Day 2 of  Medicine 2.0 opened and closed with keynote presentations that capture the scope of subject matter covered by this incredibly broad-ranging conference. 

The morning keynote, delivered by Josh Brownstein was a fascinating view into the power of crowdsourced epidemiology and public health, as realized by the tool he’s developed – HealthMap – and all its related apps and services.  By cutting out the middleman, so to speak, HealthMap makes disease and public health surveillance easier and cheaper (think app vs. field worker).  Brownstein’s group has even used the amazon.com mechanical turk service to field surveys to respondents in India at an extremely low cost.  Leveraging the tools available to increase the cost-effectiveness and timeliness of public health surveillance can have a real impact on prevention, containment and treatment of disease outbreaks.

e-Patient Dave delivered the closing keynote, in which he traced the evolution of his own experience as spokesman for the e-patient movement and advocate for patients since his last turn at keynoting Medicine 2.0, three years ago, and the evolution of the e-patient movement and the world around it in the time since then.  In that time, he’s gotten me involved in the Society for Participatory Medicine as well.  (For kicks, check out the latest work of some of the fellows of the ACMIMIMI, “Gimme My DaM Data.”)

The connection between Josh’s and Dave’s presentations?  Population health and personal health are inextricably linked; each is built on the other.  And we need good information in order to optimize each.  We insist on good information at the epidemiological level; we need to insist on it at the personal, individual, level as well.

Taking us from the population level to the personal level and back again were a dizzying array of sessions throughout Day 2 of Medicine 2.0.

My own contribution to the discourse was a presentation on data privacy and security and how patient data may be used to help broader communities of interest. (Follow the link there to read more about the rest of the session.)

I spoke with Alexander Börve about his app (iDoc24), which he presented in one of the sessions of the day – a clever, simple, dermatology app that allows the user to send a photo of a rash or lesion to a dermatologist, who replies with information about it within 24 hours (payment collected via iTunes).  See the video on iDoc24. Is this available yet in the US, you ask? What do you think? While the US represents a tremendous market for apps such as this, the plethora of regulatory structures (FDA, HHS, FTC) makes breaking into the US market a daunting prospect – as I’ve discussed at other recent conferences including the mHealth summit and Health 2.0’s Spring Fling in Boston. The question, again, is how do we encourage sharing of information rather than restricting the flow of information?  Alex is an exemplar of a type I met a number of times at Medicine 2.0 – a physician who is leaving clinical practice to pursue development of an app, in hopes of breaking out of the current paradigm of health care and reaching many more people who can be helped by an app than who can ever be seen in an office visit.  Alex hails from Sweden, but I saw this dynamic played out among German, U.S. and other physicians as well.  While this bodes well for us in some respects, I am sorry to see dynamic, engaged physicians stepping out of clinical practice.  One would hope that they find a way to return in the future.

One fascinating paper (Talya Miron-Shatz) touched on the issue of presentation of questions as influencing answers – teaching us more about the importance of carefully crafting the patient-clinician (or patient-app) encounter.

I couldn’t be everywhere at once, sadly, and there were excellent concurrent sessions on many topics, including physician rating sites, mHealth, Emergency Medicine 2.0 (featuring Nick Genes), social learning in health care through Twitter (with Brian McGowan and Ryan Madanick, among others), and Web 2.0 tools applied to chronic care (chaired by Gonzalo Bacigalupe).  Check out the #med2 twitterfeed for more (but steer clear of the spam links shared by “egg” hashtag spammers), see Joe Graedon’s Medicine 2.0 – Day 2 post at e-patients.net, and be sure to read all about Day 1 of Medicine 2.0 as well.

As always, the hallway conversations were at least as valuable as the formal sessions.  There was even a thread of comments on Twitter wondering whether there should be a study presented next year on the value of hallway conversations at Medicine 2.0.  My answer to that question: engage in more conversations through the structure of an un-conference, like the HealthCamp we held as a lead-in to Medicine 2.0.