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Happy Birthday JMIR: Call for Papers 20th Anniversary Issue

Happy Birthday: 20 Years of JMIR

In August 1999 we published the very first issue of the Journal of Medical Internet Research (JMIR), pioneering a new type of journal for an emerging field – originally, JMIR's scope was the use of the Internet and related technologies as an enabler and infrastructure for health innovations, although todays' scope of digital medicine or digital health goes well beyond "the Internet", and includes emerging technologies such as 3D printing, games, wearables, and home sensors, etc. (all technologies that would be unthinkable without the Internet as infrastructure foundation). 

The field went through several name changes – what we first called “cybermedicine” was later called “eHealth” (electronic health), then came “cHealth” (connected health), and these days people sometimes use “digital health” or “digital medicine” (despite Twitter length restrictions) – but the underlying ideas remain the same: The use of information and communication technologies and the web helps to empower patients (not least through peer-to-peer communications), provides a platform for communication, clinical information and telemedicine (these days often through mobile devices), and revolutionizes information access and medical education [1]. While most medical informatics journals focused on clinical informatics, hospital IT and electronic health records, JMIR recognized the ubiquitous and pervasive nature of emerging technologies outside of traditional health care settings.  

We were not only innovating on content, but also on form. And as we wrote 20 years ago, “As publishers of a journal about the Internet, we are also dedicated to using and experimenting with the Internet as a medium itself.” [1] – and experimented we have: We were the first open access electronic-only journal in medical informatics or even medicine (pre-dating BioMed Central and PloS), we were the first to mine “tweetations” from Twitter to calculate what is now known as “altmetrics”, we were the first journal offering a fast-track payment option for guaranteed decision making within 3 weeks, we experimented with web archiving cited webpages (WebCite), we were one of the first journals openly crediting reviewers by name (and now rewarding them with Karma credits), we pioneered new ways of knowledge dissemination through social media and cofounded TrendMD, and we continue to experiment with open peer-review, preprints, registered reports and even crowdfunding.

Today, JMIR Publications publishes 30 journals, has a modern Google-like office at Toronto’s waterfront, has a staff of 20, and was just named one of Canada’s top 500 companies.

Four of our journals have an impact factor (ranging from 3.2 to 5), and are ranked among the top 8 medical informatics journals.

20th Anniversary Special Issue – Call for Papers 

To celebrate our milestone and exit from the teenage years, we are preparing a special issue, to be published at the end of 2019. This special issue will consist mainly of invited papers written by leaders in the field, but we are also soliciting papers from the academic community. 

This will be an unusual high-profile issue that will be widely disseminated with press releases and as a special print publication at conferences.

We specifically encourage papers (reviews, viewpoints) that comment on major developments from the past 20 years or provide an outlook on the possibilities or challenges of digital health for the next 20 years. We also welcome high-quality original research or systematic reviews. Possible topics for viewpoint papers or reviews could be “Where will we be in 20 years – what will health care look like in 2039?”, or “What is the biggest achievement or research breakthrough in the past 20 years?”. 

We would like to have the submission by September 15, 2019, although we may be able to make arrangements to extend this deadline. Contributions will be peer-reviewed. 

Potential authors interested in submitting should file a pre-submission enquiry by sending an email with the subject line “20th anniversary article proposal” to ed-support@jmir.org outlining their paper idea (title and abstract). 

All article processing charges will be waived for papers appearing in the 20th Anniversary Issue.

Invited authors (as of August 21, 2019):

Alex Jadad	From a digital bottle: A message to our selves in 2039
Enrico Coiera	The last mile: The challenge of bringing digital health into real-world settings
Paul Wicks	The rise and fall of online patient communities
Bertalan Mesko	The art of medicine in the era of artificial intelligence
John Powell	Trust me I’m a chatbot: Why AI in healthcare won’t pass the Turing test
Danny Sands	Title TBD
Dave DeBronkart	Open access as revolution: Knowledge alters power
Susan Michie	On the dimensional structure of engagement with digital behaviour change interventions (DBCIs): Psychometric evaluation of the ‘DBCI Engagement Scale’)
Jeremy Wyatt	Title TBD
Tricia Greenhalgh	Infrastructure revisited: Ethnographic case study and (re)theorisation of the ‘installed base’ of healthcare IT
John Torous	A systematic review of smartphone apps for prodromal and early course psychosis and schizophrenia Beyond impact factor: JMIR's 20 years of engaging and encouraging high-quality digital health research from diverse authors
Bradford Hesse	The internet’s role in solving the last mile problem in medicine
Kenneth Mandl	TBD
Helen Christensen	TBD
Laurie Buis	Implementation: The next giant hurdle to clinical transformation
Qing Zeng, Stuart Nelson	Will AI translate big data into improved medical care or be a source of confusing intrusion? – A discussion between a physician and a medical informatics researcher
Rita Kukafka	Digital health citizens on the road to the future
Renato M.E. Sabbatini	Federated intelligence, the internet and medical decision-making
Ricky Leung	TBD

   

Call for Video Submissions

Alternatively (or additionally) we are inviting short video messages from researchers, authors, editors, and reviewers, commenting on the impact of JMIR on the field or you personally, or just wishing us happy birthday. We will be accepting video clips recorded by you, but we are also happy to have an interview with you over Skype. If you do not have time to write an article, providing comments in a short video or interview might be a good option. Snippets from the videos will be distributed through our social media channels (such as Twitter and YouTube), and some might even be published in the 20th anniversary theme issue. You can reflect on (or we can interview you) about your own research, or on a topic of your choosing. 

Submit a Quote

As a final option we are soliciting succinct quotes from researchers and the public which we may use in an editorial for the anniversary issue. Authors of these quotes will be credited and we may use their headshots as well.
We are seeking your 1-3 sentence answers to the following questions:

• What significant developments happened in the past 20 years, e.g. what is the biggest achievement or research breakthrough in the past 20 years?

• Where will we be in 20 years – what will health care look like in 2039?

If you want to contribute in this part of the anniversary issue, please answer at least one of these questions in this form before Sept 15, 2019.
If you have more to say about this then please consider submitting a full viewpoint article instead (see above).
References

1. Eysenbach G. Welcome to the Journal of Medical Internet Research. J Med Internet Res 1999;1(1):e5; URL: https://www.jmir.org/1999/1/e5 DOI: 10.2196/jmir.1.1.e5.

Infoway - Patient Scholarships at 2019 Partnership Conference - Apply by June 12!

Patient Scholarships at 2019 Partnership Conference — Apply by June 12!

The 2019 Infoway Partnership Conference is accredited as Patients Included, and we are committed to ensuring that patients have a strong presence. Patients, caregivers and family members are invited to apply for scholarships to attend the conference on November 12-13 in Ottawa. Applications close June 12. Registration for the conference is now open and discounted rates are in effect. The Delta Ottawa is our designated venue for the Conference, and it is now taking reservations. Book directly with the hotel today by calling 1-888-236-2427 and quoting Canada Health Infoway Partnership to take advantage of the special rates. Delegates may also take advantage of discounted flight and train rates from Air Canada, WestJet and VIA Rail. To access the discount codes, please visit our website.

Fantastic job at DeepMind!

I am applying for this job at DeepMind:

https://deepmind.com/careers/1561898/

eHealth Ontario Watch how access to diagnostic images and reports benefits health care providers and their patients

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Digital Health Success Stories

Diagnostic images and reports from across the province now available to health care providers With the recent launch of the Diagnostic Imaging (DI) Common Service, health care providers can now view diagnostic images and reports performed at facilities across the province, in one place.  In August, the service was made available to all authorized users in the Greater Toronto Area as well as in northern and eastern Ontario through the ConnectingOntario ClinicalViewer.  It’s also now available at two hospital organizations in south west Ontario, providing additional patient data to ClinicalConnect users who currently see reports and images and produced within their own region, and is being rolled out to more sites in the coming months. Thanks to this integration, health care providers can now obtain a more complete picture of their patient’s health, regardless of their location.   Watch the video above to see how health care providers like Dr. Koff benefit by having quick access to their patients’ diagnostic images and reports. This helps to eliminate the need for patients to carry around CD’s containing their DI information to specialist’s offices. It also eliminates the need to mail or fax test results, and the costly duplication of scans. Most importantly for patients, this network allows specialists at one facility to access images performed at other locations, allowing for more informed, timely medical decisions.

Help Us Share This Story Help others see firsthand how our work today is enhancing delivery of patient care in Ontario. Our mission is to foster an electronic health care system that puts the patient first, by leveraging existing systems and building new ones to connect health care providers with their patients' medical information.

Korean medical TV dramas III

Life

Korean TV darma - Life

There are now many Korean dramas on Netflix. Dramafever or Viki carries many and we have found they often appear there first then end up on Netflix if they are popular. Just because they are on Netflix doesn't necessarily mean they are great or anything but indeed some are very good. The most recent medical drama is called Life.  This follows several very good Netflix posted Korean dramas that were non-medical, but are equally as enthralling. I am thinking of  Mr. Sunshine, Live, Prison Playbook, and Hyeori's Bread and Breakfast.

TV dramas about hospitals probably started out as soap operas. As a kid the soap opera General Hospital appalled us for it's lack of general intelligence and fake acting. Korean epic medical dramas, to my mind starting with Hur Jun in 1999 are extremely interesting to watch - and now that I think about it - better than reading novels. Or, maybe that is an excuse for how much time I have sunk into watching Korean dramas. In fact, I mostly read these dramas anyway because without the sub-titles I am lost. I do hear and know a lot of Korean spoken language and I understand a lot about Korean culture, but it is not a language I am fluent in. For example, sometimes, I can watch a French movie and for the most part can understand what is going on, even without sub-titles. With just French sub-titles I would have an even better understanding.

Life has a well recognizable cast of excellent actors, as they - "star studded cast". I would say it is a powerful cast which would most surely ensure the success of the drama. In fact, the Wikipedia article on Life says for a cable TV drama, the ratings are very high. Anything over 10% is high, and that is very high for cable TV. The most prominent actor is the lead, Lee, Dong Work, who we saw not too long ago in Doekebi ( 도깨비 or English translation - Guardian: The Lonely and Great God ).  He is as good looking as a model, and as the secretary to the Hospital CEO, who has a crush on him in the drama says; "Looks like a Greek God", which in a sly way is referring back to his role as "The Grim Reaper" in Doekebi (도깨비).  Followers of Korean dramas often see these kinds of comical references of actors back to previous roles in famous dramas. One scene we saw recently watching Yi San again were two palace maid friends who said "I think we have met before in a past life somewhere". "Yes, I get that feeling too", which is an obvious reference for the audience who knew those two as not so friendly adversaries in the superb medical drama Dae Jang Geum. Speaking of 'having crushes", any Korean drama would not be worth it's salt without a romance plot or twist and turn, and now into episode number 5, something appears to be developing. Though I also heard that many people were enjoying this medical drama because it lacked a romantic focus.

There is an eHealth reference in Life which startled me for several reasons. The CEO needs to find a way to generate revenue in the hospital, which is a non-profit teaching hospital so that is kind of hard to do. He decides to create a subsidiary non-profit pharmacy that would sell nutritional supplements and all his physicians under this command would be asked to help sell and promote them - a kind sole sourcing monopoly. He finds a supplement company willing to sign on as partners but only in exchange for them funding a technology that the hospital needs.  We later see a scene where the nurses start using RFID bar code readers to interrogate signals and bar codes on patient wrists, medical bottles, inventories, and charts. It is the perfect way to reduce medical error. In early scenes there was a lot of drama over physicians in cancer wards covering up for medication errors that killed a patient. The CEO asked for a solution for reducing the errors but the physicians did not think of the RFID solution. It was the brilliant young CEO who was parachuted in from a subsidiary company that efficiently ran warehouse and product shipping to discover the idea of using RFID and getting his new pharmacy partner to foot the bill. All seems really good with RFID technology until the staff learn that in exchange for the benefit of the technology they now have to be salespeople for the nutritional supplements like whale oil, shark oil, etc, substances most scientifically trained specialists don't give the light of day to. From my own studies of RFID technology, the CEO is right. They do reduce medical errors and improve efficiency.  The technology, as I understand it, is also a bit expensive to implement, and maintain securely. The other thing that startled me is that RFID technology like this is at least a decade old, but really looks new and revolutionary in this drama.

There is another eHealth component in episode 7 or 8 where the CEO of the University Hospital meets a high powered CEO of an electronics company and they talk about starting a health app. They joke that the more people follow their blood pressure on the app, the more worried they will be about their health conditions and thus more prone to book appointments at the hospital and thus more money in the coffers. Thus are the benefits of private healthcare.

The main plot of this drama is how business intelligence pits its wits against medical staff in a top level (big 5) university teaching hospital by applying an all business efficiency and revenue generating model to public healthcare. I don't know all the reality of healthcare in Korea but the trend appears to be towards more privatizations. This drama explores that idea in the extreme. It always makes me think of the journal article written by the McMaster University physician and one of the founders of evidence-based medicine, Dr. Gordon Guyatt, in which he wrote that for profit healthcare is hazardous to your health. That was not just his opinion, but the results of the meta-analysis and evidence-based literature research. In Life, the CEO is played by Cho Seung Woo, who was brilliant in the 2017 drama Stranger (which was written by the same writer as Life - Ms. Lee, Soo-Yeon). Indeed the context for the drama, though not based on reality but is fiction as stated in the intro - has a basis in reality - rural Korean public hospitals being shut down by greedy profit seeking interests.

The focus of interest in the drama is whether or not the CEO of the hospital, who is just following the orders of the Chairman of some huge conglomerate to generate revenue in the hospital after it was bought out ( and don't ask me how a non-profit university teaching hospital can be bought out), is the most unethical, cold hearted greedy capitalist to ever walk the face of the earth, or whether he has inside a human heart capable of compassion and actually being able to listen to the over worked, over stressed and over resourced medical staff, who are just about to go out on strike as a protest to the CEO decision to cut and move out  to the rural areas outside Seoul 3 departments that are losing money. As an audience we start out believing he is a "malicious jerk" to quote the sub-title translation (and I think I even know how that is said in Korean) but through the sympathetic understanding of some of the medical staff and our own inner doubts, we start to believe that the CEO is a human being, who will eventually "pivot" and be able to harmonize solutions for all concerned.

What you have to do with this drama is hinge your mind on every spoken word (or sub-title) because the nuance and intrigue comes fast. You also have to pay attention and learn a lot about business, life insurance, and medical diagnosis, all at the same time. That the drama is packed with dense intelligence is all that I can say, which is why it reminds me more of reading a novel than watching a drama. It is not a "vacuum land" where you can passively watch in an empty state on the hope of being entertained. You actually believe that you can learn about how business and healthcare can operate together. These are also universal and extremely important ideas for society, such as should MDs also have MBAs, or is that some kind of oxymoron?

There have been some other medical dramas that have appeared on Dramafever and Viki but I don't think I will go into them in this Korean Medical TV Drama III post. You can discover those on your own. They are not entirely without merit. This drama called Life, however, I think will be well worth your time watching, and we eagerly look forward to see how this one will evolve past Episode 5.

Revolutionizing healthcare - reposted from Peter Diamandis

We are on the brink of a revolution in healthcare. AI is making the drug discovery process >100X faster and cheaper, and 90% more likely to succeed in clinical trials. Mobile health is predicted to become a $102 billion market by 2022, putting a virtual doctor, on-demand, in your back pocket. And the cost of sequencing your genome (3.2 billion base pairs) has decreased 100,000-fold over 13 years, a staggering speed that is 3 times faster than Moore’s Law.   Source: Social Capital via Medium But humans have barely scratched the surface. As exponential technologies explode onto the scene all at once, we are about to witness the unprecedented rise of personalized, ubiquitous and intelligent healthcare. In this blog, we’ll discuss how converging exponential technologies are enabling: Personalized medicine Delocalized (“everywhere”) care The new era of intelligent prevention We are truly living in an era when anything is possible. Personalized Medicine  Currently, research focuses on one-size-fits-all solutions. Clinical trials aim to discover therapies for the general population — and can only introduce them after years of expensive initial research, lab testing, human testing clearance, multiple phases of patient testing and maybe ultimate approval. But what if all treatments were targeted at your individual genome, from lab testing to ready product, and at a lower cost? Using their powerful deep learning systems, NVIDIA aims to tailor treatments to an individual’s genomic makeup. Others, like a team at the University of Toronto, are building genetic interpretation engines to pinpoint cancer-causing genetic mutations in individual patients. Similarly, researchers at UNC’s Lineberger Comprehensive Cancer Center use cognitive computing to identify individually relevant therapeutic options based on one’s genetic profile. But this is only the beginning. Take Harvard Wyss Institute’s organs-on-chips. Containing microfluidic channels with living human cells and mechanical mimicry of an organ’s microenvironment, the Wyss Institute’s organs-on-chips can serve as micro artificial hearts, lungs, intestines and kidneys, among many other organs. The biotech company Emulate has raised millions for use of these organs-on-chips to replace traditional animal testing and deliver personalized medicine.  Emulate uses organs-on-chips to accurately test drugs on individual, human organs. Source: Emulate In the future, these could be your cells on a chip, tested with treatment after treatment until the right one sticks, tailored exactly to your genetic makeup. But it doesn’t stop at genetically personalized treatments. Welcome to personalized diets.  Each of us has about 40 trillion microorganisms that occupy our gut, and each microbiome — like our DNA — is distinct. Through a simple home kit, Viome applies machine learning to analyze your microbiome, recommending optimal, personalized nutritional recommendations for your gut.  Bowhead Health tackles yet another approach to personalized medicine. With either saliva or a blood-prick test, Bowhead’s small home device reads this biometric data in real time and transmits the reading to doctors. As soon as key deficiencies are identified, your in-home Bowhead device dispenses a customized, vitamin-based pill, all your own. Delocalized Care Kaiser Permanente’s chairman and chief executive George Halvorson foresees plummeting healthcare costs as care migrates farther from hospitals and doctors’ offices and into any and every setting via the Internet. The harbingers of “everywhere care” are so abundant, they deserve a blog of their own. Here are the highlights: (1) mHealth (or Mobile Health) has already grown beyond a $23 billion market, and by some estimates will surpass $102 billion by 2022. Step aside, WebMD. AI-powered medical chatbots are flooding the market. Diagnostic apps can identify anything from a rash to diabetic retinopathy. And with the advent of global connectivity, mHealth platforms enable real-time health data collection, transmission and remote diagnosis by medical professionals. Already available to residents across North London, Babylon Health offers immediate medical advice through AI-powered chatbots and video consultations with doctors via its app. Babylon now aims to build up its AI for advanced diagnostics and even prescription.  Others, like Woebot, take on mental health, using Cognitive Behavioral Therapy in communications over Facebook Messenger with patients suffering from depression. New diagnostics and screening apps are also beginning to empower the next generation of patient-doctors. In addition to phone apps and add-ons that test for fertility or autism, the now-FDA-approved Clarius L7 Linear Array Ultrasound Scanner can connect directly to iOS and Android devices and perform wireless ultrasounds at a moment’s notice.  With mHealth platforms like ClickMedix, which connects remotely located patients to medical providers through real-time health data collection and transmission, what’s to stop us from delivering needed treatments through drone delivery or robotic telesurgery? (2) AR/VR will revolutionize medical training, making it immersive and ubiquitously accessible.  It’s no wonder the healthcare industry suffers from a shortage of doctors. Medical training is not only expensive, but its conventional methods also severely limit scalability. With virtual and augmented reality, however, gone are the days of peering over a surgeon’s shoulder to learn from another’s experience. Why not perform surgery on an annotated, virtual 3D body from anywhere in the world, for minimal cost, and do no harm? Companies like Echopixel and 3D4Medical are achieving this delocalization and hands-on training with remarkable style, translating 2D scans and anatomy into live AR and VR patients. 3D4Medical translates 2D anatomical and brain scan diagrams into 3D AR realities.   Source: 3D4Medical (3) AI-aided IoMT (Internet of Medical Things) may be one of the most exciting frontiers in healthcare. Welcome to the age of intravenous nanomachines, electronic implants and pill-embedded sensors. While wearables have long been able to track and transmit our steps, heart rate and various other health factors, smart nanobots and ingestible sensors will soon be able to monitor countless health parameters and even help diagnose disease. But it doesn’t stop there. As nanosensor and nanonetworking capabilities develop, these tiny bots may soon communicate with each other, enabling the targeted delivery of drugs and autonomous corrective action. Some companies, however, are working on high-precision sensors that need not enter the body. Apple, for instance, is reportedly building sensors that can noninvasively monitor blood sugar levels in real-time for diabetic treatment. In last year’s Qualcomm Tricorder XPRIZE, we were proud to grant $2.5 million in prize money to the winning team, Final Frontier Medical Devices. Using a group of noninvasive sensors that collect data on vital signs, body chemistry and biological functions, Final Frontier integrates this data in their powerful, AI-based DxtER diagnostic engine for rapid, high-precision assessments. Their engine combines learnings from clinical emergency medicine and data analysis from actual patients. IoT-connected sensors are also entering the world of prescription drugs. Just this winter, the first sensor-embedded pill — Abilify MyCite — was approved by the FDA. Digital pills such as Abilify will now be able to communicate medication data to a user-controlled app, to which doctors may be granted access for remote monitoring. But nanobots and IoT-connected sensors get a lot more exciting when they converge with 3D printers, AI supercomputers and the power of big data. Intelligent Prevention Take a minute to imagine this unprecedented convergence: Nanobot sensors flowing through your bloodstream monitor different health parameters, measuring nutrient levels and keeping an eye on your cholesterol. As data flows in, these connected sensors transmit your health data in real-time to a remote AI-powered supercomputer geared with all your genomics, microbiome and medical history data — access secured via blockchain, of course. As abnormalities are detected, this AI-driven doctor sifts through tomes of data to identify an optimal, personalized treatment based on your genetic profile and real-time health data. Once vetted and approved, a prescription arrives at the dashboard of your in-home medical 3D printer. With customized dosage, your 3D printer separates the drug’s active ingredients with micro-barriers and embeds a printed sensor to monitor variations in drug release and effectiveness. Feedback is instantaneously communicated through IoMT, and AI again improves its personalized medicine for future treatment. You might think that AI medical powerhouses and autonomous sensors leave human doctors out of luck. But many digital healthcare startups are in fact redefining and elevating the role of our doctors. Take Forward, for example. A digitized doctor’s office geared with AI-driven diagnostics and personalized medicine, Forward is finding a way to liberate its doctors from many of the tedious necessities that so often constrain their ability to engage with patients.  As medical AI enterprises like Microsoft’s Healthcare NExT and IBM Watson Health bring incredible power to diagnostics, drug discovery and genetic therapy development, doctors may be freed to take on consultative roles — educating patients, performing many more remote surgeries with the help of robotics, and aiding in preventive care. Final Thoughts Nowhere is convergence bringing greater breakthroughs than in healthcare. As transformative technologies like CRISPR-Cas9 unlock our genetic potential, quantum computing massively ups the speed of AI-powered drug discovery, 3D printing places the power of preventive medicine in the hands of consumers, and next-generation implants enhance our minds, we are truly living in an era when anything is possible. Join Me  (1) A360 Executive Mastermind: This is the sort of conversation I explore at my Executive Mastermind group called Abundance 360. The program is highly selective, for 360 abundance and exponentially minded CEOs (running $10M to $10B companies). If you’d like to be considered, apply here. Share this with your friends, especially if they are interested in any of the areas outlined above. (2) Abundance-Digital Online Community: I’ve also created a Digital/Online community of bold, abundance-minded entrepreneurs called Abundance-Digital.0 Abundance-Digital is my ‘onramp’ for exponential entrepreneurs – those who want to get involved and play at a higher level. Click here to learn more.