BB&T National Editor and Staff Reports

The Internet has always had a large presence in healthcare for individuals looking for medical information and, of course, for companies to disseminate information concerning their technologies.

But these have simply been the preliminary steps. Today, the Internet and other e-technologies are driving a rapidly expanding range of uses in the healthcare arena for a variety of applications related to consumer needs, beyond the traditional healthcare information technology applications for clinical and business uses.

Some of the newest and most intriguing examples:

• Public health officials are looking to the Internet as a way of gaining early warning of flu outbreaks in the U.S.

Google (Mountain View, California) has launched a new site that it says will be useful for identifying areas of the country experiencing flu outbreaks, weeks in advance of other tracking systems, even faster, for instance, than the Centers for Disease Control and Prevention (Atlanta).

Google Flu Trends uses tracking technology pioneered by Google to analyze millions of searches by individuals who go on the web to find information about flu symptoms and treatments, with the assumption that they may be experiencing early symptoms. This, Google says, indicates where flu outbreaks are most likely to be occurring so as to plan a response and provide warnings.

The Google strategy assembles clusters of queries people make when they are worried about flu – such as "fly symptoms," "chest congestion" or "where to buy a thermometer" – thus serving as indicators of rising flu levels.

Google said it chose flu as the initial disease target for tracking because of how widespread and deadly it can be and offering a test case, or model, for potentially tracking other disease.

Google validated the technique by comparing its figures against statistics filed over the past five years by the CDC that has a network of doctors providing reports and found it could identify areas of outbreak up to two weeks faster than the CDC.

• Google also is one the several Internet organizations offering e-systems for the creation of personal health records (PHRs), the individual alternative to a national electronic health record (EHR) which has been slow to get off the ground.

That idea is catching on, according to a new survey from Morpace Health Care practice. The survey found that 27% of respondents say they are "extremely likely" or "somewhat likely" to create an online PHR to help track their medical history and medications.

The likelihood of subscribing to these new online services did not vary by respondents' age: Americans aged 55 and older said they were as likely to create an online PHR as younger Americans.

"This movement is being driven by the availability of new technology as well as by people's desire to take control of their own healthcare and have manageable access to their medical information," said Susan Semack, VP of the Morpace Health Care Practice.

Morpace Omnibus Study interviews were completed with 1,015 consumers selected from an Internet panel of adults age 18 and over.

• The New Leaf division of Angeion (St. Paul, Minnesota) has formed a partnership with iTMP Technology (Santa Barbara, California) to launch iNewLeaf, an application that transforms the Apple iPhone and iPod touch into a fitness-monitoring system based on personal metabolic test results.

New Leaf's Active Metabolic Training program and test is offered in select health clubs, personal training studios, medical fitness facilities, and performance training centers throughout North America and the UK. A 10- to 15-minute assessment determines a person's response to exercise through oxygen and carbon dioxide breath measurement.

This profile is used to assign personalized heart rate training zones and programmed exercises. The profile also enables the tracking of the fuel source – fats or carbs – the person's caloric burn rate. Those using the system can access their information and track workouts at New Leaf's online portal,

With the iPhone's Internet connection connected to, iNewLeaf downloads a user's customized exercise plans and training zones as well as other data. iNewLeaf tracks standard metrics such as heart rate and cycling speed, power and cadence and also provides actual calories and fat calories burned, TRUcal and FATcal. After a workout, iNewLeaf uploads the workout data to

• Complementing its own website to disseminate information concerning its regulatory procedures, the FDA is teaming with WebMD (New York) to inform consumers concerning notifications, news alerts and recalls. Andrew Von Eschenbach, FDA commissioner, said during a press conference that WebMD reaches 50 million people each month and that this reach makes it particularly useful for disseminating these kinds of information.

The partnership will offer a consumer health information resource on concerning the safety of FDA-regulated products and provide public health alerts to WebMD registered users and site visitors that request them.

The FDA's information will appear in clearly marked pages on the WebMD web site that are free of advertising. FDA information will also appear in WebMD the Magazine. And the FDA web site will link directly to WebMD content.

WebMD CEO Wayne Gattinella said, "We have witnessed a tremendous move to health and wellness that is playing a role in all aspects of consumers' lives ... This partnership between WebMD and the FDA is an important collaboration that further bridges that intersection of health, wellness, and prevention."

• In a project designed to improve blood supplies in developing countries, the College of Computing at the Georgia Institute of Technology (Georgia Tech; Atlanta), in partnership with the Centers for Disease Control and Prevention (CDC; also Atlanta), has developed a Web-based tool for tracking blood safety.

The tool, accessed via standard Web browser, tracks about 80 blood safety indicators continuously at the hospital and provincial levels. A pilot test in Zambia showed that the tool could improve the timeliness and accuracy of data collection efforts, allowing blood safety officials to better forecast or predict regional and seasonal blood usage patterns.

Using information about current conditions and future demands within the target countries, a team of computer science students built a Web-based system that resource-limited countries of any size could use to report data to national authorities. The system could also be used by a global organization, like CDC, to monitor multiple projects.

The Georgia Tech team developed the tool from a Microsoft Excel version created by CDC. The team field-tested the Web-based tool in Zambia in July-August 2008 to obtain feedback from blood safety program staff.

Santosh Vempala, distinguished professor in the College of Computing's School of Computer Science and faculty leader for the project, said, "The Zambian health officials immediately saw the benefits of real-time data collection and the ability to compare different regions' needs and see trends over time."

Ministries of health in Botswana, Cote d'Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda and Zambia were to begin using the new tracking system on Jan. 1. These countries are recipients of U.S. financial support through the President's Emergency Plan for AIDS Relief.

• President-elect Barack Obama is using a variety of high-tech tools to stay in touch with public and interest group opinion on helping to shape the changes in healthcare promised during the campaign. The groundwork for debating and shaping policy is mobilizing via postings on websites, Internet correspondence, video clips, blogs and email alerts. These in turn are being use to develop "healthcare house parties" around the country to brainstorm new ideas.

Tom Daschle, Obama's choice to head up the department of Health and Human Services (HHS), conducted a conference call with 1,000 supporters, selected from over 10,000 people who had expressed interest in health issues. Daschle has asked Americans to hold healthcare "house parties" over the Christmas/New Year holiday season to brainstorm ideas on how to overhaul the U.S. healthcare system.

During the campaign, the Obama team collected millions of e-mail addresses, creating a network through which they could elicit support, ideas and funds for the campaign. And Obama's transition team has posted two health videos on the website and is asking people to log in and give their ideas.

According to Daschle, more than 10,000 comments have come in via that route. People who want to host brainstorming parties to discuss healthcare are also invited to register on the site.

Partnership strikes at mercury-based devices

Health Care Without Harm (Washington) and the World Health Organization have launched a global partnership to substitute mercury-based medical devices with safer, accurate and affordable alternatives. The partnership was reported during the opening of the South Asian Conference on Alternatives to Mercury in Health Care, sponsored by the two organizations and the Indian NGO Toxics Link.

Alexander von Hildebrand, regional adviser for chemical safety for WHO's South East Asia Regional Office, said that the initiative "aims to replace no less than 70% of all mercury thermometers and blood pressure devices around the world with digital and aneroid alternatives within the decade. It is our goal to significantly reduce the threat posed by mercury spills to patient and worker health, as well as the global environment."

Several countries have already taken steps to mandate safer alternatives to mercury-based medical devices.

It is virtually impossible to find a mercury thermometer in the U.S. today, while the European Union and Taiwan have banned them outright.