http://www.medicine20congress.com/ocs/index.php/med/index/feeds/articles/atomMedicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research: Recent Submissions2018-09-17T17:00:16-04:00Open Conference SystemsMedicine 2.0 is a new conference series on Web 2.0 application in health, medicine, and biomedical research, organized and co-sponsored by the Journal of Medical Internet Research, the Centre for Global eHealth Innovation, the International Medical Informatics Association, and CHIRAD.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2891Adrian Aguilera (@draguilera) submitted 'HealthySMS: An Automated Messaging Platform for Clinical Support and Ecological Momentary Assessment' #med2 userprofile: http://www.medicine20congress.com/ocs/social/adrian22802014-10-28T23:45:49-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-10-28T23:45:49-04:00HealthySMS: An Automated Text Messaging Platform for Clinical Support and Ecological Momentary Assessment This presentation will describe HealthySMS, an automated text messaging platform for use as a clinical decision support tool or for ecological momentary assessment/intervention. The platform can be customized with any users content and can support unique scheduling needs for a variety of purposes. The presentation will provide an overview of the system features in the context of a use case as a treatment adjunct to cognitive behavioral therapy along with lessons learned in that experience. Initial findings from this research will be presented. Future development directions will be presented such as the integration of enhanced alerts, customized responding and integration of predictive analytics. This is an exciting tool that can aid the development and implementation of research and clinical endeavors while building collaboration among diverse researchers and clinicians.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2890Ohoud Saad Alhammad submitted 'Assessing Saudis’ Knowledge and Attitudes Towards Seeking Health Information Online' #med2 userprofile: http://www.medicine20congress.com/ocs/social/ohoud2014-10-22T13:40:10-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-10-22T13:40:10-04:00Background: e-Health has proven its efficiency and effectiveness in improving the quality of health services. This concept is newly-emerging in Saudi Arabia, where many organizations are exerting efforts to develop it. Unfortunately, most are concentrated on inter-professional communication and education. This raised a need to be used as a tool for health promotion. Objective: This study assessed the knowledge and attitudes of the Saudi population towards e-Health and online health information. In terms of health promotion, what are Saudis’ perceptions of this emerging idea? And do they need more education about the available e-health resources and services? Methods: The participants completed either a web-based questionnaire or an interview. The web-based questionnaire was developed based on the literature. Twitter, Facebook, What’s App, Blackberry Messenger, and e-mails were used as distribution methods to invite people to participate in the survey. Besides English, Arabic was considered in the questionnaire since it is the official language of the target audience. Results: 358 participants responded to the survey. The majority of them (87%) admitted that they use the Internet to search for health related information. Of those, approximately 84% revealed that their main purpose for seeking health information online was to learn more about certain health conditions. Around 10% of them claimed that their reason generated from the fact that doctors don’t provide them with enough information. About 70% of the Internet users in the sample admitted that they used the Internet one to four times a month to search for health related topics. Around 50% of the participants reported that they rarely trust and apply the acquired online health information. However, 36% of them admitted that they usually use and apply this information. Almost 70% of the sample noted that they were not aware of qualified Arabic health resources available on the Internet. On the other hand, 24% of them showed knowledge of that. The most important finding was that around 76% of the respondents were not satisfied with the current situation, and they believed they needed to learn more about reliable eHealth resources on the web. Conclusions: The findings showed positive attitudes towards searching for and acquiring health-related information online. They also showed that there is a huge need to provide Saudis with educational programs that raise their awareness about reliable and trust-worthy online health resources.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2883Gunther Eysenbach (@eysenbach) submitted 'JMIR Publications and Medicine 2.0 (Expo Table)' #med2 userprofile: http://www.medicine20congress.com/ocs/social/admin22014-09-23T18:25:18-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-09-23T18:25:18-04:00JMIR Publications, Inc. is a rapidly growing innovative academic publisher. It builds on the success of <a href="http://www.jmir.org">JMIR (Journal of Medical Internet Research)</a>, which started in 1998 as a small independent open access project hosted at a university, which subsequently grew into the most influential journal in medical informatics (ranked #1 by Impact Factor by Thomson Reuters for five years, 2013 IF: 4.7) and health services research. Due to the growth in influence and submissions, and to make the operations more sustainable and professional, the journal was incorporated as company in 2011. Shortly after incorporation, several spin-off journals were launched. Currently, JMIR Publications Inc. publishes the following journals: <ul> <li>JMIR (Journal of Medical Internet Research) (ISSN 1438-8871) <a href="http://www.jmir.org">http://www.jmir.org</a> <li>JMIR Research Protocols (ISSN 1929-0748) <a href="http://www.researchprotocols.org/">http://www.researchprotocols.org/</a> <li>i-JMR (interactive Journal of Medical Research) (ISSN 1929-073X) <a href="http://www.i-jmr.org">http://www.i-jmr.org</a>) <li>Medicine 2.0 (ISSN 1923-2195) <a href="http://www.medicine20.com/">http://www.medicine20.com/</a> <li>JMIR mHealth & uHealth (mobile and ubiquitous health) (ISSN 2291-5222) <a href="http://mhealth.jmir.org">http://mhealth.jmir.org</a> <li>JMIR Serious Games (JSG, ISSN 2291-9279) <a href="http://games.jmir.org">http://games.jmir.org</a> <li>JMIR Medical Informatics (JMI, ISSN 2291-9694) <a href="http://medinform.jmir.org">http://medinform.jmir.org</a> <li>JMIR Human Factors (JHF, ISSN 2292-9495) <a href="http://humanfactors.jmir.org/">http://humanfactors.jmir.org/</a> <li>JMIR Mental Health (JMH) <a href="http://mental.jmir.org/">http://mental.jmir.org/</a> </ul> JMIR Publications Inc. also produces and organizes the annual Medicine 2.0® World Congress series (http://www.medicine20congress.com), is curator of the Medicine 2.0® Social Network (<a href="http://www.medicine20.net">http://medicine20.net</a>), is founding partner in the TrendMD project (<a href="http://www.trendmd.com">http://trendmd.com</a>)and owns several other trademarks in the health field [e.g. Healthbook®, http://healthbook.com] and altmetrics area [Twimpact™ Factor, WebCite®, http://www.webcitation.org]. For over 10 years, JMIR has been on the forefront of testing and applying Web 2.0 ideas, such as openness (open access, open peer-review) and apomediation in the scholarly communication context. JMIR has also developed novel social media based article level metrics such as the Twimpact™ Factor, which has been found to be able to predict future citations within 3 days of publication based on analysis of Twitter chatter. Shortly before the Malaga conference, JMIR will launch a major overhaul of its website, featuring responsive design that works on desktops as well as on mobile devices. The new JMIR website features Altmetrics and the TrendMD widget. The next step in the development will be the launch of profile pages of JMIR authors on the Medicine 2.0 social networking site (medicine20.net), which will be combined and connected with Medicine 2.0 users to further facilitate the creation of a virtual community of ehealth/mhealth scholars and knowledge users. Stop by at the expo table to learn more about JMIR membership, publishing your work in JMIR or the new JMIR spin-off journals including the new <a href="http://www.medicine20.com">Medicine 2.0 Conference Proceedings journal</a>, future Medicine 2.0 conferences and projects, and the medicine20.net social network.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2884Gunther Eysenbach (@eysenbach) submitted 'JMIR Publications and Medicine 2.0 (Expo Table)' #med2 userprofile: http://www.medicine20congress.com/ocs/social/admin22014-09-23T18:25:18-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-09-23T18:25:18-04:00JMIR Publications, Inc. is a rapidly growing innovative academic publisher. It builds on the success of <a href="http://www.jmir.org">JMIR (Journal of Medical Internet Research)</a>, which started in 1998 as a small independent open access project hosted at a university, which subsequently grew into the most influential journal in medical informatics (ranked #1 by Impact Factor by Thomson Reuters for five years, 2013 IF: 4.7) and health services research. Due to the growth in influence and submissions, and to make the operations more sustainable and professional, the journal was incorporated as company in 2011. Shortly after incorporation, several spin-off journals were launched. Currently, JMIR Publications Inc. publishes the following journals: <ul> <li>JMIR (Journal of Medical Internet Research) (ISSN 1438-8871) <a href="http://www.jmir.org">http://www.jmir.org</a> <li>JMIR Research Protocols (ISSN 1929-0748) <a href="http://www.researchprotocols.org/">http://www.researchprotocols.org/</a> <li>i-JMR (interactive Journal of Medical Research) (ISSN 1929-073X) <a href="http://www.i-jmr.org">http://www.i-jmr.org</a>) <li>Medicine 2.0 (ISSN 1923-2195) <a href="http://www.medicine20.com/">http://www.medicine20.com/</a> <li>JMIR mHealth & uHealth (mobile and ubiquitous health) (ISSN 2291-5222) <a href="http://mhealth.jmir.org">http://mhealth.jmir.org</a> <li>JMIR Serious Games (JSG, ISSN 2291-9279) <a href="http://games.jmir.org">http://games.jmir.org</a> <li>JMIR Medical Informatics (JMI, ISSN 2291-9694) <a href="http://medinform.jmir.org">http://medinform.jmir.org</a> <li>JMIR Human Factors (JHF, ISSN 2292-9495) <a href="http://humanfactors.jmir.org/">http://humanfactors.jmir.org/</a> <li>JMIR Mental Health (JMH) <a href="http://mental.jmir.org/">http://mental.jmir.org/</a> </ul> JMIR Publications Inc. also produces and organizes the annual Medicine 2.0® World Congress series (http://www.medicine20congress.com), is curator of the Medicine 2.0® Social Network (<a href="http://www.medicine20.net">http://medicine20.net</a>), is founding partner in the TrendMD project (<a href="http://www.trendmd.com">http://trendmd.com</a>)and owns several other trademarks in the health field [e.g. Healthbook®, http://healthbook.com] and altmetrics area [Twimpact™ Factor, WebCite®, http://www.webcitation.org]. For over 10 years, JMIR has been on the forefront of testing and applying Web 2.0 ideas, such as openness (open access, open peer-review) and apomediation in the scholarly communication context. JMIR has also developed novel social media based article level metrics such as the Twimpact™ Factor, which has been found to be able to predict future citations within 3 days of publication based on analysis of Twitter chatter. Shortly before the Malaga conference, JMIR will launch a major overhaul of its website, featuring responsive design that works on desktops as well as on mobile devices. The new JMIR website features Altmetrics and the TrendMD widget. The next step in the development will be the launch of profile pages of JMIR authors on the Medicine 2.0 social networking site (medicine20.net), which will be combined and connected with Medicine 2.0 users to further facilitate the creation of a virtual community of ehealth/mhealth scholars and knowledge users. Stop by at the expo table to learn more about JMIR membership, publishing your work in JMIR or the new JMIR spin-off journals including the new <a href="http://www.medicine20.com">Medicine 2.0 Conference Proceedings journal</a>, future Medicine 2.0 conferences and projects, and the medicine20.net social network.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2880Kristina T Phillips submitted 'Measuring Marijuana Use and Craving via Text Messaging as a Form of Ecological Momentary Assessment' #med2 userprofile: http://www.medicine20congress.com/ocs/social/kristinatphillips2014-09-22T13:52:03-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-09-22T13:52:03-04:00Background: Substance use behavior and craving can be difficult to assess, with many studies focusing on retrospective self-report. Past research examining the association between craving and substance use have not always found the two to be related, or if they are related, often the relationship is not particularly strong. In recent years, increased attention has been placed on using ecological momentary assessment (EMA) to learn more about substance use behavior in the moment, though much of this work has focused almost exclusively on tobacco and alcohol use, with less focus on illicit drugs. Several recent EMA studies have shown that craving for marijuana is related to marijuana use. Objective: The goal of the current study was to examine whether marijuana craving would predict marijuana use when measured in two different ways through EMA. In addition, we aimed to examine how marijuana use assessed through EMA compared to a commonly used and validated retrospective substance use measure – Timeline Followback (TLFB). Methods: College student marijuana users (n = 57) in Colorado (prior to legalization) were recruited to participate in a baseline assessment, two-week EMA, and brief follow-up. To help protect participants' confidentiality, only first names were collected and used throughout the study. Participants averaged 20.05 (SD = 2.60) years of age and were predominantly Caucasian (77%) and Latino (11%). Most were heavy marijuana users, smoking on average 25 days out of the last 30. Participants were sent text messages randomly during three time blocks throughout the day for a two-week period. Overall EMA response rate was 89%. Each Short Message Service (SMS) text included the same nine questions (three questions used for the current analyses). Marijuana craving was assessed on a 1-10 scale (low to high), while marijuana use was assessed by the number of times participants reported using marijuana since they were last texted and the number of minutes they spent smoking since the last text message. A 30-day TLFB calendar was completed at the follow-up. Results: We conducted two time-lagged multilevel models to examine whether craving at one assessment point predicted marijuana use at the next EMA instance. Model 1 showed that craving significantly predicted the amount of time (in minutes) participants spent smoking at the next time assessment (F[1,1771] = 1869.35, p < 0.001), with a positive relationship (β = 0.13). Similarly, Model 2 showed that craving positively predicted the number of times participants smoked (frequency) at the next time assessment (F[1,1704] = 11.69, p < 0.001; β = 0.11). A Pearson correlation between the total number of EMA and TLFB marijuana use instances was significant (r = .851, p = .01), but the percentage agreement for direct daily comparisons between the TLFB and EMA showed that only 29% of responses were exact matches. Most of the inconsistencies (66%) showed that participants reported smoking less on the TLFB. Conclusions: Our findings suggest that craving positively predicted marijuana use, measured in two different ways (time and frequency). Though there was a relationship between EMA and TLFB marijuana use, our data suggests that TLFB and EMA are probably not equivalent in daily instances reported. Relationships between retrospective and EMA methods should be further evaluated, as there are limitations to assessing past substance use following EMA measurement. Future researchers should consider incorporating innovative EMA methods to determine if findings differ from retrospective report.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2879Iria Hernández submitted 'People Who Global' #med2 userprofile: http://www.medicine20congress.com/ocs/social/Iria2014-09-18T10:50:33-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-09-18T10:50:33-04:00People Who is a platform on the internet for all the people who live with an illness. An online platform aimed at patients and their closest environment. A place to talk, share experiences, keep control over the illness and stay informed. It is a pleasant, simple and accesible place because we speak the patients’s language. People Who is an initiative developed in collaboration with patient associations, medical societies, nurses and care workers, with the support from companies and institutions. Together, we want to build a society that can better cope with illnesses. Global platform, local websites We live in a globalized world but when we talk about health, every country has its own regulations. People Who is meant to have an adaptable computing structure in order to comply with the legal requirements and good practices recommended for the industry and also to be able to incorporate medicines databases from each country. ¿Where are we? Spain _ Online 2012 | PERSONAS QUE conviven con una efermedad | www.personasque.es Germany _ Online 2014 | MENSCHEN DIE mit einer Krnakheit leben |www.menschendie.de Italy _ Online 2014 | PERSONE CHE vivono con una malattia | www.personeche.it We are working on… UK_Online 2014|PEOPLE WHO live with an illness | www.peopelwho.co.uk France_Online 2014 |LES GENS QUI vivent avec une maladie |www.lesgensqui.frhttp://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2875Luis Fernandez Luque (@luisluque) submitted 'Challenges and Opportunities of Health Serious Games' #med2 userprofile: http://www.medicine20congress.com/ocs/social/luis.luque2014-09-15T08:20:46-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-09-15T08:20:46-04:00This panel will provide a discussion about the future and present of games in the health domain. The objective of the panel is to provide an overview of all the different aspects: game design, business, integration in clinical practice and research. The panel will be hosted by Luis Fernandez-Luque (Co-director of Medicine 2.0 Malaga). Guido Giunti, co-editor of JMIR Serious Games (http://games.jmir.org/), will provide an overview of current research challenges. Ellen Brox, from Norut (Norway), will share her experience with user centric design techniques applied to design health games. Viviane Hasselmann from Klinik Vales (Switzerland) will explain how to integrate games in the clinical practice. Finally, Santiago Hors (CEO at Salumedia.com) will explain the challenges in the business development of health games.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2870Inma Grau (@inma_grau) submitted 'EPatient Panel: Exploring the Meaning and Transition Process of Becoming an EPatient in Spain/Southern Europe' #med2 userprofile: http://www.medicine20congress.com/ocs/social/igrau2014-09-10T08:25:40-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-09-10T08:25:40-04:00What is an ePatient? A first intuitive answer could be “a citizen who logs into the Internet as a patient.” But does this mere act of using the web give them some special quality? The iconic North American Technographics study by Forrester Research noted a new set of engagement roles for ePatients: trollers, inactives, spectators, joiners, collectors, critics, conversationalist and creators. Another possible classification is that of Akesson’s organizational view; which classifies e-Patient engagement according to: telemedicine; Information and Therapeutic Education; and Support. This panel will present a number of case examples of the different emerging roles for e-patients and how the transition process has emerged over the last few years through the use of social media. Imma Grau PhD in Sociology and ePatient, will speak about how an expert in health communication,becomes in a ePatient, and constitutes a foundation where to launch a project to develop a mobile application to accompany patients during chemotherapy. Joan Carles March, PhD in Medicine co-director of the School of Counseling Patients Equality, Health and Social Policy in Andalusian School of Public Health, teacher, researcher, consultant Andalusian School of Public Health. He will speak about the role that may represent the future ePatients. Pedro Dot a colon cancer patient. Antoni Roig is a reseacher at UOC/IN3 will speak about "Selfie stories: big data and personal narratives in Instagram". The aim of this presentation is to contextualize their preliminar conceptual approach to a research on Instagram as a site for personal narratives through the different uses and meanings of the selfie as a key expression of life stories, related either to general intensive use of social media or more specific contexts like health or immigrationhttp://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2864Delesha Carpenter (@LeshaCarpenter) submitted 'Adolescent, Caregiver, and Provider Preferences for an Asthma Self-Management App' #med2 userprofile: http://www.medicine20congress.com/ocs/social/dmcarpenter2014-09-05T09:36:22-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-09-05T09:36:22-04:00Background: Although the number of asthma self-management applications (apps) has increased in recent years; to our knowledge, no asthma self-management app has been developed specifically to meet the needs of adolescents. Objective: To present formative data from adolescents, their caregivers, and medical providers regarding their preferences for a mobile asthma self-management app. We will present data regarding desired app design, features, and content. Methods: We recruited a convenience sample of adolescents with persistent asthma (n=20), their caregivers (n=20), and health care providers (n=6) from two pediatric practices in an urban area of North Carolina. To be eligible, adolescents had to be 12-16 years of age, have moderate to severe persistent asthma, speak and read English, own a mobile device, and be present with an English-speaking adult caregiver. Each participant was given an iPod Touch and asked to critique two self-management apps [AsthmaMD (adult-focused) and iAsthma in Control (child-focused)] during an in-person interview after a regularly-scheduled clinic visit and again, via phone interview, after one week of app use. Provider reactions to apps were collected during a 30-minute in-person interview. Using semi-structured interviews and surveys, we asked participants to identify the app features they found most useful and describe additional features that could help adolescents better manage their asthma. Additionally, participants rated the usefulness of specific features of the apps on a scale ranging from 1 (not at all useful) to 5 (very useful). Ease of use for each app was also assessed by adolescents and caregivers on a scale of 1 (very easy) to 5 (very difficult). Eighty percent of participants completed the follow-up phone interviews. Each digitally recorded, transcribed interview was imported into MAXQDA, coded, and analyzed. Demographic and perceived usefulness data were analyzed using SPSS version 11.0. Results: Adolescents were primarily Black (47%) and male (60%). Fifty-seven percent of adolescents, 50% of caregivers, and 50% of providers preferred iAsthma in Control, and both adolescents and caregivers found iAsthma easier to use. Adolescents ranked the personalized charting function and asthma self-check features as most useful, caregivers ranked the symptom diary and the ability to send the doctor your report most useful, and providers ranked the appointment reminder feature most useful. The peak flow monitoring feature was ranked lowest among adolescents, caregivers, and providers. Conclusions: Although participants agreed that symptom tracking features would be useful in an asthma self-management app, preferences for user interface and additional self-management features varied among adolescents, caregivers, and providers. Although our study sample was diverse, our results may not generalize to adolescents and providers in other clinical settings. App developers should be aware of the varied preferences of adolescents and members of their social support network (i.e. providers and caregivers) when developing asthma self-management apps.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2860Paul Watson (@PocketDr) submitted 'Mobile App PocketDr Delivers Evidence-Based Clinical Checklists for Junior Doctors’ to Improve Management of Ill Patients' #med2 userprofile: http://www.medicine20congress.com/ocs/social/paulwatson2014-08-31T17:51:03-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-08-31T17:51:03-04:00Aim and Objectives: 1. To assess information and help used by junior doctors on call. Identify which areas they felt least comfortable with and determine whether they would use a quick access app as a resource. 2. Provide quick evidence-based on-call references for common clinical encounters via a mobile phone app. 3. Analyse use of the resource and obtain feedback to improve the app with the overall goal of improving patient safety. Methods: In 2012, an online survey of 324 junior doctors (158 FY1, 136 FY2, 26 CT1, 4 other) asked: When you need help on-call which resources do you use? Are medical apps convenient / suitable and would you feel comfortable using them? Would you use a clinically-focused book / app designed for “instant-access”? What clinical information would be most helpful to have instantly available? A literature search for best practice clinical guidelines was conducted. Checklists for the 28 most requested scenarios were written based on best practice sources including NICE and Royal College guidelines. Checklists included deteriorating conditions such as hypoxia and bradycardia, and 20 acute medical presentations such as atrial fibrillation, alcohol withdrawal and sepsis. The mobile phone app was published for doctors to download at no charge in July 2014. Results: Primary market research on resources for junior doctors on-call was carried out between 25 April and 23 May 2012, 324 foundation doctors responded to a structured online survey. Whilst the majority (77%) often referred to a senior for advice when on-call, many (61%) also often sought a peer colleague’s advice, which has implications for patient safety and untoward events. Virtually all (97%) used the internet at times to look up information, but only 37% used apps to the same extent. Most thought they were convenient / suitable (72%) and would feel comfortable using them (68%). PocketDr analytics reveal use is greatest when the least doctors were working with the minimum amount of senior support – after 5pm. Overall use at weekends was equitable with that on weekdays, but with only a backbone of on-call staff and minimal support - showing high use per doctor on-call. Conclusions: Being on-call is one of the most challenging roles of the newly qualified doctor. Undergraduate education offers a limited introduction to the practicalities of being on-call, often alone. Many junior doctors feel inadequately prepared for the role. When on-call speed and safety are vital and human factors often come into play. Time pressure and inexperience can create an uncomfortable level of stress, which may lead to clinical error. The aim of developing an open-access best clinical practice resource for on-call junior doctors was achieved. Following successful implementation of the iPhone version, an Android version is currently under development to widen access to the resource. Guidance is updated as new guidelines and evidence emerges. PocketDr is an ongoing project with many updates and improvements. Initial feedback has been positive, with requests for further checklists to be added. Research is needed to evaluate impact on patient outcomes and serious incidents.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2855Marije Baart de la Faille - Deutekom (@Marijebaart) submitted 'The Role of App Use in Preparation of Running Events' #med2 userprofile: http://www.medicine20congress.com/ocs/social/marijebaart2014-08-15T05:13:52-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-08-15T05:13:52-04:00Baart de la Faille – Deutekom, Marije and Vervoorn, Cees Amsterdam University of Applied Sciences Background The use of mobile phone apps to monitor training performance is emerging, especially in individual sports like running. To date it is unknown whether there exist a role for apps in the preparation for a running event. Important question is whether the use of an app is related to changes in training volume or other health and lifestyle outcomes. Objective To define the characteristics of app users and to investigate the relation between the use of apps and changes in training volume and health and lifestyle outcomes Methods We randomly invited 9058 runners (of 54,000 participants) of a 16-km recreational run (Dam tot Damloop) in the Netherlands to participate in this study. Runners of all levels were invited to participate. Two days after the run participants were requested to complete an online survey. In the survey the following issues were addressed: background variables (age, gender, experience with running), use of app, running physical activity (RPA: measured by amount of trained kilometres per week at three times (before start training phase, during training phase and intention after event)), health and lifestyle (health, self reported bodyweight and length, diet, smoking and drinking behaviour and energy level). The difference in RPA between baseline, training phase and post run was calculated. All participiants were divided into app users and no-app users. Differences between the two groups on RPA and health and lifestyle were assessed. Results Of all invited runners 2,969 (33%) runners agreed to participate. Of all respondents 24% was overweight (BMI > 25: based on self-reported length and weight) and 13% smoked. The average age of the respondents was 40 years and 57% was male. A third of the participants (35%) indicated to have used an app in the preparation of the run. App users were slightly often more male (59%) and younger (37 years) than average. Four out of ten respondents (39%) participated in a previous version of the run. App users participated more often for the first time in the run (52% versus 33%), ran less kilometers per week before the preparation phase of the run (56% < 10km/week versus 41% < 10 km/week) and finished 2,5 minutes slower. There existed no difference in BMI and percentage overweight between the two groups. Focusing on differences in health and lifestyle outcomes between the two groups (app users and non-app users) on all measured outcomes showed significant differences. App users increased more often their RPA (62% versus 41%), changed more often their diet (41% versus 28%), felt often more healthy due to training (71% vs 49%) and lowered more often their alcohol intake (29% vs 21%) and smoking behavior (44% versus 31%) (all p-values <0.001). Also corrected for baseline characteristics app users have a 1,9 higher change to increase RPA (p<0.0001) Conclusion In this study there appears to exist a relation between the use of an app and change in training volume and other health and lifestyle outcomes. Contact: m.baart.de.la.faille@hva.nlhttp://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2820Jeffrey H Toney (@jefftoney) submitted 'Crowdsourcing for Public Health as a Human Right' #med2 userprofile: http://www.medicine20congress.com/ocs/social/Dr. JeffreyToney2014-06-13T12:58:34-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-06-13T12:58:34-04:00Access to health services is a human right but many parts of the world fall short in achieving public health, particularly in the aftermath of natural disasters. This talk will explore how to use web-based crowdsourcing to promote public health, using successful examples employed after the 2010 earthquake in Haiti among others. Physicians, scientists as well as citizen scientists can contribute to these efforts remotely through sharing data, personal observations and by big data analysis.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2852Jeffrey H Toney (@jefftoney) submitted 'Crowdsourcing for Public Health as a Human Right' #med2 userprofile: http://www.medicine20congress.com/ocs/social/Dr. JeffreyToney2014-06-13T12:58:34-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-06-13T12:58:34-04:00Access to health services is a human right but many parts of the world fall short in achieving public health, particularly in the aftermath of natural disasters. This talk will explore how to use web-based crowdsourcing to promote public health, using successful examples employed after the 2010 earthquake in Haiti among others. Physicians, scientists as well as citizen scientists can contribute to these efforts remotely through sharing data, personal observations and by big data analysis.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2819Humaira Mujeeb submitted 'Countering Stigma towards Mental Illness through Facebook' #med2 userprofile: http://www.medicine20congress.com/ocs/social/19862014-06-13T04:32:59-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-06-13T04:32:59-04:00Background: The mental illness stigma is a proven barrier for individuals in need of mental health services. It leads to underestimation, under diagnosis and under treatment of mental disorders. Mental health literacy which entails replacing myths about mental illness with correct information using a variety of mediums has been widely used as a strategy to counter stigma around the globe. With the passage of time, depending on the shift in the use of various mediums of communication and creation of social media, the trend of countering stigma towards mental illness demands a shift. Social media such as Facebook can be used as a medium of mental health literacy and modifying the stigmatizing behavior of the people accordingly. Objective: The primary objective was to examine the effect of stigma countering educational intervention by increasing mental health literacy through Facebook on the level of stigma towards the mental illness. Besides this, an emphasis was also placed on a comparative analysis of difference in the level of stigma associated with mental illness in a variety of demographic factors such as age and gender. Methodology: The research was quantitative in nature and had a quasi experimental design (Pre and Post Intervention). For the assessment of the level of stigma towards mental illness, Day’s Mental Illness Stigma Scale (MISS) has been used. A mental health literacy intervention was carried out by disseminating information in simple English language regarding mental illness (specifically focused on the seven themes covered by the seven sub scales of Mental Illness Stigma Scale (MISS) through the specially designed Facebook page and group on daily basis for 25 consecutive days. A total of 124 facebook users between the age range of 18-40 using Facebook for at least an hour, understanding English language and are natives of Gilgit-Baltistan, Pakistan were included as the participants in the pre intervention assessment out of which only 77 completed the post intervention assessment. All the pre and post intervention assessment data was gathered through online survey website Murvey.com. The web links for both pre and post intervention assessment on Murvey.com were sent to all the respondents through Facebook page and group. The data was catalogued and analyzed with the help of SPSS 16.0 version software package. Descriptive statistics (mean and standard deviation) and inferential statistics such as paired sample t- test and independent sample t- test were applied for the analysis of collected data. Results: The results showcase a statistically significant reduction in level of stigma regarding anxiety (t (76) = 14.528, p (.000) <.05), relationship disruption (t (76) = 13.193, p (.000) <.05), hygiene (t (76) = 16.274, p (.000) <.05) and visibility of mental illness (t (76) = 14.919, p (.000) <.05) after the intervention. Furthermore, a considerable increase in the level of positive attitude towards mental illness regarding treatability (t (76) = -13.313, p (.000) <.05), professional efficacy (t (76) = -14.811, p (.000) <.05) and recovery t (76) = -12.487, p (.000) <.05) can be seen after the intervention. Conclusion: Social media such as Facebook has the potential to counter stigma towards mental disorders by means of increasing mental health literacy and consequently modifying stigmatizing behavior of people. Facebook could be a promising tool for reducing stigma associated with mental illness. Keywords: countering, stigma, Day’s Mental Illness Stigma Scale, Facebook, mental health literacy, educational interventionhttp://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2805Nasriah Zakaria submitted 'Understanding Privacy Concerns on Information Sharing Behaviors in Health Virtual Communities' #med2 userprofile: http://www.medicine20congress.com/ocs/social/drnas2014-05-28T00:59:08-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-05-28T00:59:08-04:00Background: The rapid growth of the Internet has multiplied the number of users from all parts of the world as well as intensified the issue of privacy. Yet, the ways in which information privacy affect a user's willingness to disclose and share information with others remain unclear. A very limited number of studies have addressed the privacy concerns surrounding information sharing in Malaysia and Saudi Arabia. Inherently, users may face conflicting aspects of the situation, such as intense concerns for privacy competing with the convenience of sharing information over health virtual communities (VC). Objective: This proposed study will discuss the overarching research question, “In what ways do privacy concerns induce or deter information sharing behaviors in health virtual communities (VC)?" This research has two main objectives: To provide a rich description of information sharing behaviors by act of ‘disclosure’ among members of health virtual communities (VC). To understand the ways privacy values impact the information sharing in SNSs. Methods: We propose to employ online semi-structured interviews and analyze results using content analysis . An interview is defined as a procedure for securing knowledge and means to to build knowledge . In addition, an interview is a tool with which to elicit information from a participant, to find out his or her perceptions, meanings and construct of reality (Punch, 1998); its purpose is to gather what people say about their perceptions, feelings and behaviours. In terms of population, we would like to explore the divergent patterns of privacy concerns in information sharing behaviour in Malaysia and Saudi Arabia. We anticipate that we are able to gain insights from these two major groups in Asia where research among these groups are scarce. Results: Since this is a conceptual paper, there is no results to be reported. Rather, a detail discussion of literature of privacy and information sharing in health virtual communities in these two Asia countries will be presented. Conclusion: In summary, this proposed study is relevant since there is a phenomenally high use of Internet services among the Malaysian and Saudi Arabia population. In addition, many more users are now being involved in health virtual communities (VC) but no actual empirical evidences collected in the area of privacy and information sharing. The findings could also further strengthen the current understanding health virtual communities among Asian users hence reducing the gaps in the current body of literature.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2755Madeleine Berger submitted 'Platform to Enhance the Communication of Elderly Persons – Differences of Rural and Urban Regions' #med2 userprofile: http://www.medicine20congress.com/ocs/social/berma2014-05-08T03:10:37-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-05-08T03:10:37-04:00Background: The social-demographic change in Germany is signed by a shift in the age pattern to higher age groups, increasing expectancy of life and coming with that a higher enquiry for preventive-, healthcare-, caring and nursing services. Due to the paradigm “ambulant over stationary” the question how older people can form their life and living environment more independently and more senior-friendly gains importance. Objective: The main goal of the SONIA project is to determine what simple, suitable for daily use and technical assisted communication offer can be used in real living environments to support elderly people. Methods: The study design is a mixed method. Several workshops and interviews were conducted in rural and urban areas to determine the needs of elderly people. Parallel to that a literature and market research was done to find out what kind of technologies are suitable for the aim of the project. Due to that, a flexible platform running on Android 10” tablet devices was picked for the field tests. The field tests take place in one urban and two rural test regions in Baden-Württemberg. An ethical review committee approved the concept of the project. The data acquisition of the field tests will be conducted in the form of interviews before, during and after the field test, as well as in two online-assessments. Results: Due to the early stage of the project, field tests so far only started in the urban test region. Tablets have been handed out to 25 elderly persons early in the year 2014. Training courses, how to use a tablet and apps like the mail program, ChatON, or Skype have been conducted. Since April 2014 a simple platform was installed on all devices to enhance the communication of the test persons among themselves and to build a community. This platform contains features like a notice board and an event calendar. Important to note is, that the moderation of the community is supervised by the quarters manager of the urban test region. The field tests of the rural test regions will start in June and September 2014. Conclusions: So far, it seems more important what kind of affection elderly persons have to technology and how their knowledge base concerning the usage of technology is, than where they live. Although the analysis of needs showed that clubs have a greater importance in rural areas than in the city, to preserve their social groups is important for both regions. Barrier-free environments are as important in urban regions as in rural regions. To build a regional community for elderly it is important to identify the local social groups and to find moderators to keep communication living.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2749Nasriah Zakaria submitted 'Tutorial: Advancing Qualitative Research Methods in Health IT Research' #med2 userprofile: http://www.medicine20congress.com/ocs/social/drnas2014-04-28T23:26:27-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-04-28T23:26:27-04:00INTRODUCTION Qualitative method is becoming more prevalent in today’s research as it helps to illuminate, support and describe a phenomenon in a richer manner as compared to using quantitative method single-handedly. This tutorial will provide a roadmap to understand the nature of qualitative research and how it is applicable and advantageous in the context of healthcare research. In the field of health IT research, the use of qualitative research method is still under-utilised. Nonetheless, this research method begins to generate higher interest among the researchers. Using such method allows immense opportunities for respondents to provide in-depth descriptions on the problems and challenges they are facing or have experienced in healthcare setting. In order to facilitate qualitative research, researchers also need to employ a more efficient method to analyze massive datasets with the use of computer assisted qualitative data analysis system (CAQDAS). Hence, this tutorial is expected to create awareness and knowledge for those who are less familiar in conducting qualitative research method. While for those who are familiar, this tutorial will allow researchers to enhance learning and be skillful in utilizing data analysis tool as much as they are competent in using SPSS in conducting quantitative method data analysis. TUTORIAL OBJECTIVES: By the end of this tutorial, participants should be able to: • Develop a road map of qualitative research with a clear understanding of its epistemology and philosophy; • Acquire skills to conduct effective interviews in terms of the process and approaches; • Recognize the rationale and components of using interview for qualitative approaches; • Design a content analysis research project using computer assisted qualitative data analysis software (CAQDAS) by using Atlas.ti. TUTORIAL PROGRAM: The tutorial comprise of three (3) different sections in order to provide competencies, knowledge and hands-on program using CAQDAS to facilitate data analysis. The first section will provide a road map to understand the qualitative research methodology. Here, the facilitators will describe the challenges often faced by qualitative researchers in each of the research process from a qualitative-based method. The next section will focus on a well-known data collection approach called interview. The facilitators will highlight the process and challenges of conducting interview sessions in an effective manner, avoiding bias and making sure the datasets obtain are meaningful, rich, and in-depth. In the last section, the facilitators will present the use of content analysis by introducing ‘hands-on’ application of Atlas.ti, one of the well-known CAQDAS tool for data analysis. On the overall, this tutorial will benefit researchers, scientists, or any practitioners who would like to learn and explore the use of qualitative method with ‘hands-on’ application of Atlas.ti for their qualitative analysis in employing the qualitative methods.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2748Tomáš Pruša (@prusatomas) submitted 'Guidelines for Social Media in the Czech Republic' #med2 userprofile: http://www.medicine20congress.com/ocs/social/prusatomas2014-04-28T21:59:53-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-04-28T21:59:53-04:00Background The use of social media in the Czech Republic is on the rise in many areas. Although healthcare is no exception, its rise has been more gradual. Monitoring of social media in healthcare in the Czech Republic and the subsequent analysis of the obstacles to their use allowed us to describe the current situation, analyse the trends, and define possible causes. Based on the results obtained, guidelines for the use of social media in healthcare have been proposed. Objective Creating the first guidelines for the use of social media in healthcare in the Czech Republic. Methods: To get an overview of the use of social media in healthcare, profiles were systematically searched and followed for 4 years. Free, available metrics, which were then processed by descriptive statistics, were used for the description. For predefined profiles, a more detailed qualitative analysis of their use was conducted and strengths and weaknesses were identified. To ensure a comprehensive approach, communication with the national audit bodies in healthcare was established and foreign literature search of approaches in this area was conducted. Based on the obtained information, draft guidelines, which introduce users not only to general principles, but also to the specifics of the use of social media in the healthcare according to the Czech law, were compiled. Results For observed groups of subjects, 10-50 % objects used social media, depending on the device type. The increase in the number of profiles was monitored in the period statistically significant. When comparing the representation of the media with similar groups of health facilities, the result was different from foreign experience. The identified strengths include professional and quality information that is not often used correctly. The weaknesses include lack of system, irregularity, and self-centeredness. The reported barriers to the use of social media include financial and human resources, concern about the privacy, and distrust of persons responsible in these media. The law of the Czech Republic and the obligation to report adverse effects was an important obstacle, as well. Despite the existence of the Guideline on Good Pharmacovigilance Practices Module VI (European Medicines Agency), no recommendations or regulations apply the law of the European Union for social media. Draft guidelines for social media identifying problematic issues and possible solutions were prepared, together with a summary of the current status results and an overview of the potential of social media for healthcare facilities, in the form of brochure and electronically distributed to hospitals. The information is also available on the website. The feedback is being processed. Conclusion The preparation of draft guidelines is based both on the data obtained in the Czech Republic, and the information from abroad. Mutual cooperation will not only ensure the exchange of valuable experiences, it could also contribute to the creation of common guidelines and standards in the future. Currently, we want to encourage the willingness of health facilities and health workers to use social media to communicate with patients, and provoke discussion about the possibilities of social media.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2743Hendrik Borgmann (@HendrikBorgmann) submitted 'Impact of Twitter on Clinical Practice and Its Usefulness for Urologists' #med2 userprofile: http://www.medicine20congress.com/ocs/social/hendrikborgmann2014-04-28T16:46:46-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-04-28T16:46:46-04:00Background: Recent studies have reported of an increasing use of social media at urology conferences and successful introduction of the international urology journal club on Twitter. The impact of social media on professional goals as patient care, networking or research activity of urologistshas not been delineated yet. Objective: To assess the opinion of twitter users on the impact of twitter on clinical practice and on its usefulness for professional activities. Methods: We created an 11-item survey on www.surveymonkey.com addressing the point of view of the congress participants on the clinical usefulness of social media for professional development. The survey was designed and carried out in accordance with the Checklist for Reporting Results of Internet-E-Surveys (CHERRIES). It was distributed via twitter through the conference hashtag #eau14 during the Annual Congress of the European Association of Urology from April 11-15, 2014. Results: Among 57 respondents, 72% found Twitter having an impact on their clinical practice, although only 1/3 indicated that they had made a clinical decision on the basis of an online case discussion. The greatest perceived benefits of Twitter were for networking (98%) and distribution of information (96%), while the majority of users also found it beneficial for research (71%), career development (71%) and advocacy (66%). Conclusions: To sum up, Twitter participants of the Twitter survey during the 2014 European Association of Urology Congress indicated several potential benefits of social media for clinical care, academics and professional development.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2737Hendrik Borgmann (@HendrikBorgmann) submitted 'Quality, Accessibility and Readability of Online Health Information on Prostate Cancer' #med2 userprofile: http://www.medicine20congress.com/ocs/social/hendrikborgmann2014-04-28T14:13:40-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-04-28T14:13:40-04:00Background: The Internet currently serves as a source for information seeking for 60-80% of patients. Recent studies have reported of acceptable quality, accessibility and readability of health information on cardiovascular and orthopedic diseases. Especially in the field of prostate cancer patients are offered many different treatment options and thus are in need of valuable information. Objective: The aim of this study was to assess the quality, accessibility and readability of health information on prostate cancer on the Internet. Methods: We searched Google for the term "prostate cancer" and assessed the first 20 search results. Quality was measured by compliance to the HON-code and by assessment of the DISCERN score. The validated LIDA tool was used to measure accessibility, usability and reliability. The readability was assessed using Flesch Flesch-Kincaid Grad Level and Automated Readability Index. Results: Seven of 20 websites (35%) were certified by the HON-code. The mean DISCERN instrument score was 63% ± 20%. The mean LIDA tool scores were 91% ± 5% for accessibility, 91% ± 3% for usability and 86% ± 9% for reliability. The mean Flesch Flesch-Kincaid Grad Level was 7.4 ± 1.6 and Automated Readability Index was 6.9 ± 1.8. Conclusions: Health information on prostate cancer in the Internet is of high quality according to the DISCERN instrument. However, only one third of websites are HON-code certified. Websites show good to excellent values for accessibility, usability and reliability. Information provided in these websites is easy to understand. An education of 7 school years is sufficient to read online health information. Thus, caregivers should advise patients to seek for health information online in addition to their personal visits in doctor's offices and hospitals.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2725Renáta Kolářová submitted 'The Interactive Textbook of Cardiology' #med2 userprofile: http://www.medicine20congress.com/ocs/social/kolarova92014-04-28T11:20:36-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-04-28T11:20:36-04:00Currently there’s no similar learning tool for students of medicine in the Czech Republic. The Textbook’s format is inovative and we expect that it starts formation of further textbooks based on a similar princip. We would like to present an innovative Cardiology education platform eCardio.cz. The Interactive textbook of cardiology is based on the learning platform and e-learning system. These basic elements of the project work as a full web based applications, that are available for all users from anywhere throught using the web browser. The system is based on curent technologies, which provide the effective development, management and expandability in the future. Innovation is achieved through the creation of a new learning platform in a cardiology format with educational tools derived from the film and multimedia sectors, tests, interpretative parts, illustrations, and social networking features that enable creation of a learning community. The new platform is tested in a pilot semester and – according to feedback from participants – eventually implemented in teaching methods. The concept will allow continual updating and innovation for teaching professionals involved in medical practice from the entire country and abroad. The final output will be created in English, which should enable and promote its use internationally.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2842Renáta Kolářová submitted 'The Interactive Textbook of Cardiology' #med2 userprofile: http://www.medicine20congress.com/ocs/social/kolarova92014-04-28T11:20:36-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-04-28T11:20:36-04:00Currently there’s no similar learning tool for students of medicine in the Czech Republic. The Textbook’s format is inovative and we expect that it starts formation of further textbooks based on a similar princip. We would like to present an innovative Cardiology education platform eCardio.cz. The Interactive textbook of cardiology is based on the learning platform and e-learning system. These basic elements of the project work as a full web based applications, that are available for all users from anywhere throught using the web browser. The system is based on curent technologies, which provide the effective development, management and expandability in the future. Innovation is achieved through the creation of a new learning platform in a cardiology format with educational tools derived from the film and multimedia sectors, tests, interpretative parts, illustrations, and social networking features that enable creation of a learning community. The new platform is tested in a pilot semester and – according to feedback from participants – eventually implemented in teaching methods. The concept will allow continual updating and innovation for teaching professionals involved in medical practice from the entire country and abroad. The final output will be created in English, which should enable and promote its use internationally.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2724Marco Bardus (@marcobardus) submitted 'Smartphone and Web 2.0 Applications for Weight Management: A Review of the Literature' #med2 userprofile: http://www.medicine20congress.com/ocs/social/marcobardus2014-04-28T03:02:46-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-04-28T03:02:46-04:00Background: Smartphone and Web 2.0 applications offer appealing solutions for delivering targeted and personalised e-health interventions that address various health behaviours, including dietary and physical activity behaviours. These applications show great potential as they can reach large segments of the population at relatively low cost. It is yet unclear the extent to which these applications are used and whether their use is associated with effects on behaviour. Furthermore, little work has been done in understanding what components of e-health interventions are associated with better results. Intervention components include behaviour change techniques (BCTs) employed (e.g., goal setting, self-monitoring, feedback provision, etc.), tools and delivery modes used (e.g., automated text messages, apps notifications, emails providing advices and challenges, displaying data allowing comparisons among users, inboards, etc.), and particular Web 2.0 features utilised (i.e., social networking, status updating, content sharing). Understanding which components are associated with positive (or negative) effects for particular target audiences is fundamental in developing effective e-health interventions employing Web 2.0 and smartphone applications. Objective: This paper investigates the utilisation of Web 2.0 and smartphone applications in e-health interventions for weight management by “decomposing” existing interventions and identifying which components are associated with effectiveness. Methods: A systematic review of the literature will be conducted to identify which intervention components and related Web 2.0 and smartphone apps features are associated with what effects on behaviour. Intervention components will be classified according to an extended version of Abraham and Michie’s (2008) taxonomy for behavioural change techniques, and will include information about delivery modes (e.g., Web 2.0 or smartphone app, email, text message) and Web 2.0 features employed. Research in Progress: The review is part of a research project starting in May 2014. By the time of the presentation we will have concluded a preliminary scoping review, so that a map of the available evidence could be described and discussed. The work will highlight how smartphone and Web 2.0 applications are used in interventions designed to increase physical activity and change dietary behaviour patterns as well as how effective such apps are at prompting weight loss and weight maintenance. Additionally, this research will seek to identify the change processes involved in the creation of such apps, that is, which techniques, tools, and delivery modes are associated with effectiveness.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2715Macrina Camps submitted 'Telemedicine Project In Africa: “Salud 2.0”' #med2 userprofile: http://www.medicine20congress.com/ocs/social/macrinacamps2014-04-21T02:48:36-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-04-21T02:48:36-04:00Telemedicine Project In Africa: “Salud 2.0” Fundacion Recover Hospitales para África is a spanish NPO specialized in hospital cooperation committed to Africa’s Health and well-being of African people. Africa suffers 24% of world´s illness, managing it with 3% of the health professionals in the world and with 1% of the funds. In Subsaharian Africa there are no specialists (Cameroun has 20 radiologists for 20,000,000 people) Our challenge is to connect African general Doctors with Spanish Specialists Doctors. To achieve our goal we are developing the Project Pilot “Salud 2.0” to connect African general Doctors (with no specialty) located in hospitals with a non-profit strategy, with a network of Spanish specialist, volunteers, committed to Africa’s reality. The objectives of the project are I. Offer a medical assessment support of cases of African patients II. Training III. Develop of knowledge and medical research. We use a very simple tool. A medical exchange platform (like Facebook), called MEDTING where each case has a file in only one screen. The Spanish volunteer doctor can analyze this file from his computer in his free time. Our method is: a) Design of a structure of networking in MEDTING b) Training c) Monitoring and support We obtained excellent results in the first PILOT- project (started in 2013): - Training for African Doctors but also for Spanish Doctors who get to see very rare cases - Better treatment for African patients - Generation of Knowledge (academic database) - Beginning of shared publishing between the African & Spanish doctors - Low cost for initial investment and annual maintenance PILOT 2013 Connected Hospitals 3 (Cameroon) African doctors 13 (equivalent to 40) Spanish doctors 26 (150 consulted) Number of clinical cases 200 / year Complex cases 20% of the cases are requested trainings by the African doctors Conclusions “Salud 2.0” is an innovative and successful Project that combines charity medical assistance with a powerful generation of knowledge & training to promote a healthy environment in Africa. This Project is an opportunity for Spanish specialists to find a way to make sanitary cooperation from “home” with continuity over time. African physicians have the opportunity of being trained being able to share their insights with Spanish specialists.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2713Macrina Camps submitted 'Telemedicine Project In Africa: “Salud 2.0”' #med2 userprofile: http://www.medicine20congress.com/ocs/social/macrinacamps2014-04-16T05:59:37-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-04-16T05:59:37-04:00cooperation committed to Africa’s Health and well-being of African people. Africa suffers 24% of world´s illness, managing it with 3% of the health professionals in the world and with 1% of the funds. In Subsaharian Africa there are no specialists (Cameroun has 20 radiologists for 20,000,000 people) Our challenge is to connect African general Doctors with Spanish Specialists Doctors. To achieve our goal we are developing the Project Pilot “Salud 2.0” to connect African general Doctors (with no specialty) located in hospitals with a non-profit strategy, with a network of Spanish specialist, volunteers, committed to Africa’s reality. The objectives of the project are I. Offer a medical assessment support of cases of African patients II. Training III. Develop of knowledge and medical research. We use a very simple tool. A medical exchange platform (like Facebook), called MEDTING where each case has a file in only one screen. The Spanish volunteer doctor can analyze this file from his computer in his free time. Our method is: a) Design of a structure of networking in MEDTING b) Training c) Monitoring and support We obtained excellent results in the first PILOT- project (started in 2013): - Training for African Doctors but also for Spanish Doctors who get to see very rare cases - Better treatment for African patients - Generation of Knowledge (academic database) - Beginning of shared publishing between the African & Spanish doctors - Low cost for initial investment and annual maintenance PILOT 2013 Connected Hospitals 3 (Cameroon) African doctors 13 (equivalent to 40) Spanish doctors 26 (150 consulted) Number of clinical cases 200 / year Complex cases 20% of the cases are requested trainings by the African doctors Conclusions “Salud 2.0” is an innovative and successful Project that combines charity medical assistance with a powerful generation of knowledge & training to promote a healthy environment in Africa. This Project is an opportunity for Spanish specialists to find a way to make sanitary cooperation from “home” with continuity over time. African physicians have the opportunity of being trained being able to share their insights with Spanish specialists.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2712Macrina Camps submitted 'Telemedicine Project In Africa: “Salud 2.0”' #med2 userprofile: http://www.medicine20congress.com/ocs/social/macrinacamps2014-04-16T05:46:52-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-04-16T05:46:52-04:00Fundacion Recover Hospitales para África is a spanish NPO specialized in hospital cooperation committed to Africa’s Health and well-being of African people. Africa suffers 24% of world´s illness, managing it with 3% of the health professionals in the world and with 1% of the funds. In Subsaharian Africa there are no specialists (Cameroun has 20 radiologists for 20,000,000 people) Our challenge is to connect African general Doctors with Spanish Specialists Doctors. To achieve our goal we are developing the Project Pilot “Salud 2.0” to connect African general Doctors (with no specialty) located in hospitals with a non-profit strategy, with a network of Spanish specialist, volunteers, committed to Africa’s reality. The objectives of the project are I. Offer a medical assessment support of cases of African patients II. Training III. Develop of knowledge and medical research. We use a very simple tool. A medical exchange platform (like Facebook), called MEDTING where each case has a file in only one screen. The Spanish volunteer doctor can analyze this file from his computer in his free time. Our method is: a) Design of a structure of networking in MEDTING b) Training c) Monitoring and support We obtained excellent results in the first PILOT- project (started in 2013): - Training for African Doctors but also for Spanish Doctors who get to see very rare cases - Better treatment for African patients - Generation of Knowledge (academic database) - Beginning of shared publishing between the African & Spanish doctors - Low cost for initial investment and annual maintenance PILOT 2013 Connected Hospitals 3 (Cameroon) African doctors 13 (equivalent to 40) Spanish doctors 26 (150 consulted) Number of clinical cases 200 / year Complex cases 20% of the cases are requested trainings by the African doctors Conclusions “Salud 2.0” is an innovative and successful Project that combines charity medical assistance with a powerful generation of knowledge & training to promote a healthy environment in Africa. This Project is an opportunity for Spanish specialists to find a way to make sanitary cooperation from “home” with continuity over time. African physicians have the opportunity of being trained being able to share their insights with Spanish specialists.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2695Stefan Becker submitted 'Demographic and Health Related Data of Users of a Mobile Application to Support Drug Adherence Is Associated with Usage Duration and Intensity' #med2 userprofile: http://www.medicine20congress.com/ocs/social/ibecker2014-03-28T06:15:02-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-28T06:15:02-04:00Background: Drug adherence is a problem in the management of patients with chronic conditions. Numerous mobile applications try to support users in their regular and correct drug intake. Yet high attrition and digital divide is described in the usage of health-related apps. On developing software for patients it is therefore important to know whether users are likely to login a mobile application by themselves and who may need further assistance. Objective: To analyze demographic- and health-related factors associated with “long-term-usage” and “more intense” usage of the mobile application “Medication Plan”. Methods: Between 2010-2013 the application “Medication Plan” could be downloaded free of charge from the AppleAppStoreTM. Users were able to keep and alter a list of their regular medication. A local push-notification supported the regular intake. Demographic and health-related data were collected via an online questionnaire. This study analyzed data captured on "Medication Plan". Dependent variables were “duration of long-term usage” (defined as >1day and if no activity in app usage was recorded for >10 days users had stopped applying) and “intensity of usage per day” during time of active usage. The unique identifier numbers were irreversibly encrypted and its activity tracked. Associated information was analyzed. Results: Overall activity of 1708/1799 users, who fully completed the questionnaire, was recorded between December 2010 and April 2013. 69 % (1183/1708) applied “Medication Plan” more than a day. Of those 1183 users, 74 % were male (872), 15% (182) were <31 years, 48% (567) between 31 and 50 years and 37% (434) >50 years of age. 29% (338) had gained a university degree. 55% (651) stated to be suffering from cardiovascular disease, 7% (79) from diabetes, 5% (64) from lung disease, 5% (58) from liver disease. 70% (826) were taking 3 or less different medications/day and 30% (357) were taking 4 or more medications/day. Variance analysis presented the following effects with respect to duration of usage: sex and educational attainment had no effect. Yet with a mean duration of usage of 23.3 days (SD 36.9) by users < 21 years there was a significant increase over all age cohorts with users of 60 years and above using the application for 103,9 days on average (SD 20.7) (F=2,581; df=5; p=0.025). With regard to usage intensity demografic predictors (sex, age and educational attainment) showed no effect. Usage intensity was directly associated with an increasing number of prescribed medication and increased from on average of 1.87 uses per day (SD 1.83) and 1 drug per day to on average 3.71 uses per day (SD 2.12) for users stating to be taking more than 7 different drugs a day (F=4.017; df=7; p<0.001). Conclusion: With regard to “long-term” usage and usage intensity, our data show that the often cited threefold “digital divide” between age groups, sexes and according to education levels could not be detected among “long-term” users. Particularly older users and those with more complicated therapeutic drug regimes seemed to have relied on our service. The data show that such technology may indeed be a promising approach to support the treatment of patients with chronic conditions.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2684Julia Moreland (@JulsMoreland) submitted 'The Power Exchange between Patient and Health Professional: A Grounded Theory Approach' #med2 userprofile: http://www.medicine20congress.com/ocs/social/julia-moreland2014-03-20T18:07:52-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-20T18:07:52-04:00Background Online health information is changing how patients interact with health professionals. Much research focuses on the minefield of unregulated information and the impact this has on positive and negative patient outcomes. However, it is vital that the health professional be considered in this process as this information potentially alters the power relationship between patient and health professional. Objectives The objective of this pilot study is to develop an appropriate methodological approach in order to gain some understanding of how online health information may be altering the power dynamic between patient and health professional. Pressure on health professionals to justify diagnosis and subsequent treatment recommendations is to be measured. Methods A focus group (n=10) is being conducted among health professionals in order to generate data which enables exploration of the power exchange between patient and health professional in relation to previously exclusive health information. This pilot study seeks to identify any negative impact on health professionals and discover whether it is possible to measure this impact by breaking interactions between actors into economic transactions. Using Nvivo, a framework analysis will analyse evidence to support themes of power and efficacy in a healthcare context. Nvivo generates outputs which can allow the researcher to identify themes and patterns which may otherwise be difficult to see. Results Preliminary findings indicate that some health professionals are beginning to feel undermined by patient self-diagnosis and pressure to prescribe desired treatments based on online health information. Conclusions A research paradigm to investigate the extent and impact of online health information seeking on health professionals will be developed to inform a full-scale study on this important issue.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2643Carolyn W Simpkins (@cwsimpkins) submitted 'Quality Improvement on the Frontline: Leveraging Virtual Workspace, Mentoring and Tutorials to Jumpstart Quality Improvement by Healthcare Providers' #med2 userprofile: http://www.medicine20congress.com/ocs/social/carolynws2014-03-20T10:00:52-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-20T10:00:52-04:00We identified a challenge facing the quality improvement movement in healthcare, which is that while frontline clinical staff had the direct insights into the problems and possible solutions to healthcare quality issues, they were too busy with their patient care duties to set aside time to develop the skills and then design and pursue projects to improve the quality of the care they were engaged in. In response we convened an advisory panel of over 30 global experts in Quality Improvement (QI) in healthcare and designed an online workspace which combined ease of use, asynchronous working groups to accommodate busy clinical work schedules, online mentoring and instant tutorials throughout a step-by-step, Standards for Quality Improvement Reporting Excellence (SQUIRE http://squire-statement.org/) compliant workbook structure which would guide clinical workers from QI novice through a well-designed, well-documented, completed QI project. We offer one-click submission for publication in a peer-reviewed, pubmed indexed journal as extra reward for these efforts, and to begin to build a global database of clinical improvement evidence, one which will be increasingly metatagged, searchable and combined with a virtual community We have enrolled users from five continents and have been excited to see the movement growing with close to 2000 projects undertaken from 2012 to 2014, and, importantly, have seen the improvement interventions described in published projects rapidly spreading from one region to another through this platform. We will describe an example in which an intervention involving redesign of the patient education process and written medication instructions for patients with low literacy, which was originally designed by a team in Lahore, Pakistan, was adapted for a similar but distinct purpose in Toronto, Canada and is now being revised for implementation by a group in Malawi. The creation of an online collaborative workspace in publication, which combines tutorials and tools with the project work itself, is a model we hope will be applicable in many arenas. We will describe early exploration of this tool in a setting to organize an initiative to incorporate practical training in QI into a residency training program clinic, customization by a specialty organization to support their virtual learning collaborative seeking to increase QI activities throughout the specialty, and the potential for using this tool to underpin a multispecialty Maintenance of Certification (MOC) program in a large academic medical center across numerous clinical departments and multidisciplinary teams. We will present the experiences of users from a wide range of settings and geographies deploying the platform in a variety of contexts as described above.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2683Juanita Fernando submitted 'Lessons Learned; Embedding EHealth into Undergraduate Medical Education' #med2 userprofile: http://www.medicine20congress.com/ocs/social/juanitaf2014-03-20T00:51:09-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-20T00:51:09-04:00Introduction The gap between current undergraduate medical curriculum and eHealth and clinical informatics in health care contexts has been clearly identified in the literature. eHealth requires a fundamental change to the design and delivery of the medical curriculum to ameliorate forecasted shortages in the digital medical workforce. Yet a mismatch between the current undergraduate medical education curriculum and practice reality have not been satisfactorily addressed. This work describes outcomes from the delivery of an innovative eHealth informatics elective, which was designed to embed health informatics, a disruptive pedagogical concern, into undergraduate medical education. Method This single case study uses an action research approach to draw on the process of progressive problem solving that improves educational approaches to eHealth informatics in undergraduate medical education settings. The study shares key aspects of our learning with others involved in eHealth training to support similar informatics innovations for consideration in the future design of undergraduate medical curriculum. Results We analyze lessons learned from the design and delivery of a creative eHealth elective for first year medical undergraduate students at Monash University (Australia). We needed to overcome seven key challenges “on the run” to help prepare the students for digital practice horizons. Firstly, a lack of suitable funding and resources hampered elective design. Medical students enrolling in the elective were overwhelming male and lacked techno-savvy in the context of medical practice and learning. Medical students were unaware of the risks, benefits and security threats relating to the application of eHealth systems in practice. Only a very limited number of academic staff possessed the specific skills required to achieve informatics learning outcomes. Specific skills training were required for most students enrolled in the elective. Finally, we needed to ensure the transparency of medical and eHealth informatics jargon to support student learning. Discussion The design and delivery of this elective allowed the education content around serious computer games and applications for eHealth to be embedded into the medical pedagogy. Direct and collegiate support was a critical element in the successful development of the program. The program did not require additional space in an already busy curriculum. Student feedback suggested gender imbalances in the class may have been addressed by improved communication. The evidence also indicates noteworthy mismatches between the perceptions of course designers and the expectations and skill level of students. Academic staff required robust eHealth informatics, information privacy, and security teaching skills to lead the elective. In addition, significant resource constraints became apparent requiring flexibility and the capacity to modify the program during delivery. Nonetheless the elective provided a space for students to reflect upon their own learning in eHealth informatics. Experience in design and delivery of this elective has informed content for knowledge management, which is a core component of the current undergraduate medicine curriculum at our institution.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2671Robert Craig Sineath (@rsineat) submitted 'Methods for Improving Consent and Survey Completion in Online HIV Prevention Research with Young Men Who Have Sex with Men' #med2 userprofile: http://www.medicine20congress.com/ocs/social/rsineat2014-03-19T20:27:45-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-19T20:27:45-04:00Background The internet is effective in reaching participants for data collection in public health, especially among hard-to-reach populations like young men who have sex with men (YMSM). When engaging participants without personal interaction, it is important to ensure that participants understand risks of the study and develop innovative ways to retain participants to reduce nonresponse bias. From previous research, we know that participants spend an average of 28 seconds on the consent page, suggesting that the participants do not fully digest the informed consent information; in our most recent online survey, 21% of 9164 respondents who consented to take the survey did not finish. Objective We used online focus group discussions to explore alternative methods for delivering consent information and maximizing retention of YMSM throughout the length of an online survey. The alternate methods explored in these focus groups are being developed for a randomized controlled trial to test their efficacy. Methods We conducted five synchronous (“chat room”-based) online focus groups in July and August of 2013 with YMSM between the ages of 18 and 29 living in the United States. Participants were recruited via banner advertisements placed on Facebook and Black Gay Chat. Topics of discussion during the focus groups included previous experiences with online research and consent, privacy concerns, alternate online consent mechanisms, and innovative incentives to promote survey completion. Results Most participants had fewer concerns about their privacy in online research compared to in-person research, especially when the research is conducted by an institution perceived to be reputable. Participants were more willing to be truthful with sensitive topics such as drugs and sex when participating in online research, compared to in-person research. All participants indicated that they did not fully read the consent form for the focus groups. Suggestions for effective alternate consents included videos and a brief consent form with an outline of key points. The most important factors mentioned by participants for an effective video consent included brevity, high production value, legitimacy of the research institution, entertainment value, relatability of the presenters, and an appeal to altruism. To maintain engagement after consent, most participants agreed that it is important for researchers to offer an incentive for any study longer than 15 minutes. Although money was mentioned as an effective motivator in each focus group, alternate incentives included receiving access to interesting statistics, personalized messages of gratitude from the researchers emphasizing the importance of the project, messages speaking to altruism, a survey progress bar, sex appeal in the survey branding, and a dashboard comparing the participant’s data to data of others at the end of the survey. Conclusions YMSM are frequently targeted for online HIV prevention surveys and are becoming more difficult to engage in research because of high exposure to surveys and long standard consent forms. New technologies offer innovative opportunities to improve ethical conduct and increase retention of participants in web-based research. These should be exploited in all areas of online health research, especially HIV prevention among YMSM.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2518Christophe Robert Laurent (@spoedman) submitted 'The Use of an Omnipresent Array of Dynamic QR Codes to Establish Bidirectional Multi Platform Social Media Communication and Conversation Between Visitors and Organizers During Mass Events.' #med2 userprofile: http://www.medicine20congress.com/ocs/social/spoedman2014-03-19T19:40:29-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-19T19:40:29-04:00Most known formats of communication of citizens with authorities during calamities or adverse events are governed by long established methods or models, and still depend mainly on dependable, established and trusted channels. In case of a medical emergency, people do not start calling around for an ambulance, but call the trusted 911 number on the telephone or cellphone. Pilots use a format for their communication when signaling they are in trouble, just as ship captains use a radio, and a trusted vocabulary (Mayday ...). An older non-verbal communication of trouble or problems, is a version of the trusted MORSE version of S.O.S., either with lights, sounds, or radio clicks. The problem with social media is that such a conceptual canalization of communication between citizens and the authorities during adverse events does not exist as of yet. Because of the (more or less) known size of their population, their proneness for adverse events, and their high percentage of smartphone users, mass events are a very good breeding ground for testing novel methods of bilateral communication between authorities and the visitors, either during the event itself, as well as during calamities at events. Very much hope and energy is being put in disaster mapping, and big data as one of the sources for disaster mappers. But the fact remains that disaster mapping is always a post factum effort, and that the date mostly form a reconstructive map, rather than an ad hoc tool for first responders. At least up until now. This presentation outlines the efforts that are realized to put together a reference frame for communication between the organizers, authorities, and visitors of mass events, as it has been conceived for use at a number of events in Europe in 2014. The aim is to build a bridge using social media, that would turn the previously non directional calls for help from the public, and instructions from the authorities, to easily findable information on social media, even if the visitors did not use social media on the event before. And independent from the social media platform they use as a primary communication form. A QR code reader is provided in different Festival Apps already, and is used by many smartphone users anyway. Augmented reality apps such as Layar, Wikitude and Junaio also read, and translate QR codes into webpages. The visitor is being trained in using QR codes by Facebook Likes and games from companies on the premises of the festivals. An array of five clear dynamic QR codes is displayed at the top and/or bottom of every medium that has print on it: folders, posters, doors, screens, tickets, booths and much more. The five dynamic codes, in the popular blue, yellow, red and green plus black, each have their category/subject of communication, and link the user to the possibility to receive or report information on that category. Even when all audio and video possibilities are lost, they still form a bridge, using social media, between visitors and organizers or authorities.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2789Christophe Robert Laurent (@spoedman) submitted 'The Use of an Omnipresent Array of Dynamic QR Codes to Establish Bidirectional Multi Platform Social Media Communication and Conversation Between Visitors and Organizers During Mass Events.' #med2 userprofile: http://www.medicine20congress.com/ocs/social/spoedman2014-03-19T19:40:29-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-19T19:40:29-04:00Most known formats of communication of citizens with authorities during calamities or adverse events are governed by long established methods or models, and still depend mainly on dependable, established and trusted channels. In case of a medical emergency, people do not start calling around for an ambulance, but call the trusted 911 number on the telephone or cellphone. Pilots use a format for their communication when signaling they are in trouble, just as ship captains use a radio, and a trusted vocabulary (Mayday ...). An older non-verbal communication of trouble or problems, is a version of the trusted MORSE version of S.O.S., either with lights, sounds, or radio clicks. The problem with social media is that such a conceptual canalization of communication between citizens and the authorities during adverse events does not exist as of yet. Because of the (more or less) known size of their population, their proneness for adverse events, and their high percentage of smartphone users, mass events are a very good breeding ground for testing novel methods of bilateral communication between authorities and the visitors, either during the event itself, as well as during calamities at events. Very much hope and energy is being put in disaster mapping, and big data as one of the sources for disaster mappers. But the fact remains that disaster mapping is always a post factum effort, and that the date mostly form a reconstructive map, rather than an ad hoc tool for first responders. At least up until now. This presentation outlines the efforts that are realized to put together a reference frame for communication between the organizers, authorities, and visitors of mass events, as it has been conceived for use at a number of events in Europe in 2014. The aim is to build a bridge using social media, that would turn the previously non directional calls for help from the public, and instructions from the authorities, to easily findable information on social media, even if the visitors did not use social media on the event before. And independent from the social media platform they use as a primary communication form. A QR code reader is provided in different Festival Apps already, and is used by many smartphone users anyway. Augmented reality apps such as Layar, Wikitude and Junaio also read, and translate QR codes into webpages. The visitor is being trained in using QR codes by Facebook Likes and games from companies on the premises of the festivals. An array of five clear dynamic QR codes is displayed at the top and/or bottom of every medium that has print on it: folders, posters, doors, screens, tickets, booths and much more. The five dynamic codes, in the popular blue, yellow, red and green plus black, each have their category/subject of communication, and link the user to the possibility to receive or report information on that category. Even when all audio and video possibilities are lost, they still form a bridge, using social media, between visitors and organizers or authorities.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2667Ture Alander (@TureAlander) submitted 'Experiences of a Patient Portal with Access During 9 Years to the Medical Records, in Primary Care.' #med2 userprofile: http://www.medicine20congress.com/ocs/social/ture01502014-03-19T19:35:51-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-19T19:35:51-04:00Background A patient portal, called “Health Care Account” (HCA), which allowed patients to access their primary health care records and patient administrative information from Uppsala University Hospital was evaluated during 2002-2012. The project is the first of its kind in Sweden and probably the longest follow up of a patient portal in the World. Objective The aim with this study is to address questions about the benefits for patients as well as healthcare professionals with a patient portal used in clinical practice for a long time. The specific questions are: What information is of most interest to the patient and how can it be made available and presented? Which type of patients were attracted to the portal? What were the security concerns? How did the portal influence the work at the practice? Methods The setting of the system was a single practice, in Uppsala county of Sweden. 2213 listed patients (16-97 years, 52.9% men) were invited to use the portal. Patients had access to the HCA by a link on their primary physician’s web site. After login, a menu was presented where the patient could directly obtain Medical records information such as, scheduled future visits, documents, patient information, medicines, lab results, sick leave, hypersensitivity, fees, doctor notes, and diagnoses. The HCA was restricted to publish date and type of incoming and outgoing documents such as x-ray results, referrals, and discharge summaries. The reason for this was that we believed that contact with a physician was necessary in order to explain the contents of such documents for the patient. For the same reason, reference values for lab analyses were also omitted. Links to the administrative systems of the Uppsala University Hospital and a messaging function were also included. Furthermore, links to external information such as pharmaceutical dictionary (Patient FASS), and the medical dictionaries InfoMedica and Pion were also included. Both evaluation questionnaires and interviews were conducted and implemented on two separate occasions. Uppsala University Ethics Committee approved the research Project. Results This long term follow up study revealed that patients with chronic conditions, and patients living in a one-person household benefit the most of the portal. The most popular services were the access to laboratory results and doctor´s notes. There were no major security concern and the portal had no negative impact on the work at the practice. Conclusions Patients with chronic illnesses and patients living alone benefit the most of direct acces to their Medical records. The patient portal is easily implemented in clinical practice.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2668Sam Nordfeldt submitted 'Health Practitioners’ Use of an Open Message Board for Dialogues with Young Diabetes Type 1 Patients' #med2 userprofile: http://www.medicine20congress.com/ocs/social/samno2014-03-19T19:10:08-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-19T19:10:08-04:00Background: Management of paediatric diabetes type 1, including frequent insulin injections and intensive self-control of blood glucose, is part of everyday life. The treatment has to be performed by the young patients themselves, along with their guardians, gradually and over time becoming their own experts. Through the varying phases of the disease trajectory they are guided by paediatric diabetes teams, consisting of nurses and nurse specialists, physicians, dieticians, social workers and/or clinical psychologists. The practitioners meet young patients, along with their guardians, when hospitalized at onset, and continue to see them quarterly or more often as outpatients over many years. Regular appointments in the clinic and telephone contact when needed are the traditional means of communication. Objectives: To what extent and by what means may specialized pediatric diabetes health practitioners deliver medical advice online? Methods: Since 2008, the practitioner-driven open Swedish web portal diabit.se targets children and adolescents with diabetes type 1. The portal is funded by the healthcare providers - County Councils. The service includes an open message board moderated by young people with diabetes, and monitored by specialized health practitioners. As a new pilot project, the message board simply has been expanded with a special section for ”Ask a practitioner”. A group of networking practitioners volunteer as moderators, aiming to respond in maximum one working day. The practitioners’ responses show their real names, professions, affiliations and photos in the message board whereas young patients, parents and others use anonymous alias. Due to the format, a single response from one practitioner may grow to a thread with comments of other practitioners and of any other user as well. Results: The open message board format worked well. The posts were relevant, respectful and reflective without any sign of abuse. Practitioners found their participation meaningful and time-efficient. Page visits counts for the ”Ask a practitioner” - threads grow continuously. Thread examples from the pilot period are presented. Conclusions: The unique questions and following open dialogues add value to the web portal. Information systems where both patients and health professionals engage show a potential for improvement of care - offering users the best of both worlds. More on this project in JMIR: http://www.jmir.org/2009/2/e12/ http://www.jmir.org/2010/2/e17/ http://www.jmir.org/2012/6/e154/http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2666Maria Hägglund (@MariaHagglund) submitted 'Tutorial: Using Formative Evalutions to Increase Usability in Patient EHealth Services – a Practical Tutorial' #med2 userprofile: http://www.medicine20congress.com/ocs/social/mariahagglund2014-03-19T18:26:39-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-19T18:26:39-04:00eHealth is often suggested to have the potential to revolutionize the way healthcare and prevention is provided, shifting the balance of power and responsibility from healthcare professionals to patients and citizens [1]. Many patients today are no longer content to be passive recipients of care, they want shared decision making, active participation in healthcare processes and access to their own health data. These patients and citizens in general are increasingly requesting access to and control over their health information by e.g. online access to electronic health records (EHRs)[2], self-monitoring of health-related issues, and active use of internet-based education and support groups. However, poor usability and adaption to users’ needs are often quoted as barriers for wide-spread and sustainable adoption of consumer health informatics and public eHealth services [3]. In order to improve ICT systems, it is necessary for designers to understand any deficiencies and to correct design flaws. There are today numerous methods to assess ICT in healthcare [4]; formative to improve ICT systems during development or summative assessments of the ones already implemented. However, many authors report problems during evaluation [5] and although several studies assert the value of usability and knowledge of human factors in development and evaluation of health information systems [6][7][8][9][10], many systems fail in supporting healthcare professionals in their work [5][11]. We believe that this may be due to a lack of awareness and practical knowledge and tools to perform early formative evaluations in design of new applications [3]. Focus in healthcare is often on summative evaluations to prove the clinical effects of health applications, however, if usability problems are not identified and corrected early on, these will affect the long-term adoption of the new tools decreasing the clinical effectiveness of interventions. We therefore propose a hands-on 4 hour tutorial where we introduce the concept of usability, and discuss how different aspects of usability can be measured, followed by practical exercises where the participants are introduced to different evaluation methods and get to apply them in pre-defined evaluation scenarios. In order to strengthen the role of patients and relatives, the tutorial focuses on patient-centric provision of care, following the ongoing shift from organization to citizen-centred care [12]. The usability of the intended innovation is an important quality measure, a key to failure or success of a product [13]. Formative evaluations can be done assessing systems either together with users (user-driven evaluations), or using approaches where usability experts formally assesses an interface design with respect to a set of heuristics, or design principles (expert-driven evaluations). In this tutorial, we will explore both expert-driven and user-driven evaluations; (1) Heuristic evaluations with experts [14][15], and (2) Think-aloud usability tests with end-users. Expected attendee background: Software developers, health- and social care professionals, patients and policy makers involved or interested in the design, implementation and evaluation of patient eHealth services. [1] S. Koch, T. Hasvold, A. W. Kushniruk, A. Marcelo, and G. Kouematchoua Tchuitecheu, “eHealth - nurturing patient empowerment? State of the art and reflections from four continents. In: Panel discussion. Medinfo 2010, Cape Town, South-Africa.,” In: Panel discussion. Medinfo 2010, Cape Town, South-Africa. [2] I. Scandurra, R.-M. Åhlfeldt, and Å. Cajander, “Towards National Deployment of Online Medical Records and eHealth Services.,” in Accepted for ePublishing in “Vitalis14 PReP” (gupea.ub.gu.se)., 2014. [3] I. Scandurra, J. Holgersson, T. Lind, and G. Myreteg, “Development of Patient Access to Electronic Health Records as a Step Towards Ubiquitous Public eHealth.,” European Journal of ePractice; From eHealth to mHealth, vol. 20, 2013. [4] J. Brender, Handbook of evaluation methods for Health Informatics. Elsevier Academic Press;, 2006. [5] E. Ammenwerth, S. Gräber, G. Herrmann, T. Bürkle, and J. König, “Evaluation of health information systems - problems and challenges,” Int J Med Inform, vol. 71, pp. 125–35, 2003. [6] T. Timpka and C. Sjoberg, “Development of systems for support of collaboration in health care: the design arenas,” Artificial Intelligence in Medicine, vol. 12, no. 2, pp. 125–136, 1998. [7] M. Berg, “Patients and professionals in the information society: what might keep us awake in 2013,” International Journal of Medical Informatics, vol. 66, no. 1–3, pp. 31–37, 2002. [8] A. Andersson, N. Hallberg, and T. Timpka, “A model for interpreting work and information management in process-oriented healthcare organisations,” Int J Med Inform, vol. 72, no. 1–3, pp. 47–56, 2003. [9] A. W. Kushniruk and V. L. Patel, “Cognitive evaluation of decision making processes and assessment of information technology in medicine,” International Journal of Medical Informatics, vol. 51, no. 2–3, pp. 83–90, 1998. [10] B. Kaplan, “Evaluating informatics applications - some alternative approaches: theory, social interactionism, and call for methodological pluralism,” Int J Med Inform, vol. 64, no. 1, pp. 39–56, 2001. [11] M. Berg, “Patient care information systems and health care work: a sociotechnical approach,” Int J Med Inform, vol. 55, no. 2, pp. 87–101, 1999. [12] E. H. Wagner, S. M. Bennett, B. T. Austin, S. M. Greene, J. K. Schaefer, and M. Vonkorff, “Finding Common Ground: Patient-Centeredness and Evidence-Based Chronic Illness Care,” The Journal of Alternative and Complementary Medicine, vol. 11, no. Supplement 1, p. S–7 – S–15, 2005. [13] B. Kaplan and N. Shaw, “People, organizational, and social issues: evaluation as an exemplar,” in Yearbook of medical informatics, R. Haux, Ed. Stuttgart: Shattauer, 2002, pp. 71–88. [14] I. Scandurra, M. Hägglund, D. Moström, and S. Koch, “Heuristic Evaluation Extended by User Analysis : A Fast and Efficient Method to Identify Potential Usability Problems in Health Information Systems Heuristic Evaluation combined with a User Analysis,” Journal On Information Technology In Healthcare, vol. 4, no. 5, pp. 317–325, 2006. [15] I. Scandurra, M. Hägglund, M. Engström, and S. Koch, “Heuristic evaluation performed by usability-educated clinicians: education and attitudes,” in Stud Health Technol Inform, 2007, vol. 130, pp. 205–216.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2661Emily Knight submitted 'Public Health Guidelines for Physical Activity: Is There an App for That? A Review of Android and Apple App Stores' #med2 userprofile: http://www.medicine20congress.com/ocs/social/eknigh22014-03-19T17:31:53-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-19T17:31:53-04:00Background: It is well reported in the literature that adults in developed countries are not achieving the requisite daily physical activity (PA) for health. There is a growing evidence base supporting the use of mobile health applications (apps) to promote PA behavior change within the health care setting. However, there is arguably less information demonstrating the evidence-informed development of apps. This may pose challenges for health professionals and consumers alike when selecting and implementing apps to achieve desired health outcomes and behaviours. Objective: The purpose of this review was to identify evidence-based apps which could be used by health practitioners to enhance PA prescription for health promotion. Methods: App stores for Apple and Android platforms were searched by 4 independent reviewers (2 per platform) using keyword (“physical activity”, “fitness”, “walking”, and “pedometer”) and category (“Health & Fitness” both free and paid) searching of available apps during a single day. The app description page of the first 100 results from each search were screened for eligibility. Data were extracted from the description page for all eligible apps, which included descriptive data for evidence-based features (e.g. PA guidelines, behavior change theories), social behaviour (e.g. linking with social networks), and clinical utility (e.g. cost, linking with peripheral health devices). Results: The search generated 2400 results. After removing duplicates (n=1282) and ineligible apps (n=739), descriptive review was conducted for 379 apps (n=173 Android, n=206 Apple). None of the apps included an evidence-based PA target. However, a daily PA target of 10,000 steps was included in 1% (n=4) of apps. None of the app description pages indicated a theory for behaviour change. 5% (n=18) of apps were endorsed by or linked to an agency, of which 28% were academic (n=5) and the reminder (n=13) were commercial. 54% (n=203) indicated capacity for social networking, 25% (n=93) included a calendar feature for scheduling PA, and 12% (n=45) had a reminder feature for PA sessions. 16% (n=61) had capacity to pair with a peripheral device, such as proprietary devices (e.g. brand-specific step counters) or associated health devices (e.g. weigh scale, heart rate monitor, blood pressure monitor). 38% of apps (n=142) had an associated cost for download, which ranged from $0.99-9.87, and the remainder (n=237) were free to download. Conclusions: Despite the abundance of available health and fitness apps for PA, there is a shortage of evidence-based apps, which may limit the clinical utility. The present review indicates that there are a limited number of PA apps that include a feature to link with peripheral health devices, which could be useful for health management. From a behaviour adoption perspective, there are limited apps that include features like social collaboration, scheduling, and reminders for achieving prescribed health behaviours. Results from the current review demonstrate need for development of evidence-informed apps to promote PA.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2655Amr Jamal (@dramrjamal) submitted 'The Impact of Online Health Information Seeking Behavior on Self-Care Activities among Adult Diabetic Type-2 Patients' #med2 userprofile: http://www.medicine20congress.com/ocs/social/amrjamal2014-03-19T16:39:43-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-19T16:39:43-04:00Background: In present surge for patients-centered case, patients frequently and increasingly use the Internet for access health related information (HRI) and the information obtained has an impact on their healthcare outcomes. Inspite of growing interest in the quality of online health information sources, existing research reveals a lacuna in the realm of diabetes patient’s online HRI seeking behavior and its impact on their self care. Objective: To explore online HRI seeking behavior among Saudi adult diabetes type 2 patients and to evaluate the impact of online HRI seeking behavior on self-care activities for their diabetes management. Methods: We surveyed 344 patients with type 2 diabetes attending the primary care clinics at King Khaled Hospital. Main outcome measures included the ability to access the Internet, Internet use to search for health related information, and responses to such Internet searches with their self care related activities. Further analysis of whether there were differences based on age, gender, socio-demographic and diabetes-related self care activities by online HRI seeker were performed. Results: Among 344 patients, 74% were males and overall mean age was 53.47±13.8 years (range between 16-84 years). Among all participants, only (39%) were internet users and out of them 71.6% (n=96) used internet for HRI. Most of the participants reported that their primary source of HRI is their physician (63%), followed by television (45%), Family (33%), newspapers (29%) and internet (27.9%). The primary topics they were looking for were therapeutic diet for diabetes (57%) ,symptoms of diabetes (54%) ,diabetes treatment (52%) and causes of diabetes (50%). Longer diabetes duration, genetic history of disease, unemployment and not seeking diabetes education were the most common barriersfor online HRI seeking behavior. Younger age, gender, marital status, higher education and income, and duration of internet usages were positively associated factors with online HRI behavior. Most (92.7%)of the online HRI seeker reported remarkable positive change in their behaviors after seeking online health information. Overall odds ratio (OR=1.56, 95% CI 0.629-3.280) of all of the completed self care questionnaire responses demonstrated that those seeking HRI were 49.4 % more likely to be conscious about their self health care compared to none online HRI seekers. Conclusions: Among diabetes patients primary source of HRI was a physician, followed by the TV. Around one fourth proportion of sampled diabetes patients were using internet for HRI. The major factors associated positively with online HRI seeking behavior were age, gender, marital status, level of education and diabetes education. Overall present study findings demonstrated that those seeking online HRI were more conscious about their diabetes self health care compared to none HRI seekers. Hence, physicians, public health professionals, and e-Health developers should cooperate to educate and encourage diabetes patients to search for online health information in order to improve their health outcomehttp://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2648Donna Spruijt-Metz (@metzlab) submitted 'Building New Computational Models of Momentary Health-Related Behavior' #med2 userprofile: http://www.medicine20congress.com/ocs/social/DonnaSpruijt-Mtz2014-03-19T14:50:04-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-19T14:50:04-04:00In the quest to understand, change, and maintain health-related behaviors, behavioral theories that are predictive, prescriptive, and parsimonious are key to developing successful interventions. Mobile technologies (e.g. smartphones, computers, embedded, wearable/wireless sensors) provide increasingly rich data and opportunities for personalized, ‘Just-In-Time’ Adaptive Interventions (JITAI). These interventions can be fine-tuned to ‘adapt’ to individual’s behaviors as they change over time, and feedback can be immediate through sensors or mobile phones based on specific times, sensed/reported events, or locations. The ability to provide personalized and adaptive support to individuals, exactly when it is needed (e.g., just prior to the moment when a person engages in a less favorable behavior like eating fried foods), or as feedback directly after a behavior (e.g. praising a bout of exercise), affords huge potential for fostering healthier behaviors. However, current behavioral theories were not developed to drive such JITAIs. Individuals now leave ‘digital footprints’ that reveal their behavior on a momentary, dynamic, contextualized and longitudinal basis. Behavior, feelings, thoughts, environment & location, time, social contexts, and temporal interrelationships between behaviors can be captured digitally and often transmitted in real time. These data provide the opportunity for new, dynamic, multi-method, conceptually driven, and data-rich approaches to theory development to support adaptive interventions. Full utilization of these data to support JITAI requires behavioral theories that provide insights about appropriate decisions rules for adaptation that guide which intervention strategies to use at what time. Likely requirements for these momentary theories of behavior include a) accounting for behavioral feedback loops (i.e. how my breakfast this morning influences my snacking behavior at lunch, or how stress today influences sleep tonight), and b) taking into account the lagged and contextualized nature of emotions & cognitions that potentially drive behavior (e.g. a put-down in a negative work environment might influence a person’s self-efficacy to exercise later in the day). This talk will outline a transdisciplinary approach to modeling momentary, contextualized behavioral theory as a dynamical system; an approach that enables improved model specificity, evaluation, forecast, and iteration. A strategy for seeding new models with existing theories will be outlined using the Social Cognitive Theory as an example. Strategies for integrating data and new theoretical constructs that emerge from a variety of sources (e.g., smartphones, wearable/ deployable sensors, digital trails that people leave through social networking and internet use) into this preliminary model to support more dynamic theories will be discussed. Incorporation of “dynamic” insights drawn from a dynamical model will be contrasted with the more static predictions made via traditional conceptualizations of behavioral theory. The final discussion will include the arc of development and cross-validation that can occur via the use of a mixed-methods approach for theory development, including a) model simulation, b) the use of “informative” and “optimized” idiographic system identification experiments to support empirical validation and refinement of dynamical models, c) strategies for identifying and integrating missing features from the preliminary model (i.e. linkages between variables, d) decision-rules for interventions, or contextual moderation) and e) the creation and evaluation of a JITAI.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2645Carolyn W Simpkins (@cwsimpkins) submitted 'Tutorial: Leveraging Virtual Workspace and Mentoring to Establish an Organisation-Wide Quality Improvement Program - Everything You Need to Know in 3 Hours' #med2 userprofile: http://www.medicine20congress.com/ocs/social/carolynws2014-03-19T14:47:02-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-19T14:47:02-04:00Your staff working on the frontline get a unique insight into how to improve healthcare. We also believe they are fundamental to driving quality and delivering better outcomes for patients. But they are challenged to carve out time from busy clinical schedules to work in teams, learn new quality improvement skills, and work collaboratively on projects to improve quality. In this mini-course we’ll help you to assess your organization’s needs and opportunities and then develop an action plan ready for you to implement when you return, one which leverages an online virtual workspace and mentoring capabilities to make it possible for busy clinicians to carve out the time to learn quality improvement while doing. The session is suitable whether you already have an established quality improvement program or are just starting to consider how to start engage frontline staff in driving outcomes. After this session, participants will be able to: · Understand the QI needs and opportunities of your organization and how to successfully implement a QI program · Understand how to develop structured QI training to upskill and empower your staff and support their work · Describe how mentoring, coaching and good leadership can dramatically enhance success and how you can deliver this virtually with limited resources and time · Have a ready to implement action plan to harness the potential of frontline staff to meet your organization’s healthcare improvement objectives.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2642Daniela Paolotti (@danielapaolotti) submitted 'Predicting the Influenza Season 2013-2014 in Italy' #med2 userprofile: http://www.medicine20congress.com/ocs/social/danielapaolotti2014-03-19T13:57:14-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-19T13:57:14-04:00Background Influenza-like illness in Europe is monitored by means of nationwide networks of sentinel General Practitioners (GPs) detecting only medically attended ILI cases. Internet-based community surveillance of influenza is an increasingly-used tool in epidemiological data collection, especially for recruitment and follow-up of large cohorts as it can help to determine the disease burden, time trends and seasonality, and to characterise care-seeking and treatment behaviour as well as patterns of absenteeism. Internet-based systems can thus enhance traditional GP-based surveillance and support the interpretation of recorded data, both for pandemic and seasonal Objectives An Internet-based community surveillance of influenza-like-illness (ILI) can become a means of gathering epidemiological data from the general population in a participatory fashion. In this work we show how the high geographical and temporal resolution of the web-based participatory surveillance of influenza allows the feed of predictive models for the weekly forecast of influenza. Methods A network of Internet-based surveillance systems, called Influenzanet (www.influenzanet.eu), has been active in ten European countries (the Netherlands, Belgium, Portugal, Italy, the United Kingdom, Sweden, France and Spain, joined by Denmark and Ireland since 2013-2014), each using the same platform with the aim of gathering epidemiological data across different countries in a standardized way and with the participation of a self-selected cohort of volunteers followed over the influenza season. Upon registration, users are invited to fill in a background questionnaire containing various socio-demographic, medical, geographic and behavioural questions and location of home and workplace at resolution level of postal codes. Users are reminded weekly, via an email newsletter, to report their health status through a brief symptoms questionnaire. In our analysis, data from 2013/2014 for Italy are used. The platform in Italy is called Influweb ( www.influweb.it ). Starting from week 46 of 2013, we have collected data about ILI daily incidence in each postal code in which there are active participants. In order to provide weekly predictions, we combined web surveillance data, historical sentinel surveillance data and an epidemic stochastic generative model (GLEAM, http://www.gleamviz.org ) to predict the timing, peak and intensity of the current influenza season. Results The results of the predictions obtained with this methodology provide the following indicators of the current influenza season: -Start of the influenza season at the national level -Peak week at the national level -The highest numeric value reached at the national level -Number of weeks the epidemic remains above baseline at the national level. According to our predictions, the flu epidemic in Italy was supposed to reach the peak in the week between 3rd and 10th of February 2014. This prediction has been confirmed by the data collected by the national sentinel surveillance. The geographical trend has not been uniform, as a higher flu activity in the northern part of the country was predicted and observed. Conclusions The integration of digital surveillance data from participatory systems with the modeling approach is a powerful combination which provides a tool to make predictions, several weeks in advance, about the unfolding of the seasonal influenza in a specific country. Future work will foresee an integration with the national syndromic surveillance system responsible for preparedness and response, also in order to enhance user participation, retention and engagement.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2597Elia Gabarron (@EliaGabarron) submitted 'Tutorial: Use of Google Analytics to Assess the Impact of Public Health Websites and Apps' #med2 userprofile: http://www.medicine20congress.com/ocs/social/egabarron2014-03-19T13:39:25-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-19T13:39:25-04:00Background Google Analytics (GA)1 is a free service that provides detailed information and statistics about the users and their interactivity in a website or app2. The GA Interface is customizable, ranging from digital dashboards to overview reports and presentation of the data3. The analyses of components collected by GA (users; session; and interaction)2 can represent a resource for measuring the impact of public health websites/apps (i.e.; impact of dissemination/users interest). Data from GA can be further processed with other open source tools (e.g. OpenRefine4) and be combined with public datasets in order to enhance the understanding of the available information. 1. Objective The purpose of this tutorial is to present case studies showing how GA and other tools are being used to enhance the understanding and assess the impact of public health websites/apps. 2. Contribution from teachers The tutorial will be carried out by 5 teachers: - Luis Fernandez Luque is Research Fellow at the University of Seville, Spain. He has extensive research experience in e-health and social media. - Elia Gabarron is psychologist and PhD candidate at the Norwegian Centre for Integrated Care and Telemedicine (NST); her research area is focused on the use of gamification and social networking for public health. - Konstantinos Antypas is nurse and researcher at NST. His research area is in computer-based tailoring, behaviour change, physical activity, and rehabilitation. - Olav Nilsen is a physiotherapist and a PhD candidate at NST. His research area is Internet- and mobile phone based interventions for behavioural change, with a focus on smoking cessation. - Enrique Dorronzoro is PhD researcher at the University of Seville and R&D advisor at Salumedia. He is computer engineer and his research is focused in wireless networks sensors, AAL systems and user interfaces. 3. Education Goals The tutorial will show what kind of information is collected by GA; how to use the GA Interface; how to configure it; and how to obtain reports to assess the impact of a public health website/app. It will also briefly present the use of OpenRefine to combine GA data with data from other sources. Target audiences are researchers and professionals working on the use of websites/apps for public health, and every person interested in increasing his/her knowledge of Google Analytics. 4. References 1. Google. Google Analytics. [cited 2014 Mar 12]. Available from: http://www.google.com/analytics/ 2. Google. Google Analytics Academy. [cited 2014 Mar 12]. Available from: https://analyticsacademy.withgoogle.com/explorer 3. McGuckin C, Crowley N. Using Google Analytics to evaluate the impact of the CyberTraining project. Cyberpsychol Behav Soc Netw. 2012 Nov [cited 2014 Feb 28];15(11):625–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23075266 4. Google. Google Refine. [cited 2014 Mar 16]. Available from: http://code.google.com/p/google-refine/http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2632Beni Gómez Zúñiga submitted 'E-Patients Generating Collective Intelligence for the Biomedical Research in Rare Diseases: a Methodological, Conceptual and Applied Model.' #med2 userprofile: http://www.medicine20congress.com/ocs/social/bgomezz2014-03-19T10:52:17-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-19T10:52:17-04:00Background: For parents of children with a rare disease (RD), a critical source of stress and uncertainty is the lack of information about the disease and the absence of curative therapies. Many of them turn to peers on the Internet, seeking for information and support. Moreover, those families have developed considerable expertise and are advocating for greater formal collaboration in research. In fact, the European Rare Disease Organization (EURORDIS) highlights the empowerment of patients in research, recognising that patients are full and equal partners, developers and funders of research in RD. Objective: (1)To examine the psychosocial effects on parents of children with Lowe syndrome of participation in a collaborative research project; (2) to develop an international database of biomedical information on Lowe syndrome. Methods: a) Four dimensions were extracted from patient and research need analysis: Medical knowledge, Psychological/Socials aspects, Communication/Dissemination, and Fundraising. b) Explicit actions were defined for each of those dimensions thorugh the collaboration of families, doctors and researchers in the context of 2.0 technologies. Results: The main result is the ePACIBARD (e-Patients and Collective Intelligence for the Biomedical Advance on Rare Diseases) model. A general model that is based in the concepts of MIT Collective Intelligence Lab and the use of 2.0 technologies, with a modular environment that can be adapted to different diseases. More specific results related to Lowe Symdrome are: User generated content: databases generated by patients with information about different aspects of the daily life and clinical history of Lowe Syndrome. Educational materials about the disease developed by expert clinicians to help families in developing a better understandig of the desease. Collaboration with associations of Lowe Syndrome in France, Italy and Germany, and with doctors and researchers of those countries. Conclusions: It is possible to break the vicious circle between the lack of research and lack of hope that affects families with rare diseases. The involvement of families in research generates closer relationship among patients and clinicians, with increased reciprocal confidence. Medical knowledge on natural history of rare diseases can be increased through collaborative biomedical research, involving patients and their families.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2627Caroline Free submitted 'The Development of and Recipient Experiences of a Mobile Phone Based Intervention Promoting Sexual Health in 16-24 Year Olds in the UK.' #med2 userprofile: http://www.medicine20congress.com/ocs/social/carifree2014-03-19T07:19:50-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-19T07:19:50-04:00Background: Text messaging interventions can increase STI testing. Their effect on other sexual health behaviours has not been established. Objectives: To develop and pilot an acceptable text messaging intervention designed to increase safer sexual health behaviours: correct treatment of Chlamydia (avoiding sex for seven days, informing partners) condom use, testing before unprotected sex with a new partner. To explore participants experiences of receiving the intervention Methods: We developed messages drawing on (1) the behaviour change techniques in effective face-to-face sexual health interventions, (2) empirical evidence regarding the factors influencing safer sex behaviours (3) sexual health counsellor expertise (4)user views obtained in panels (n= 50), by questionnaire (n=100) and in a pre-test sending the text messages to phones (n=10). RF then conducted qualitative telephone interviews with 20 people about their experience and identified key themes. Results: We identified 33 behaviour change techniques in effective face-to face interventions. Five principles emerged from the participant panels. Messages should: (1) be mainly for those with a positive Chlamydia diagnosis,(2) be no more than 2/3 a day for a few days then fewer, (3) cover key information, what action was needed and tips about how to do it, (4) be a knowledgeable advisor in tone and (5) some content e.g. ‘relationships’ ‘behavioural planning’ were considered unacceptable. Recipients reported that they liked the tone and the frequency and timing of delivery of messages. The information contained in the texts was useful. Some of the women described how the texts boosted their confidence and reduced the stigma and concerns they had after their Chlamydia diagnosis. Recipients explained that messages on partner notification helped them to approach the discussions sooner and more calmly. Some recipients reported the messages had altered their behaviour so they informed their partners about an infection and/or use condoms. Conclusion: The intervention is acceptable to users. We are currently testing the intervention in a pilot trial.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2626Caroline Free submitted 'The Development of and Recipient Experiences of a Mobile Phone Based Intervention Promoting Sexual Health in 16-24 Year Olds in the UK.' #med2 userprofile: http://www.medicine20congress.com/ocs/social/carifree2014-03-19T07:16:08-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-19T07:16:08-04:00Background: Text messaging interventions can increase STI testing. Their effect on other sexual health behaviours has not been established. Objectives: To develop and pilot an acceptable text messaging intervention designed to increase safer sexual health behaviours: correct treatment of Chlamydia (avoiding sex for seven days, informing partners) condom use, testing before unprotected sex with a new partner. To explore participants experiences of receiving the intervention Methods: We developed messages drawing on (1) the behaviour change techniques in effective face-to-face sexual health interventions, (2) empirical evidence regarding the factors influencing safer sex behaviours (3) sexual health counsellor expertise (4)user views obtained in panels (n= 50), by questionnaire (n=100) and in a pre-test sending the text messages to phones (n=10). RF then conducted qualitative telephone interviews with 20 people about their experience and identified key themes. Results: We identified 33 behaviour change techniques in effective face-to face interventions. Five principles emerged from the participant panels. Messages should: (1) be mainly for those with a positive Chlamydia diagnosis,(2) be no more than 2/3 a day for a few days then fewer, (3) cover key information, what action was needed and tips about how to do it, (4) be a knowledgeable advisor in tone and (5) some content e.g. ‘relationships’ ‘behavioural planning’ were considered unacceptable. Recipients reported that they liked the tone and the frequency and timing of delivery of messages. The information contained in the texts was useful. Some of the women described how the texts boosted their confidence and reduced the stigma and concerns they had after their Chlamydia diagnosis. Recipients explained that messages on partner notification helped them to approach the discussions sooner and more calmly. Some recipients reported the messages had altered their behaviour so they informed their partners about an infection and/or use condoms. Conclusion: The intervention is acceptable to users. We are currently testing the intervention in a pilot trial.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2619Lauri Ann Linder submitted 'IPad-Based Symptom Heuristics App to Empower Adolescents and Young Adults with Cancer' #med2 userprofile: http://www.medicine20congress.com/ocs/social/llinder2014-03-18T23:02:47-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-18T23:02:47-04:00Background: Nearly 70,000 adolescents and young adults (AYAs) are diagnosed with cancer each year in the United States. AYAs experience multiple co-occurring, interrelated symptoms due to their disease and its treatment that can adversely affect their quality of life. An assessment approach that empowers AYAs to describe their unique symptom experience and its meaning is critical for effective symptom management. Objective: The primary aim was to evaluate the feasibility and acceptability of an investigator-developed symptom heuristics iPad application, the Computerized Symptom Capture Tool (C-SCAT). The secondary aim was to explore symptoms and symptom clusters (groups of 2 or more related symptoms) identified by AYAs using the C-SCAT. Methods: The C-SCAT uses an inductive heuristics approach, empowering AYAs to relate their unique cancer symptom experience. From a menu of 30 symptoms, the C-SCAT directs AYAs to drag and drop symptoms experienced within the past 24 hours into a designated area on the iPad screen. Pop-up windows ask about possible causes, alleviating/exacerbating factors, attempted self-management strategies, and the interference of the symptom with daily activities. AYAs can draw arrows to indicate causal and temporal relationships among symptoms and circle clusters of symptoms that they perceive to be related. Additional pop-up windows guide AYAs to provide names for symptom clusters and to identify key symptoms within clusters. The C-SCAT generates a final graphical image featuring individual symptoms, relationships between symptoms, symptom clusters, and priority symptoms within clusters. AYAs completed the C-SCAT 24-96 hours following initiation of a chemotherapy cycle. Evaluation of feasibility included review of completion rates and AYAs’ perceived accuracy of the final image created through the app. Acceptability was evaluated through an investigator-developed survey. Results: 72 AYAs (median age 18 years) completed the C-SCAT in a mean of 25 minutes. 74% reported the final image was an accurate representation of their symptoms. Most AYAs judged the app questions as clear, instructions as easy to follow, and time to complete as appropriate. 83% endorsed a preference for using the iPad vs. a paper version. AYAs related a greater awareness of their symptom experience and an appreciation for creating a pictorial representation. AYAs reported a median of 8 symptoms (range: 1-21) with 65% identifying the presence of symptom clusters (median 2 clusters; range 1-4). Cluster names reflected AYAs’ perceptions of their treatment (e.g. “chemo effects”), physical aspects (e.g. “appetite-related”), and psychosocial aspects of their cancer experience (e.g. “not myself”). Conclusions: The C-SCAT empowers AYAs with cancer by shifting the paradigm of symptom and symptom cluster assessment from a deductive to an inductive approach that considers how AYAs interpret and give meaning to their symptoms. The C-SCAT demonstrated feasibility, acceptability, and capacity to generate rich relevant data regarding the individual’s symptom experience. It has potential use in clinical care to foster patient-provider communication about complex symptom experiences and to facilitate symptom management not only for AYAs with cancer, but also for individuals across other age groups and disease states.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2611Rowena L. Briones (@RLBriones) submitted 'Harnessing the Web: How E-Health and E-Health Literacy Impact Young Adults’ Perceptions of Online Health Information' #med2 userprofile: http://www.medicine20congress.com/ocs/social/rlbriones2014-03-18T17:49:04-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-18T17:49:04-04:00Background: The rise of technology has changed how people take control of their health, enabling individuals to choose to live healthier lives and make better treatment decisions. With this said, the Internet has emerged as the channel used by individuals for actively seeking or passively receiving health information. Some of the biggest advantages of using the Internet for disseminating health messages are its constant availability, its ability to provide useful information, and the fact that it offers anonymity to users. Objective: The purpose of this study is to explore how young adults assess the quality of health information, and how they construct meaning of online health information in general. Through 50 in-depth interviews, this study aims to examine how and why young adults turn to the Web for health information, and what strategies they employ to ensure that they are getting credible information. Methods: 50 in-depth interviews were conducted with young adults to explore how they make meaning of online health information. Depending on the geographic area of the participant, the interview took place face-to-face at a location convenient for them, over Skype, or over the telephone and lasted on average 40 minutes. The interviews were transcribed verbatim, fully retaining the speech style of the moderator and the participants. Data was analyzed using techniques from the grounded theory approach, using a constant comparative method to allow for themes to emerge from the transcripts. Results: The participants shared several benefits to this mode of health information seeking, claiming that it made for more productive visits with doctors and made health information more readily accessible through a variety of different formats. Additionally the participants demonstrated their e-health literacy levels by discussing how they assessed online health information, engaging in a series of strategies that encompassed different aspects of e-health literacy. Social media channels were brought up by the participants as relatively new tools that can be used to assist in the seeking, understanding, and sharing of health information. However, participants also cautioned about the use of social media in regards to its informal nature, warning users to evaluate sources accordingly and to use these channels as supplementary outlets of information for more traditional channels. Conclusions: The use of the Internet and technology for health purposes is a growing area for both scholarship and practice that has strong implications for health consumers, medical professionals, and communicators alike. Specifically, this research explored how young adults made meaning of online health information. The findings that emerged demonstrated that the online space is an acceptable channel through which young adults can find and share information. However, in spite of the rising usage of social media by this particular group, the findings showed that they were hesitant and wary of the channel, not seeing it as a resource for health information but more of a channel for networking and entertainment. In spite of this, this study shows that the online health information seeking behaviors is an area that warrants further exploration.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2610Rowena L. Briones (@RLBriones) submitted 'Harnessing the Web: How E-Health and E-Health Literacy Impact Young Adults’ Perceptions of Online Health Information' #med2 userprofile: http://www.medicine20congress.com/ocs/social/rlbriones2014-03-18T17:32:00-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-18T17:32:00-04:00Background: The rise of technology has changed how people take control of their health, enabling individuals to choose to live healthier lives and make better treatment decisions. With this said, the Internet has emerged as the channel used by individuals for actively seeking or passively receiving health information. Some of the biggest advantages of using the Internet for disseminating health messages are its constant availability, its ability to provide useful information, and the fact that it offers anonymity to users. Objective: The purpose of this study is to explore how young adults assess the quality of health information, and how they construct meaning of online health information in general. Through 50 in-depth interviews, this study aims to examine how and why young adults turn to the Web for health information, and what strategies they employ to ensure that they are getting credible information. Methods: 50 in-depth interviews were conducted with young adults to explore how they make meaning of online health information. Depending on the geographic area of the participant, the interview took place face-to-face at a location convenient for them, over Skype, or over the telephone and lasted on average 40 minutes. The interviews were transcribed verbatim, fully retaining the speech style of the moderator and the participants. Data was analyzed using techniques from the grounded theory approach, using a constant comparative method to allow for themes to emerge from the transcripts. Results: The participants shared several benefits to this mode of health information seeking, claiming that it made for more productive visits with doctors and made health information more readily accessible through a variety of different formats. Additionally the participants demonstrated their e-health literacy levels by discussing how they assessed online health information, engaging in a series of strategies that encompassed different aspects of e-health literacy. Social media channels were brought up by the participants as relatively new tools that can be used to assist in the seeking, understanding, and sharing of health information. However, participants also cautioned about the use of social media in regards to its informal nature, warning users to evaluate sources accordingly and to use these channels as supplementary outlets of information for more traditional channels. Conclusions: The use of the Internet and technology for health purposes is a growing area for both scholarship and practice that has strong implications for health consumers, medical professionals, and communicators alike. Specifically, this research explored how young adults made meaning of online health information. The findings that emerged demonstrated that the online space is an acceptable channel through which young adults can find and share information. However, in spite of the rising usage of social media by this particular group, the findings showed that they were hesitant and wary of the channel, not seeing it as a resource for health information but more of a channel for networking and entertainment. In spite of this, this study shows that the online health information seeking behaviors is an area that warrants further exploration.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2600Francisco J Grajales III (@Ciscogiii) submitted 'Exploring the Quality of Health Apps: The ISYS Ranking System' #med2 userprofile: http://www.medicine20congress.com/ocs/social/fragra2014-03-18T11:21:12-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-18T11:21:12-04:00Background: Approximately 63 Billion apps were downloaded in 2012, of which, an estimated 44 million were health-related. Paradoxically, most downloaded health-apps are seldomly used within a month of their initial download date, mainly because it is difficult for users to identify the overall quality of the app before it is downloaded. In essence, when users begin interacting with the recently downloaded app, they realize that it is not exactly what they were looking for. The variety options from which to download from have also been reported as overwhelming for patients. With hundreds, sometimes thousands, of sellers and app flavors that range from smoking cessation, to weight loss, to health (e.g., blood glucose and blood pressure), and even bowel movement-social apps (e.g., iPoop), patients need an user-friendly way to identify what will be good for them and what they want. The quality of health-related information on the web is not a new topic of debate, as it was identified in the early nineties, as soon as the internet became accessible to the masses. More recently however, large policy-making bodies have begun to regulate health-related apps in an effort to improve the quality available to consumers. On September 2013, for example, the FDA issued the Mobile Medical Applications Guidance for Industry and Food and Drug Administration Staff Guidelines. The FDA is not alone and although other “high-level” policy-making bodies and ranking initiatives have been proposed, few rating systems are scalable to the number of apps being released on a daily basis and even fewer follow an evidence based, patient-centric, quality ranking process. Objective: We aimed to create a patient-centric, evidence-based, scalable, health-app ranking system. Methods: This research was conducted using a three phase approach: 1) Literature Review; 2) Delphi of Experts; and 3) Ranking System Validation. A broad search string was used to query English- and Spanish-language articles published since 1993 on the PubMed and EMBASE databases. Supplemental (scoping queries) were also completed on Google Scholar. A total of 18 articles met our inclusion criteria and their relevant data was extracted using a standardized template. To prevent Hawthorne Bias, the evidence from the literature review was incorporated into the second round of the Delphi. Data is currently being synthesized into validated for health-app quality. Statistical analyses are being conducted in MS Excel 2013. Results and Conclusion: We identified four axes which can be combined to appraise quality of health-related apps. Upon ranking system validation completion, we will undergo a patent-filing process. However, we are committed to presenting our latest results during the congress presentation.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2598Angela Leis (@angelaleism) submitted 'The Quality of Health Related-Content Websites: 15 Years of Experience of Web Médica Acreditada Quality Program' #med2 userprofile: http://www.medicine20congress.com/ocs/social/mleis2014-03-18T10:43:13-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-18T10:43:13-04:00Background: The quality of health information on the Internet is very variable and there is an interest in offering patients and the general public different tools to obtain the best information. One of the solutions proposed was the evaluation of websites by health organizations. Web Médica Acreditada Quality Program (WMA) was launched in 1999 by the Medical Association of Barcelona (Spain), with the aim of offering tools for the empowerment of Internet users. WMA is a 'third party' program based on a set of criteria and the evaluation process of health-related content websites. The certification process consists of several steps: voluntary evaluation request, assessment and report based on WMA quality criteria, when recommendations are implemented the website is certified receiving a trust-mark and it is included in the WMA Google Custom Search and in a specific list of certified websites. An annual review is carried out for its recertification. In this paper fifteen years of experience in the certification of health-related content websites through a quality program based on a rating process and a trust-mark is described. Methods: Observational study that describes the features of websites included in a quality program of medical websites and the certification process applied for 15 years. The set of criteria is based on a specific Code of Conduct, the European Union quality criteria for health websites and the active participation in several European projects and initiatives such as MedCIRCLE, QUATROPlus and MedIEQ: authorship, content (scientific information, sources and update), confidentiality, advertising and funding, virtual consultation, legal and ethical requirements. The variables of websites described are: total number of websites, language, criteria for not completing the certification, type of organization, and other trust marks present, target and funding. Results: Until the year 2013 there were 1,050 certified working sites (around 300 sites more did not work) including thousands of web pages. Only 50% of applicants have completed the certification process. Less than 10% were certified without suggestions or modifications. The majority of websites are from Spain and Latin America. Above all, languages present on the websites are: Spanish, English and Catalan. Types of websites: 30% professional personal, 26.5% health services, 24% scientific & universities, 8.5% patient associations & NGOs, 5% drug industry, 6% other. The main reasons for not completing the certification are: legal and ethical requirements, the medical doctor responsible not identified and scientific information inappropriate. The main targets are adult patients/users and medical doctors. Private contribution is the main source of funding. Discussion: Quality, content and features of medical websites are very variable. There is a big interest in getting a certification from health services and professional websites. Knowledge about quality of sites responsible and designers have improved over time. Changes in ICT legislation, ethics and new online services, require a continuous review of the certification processes and quality criteria. Social Media and Apps are introducing new needs and challenges. It could be interesting to study again the real impact of trust marks amongst the general public to reveal whether they use them to decide to trust or mistrust a health-related content website.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2595Igor M. Ramos-Herrera submitted 'The Health Atlas of Jalisco: a New Web Service for the Health Ministry and the Community' #med2 userprofile: http://www.medicine20congress.com/ocs/social/ramos_igor2014-03-18T09:25:07-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-18T09:25:07-04:00The Health Atlas of Jalisco is a project created at the University of Guadalajara, Mexico, which started on 2011 and has been sponsored by the State’s Council of Science and Technology, also we signed an agreement with the Health Ministry of Jalisco so we can work with their data and we set it for their service. This web-based service's aim is to show a collection of thematic maps that represent the main health indicators of the Province of Jalisco based on 2010 to 2012 public data and oriented to evaluate if the Millennium Goals set by the World Health Organization were accomplished there. The Atlas is currently available at www.geografiasalud.org and it uses InstantAtlas software with which the user can interact to generate a series of thematic maps about the main health indicators for the Province. The atlas is also intended to help the Health Ministry to provide information requested every month by hundreds of users from the same or other ministries, health journalists, and the general public that use the transparency law roads to ask the health ministry; besides it can be used by anyone interested through its web interface. This work reports the first results of this project, and the advances in the technique that we have adapted from the empiric experience of teachers and professionals of geography. We created a set of geographic maps (shapes) which we combined with the health information provided by the Health Ministry of Jalisco from data collected in 2010 and 2012. We processed the data and the maps with the mentioned software and made it available through the web site we setup for the user to generate and get the maps. Users can obtain maps and information at the state, health jurisdiction and county level. By now we have put there more than one hundred health, economic, education, and infrastructure indicators, the plan is that when we finish the Atlas there will be more than two hundred indicators. The results of this project will also help the Health Ministry of Jalisco in taking decisions and setting some of its actions for the next six years. By far we have learned that it is very difficult to use all the information we planned because there are some governmental and information confidentiality issues that we need to attend. We will work on this areas this year.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2594Iñaki Bartolome Martin submitted 'Playing Games for Combating Cognitive Impairment' #med2 userprofile: http://www.medicine20congress.com/ocs/social/eldersarea2014-03-18T08:24:48-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-18T08:24:48-04:00Background Ideable Solutions is a ICT Company which is developing a technical software for the elderly. It’s a platform that helps caring elderly people at home by tablets using: - Videoconference with caregivers and relatives. - Sharing pics by relatives. - Watching videos at home. - Sending reminders on health control, medication management, etc. - Monitoring health data - Etc. Cognitiva Memory Units is a company that work in its centres with elderly people that have started suffering cognitive impairment. Objective: From april to September Cognitiva Memory Units will test a platform based on serious games, in which: - Cognitiva’s psychologists define the cognitive impairment level for each person. - They create a roadmap of games that must be played by that patient. - Games are related to mental capabilities that must be trained in each case. - Elderly people receive reminders for playing in tablets in a very usable and accessible platform. - Executions of games are evaluated in real-time by psychologists. Methods: Cognitiva Memory units and Ideable are working together in defining a platform that lets psychologists define therapies for the elderly depending on: - Cognitive level. - Capabilities that they must work on. - Types of games They define a training route that must be done by playing different days to the games that have been assigned to each person. Cognitiva’s methodology with its users has been approved by Spanish Azheimer Association. Participants: 60-80 people over 65 with memory problems, cognitive impairments or other degenerative diseases diagnosed. Variables: The dependent variables that are used in the study are those that will be measured in the 3 assessments. These variables will be measured through neuropsychological assessment protocol for Cognitiva, which consists of the following scales: • Neuropsi • RIAS (Memory Scale) • Test Clock • Test Short Attention • Trial Making Test A-B-TMT • Beck-TFF • GDS • Zarit • AVD-Johnson Besides these ones also consider those calculated pacing platform Computer: ICG (general cognitive index), emotional state after each session of stimulation, self stimulation session and total time of stimulation. These variables are calculated automatically by the platform, giving a cumulative total of all the sessions so far. Results Once all data is collected we shall start comparisons by SPSS software with a significance level of p <0.05. We want to identify how effective is the ICT platform for delaying and even stopping cognitive impairment by playing serious games defined in kwido platform. All the results of games played by patients let Cognitiva’s psychologists track the evolution of patients’ cognitive impairment and even change roadmap for including new games related to the capability that is going worse. Conclusions We want to present as conclusions how playing games can be effective against cognitive impairment, in terms of how time played improves players’ cognitive ages.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2592Nick Glozier submitted 'Embedding Ehealth Trials in Clinical Practice' #med2 userprofile: http://www.medicine20congress.com/ocs/social/NickGlozier2014-03-18T04:38:48-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-18T04:38:48-04:00Background: Despite claims that internet treatments for psychological conditions might be used alongside i.e. contemporaneous with clinical treatment, as opposed to preventation, early intervention, non-clinical, or post treatment populations, the logistics, ethics, feasibility and acceptabilty of undertaking such a trial in a help seeking and clinician treated population has little evidential guidance. Objective - To describe the logistic and ethical issues raised in conducting ehealth trials in "patient" populations from the researcher's view point and the feasibility, acceptability and adherence issues from a qualitative study of trial participants Methods: SOMNA is an RCT comparing internet based CBT for insomnia (Shuti) with an active internet control conditon as an adjunctive treatment for depression in older men. The participants all receive psychiatrist coordinated guideline based treament for their depression for three months and are randomly allocated to one arm for a nine week intervention period with pre post assessments of psychological and phsyical health and sleep paramaters including actigraphy. The logistical and ethical issues in embedding such a trial, rather than the internet-based logistics in most such intervetniosn, have been recorded by the research team So far 46 participants have been recruited and randomised. A qualitative study by a blinded researcher of a subset of these is underway to evaluate participant engagement in this setting Results: Research in progress. Conclusions: Research in progress but these will inform future ehealth-clinical interfaceshttp://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2591Ahmed Abdeen Hamed (@ahmedelmasri) submitted 'Discovering Marijuana-Drug Interactions Using K-H Networks' #med2 userprofile: http://www.medicine20congress.com/ocs/social/ahamed2014-03-18T00:50:58-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-18T00:50:58-04:00<br>Background:</br> Medical marijuana has become legal in 20 American states and the District of Colombia (DC). There is an ongoing political movement to legalize medical marijuana in the U.S.A. and in other countries. This new reality brings new challenges, such as understanding which drugs have adverse side effects when prescribed simultaneously with medical marijuana? <br>Objective:</br> Given an initial finite set of drug-related keywords, we construct a network of Keyword-Hashtags (K-H networks) from Twitter micro-blogging data (tweets). Such co-occurrence networks have shown promising results in uncovering drug-drug interactions. With the rapid movement of marijuana legalization, identifying evidence from social collective behavior as captured by millions of tweets, may lead to further investigations of actual Marijuana-drug interactions, such as pharmacokinetic in vitro, in vivo, and clinical studies. Developing a database of such interactions and making it publically available would be useful to identify potential adverse reaction cases. <br>Methods:</br> Using HashnetMiner, a previously developed network mining algorithm (currently under review), we perform large-scale network analysis to identify patterns that may indicate marijuana-drug interactions. K-H networks are constructed from tweets harvested using the Twitter Streaming APIs. Drug common names are used as keyword inputs to the Twitter API to retrieve tweets that have one or more drug names. We then harvest all hashtags that co-occur with drug names and meet a certain support threshold. We acquired a complete list of drug names from publically available databases (i.e., drugs.com, drugbank.ca, and FDALabel database). We test several methods to extract association rules: association analysis algorithms such as Apriori and FPGrowth, as well as network analysis methods to extract pair-wise associations in co-occurrence graphs. From the relevant associations, we construct the K-H networks using the igraph network framework as well as proximity networks. The HashnetMiner algorithm then operates on these networks to search and extracts the patterns that may be significant. Pharmacists and domain experts subsequently curate the findings,, whereby drugs are mapped to their generic names and stored in a public database for further analysis by the community. <br>Results: </br> Using approximately two million tweets, we found evidence that medical marijuana interacts with the following drugs: (1) Albuterol – which is a sympathomimetic amine that can cross the blood brain barrier and induce central psychic effects. The collective behavior from Twitter indicates that combining albuterol and marijuana induces euphoria. (2) Clarinex – The clinical use of cannabinoid receptor agonists in the treatment of AIDS symptoms may also exert beneficial adjunctive antiviral effects and regulate HIV infectivity. <br>Conclusions: </br> Large-scale Twitter analysis of human collective behavior, with network analysis shows great potentials in exposing evidence of drug interactions with marijuana use. Storing such evidence in a publically available database is a valuable resource and will enable further scientific and rigorous investigation of potential effects.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2576José Joaquín Mira submitted 'Bar and Quick Response Codes Helping Elderly Patients for a Safer Drug Use' #med2 userprofile: http://www.medicine20congress.com/ocs/social/josemira20132014-03-15T08:00:13-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-15T08:00:13-04:00Background: Elderly patients follow usually a complex therapeutic regimen taking diary five or more medications. Many of them have had the experience of pill confusions or mistakes of the correct dose. These mistakes often were only a scare, but sometimes had severe consequences. In a series of studies with groups of elderly patients with several chronic pathologies we had learned from them some tricks useful for a correct use of their medication. Objective: To design and develop an app that transforms medication-associated EAN-13 (barcodes) and QR into verbal instructions, to enable safer use of medication by the patient. Methods: We developed an app capable of storing some key information about a medicine as audio recordings. The users should be able to access such data just by showing the medicine box to their smartphones or tablets, and the app should give the information via voice. This app was especially created for using drugs by elderly patients with mild memory impairments and caregivers who tend to rotate between the morning and evening or between brief periods of time. The study was approved by the Ethics Committee of Miguel Hernández University (reference DPS-JJM-01-13) and funded by the Generalitat Valenciana, reference PCC-19/13. Results: The app was named TUMEDICINA (YOURMEDICINE). As soon as the app is started; it begins a barcode or QR search. Once a code is detected, the app enters the patient area and allows the patient to hear the different data fields associated with the medicine. A secret gesture (in our case, a diagonal swipe across the tablet’s touchscreen) allows us to leave the patient area and enter the caretaker area, where all data associated with a medicine can be introduced or modified. The caretaker can also check the current recordings. Whenever the return button is tapped the app starts searching for codes again. A total of 61 patients tested this app. Their mean age was 68.8 years (SD 8.3). Thirty-eight (62.3%) were men. A mean of 3.0 (SD 2.0) chronic disorders was reported. The mean number of drugs taken daily was 6 (SD 3.2). Thirteen (21.3%) patients reported having made at least one medication error during the previous year. A smartphone was previously used by 13 (21.3%) participants. The degree of satisfaction with TUMEDICINA was 8.3 (SD 1.6) points, out of a maximum of 10. There was a not difference in the assessment between patients with or without experience using cell phones or surfing on the Internet (p=0.88). Conclusions: TUMEDICINA is a first attempt to apply barcodes or QR technology to an application attempting to prevent medication errors among older persons taking 5 or more drugs daily. The study patients valued an application positively and considered it useful for a safer use of their drugs. The use of this app was equally easy for the patients who already had experience with cell phones as for those who were using this technology for the first time.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2569Kelly A Grindrod (@kgrindrod) submitted 'Free Mini-Tutorial: Bridging the Digital Health Divide: Helping Older Users with Mobile Health Technologies' #med2 userprofile: http://www.medicine20congress.com/ocs/social/grindrod2014-03-14T12:37:29-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-14T12:37:29-04:00This interactive workshop will provide practical strategies for both helping older adults use mobile health (mHealth) tools and for engaging older adults in the development of new tools. The objective is to share lessons learned for making mHealth tools more accessible to older adults. We will begin with a demonstration of the mobile technology work-arounds recommended by older users including inexpensive assistive tools, system settings and design features. We will then explore approaches that can be used to recruit and engage older adults in systems design and user experience testing. A discussion will follow on the responsibilities that mHealth designers and mHealth developers have in creating accessible tools and that health professionals have as apomediaries for mHealth. The premise of this workshop is that the popularity of mHealth tools and devices is exploding but there are certain populations that have more difficulties accessing new and emerging technologies than others. Individuals who are not online (also known as “non-liners”) are largely older and low income. The same population is disproportionately affected by chronic illness. While mobile touchscreen devices have made Internet-enabled technologies more affordable and usable, only one in five older adults currently uses a smartphone. Though many are interested in using new technologies to monitor or track their health, the tools and devices currently available are often designed for younger generations and fail to consider the age-related barriers to use including changes to vision, hearing, cognition and physical ability. Over the past two years, we have worked with over 150 adults between the ages of 50 and 93 to explore the usability and usefulness of mHealth tools and devices from their perspectives. We used mixed methods approaches such as focus group testing sessions, the Systems Usability Scale and questionnaires built on the Technology Acceptance Model to examine touchscreen devices, mobile medication management applications and wearable activity trackers. The overall goal of this workshop is to encourage clinicians, developers and researchers to consider how they may be contributing to the digital health divide for older and low income users and how they can help bridge the gap.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2568Barbara Sassen submitted 'Results of a Randomized Controlled Trial: Can we support healthcare professionals to improve the processes of shared-decision making and self management in a Web-based intervention?' #med2 userprofile: http://www.medicine20congress.com/ocs/social/barbarasassen2014-03-14T08:50:26-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-14T08:50:26-04:00Background: Research to assess the effect of interventions to improve the processes of shared-decision making and self management directed at healthcare professionals, is limited. Using the protocol of Intervention Mapping, a Web-based intervention directed at healthcare professionals was developed to complement and optimize health services in patient-centered care. Objective: The objective of the Web-based intervention was to extent healthcare professionals’ intention and encouraging behavior towards self management, following cardiovascular risk management guidelines. Methods: A randomized controlled trial was used to assess the effect of a theory-based intervention, using a pre-test and post-test design. The Web-based intervention was designed to increase healthcare professionals’ awareness of their thoughts, and learn skills and strategies to support patients in their self management. The Web-based intervention consisted of modules, including individualized text messages, self-completion forms, and charts and tables. The study was a closed trial with face-to-face components. The website employed a module to facilitate the professional to extent his professional behavior. The website employed a module to improve patients’ intention and risk-reduction behavior towards cardiovascular risk, with parallel a module with a support system for the healthcare professional. Healthcare professionals (N = 69) were online recruited and randomly allocated to the intervention group (N=26) and (waiting-list) control group (N=43). Healthcare professionals invited their patients to participate. The outcome was extended professional behavior towards health education. Outcomes were self-assessed through questionnaires based on the Theory of Planned Behaviour. Social-cognitive determinants, intention and behavior were measured pre-intervention and at one year follow-up. Results: The module to extend professionals’ behavior was used by 45.2% (n=12) of the healthcare professionals. The module to support the health professional in his encouraging behavior towards patients was used by 47.6.8% (n=14) of the healthcare professionals. The module to improve patients’ risk-reduction behavior was provided to 44.4% (n=24) of the patients. In 1 of every 5 patients the guideline following cardiovascular risk management was used. The Web-based intervention was poorly used. In the intervention group, no differences in social-cognitive determinants, intention and behavior were found for healthcare professionals, compared with the control group. We narrowed the intervention group (by transferring the healthcare professionals who did not use the website to the control group), and no significant differences between the intervention and control group were found in social-cognitive determinants, intention and behavior, except for barriers. Results showed a significant overall difference in barriers between the intervention and the control group (F-test=4.128, p=0.02). Conclusions: Since attendance and use of the Web-based intervention was sub-optimal, we cannot conclude that the intervention is ineffective. Rather, the healthcare professionals were not able to extend their professional encouraging behavior and were withheld to use the website because of time and organizational constraints. Professionals in the intervention group experienced higher levels of barriers to encourage patients, than professionals in the control group. We were not able to detect improvements in the processes of shared-decision making and self-management of the patients. Although education level of the participants was relatively high and the intervention was pretested, it is possible that the way the information was presented could be the reason for low participation and high dropout. Further research embedded in professionals’ regular consultations with patients is required with specific emphasis on the processes of dissemination and implementation of innovations in patient-centered care. Training-on-the-job may improve eHealth use in healthcare settings.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2565John Paul Fox submitted 'OpenClinical.net: Software Tools and Infrastructure for Medical Knowledge Engineering and Promoting Best Clinical Practice' #med2 userprofile: http://www.medicine20congress.com/ocs/social/JohnFox58662014-03-13T13:11:24-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-13T13:11:24-04:00The OpenClinical project was established in 2001 to provide an information service and web portal for raising awareness and promoting safe design and use of decision support, workflow management and other knowledge based services in clinical practice (www.openclinical.org). The web site was under continuous development until 2011 when it had about 600 pages of material covering technical, clinical, public policy and many other aspects of the field, with links to data sources, projects, demonstrations and prototypes. The site was widely used for reference and teaching and at peak was receiving more than 350,000 visitors per annum, but the growing interest in clinical decision support and other knowledge-based services and the dramatic growth of the eHealth industry over the last decade has meant that it has become difficult for a small and unfunded organisation to keep it up to date. However, the project has achieved its main objectives and we are now building on the success of the first phase by reconfiguring it in a radically new form. OpenClinical was seen from the outset as an opportunity to support the formalisation and dissemination of medical knowledge as well as providing a conventional information service. Part of the project, therefore, has been focused on the creation of software tools for building and sharing applications to support quality and safety of patient care. OpenClinical.net was established in 2005 and has been developing steadily since then in a collaboration between Oxford University, University College London and the Royal Free Hospital, supported by Deontics Ltd (www.deontics.com) who are providing the Tallis software for developing and trialling medical applications in any clinical area. The OpenClinical membership rules will permit anyone to participate who wishes to contribute to the work of the project (such as medical content authors, software developers, project managers, peer reviewers etc). We are seeking partnerships of all kinds with colleagues who share OpenClinical.net’s aspirations and are willing to work within its governance framework (www.openclinical.net/vignette/principles-of-the-openclinical-community.html). Membership of the community will in the first instance be limited to individuals and organisations that have been nominated by existing members, but we hope to lift this restriction when the project is more mature and the project is capable of coping with a larger and wider membership. The OpenClinical.net application repository Repertoire currently contains 50+ apps of many types and levels of complexity, including clinical demonstrators, tutorial examples and reusable components as well as clinical-strength applications. The full service is expected to launch in 2014, but potential authors or researchers who wish to create and share knowledge of best medical practice are invited to contact us at any time, whether to contribute applications and ideas, or to find collaborators to work on projects or research questions about the safe and ethical use of this new kind of knowledge management.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2761John Paul Fox submitted 'OpenClinical.net: Software Tools and Infrastructure for Medical Knowledge Engineering and Promoting Best Clinical Practice' #med2 userprofile: http://www.medicine20congress.com/ocs/social/JohnFox58662014-03-13T13:11:24-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-13T13:11:24-04:00The OpenClinical project was established in 2001 to provide an information service and web portal for raising awareness and promoting safe design and use of decision support, workflow management and other knowledge based services in clinical practice (www.openclinical.org). The web site was under continuous development until 2011 when it had about 600 pages of material covering technical, clinical, public policy and many other aspects of the field, with links to data sources, projects, demonstrations and prototypes. The site was widely used for reference and teaching and at peak was receiving more than 350,000 visitors per annum, but the growing interest in clinical decision support and other knowledge-based services and the dramatic growth of the eHealth industry over the last decade has meant that it has become difficult for a small and unfunded organisation to keep it up to date. However, the project has achieved its main objectives and we are now building on the success of the first phase by reconfiguring it in a radically new form. OpenClinical was seen from the outset as an opportunity to support the formalisation and dissemination of medical knowledge as well as providing a conventional information service. Part of the project, therefore, has been focused on the creation of software tools for building and sharing applications to support quality and safety of patient care. OpenClinical.net was established in 2005 and has been developing steadily since then in a collaboration between Oxford University, University College London and the Royal Free Hospital, supported by Deontics Ltd (www.deontics.com) who are providing the Tallis software for developing and trialling medical applications in any clinical area. The OpenClinical membership rules will permit anyone to participate who wishes to contribute to the work of the project (such as medical content authors, software developers, project managers, peer reviewers etc). We are seeking partnerships of all kinds with colleagues who share OpenClinical.net’s aspirations and are willing to work within its governance framework (www.openclinical.net/vignette/principles-of-the-openclinical-community.html). Membership of the community will in the first instance be limited to individuals and organisations that have been nominated by existing members, but we hope to lift this restriction when the project is more mature and the project is capable of coping with a larger and wider membership. The OpenClinical.net application repository Repertoire currently contains 50+ apps of many types and levels of complexity, including clinical demonstrators, tutorial examples and reusable components as well as clinical-strength applications. The full service is expected to launch in 2014, but potential authors or researchers who wish to create and share knowledge of best medical practice are invited to contact us at any time, whether to contribute applications and ideas, or to find collaborators to work on projects or research questions about the safe and ethical use of this new kind of knowledge management.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2564Vandana Y. Bhide (@VeeMD) submitted 'A Curriculum to Enhance Online EProfessionalism among Internal Medicine Residents' #med2 userprofile: http://www.medicine20congress.com/ocs/social/vbhide2014-03-13T11:35:34-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-13T11:35:34-04:00Background: Social Media platforms such as Facebook and Instagram are widely utilized by post-medical school resident physicians. Several incidents of breaches of electronic professionalism by resident and practicing physicians have been highly publicized in online media. Some of these incidents violated patient privacy guidelines and have resulted in official sanction by State Medical Boards in the United States. Professionalism is a core competency required of resident physicians in training. Many intern and resident physicians are unaware of how their online activity is accessible to the public and can impact on their future employment. They are also unaware that even with strict privacy settings, anything residents post online may be viewed, and unprofessional posts reflect negatively on both Mayo Clinic and the medical profession. Objective: The Internal Medicine Clinical Competency Committee at Mayo Clinic Florida felt an education curriculum to enhance physician professionalism among first to third year internal medicine interns and residents was urgently needed. It was essential to provide a format other than face to face lectures/small group discussion in order to accomodate the schedules of interns and residents, who work at night and on weekends. They would not otherwise be able to attend weekday daytime curriculum activities. Methods: A year-long eProfessionalism curriculum was developed. It included an institution-wide Mayo Clinic Florida Grand Rounds presentation, a #SocialatMayo video on the MayoClinic YouTube channel, a presentation to Internal Medicine interns and residents, and a small group workshop discussing challenging scenarios involving physician-patient social media interactions. The Mayo Clinic social media policy was presented. Two volunteer second year residents also developed a peer to peer workshop to enhance social media professionalism. All formats and and cases were posted on a private Blackboard site developed for the Internal Medicine residents. Tools utilized on Blackboard provided documentation that each resident had viewed the required materials. A social media professionalism pre-test and post-test utilizing a smartphone polling application was utilized. This allowed demonstration of resident core competency in professionalism. There was also collaboration with the Mayo Clinic Center for Social Media and the Mayo Clinic Center for Professionalism. Results: Residents showed improved performance on the social media professionalism posttest after undergoing the year-long curriculum. Conclusions: Intern and Resident physicians had a greater understanding of Mayo Clinic social media policy and how their online behavior could reflect on Mayo Clinic and the medical profession. Interns and residents were able to discuss in an open atmosphere questions about physician-patient online scenarios. This curriculum enhanced professionalism, a required core competency, among Internal Medicine interns and residents at Mayo Clinic Florida.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2768Vandana Y. Bhide (@VeeMD) submitted 'A Curriculum to Enhance Online EProfessionalism among Internal Medicine Residents' #med2 userprofile: http://www.medicine20congress.com/ocs/social/vbhide2014-03-13T11:35:34-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-13T11:35:34-04:00Background: Social Media platforms such as Facebook and Instagram are widely utilized by post-medical school resident physicians. Several incidents of breaches of electronic professionalism by resident and practicing physicians have been highly publicized in online media. Some of these incidents violated patient privacy guidelines and have resulted in official sanction by State Medical Boards in the United States. Professionalism is a core competency required of resident physicians in training. Many intern and resident physicians are unaware of how their online activity is accessible to the public and can impact on their future employment. They are also unaware that even with strict privacy settings, anything residents post online may be viewed, and unprofessional posts reflect negatively on both Mayo Clinic and the medical profession. Objective: The Internal Medicine Clinical Competency Committee at Mayo Clinic Florida felt an education curriculum to enhance physician professionalism among first to third year internal medicine interns and residents was urgently needed. It was essential to provide a format other than face to face lectures/small group discussion in order to accomodate the schedules of interns and residents, who work at night and on weekends. They would not otherwise be able to attend weekday daytime curriculum activities. Methods: A year-long eProfessionalism curriculum was developed. It included an institution-wide Mayo Clinic Florida Grand Rounds presentation, a #SocialatMayo video on the MayoClinic YouTube channel, a presentation to Internal Medicine interns and residents, and a small group workshop discussing challenging scenarios involving physician-patient social media interactions. The Mayo Clinic social media policy was presented. Two volunteer second year residents also developed a peer to peer workshop to enhance social media professionalism. All formats and and cases were posted on a private Blackboard site developed for the Internal Medicine residents. Tools utilized on Blackboard provided documentation that each resident had viewed the required materials. A social media professionalism pre-test and post-test utilizing a smartphone polling application was utilized. This allowed demonstration of resident core competency in professionalism. There was also collaboration with the Mayo Clinic Center for Social Media and the Mayo Clinic Center for Professionalism. Results: Residents showed improved performance on the social media professionalism posttest after undergoing the year-long curriculum. Conclusions: Intern and Resident physicians had a greater understanding of Mayo Clinic social media policy and how their online behavior could reflect on Mayo Clinic and the medical profession. Interns and residents were able to discuss in an open atmosphere questions about physician-patient online scenarios. This curriculum enhanced professionalism, a required core competency, among Internal Medicine interns and residents at Mayo Clinic Florida.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2555Stephen P. Yang (@syangman) submitted 'Mobile Health (mHealth) Apps for Improved Health in Medicine' #med2 userprofile: http://www.medicine20congress.com/ocs/social/exergamelab2014-03-13T00:00:07-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-13T00:00:07-04:00Mobile health (mHealth) apps are popular on all mobile device platforms (Android, iOS, and Windows) and form factors (smartphones, tablets, and even the latest wearable fitness gadgets such as FitBit, Nike+ FuelBand, Google Glass, and smartwatches). With nearly 100,000 available health and fitness-related apps, only a small percentage (15%) of the dedicated medical apps are linked to medical providers. Some predict the worldwide revenues of mHealth apps to reach $26 billion by 2017 (Research2Guidance, 2013), but currently there is little regulation on how these apps can be integrated to collect, store, and transfer data, provide tangible benefits to patient health, and lower healthcare costs (Kamel Boulos et al., 2014). With seven in ten U.S. adults tracking a health indicator for themselves or for a loved one (Fox & Duggan 2012), there is a need to have effective mHealth apps that can contribute to behavior change, motivation, self-management, and adherence to medical protocols. Using smartphone features like global positioning system (GPS), motion sensors (accelerometers, gyrometers, magnetometers), wireless communications (Wi-Fi, Bluetooth, Near Field Communications-NFC) and cameras, these apps are able to provide users more than just one’s location. They can be used to prompt users to: perform a certain task (reminder to take medication); provide feedback on recent physical activity patterns; engage with others online and perhaps even in the physical world; and even provide users with interactive features within a game such as leaderboards and social networking features (gamification). This presentation will review the latest commercial fitness and medical mHealth apps, games, and devices that use GPS, and related location-aware apps with social and gamification features. Specific attention will be given to apps and devices that have been used in clinical research or pilot projects. This review categorizes past findings for specific medical conditions and indicates existing gaps in the literature. Future recommendations for research and development of technical features are suggested based on findings and suggestions from other fields of study, including human-computer interaction (HCI), behavior change, and social networking theories. Using advanced features on smartphones (GPS, motion sensing, geosocial) coupled with an app that is able to assist mobile users to not only track location but also to interact socially with others, playing games based in real-life or alternate-reality (ARG), has the potential to give healthcare professionals better health managements tools to ensure compliance to protocols, rehabilitation, and behavior change. This presentation will focus on the current state of mHealth apps for health and medicine; outline the available mHealth apps that capitalize on persuasive and pervasive technologies, and provide alternate suggestions and features that may impact future healthcare programs and outcomes.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2556Tomáš Pruša (@prusatomas) submitted 'Evaluation of the Web-Based Food Frequency Questionnaire Developed for the European Longitudinal Study of Pregnancy and Childhood' #med2 userprofile: http://www.medicine20congress.com/ocs/social/prusatomas2014-03-12T23:59:36-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T23:59:36-04:00Background The validation of online dietary assessment instruments is important in the diet evaluation in the ELSPAC study. Completing the food diary is time-consuming and children are often unfamiliar with the standard portion sizes which could mean an error associated with self-reported intakes; therefore, besides a food frequency questionnaire and a 24-hour recall, photographic food records were used to collect the data, as well. Objective The aim of this study was to evaluate an online food frequency questionnaire (FFQ) against a 24-hour dietary recall. Methods The aim of the study was to update the existing FFQs used in the ELSPAC study for various age groups, transfer them into the online environment with real-time evaluation, create a food portion size database for the age groups, and evaluate the comparing nutrient and food group intakes from the FFQ using the 24-hour recalls. In the first phase, 100 participants were randomly selected from the cohort. Each participant was provided with a set of 24-hour dietary recalls and a 220-item FFQ. Correlation coefficients were calculated for selected energy-adjusted macronutrients and micronutrients. At this stage, the feedback from the respondents was received, as well. Online questionnaire was used to contact participants in the new cohort, who took part in the original study, to compare their experience with the original paper questionnaire and the new FFQ. Results Research in progress. The validation study subjects represent the total cohort very well in the first phase. We hypothesize that the correlation coefficients between the FFQ and the 24-hour dietary recalls for nutrients and foods will range from 0.5 to 0.9 (beverages, alcohol). We also expect that, compared to the recalls, the FFQ will tend to underestimate energy and fat intakes, and overestimate fruits and vegetable intakes. The feedback is being evaluated and the comments of the respondents are being processed. Conclusion Research in progress. In the ELSPAC study, the online FFQ for various age categories has been used for the first time in the Czech Republic. The data indicate acceptable relative validity and reproducibility of the FFQ in this study population. Dietary data are just a part of an extensive study and although the FFQ may not be a valid indicator of an individual’s intake, we expect to use the data to measure error correction in the analyses of diet and disease risks in the population. In the following phases, the validation will be carried out repeatedly, always for each age group separately. The feedback shows a higher level of good user experience and a higher affinity to cooperation which is an integral part of any longitudinal study. This will be followed by the support using social media and the development of an interactive environment.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2547Calvin Ke (@calvinke) submitted 'Use of Web-Based Virtual Patient Simulation to Enhance Interprofessional Collaboration Skills in Diabetes Team Care' #med2 userprofile: http://www.medicine20congress.com/ocs/social/calvinke2014-03-12T23:55:50-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T23:55:50-04:00Background The increasing incidence of type 2 diabetes mellitus (DM2) is associated with significant morbidity and rising healthcare costs. The physician-only model is no longer the standard of care, with diabetes team care models involving allied health professionals demonstrating superior outcomes. Collaboration in an interprofessional context is a core competency for Canadian medical students, and teaching this skill can be challenging in traditional classroom settings. Virtual patient simulation (VPS) is an effective and innovative platform for medical education. A VPS model focused on interprofessional diabetes care education for medical students is currently lacking. Objective To review the literature on simulation for interprofessional diabetes care medical education and to develop an effective web-based VPS model for interprofessional diabetes care which can be deployed in Canadian medical school settings Methods We searched the MEDLINE database for studies on the use of simulation in interprofessional diabetes education, as well as pedagogical principles behind effective VPS design. Using HTML, Javascript, and CSS, we designed a web-based interprofessional diabetes education case. Results Only 1 publication was found which described a web-based diabetes management course aimed specifically for pharmacy students. Our literature search on successful VPS model design revealed several key principles of VPS including student interaction, specific feedback based on student responses, optimal use of media, relevant learning objectives, recapitulation of learning points, authenticity, and review questions. We designed a web-based VPS case on interprofessional diabetes (http://www.ebmcalc.ca/virtualpatient) for integration into the medical curriculum. Conclusion We developed a web-based VPS model for interprofessional diabetes care education which was chosen as the national winner in the Canada Health Infoway competition. This case is being integrated into the undergraduate medical curriculum at University of British Columbia, and plans are underway to evaluate its effectiveness.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2554Tomáš Pruša (@prusatomas) submitted 'Web-Based Food Portion Size Database in the Czech Republic' #med2 userprofile: http://www.medicine20congress.com/ocs/social/prusatomas2014-03-12T23:54:41-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T23:54:41-04:00Background In the ELSPAC study, images of the portion sizes for various age groups have been used for the food frequency questionnaire (FFQ) and the 24-hour dietary recall, using a database. Since no standard food portion size database is available in the Czech Republic, a database has been created and further developed for the study, and now it is available online. However, digital images of food are often designed for adults, based on the adult portion sizes, so they are unsuitable for children; therefore, it is necessary to develop a database respecting differences of the age groups. Objective The aim of the pilot study was to create a web-based food portion size database of chosen food and assess the accuracy of portion-size estimates using digital images. Methods Based on the available methods for creating food portion size databases and images, we have developed a method for creating such a database. The food identification for the pilot study was based on the FFQ of the ELSPAC study for various age groups. The portion size was derived from the official national recommendations in the context of the existing foreign databases and real food and meals. 3 portion sizes for adults and children were designed for the FFQ of the ELSPAC study. In the pilot study, we also prepared a (more precise division) division into 6 portions to compare the estimate accuracy when 3 or 6 portions are used. The next accuracy comparison was carried out using the images with and without known objects (a tennis ball, safety matches, etc.). To verify the accuracy of the portion-size estimates using digital images in the pilot study, we chose 50 respondents and divided them into subgroups according to the image type they worked with (according to the number of portions and the presence of an object). All respondent were given packets of food and meals of known weight, representing various food groups and food processing. The next day, the participants were asked to fill in a simple online questionnaire and choose portions of food and meals they had eaten the day before. Results Research in progress. We presume that a higher number of portions for adults and images with objects will help provide a higher accuracy. We also hypothesize that a higher accuracy can be ensured by using portion size images corresponding to the age of children. Conclusion Research in progress In the pilot study, the first part of the only online food portion size database available in the Czech Republic has been designed and developed. The accuracy of portion-size estimates and the suitability of the portion images for various age groups have been verified, as well. Thus, the online food portion database can become a suitable and commonly used dietary assessment instrument. Based on the gathered data both from this survey and the first users, and the implementation of the FFQ, more ideas for the tool development have been suggested.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2549Michelle Litchman submitted 'Engagement in the Diabetes Online Community is Associated with Better Glycemic Control' #med2 userprofile: http://www.medicine20congress.com/ocs/social/MichelleLitchman2014-03-12T23:46:19-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T23:46:19-04:00Background: Diabetes requires ongoing self-care management and many individuals with diabetes become experts in translating medical recommendations into real-life strategies to manage their diabetes day-to-day. The diabetes online community (DOC) is one place where discussions about day-to-day diabetes management strategies occur among peers. The DOC comprises multiple websites that include social networking sites, blogs, and forums in which apomediated diabetes related discussions occur. Online communities have been shown to provide disease specific practical advice, emotional support, shared experience, and encourage empowerment; however little is known about how DOC use is associated with diabetes self-management. Objective: The purpose of this study was to explore who uses the DOC, how it is used, and the perceived benefits of DOC use in relation to health indicators. Method: An online survey was conducted among multiple DOC sites over a 7 month period in 2012-2013. Binary logistic regression and modeling was performed to determine the extent to which DOC use predicted an A1C < 7 or ≥ 7% controlling statistically for other variables. Results: A total of 183 adults participated in this study, the majority were female (71.6%), undergoing intensive insulin management (80.3%), with a mean age of 44.7 (SD=14).). Participants had high diabetes self-care (M=72.4, SD=12.1), health related quality of life (SF-12v2 physical component summary M= 64.75, SD=19; mental component summary M= 66.56, SD=21.6), and bonding social capital (M=3.08, SD=0.64) and bridging social capital (M=3.68, SD=0.68) scores. DOC engagement was a strong predictor of A1C; every point increase in DOC engagement yielded 33.8% reduction in odds of having an A1C ≥7%. Conversely, there was a 2.7 times increased odds of having an A1C ≥7% among participants who reported the DOC helped them learn about strategies to improve insurance coverage for diabetes related medications, supplies, and technology devices . Conclusions: The results of this study suggest that individuals highly engage with the DOC are more likely to have better glycemic control, high health related quality of life, and self-care levels. Participants found online peer health to be beneficial with regards to knowledge and support. DOC members are often not informing their health care provider about their participation with the DOC suggesting that health care providers should be familiar with the DOC. Supplementing usual healthcare activities with DOC engagement may encourage knowledge and support among a population who need both to optimize diabetes self-management. Further studies are needed to determine how participation with the DOC affects health outcomes.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2540Steve Pomedli (@pomedli) submitted 'Following the Tweets: the Dynamics of a Physician Network on Twitter' #med2 userprofile: http://www.medicine20congress.com/ocs/social/pomedli2014-03-12T23:20:24-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T23:20:24-04:00Background Canadian physicians have become increasingly active on Twitter, using it as an effective way to share clinical evidence, discuss medical education, advocate for social change, and debate topics relating to health policy and politics. Providers have begun to take advantage of this platform, forming new connections and creating professional networks to enhance their clinical practice. Objective Through a network analysis of a country-wide physician cohort on Twitter, we aimed to characterize the behaviour within this network, the types of connections that have been formed, the nature and strength of these relationships, and the ways in which demographically different groups interact. Methods Drawing upon messages sent within this network over a 6-month period, we have linked these messages to users with known demographic characteristics--including age, specialty, and practice location--allowing us to quantify and type the messages originating from within this network, and understand message propagation and dissemination via key users and network linkages. Results Demographic characteristics of the network reveal diverse geographical locations, practice specialty, and all career stages. Our analysis suggests how various linkages and connections are form and maintained, and how such a network can be used for far-reaching advocacy and information dissemination. Finally, our data provides insights into this population’s rationale for participation, the diversity of content discussed and user behaviours. Conclusions With increasing recognition of the potential opportunities to use social media professionally, our study characterizes the behaviour of a nation-wide cohort of Canadian physicians and describes their behaviour, interactions, and the network dynamics. In addition to encouraging other providers to join this evolving network, our data suggests that networks of this nature may prove useful in connecting healthcare providers across different career stages, specialties, institutions, or geographical locations.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2548Leonid Kandel submitted '"A Russian and an American Sit in a Bar" - Treatment of an Immigrant Patient' #med2 userprofile: http://www.medicine20congress.com/ocs/social/kandel2014-03-12T23:17:37-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T23:17:37-04:00Background Many patients use internet as an important source of the information about their medical conditions and treatments. They use it both for their own knowledge and to improve their ability to understand their physician's decisions. Immigrants have more difficulties in accessing health care for many reasons; among these are language barriers and cultural differences. For these patients, medical information on the web can be even more powerful tool, as they can access it in their mother tongue. However, the discrepancy between the health information in different languages is rarely acknowledged. This study was conducted to examine these differences in order to provide physicians with better understanding of immigrants and their disease and treatment perception. Our hypothesis is that there is a profound difference between health information, found in different languages that might influence the patient perception of and compliance to the treatment. Objective The objective of this study is to examine the differences in medical information in different languages as found on Internet. Methods Two medical terms "total hip replacement" and "low back pain" were searched via Google. These terms were chosen as they both represent common medical conditions and easily translated to other languages. The first one is a condition with a strong commercial market behind it, while the second is less connected to medical industry, but has more alternative remedies. The search was conducted in 2 languages: English and Russian. The language choice reflects 2 types of searched information: by a native US patient (and physician) and by an immigrant from a country with a different medical approach. First 2 pages of each search result (which included 20 links and some sponsored links) were examined by a researcher who speaks the both languages fluently. The information on the first page of the explored link and immediately accessible via clearly presented menu (one level deep) was considered as readable by an average patient and thoroughly investigated. The data was collected and mapped according to a clear predetermined protocol. Each site was examined for an ownership, number of advertisements and presence of predetermined clinical data (coding). For each of the two selected medical terms, a few crucial clinical data elements were chosen, by an experienced arthroplasty and spine surgeon, respectively. Among explored clinical elements: required tests, treatment options, surgery options, rehabilitation and complications. Each site was assessed for the presence of strongly misleading information. Results The overall search result showed that none of the sites in Russian, as opposed to 4 sites in English, were owned by professional medical associations. Significantly more sites in Russian language were owned by different private clinics including from other countries, while more sites in English were owned by commercial companies. There was no significant difference in the average number of advertisements per site. But English search page was loaded with law suits advertising. The information presented in Russian sites had significantly less coded clinical data elements than information in English sites. The most significant difference was in complications description. There was more rehabilitation approaches discrepancies in Russian and in English. Significantly more alternative treatment methods and products were advertised for low back problems in Russian that in English. Some alternative methods in Russian sites are totally inappropriate from the modern medical science point of view. Conclusions In western multi-language immigrant society, the Internet search for medical information is performed in different languages. The physician should be aware that his patient might read a very different – sometimes misleading – information about the disease and the treatment options. This fact might require additional efforts of the physician to improve the health communication with him not-native speaking patient. Additional immigrant languages and medical fields are to be investigated to give to give the physicians the fullest picture of the medical information Internet world.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2528Amna Husain (@husainam) submitted 'A Social Networking Tool For Collaborative Care For Patients, Caregivers and Health Care Professionals' #med2 userprofile: http://www.medicine20congress.com/ocs/social/ahusain2014-03-12T23:06:02-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T23:06:02-04:00Background: Adolescents and young adults with cancer, as well as children with complex health needs are considered medically complex, requiring the care and skills of various healthcare professionals (HCP) who are often based in different places or settings. Effective communication between HCP across institutions is critical to achieving optimal health outcomes; however currently there is no organized system for this purpose, which places the burden of coordination of care on patients and their families. Objective: To develop and test the usability of a secure, cross-setting, cross-institutional, and inter-professional online clinical collaboration system (Loop) for patients, caregivers and HCP to further refine the prototype. Methods: A qualitative approach with semi-structured audio-taped individual and focus group interviews and observation by a trained observer was undertaken, with 3 iterative cycles (conducted until data saturation) to determine the usability of the user interface of the Loop tool. A purposive sample of English-speaking adolescents (n = 10; mean age = 17.5, standard deviation [SD] 3.0), young adults (n = 2; mean age = 22.8, SD 2.1), caregivers of young children (n = 7; mean age = 36.4, SD 3.6) and HCP (n = 22) were recruited from two Canadian tertiary care centers for individual interviews. In addition, a purposive sample of English-speaking HCP specializing in pediatric oncology (n = 7) and pediatric complex medical care (n = 5) were recruited for the 2 respective focus groups. Descriptive statistics and simple content analyses were used to organize data into categories that reflected emerging usability themes. Results: All participants had access to a computer and Internet at home, however adolescents and young adults reported higher levels of comfort using computers and the Internet compared to caregivers and HCP. Identified usability themes centred on: (1) problematic navigation, (2) needed interface-related changes (format, layout and aesthetics), and (3) necessary additional functionalities. To address these issues the following design solutions were implemented: (1) the message stream was changed to present messages from all users (e.g., HCP, patients) in a single stream and enhance collaboration between parties, (2) new message notifications were made more obvious and user friendly, and (3) the capacity of the search function was enhanced. No new issues were identified following the third cycle of testing. Overall, participants liked the appearance of Loop, valued its purpose, and felt it was easy to navigate, use and understand. The vast majority of participants responded that they would use Loop if it was available, however there was concern regarding the implementation of the system into their daily workflow. Conclusion: Usability testing was a crucial step in refining the clinical collaboration system to meet the various end-users needs. Development of the system has required thoughtful balancing of individual user needs and the need for a unifying tool with a clear purpose that may be applied widely across the healthcare system. Future work will focus on examining the impact of Loop on patient and health service utilization outcomes using a randomized controlled trial.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2790Amna Husain (@husainam) submitted 'A Social Networking Tool For Collaborative Care For Patients, Caregivers and Health Care Professionals' #med2 userprofile: http://www.medicine20congress.com/ocs/social/ahusain2014-03-12T23:06:02-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T23:06:02-04:00Background: Adolescents and young adults with cancer, as well as children with complex health needs are considered medically complex, requiring the care and skills of various healthcare professionals (HCP) who are often based in different places or settings. Effective communication between HCP across institutions is critical to achieving optimal health outcomes; however currently there is no organized system for this purpose, which places the burden of coordination of care on patients and their families. Objective: To develop and test the usability of a secure, cross-setting, cross-institutional, and inter-professional online clinical collaboration system (Loop) for patients, caregivers and HCP to further refine the prototype. Methods: A qualitative approach with semi-structured audio-taped individual and focus group interviews and observation by a trained observer was undertaken, with 3 iterative cycles (conducted until data saturation) to determine the usability of the user interface of the Loop tool. A purposive sample of English-speaking adolescents (n = 10; mean age = 17.5, standard deviation [SD] 3.0), young adults (n = 2; mean age = 22.8, SD 2.1), caregivers of young children (n = 7; mean age = 36.4, SD 3.6) and HCP (n = 22) were recruited from two Canadian tertiary care centers for individual interviews. In addition, a purposive sample of English-speaking HCP specializing in pediatric oncology (n = 7) and pediatric complex medical care (n = 5) were recruited for the 2 respective focus groups. Descriptive statistics and simple content analyses were used to organize data into categories that reflected emerging usability themes. Results: All participants had access to a computer and Internet at home, however adolescents and young adults reported higher levels of comfort using computers and the Internet compared to caregivers and HCP. Identified usability themes centred on: (1) problematic navigation, (2) needed interface-related changes (format, layout and aesthetics), and (3) necessary additional functionalities. To address these issues the following design solutions were implemented: (1) the message stream was changed to present messages from all users (e.g., HCP, patients) in a single stream and enhance collaboration between parties, (2) new message notifications were made more obvious and user friendly, and (3) the capacity of the search function was enhanced. No new issues were identified following the third cycle of testing. Overall, participants liked the appearance of Loop, valued its purpose, and felt it was easy to navigate, use and understand. The vast majority of participants responded that they would use Loop if it was available, however there was concern regarding the implementation of the system into their daily workflow. Conclusion: Usability testing was a crucial step in refining the clinical collaboration system to meet the various end-users needs. Development of the system has required thoughtful balancing of individual user needs and the need for a unifying tool with a clear purpose that may be applied widely across the healthcare system. Future work will focus on examining the impact of Loop on patient and health service utilization outcomes using a randomized controlled trial.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2541Nicholas Genes (@nickgenes) submitted 'Tutorial: Analyzing Twitter for Public Health Research (extra registration required)' #med2 userprofile: http://www.medicine20congress.com/ocs/social/nickgenes2014-03-12T22:46:07-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T22:46:07-04:00Background: Analysis of social media can serve as a powerful tool for research in a variety of health disciplines. Twitter, with its popularity, frequent engagement, public messaging, open API, and rich metadata, is a compelling platform for study. To date, most analyses of tweets are imprecise or opaque, using algorithms better suited to marketers instead of scholars. A sound analysis of social media rests on the successful application, in tandem, of concepts from linguistics, mathematics, and computer science. Objectives: By the end of this 4-hour session, participants will be able to 1) understand the technical requirements for automated Twitter API queries, 2) write their own queries of Twitter content, and metadata such as user profile details or location, 3) collect and analyze the JSON search results, 4) use Python’s Natural Language Toolkit (NLTK) for basic linguistic analysis and clustering analyses, and 5) make statistically sound inferences from those analyses. Overview: Participants should bring a laptop (preferably a MacBook) to get the full benefit of the hands-on demonstrations. The tutorial instructors will contact participants who sign up in advance, with a user-friendly guide that introduces the command line and walks users through the installation of necessary software packages and registration on GitHub. In this tutorial, users will quickly begin to collect publicly available information from Twitter’s streaming API, by modifying our prepared templates for their own research interests. They will apply their own analyses, under our guidance, and go home with a clear plan on how to collect sufficient data to produce meaningful statistical inferences on the collected data. About the organizers: The tutorial will be led by three physician-scientists with several peer-reviewed publications regarding the analysis of social media for medical applications, as well as additional peer-reviewed and lay publications on the role of the internet and IT on healthcare. The three of us have overlapping but diverse interests across a range of Medicine 2.0 disciplines and can provide close guidance to participants with troubleshooting, research techniques, and statistical analyses. This is a preconference event. Either register by choosing the tutorial as additional option when you register for the Medicine 2.0 Malaga conference, or register separately via <a href="http://www.eventbrite.com/e/tutorial-analyzing-twitter-for-public-health-research-tickets-12960470115?aff=eorg">Eventbrite</a>.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2524Ashwin Kutty (@ideolocator) submitted 'The Business of Healthcare - Mobile' #med2 userprofile: http://www.medicine20congress.com/ocs/social/kutty2014-03-12T22:43:33-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T22:43:33-04:00Healthcare needs a new approach in how care is delivered. It is no longer a top-down institution driven business as it once was. The delivery of care as we have all heard needs to change, from care within the community to delivering care more specifically how, when and where the patient requires it. It is in the best interests of all concerned to make sure care and support is delivered to patients for direct & preventative care the way they are willing to receive it. The business of healthcare needs to take a consumerist view on how it needs to be delivered. This requires understanding the demographic you want to serve, the KPI’s & the ROI’s of investing in technological trends, the data that speaks to the efficacy of a service, the modality in which it is delivered and the platform in which it is delivered. Understanding this requires modeling access to care and the supports thereof in a fashion that is digestible & accessible. We are presenting the new form of healthcare, specifically in the mobile space that considers solutions we present as examples. Some of the concepts used that will be discussed are: 1. Consumer Demographic – What is the demographic we are targeting? What are their likes/dislikes? 2. Consumer Access – How will the consumer access the product/service? Where will they access it? How do they prefer accessing it and how many different ways would we need to provide it to feed the varied demographic? 3. Education/Learning Modalities – How does a consumer learn or digest information? Differing consumers have different learning styles and habits, be it as visual learners, auditory learners, tactile learners or ones who prefer the reading/writing styles of learning. 4. Platform Variability – How do you engage consumers across platforms depending on their own preference & use? How does that define & drive delivery? 5. Technological Trends – What are the technological trends, both the current as well as one for the future that will drive where the consumer lives and will live in the future? How does technology become both a driver and not be a momentary trend? 6. Consumer Trends – What are the consumer trends? With millennial’s now leading the pack of how population trends are driven, what are the next set of consumer trends that drive the delivery mechanisms? 7. Marketing & Communications – Is developing a good product enough? If you build it will they come? What is the role of endorsers, promoters, supporters? What is the role media can play? Does social media alone drive the momentum? 8. Key Performance Indicators (KPI) – What are the key performance indicators that need to be looked at? In a mobile friendly world, when you develop a product, is it enough that it is now on the App Stores? What else needs to happen? What are the benefits of hiring professionals to increase traction and decrease traditional “Healthcare Drag”.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2788Ashwin Kutty (@ideolocator) submitted 'The Business of Healthcare - Mobile' #med2 userprofile: http://www.medicine20congress.com/ocs/social/kutty2014-03-12T22:43:33-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T22:43:33-04:00Healthcare needs a new approach in how care is delivered. It is no longer a top-down institution driven business as it once was. The delivery of care as we have all heard needs to change, from care within the community to delivering care more specifically how, when and where the patient requires it. It is in the best interests of all concerned to make sure care and support is delivered to patients for direct & preventative care the way they are willing to receive it. The business of healthcare needs to take a consumerist view on how it needs to be delivered. This requires understanding the demographic you want to serve, the KPI’s & the ROI’s of investing in technological trends, the data that speaks to the efficacy of a service, the modality in which it is delivered and the platform in which it is delivered. Understanding this requires modeling access to care and the supports thereof in a fashion that is digestible & accessible. We are presenting the new form of healthcare, specifically in the mobile space that considers solutions we present as examples. Some of the concepts used that will be discussed are: 1. Consumer Demographic – What is the demographic we are targeting? What are their likes/dislikes? 2. Consumer Access – How will the consumer access the product/service? Where will they access it? How do they prefer accessing it and how many different ways would we need to provide it to feed the varied demographic? 3. Education/Learning Modalities – How does a consumer learn or digest information? Differing consumers have different learning styles and habits, be it as visual learners, auditory learners, tactile learners or ones who prefer the reading/writing styles of learning. 4. Platform Variability – How do you engage consumers across platforms depending on their own preference & use? How does that define & drive delivery? 5. Technological Trends – What are the technological trends, both the current as well as one for the future that will drive where the consumer lives and will live in the future? How does technology become both a driver and not be a momentary trend? 6. Consumer Trends – What are the consumer trends? With millennial’s now leading the pack of how population trends are driven, what are the next set of consumer trends that drive the delivery mechanisms? 7. Marketing & Communications – Is developing a good product enough? If you build it will they come? What is the role of endorsers, promoters, supporters? What is the role media can play? Does social media alone drive the momentum? 8. Key Performance Indicators (KPI) – What are the key performance indicators that need to be looked at? In a mobile friendly world, when you develop a product, is it enough that it is now on the App Stores? What else needs to happen? What are the benefits of hiring professionals to increase traction and decrease traditional “Healthcare Drag”.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2539Nicholas Genes (@nickgenes) submitted 'Twitter Discussions of Nonmedical Prescription Drug Use Correlate with Federal Survey Data' #med2 userprofile: http://www.medicine20congress.com/ocs/social/nickgenes2014-03-12T22:33:39-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T22:33:39-04:00Background: The drugs people use, and the way people learn about drugs, have changed in recent years. Methods of surveying usage and educating the public about health risks must correspondingly change. Analyzing social media represents a fast, inexpensive way to uncover the epidemiology of drug use and identify points of intervention. Objective: To (1) automatically categorize Twitter messages about prescription opioid use into discussions about medical or nonmedical use employing unsupervised clustering, and (2) determine whether Twitter message content and metadata about nonmedical prescription opioid use correlates with prior US federal survey-based estimates, by state. Methods: Twitter’s streaming API was queried for 60 days for geocoded tweets mentioning any prescription opioid currently sold in the US. Before a linguistic analysis, the text was converted to lowercase. Non-ASCII characters and stopwords were removed, and words were lemmatized. Messages were clustered according to semantic distance (a novel measure of textual similarity based on average path distances of each message’s recognizable words, from WordNet). We normalized the number to medically-related tweets to the total number of tweets emitted from a region to control for variations in tweets volume due to geography. We compared the results to reference data derived from the 2010-2011 NSDUH State Estimates of Substance Use and Mental Disorders. Results: 100,000 tweets mentioning prescription opioids were obtained and, through semantic distance, automatically separated into distinct clusters related to medical use, nonmedical use, and unrelated to use. Nonmedical usage tweets correlated to federal estimates to the resolution of states, with r = 0.60. Conclusions: This is the first demonstrations that tweets (that is, extremely short pieces of text) regarding medical and nonmedical usage of drugs can be automatically categorized based on linguistic features. Our estimates of nonmedical usage of prescription opioids correlate with federal estimates at the state level. Discussions of these and other drugs of abuse can be analyzed, in real-time and at finer geographic resolution, at a fraction of the cost of federal surveys, to help guide public health outreach, education and policy solutions.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2535Trevor Jamieson (@DrTJamieson) submitted '“Loop” as a Window: Analytics and Social Network Theory to Understand Teams of Care' #med2 userprofile: http://www.medicine20congress.com/ocs/social/wtjamies2014-03-12T22:32:42-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T22:32:42-04:00Background: Loop is a secure online tool for ongoing, dynamic team-based communication centered on the patient for the purpose of collaboration in their care. Loop assembles the patient's actual team of care, and adds the patient and informal caregivers as key team members. In areas such as cancer care and palliative care the teams of health care professionals (HCP) involved are often complex, fragmented, non-static and geographically dispersed. To capture the entire team, Loop is cross-setting, cross-organizational, inter-professional, and its development has been user-driven from its inception. In addition to its use as a communication platform, Loop has been developed to allow for real-time performance analytics as well as complete data extracts for in-depth analysis. The existence of a tool is, of course, no guarantee of its uptake, and there are many potential barriers that even the most useful tool must overcome: money, time, and regulation to name the most obvious. In this study, we undertake a mixed-methods analysis of the organic networks and interactions that develop with the provision of a tool for cross-institutional and cross-jurisdictional collaboration. Through interviewing of participants and both quantitative and qualitative analyses of the connections that develop, the messages exchanged, and ultimately the team-based behavior that is observed, a greater description of the inherent barriers in the system that impede teams of care becomes possible. Objective: The primary objective of this study is to describe a system as it develops after the provision of a tool that should, in theory, facilitate greater team interaction and group behavior. The secondary objective is to propose systemic modifications that may overcome barriers that are observed. Methods: A complimentary study performing a pragmatic randomized controlled trial is the setting for this evaluation. 35 intervention teams and 15 control teams (groups of providers, caregivers and patients without a networking tool to facilitate interaction) will serve as the basis for this analysis. The tool’s impact on the organic formation of the team will be analyzed using mixed-methods. In the experimental groups, an analysis of the messaging metadata will be assessed for the types of interaction and themes of interaction. Instances of behavior that may foster or impede team behaviors, for example, patient inclusion vs. exclusion in conversation, directed vs. non-directed messaging, or one to one vs. one to many messaging will be specifically examined. Social network analysis will be used to map the structure of the emergent teams, identify key players, and will be combined with interviews in order to foster a more complete understanding of the systems as they develop. Results: Research in Progress Conclusions: Research in Progresshttp://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2841Trevor Jamieson (@DrTJamieson) submitted '“Loop” as a Window: Analytics and Social Network Theory to Understand Teams of Care' #med2 userprofile: http://www.medicine20congress.com/ocs/social/wtjamies2014-03-12T22:32:42-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T22:32:42-04:00Background: Loop is a secure online tool for ongoing, dynamic team-based communication centered on the patient for the purpose of collaboration in their care. Loop assembles the patient's actual team of care, and adds the patient and informal caregivers as key team members. In areas such as cancer care and palliative care the teams of health care professionals (HCP) involved are often complex, fragmented, non-static and geographically dispersed. To capture the entire team, Loop is cross-setting, cross-organizational, inter-professional, and its development has been user-driven from its inception. In addition to its use as a communication platform, Loop has been developed to allow for real-time performance analytics as well as complete data extracts for in-depth analysis. The existence of a tool is, of course, no guarantee of its uptake, and there are many potential barriers that even the most useful tool must overcome: money, time, and regulation to name the most obvious. In this study, we undertake a mixed-methods analysis of the organic networks and interactions that develop with the provision of a tool for cross-institutional and cross-jurisdictional collaboration. Through interviewing of participants and both quantitative and qualitative analyses of the connections that develop, the messages exchanged, and ultimately the team-based behavior that is observed, a greater description of the inherent barriers in the system that impede teams of care becomes possible. Objective: The primary objective of this study is to describe a system as it develops after the provision of a tool that should, in theory, facilitate greater team interaction and group behavior. The secondary objective is to propose systemic modifications that may overcome barriers that are observed. Methods: A complimentary study performing a pragmatic randomized controlled trial is the setting for this evaluation. 35 intervention teams and 15 control teams (groups of providers, caregivers and patients without a networking tool to facilitate interaction) will serve as the basis for this analysis. The tool’s impact on the organic formation of the team will be analyzed using mixed-methods. In the experimental groups, an analysis of the messaging metadata will be assessed for the types of interaction and themes of interaction. Instances of behavior that may foster or impede team behaviors, for example, patient inclusion vs. exclusion in conversation, directed vs. non-directed messaging, or one to one vs. one to many messaging will be specifically examined. Social network analysis will be used to map the structure of the emergent teams, identify key players, and will be combined with interviews in order to foster a more complete understanding of the systems as they develop. Results: Research in Progress Conclusions: Research in Progresshttp://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2527Roman Kerekes submitted 'CARDIO3®ECHO Expert System for Echocardiography : a Smartphone Application' #med2 userprofile: http://www.medicine20congress.com/ocs/social/rekesh2014-03-12T21:27:06-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T21:27:06-04:00BACKGROUND Echocardiography is one of the non-invasive, widely available and basic methods to examine the heart. Current devices allow echocardiographic measurements and calculations of large amounts of hemodynamic and morphological parameters. To establish the diagnosis and assessment of severity of heart disease, it is needed to evaluate all available data. OBJECTIVE The goal of this study was to investigate the feasibility of CARDIO3®ECHO expert system for the diagnosis of heart diseases, using echocardiographic measurement data. METHODS We created a simulator for the measurement of echocardiographic parameters and implemented basic calculations of hemodynamic parameters (volume, flow, pressure or velocity). This system was tested on a database of findings of the CARDIO3® Comprehensive Atlas of Echocardiography. The measurement results are the basis for the text description, which is compiled from standard clinical keywords. The application enables adding other parameters required for the evaluation of echocardiographic findings, such as age, weight and height of the patient. The results and calculations are stored in the database to verify the accuracy of the measurement. The system highlights the possible discrepancy between the measured parameters and calculated values. The application includes stratification of measurement results and the severity of heart disease. RESULTS During testing on the CARDIO3® database consisting nowadays of 644 echocardiographic samples (112 various case reports), we revealed several inaccuracies in calculated clinical findings. For instance the left atrium short axis dimension measured from parasternal view (LA PSAX) indicated a normal (non-dilated) left atrium (LA) size whereas measurement of the left atrium volume from apical view resulted in moderate LA dilatation (due to the elongated shape). Another example was the evaluation of severity of aortic valve stenosis. Aortic valve area (AVA) measured directly from the parasternal short-axis view (PSAX) mismatched the calculation of AVA using a continuity equation. The system makes alerts if any controversy occurs in the assessment of valvular heart diseases, systolic or diastolic ventricular function, evaluation of pulmonary hypertension or hemodynamics in restrictive cardiomyopathy/constrictive pericarditis. The app is available on iPad devices. The authors of the cases and charts are comprised of clinical cardiologists and internal fellows. CONCLUSIONS Our study showed that simulator-based training in echocardiography could be very effective and if implemented in the echocardiography device may be helpful in clinical practice. In a routine clinical setting it enables quicker processing of the examination protocol and a prompt final recommendation for the management of the patient.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2515Anne Brice (@annebriceuk) submitted 'Creating a Database of Internet-Based Clinical Trials to Support a Public-Led Research Programme.' #med2 userprofile: http://www.medicine20congress.com/ocs/social/abriceuk2014-03-12T21:14:49-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T21:14:49-04:00Background There is a need to improve participatory approaches in health care research in order to ensure that the most important questions of patients and the public are answered. The International Network for Knowledge on Well-being (ThinkWell) research programme aims to use online technologies to promote user-led research in health care. However, it is unclear how many clinical trials have been conducted using internet-based technologies, and how these map against coverage of health care conditions and interventions, or share learning and expertise in methods. Objectives This research project was designed to create a database of randomised trials in health care conducted using internet technologies. The database has provided a source of data for ThinkWell researchers, including help in determining how many randomized trials have used internet-based technologies as part of their trial processes, what stages of the trial process use these technologies, and how use has developed over time. In addition a range of trial characteristics have been mapped including the range of conditions and topics, types of interventions, trial participants and use of participatory methods. Methods A comprehensive literature search was undertaken in order to retrieve a set of relevant research reports, from a wide range of sources. Results were imported into a bibliographic software package and screened against inclusion and exclusion criteria. Included studies were then mapped against a number of key dimensions, with the key themes developed iteratively throughout the process. The final set of studies has been exported into a database, browsable by the key identified facets, and also searchable by text word. The database has been made available to the ThinkWell research team for further analysis and use. Results The initial database searches were conducted between January 2011 and September 2012 and retrieved 16,824 results. Following screening a final database of 1513 studies was created. In addition to core bibliographical details, studies were coded for topic or condition; country; intervention; trial stage and participatory methods. There is a predominance of activity in interventions related to core public health issues such as obesity, smoking, alcohol misuse, and physical activity, and in mental health issues such as depression and anxiety. The other main theme covers conditions where self-management or monitoring is a major feature of care. Conclusions The results from the database creation exercise demonstrate the increase in the use of internet technologies within internet-based clinical trials. A number of key themes have emerged from the analysis including location of expertise, and the predominance of trials covering specific conditions and interventions. A number of other challenges emerged from the research including issues relating to the reporting of internet-based trials, and retrieval issues resulting from a lack of consistent taxonomies and indexing. Further research will be undertaken in order to investigate how well participant experiences in internet-based clinical trials has been understood, and how the data can be used to improve trial design and recruitment, and to support the public-led research agenda.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2520Julie Barnett (@julieatselhurst) submitted 'Embodying the Health Professional - Patient Relationship in E-Interventions' #med2 userprofile: http://www.medicine20congress.com/ocs/social/juliebarnett2014-03-12T20:30:21-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T20:30:21-04:00Background: Increasingly, health policy is encouraging the development of innovative, cost-effective and efficient technological solutions to support overburdened health sectors. This may mean a diminished reliance on face to face contact of health professional and patient. This is potentially problematic given the positive influence that the doctor patient relationship has on adherence, perceived quality of care and health outcomes. Recently the notion of ‘supportive accountability’ has been proposed as a framework for the way in which relationships can best support e-interventions. We extended this to consider the ways in which the relationship can be best embodied within e-interventions. Objective: To (a) characterise the way in which e-interventions can embody the offline relationship between the patient and health professionals and (b) to evaluate patient perceptions of the nature of the relationship and the characteristics of the e-intervention that these were attributed to. Methods: An online platform that provided a PC interface for the health professional and a linked mobile application for the patient was developed. The design of the platform (myPace) sought to embody 3 key elements of the supportive accountability framework: social presence, expectations and performance monitoring. The potential of the software to embody these characteristics was explored in the context of 10 peer-to-peer interactions focusing on losing weight. Interviews explored the sense that participants made of the interactions that they had and a thematic analysis sought to characterise the manner and extent to which the software had enabled supportive accountability. Results: The myPace platform included features that signalled social presence (through timely and context relevant motivational messaging), enabled clear communication of expectations of patient behaviour (through relevant goal setting) and that enabled the patient to monitor their performance (integrating weight changes with information about mood and goal related achievements) . The evaluation, whilst conducted outside formal health professional/patient contexts, provides a detailed picture of the sense that participants made of each of these design features and provided considerable encouragement for development of the supportive accountability framework within e-interventions in health care environments. Conclusions: The results of this study suggest that the supportive accountability framework might be usefully extended from the current focus on how off line relationships can help enhance online outcomes to help design e-interventions that embody meaningful signals of supportive human presence.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2513Gonzalo Mora submitted 'Pre-Med2 Tutorial: From The Idea to the App in 4 Hours (extra registration required)' #med2 userprofile: http://www.medicine20congress.com/ocs/social/gmora2014-03-12T20:07:54-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T20:07:54-04:00The 4-hour course is designed as mini Medicine hackathon to go from the concept or idea for an App about a clinical or healthcare topic to the roadmap and prototype (mock-up) of the app, with the full range of options from simple and informative Apps to highly sophisticated database Apps with powerful back-end systems and social media integration. No previous programming knowledge is required. This is a preconference event. Either register by choosing the tutorial as additional option when you register for the Medicine 2.0 Malaga conference, or register separately via <a href="http://www.eventbrite.com/e/tutorial-from-the-idea-to-the-app-in-4-hours-tickets-12939214539">Eventbrite</a>.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2451Gonzalo Mora submitted 'Patient Data Protection in a Free Photo Sharing Network for Healthcare Professionals - The InsightMedi Mobile App Case' #med2 userprofile: http://www.medicine20congress.com/ocs/social/gmora2014-03-12T19:49:12-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T19:49:12-04:00In October 2013 we launched InsightMedi App, a free Photo Sharing Network for Healthcare professionals, in a Beta phase. The main challenge was to fulfill patient data protection regulations, not only HIPAA but also worldwide regulations, before releasing the open use of the app. Given the great importance of this aspect we developed a security protocol with 6 levels. Level 1.- The terms of use of the application report, when the user register for the first time , the requirement that all pictures must be anonymized (no history numbers , names, or any other patient identifying information). Level 2.- At the beginning photo upload process, a message appears recalling again that obligation for the image to be uploaded. Level 3.- The application provides an image editor that allows us to cut areas, or delete names, numbers, or any other markings that could identify a patient (incisions, scars, tattoos, ...) Level 4.- No sensible metadata is uploaded with the image (so any DICOM kind of patient information is detached from the image file). Level 5.- Once an image is uploaded, the user is informed that the image will be available for the rest of users after a human review process is done (automatically a message is sent to the development team where one person “on call” is responsible for verifying that the image meets the requirements of the app (which is anonymized , about a health issue, not a picture from a book , respectful with the patients, etc ... ). As soon as the image is approved it is available for all the users. In case the image was rejected, the user that sent the image receives an email with the reason why it has been rejected, along with a push message for a quicker notification. Besides the above, there is another Level 6 where any user has the right to report an image as inappropriate if they consider that, and this option automatically triggers a new process of review by the development team. With this security protocol that was launched in January 2014, with the open phase of InsightMedi App, we have been able to guarantee the patient data protection regulations, thus providing the healthcare professionals with a free tool to share anonymized clinical information in a safety environment. The implementation of this process is detailed in the presentation as well as other as other security strategies that were initially considered in the protocol.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2509Tobias Hartz (@tobgerm) submitted 'Social Media Guidelines for Communication in Health Settings in Germany' #med2 userprofile: http://www.medicine20congress.com/ocs/social/hartz2014-03-12T19:33:36-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T19:33:36-04:00Background: The use of social networks has increased tremendously within the last years. Today, Twitter, Facebook and others are used to find information on medicine and health topics as well. Those services are also used by patients to get in contact with each other or with their physician. For physicians, on the other hand, this kind of communication can lead to legal and ethical issues, when it comes to data privacy. In Germany, the German Medical Association has published recommendations on the use of Social Media for physicians and medical students in May 2012. However, most clinics in Germany still have not implemented official guidelines on the use of social networks or use guidelines which do not focus on communication. This leads to an uncertainty among physicians about how the possible benefits of social networks can be used without negative consequences. Objective: Therefore our aim was to develop and promote guidelines which give health care provider in general an orientation when using social networks to communicate with patients. Methods: First we conducted an international systematic literature research using PubMed in order to identify relevant articles and guidelines which address in particular the issue of communication in social networks by health care professionals. In addition, relevant articles were sighted through hand search via references. Furthermore, relevant health care providers and organizations in Germany were asked for available guidelines. Therefore, all university hospitals, selected private hospitals, hospital chains and insurances as well as several physicians associations and non-profit organizations were approached by email or phone. Available guidelines were reviewed and categorized according to its content and addressee. Results: In total, six relevant articles were obtained from the literature research. 67 institutions were contacted. 47 replied. Out of those 16 had guidelines available. Eleven had guidelines in development. After reviewing the relevant literature and available guidelines, we identified eight recommendations for safe use of social networks in health care settings by pooling relevant and reoccurring elements. In contrast to most guidelines used by health care providers which focus mainly on legal aspects such as online defamation, main issues addressed by our guidelines are data privacy concerns and possible impacts of befriending with patients. We suggest that health care providers carefully review their online behavior and are aware of which content they share. Befriending might have a great impact on the patient-physician relationship, therefore we find it crucial to either limit befriending or ensure that date privacy settings are applied to avoid those connections to become public. Conclusion: Our guidelines provide orientation for physicians who want to use social media as a platform to communicate with their patients. The issues address several aspects of online behavior which should be followed by everyone in the health-care sector. Doing so will allow to benefit from the possibilities social networks offer without the danger of being subject to legal charges or ethical dilemmas.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2487Allisson Dantas Oliveira (@Allisson_Dantas) submitted 'Malaria System: a New Tool for Automatic Diagnosis of Malaria in Mobile Devices' #med2 userprofile: http://www.medicine20congress.com/ocs/social/allissondantas2014-03-12T19:17:32-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T19:17:32-04:00Background: Malaria is a worldwide public health problem and it is mainly related to remote areas. In this way, low cost systems for automatic diagnosis has become a priority investigation in several research groups. On the other hand, there are new cases due to climate changes which allow the survival of Anopheles in areas previously not inhabited. In this way, the coming years will see a great demand for in loco diagnostic and evaluation systems to these new areas. Objective: Mobile devices have been viable alternatives in several health systems and epidemiological control. The research groups EpiSchisto Risk Modeling (www.epischisto.org) and Discrete Modelling and Simulation of Biological Systems (http://mosimbio.upc.edu) have developed automatic diagnostic tools for diseases including schistosomiasis and malaria. In this work, a detection system for Plasmodium parasites (malaria) at low cost with mobile devices is presented. Methods: This work is under the computer vision area that theoretically simulates the human visual (SHV). The SHV is responsible for this visual perception of a human being (in recognizing objects, shapes, among others). Computer vision techniques seek to apply this knowledge to a computerized machine. This operation is not as simple one since there are some perceptions of the human visual system that has not yet been completely explained. The use of techniques of computer vision and artificial intelligence in this project is the theoretical foundations of the detection system for low-cost malaria presented here. The development phases of the system are: capture image - the image is captured using a coupled experimental mobile device system and a microscope; segmentation - operation to reduce the computational cost. This step consists in removing the background around blood cells, thereby reducing the search scope of the recognition algorithm; training and classification - sorting through artificial intelligence techniques for training with positive and false positive images (with and without malaria parasites) partitioned into 80% training and 20% for validation or testing. Results: An Android based system was developed, it finds the Plasmodium infected parasites in the image. The execution time has an average time of 1000ms to detect each parasite. The system is limited on the identification of the parasite into P.falciparum specie (step trophozoite). In this phase the parasite has an annular shape. The system were tested in a set of 465 images with 50 positive ones and 415 negative ones. The hit rate of the system is currently at 60%, where so every 100 infected 60 parasites are identified. Conclusions: The main contribution of the Malaria System is its low cost and its usability. This is special when used in remote areas by Public Health agents. In these places, the human capital is also a scarse resource and nevertheless the results can be seen in loco and in real time. The results will be sent to a central unit control once the device get internet connection.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2505Raquel Gomez Bravo (@rqgb) submitted 'Ready to Manage Intimate Partner Violence?' #med2 userprofile: http://www.medicine20congress.com/ocs/social/rqgb2014-03-12T19:15:29-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T19:15:29-04:00Background: Domestic violence is a widespread public health problem affecting one in three women, with serious consequences. Despite this high prevalence, it is estimated that only 3% of cases are presently being identified in primary care settings, and general practitioners (GPs) - as the most likely first-line professionals to be contacted - are uncertain of what to do if a case is discovered. Low awareness amongst GPs concerning intimate partner violence (IPV) has been demonstrated repeatedly, and there is unanimity in calls for effective trainings of primary care physicians in the prevention, detection, early intervention, assessment, treatment, handling, crisis-intervention, documentation, referral and follow up caring during and after an episode of intimate partner violence. Objective: The aim of this research project is to seek input from the widest possible geographical range of Primary Health Care providers in Europe on their perception of their needs for specific training to address Family Violence and preparedness to manage this kind of situations. Methods: A pilot study using PREMIS (Physician Readiness to Manage intimate Partner Violence Survey), a 15-minute questionnaire, will be carried out over one month through the primary care network in Europe with the aim to investigate physicians’ perceptions of their competencies and training needs in Family Violence. The PREMIS tool will be the instrument used to measure physicians’ previous knowledge, attitudes, beliefs, behaviours and skills. This test has high consistency with constructs that theoretically contribute to effective healthcare provider response to victims of IPV; in addition, PREMIS has good external validity with earlier instruments, while being more current and more comprehensive than previously used tests. In addition PREMIS has been demonstrated to be sensitive to change, and successfully discriminates between trained and non-trained physicians. As we need to have a wide geographical reach, this descriptive study will be self-reported online using the “lumos!” platform, which enables the development and coordination of questionnaire-based studies. The platform can be easily extended and tailored for special purposes and can be employed for the needs of virtually any research study. One of the features that we have extended is the sharing of the questionnaires in different social networks with the aim of inviting many different professionals to participate in our study. Finally, all the data will be stored on a server, and snapshot reports will be shared with the research team throughout the duration of the study. Results: The results of this study will be presented at the Conference. Conclusions: Domestic violence remains a major public health and clinical problem with a poor health care response. The easy-to-use platform, which is accessible and feature-complete for surveys, will attract more colleagues to participate actively and engage more physicians, due to the advances in connectivity, effectiveness and efficiency of the “lumos!” platform. By using this tool it will be possible to identify potential deficits in Primary Care professional’s curricula, evaluate possible training initiatives to develop their competencies and develop curriculum guidelines including assessment of perceived learning needs.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2493Tobias Hartz (@tobgerm) submitted 'Attention Facebook – Patients and Health Care Provider Meet in Social Networks' #med2 userprofile: http://www.medicine20congress.com/ocs/social/hartz2014-03-12T19:08:40-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T19:08:40-04:00Background: Nowadays more and more people communicate on health issues via the internet. They use social networks like Facebook or Twitter to exchange views, to get information or to support each other. Mainly questions concerning health or diseases of oneself or relatives are in focus. Social networks offer good ways to interact and exchange experiences with other people and to receive hints and information by people one knows or believes to know. Health care providers also use social networks, but rather for private matters. Thus, often patients find their doctors or nursing staff in social networks and are trying to befriend them or contact them over these channels. However, how should you react to these befriending by patients? How do you react if you meet patients on Facebook who openly speak about their history of disease? Or relatives seeking for support and describing every detail of their child’s disease? Objective: The Training should be offered for health care provider on secure conduct and appropriate communication in social networks. Method: In lectures, the different subject areas are defined and the necessary knowledge is conveyed. The participants then work on specific assignments in small groups at PCs. In discussions with the whole group, the results and experiences of the different groups are shared. Result: A concept for a 2-hour workshop addressing appropriate communication in social networks has been developed directed at health care professionals at the local university hospital. The workshop starts with a short introduction about the development of social networks, the risks in case of careless handling of them, and the measures which can be taken to improve security. Subsequently, different Facebook profiles are analyzed at PCs according to the reported criteria. The results are summarized by the group and the most important points for secure conduct are emphasized. In the second part of the workshop, recommendations are given on appropriate communication, on befriending and on how to act after having received Online-friendships. A specific assignment is that some participants are asked to establish a closed Facebook group (at prepared PCs) and to invite the other participants to find and join the group. Afterwards, a discussion within this Facebook group is about to get started according to a given scenario. After 10 minutes, the chat stops and the group collects and shares their experiences. A first course with evaluation is set for middle of March 2014. Discussion: The participants receive concrete recommendations and information on secure and appropriate conduct in social networks. Equipped with this knowledge and these competencies they can act as multiplicators. They could be contact persons for colleagues or for patients and their relatives who often have little insight into aspects of security and sustainability in social networks, especially when they find themselves in extremely stressful situations due to diseases.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2503Raquel Gomez Bravo (@rqgb) submitted 'Ready to Manage Intimate Partner Violence?' #med2 userprofile: http://www.medicine20congress.com/ocs/social/rqgb2014-03-12T19:08:31-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T19:08:31-04:00Background: Domestic violence is a widespread public health problem affecting one in three women, with serious consequences. Despite this high prevalence, it is estimated that only 3% of cases are presently being identified in primary care settings, and general practitioners (GPs) - as the most likely first-line professionals to be contacted - are uncertain of what to do if a case is discovered. Low awareness amongst GPs concerning intimate partner violence (IPV) has been demonstrated repeatedly, and there is unanimity in calls for effective trainings of primary care physicians in the prevention, detection, early intervention, assessment, treatment, handling, crisis-intervention, documentation, referral and follow up caring during and after an episode of intimate partner violence. Objective: The aim of this research project is to seek input from the widest possible geographical range of Primary Health Care providers in Europe on their perception of their needs for specific training to address Family Violence and preparedness to manage this kind of situations. Methods: A pilot study using PREMIS (Physician Readiness to Manage intimate Partner Violence Survey), a 15-minute questionnaire, will be carried out over one month through the primary care network in Europe with the aim to investigate physicians’ perceptions of their competencies and training needs in Family Violence. The PREMIS tool will be the instrument used to measure physicians’ previous knowledge, attitudes, beliefs, behaviours and skills. This test has high consistency with constructs that theoretically contribute to effective healthcare provider response to victims of IPV; in addition, PREMIS has good external validity with earlier instruments, while being more current and more comprehensive than previously used tests. In addition PREMIS has been demonstrated to be sensitive to change, and successfully discriminates between trained and non-trained physicians. As we need to have a wide geographical reach, this descriptive study will be self-reported online using the “lumos!” platform, which enables the development and coordination of questionnaire-based studies. The platform can be easily extended and tailored for special purposes and can be employed for the needs of virtually any research study. One of the features that we have extended is the sharing of the questionnaires in different social networks with the aim of inviting many different professionals to participate in our study. Finally, all the data will be stored on a server, and snapshot reports will be shared with the research team throughout the duration of the study. Results: The results of this study will be presented at the Conference. Conclusions: Domestic violence remains a major public health and clinical problem with a poor health care response. The easy-to-use platform, which is accessible and feature-complete for surveys, will attract more colleagues to participate actively and engage more physicians, due to the advances in connectivity, effectiveness and efficiency of the “lumos!” platform. By using this tool it will be possible to identify potential deficits in Primary Care professional’s curricula, evaluate possible training initiatives to develop their competencies and develop curriculum guidelines including assessment of perceived learning needs.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2478Raymond Robert Bond submitted 'Utility and Accuracy of Online Schematics That Illustrate ECG Electrode Positions' #med2 userprofile: http://www.medicine20congress.com/ocs/social/raymondbond2014-03-12T18:55:19-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T18:55:19-04:00Background The 12-lead Electrocardiogram (ECG) is one of the most widely used diagnostic tests for assessing patients. It is routinely used to determine the cardiac state of person’s heart. Nevertheless, 12-lead ECG acquisition requires precise placement of 6 chest electrodes and 4 limb electrodes. It has been reported that 36% of electrodes are misplaced and that an electrode misplacement can cause a misdiagnosis and result in inefficient therapy. And given students and clinicians often use Internet resources to assist in the recording of clinical procedures; we decided to assess the veracity of Google images. In particular, we assessed those online images that could potentially be used by clinicians to guide the positioning of ECG electrodes. Objective: To determine the utility and accuracy of online images that illustrate ECG electrode positions Methods: Common search criteria was defined as “ECG electrode positions”. The top 42 relevant images that illustrate ECG electrode placement were scrapped from Google images in the web browser. Six expert delegates from the International Society of Computerised Electrocardiolgy (San Jose, California) independently reviewed and assessed each of the images. Using a rating scale (where 1 is negative and 10 is positive), each expert rated the usefulness and the accuracy of electrode positions as illustrated in each of the schematics. They were also asked to identify which electrodes were wrongly positioned in each image. Results: Fleiss' generalized kappa coefficient indicates a slight agreement between how experts rated the usefulness (Pa = 0.2) and the accuracy (Pa = 0.17) of each image respectively. Out of the 10-point rating scale, the images were on average rated 4.07 (SD=1.89) for accuracy and 4.02 (SD=1.94) for usefulness. The ratings given for usefulness and accuracy did have a strong correlation as expected (r > 0.9 [Pearson’s correlation coefficient]). The most useful image according to the experts was rated as 7.2 (SD=1.72). This image can be found online [tinyurl.com/ns9xofp] and is returned as the fourth item as a result of the Google image-ranking algorithm. However the most useful image was not rated as the most accurate image. In terms of electrode positioning, the most accurate image according to the experts was rated as 7.2 (SD=2.48). And this image can also be found online [tinyurl.com/pc57vyb] and is returned as the 28th item as a result of the Google image-ranking algorithm. Conclusions: All experts in this study agree that the quality of these web-based images that illustrate ECG acquisition is poor. Neither the accuracy of electrode positions or the utility of the schematics are suitable to guide clinicians in the accurate recording of the 12-lead ECG. Clinicians should be careful with regards to which web-based image they decide to use as an adjunct in clinical practice.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2495Ahmed Allam submitted 'A-DISCERN: Developing an Automated Tool for Identifying Better Online Quality Information regarding Treatment Options' #med2 userprofile: http://www.medicine20congress.com/ocs/social/ahmed-allam2014-03-12T18:49:25-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T18:49:25-04:00Background: Many studies have reported that looking for medical information on the Internet nowadays is one of the primary means of health information seeking. However, the promise of the Internet as a decision support system is seriously marred by the fact that the quality of online health information varies tremendously. Initiatives proposing guidelines, checklists and quality indicators sought to help in solving the problem. However, these guidelines and quality criteria are laborious because of the effort and time needed to manually evaluate each criterion. DISCERN (http://www.discern.org.uk) is one of the tools developed to evaluate the reliability and the quality of information on treatment choices. Objective: DISCERN can be used without specialist knowledge or reference to publications and advisors, focusing only on the textual content of online publications. This has made it one of the main tools used in scientific studies on health information quality. Therefore, we seek to develop an algorithm that automates the rating of the DISCERN tool. By exploiting natural language processing (NLP) and the use of unified medical language system (UMLS) Metathesaurus, following a supervised machine learning approach. Method: We considered the first 15 DISCERN questions as criteria. A medical text (document, webpage, etc.) needs to be scored for each DISCERN criterion on a 5-point scale. The goal of the automated rating is to maximize the accuracy of classifying each criterion, and to consequently maximize the accuracy of predicting the overall score. Using Google Trends, we explored the medical topics having the highest search volume from 2004 until now. Breast cancer, arthritis and depression were among them and eventually chosen for the study. Searching Google and Yahoo for each topic, 271 articles focusing on treatment choices and options were extracted from various web domains. Two raters (Master students) were trained for a 2-months period on using the DISCERN. A Web-based platform was developed for independently rating the medical texts for each criterion and selecting parts of the text justifying raters’ scoring. The rating process will finish by March 2014. Results: The development of the algorithm/classifiers will be described and evaluated using performance measures taking into consideration cross-validation techniques for avoiding overfitting. Moreover, the choice and the process of features/attributes selection from the medical texts will be explained in addition to possibility of the development of feature selection algorithm with the purpose of obtaining the best features subset to be used later in the model. Conclusion: An automated DISCERN will have an implication on general health information consumers, patients and health information providers. In a next phase, we plan not only to construct an automated metric for quality evaluation but also to develop an educational tool (ex. Web-based application, browser extension) that would benefit the health information consumers. Similarly, health information providers would use it as automated checklist before publishing medical articles on Internet. Not to mention its benefit to the scientific community especially scholars concerned with the quality of health information. Finally, having an automatic evaluation criteria will allow for its integration in the ranking algorithm of search engines that would affect the ranking criteria; displaying webpages in the retrieved search result set that are of higher quality concerning health information content.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2492David de Mena (@primum.es) submitted 'Startup-Pitch: Home Care Telemonitoring System' #med2 userprofile: http://www.medicine20congress.com/ocs/social/dvdmena2014-03-12T18:35:25-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T18:35:25-04:00The ageing of the global society has exponentially increased the medical needs of the elder and chronic patients. The hospitalization time and the frequency of hospital returns are serious problems for all kind of patients and has an important economical impact on the health service providers as well. It is a must to both reduce costs and increase the quality of life of the patients. Primum Health IT has developed a Homecare Telemonitoring System (PHTMS) for the elder and chronic patients, improving their quality of life and reducing the transportation and hospitalization costs. Primum Health has developed a mobile telemedicine system for monitoring patients. Data from wireless medical sensors (IEEE 11073) are taken by a mobile device and sent through a private mobile network to a secure cloud-based platform where doctors can diagnose and have access to the patient’s medical record. Patient medical records can be integrated with any EHR already installed.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2486Miguel Angel Mayer (@mmayerp) submitted 'End-User Recommendations for Safer Use of Mobile Health Applications (mHealth Apps)' #med2 userprofile: http://www.medicine20congress.com/ocs/social/MiguelMayer2014-03-12T18:14:00-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T18:14:00-04:00Background: The use of health apps promises to be a medium that is bound to contribute to the improvement of patient care as well as a useful complement to people`s health and well-being activities. Currently different guidelines have been established for developers and designers but not for the general public on how to decide and use mobile health applications. The empowerment of patients in using mobile applications should be a key point. Objectives: to emphasize the need to provide specific guidelines and general recommendations for the safer use of health apps by end-users (patients and the general public) and to empower them when choosing and installing health apps. Methods: Search strategies based on the combination of the following keywords: patient, general public, end-user, mobile health apps, applications, guidelines and recommendations, were performed in the 10th February 2014, using Google Scholar, PubMed, Google, Bing and Yahoo!. The first 100 results displayed in these search engines were reviewed in order to find information related to specific guidelines for the general public in using health apps. PubMed provided 32 articles. Based on the analysis of the information obtained and the experience in the field, the authors defined specific recommendations for the general public in using health apps. Results: Information related to recommendations specifically addressed to patients or the general public were not identified in Bing, Yahoo!! and Google Scholar, not giving them relevant information on how to decide the installation of a health app and critical aspects after installing and when using them. In Google appeared one result with a brochure with some recommendations for patients. In PubMed there were no relevant articles. Discussion and conclusions: There is a particular concern about the number and quality of health mobile applications in the different stores and their potential impact in healthcare and above all how the health apps should be used by the general public and patients. The searches performed displayed a lot of guidelines and recommendations specifically addressed to developers, designers, health organizations and enterprises linked with the design and manufacture of health apps but not for end-users. Surprisingly it was only possible to find one brochure with general recommendations for the general publicThis information helped authors to draw up the recommendations proposed. It is advisable to provide specific guidelines in order to empower the general public and patients when deciding and using health apps. The recommendations proposed include different important points that end-users have to consider before downloading and installing a specific health app and when using mobile health applications. Recommendations: General Aspects: app origin (store), number of downloads, users’ evaluations, target and function, need of Internet connection to operate, developer identification, global or nationwide basis use of the health app service or information, recommended by health professionals. Technical and Content Aspects: language, people and health professionals in charge identified, scientific evidence or external accreditation present, update and version, full help section, disability profile options (visual and tactile), contact information, type of use of personal data in detail (cloud or local).http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2471Jonathan Turner (@jonathanuk) submitted 'Modulation of Medical Condition Likelihood by Patient History Similarity' #med2 userprofile: http://www.medicine20congress.com/ocs/social/jturner2014-03-12T18:07:05-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T18:07:05-04:00Background: An ambition of modern medical care is ‘personalised medicine’ – tailoring care regimens and treatment pathways according to the particular genotype of the patient and the subtype of the condition being treated. However, initial diagnosis can be less personalised, with decision support systems being based on general rules, symptoms and basic demographics of the patient presenting for care. We describe a system whereby general probabilities of conditions for a patient are modulated by comparison of the patient’s longitudinal clinical history, including seemingly unrelated historical conditions, with those who have had similar histories and may or may not have gone on to develop other conditions. Objective: Our objective is to determine whether the probability of a particular condition existing in an individual patient can be modulated by examining that patient’s longitudinal clinical history and comparing it to others who have had a similar history. Methods: We have taken clinical event codes and dates from anonymised longitudinal clinical records for 26,000 patients, extracted from several primary care sources and merged these into a single data set of 749,000 recorded events. In the UK, the majority of primary care records are coded using Read Codes, a hierarchical coding system developed in the 1980s. Where necessary records using other coding systems (e.g. ICD9/10, SNOMED CT) have been translated into Read Codes; however, in principal, any standard coding system could be used as the target system. Once our data set was established, we reserved a proportion of the records as a test set. Furthermore, patients from this test set had their most recent conditions reserved. These truncated test records were compared with records in the main records set to discover those patients with the most similar histories; information on the event histories of these ‘similar’ patients were then used to predict an increase or decrease in probabilities of particular conditions for our test patients, using techniques adapted from recommender systems. Results: Using Read codes to represent a patient’s sequence of diagnoses, we were able to generate association rules for particular combinations of conditions by collaborative filtering. Confidences in the results were improved by reducing the granularity of the coding, although this produced less granular predictive outputs. Conclusions: We found challenges in merging records from different data sets and particularly when merging records that used different coding systems. However, we have been able to demonstrate some associations between diagnosis codes in longitudinal clinical histories and our results suggest that there is potential for using this technique to refine the probabilities of individual patients having particular conditions and for individuals to assess how lifestyle choices could affect their future health outcomes.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2485Maddalena Fiordelli submitted 'Are We Fully Exploiting the Potential of Mobile Devices? Addressing social isolation through mHealth' #med2 userprofile: http://www.medicine20congress.com/ocs/social/maddalena2014-03-12T18:03:21-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T18:03:21-04:00Background: The complex interaction between behavioral and psychosocial factors in explaining health disparities has been widely documented in the literature. Among the psychosocial factors, social isolation constitutes nowadays one of the biggest issues of the industrialized world, and is recognized as a major risk factor for a wide range of negative health outcomes, being compared even with cigarette smoking. Increasing levels of social isolation are the result of both societal and individual factors. At a societal level, its premises lay in the increasing aging population and in the individualization of the society, resulting in more and more people living alone. Individual factors contributing to social isolation are the loss of a loved one, a poor level of physical health, suffering from a mental illness, one’s geographical location or other logistic problems. mHealth has shown to have a potential positive impact on a variety of behavioral and psychosocial factors and, as a consequence, on overall health. Although mobile phone characteristics (e.g., personal, intelligent, connected, always with people) seem particularly suitable to address issues related to social isolation, so far its impact on this specific field has not been systematically investigated. Objective: The objective of this paper is to systematically review the existing literature describing the impact of mobile interventions on social connectedness in order to identify possible ways to use mHealth to address social isolation and the related health disparities. Methods: Seven electronic databases (MEDLINE, PsycINFO, Web of Science, CINAHL, Communication and Mass-media Complete, Cochrane library, and ACM digital library) were systematically searched for peer-reviewed publications describing mobile interventions aimed at different purposes, but including social connectedness among their outcomes (primary or secondary). Results: Included articles showed that the main focus of mobile interventions is on young adults, on people with mental or additive disorders, or on people who need to self-manage their chronic condition. Even if social isolation was never the core interest of the research, encouraging findings indicate that the use of mobile in those specific populations successfully increased social connectedness. Nevertheless the impact of mobile interventions on the population that is at higher risk for social isolation, namely older adults after retirement age, was never explored. Conclusion: Mobile devices have the potential to become an essential tool for facing social isolation, and these findings are indicating a field whose importance has been so far underestimated. Research on elderly population and systematic interventions with social connectedness as a primary outcome could reveal a promising area for mHealth.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2473Stathis Th Konstantinidis (@staconst) submitted 'Seniors Exergaming 2.0: The Role of Social and Motivational Aspects on Games for Elderly's Physical Training through Web 2.0 Techniques' #med2 userprofile: http://www.medicine20congress.com/ocs/social/staconst2014-03-12T17:23:59-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T17:23:59-04:00An increase in the life expectancy causes an ageing population and according to the UN reports the rate of population ageing in the 21st century will exceed that of the previous century. The resources for care will be even more limited in the future than they are now. There is thus an aim for the society that seniors can manage by themselves as long as possible, while at the same time keeping a high quality of life. Inactivity is the most common reason for loss of functional capabilities among seniors, but physical activity can effectively delay this process, and is one of the most important factors in promoting wellbeing among seniors. However, adherence to exercise programs is a major obstacle. It requires large human resources to have long term effects. In this light exergames are promising. There are several commercial exergames on the marked capturing hand and leg movements, steps and movements of the body joints. Even if the games are made for children or young adults, containing lot of action (speed, a lot of information on the screen, funny sounds, etc.), some of them can successfully be played by seniors, but they do not always provide good exercises practices. In addition there are a few research projects focusing on mobility of seniors through exergames, but fewer researching the motivational and social aspects. This presentation focuses on the web 2.0 techniques applied in senior exergaming fostering social and motivational aspects. Two research projects act as the arena of boosting the research in progress for testing the above concepts into seniors' exergames: (i) The Nettrim project (http://nettrim.norut.no), an interregional project between Norway and Sweden, examines closer all these sides of socialization as a motivating factor, and by understanding them more closely, takes advantage of this in designing motivating exergames; (ii) The GameUp project (http://www.gameupproject.eu) uses these technologies to promote mobility by encouraging elderly persons to be more physical active and motivate them to move more by increasing their self-efficacy. This is done by developing a platform for social and exercise games that reduces physical and motivational barriers of elderly people's mobility. The GameUp platform is being tested in three different countries: Norway, Switzerland and Spain. A social motivational framework will be presented containing persuasive techniques that are used in exergaming and the connection with the social aspect will be emphasized. Initial lab test results will fulfil the presentation concept showing the importance of social applications and tools in exergames for seniors in order to increase the motivation by means of peer-support. This on-going research that grows both with social and motivational aspects, will contribute to answer whether or not web 2.0 techniques applied in suitable exergames for seniors can increase their mobility, decrease the frailty danger and keep them healthy active citizens of the modern ageing society.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2477Morwenna J Kirwan submitted 'The Design and Usability of an Educational Website for Health Professionals' #med2 userprofile: http://www.medicine20congress.com/ocs/social/m_kirwan2014-03-12T17:22:57-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T17:22:57-04:00Background: Limited research exists addressing the design and usability of educational websites for health professionals. This study describes the development and formative evaluation of a website designed to support a physical activity intervention, targeting Physical Education (PE) teachers. Few studies have been conducted with adolescents, but numerous studies have shown that interventions designed to improve primary and middle school PE teachers’ lesson planning and delivery can increase the moderate to vigorous physical activity that students accumulate during PE lessons. Objective: The aim of this study was to evaluate the usability of the AMPED (Adolescent Motivation in Physical Education) intervention website using both quantitative and qualitative measures. The AMPED website was designed to support PE teachers participating in a professional development program. Methods: The AMPED website has multiple components, including: Reflections on Current Practice (videos of PE lessons), Action Plans to create goals, Resources for lesson planning and execution and a Discussion board for teachers to collaborate and share ideas. As the AMPED website was designed for teachers, teaching staff from the University of Western Sydney were recruited (via email) to participate in usability testing. The website was designed to be accessed via an iPad, thus participants were required to have minimum 2 months experience using this device. Participant testing occurred in two phases. Pre-modification testing (n=8) was conducted to identify usability issues with the AMPED website by asking participants to complete five basic operation tasks. The website was then modified based on issues identified from the first phase of testing. A separate sample of participants (n=9) completed the same tasks during post-modification testing to examine the effectiveness of the modifications. Results: Design improvements to the AMPED website resulted in a reduction in the number of errors and time taken to complete some of the tasks. The first round of usability testing (Pre-modification group) identified that the most common errors users made related to logging in (Task 1); completing the Reflection of Current Practice (Task 3), which involved watching a video of a PE lesson and reflecting on performance; and Creating an Action Plan (Task 5), which included generating goals to improve teaching and lesson management. Following design changes made to the website the second round of testing (Post-modification group) saw a significant decrease (of 80%) in the number of errors made when logging in to the website (Task 1). The time taken to complete Task 3 was significantly reduced by 34% and the time taken to complete Task 5 significantly decreased by over half (56%). There was no significant difference between groups in terms of subjective usefulness and usability of the website, measured by a modified version of the System Usability Scale. Thematic analysis of the semi-structured interviews revealed three usability themes: design, layout and navigation. Conclusion: This study outlines the development and design process of an innovative health-professional development website for PE teachers. The results of this study established the website’s feasibility and identified opportunities to improve its acceptability and usability. Currently the effects of the AMPED intervention including the website are being evaluated in a randomised controlled trial.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2469Enny Das submitted 'Generalizing Tweet Patterns across Epidemics with Varying Threat Levels: A Comparison of H1N1, SARS, and Mumps' #med2 userprofile: http://www.medicine20congress.com/ocs/social/EnnyDas2014-03-12T16:26:44-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T16:26:44-04:00Background & Objective Public responses to health epidemics such as H1N1 and SARS follow unpredictable patterns. Analyzing social media data can increase insight into public opinion and health behavior. Research thus far analyzed tweet content and sentiment about a single disease (Chew & Eysenbach, 2010; Signorini, Segre & Polgreen, 2011; Salathé & Khandelwal, 2011). The present research extends these findings by looking at generalizable patterns in social media content across epidemics (H1N1, SARS, and mumps) as a function of the key factors that determine epidemic threat level: severity (Witte, 1992) and temporal and spatial distance (cf. Henderson, Fujita, Trope & Liberman, 2006; vulnerability in Witte, 1992). Based on previous theorizing that perceptions of personal threat are defined more by perceptions of vulnerability than by perceptions of severity, we hypothesized that expressions of threat and humor would vary mainly as a function of temporal and spatial distance of a health epidemic (e.g., Das, de Wit, & Stroebe, 2003). Method 8.986 relevant Dutch tweets were gathered via Twiqs.nl. We used the markers ‘(#)SARS’, ‘(#)H1N1’ and ‘(#)(de)bof’ (mumps). These epidemics differ in severity (H1N1 and SARS > mumps), temporal distance (mumps > H1N1, SARS at time of measurement) and physical distance (H1N1, mumps > SARS). For mumps we also compared tweets sent within > outside a radius of 30 km of affected locations based on ID-location. Two independent coders manually coded tweets on eight categories, e.g., threat/fear, humor, secondary consequences and protection measures (H1N1: κ=.75, SARS: κ=.75, mumps: к =.73). In order to assess agenda setting patterns, we also coded articles from five main Dutch newspapers about H1N1 (N=100; κ=.75) and SARS (N=21; κ=.94). Results Tweets about H1N1 (severe, small physical distance) contained more serious categories (e.g. threat (36.41% versus 26.00%, χ2(1)= 38.80, p<.001), protection measures (11.04% versus 3.09%, χ2(1)= 78.08, p<.001) than tweets about SARS (severe, large physical distance), which mostly contained jokes (40.66% versus 18.78% in H1N1, χ2(1)= 116.32, p<.001) or use of the disease as a swear word (24.19% versus 0.82% in H1N1, χ2(1)= 177.24, p<.001). Tweets with a small physical distance contained marginally more threat (25.00%) than tweets sent from further away (14.18%, χ2(1)=3.10, p=.078). No significant differences in humor for small (24.04%) and larger physical distance were observed (30.50%, χ2(1)=0.89, p=.345), although the pattern was in the predicted direction. No significant differences in tweet content were found as a function of disease severity. Tweet peak patterns across time closely followed newspaper patterns, suggesting a classic agenda setting effect. Conclusions Expressions of threat and humor in social media appear especially informative to monitor public perceptions of personal vulnerability to a health epidemic. Threat tweets were most prominent, and humorous tweets slightly less prominent when an epidemic was psychologically or physically close, even when it was not very severe. Findings inform the monitoring function of social media.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2466Leonor Roa (@draleoroa) submitted 'Medical Doctors as Online Health Content Curators- Experiences from a New Form of Educating the Patient and His Family' #med2 userprofile: http://www.medicine20congress.com/ocs/social/leonor_roa2014-03-12T16:25:17-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T16:25:17-04:00Background Since the beginning of the professionalization of the medical duty the education of the patient has been on the agenda of the medical personnel. Tools like online communities, info portals, mobile tools or content archives help to leverage the power of educating persons. Objectives “People who” was established in order to create and promote a multi service digital platform to improve life quality of people who live with an illness: people who suffer, who take care or who are interested in this illness. Approaching it from people´s reality. Solution: Segmented by diseases it was developed with an specific visual identity and URL for each of the different illnesses and includes 5 different sections (Community, Data Center, Apps, Experiences and Magazine) which represent three different dimensions: social, tools and information. Doctors participate actively in the community answering direct questions, moderating conversations or giving advice. They also curate and create content for the magazine thinking on people´s interests and using easy and understandable language. “People who” has different stakeholders like patients associations who are able to find a new channel to spread their mission. Pharmaceutical and other companies, who are able to sponsor communities and are able to find new ways to understand the patients. They can listen to patient´s conversations, access statistics but cannot take part in the conversations Specific country regulations are followed to protect personal data and people´s privacy. Commercial names are automatically replaced by the active principle in order to avoid un proper prescriptions. Figures: 9 diseases, 4 doctors,1 psychologist, 1 personal trainer and 1 nutritionist. 7 partners, more than 50 patients associations and more than 8700 users in 24 months with: 37,000 visits/month, 1,200,000 pages seen, 57,395 Facebook likes and the following video reproductions 98,693: 36,348 in bipolar disorder, 27,187 in Alzheimer, to 1590 in Leukaemia (Sept. 2014). In order of users: Diabetes, Bipolar Disorder, Arthritis, Epilepsy, Alzheimer, Psoriasis, Transplant and Leukaemia. Total number of interactions with Doctor 2.0: in community 1692 ( 51% general practitioner, 29% psychiatrist, 19% endocrinologist, 1% hematologist) The main topics in the platform are: support, treatment, food, exercise, jobb and health system. In May 2014 started Italy( Diabetes) and Germany ( skin cancer). New countries will start in November 2014 with new communities. Conclusions: “People who” is a digital platform for patients in collaboration with associations, partners and organizations that want to built a society able to cope better with an illness. This opened a new dialogue with people, not only patients, dealing with an illness making them feel comfortable at home. How medical doctors are able to interact in this environment is a natural step of augmenting their dialogue into the virtual world. Working on these communities has been beneficial also for the development of medical professionals in order to get in contact with people who suffer illness. This information is valuable for health care professionals and gives a fresh view on how to educate and improve the patient’s life.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2467Carol S Bond (@cbond) submitted 'Quality of Health Websites – Time for a Rethink.' #med2 userprofile: http://www.medicine20congress.com/ocs/social/cbond2014-03-12T16:24:44-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T16:24:44-04:00Articles discussing the quality of health websites started to appear in the late 1990’s. A systematic review into the ‘Reliability of health information for the public on the world wide web’ in 1997 concluded there was an ‘urgent need’ to check this web information for accuracy, completeness and consistency. Fast forward nearly 20 years, and reviews of health websites are now concluding that the quality of the information is poor, incomplete and written at a level patients will not be able to understand. The description of the problem has developed in the intervening years, but the conclusions remain the same. Rather than reviewing more and more websites and continuing to reach the same conclusion perhaps it’s time to consider if the evaluations are wrong. A review of the literature shows that commonly used tools to help evaluate the quality of websites are HONcode, DISCERN, LIDA and readability tools, with many people also creating their own tools. As internet health information has evolved so have evaluation tools. The earliest was HONcode, which went live in 1996 and DISCERN was developed from a project that started in 1996. A common feature of all of these tools is an emphasis in the qualifications of the authors and their ability to provide evidence based, impartial, best practice information. The majority of studies reviewing websites are carried out by researchers and healthcare professionals. There is a pattern of medical specialists reviewing websites in their area of expertise. The patient’s voice is however often missing. Where this is present on the websites being reviewed it is often overlooked as a distinct type of information within the context of the website, or worse dismissed as not being ‘information’ in the medical sense of the word, for example one review looked at information pages ‘attached to discussion groups’ but not at the discussion group elements of the website. At the same time that quality evaluation tools were starting to be developed Tom Ferguson was starting to write about the emergence of lay health care consumers as active participants in online health networks, through the connectivity offered at that time e.g. bulletin boards and USENET. He concluded that lay care could offer higher quality care than professional care. The debate over quality of information begs the question of who the information is for, and what they consider to be good quality. If, for instance, the criticisms leveled at websites include a concern over these being written at a level patients will not be able to understand, the best person to judge this is presumably the patient who can then chose to not use that website More recent research has shown that people looking for health information online carry out their own quality checks, comparing information from a variety of sources, and valuing peer information as well as ‘expert’ information. We can solve the problem of the quality of health information on the Internet by revisiting how reviews are carried out, by whom, and who’s voice needs to be heard.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2455Carlos-Luis Sanchez-Bocanegra submitted 'A Semantic Web Health Recommender System: Enriching YouTube Health Videos' #med2 userprofile: http://www.medicine20congress.com/ocs/social/kako2014-03-12T16:01:33-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T16:01:33-04:00Background: Social media have large volume of accurate and trustworthy health content available over Internet, giving precise health information can be difficult. Flooding health information is mixing with misleading recommendations. We believe that community wisdom obtain accurate and precise health information. Objectives: To retrieve precise recommendation in correspondance with trusted video contents. Methods: We designed a method that estimates the precise of recommended links with trustworthiness health videos. In two different experiments (Diabetes and Blood Pressure), four clinicians evaluated recommender links from 23 health videos (6 of Diabetes recollected from diavideos portal (http://ehealth.norut.no/diavideos/) with more than 3 recommended results and 17 of Blood Pressure from HT most popular videos with more than 3 recommended results), they provided 114 ratings. Results: Our method may be used for an precise recommender links in relation with video content, Overall, inter-rater reliability gave a substantial agreement (0.65 Kappa Cohen) with Blood Pressure precision@3 = 0.91 and (0.69 Kappa Cohen) with Diabetes precision@3 = 0.67. However, the method need to increase the number of recommender links in some videos (only 1 o 2 recommender links). Conclusions: The method showed promising results (specially in Blood Pressure).The main difference between HT and DM is the number of recommended videos from the HealthTrust algorithm. Our research indicates that the use of semantic web for recomender links may be precise with trusted video contents.http://www.medicine20congress.com/ocs/index.php/med/med2014/schedConf/cfp#2456Ravindra Persad Maharaj (@ravipm2000) submitted 'Social Media Use Among Practicing Physicians in the Caribbean.' #med2 userprofile: http://www.medicine20congress.com/ocs/social/ravipm20002014-03-12T15:44:21-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T15:44:21-04:00Background: Social media is being used by medical professionals as a form of communication based on Internet networking to create, discuss and share information. No known research exists on the use of social media by physicians in the Caribbean. Consequently, practitioners in this region may be trailing others in the developed world that have productive professional and personal social media experiences on this mode of communication. Objective: The purpose of this paper was to identify thel use of social media by Caribbean Medical professionals to ultimately benefit the governing bodies as well as to encourage practicing professionals who are not current social media users to take advantage of the realm of connectivity that exists among social media savvy physicians. Methods: Medical Boards of four island nations in the Caribbean were invited to take part in a survey questionnaire developed and published online using the Survey Monkey software. Only two of the four Medical Boards opted to participate. After ethical approval was granted by the UWI, the questionnaire was made available online for two months in 2013. Responses from 100 practicing physicians were deemed eligible for the study by pre-developed inclusion criteria. Results: Of the 100 participants, predictably 28% were in the 25-30 age range followed surprisingly by the over 60 age group (19%) . 77% of the participants reported having used social media and all recommended that further analysis be conducted. Approximately 27.5% reported using social media for personal communication. The next highest use of social media was for keeping abreast of current events. 20% reported using social media for continuing education purposes, 19.5% for connecting with their peers, but only 4.3% confirmed using social media for connecting with their patients. Among the non-users of social media, 23% cited lack of available time and fear of the reliability of health information on social media networking sites, when compared to the trustworthiness of traditional sources. However, 25% of the non user reported they would use social media if they are encouraged or directed to do so by their governing medical bodies. Conclusion: This data is the first of its kind collected in the region, and therefore establishes a base for the participating medical bodies of the Caribbean to determine how best to use the data. It is clear that more physicians need to be encouraged and convinced that certain types of social media are trustworthy and reliable sources of communication for both personal and professional use. The medical bodies that participated in the study will be advised that the respondents who are not using social media for health related communication are willing to be guided by them. The authors are committed to ensuring that medical governing bodies in territories of the Caribbean become aware of the untapped possibilities of social media as viable tools for providing information, remaining connected to breaking medical information and also for continuing education. As such, we support the development of practical guidelines to assist physicians to communicate in the online environment while maintaining professional standards.http://www.medicine20congress.com/ocs/index.php/med/med2014b/schedConf/cfp#2457Tobias Hartz (@tobgerm) submitted 'Care4Talk – Secure Messenger for Clinical Settings' #med2 userprofile: http://www.medicine20congress.com/ocs/social/hartz2014-03-12T15:35:39-04:00Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research2014-03-12T15:35:39-04:00Background: The amount of communication via social networks and messengers in the fashion of Facebook and WhatsApp has rapidly increased since their introduction. Simultaneously, the usage of services such as SMS and MMS have started to decrease continually and have been superseded by Facebook and co. The usage of such messaging services in a clinical context, e.g. between patients and doctors sounds very promising, too. However using these networks – especially their usage in a clinical setting – leads to the question of how secure they really are, who is holding the data, and how much information is shared unknowingly and without permission. Objective: We create an alternate messenger, especially for clinical settings. The purpose of the messenger lies in supporting patients and their familie in bonding with other patiens. Methods: The functionality of the messenger comprises sending messages in a pair as well as in a group of people. Other users can be found via a search and added to an ignore list if the user does not want to receive their messages. Furthermore, the user has complete control over the extent of information regarding himself that other users are allowed to see. The implementation of the messenger consists of three components: A client which uses PhoneGap to be able to deploy the mobile messenger on a variety of different operating systems of smartphones such as iOS, Android, and Windows phone and two servers. Whereby the first one serves as a communication server which forwards messages from one client to the other. In this case Openfire, a real time collaboration server which uses XMPP as a protocol for instant messaging, takes on the role of the communication server. The second server stores information about the users which they knowingly shared such as their username, email, gender, et cetera, and acts as a data server. Results: To date the basic functionality such as sending and receiving messages as well as creating groups to share messages with more than one person has been implemented. Additionally the user is able to search for other users and add them to an ignore list. The service is hosted by the clinic itself. Further functionality which concerns security issues such as sending encrypted messages and using secure connections are not implemented yet and will be an objective for the released version of the mobile messenger. Conclusion / Outlook: Our mobile messenger offers an alternative to the known social networks and messengers and shows the possibility of a more secure way of text-based communication. No third party is involved. The next objective is the usage and testing of our messenger in a clinical setting. One scenario in which our messenger could be of aid is in the ambulant palliative care. Care4Talk shall support communication between medical staff and patients and their relatives.