Steve Goldberg President and CEO iNET International Inc

GLC - MRA Conference January 21-23 2009GLC - MRA Conference January 21-23 2009

An Evolution Of Using SocialAn Evolution Of Using Social Networks For Data Collection: Networks For Data Collection: A Healthcare Perspective A Healthcare Perspective

Steve GoldbergPresident and CEOiNET International Inc


about INETabout INET Founded in 1998 as an Information and Communication Technology

(ICT) Consulting firm.

INET Online Data Collection Practice: programming and hosting, online sample, and translation services for international studies.

INET Wireless Diabetes Practice: supporting the implementation of chronic disease management.

Research collaboration with CMMT at IIT Chicago with a focus on ways to best apply ICT use in Healthcare


where INET fits?where INET fits?

Client’s Business Outcomes

Methodology

Study Design

Data Collection

Tabulation and Coding

Analysis

Presentation

Online Data Collection

program and host

online surveys&

provision online sample

solutions

Quantitative Market ResearchStudies


Today’s TalkToday’s Talk

Using Social Networks For Data Collection

Need For Online Communities: A Healthcare Case Study

Moving Toward An Online Community To Support Diabetes Self-Care


Evolution Of Social Networks For Evolution Of Social Networks For Online Data CollectionOnline Data Collection

Online CommunitiesOnline CommunitiesSocial NetworksSocial NetworksOnline PanelsOnline Panels

Fast and HighlyFast and Highly Responsive Responsive

Extremely Low CostExtremely Low Cost

Rigorous Data QualityRigorous Data Quality Measures Measures

Learning &Learning & Motivating Change Motivating Change

PassivePassiveParticipationParticipation

ActiveActiveParticipationParticipation


2006 - Dion Hincliffe : Web 1.0 vs Web 2.0

Two Way CommunicationTwo Way Communication

Social NetworksSocial Networks


Social Network: FacebookSocial Network: Facebook


Social NetworkingSocial Networking& Softwares& Softwares


Unique Audience: Individuals who have visited a Web site (or network) at least once in a fixed time frame, typically a 30 day period.

Top 10 Social NetworksTop 10 Social Networks


Age DemographicsAge Demographics


Cultural IntegrationCultural Integration


Fielding Studies Using Social NetworksFielding Studies Using Social Networks Consumer Studies:

Peanut Lab has:– Assess to Facebook which has 140 million users and 70% are outside the US. and 80 other social network

(web) sites,– 27 million visitors/month– Response rate of 29%.– Peanut Labs was created 14 months ago, has annualised turnover of $10m - Sept 29 2008

B2B Studies: LinkedIn new entry into B2B sample solution with over 150 industries and 30 million professionals (50% are IT and business decision makers.) October 2008

Healthcare Studies:

Sermo - over 60,000 physicians and is growing between 1,000 to 2,000 physicians per week. Physicians can post observations and questions through the use of internet connections, blogs, instant messaging and other Web 2.0 applications. April 2008


Virtual Currency & Data Collection Virtual Currency & Data Collection Business ModelBusiness Model


Mechanics Of A Virtual IncentiveMechanics Of A Virtual Incentive

Access Generation Y = facebook + virtual incentive = 29% Response Rate

Qualified fluff owners have an option to take a survey

for “munny”

Qualified fluff owners have an option to take a survey

for “munny”

An owner needs “munny” to care and feed their fluff, buy gifts and do lots of fun activities.

An owner needs “munny” to care and feed their fluff, buy gifts and do lots of fun activities.

2

3

A fluff owner community represents ~160,000 daily

active users (3% of the daily facebook users)

A fluff owner community represents ~160,000 daily

active users (3% of the daily facebook users)

1


A Framework for Data QualityA Framework for Data Quality

Social Network Sample = digital fingerprint + validation measures = quality data

Social Networks

OnlineCommunity

OnlineCommunity

OnlineCommunity

recruit fully opted-in respondents

Profile Database nProfile Database 1

pre-survey: digital fingerprint

one-off (i.e. cookies) ongoing (i.e. pattern)

post-survey: validation measuresspeeders, straight-liners, zig-zagers, knowledge / security question

failures, OE legibility, screen scrapers, and geo IP variances

identify duplicate, heavy or professional user

Online Community nOnline Community 1 ….....


Online Surveys Employ Graphical User Online Surveys Employ Graphical User Interfaces (GUI) and MessagingInterfaces (GUI) and Messaging

A cluster analyses summary

report

Integrate Quant-Qual

Tools


US

INMX

BR

KREP IT

AU

CN JP

CA

INET sample suppliers = World Wide Online Access to > 400,000 physicians

Online Sample: Mix of Old And NewOnline Sample: Mix of Old And New

US

Opt-in Members

CountryRecruitment Method

60,000 +1000/wk

USSocial Network

BR

CN

AU

IN

IT

EPTelephone to web

MXCATI Back End Data Entry (BEDE)

9,500CA

Telephone to web & back end recruit

7,400FR

F2F BEDE

145,000US

Pseudo Online Community

121,000JP

60,500DE

57,000UK

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Pa

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Need For Online Communities:Need For Online Communities:A Healthcare Case StudyA Healthcare Case Study

To Become Motivated To Change: Extremely high dissatisfaction levels in healthcare –> survival anxiety.

What Needs To Be Changed: Focus on patients transition from passive participation to an active player in their own care.

To Make The Change Permanent: Improved healthcare outcomes for everyone at a fraction of today's costs.


The cost to the U.S. economy of treatment The cost to the U.S. economy of treatment and lost productivity caused by chronic and lost productivity caused by chronic illnesses among U.S. residents is more illnesses among U.S. residents is more than $1.3 trillion per year, and if current than $1.3 trillion per year, and if current

trends are not reversed, costs could reach trends are not reversed, costs could reach $6 trillion by 2050, according to a report $6 trillion by 2050, according to a report

released Tuesday by the released Tuesday by the Milken InstituteMilken Institute, , the the San Francisco ChronicleSan Francisco Chronicle reports [Oct reports [Oct

03, 2007] 03, 2007]


Looking At Chronic DiseaseLooking At Chronic Disease

In Canada, chronic diseases account for 70% of all deaths, more than 60% of healthcare costs.

Diabetes, depression, congestive heart failure, hepatitis and asthma are examples of chronic diseases.

World wide between 2000 and 2030 the number of people with diabetes may increase from 171 million to 366 million, a 114% increase.

Of those with diabetes in 2030 it is expected that 298 million will be in developing countries.


The Worldwide Epidemic:The Worldwide Epidemic:Diabetes TrendsDiabetes Trends

www.who.intwww.idfZimmet P. et al Nature: 414, 13 Dec 2001

8th Annual INET Mini-Conference, "A Wireless Diabetes Program: A patient, hospital and primary care collaboration." June 20, 2006 - Keynote: "Diabetes in Canada: Issues and Challenges in Clinical Care" Dr. Stewart B. Harris MD, MPH, FCFP, FACPM

21.935.864%

6.915.2

210%

20.925.823%

1.32.2

69%

5.511.6

111%

World2000 = 159 million2025 = 280 million

Increase 76%

102.2189.485%

Number of Diabetics: 2000-2025

Numbers are millions

Hoy et al.


Why the Epidemic? Why the Epidemic?

Physical Inactivity– 60% to 85% of adults are not active enough to

maintain their health

Diet– Calorie dense; high fat

Aging population Urbanization

– Shift from an agricultural to an urban lifestyle means a decrease in physical activity



Portion Size: 1950s to 2000Portion Size: 1950s to 2000



““Each System is Perfectly Designed to get the Each System is Perfectly Designed to get the Results it Achieves.Results it Achieves.

We designed our health system to manage We designed our health system to manage acute illnesses, not manage (much less acute illnesses, not manage (much less

prevent) chronic ones.”prevent) chronic ones.”

Michael M. Rachlis MD MSc FRCPCMichael M. Rachlis MD MSc FRCPC

9th Annual INET Mini-Conference, "Telehealth: Support Diabetes Self-Care." June 20, 2007, Keynote: "How do we Re-tool Ontario’s Health Care System for Chronic Disease Management and Prevention?" Dr. Michael M. Rachlis, MD, MSc, FRCPC


Transitioning to Self-CareTransitioning to Self-Care


Empower and Prepare Patients to Empower and Prepare Patients to Manage Their Health and Healthcare Manage Their Health and Healthcare

Self Management Support

Programs emphasize the patient's role in managing the illness. Educational resources increase patient knowledge, confidence, and

skills. Patients are assisted in setting personal goals and are given a variety

of other aids to assist in changing behavior. Mechanisms for patient peer support are accessible and the patient

has access to behavior change programs. Measurement methods and feedback are provided to patients. Patients are assisted in improving communication with providers

about their health care.

http://www.doh.wa.gov/cfh/WSC/Model_Info/self_management_support/default.htmhttp://www.doh.wa.gov/cfh/WSC/Model_Info/self_management_support/default.htm


Improved healthcare outcomes for everyone Improved healthcare outcomes for everyone at a fraction of today's costsat a fraction of today's costs

Enable people to achieve their self management support goals. Minimize risk by implementing new processes in small

manageable bite size pieces. Offer the lowest cost (ICT) solution by leverage existing

systems and use pervasive technologies:– Internet– Cell phones– Social Networks: Facebook, Linkedin

Keep it very simple

&

Knowledge-based Systems Development Model Center for the Management of Medical Technology (CMMT)


Sheldon Silver MDFamily Practice

Staff Physician Credit Valley Hospital

Using Cell-Phones To Facilitate Using Cell-Phones To Facilitate Diabetes Self-CareDiabetes Self-Care


HHA1CA1C

Glycosylated hemoglobin


Adapted from Stratton IM, et al. UKPDS 35. BMJ 2000; 321:405–412.

UKPDS: decreased risk of diabetes-related complications UKPDS: decreased risk of diabetes-related complications associated with a 1% decrease in A1Cassociated with a 1% decrease in A1C

UKPDS: decreased risk of diabetes-related complications UKPDS: decreased risk of diabetes-related complications associated with a 1% decrease in A1Cassociated with a 1% decrease in A1C

Per

cen

tag

e d

ecre

ase

in r

ela

tive

ris

k co

rres

po

nd

ing

to

a 1

% d

ecre

ase

in A

1C

**

Any diabetes-related endpoint

21%

**

Diabetes-related death

21% **

All cause

mortality

14%*

Stroke

12%

**

Peripheral vascular disease†

43%

**

Myocardial infarction

14%

**

Micro-vascular disease

37%

**

Cataract extraction

19%

Observational analysis from UKPDS study data

†Lower extremity amputation or fatal peripheral vascular disease*P = 0.035; **P < 0.0001


Wireless Diabetes Wireless Diabetes Management ProtocolManagement Protocol

Patient’s phone is loaded with a program & ID# Enter blood sugar readings. The data is sent back electronically and wirelessly to their

MD; Data consists of only an ID# and blood sugar as well as

date and time of reading No identifying data; privacy is protected; Avoids hoarding of data. MDs/RNs monitor data on SmartPhone / PC Action plan sent back to patient. Excellent MD/RN – patient relationship Community team approach with DCC & CCAC


Action Request i.e. ”Keep up the good work”

Diabetes Management System (Bayer WinGlucofacts & INET Sync)

Healthcare Team

Patient Privacy: No identifiable information is transmitted.

Peoplew/Diabetes

Supporting Diabetes Self Care

Receive Sugar Levels

Send Action Request

Enter Sugar Level

GlycemiCare Server

Prevent Diabetes Related Complications with Better

Control of Glycemic Levels, Measured by HA1C


Pilot Project: Diabetes Care Centre, Pilot Project: Diabetes Care Centre, Credit Valley Hospital (CVH)Credit Valley Hospital (CVH)

Pilot was support with an Education Grant Funded by Bayer Diabetes Care Division

Pilot started in 2006 with approval from CVH Ethics Review Broad.

25 patients enrolled and 20 completed. 15 patients participated > 3 months, 7 patients => 5 months. 20 patients submitted both pre and post HA1C. 18 patients reduced HAIC and 1 patient maintained good control


Patient FeedbackPatient Feedback


Empower and Prepare Patients to Empower and Prepare Patients to Manage Their Health and HealthcareManage Their Health and Healthcare


Programs emphasize the patient's role in managing the illness. Educational resources increase patient knowledge, confidence, and

skills. Patients are assisted in setting personal goals and are given a variety

of other aids to assist in changing behavior. Mechanisms for patient peer support are accessible and the patient

has access to behavior change programs. Measurement methods and feedback are provided to patients. Patients are assisted in improving communication with

providers about their health care.



Empower and Prepare Patients to Empower and Prepare Patients to Manage Their Health and Healthcare Manage Their Health and Healthcare


Programs emphasize the patient's role in managing the illness. Educational resources increase patient knowledge, confidence,

and skills. Patients are assisted in setting personal goals and are given a

variety of other aids to assist in changing behavior. Mechanisms for patient peer support are accessible and the

patient has access to behavior change programs. Measurement methods and feedback are provided to patients. Patients are assisted in improving communication with providers

about their health care.


NEXT Step


People Looking To Educate People Looking To Educate Themselves For Self-Care Themselves For Self-Care


Online CommunitiesOnline Communities::How groups are How groups are

remarkablyremarkablyintelligent showing how intelligent showing how shared observation and shared observation and their members collective their members collective

wisdom can produce some wisdom can produce some astonishingastonishing

clinical insights.clinical insights.


A culture of learning and motivating changeA culture of learning and motivating change


Moving Toward An Online Community To Support Diabetes Self-Care

Action Request i.e. ”Keep up the good work”Diabetes Management System

(Bayer WinGlucofacts & INET Sync)

Healthcare Team

Patient Privacy: No identifiable information is transmitted.

Peoplew/Diabetes

Supporting Diabetes Self CareSupporting Diabetes Self Care

Receive Sugar Levels

Send Action Request

Enter Sugar Level

GlycemiCare Server

Prevent Diabetes Related Complications with Better

Control of Glycemic Levels, Measured by

HA1C

Virtual Currency & Online Data Collection Business Model










WIP: Transition WIP: Transition Research MethodsResearch Methods

Future: Build Online Future: Build Online CommunitiesCommunities

Today: Online Data Today: Online Data CollectionCollection


THANK YOU!THANK YOU!

Steve Goldberg President and CEO iNET International Inc

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