Saturday, September 26, 2015


MappyHealth is a Twitter app that has been out for 3 years now. It was developed by two nursing informatics experts based on the observation that people were using social media to talk about illness long before traditional media became aware of an outbreak. For more detailed information on how it works, here's the original presentation by the authors. The aggregated from all these tweets is used by the US Department of Health and Human Services and is searchable at

Using the map tool, the 150 places with the most health tweets included Las Vegas (202 tweets), Nevada (917 tweets), and Paradise NV (138 tweets). Since this data is based on geolocation -- using computers or cell phones to determine roughly where someone is -- it includes the many visitors to our area (and there is a major music festival in town right now). The entire table is downloadable for further analysis. You can easily change the order of the lists based on a disease; for example, sort by STDs to learn that right now, Miami and Fort Lauderdale are the top towns for tweets about sexually transmitted diseases.

In fact, a little research shows that 20% of the tweets tracked were about STDs. A few thousand people have tweeted about them every day for the last several weeks! More of these tweets were made in the afternoon or evening than in the morning -- probably an artifact of sleep/wake cycles and work/school schedules. Clearly, STDs are an ongoing problem among Twitter users who tweet about medical conditions. Rather than indicating a possible outbreak, this indicates a need for more information about safe sex.

It is also possible to drill down deeper and find out, for example, there have been more tweets about gonorrhea in the last few days. If I tracked this data regularly, I would be able to identify whether this were an abnormal spike in activity. I would probably also develop a feel for seasonality of disorders that I track.

Theoretically, you can also map out where people are talking about a specific illness. Unfortunately, this functionality was not working correctly for me. I did not have a sense for whether the problem was on my end or at the server level.

Obviously, this tool tells us two things. First, a surprising number of people are more than willing to tell their friends and followers about their medical issues in a semi-public forum. These same people would be rightly outraged if a medical professional posted the exact same information; we must be aware of the necessary double standard. Second, in the hands of a skilled epidemiologist, this information can help communities identify trending health problems and allocate necessary resources. There is also one important limitation to remember: only active Twitter users are providing the data: "Twitter users represent a cross-section of the population that doesn't include all locations, socio-economic classes, and age groups. Two of the largest demographic groups that are underrepresented in Twitter are among the most likely to be affected by flu outbreaks: children and the elderly." In short, this very cool information is a supplement to data from organizations like the CDC, not a replacement.

APA versions of links cited above:

Fudin, S. (2013, May 1). Tracking real-time health with Twitter data serves as an early warning system. Retrieved September 26, 2015, from

2015 Life is Beautiful Festival - Downtown Las Vegas. (2015). Retrieved September 26, 2015, from

McCann, E. (Ed.). (2012, September 14). Twitter app takes on public health. Retrieved September 26, 2015, from

Norris, B., Boicey, C., & Silverberg, M. (2012, June 3). MappyHealth - Monitoring disease trends, 140 characters at a time -#N... Retrieved September 26, 2015, from

Terry, K. (2012, September 12). Twitter App Tracks Illness Outbreaks - InformationWeek. Retrieved September 26, 2015, from

Welcome! We are tracking disease trends, 140 characters at a time. (n.d.). Retrieved September 26, 2015, from

(2015, August 3). Retrieved September 26, 2015, from

Velotta, R. (2015, September 24). Street closures for Life is Beautiful begin in downtown Vegas. Las Vegas Review Journal. Retrieved September 26, 2015, from


The Centers for Diseases Control and Prevention -- the CDC for short -- is an important government agency within the United States Department of Health and Human Services. Their mission is "to protect America from health, safety and security threats, both foreign and in the U.S...To accomplish our mission, CDC conducts critical science and provides health information that protects our nation against expensive and dangerous health threats, and responds when these arise." As you can see, information is so important to the CDC that they mention it right in their mission statement.

So what kind of information do they have? There's a whole page devoted to current disease outbreaks, both here and abroad. Last year's ebola outbreak should remind us that disease halfway around the world could conceivably arrive here on the next plane. There's information on recommended adult vaccinations, a topic vitally important both to healthcare professionals and the general public. Need to know reliable information about a particular disease? They've got it. Their health information goes beyond disease, as well: they have information for healthcare providers and families to help prevent falls in the elderly too. These falls are a huge problem, causing pain, costing money, and shortening lives.

The CDC also gathers and uses information that is not intended for the general public, but rather to help health care professionals. The Morbidity and Mortality Weekly Report is a rundown of current issues in disease control and prevention. This week's issue includes alcohol use in pregnant women, Vancomycin-Resistant Staphylococcus aureus, and progress eliminating Rubella (did you know Rubella is already eradicated here?). The CDC also runs a public health image library -- a wonderful resource for any student, educator, or health care professional trying to put together a presentation. In fact, all images in this post are courtesy of the CDC PHIL.

In short, the CDC has a lot of resources available to help all of us both control and prevent disease, as well as other serious health problems.

APA versions of citations above:

CDC. (2015, May 15). Retrieved September 26, 2015, from

Falls. (2012, October 1). Retrieved September 26, 2015, from
Park, A. (2015, September 24). Here's What U.S. Leaders Learned from Ebola One Year Later. Retrieved September 26, 2015, from

Rubella (German measles) eradicated from Americas - BBC News. (2015, April 29). Retrieved September 26, 2015, from

Friday, September 25, 2015

Telemedicine is not Facebook

Did you know that Facebook has well over a billion users? Let me write it out to show the magnitude:
That's over One Thousand, Two Hundred Thirty Thousands of Millions of users.
Over 750 million users show up on Facebook every day, sharing whatever comes to mind: the latest political talking point; inspirational messages ("Dare to Share if U love Jesus!"); personal news; pictures of almost anything you can imagine; and of course, cat videos. In fact:
(please see image for appropriate attribution)

It's a good thing when friends like or share your Facebook posts. It's a bad thing to like and share your medical issues. You will not be making a doctor's appointment via social media anytime soon.

But social media does have a purpose when it comes to medicine. In fact, it serves many purposes. Social media can help people network with others with similar medical issues, forming online support groups. Internet sites can aggregate genomic information, as at 23andMe. They can allow medical professionals to network -- and potentially collaborate. Even more interestingly, they can be used as a research tool for such tasks as tracking a disease through the social networks of patients (who again, "share too much online"). One exciting area where telemedicine and social media intersect is reaching out to younger people to inform them on health issues (this article is available for free to Touro students through the library, login is required).

There is one very important thing to remember when using social media for medical purposes: ethical standards. Don't forget issues like professionalism and confidentiality when online.

APA versions of links cited above:

23andMe - Genetic kit for ancestry | DNA Service. (2015). Retrieved September 25, 2015, from

Decamp, M. (2015). Ethical issues when using social media for health outside professional relationships. International Review of Psychiatry Int Rev Psychiatry, 97-105. Retrieved September 25, 2015, from

Iii, F., Sheps, S., Ho, K., Novak-Lauscher, H., & Eysenbach, G. (2014). Social Media: A Review and Tutorial of Applications in Medicine and Health Care. J Med Internet Res Journal of Medical Internet Research. Retrieved September 27, 2015, from

PROTALINSKI, E. (2014, January 29). Facebook Passes 1.23 Billion Monthly Active Users. Retrieved September 25, 2015, from

Wong, C., Merchant, R., & Moreno, M. (2014). Using social media to engage adolescents and young adults with their health. Healthcare, 220-224. Retrieved September 25, 2015, from

Telemedicine: Is it Right for You?

You are sick. You don't feel like going anywhere. But even though you're not sure how serious it is or whether there is medication to make you feel better faster, you don't want to spend all afternoon trying to get seen in some urgent care clinic that will charge you lots of money.

What do you do now?

Help might be as close as your phone or your computer:
Telemedicine, or “telehealth,” is the provision of remote access to a physician via phone or videoconference to address a health care issue. It’s not a new concept. It’s well-established in rural areas for specialty consultations, and has been widely used in many primary care practices...."
The idea is simple. You talk to the doctor remotely. He asks appropriate questions. He can make his best guess about what's wrong and make a recommendation or even write a prescription. The problem is that word, "guess." He might be able to see your throat on a webcam, but he can't culture the germs. He can't tell if that slight blue tint is just your lighting, or if you are slightly blue because you're having trouble getting oxygen into your blood. And since telemedicine is not free -- there's big money in it -- if it's serious enough that he tells you to get up and see a doctor in person, you could be out two fees instead of one. Here's a scholarly article from April's NEJM detailing more of the challenges.

Make no mistake: Telehealth is part of the future of medicine, but the doctor's office isn't going completely virtual any time soon.

Image of "Sick Guy" courtesy of ClipArtBest.

APA versions of links cited above:

Frist, B. (2015, March 12). Telemedicine Is A Game-Changer For Patients, The System. Retrieved September 24, 2015, from

Jackson, A., Cramer, J. (2015, June 10). Doctor On Demand CEO: Medicine At Your Fingertips | Mad Money | CNBC. Retrieved September 24, 2015, from

Kahn, J. (2015). Virtual Visits — Confronting the Challenges of Telemedicine. New England Journal of Medicine N Engl J Med, 1684-1685. Retrieved September 24, 2015, from

Telemedicine: It's a No Brainer

Stay tuned for more!

Courtesy of the American Telemedicine Association.

Thursday, September 24, 2015

To the Undiscovered Country

... The future.

Because this blog is a project for an informatics class, the content of this site will be relevant to the goals of this class.

As a... nurse, why would you need to know about information management?
In this modern world, there are very few professions that do not involve information management on some level. Businesses have always had files; libraries have always had systems for organizing the shelves.  Every time you write a to-do list or enter an appointment into a calendar, you are managing information. Of course, few people think of it that way. The new thing is that instead of managing information on paper or in file cabinets, we are managing it with computers.

Computers have been used in healthcare since the 1950s (Nelson, 2014, p. 4). Today they are an important resource for healthcare professionals and students alike. Thanks to the computer, I can access and easily search a dozen textbooks in minutes. If my search is fruitless, the entire school library is a few clicks away. Instead of waiting for the journal detailing the latest evidence-based practice to arrive, I can read it online. Thanks to a technology called RSS, new articles from my favorite sources can be waiting on my computer every morning.

But what about in the clinical setting? The computer allows me to easily look up information on any patient in an electronic health record (EHR) (Lewis, 2014, p. 10). This includes both medical and nursing diagnoses, allergy information, latest lab values, current orders, medications, the patient's risk for falls or pressure ulcers ("bed sores"), the physician's name and how to reach him/her should the patient's condition change. and more. With this information in hand, I know what needs to be done for whom, and what warning signs I should be seeking. A good system will help me avoid common mistakes such as medication errors.

But "With great power comes great responsibility." Data can be used, but it can be misused. It is my responsibility to safeguard the information with which I am entrusted. It's not just a good idea; it's the law.

Where do you see yourself in 5 years after graduation? What is one way you could become involved in [healthcare informatics] in your workplace...?
I will drive a fast car, have a cool house with lots of computers in it, and spend a week at the beach at least twice a year. Oh, you mean as a nurse?

In 5 years, I think it is likely that I will have (or be nearly finished with) an MSN degree. Add that to the fact that I am more mature and have a background both in education and management, it is very likely that I will be a nurse manager at least part of the time, and probably in charge of new hires at least on the level of my floor. This puts me in an important place in regards to the implementation of healthcare IT, I need to be aware of changing needs, and have a sense for technology that will save time, save money, and save lives on my floor. I may well be one of the innovators or early adopters, (Nelson, 2014, p. 33) tasked to train co-workers. I will be one of the people who gets asked "how is that new system working out?"

Lewis, S., Dirksen, S., Heitkemper, M., Bucher, L.  (2014). Medical-Surgical Nursing: Assessment and Management of Clinical Problems, 9th Edition [VitalSource Bookshelf version].  Retrieved from

Nelson, R., Staggers, N.  (2014). Health Informatics [VitalSource Bookshelf version].  Retrieved from


Hello, World.

I am currently a nursing student working on a BSN at Touro University Nevada. My anticipated completion date is July of 2016. This blog is a project for NUR 406, Informatics and Healthcare Technologies. If you like my writing, please visit my original blog at

Thanks for stopping by, and please feel free to leave comments. Inappropriate or offensive comments will, of course, be dispatched with extreme prejudice.