“DIGITAL LITERACY:
The Citizen and the Patient”
Strategic binoculars for a new landscape
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
“I know of no better repository for the knowledge and power of society
than with the people themselves; if we think them not enlightened
enough, we must inform their discretion.”
….the seeds of Jeffersonian democracy
Michael D. McDonald, Ph.D.
“The Public Health Communications Toolbox” 1995
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
“Nanotechnology, biosensors, body networks, and smart homes are
combining to give consumers the tools to take control of their health
and maintain their lifestyle.
This emerging network of technologies can also help create a web of
interpersonal relationships that reinforce healthy behaviors and
medical compliance.
The detailed, continuous and individual data from such a network is
synergistic with advances in both human genome and conventional
medical research, and offers the potential for creation of a data-rich,
personalized, and preventative medical science . ”
Alex Pentland and The Media Lab’s
Health Special Interest Group, Massachusetts Institute of Technology
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
Individual – BodyMedia, Smart Shirt, Money, RFID
tags, Ambient Technologies
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
images from
www.bodymedia.com
Community – Digital Dividends, Kurzweil & The
Brain, Smart Money’s Map of the Market, The Boston Marathon
Digital Dividends
Smart Money
Ray Kurzweil
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
How can we be wise in using all of this data?
…as citizens?
…as patients?
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
Introduction
The Relationship between Citizen and
Patient (and wellness-seeker)
Changing Definitions
Emerging Technologies & Trends
Bellwether Industries for health
finance, aviation, law
consortiums, graphic interfaces
The Far Horizon
our bodies, our communities, our planet
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
Introduction:

strategic binoculars for the new technology landscape:
a landscape with sensors, networks, and the semantic
web, an “aware and alive” environment of smart shirts,
homes, RFID tags, WiFi
where lots of conversation happens:
people & people, people & things, things & things
a new landscape in for opportunity and protection

As Paulo Friere felt, literacy is a dynamic changing interactive
experience. We are changed by our literacy.
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
How can we be wise in our overlapping roles
…as citizens?
…as patients?
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
The Relationship between Citizen and Patient
We are all citizens. And we are all patients.
 We all seek the health of our families, and hopefully of our
communities, our regions, nations, and our world.
 Roles overlap. Connectedness globally, SARS.
 Informed=Able
 Advocacy groups
 Responsibility - health and social problems
 Examples: e-government of Mexico, U.S. state of Wisconsin

May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
How can we be wise in our changing literacy?
…as citizens?
…as patients?
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
Changing Definitions:
1990’s:
Gilster and others focused on hardware & software and the ability
to critically manage and produce information; computer-based,
categories of competencies
2000’s:
+ cultural competency, responsibility in creation, digital society,
possibilities of non-linear and other kinds of thinking
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
Changing Definitions continued:
The larger Digital Society:
ITU (International Telecommunication Union)
“2003 World Telecommunication/ICT Indicators Meeting”
January 15-19, 2003, in Geneva, Switzerland
white paper on “8 C’s of the Information Society”
Connectivity, Content, Community, Commerce
Capacity, Culture, Cooperation, Capital
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
Changing Definitions continued:
The larger Digital Society:
21st Century Literacy Summit in Berlin, Germany (March, 2002)
Technology literacy
Information literacy
Media literacy
Global literacy
Literacy with responsibility
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
Changing Definitions continued:
What is not being said?
Digital literacy as the ability to use technology to enhance and
modify the individual’s genetically- and environmentallydetermined thinking patterns and brain physiology.
(functional MRIs, biosensors)
Digital literacy as the ability to protect oneself and one’s data.
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
What technologies and trends will affect us?
…as citizens?
…as patients?
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
Emerging Technologies and Trends

Patient needs -> the centerpiece of health care
(U.S. Institute of Medicine 2001 reports, “Informing
the Future” and “Crossing the Quality Chasm”)
May03 Launch of www.askme3.org
(3 ?s: What is my main problem? What do I need to do?
Why is it important to do this?)

E-Government Initiatives (Mexico, U.S, others) for
efficiency and responsiveness
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
Emerging Technologies and Trends continued

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Information Architecture, Semantic Web
Sensors, RFID chips, Bots (robots)
Agent technologies, Groupware
Affective and persuasive computing
Usability, Visualization tools
Simulations
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
Emerging Technologies and Trends continued
“…I think it is difficult for people to conceive of an environment which is, of itself,
intelligent and aware. We are quite used to the opposite: a "dumb" environment,
in which we are safe and secure, where it takes almost superhuman effort and
lots of money to get information in and out from wherever we might be. Who can
imagine the opposite: an environment in which getting information in and out is
almost omnipresent, and almost free? Even more shocking: one in which
cameras and sensors are also ubiquitous, and in which embedded Radio
Frequency IDs are, like their sensors, everywhere?…The space around you is no
longer a buffer, but is a conductor. For the first time in the history of the planet,
you will not be hidden by your environment, but connected by it.”
Mark Anderson, Strategic News Service 30 April 2003 (www.tapsns.com)
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
Emerging Technologies and Trends continued
1) The aging population –
great concern
increased burden of chronic disease
decreased tax base of shrinking workforce
strategies for “aging-in-place”
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
…a note about home-centered health
management…



The locus of health management will move back to the
home
“Ironically, it’s beginning to seem that this period of
apparently normal centralization [..to special facilities..]
was a temporary aberration. A century later, gains in
technology are moving care back to home settings.”
“…home-centered capability is expected to become a
catalyst for a huge health paradigm shift from ‘lastminute heroic intervention’ to ‘consumer-driven
individualized prediction, prevention, early detection,
and maintenance’.”
William Herman, Center for Devices and Radiological Health,
FDA (U.S. Food and Drug Administration)
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
Emerging Technologies and Trends continued
2) The Wireless Landscape and the Semantic Web
–
WiFi landscape is changing from “raisin muffin” to the “cooperative
cloud” as the environment becomes alive and aware, generating its
own data and interacting with other “things” as well as people.
The Semantic Web uses a multitude of technologies which make data
easy to use by computing devices; devices talk with each other, work
with software agents sent by you to find and analyze information, and
speeds information flow to whatever person or device needs it. Within
ten years. Defense into commerce.
.
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
Emerging Technologies and Trends continued:
3) The balance of access with privacy and liberty
As natural boundaries collapse for information and data, we will
need to discuss what artificial boundaries we want to set – for
other people, computing devices, and data.
Examples:
RFID tags need killer switches when we leave the store
Smart fabrics that dispense vitamins, antifungal agents, or
nutrients, need clear labeling

May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
Emerging Technologies and Trends continued:
3) The balance of access with privacy and liberty cont.
Examples continued:
Data mining of marketers and government will need
secure aggregation tools.
Programs such as HIPPA must protect both the flow of
data and the privacy of data.


May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
Emerging Technologies and Trends continued:
3) The balance of access with privacy and liberty cont.
Already problems from commerce and government:
Genetically modified foods in market with no labeling, in US.
Email spam -> national legislation.
Atlanta marketing firm is using functional MRIs to test.
In April, the state of Hawaii in the U.S. passed a resolution
protecting the individual liberties of its citizens and calling
for the repeal of certain provisions of the USA Patriot Act,
rushed through Congress in the aftermath of 9/11.
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
Emerging Technologies and Trends continued:
And, of course,
“The dominant language… and economic driver…of
this century… is going to be GENETICS….Those
who remain illiterate in this language won’t
understand the force making the single biggest
difference in their lives.”
Juan Enriquez, As the Future Catches You, 2001
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
What bellwether industries will be our strategic
binoculars?
…as citizens?
…as patients?
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
Bellwether industries for health –
strategic binoculars
Bellwether Industries for health –
strategic binoculars:
finance
aviation
law
and examples of consortiums, graphic interfaces
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
Bellwether Industries for health:
Characteristics:
 Greatest information imbalances among
stakeholders
 Similar characteristics for consumer decisions
 Use of new technologies in different ways and at
different rates of adoption
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
Example –
Decision Tools in Wealth
fidelity
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
“The whole thing reminds me of the
uncomfortable feeling I experienced when I first
sought out investment advice….I concluded that I
had to undertake the generalist’s job myself; I had
to take the high-level management of my
investments into my own hands. ”
Andy Grove, Co-Founder and Chair, Intel
Fortune, April 1996 “Taking on Prostate Ca”
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
Example –
Decision Tools in Health
nexcura.com’s
cancerfacts
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
Example –
Decision Tools in Aviation
Richard Rockefeller, MD
Health Commons
Institute
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
Example Decision Tools in Law
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May 2003
CRICSVI PueblaMX
35 years ago, the legal self-help movement
began with one book, How to Avoid Probate
Today, Nolo Press has 100+ titles, and over
$13M in sales
U of Pittsburgh: free 47 cyber law courses
AZ set up a self-service center in 1995 for
phone, web or in-person actions for domestic
protection orders on the same day w/out lawyer
The Web is driving comprehensive services ->
unbundled, tailored
Jean Wooldridge, MPH
www.st-cloud.com
“DIGITAL LITERACY:
The Citizen and the Patient”
Bellwether Industries for health –
strategic binoculars:
Consortiums and Graphic Interfaces
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
Example of Collaborations –
Intel’s Proactive Health
Research Program
“think big,
think long-term”
“ask the
customer early
and often”


Eric Dishman
and his team
Helping the elderly age gracefully at
home with
• sensor network, home network
• activity tracking, ambient display
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
Example of Collaborations –
Hybrid Vigor
Denise Caruso and team
“Virtual
watering
holes for a
global
network”
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
Example of Collaborations –
Medbiquitous



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40 professional
societies from 5
continents
5 journals
17,000 surgeons
50,000 unique
visitors/month
Shared database
and applications
A single portal for Cardiothoracic Surgery information
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
Example of Graphic Interfaces World Resources Institute
idea
capsules
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
World Resources Institute’s
Digital Dividends Clearinghouse
using Praja
technologies
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
Example of Graphic Interfaces –
Kurzweil and The Brain
dynamic
spider web
of relationships
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
Example
of Graphic
Interfaces
– Cancer
Information
Continuum
presentation
by St. Cloud
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
Example of Graphic Interfaces BodyMedia
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
Example of Graphic Interfaces Smart Money’s Map of the Market
real-time
dynamic
interface with
sophisticated
graphic
encoding of
information
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com
Digital Literacy –
The Far Horizon




May 2003
CRICSVI PueblaMX
Our Bodies
Our Communities
Our Planet
Symmetries, Transparencies and
Symbiotic Stewardships
Jean Wooldridge, MPH
www.st-cloud.com
Contact Information:
Jean A. Wooldridge, MPH
St. Cloud Communications
Bellevue, WA
Jean@st-cloud.com
Earth photos courtesy of NASA
May 2003
CRICSVI PueblaMX
Jean Wooldridge, MPH
www.st-cloud.com