What I Learned at My Second Code-a-thon

Today I went to the kickoff of my second ever code-a-thon. Like this one, my first took place in San Francisco almost exactly a year ago. My wonderful Health 2.0 colleagues host these events across the country throughout the year. They’ve traveled to Blacksburg, VA to tap the knowledge of the small town that Forbes ranked among the best for business. And they’ve visited the deep south, Lafayette, LA, to talk about and address childhood obesity, a regional and national issue.

For me though, as someone who took a year gap between health code-a-thons, today’s event has given me a little bit of insight as to what’s going on in the Bay Area right now, as well as to what’s changed or hasn’t changed, in the past year in the health tech space.

I attended as a spectator, or as an anthropologist who enjoys observing programmers in their natural habitat ― in this case, a loft in downtown San Francisco called the Mashery. The code-a-thon is themed around habits and how to break some and encourage others with technology. Developers weren’t the only group represented. As is typical, designers, health care professionals and business developers also came. This year, there seemed to be a healthy mix of all four. About 200 people had pre-registered, and the venue was packed.

Not everyone will stay in the race until demos at 4 p.m. Sunday, but the ratio of ideas to people indicated that there’s enough work for them all this weekend. Before attendees meet up and find their teammates, there’s usually a short session for idea pitching. However, today’s session wasn’t short. This was one of the first differences I noticed from last year.

Last year when it came time to pitch, the room was silent. There was only the sound of humming internal computer fans.

This year many seemed to know the format, and so they knew to brainstorm ahead of time. One person after the next went up to pitch. Their preparedness made the event seem a little more intense, maybe even a little more serious. The attendee body in general appeared older and wiser; not everyone was a grad student from a nearby university or a twenty-something entrepreneur.

Last year, the event’s organizers included a health care education segment in the agenda. Health 2.0′s Matthew Holt gave a United States health care system 101 lecture. This year that was skipped. Speakers instead included internist Jan Gurley, who treats indigent patients in San Francisco, and behavior analyst and Stanford lecturer Nir Eyal.

Last year was about creativity, outside of the box thinking, and imagining what could be possible. And interestingly, within the past year, those ideas turned out to pretty accurately predict what was possible.

At the 2011 San Francisco code-a-thon, the first-place team designed a remote monitoring app for patients recovering from a cardiac event. The team used a Microsoft Kinect to help patients perform rehabilitation exercises and to video conference with a doctor.

This year the West Health Institute began actual clinical research testing the same concept. The institute is studying how Kinect can be used in patients’ physical therapy routines.

Last year at the code-a-thon, another winning team designed an app that uses a virtual cat to remind patients to take their medications. This week, a company called GeriJoy launched out of the Blueprint Health accelerator. GeriJoy created virtual dog to provide seniors with the mental health benefits of pet therapy.

This year’s code-a-thon is just about half way through. So far it’s led to some productive conversations about the limits of today’s health technology. Gurley and Eyal touched on tech’s shortcomings in their highly intelligent, inspiring, and — in Gurley’s case — hard-hitting talks.

For one, patient-collected health data hasn’t proven that useful to doctors yet. It’s typically presented without context and in a way that doctors can’t work with.

“When it comes to behavior, if you can’t act on it, it’s not useful,” Gurley said.

Likewise, if an app or data that an app provides doesn’t help your doctor help you act, it’s not useful. Doctors in the audience agreed. “I don’t want body sensor data coming at me,” one physician said.

Gurley went on to talk about one health habit-related topic she said no one seems to be addressing right now ― substance abuse.

This is a particularly difficult topic, for obvious reasons, and also because to encourage change, she believes you need to put a positive spin on the situation. Gurley said behavior change methods that reinforce shame don’t work. For this reason, she’s learned to praise patients who only buy drugs using money from earned pay (as opposed to trading sex for drugs).

Eyal agreed that positive spins are more effective, and he explained that this is why behavior changing tech is so difficult to create. “It’s really hard to offer a ‘don’t do’ technology. It’s not for lack of trying,” he said. “I’m watching lots of companies that are trying.”