It occurred to me over the past week that if you were to get inside my Evernote, you would instantly learn so much about me.

In some ways, the structures of our individual “clouds” say a lot more about us than any diary could. E.g., “this is how I curate”, “this is what matters to me”, “this is my weakness – the stuff I need a cloud to help me remember”.

But this is also what makes Evernote so great. They never really tell you how to use it. It’s up to you. In this way, your Notebooks become insanely personal. And if you come up with something neat, maybe you’ll feature on the Evernote Tumblr.

Well, here’s a glimpse of mine (click to enlarge):

• Blog Ideas: Did I think of something cool on the subway? I note it on my iTouch Evernote app and sync as soon as I get a network connection.
• Clinical Notes: No patient information here. Just interesting clinical insights (right now, mostly useful tips for talking to patients).
• Ethics: I love Virtual Mentor, the AMA’s SUPERB medical ethics journal. I work through the cases in my spare time and save them as notes. Tagging is invaluable here. For example, if I need notes on “abortion”, there you go. Also great for keeping notes on Medical Law.
• Fiction: Bits and pieces of stories.
• Press: The Evernote extension for Chrome and Firefox makes clipping my blog press easy-peasy. Never forget any URLs again!
• Random: A little bit of everything – mostly my favourites from Ask Metafilter and images from websites.
• Research: It started out as a repository for terms I didn’t understand in journal articles like “Principal Components Analysis”. Now I’m beginning to really like Evernote’s PDF capabilities – especially being able to embed and flip through whole articles inside a note – so I will be taking it out for a test drive as a Systematic Revew tool.
• US Health Reform 2009: Possibly my most useful notebook EVER! I started collecting articles on the Health Reform debate in September 2009 by bookmarks, but it just didn’t cut it. Then I got Evernote and spent a few days going back through all the links I shared on Twitter re: HR and this baby was born! So, now, say I want to get all my saved articles on Medicare – I just click the “Medicare” tag. Of course, this notebook is quite interesting in earlier versions of Evernote as the Time Band shows when I added each note – it’s like seeing HR happen right before your eyes – unfortunately, the latest release seems to have scrapped that feature.

A question for you: Evernote and personal health info

One thing I noticed from my own notebooks was the conspicuous lack of personal health information. I have, of course, read all about the dangers of doctors storing any patient information in Evernote (HIPAA nightmare…), but I wonder whether patients themselves go ahead and keep records in Evernote?

Let me know if you’ve seen this!

And now I want to ask you: what’s in your Evernote and why? And, secondly, if you’re a patient, do you/would you store personal health information on it?

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For further reading on Evernote in medicine and health, check out DrV’s post at 33charts: 8 Ways Physicians Can Use Evernote

Is there a more universal desire right now than the “upgrade”?

Better yet, nearly instant upgrade. It actually gives me an absurd giddy feeling. Example: This weekend, I upgraded to WordPress 3.0. The interface doesn’t look that different, but I watched the video documenting the tweaks and fixes, and felt lighter anyway. It’s a little voice that squeals: my blog is shiny – and so am I.

So I get a kick out of MealUpgrade.com, a new website by Shape Up America and the National Turkey Foundation (bizarre? Scroll to the caveat…).

It’s an “app” submitted to the Apps for Healthy Kids Competition, an initiative by First Lady Michelle Obama to help combat childhood obesity. The competition challenges developers to build apps that use the USDA Nutrition Data Set (made available via the President’s Open Government project) in creative, engaging ways. Meal Upgrade allows you to choose a typical dish and learn how to “upgrade” it (reduce calories) by substituting ingredients.

For example, the snapshot below shows how to upgrade from a hamburger to a turkey burger, with other options like switching to whole wheat bread and having baked potato instead of fries.

Pluses:

• I think kids will enjoy it, if only for the fun of hitting the Upgrade button and briefly sitting in uncertainty.
• Could be quite educational. For example, you could have students guess upgrades and see if they correspond to what the app suggests.

  It could also tie into doctor-education projects like the one mentioned recently by Healthymaginations, through which doctors learn how to “select, purchase, and cook” healthy food, hopefully influencing patients.

Not-so-pluses (but could be improved!):

It’s unfortunate that the website is not actually “working” in the background, because the possible meals that can be upgraded are “hard-coded”, so to speak. I would thus suggest:

• Dramatically expanding the menu. For example, including snacks, desserts, and beverages.
• Adding functionality that allows you to tell the app what ingredients you have available, and have it calculate in real-time the possible upgrades you can make to the dish of choice.
• Allowing users to submit suggestions for upgrades. And vote on them too
• Making a corresponding iPhone app so that you can begin planning upgrades on the go and at the grocery store.

And a caveat: as this project is sponsored by the National Turkey Foundation, the upgrades are heavily biased towards substituting turkey for other protein…slightly annoying yet understandable!

Parting words

The submission period for Apps for Health Kids is ending on June 30th (my birthday!) and then the voting will begin. I hope to see a lot of other great entries, and am super-psyched about the concept of Open Government.

Next, I’m thinking – Upgrade My Workout?

Lifehacker’s already got Upgrade Your Life so now let’s focus on specific parts of that!

My favourite online dictionary is, without a doubt, Wordnik.

Do you think we need a social dictionary like Wordnik for medicine?

Here’s the thing. I’ve always said that the reason I’m not retaining new words is that I don’t really understand how they’re used: Wordnik remedies this problem by providing a plethora of contextual clues. Here’s a rundown of my favourite features using the examples of “fibromyalgia” and “h1n1”:

• Examples. This section pulls the oddest sentences (not intentionally, I’m sure, but the result is often very original) featuring your word from a vast array of unconventional sources, including CNN transcripts, diary entries, and classic literature.

The worst part about having the fibromyalgia is looking foward to being able to go to bed. —bettyalready Diary Entry

WEIL: I would say that fibromyalgia is a subset of chronic pain syndrome. —CNN Transcript Nov 10, 2004

Lyrica for nerve pain and fibromyalgia is now a $2.5 billion-a-year product, but smoking cessation treatment Chantix hasn’t lived up to expectations because of links to depression and suicidal thoughts. —Kansas City Star: Front Page

• On Twitter. The latest tweets containing your word. If we could somehow filter out the spammy tweets, how great would this tool be to gauge the hive mind!

• Flickr. These are some photos for h1n1. Check out the masks!

• Related. Sort of like a thesaurus. I know it looks a bit sparse (there are more under the Related tab), but compared to typical online dictionaries (some of which don’t even contain fibromyalgia), this is pretty good!

• Stats. Charts and graphs showing frequency of occurrence, punctuation patterns, and more.
• Comments. There are some good social networking features like the ability to favourite, comment, and create lists of words.

Plus, Wordnik has all the typical features of a dictionary including definitions from multiple sources, pronunciations, and etymologies.

Now, I know there are a lot of medical dictionaries out there. It also seems that communities such as PatientsLikeMe have sections that are starting to look like social medical dictionaries – for example, a search for Lyrica pulls up related forum posts, and detailed information like side effects that Wordnik does not have (click to enlarge):

Yet I feel that there might be room for something more “social” than the rigid definitions on The Free Dictionary’s Medical Dictionary (although it’s pretty good) yet more systematically organized than the PatientsLikeMe forums.

Another reason: as much as patients are being empowered by the internet, I wonder if the adventure for most even gets as far as signing up for a website like PatientsLikeMe. If a reliable, crowd-sourced, and dynamic medical dictionary could show up as the number one hit on Google for their queries, perhaps useful medical knowledge would reach the most people most quickly.

In the meantime, Wordnik is actually having a 2010 Developer’s Challenge right now, so if you’re inspired by this post, get cracking and maybe the medical community will one day owe you a debt of gratitude!

Toronto’s Medicine 2.0 scene is heating up!

Hot on the heels of my recent visit to the Center for Global eHealth Innovations in Toronto, the Center released an exciting new (and free!) iPhone app for Type I diabetics to track their blood sugar: Bant.

Bant is short for Banting, the Canadian who discovered insulin at – where else? – University of Toronto in 1921. And not only is the name stylish, but so is the design.

I downloaded the app yesterday and gave it a spin, with impressive results:

• The first screen is Readings (left), where you select the meal for which you want to add a glucose reading. Then you can simply drag and drop the appropriate marker to the desired time and concentration on the graph. The blue section indicates the goal concentration range.

• As you accumulate data points, you can view a graphical summary under Trends (left).
• Individual readings can also be adjusted from the Bant Book screen (middle), which includes the options to add text notes and/or share your thoughts via Twitter (right).

(more…)

Just wanted to post about VitalHub, the latest in iPhone + EMR — being developed and implemented in-house at Mount Sinai Hospital in Toronto!

Watch the beautiful video of it in action, courtesy of the Apple website.

The essentials:

• VitalHub allows health care professionals to access records from 66 applications being used at Mount Sinai Hospital, including those storing clinical data, reference materials, and patient information.

“We now have access to exactly what we have in our computers here in the hospital. We can get access to our patients’ data whenever and wherever we want it. Knowing what’s happening with their drugs, radiology, laboratory values, microbiology results — it really enables me to make decisions on the go.”

• Access from anywhere.

“Whether using Wi-Fi or 3G on iPhone, doctors can access VitalHub no matter where they are,” explains Dwivedi. “They can review a patient chart before they come into the hospital, whether they are at home, in a restaurant, or at an airport.”

 

• Security is provided by password and VPN certificates.

FYI, Sinai is one of several large hospitals located just down the street from U of T/MaRS/Center for Global eHealth Innovations (and also where I did my honors thesis!) so I think this is very exciting for the downtown Toronto eHealth conversation!

Yesterday, I was reading on Hans Oh’s blog that eHealth seems to be becoming “mainstream” — in that it’s cool to be devoting time, effort, and research monies towards it, there are articles on NEJM about it – and it seems that VitalHub, which is very openly promoted by the hospital, is an example of that happening in Canada. I am glad to see that people are really noticing what Dr. David Kibbe said: that actually many physicians have been happy to adopt the iPhone, but such a small percentage have adoped EMRs. It might just be that we have been waiting for innovations like this, piggybacking on technologies that are already accepted by health care workers.

We’ll keep an eye on the official website, Apple’s site, and the Baron Group blog for further information in the coming months.

Torontonians (and others), what do you think?