January 2010 Vol.

2 Issue 1

TEKTIC 3G

12:51
Thursday,
Thursd January 14

IN THIS ISSUE: Page 2 -FOREWORD FROM THE STEERING COMMITTEE - Page 2 - iPHONE
iT’S ALL iN ME - Page 4 - INTERVIEW WITH DR.CAMERON NORMAN - Page 7 - THE 2.0 FACTOR:
MUSINGS OF A HYPERCONNECTED WORLD - Page 8 - A HANDFUL OF USEFUL MEDICAL APPS FOR
THE iPHONE - Page 9 - HEADLINE IN eHEALTH - Page 10 - ELLUMINATE - Page 10 - FOCUS OF THE
MIND:BOY INTERRUPTED....
HAPPY NEW YEAR! We are very excited this month to present and issue featuring the iPhone. Since it’s
introduction in the summer of 2007, the iPhone has been more or less embraced by the public with it’s TEKTIC 3G
functionality and wide selection of applications with both practical and frivilous activities. Furthermore,
with the expanded liscencing agreements between Apple and various mobile phone providers, it is
become increasingly pervasive in our society. Furthermore, it has provided many useful apps and is
starting to be embraced by the medical community. This issue will provide some real life accounts on
12:
Thursday,
how the iPhone is being utilized in the medical setting as well as highlight some apps that have been
popular with health practitioners worldwide.

We are also very excited to feature an interview with TEKTIC member Dr. Cameron Norman. It is fitting
that he be featured in this issue with his extensive experience working with the internet and social media
to engage the youth. The iPhone and many other smartphones are ICTs that have definitely increased the
use of social media by allowing it’s owners to access these websites through a data plan or Wifi.

We hope you enjoy the interview as well as this iPhone edition of the TICr!

****IMPORTANT ANNOUNCMENT!*******
For all founding members, TEKTIC Travel Funding applications are due January 31, 2010.
If you have not already submitted an application do so soon! These funds will support
travel and dissemination costs related to your TEKTIC funded projects. Applications up to
$1,500 will be accepted. All travel expenses must spent by June 1, 2010. Have questions?
Email Jen (jennifer.c@ubc.ca) for more information and the application form.

iPhone - iT’s All iN Me

By Farida Hussain

Health professionals have taken to their iPhones like kids take to candy. Eyes light up when I request a quick chat about
the gadget. As one doctor playfully pinches his way into a map of the neighbourhood, I feel slightly embarrassed - it’s like
talking to someone about an old lover...

Page 2
 Dr. Allen Rowley, radiologist at the UBC Faculty of
Medicine uses the iPhone on his shifts at the VGH. He uses
applications (apps) like Netters
Flash Cards for reference while
reviewing a patient’s symptoms
and test results. “I could look
it up on my computer or in a
book, but with the iPhone I
could be walking down the street
and have a thought about one
:51
January 14
of my diagnoses. I can then pull
up an image of the popliteal
nerve and refer to my notes on
the patient...” The portability of
clinical reference material is key
to the success of the iPhone. For
one doctor in Croatia, the iPhone
is better than his informed pocket
guides because it’s the same size,
but much easier to use!
Popular among most health
professionals is an app called
Epocrates – a reference guide that
could potentially standardize the
rapidly expanding knowledge
base for all medical practitioners.
It is tailored to the workflow of
doctors and caregivers, and is an
easily searchable clinical reference iPhone boasts a camera to record clinical findings, wifi for
to disease highlights, definitions,
initial therapies and treatment.
Dr. Mark Nigro Clinical Professor, more. With over 700 medical
Urologic Sciences, UBC &
VCH switched from his trio to
the iPhone. For Dr. Nigro, the
iphone is more about logistical
communication than decision support. “I’m always in a hurry.
With the iphone I don’t accidentally hang up – no dropped
calls, and it’s much easier to dial and receive calls.”
Bob McKeever has programmed a utility connecting the
central schedule database and individual iPhones for the
Urology dept. at VGH. This gives doctors access to on-time,
online schedules of ongoing and future seminars, meetings,
operations, out-patients and clinics on a two-way interface
that is automatically updated every 5 minutes. Never before
has hospital scheduling been so streamlined, supported, and
easy to relay. By the end of February, 2010, all doctors in the
department will carry an iPhone. According to Mr. McKeever,
the beauty of the iphone lies in just how easy it is to code
for. He can customize apps based on doctors requests. For
example, if a doctor wants to view only the summary sheets
of all his patients, an app can be developed specifically for
that purpose.
For Kim Campbell from UBC’s department of Midwifery,
the iphone is her baby. “LOVE my iPhone. I use it every day
at work or at play.” She recommends the iphone to enable
students to have point of care information and guidelines
that foster safe and timely advice and interventions. The
iPhone has tools for diagnostic aid, obstetrical and neonatal
resources, and calculators. Additionally, “the contacts calendar
keeps us organized, the email function keeps us in touch, the
GPS helps us find our clients, and the games keep me awake
when I’m waiting for...anything!”
Convergence = Convenience. All the good things about
health communication technology have come together in one
pocket-sized package with an effortlessly slick interface. The
file-sharing, and the capability
of being a stethoscope, a
blood sugar monitor, and lots
apps for clinical decision
support, it may well be just
what the doctor ordered.
Page 3
How did you end up working in
eHealth? More specifically working
in health promotion with the youth?
I was training to be a community
psychologist and doing a placement with
the Waterloo Region District School
Board and working in a program for those
young people considered to be “highest
risk” in the region who were not in care or
custody, but were not yet 16. Part of this
amazing program was that each student got
‘Internet time’ each week when they could
log in and surf around for school projects
and just to discover. This was the mid 90’s
so the Web was very new and most people
didn’t really know how the platform could
be leveraged for problem solving; the focus
was on information provision. In a pre-
Facebook, pre-Google, non-YouTube era,
these young people were able to navigate
through the Web and find other young
people who could help them find housing,
work, and provide social support during
those times they didn’t have any. They were
so good at this at a time when there were
so few tools to help them navigate through
the Internet. This did more to influence the
social determinants of health than anything
else I’d ever seen with this population.
Yet, it wasn’t about the technology,
rather it was how it helped them make
connections and learn that mattered.
What was defining moment
in your career which led you
to where you are today?
That time at the School Board was pivotal.
If there is one pivot point, I’d say it was
the case with this one young boy who was
seriously delayed in his ability to read (he
Page 4
was about 5 years behind in reading from Literacy Scale that I developed is now in
his peers). For some reason, he got really use around the world and in multiple
interested in chat groups for teens and languages and that blows my mind. When
was so captivated by the opportunity to I was invited to Washington, DC to
meet others like him that he camped out address the Institute of Medicine about
at the steps of school at 7am and staying eHealth, literacy and communication
afterwards until school closed just so he and know that my contributions would
could get some extra time online. At that be shaping US health policy for the
time most of the Net was text-based so coming decade, I was gobsmacked.
the only way to use it effectively was to It’s been flattering and humbling.
learn to read. Well, this young kid wound
up improving his literacy levels by three What was your biggest
grades in two months because he was so professional hurdle?
interested in the world on the Internet.
Getting people to understand eHealth and
This was one case where I came to see
the context in which it can be used. Even
where the future was and I wanted to be
as late as 2001, I was still getting feedback
a part of it. Harvey Skinner was doing
on grant submissions from reviewers
research at the University of Toronto
questioning why anyone would bother
with what was then TeenNet, a project
using the Internet to solve health problems
I later took over as the lead investigator
and that it was just a novelty. Now, people
(and is now called the Youth Voices
scratch their heads and wonder why
Research Group) and I made the transition
Twitter would be useful (if they know what
from psychology to public health . It
it is at all) or think time spent on social
was foundational for me in seeing the
networks is just goofing around. We once
importance of literacy and the sheer
thought that about email and now look
innovation and skill of youth in leading the
at it! Carving large chunks of ‘real estate’
way for how networks can influence our
in a grant application just to explain the
world and be leveraged to promote health.
basics is really a hurdle to getting the kind
of research support necessary to build the
Do date, what do you consider your
kind of programs of work that is innovative,
biggest professional accomplishment?
relevant and accessible to the world
My work on literacy and health -- a theme without being too piecemeal. But that’s
throughout my research -- is something innovation work for you; it’s not all fun.
I’m most proud of. As a teacher as well
If you weren’t a researcher/educator,
as a researcher, I find the concept of
what would you be, what profession
literacy as so fundamental to our work,
would you be in (ie, what are
yet it is also so taken for granted. It has
your other areas of interest)?
been real honour to be able to help
shift the dialogue just a little on making
I might have been a science journalist. I
eHealth more accessible to a broader
love to write and engage in dialogue with
audience through literacy. The eHealth
 The simplest things are the clinical setting, it will make the
often the ones that stick. I time spent together more meaningful. I
think technology is going don’t think this is utopian either. Right
to allow the public to drive now, there are too many systems and
people and so journalism in the Web 2.0
the healthcare agenda, self-care and disease cultural barriers that prevent this from
era would have suited me perfectly! Of
management and innovation and take it happening well, but that will change.
course, there isn’t a whole lot of money
from the hands of technocrats and health
in it now and, with blogs and Twitter
and such, I suppose I’m pretty close to
providers. Tools like Twitter, Facebook Youth Voices Research
and their evolved next generations will
being one right now! Most of my career
do this. This is a very good thing in my Tell us about one key issue or event
questionnaires in school suggested I’d
eye. It allows health professionals the that inspired the Youth Voices?
make a good clergyman and there are
chance to go back to applying knowledge
days which the idea of become a non- The pivotal moment came when we
in a particular context and focus on the
networked monk sounds quite appealing. lost our funding for a provincially-run
relationship with patients, while engaging
them as allies rather than having to keep all project to disseminate the Smoking Zine
What is your one (or two) favorite
that information on hand. Oddly enough, program (a Web-based intervention for
technological development
this technology could allow the clinical smoking cessation that we’d developed
from the past 10-15 years?
encounter to be more human. By this I and even did a large randomized trial
One is Twitter. I am really big on it mean creating space where professionals on). This left us stuck with a re-vamped
because it is so simple, yet so powerful as feel comfortable using IT on the job all website and 1000’s of printed guides,
a communication and sharing medium. I the time and enabling them through IT but no way to disseminate them....
also love to be wrong sometimes and I to connect to their patients away from
thought it was a silly idea at first (Facebook Continued Next Page...
updates without the functions),
but then as I got to learn
more about it I found myself
captivated by what it could lead
to. The other is the iPod and
iTunes. It really is an amazing
thing when you think about
how its transformed how we
experience media and how
-- even though we had laptops
and MP3 players -- it was the
iPod that ushered in an era of
portable media and completely
changed the way I connect
to music, access lectures, and
listen to radio programs, now
making them more accessible.

Where do you see technology

fitting in with healthcare
20 years from now?

Page 5

It was at that moment that I realized we had to get out of
the technology development business -- something we’d
done for 10 years. There were so many good tools out there
at the time and I felt that we could make a bigger difference
in health care and public health by understanding how
existing (and whenever possible, free) tools could be utilized
to support public health professionals and helping groups
use them more effectively to engage youth. Since then, we’ve
been more like a social innovation, action and design research
firm. That was when we went from TeenNet to become
the Youth Voices Research Group and we haven’t looked
back, except with fond memories of those early days.
What stage is the project at currently?
Our current evolutionary stage is focused on integrating systems
thinking principles with technology’s power to connect diverse
groups who wouldn’t come together normally to tackle big
chronic disease problems. These are the complex problems that
have no one cause and require a diverse set of perspectives to
successfully address like food systems health and tobacco control.
We’ve tested and refined a model around integrated learning
communities that connect groups as diverse as business leaders,
scientists, funders, and health care practitioners with youth
leaders using a web of tools like Facebook, Ning, and Twitter
simultaneously and in face-to-face ‘unconferences’. It’s a lot of fun.
What can we look forward to seeing from it in the future?
Coming back to my interest in literacy and my continued interest
in social media, we are about to rollout the first of what we
hope will be a series of multi-platform knowledge translation
initiatives. To be specific, we have a report we did for the Public
Health Agency of Canada on transitions in youth and we’re pretty
much done with it. But rather than just send the report off then
put it up on a website and leave it alone, we are going to create
a YouTube version of it, do some interviews with youth, and
create ‘Twitter-sized’ nuggets to be released at the same time and
add it all to a social network on Ning where the public can add
comments, edits and create new versions of the report. It’s the
public who paid for it and we’re in public health so why not make
this stuff accessible to everyone and not just the eggheads like us.

What was your first job?
Flyer delivery boy and
then as a dishwasher in a
restaurant. My dog loved
it when I came home after
that dishwashing job and
it, more than any job
I’ve ever had, showed
me the value of a dollar
and a hard day’s work.
If you were stuck on
a desert island with
only three things
(inanimate objects),
what would they be?
1) My iPod (assuming I’d
loaded it up with podcasts
and had a battery charger
with it!). 2) My espresso
machine with burr grinder
and 3) my coffee roaster
(all assuming that this
desert island also had
a coffee plantation on
it!). I’d be wired literally
and figuratively!
What is your Guilty
Pleasure/Indulgence?
I have an abnormal
passion for croissants.
Not the stale ones that we
usually get at conferences,
but the kind made with
so much butter than a
cardiologist might pass
out just thinking about.
What is one thing with
technology that you
never expected them
to be able to do? (from
Dr. Elaine Chong)
What a great question.
I’d say: inspire me to
exercise more. I have a
Nike+ system wristband
that tracks my stats on
my runs and uploads it
to a website as part of a
community and even has
these little avatars that
make fun of me when I
don’t run regularly. I never
thought something like
a computer could make
me do physical activity.
If you had a question for
the next TICr Interviewee,
what would it be?
What technology gives
health the biggest
bang for the buck?
(here or globally)

Page 6

THE 2.0 FACTOR:
Musings of a
Hyperconnected
World
by Francisco J Grajales III
Topic: Cisco’s 2010 eHealth Predictions
The first decade of the 21 century
st
is here! For the agog-types, it is the you can
infamous year of the White Tiger
and the 21 Winter Olympic Games, which will take place
st
in our beautiful Vancouver, British Columbia. With this first
article of the year, I won’t focus on your New Year resolutions
or the gadgets that can help you keep them in check; rather, I
follow Nostradamus in predicting a few changes to our fields
of eHealth and Technology-Enabled Knowledge Translation.
Last year we saw the Netbook, e-Book Reader, and App
Phone (short for mobile phone with a downloadable
application) proliferate. This year, my Bluetooth
LED ball shows four transformations coming:
1. f(Web 2.0 AND Medicine) PubMed
. We will see the first
exponential growth of peer-review literature relating to
Web 2.0 in medicine. Figures 1 and 2 (see below) were
featured in a recent article published last year by a
fellow tweep and emerging technologies librarian @
pfanderson.1 I believe the data speaks for itself.
2. Augmented reality (AR) comes to your pocket. If you are
wondering what AR is all about, don’t worry, chances are that you
are not alone. In essence, it is the nexus of physical and sensory
worlds with web-based information. For example,
AED4EU ( http://bit.ly/2OCpAf ) is an application
created by a friend of mine, @zorg20, which allows
anyone who finds a person in cardiac arrest to point
their phone and
while using the
camera; GPS
and Internet
data merge
on the screen (right) to help
find the closest
sparky (Automatic External
Defibrillator). This will ultimately
decrease time-to-shock where
there is a 10% decrease in the
likelihood of resuscitation
with each passing minute.
3. Embedded sensors get cheap!
Wearable sensors like the fitbit
( www.fitbit.com ) allow you to track sleep, exercise, calories
burned, and wirelessly upload your data to the net automagically;
best of all, they cost less than a hundred dollars. Thus, we will see
a ubiquity of sensors come into the market that allow you to track
of your dog, wife, and kids’ lives to the step. We will also see an
increase in the number of clinical trials that use these gadgets.
4. Social media policies come out of the closet. 2010 will
bifurcate our social media use. Health regions, universities, and
professional health-related associations will do one of two: A)
run away and deem Facebook/Twitter the source of all evil
and “ban” the use of Social Media almost completely; or B) they
will train their staff to use social media in a responsible manner
and allow an enhanced patient-clinician relationship. An early
example of this is McMaster University’s new Medical School
policy where, any medical student or staff who uploads a picture
in an inappropriate environment, or that, which propagates
alcohol use, will automatically be placed on academic probation.
As the old Mexican saying states: “We will see, said the blind
man.” In the meantime, have a very successful New Year!
[1] Anderson et al. An Online and Social Media Training
Curricula to Facilitate Bench-to-Bedside Information
Transfer. Positioning the Profession: the Tenth International
Congress on Medical Librarianship (2009) pp.
Page 7
A Handful of Useful Medical Apps for the iPhone
By Nelson Shen
In the second half of 2009, Mobclix found that health care applications (apps) more than doubled from 616 apps to 1399.1
With so many apps, how would one go about compiling a Top X (insert number of choice) list of medical apps? A simple
search of “Top 10 iPhone medical apps” yields approximately 14 million hits with each claiming that their top 10 app list
is the real one. This list is not a top ten list nor is it comprehensive, it is simply a list of apps that a health care professional
should take note of should they have a urge to populate thier iPhone with some medical apps.

1. Epocrates - Epocrates appears to be the most popular medical app for health practictioners. Epocrates is a
database of over 3300 medications that includes information on dosing, adverse effects, drug interactions, prices,
and pictures. It also has a function that allows users to make several types of medical calculations. Price: $0 - $299

2. MedCalc - As the name implies, this app is a medical calculator that contains more than 40 types of calculations
and scores. Examples of calculations include: Absolute Neutrophile Count (ANC), Body Mass Index (BMI),
Fractional Excretion of Urea (FEUrea), Mean Arterial Pressure (MAP), MELD Score (Model for End-Stage Liver
Disease), Oxygenation Index, and many others. Price: Free

3. AirStrip OB - AirStrip OB allows obsteritricians to monitor patient’s statuses, such as baby’s heartbeat remotely.
Although this application is free, it requires that the hospitals install the AirStrip Software Suite. Price: Free

4. Anatomy Lab - This app is a study tool that provides medical students and practitioners with a virtual cadaver
and allows them to dissect and view various structure and layers of the cadaver. It also provides users with
information on the different structures and allows them to jot down some notes about it. Price: $9.99

5. The ECG Guide - The ECG Guide is also a study tool used to help students and practitioners read and
interperate Electrocadiograms. The app provides a detailed breakdown of the ECG and provides in depth
explanations of normal and abnormal cardiac functions. The app also contains many examples and quizzes to help
faciliate learning through usage. Price: $4.99

6. ICD9 Consult - This app is a quick reference guide to the Internatonal Statistical Classification of Diseases and
Related to Health Problems Code. It helps classify diseases, their symptoms, abmormal findings, and causes of
injury or disesase. Price: $14.99

7. CliniPearls - Developed through TEKTIC funding, this app will provide physicians with provides up-to-date,
evidence-based guideline information at the point-of-care. Look for this app in iTunes later this year. This app will
also be featured in an upcoming issue of TICr. Price: TBD

______________________________
1 http://www.fastcompany.com/blog/lydia-dishman/all-your-business/8-great-medical-apps-healthcare-professionals

Page 8
Headline in eHealth: Times feature, entitled Insurers Shun Multitasking Speech Devices,
this past September:
The top selling iPhone medical app of 2009
By Brian Dolan “Kara Lynn has amyotrophic lateral sclerosis, or A.L.S., which has
attacked the muscles around her mouth and throat, removing her
ability to speak. A couple of years ago, she spent more than $8,000
to buy a computer, approved by Medicare, that turns typed words
into speech that her family, friends and doctors can hear…
Still, advocates argue, advances in computing and easy-to use
speech software have opened doors to use cheap mainstream
alternatives. Indeed, the price drops have made it possible
for A.L.S. assistance groups to buy dozens of netbooks, install
specialized software like Proloquo2Go and lend them to clients.”

For at least a brief time, Proloquo2Go became the face of Medicare

and insurance reform for text-to-speech devices in the U.S.
Apple recently announced the top selling apps, songs, games and Following the feature, famed film critic Roger Ebert, a papillary
podcasts from 2009 in an iTunes feature it called iTunes Rewind thyroid cancer survivor, wrote the Times to criticize the insurance
2009. Perhaps surprisingly, one medical iPhone app policy: “It’s stupid of insurance companies to insist on an inferior
made the list of the top 30 selling iPhone applications device costing 10 times as
in 2009: Proloquo2Go. The app, which costs $189.999, much,” he wrote.
appears among apps that generated the most revenue in
2009, which seems to be how Apple created a list of the Proloquo2Go certainly
Top Selling apps for the year. deserves the honor of
being the top medical
Here’s how the app describes itself: “Proloquo2Go app for 2009 as the app
is a new product from AssistiveWare that provides a clearly demonstrates the
full-featured communication solution for people who disruption wireless health
have difficulty speaking. It brings natural sounding devices and apps are
text-to-speech voices, up-to-date symbols, powerful beginning to create. Time
automatic conjugations, a default vocabulary of over will tell if and when that
7000 items, full expandability and extreme ease of use disruption will translate
to the iPhone and iPod touch.” into a more informed
reimbursement policy.
Other apps in the list include Major League Baseball,
CNN, ESPN, AOL AIM, Family Guy and more. Source:
Proloquo2Go must have sold a number of apps to http://mobihealthnews.
make the list — even at number 23 of 30, it outsold com/5753/the-top-selling-
ESPN, Family Guy and ESPN among tens of iphone-medical-app-of-
thousands of others. No small feat. 2009/

So how did a relatively obscure app rise above the rest?

Perhaps one article from a major newspaper this fall
helped out: Proloquo2Go was the focus of a New York

Page 9
 Would you
like to have
your project
profiled in
t h e T I C r,
present your
project at an
Check the January TICr or www.TEKTIC.ca
upcoming for the Next Elluminate Session!
Elluminate session, or have an
announcement to make? Please email
Jennifer Cordeiro at Jennifer.c@ubc.ca
for more details.
Frames of Mind is a monthly film event
founded by Dr. Harry Karlinsky, TEKTIC
member, utilizing film and video to promote
professional and community education on
issues pertaining to mental health and illness.
Boy Interrupted
Wednesday, January 20th, 2010 - 7:30pm
USA 2009. Directors: Katie Cadigan, Laura Murray

Every parent’s worst nightmare is, unquestionably, the death of their child — the
very event experienced by Dana Perry in 2005 with the suicide of her 15-year-old
son Evan. A documentary filmmaker by trade, Dana sought solace by creating a
film to try to understand the mind of a boy who asked in his suicide note “only to
be forgotten.” In this, her “Mother’s Lament,” Dana takes us back through 15 years of home movies and photographs
to paint a portrait of a child who was different — and even obsessed with death — from a very early age; the “darkest
of souls,” she calls him. Home movies of Evan at seven show him demonstrating how he might hang himself from his
bunk bed. His first suicide attempt, at age 11, landed him in a treatment facility, where he was diagnosed with bipolar
disorder — an echo of another family tragedy, the suicide of an uncle, years earlier. For Evan, medication and therapy
seemed to be helping; as he moved into adolescence, things seem to be going well for the first time in years. The blow,
when it comes, is devastating. Colour, 92 mins.

“Mournful, pained and beautifully put together” (John Anderson, Variety).

“Deeply absorbing . . . Boy Interrupted is hard to reckon with, but even harder to shake off” (Scott Foundas, LA
Weekly).
Post-screening discussion with Judy Davies, Jude Paltzer and Dr. Jana Davidson.

Co-sponsored by Mood Disorders Association of BC (MDA), The Josh Platzer Society, the
Crisis Centre and the Child & Adolescent Response Team (CART), Vancouver Community
Mental Health Services.

For more information, tickets, full reviews, and trailers, visit www.framesofmind.ca.

The TICr is Made Possible Through the Partnership of the Following Insitutions: