Google I/O Real time stream

Friday, May 29, 2015

Live stream from San Francisco May 29 ,2015 9:00 AM

Health Train Express stopped at Moscone Convention Center to take a break from Health Reform, Health IT and the never ending conflict of practicing medicine.  Hopefully this will be a period of recreation and re-vitalization.

For those of  you who tuned in yesterday,  you found us a Google's i/O, their annual exposition in San Francisco to display and deep dyve into their latest advances and new entries in the android space.

If you are here and you managed to get up after a night of carousing the shebang starts at 9:00 AM PDT.

Here is a  photo montage of yesterday's extravaganza in the big hall. The pre-keynote show included a galaxy size game of Pong.

Google I/O  May 28, 2015

Today there are a large number of events, and breakout sessions. I have to make some diffiicult choices, as well will you.  Yoda is sitting right next to me this morning, and I feel the FORCE .

Much of health care now involves mobile apps and Google' android phones and tablets are already playing a large role in many of your practices.

For those of you who are still working in 2000 this is your chance to catch up.  Open your window, take a deep breath and pretend you are here with us in San Francisco.


Thursday, May 28, 2015

Google I/O 2015

Google I/O 2015

Live stream from San Francisco  May 28,2015  9:30 AM

Health care will benefit from "mhealth". on Android, wearables, remote monitoring, health messaging.

Automobile manufacturers:  Volkswagon, General Motors, Audi, Hyundai Sonata, Ford, GM, Mitsubishi
35 auto manufacturers

Television: Sony, Phillips, 

4,000 devices, 'be together, be the same '  400 OEMs, 500  carriers, 

Leave no one behind.

Android wear

Android TV: Sony, Sharp, Chromecast, 17milliion devices HBO  Streaming consoles, 

M developer Preview:  Customized with selective app permissions before activation. and ability to revoke specific permissions.

Web Browsers:  Custom tabs sign in  saved passwords  autofill  security


   Fingerprint standardized identification

Android Watch  LG   

Check back tomorrow here on Health Train Express

Wednesday, May 27, 2015


brought to you courtesy of the Cystic Fibrosis Research. Inc

This week we seek nominations for our CFRI Volunteer of the Year Award as well as our CF Professional of the Year Award, provide research updates, invite you to our 28th National Cystic Fibrosis Family Education Conference, continue our search for “CFRI Ambassadors,” announce the online posting of our Pediatric CF Education Conference, promote clinical trial opportunities, and share our other exciting programs and events!

Two prestigious awards will be presented at CFRI’s 28th National Cystic Fibrosis Family Education Conference on August 1, 2015. The Dave Stuckert Award will be presented to a CFRI volunteer who has made outstanding contributions to the CFRI community through education, outreach and support. The CF Professional of the Year Award will be presented to an individual who has made an outstanding contribution in the field of cystic fibrosis through education, outreach, support, medical expertise, clinical practice, or research. Please send your nominations of 100 - 150 words or less to Siri Vaeth Dunn by June 30th. For more information, please click here.

▶ CF researchers in the UK will livestream the announcement of their landmark gene therapy trial on May 30th. In a rare move, researchers will take the results of their research directly to the CF community. Hosted by the Cystic Fibrosis Trust, scientists will share the much-anticipated results of the eight-month clinical trial that evaluated Wave 1 CF therapy, in which a corrected copy of the gene related to CF is inserted to substitute for the defective gene. After the webcast, Professor Eric Alton – who will be familiar to those who heard him speak several years ago at CFRI’s annual education conference – will answer questions from viewers. For more information, click here.
▶ Researchers from Oregon State University (OSU) in Corvalis and Aradigm Corporation have announced the results of their study of the effectiveness of Lipoquin® and Pulmaquin®, investigational drugs for the treatment of non-tuberculous mycobacteria (NTM). While NTM is very common in the environment, for those with cystic fibrosis it often causes severe pulmonary infections, the most common symptoms of which are fever, cough, hemoptysis, weight loss, fatigue, and night sweats. Pulmonary NTM infections can cause irreversible bronchiectasis. Results of the study with mice demonstrated that the use of Lipoquin ® and Pulmaquin ® reduced the growth of the bacterium. Said Dr. Luiz Bermudez, professor of Biomedical Sciences at OSU, "I am very pleased that the encouraging effects of Lipoquin and Pulmaquin against PNTM in the biofilm and macrophage in vitro assays have been confirmed with this short treatment in our animal model. This test system was previously evaluated and demonstrated to provide results comparable to the results obtained in humans.” Studies will continue with this promising therapy. For more information, click here.

CFRI’s 40th Anniversary Gala, to be held at the stunning Carolands chateau on September 25,will feature gourmet small plates, fine wines and champagne, fabulous entertainment -- including Tammy Nelson from Beach Blanket Babylon in San Francisco --  and an exciting live auction! Please join us at one of the most beautiful properties in the state! This event is expected to sell out. To purchase tickets, or to find out about the many sponsorship opportunities available, click here. All funds raised will support CFRI’s CF research, education and support programs. Generously sponsored by NBC Bay Area, Vertex Pharmaceuticals, AbbVie, and Chiesi USA.
CFRI Continues to Seek Ambassadors! CFRI’s office is in California, but our reach is global. We need your help as a CFRI Ambassador in your community. As an ambassador, you would actively work with your CF center to distribute CFRI materials, and discuss CFRI’s programs with your fellow patients, caregivers and members of the care team. You could also present at your center’s CF Education Day. Providing presentations/discussions about CFRI and our services to a group of 10 or more friends, patients, associates, business/service groups, etc. is also vital. Those of you who live outside of the United States are also encouraged to participate! For more information, contact Mary Convento at
Mother's Day may have passed, but the ability to honor mothers and help support CF research and education has not! Please join us as a Tea Sender, and help us to reach our goal of $175,000. Pleaseclick here or call 855.237.4669, and we will send you everything you need, including beautiful invitations, teabags, CFRI information, and more. CFRI's Mothers' Day Tea lasts far beyond May 10th; you can send invitations to your friends and family in the weeks to come asking them to enjoy a cup of tea, while reflecting on loved ones who live with cystic fibrosis. This reflection is capped off with a donation to CFRI in support of our research, education and support services to the CF community. We look forward to hearing from you! Please note: if you prefer to participate in a virtual tea, you can click here for more information.

 For those you who missed CFRI’s inaugural Pediatric CF Education Conference, held on May 16, you may now watch the presentations online! Topics include updates on the CF pipeline, transition for adolescents, respiratory therapy tools of the trade, and nutrition tips, all presented by some of the most renowned CF experts in the SF Bay Area. To watch the conference presentations, click here. 
    Please mark your calendar for the next CF Caregivers Support Group on Tuesday, May 26 from7:00 pm – 9:00 pm PST. The group meets at CFRI’s offices, but participants from across the country are encouraged to phone in and participate. Facilitated by Sruthi Veeravalli, MSW, the support group is part of CFRI’s Cystic Fibrosis Quality of Life (CFQoL) Program. To participate by phone, call 1-860-970-0300, and type in code 7738539#. Click here for a support group flyer. Please share with others. Made possible by Vertex.
    FREE counseling services available to the nationwide CF community! We are currently supporting services in 8 states! As part of CFRI’s CF Quality of Life Program, a Living Legacy of Peter Judge, CFRI will cover the cost per individual counseling session with your selected therapist. There is no charge to you! Thanks to Vertex, this funding is available through August, or when all funds have been expended, whichever comes first. Your selected therapist MUST contact CFRI prior to providing each subsidized session. For more information, click here or call CFRI at 650.404.9975. Made possible by Vertex.
    Teletherapy services! For those people interested in individual therapy, for whom traveling to a therapy session is not feasible, CFRI will underwrite HIPPA-compliant teletherapy sessions with licensed therapists. If you are interested in learning more about this program, and/or to receive a referral to a participating therapist, call Siri Vaeth Dunn at 650.404.9445. Made posssible by Vertex.
    High school seniors and college students: It’s scholarship time! The deadline for the 2015 AbbVie CF Scholarship is May 27th. For information about this scholarship, click here. For information on the many other scholarships available to the CF community, click here.

Dr. Terry Robinson and Dr. Carlos Milla at Stanford Hospital are currently recruiting participants in California for a study to evaluate the effectiveness of a noninvasive lung function test, the Lung Function Index (LCI), as an effective screening tool for detecting early CF lung disease. The LCI results will be compared to CT scan results. If the LCI is able to effectively screen for early lung disease, it would limit the number of CF infants and toddlers needing more comprehensive chest CT evaluation. The goal is to enroll 30 CF infants/toddlers and test them over the first year. Follow-up testing would then be 2 years later. Testing will include LCI measurement and low-dose Controlled Ventilation Infant CT scan. For more information, call Colleen Dunn at 650.736.0388.
AbbVie is sponsoring a long-term observational study in cystic fibrosis patients who are participating in the Cystic Fibrosis Patient Registry to assess the occurrence and risk factors for a rare bowel disorder called fibrosing colonopathy (narrowing of the large intestine). Patients will be followed at their regular clinical care visits over a 10-year period and approached if they develop symptoms of fibrosing colonopathy for collection and use of further detailed information. For more information, click here.
PTC Therapeutics is enrolling over 200 patients with a CF nonsense mutation (nmCF) at research centers worldwide in the Ataluren Confirmatory Trial in CF (ACT CF). For more complete inclusion and exclusion criteria, click here
Vertex Pharmaceuticals is currently recruiting participants with CF who are homozygous for the F508del-CFTR mutation for a multicenter Phase 3 clinical trial designed to evaluate the efficacy and safety of VX-661 in combination with ivacaftor.  For a complete study description, please click here.
Dr. Jeff Wine is still seeking subjects who do not carry a CF gene for his study. Participants must live in the SF Bay Area. For more details, click here for a flyer, email or call 650.725.2785.
Study: Osteopathic Manipulative Medicine (OMM) and CF Bowel Issues: A study exploring OMM and its impact on CF bowel obstruction (constipation) is currently enrolling participants. OMM is a gentle physical manipulation that has been shown to improve bowel function. Participants will earn $200 for participating.  For more details, click here, or contact Sara Modlin at or 925.456.4519.


NEW DOCs  'Practice Closing"  "Practice for Sale"

At one time medical graduates would scour medical journals or other sources for this announcement.

Consider the chagrin and desperation of many physicians who have worked for 35 or more years building a medical clinic or practice. One that on the surface is thriving.

The solo practitioner is at a serious disadvantage when retiring. He has several options:

1. Close the doors, walk away and sell assets at auction or to another physician
2..Sell the business to a young physician, hospital or a large group.
3. Bring in an associate several years prior to retiring, and work part time for the new graduate.

Advance planning is critical, however given the volatility of marketplace economics and the rapidly changing environment even the best plan may fail.

It is a SAD fact. Most physicians take great pride after they have built a medical practice, developed a stellar reputation, work very hard for  30 or more years, and leave a legacy business intact for a community  At one time a retiring MD had not only the assets of the practice, it also had considerable cash value in "goodwill"  The ongoing inertia of a practice and the implied recommendation by the former physician are enormous. It carries with it a cash flow from ongoing patients, their family and friends. In some cases  'goodwill' was larger than the capital assets of the medical business.

Today 'goodwill" is almost meaningless. Health Reform and the rise of group medical practice is like the battleship of medicine vs the PT boat. While the PT boat can be nimble on it's feet and change direction according to circumstance, it can easily be rammed or swamped by the battle ship.

The legacy of a medical practice may wind up in a classified ad, or an auction block.

Today many older physicians fade away, remembered only by colleagues and grateful patients.

Knowledgable physicians know they will not become rich as MDs.  They will always be in demand, however they may or will become the civil servants of society,paid a  handsome wage compared to most workers, and will have sacrificed their autonomy in a rigid oppressive heath system.

Other businesses such as restaurants, tire dealerships, fast food franchises, and thousands of mom and pop enterprises can sell and use their business as a considerable retirement asset.

Most people do not know that many many physicians are unable to save for retirmenent due to increased operating expenses, decreased reimbursements, or early disability.

Earning and using an M.D. is no longer the  guarrantee of life long security..

It's the patient's loss as well.

Tuesday, May 26, 2015

What is Kevin Spacey doing on the Health Train Express ?

My colleagues know I am involved in social media and author two of blogs.  I realize I am no expert on social media (contrary to some of my physician colleagues on #hcsm) I have no certificates on my wall.

Kevin Spacey was invited to speak at a   'Content Management" meeting as a keynote speaker. He was as brilliant as he is  on "House of Cards".

What I do here on Health Train  Express and Digital Health Space is tell a story about health reform and health information technology.

Story telling is an art form. Spacey outlined the three necessary components of a story.

The story is everything

"1. Create Conflict

First and foremost, in order to tell a riveting story it must include a good conflict. Conflict creates tension and tension keeps people engaged, according to Spacey. “Our stories become richer and become far more interesting when they go against the subtle order of things to achieve something different and effective,” he said in his Content Marketing World 2014 speech. When it comes to conflict though, it must be genuine. The conflict should drive the overall story and affect how characters react. It should also inspire an audience to engage and react with the storyline.

2. Be Authentic

The second most important part of good storytelling is authenticity. He even quoted a fictional man well-known for speaking his mind to emphasize the importance of being authentic, House of Cards’ Frank Underwood: “There is no better way to overpower a trickle of doubt than with a flood of naked truth.” Spacey said when marketers embody a certain honesty they are more likely to create great campaigns. In order to be successful in content marketing, we must stay away from what’s predictable and already been done before. We have to be honest, genuine and stay true to our brand and voice. We also shouldn’t be afraid to take a risk and have a strong voice.

3. Value Your Audience

Finally, good storytelling can’t happen without valuing and understanding your audience. “As storytellers, we are nothing without our audiences. We must constantly strive to build our audiences and give them content worth sharing,” Spacey said. Good content marketers should always be listening and responding to their audience’s wants and needs. If we aren’t doing this, we’re just creating content to create content and contributing to the rest of the noise."
So.....what does this have to do with blogging and Health Train Express ?
" Content Marketing" has flipped the model. It has created a space where Hollywood is coming to it rather than producing it's own content, innovators and forward thinkers are being asked to use their facilities to produce content for YouTube, Scripted,  and other platforms such as Copromote


Does Health Train Express fit this model?

1. Conflict is everywhere in health. It has increased exponentially, exploding into the most common form of health news, Health Reform, Health Information Technology, and Health economics. 

2. Authenticity has been a pillar of Health Train Express, beginning in 2004 when our first articles were on the development of Health Information Exchanges, and Regional Health Information Organizations. Articles based  upon credible sources, other blogs, established print media and content from professional meetings, government sources. It must be newsworthy and preferably 'breaking news'.

3 Value your Audience, goes without saying but must be mentioned.
          a. Who is your audience and  understanding your audience.
          b. Interactivity with your readers and open to comment.
          c. Provide linkage to other important and related information.

There are no more enthusiastic sources for your blog than enthusiasts who follow you.

How to Find Evangelists in Your Audience

1. Excel at Your Service

Think about the best steak dinner you ever had in your entire life. In all likelihood, you told a bunch of people about it. Had it only been an average steak dinner, you probably would tell no one about it. It was okay, but not up to a recommendation. Whatever your product or service is, excel at it first.

2. Show Appreciation to Your Repeating Readers (ie, interact with commentary)

Find your customers and show them how much you appreciate them. If you have a “fan page” or a Google+ page, offer your followers a special deal every now and then. A steak restaurant may offer a free dessert to anyone who mentions the page or blog where you announced the special deal.

3. Listen & Respond to Complaints

Do all you can to make the situation right. Admitting that an article contained a mistake or was challnged, then fixing it for the reader will enhance your reputation on social media and convert a disappointed reader and follower into an evangelist, along with others who read your reviews. You must maintain a positive reputation on social media.

4. Leverage Your Readers

Your employees can be evangelists or at least emissaries. This requires a two-step method that authors needs to implement. First, they need to love where they work because they are treated with respect and feel valued by their readers. The second is that they need to be well-trained in social relationshiops and praised when they have done something routine that makes a follower happy.
5. Quality Over Quantity

It’s better to focus like a laser on a small number of topics in order to make it manageable for you to build a personal relationship. Communication with you for any reason should be easy, so make sure they know how to reach you if they believe they need to. Publish less, and publish with authority.

Evangelist marketing is one of the few marketing efforts that start with the reader
rather than yourself. It is a form of word-of-mouth marketing. When you identify a potential evangelist, ask for a testimonial. When you do this, you are letting these key people know that you appreciate them as your customer.
Evangelists are credible with their peers and can be more influential than a celebrity endorsement. They are underused resources that, if nourished and developed, are the key to growing your business.

The final words from Kevin Spacey,

"Hunt, or be hunted"

Friday, May 22, 2015

Patient Engagement has been dubbed the Blockbuster Drug of the 21st Century

The healthcare market is transitioning to a consumer-driven health market that could cut hospital inpatient expenses by 40% percent over the longer term. There has been an explosion of Patient Generated Health Data (PGHD) as well as care coordination platforms that will enable specialized "smart care" teams to excel at chronic disease management, prevention and non-acute interventions.

Patient engagement holds the promise of improved health outcomes, better patient care, and lower health care costs. It is of great value to patients by stimulating positive patient behavior, by providing real time patient education and by facilitating shared decision making with clinicians. As our population ages, it makes it enables family members’ to provide support for elderly patients.

Rather than depersonalizing health care, HIT may promise to make it more patient-centered, with the caveat "If you build it , will they come ?"  Early studies reveal that the majority of Americans fail to use HIT.  In a previously published post, 

Join us to learn about the key elements of a Patient Engagement Framework and the Patient Engagement Journeys at Intermountain Healthcare and El Camino Hospital.

Third Annual Patient Engagement Summit

June 4, 2015
8:30 AM -  4:00 PM , PT
UCSF Mission Bay Campus
Genentech Hall
600 16th Street
San Francisco, CA 94158

The vocabulary and eponyms of the 21st Century Health Space have changed.

Thursday, May 21, 2015

The Bioprinting Process for skin

L'Oreal is partnering with 3D bioprinting company, Organovoto take their current skin farming to the next level. L'Oreal currently grows its own skin for testing beauty products and formulations. It is a necessary step before releasing products to market, so L'Oreal can see just how safe and effective its formulas are. Organovo is an industrial bioprinting company that 3D-printed artificial veins from living tissue in 2010.

Evena Medical is the maker of a medical device that allows nurses and doctors to view the veins beneath one's skin, with the original device it created having been deployed a while ago and involving the movement of a large contraption. Because of the device's size, it both made the act of giving and IV easier and more cumbersome, something the company's latest invention should fix. The Evena Eye-Onsmart glasses offer the same skin-penetrating view, but are entirely portable.
The original device had a swing-out armature with a display that showed the patient's veins, which you can see in the image below. The portable glasses provide much the same visual, but as a wearable device that is akin to Google Glass and other similar devices. The use of glasses makes use of the technology within clinics and hospitals easier, not to mention removing the hassle of transporting the unit around.
It is interesting watching the glasses in action, since they are able to visualize the movement of blood in real-time, which is demonstrated in the video below. The technology on board comes from Epson's Moverio smart glasses technology, and is accompanied by some other tech, among them being storage in the glasses that allows a patients unique vein patterns to be stored.