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!

I thought it was about time to write a post about the woes of doctor-patient email.

Last week, a friend was having some issues with his phone, so his family doctor’s office couldn’t get in touch to inform him of the date of his specialist’s appointment. He didn’t know about the trouble until he popped in for a visit, which was when his doctor asked him – if he didn’t hear by a certain date – to call the specialist himself.

A good solution to the problem, but I couldn’t help wondering why email wasn’t an option. I mean, practices routinely collect our emails now, but I still don’t see them used very often. What if my friend kept having phone issues? What if he forgot to call?

Later, after the appointment had been worked out, he told me that the specialist ended up sending him an email with instructions on how to prepare for the procedure. This was appreciated, and got us both thinking about what exactly are the barriers to doctor-patient email.

What counts as private info? How do other providers deal with this around the world?

Let’s look at what’s out there.

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How about this for an analogy?

On reading that the Senate’s health reform bill has swapped the controversial “public option” for a “buy-in” Medicare option + two national private insurance policies (Washington Post), I immediately had a giddy vision of the diagram on the left from Bruce Alberts’ Molecular Biology of the Cell.

This diagram describes how post/co-translational protein folding works.

1. On-Pathway: slowly moving along as a molten globule, trying out different combinations until it finds the correct conformation.

2. Off-Pathway: somehow turned into a not-so-good conformation, so chaperone proteins can help get it back on track.

3. “Irretrievable Accidents”: are ubiquitinated and chewed up by the proteasome.

Will health care reform become an “irretrievable accident”?

It’s been an interesting journey for me to learn about the American health system as a Canadian, so let this be my disclaimer that I’m definitely not an expert. However, it seems to me that the original objectives are getting more and more convoluted as this debate continues.

President Obama gave the “buy-in” option his approval, calling it “a creative new framework”. But given the choice, would “creative” be my favourite word I’d want to use to describe my health care?

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