re:health – a Review

On day three of the re:publica 2015, stage 10 hosted a diverse program for re:health. Ranging from google infoboxes, mHealth, 3D printers in disaster areas to depression on the internet, the theme track attracted a broad audience throughout the day and was the cause of intense discussions, also on Twitter. 

The panel "Die Logik von Google und der Anspruch an gute Gesundheitsinformationen" (the logic of Google and the standard of good health-care information) was filled to capacity. At the beginning of the year, Google introduced a new feature: infoboxes. They are based on the Knowledge Graph which started in 2012, have been checked by medical health professionals and give information on 400 important medical indications. The infoboxes are situated at the top or at the side of the first search results. Timo Thranberend from the Bertelsmann Stiftung, Jens Redmer from Google and Klaus Koch from the Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG) discussed whether this feature will be introduced in Germany also and what it would mean for suppliers of health care information such as the IQWiG. Comparing the offers of information, Google did not come close to the detailed information provided by www.gesundheitsinformation.de. Despite all differences, the approach of discussing topics, such as quality criteria, will be continued.

[caption] Klaus Koch, Jens Redmer and Timo Thranberend – the panelists of "Die Logik von Google und der Anspruch an gute Gesundheitsinformation"; credit: Tobias Neisecke (CC BY SA-20). [/caption]

The panel of the International Telecommunication Union (ITU) discussed innovative solutions for low-income regions. According to Hani Eskandar, the ICT Applications Coordinator at the ITU, ‘business as usual’ is no longer an option in the global fight against chronic diseases. Mhealth, in particular, may be able to help manage illnesses such as diabetes and encourage a change of lifestyle. The simplest solution is, however, not always the cheapest. "In many areas, services based on text messaging are very expensive", reports James Odede, co-founder and director of the innovation space Lakehub in Kenya.

In industrial nations 3d printers are presently high in demand. However, their true advantage may soon be demonstrated increasingly in areas of crises. "Our most important insight was the fact that 3d printers can effectively print useful things for hospitals", says Andrew Lamb from Field Ready. In his talk, he demonstrated a few exciting examples - including a clip for an umbilical cord and a hand prosthesis - which helped a lot to improve the medical supply in Haiti last year.

The morning session on Thursday confronted speakers as well as listeners with the topic of "Depression on the Internet". Accounts from Tara Falsafi, Dominik Schott and Hagen Terschüren showed clearly that depression has many faces. Often, it is not so much the negative emotions that cause distress but the lack of feeling any emotion at all. It depends on the person and their online experiences whether a transparent approach to handling their illness and an exchange with depressed and non-depressed people over the internet helps or leads to further distress. The debate on social media made many aware of the fact that they ought to seek help. Whereas blogging can help, it cannot replace therapy. One reason for this is the negative reaction a depressed person may get from readers. This can lead to further distress.

Psychiatrist Jan Kalbitzer wanted to investigate the question that science could not answer so far: Does the internet cause mental illness? Among all technological achievements, digitalization is the innovation most likely to change our psyche in a profound way. For this reason, Kalbitzer, together with some of his colleagues, decided to establish a center for internet and mental health at the Charité, the Zentrum für Internet und Seelische Gesundheit (ZISG).

The consequences of the increase in digitalization were also the topic at Shari Langemak's session "The Dark Side of Healthcare Innovation". As a doctor and a journalist in the medical field, she posed five questions within her presentation which reflected upon the biggest ethnic challenges for medicine in the near future. She prompted listeners to think about controversial issues such as data privacy, genetic engineering and growing health costs

In his session, artist and design poet Marco van Beers contemplated what it means to be human in a technological world. More and more, man and technology are physically merging with one another. It wasn't Marco's intention to explain the future. Rather, he wished to stimulate a discussion and illustrate possible scenarios. Each individual ought to choose for him or herself what he or she really desires and what he or she does not.

[caption] Marco van Beers during his talk; credit: Andrea Kamphuis (CC BY-SA 2.0). [/caption]

In his session, pediatrician and E-learning specialist Kai Sostmann from the Charité outlined his future vision of a fictive couple who wanted a baby. They 'meet' on a genetic dating site and use smart condoms to avoid STDs. The designed baby is born with 3 terabyte genome data. An additional 2 gigabytes per year are transferred through the romper suit equipped with sensors and through the mother's smart bra.

Alexander Schachinger sees himself as a consultant explaining the digital world to the German mental health system. Since 2009, he has been carrying out surveys online on the topic of what patients, their friends and relatives, and the sick do on the internet ("Was machen Patienten, Angehörige und Kranke im Internet?"). In his talk, he speaks of two parallel worlds, the classic mental health system ("Let's make a leaflet") ("Wir machen mal eine Broschüre") and an E-patient who informs him or herself online and networks.

Nagina Javaid from the NHS in England and Anthony Zacharzewski from the organization Democratic Society introduced the project NHS citizen which should enable citizens to influence issues and methods of the NHS. After one and a half years of "active listening", the online design which was transparently worked on in public has only recently been finished. This in itself is a small revolution. For the participation to function permanently, however, a radical cultural change is necessary.

[caption] Nagina Javaid introduces the NHS Citizen project; credit: Andrea Kamphuis (CC BY-SA 2.0). [/caption]

Natalie Masche and Andrea Kamphuis introduced the social media campaign #screenonly with which the IQWiG aimed to hinder regression in data transparency in 2014. The European Medicines Agency wanted to handle third-party-access to study data submitted to them so restrictively that assessments would have become impossible. The campaign was successful but it remains unclear under which circumstances scientists may become activists and to what extent they may simplify facts.

In the last session of the day, Tobias Neisecke presented the practices and beneficial offers of commercial physician rating portals in an entertaining and interactive way. He demonstrated how it was possible to promote positive evaluations with premium accounts and exposed plastic surgeons as a target group for fee-based services of rating portals. 

photo credit top image: Tobias Neisecke (CC BY-SA 2.0)



Media Echo 

"Cologne at the re:publica 15 - Andrea Kamphuis and Natalie Masche: Simple tools make major difference!"
Kölner Stadtanzeiger (28.04.2015)

"I want you to know my suffering!"
Welt.de (07.05.2015)

"re:publica-talk tipps: How dangerous is self tracking?"
spiegel.de, 07.05.2015


"Doctor's visit via app"
Die Welt (17.05.2015)


"Stop printing toys when you can save lives with 3d printers!"
wired.de (05.2015)