed to me that we were in fact in the company of a tiny, grotty, city MOUSE which continued to gnaw in the dark, scale towels hung over doors and zip about under objects for the remaining hours. We ‘went to sleep’ at least 5 times to then awake in cursing fury (furry?) at the rodent who waited to lights out before motioning again. John tipped his room upside down, thrashed around with a broom stick, and froze us to death with the door open and eventually we fell asleep – the mouse somewhere else in the house (the stair?)  – at about 4.30am or 5.

No, right there. GET HIM!

Monday 19th April

Rest Day. Eat pasta and pizza. Tidy flat. Sleep. It’s as simple as that.

Amazing Woman

From the marathon website.

Irene will be one of the oldest women to run this year’s Virgin London Marathon at the age of 82. Irene ran her first marathon in 1989 after loosing her husband in October 1988, she ran in his memory at the age of 60. Irene has been the oldest runner for several London Marathons finishing in the top two for her age group.

For more stories, click here

Truly inspirational stuff…