The Value of Openness: The PatientsLikeMe Blog

Ever wonder what your fellow members were up to on their sponsored walks and runs in various states across the country? Last week, PatientsLikeMe launched a Flickr page for the PatientsLikeMeInMotion^TM program. Now you can see photos of members just like you in motion!   We are excited to share the experience of sponsored teams and three-star members with everyone.

Since its inception in 2009, PatientsLikeMeInMotion^TM has sponsored more than 115 teams across seven disease communities.  With over 2, 100 participants to date, the program has given many members the chance to demonstrate their PatientsLikeMe spirit as well as connect with others who have shared similar experiences.

It’s always great to see how PatientsLikeMe members are just as passionate offline as they are online.  Now, everyone can catch a glimpse our members in action from New York to Ohio to California!  The PatientsLikeMeInMotion^TM Flickr page currently hosts photos from walks in the ALS, MS, Parkinson’s, Transplants, Fibromyalgia and Mood communities…with more to come.  We are proud to feature events such as The National MS Society’s “Walk MS” series, ALS Association’s “Walk to Defeat ALS” series, Parkinson’s Unity Walk, and events run by the National Alliance on Mental Illness (just to name a few). Have photos you would like to submit? We would love to see them.  Email us.

Thank you to all the members who have contributed their time and photos to PatientsLikeMeInMotion^TM. You continue to inspire others.  And thanks to all the members of the PatientsLikeMe community for continuing to share.

Attending the National Kidney Foundation’s 2010 U.S. Transplant Games was an eye-opening experience.  And it wasn’t just the thousands of transplant recipients, living donors, and donor families who made the event so memorable.  It was the passionate commitment to transplantation by so many different individuals and organizations.

Dozens of nonprofits, donor and support groups, and pharmaceutical manufacturers descended upon Madison, WI to meet those touched by transplantation and celebrate their stories.  An incredible number and variety of resources were offered by these organizations to drive donor awareness, support the needs of transplant recipients, and facilitate connections with others (see the photo of Novartis’ “Wall of Inspiration”).  The simple act of pin trading between two people often caused them to open up about their transplantation experience and what brought them to the Games.

As the founding sponsor of the Games two decades ago, Novartis continued to serve as the event’s lead sponsor and pledged its continued support in the future.  Other noteworthy pharmaceutical sponsors of the Games included Pfizer, Bristol-Myers Squibb, Astellas, and Genentech.  Together with Novartis, these organizations have invested many years and many millions of dollars developing the immunosuppressants that transplant recipients need to maintain the health of their organs.

Novartis also demonstrated its commitment to organ recipients last year by partnering with PatientsLikeMe to develop the Transplants Community.  Novartis wants to learn from this Community - just as patients learn from one another - what challenges patients face and what unmet needs can be addressed.  By partnering with patient-centric organizations like Novartis, PatientsLikeMe fulfills its mission of improving patients’ lives by discovering important research insights through shared patient data.

PatientsLikeMe is headquartered just outside Boston, which is coincidentally the city where the first successful kidney transplantation occurred more than 50 years ago.  We are proud to extend Boston’s long-standing commitment to organ candidates and recipients.

www.flickr.com 2010 Transplant Games photoset

As you may know from reading Molly’s post last week, a few of us from the PatientsLikeMe staff recently attended the National Kidney Foundation’s 2010 U.S. Transplant Games in Madison, WI. In addition to supporting some of our current nonprofit and industry partners, PatientsLikeMe was an exhibitor at this year’s event. Our goal was to meet as many “Gamers” as possible to hear more about their journeys and to introduce our community where thousands of others are sharing their experiences. (Check out some of the more memorable moments in our photo gallery of the Games on our PatientsLikeMeInMotion^TM Flickr page).

If you were a “pin trader” at the Games (a tradition akin to the “trading” that happens at Disney World), you probably walked around with our PatientsLikeMe-branded pin bag hanging from your lanyard or clipped to your belt loop. We gave out thousands of these small blue bags! Or maybe you stopped by the booth to grab a mousepad for a friend, take some leaflets for your clinic or steal a piece of chocolate for an afternoon sugar boost. Regardless of the reason, it was our pleasure to be there and support you in whatever way we could. Below is a video we showed at the booth to help people learn more about our transplants community. (Thanks to our colleagues Aaron and Adam for pulling it together!)

In the middle of day two at the booth, one gentleman stopped by and said to me - “I had my transplant years ago. I don’t really need social support at this point, so, tell me, why would I join a community like this?” And he waited patiently for the answer.

What I love about working for our company is that we don’t pretend to be something we’re not. If PatientsLikeMe is not for you, then it’s not for you. If our site were just a forum or simply a social network, then maybe he’d find little value in joining, and I told him that. But, he listened as I explained why we’re not just a forum. Some recipients still have questions about what they’re experiencing on a daily basis (e.g., “is it normal to still feel fatigue a few years after my transplant?”) and want to find information from patients’ real-world experiences. Other members create profiles to chart their own health over time and share that with their doctors; they may even choose not to interact with other patients. Still, we see many members - just like this gentleman - who had an organ transplant years before and are on our site to share their health journey so that others can learn from it. It’s this generosity in “giving back” that struck us from the first day we opened the doors to our online Transplant Community, and it’s what made the Transplant Games such an overwhelmingly inspirational experience. In the end, it was this generosity that made him say - “Well, good answer. I can jump on that wagon.” All aboard.

Thank you to everyone for doing what you do - online and off - to help raise awareness of organ transplantation and help others learn from your experiences.

The spirit of Team Mid New England and the U.S. Transplant Games has infiltrated PatientsLikeMe!  We have just gotten back from an amazing trip to Madison, WI to watch Team Mid New England take to the athletic fields and to spread the word about our transplants community at PatientsLikeMe.

We had the opportunity to sponsor Team Mid New England at the Games. Their blue shirts were easy to spot in the crowds of more than 7,000 people.  They wore our logo on their backs and traded our pins to spread the word about PatientsLikeMe.   On Saturday, we were able to gather them all for this fantastic team photo.   (See all of our photos from the weekend here).

Their energy and excitement was contagious.  Check out this video of Team Mid New England marching into the Coliseum during Opening Ceremonies.

At the Transplant Games, transplant recipients, living donors, and donor families all come together to celebrate life and honor their loved ones.  They say they come for sport, but really they come to share their stories, to meet one another, and to be a part of something greater than themselves.  It’s not dissimilar at PatientsLikeMe where transplant patients can find patients like them, share their story, learn from one another, and contribute to research.

Listen to YellowIsJoy, a current transplant community member talk about her experiences at the Games and on PatientsLikeMe.  You can feel her energy and her appreciation after receiving 3 life saving kidney transplants.   She is making the most of her life and stresses the importance of choosing new adventures every day.

The athletes, donor families, and friends that comprise Team Mid New England were gracious, energetic, and wonderful cheerleaders for PatientsLikeMe.  Congratulations to the team for bringing home more than 20 medals!  Let’s make it 40 in 2012!

Earlier this year, the University of Arizona hosted a unique meeting for scientists, policy makers, and law experts to explore the legal, ethical, and policy implications of personalized medicine. The opening keynote was by Dr. Lee Hartwell, 2001 Nobel Prize recipient in Medicine / Physiology and Director of the Fred Hutchinson Cancer Research Center and he invited the audience to consider the role of patients in research. He stated that there was an “increasingly important role for patients in this process” and that scientists currently “rely on trial data, totally insufficient to the problem.”  Dr. Hartwell also stated that “when you talk to patients, they want to make a contribution. They would like their medical info made useful to other people. The only thing that keeps them from doing so is the threat of losing their life insurance or losing their job.” The views of pioneers such as Dr. Hartwell are important in medicine and it was energizing to hear such a well regarded figure espousing a philosophy with which we so strongly agree.

The lunchtime speaker was David Ewing Duncan, a journalist whose recent book “Experimental Man” detailed his journey to try and undergo every medical test available to science (including genetics, brain scans, and lab measures) in order to find out more about his health risks and how to live the best life possible. As the cost of genetic sequencing comes down to the mythical “$1,000 genome,” we may one day all take the same journey as Duncan to explore how much of our health outcomes are determined by data accessible to us right now. There will undoubtedly be ethical and moral conundrums along the way as genetic science moves from the specialist clinic to all of us as consumers, but ultimately understanding your own DNA is as much of a right as being able to look in the mirror.

Moving from genotype to phenotype, I gave a presentation in the afternoon about our work at PatientsLikeMe.  More specifically, I focused on how our platform allow patients with serious medical conditions to find out where they stand in the context of other patients like them, and how systems like ours might one day be able to help guide them to the most effective treatments to improve their outcomes.  Highlights from my presentation are now on our YouTube page.

A few weeks back, we were delighted to join the National Kidney Foundation of New England at their Transplant Games Team Meeting to give a demonstration of the PatientsLikeMe Transplants Community. Later this week, we’ll be joining Team Mid-New England as their official t-shirt sponsor as they “take the field” for the U.S. Transplants Games in Madison, Wisconsin.

As part of our demonstration, we focused a lot on the value of creating a patient profile. Everything you’d want to know about your transplantation journey is charted on the profile to make it easier to visually see what’s going on with you before, during and after your transplant.  Many of our patients print out their profile charts and share them with their doctors.  Beyond the individual learning, the power of the patient profile is that it is shared with the entire community.  The treatment and symptom information you enter gets rolled up into community reports so you can see if what you’re experiencing is similar to the experiences of others, and you can help others do the same.

At the end of the session, we had a lot of great questions.  Here are a few:

• Can you chart how exercise is helping you minimize symptoms after your transplant? Yes - check out the “exercise treatments” that patients are currently adding to their profile.
• Will PatientsLikeMe partner with smaller nonprofits (like the Kidney Transplant/Dialysis Association (KTDA) and Quarter Century Club? We’re always open to speaking with nonprofits to see how we can work together. Send an email to partners@patientslikeme.com if you think a nonprofit you are involved in would like to partner with PatientsLikeMe.
• Can you only contact other patients publicly through the forum? No. The forum is a great gathering place for many of our patients, but you can also develop relationships one-on-one by sending private messages or leaving comments on other profiles.
• Do you have leaflets I can distribute at my dialysis center? Absolutely. If you’re interested in spreading the word in your support groups, you can download some materials on our Tell The World page. If you’d like to receive some more official leaflets to distribute at your Dialysis Center, send us an email with your request at goodies@patientslikeme.com.

We are excited to attend this year’s U.S. Transplant Games.  This will be our first time at the Games, so we are grateful to have our Team Mid New England pros guiding the way.  If you’re coming to the Games, please stop by our booth at the Expo to say hello and pick up some goodies.  And, if you see our logo on the back of a Team Mid New Englander, be sure to ask them for a limited edition PatientsLikeMe Pin.   See you at the Games!

Our research team here at PatientsLikeMe carries out world-class research in collaboration with academic centers, commercial partners (see “how we make money“), and to help answer questions from our patients. We share our findings with the world through this blog, peer-reviewed publications, and by attending academic conferences like the Consortium of Multiple Sclerosis Centers (CMSC) annual conference. This meeting, now in its 24th year, is for neurologists, nurses, researchers, and other healthcare professionals involved in MS to share their knowledge, network, and form new research collaborations.

In collaboration with our partners at Novartis, our MS community recently participated in a research study exploring the reasons why people don’t always take their disease-modifying therapies as prescribed. Adherence to medication is a big issue in chronic conditions; although we all mean to take our meds as prescribed by physicians, good intentions can fall by the wayside when real life interferes with our plans! Decreased adherence could lead to less medication efficacy, more relapses, and a higher burden of disability for MS patients.

By exploring the messages posted in our vibrant MS forum, and carrying out a review of the scientific literature, we constructed a new questionnaire called the “MS Treatment Evaluation Questionnaire” (MS-TEQ) that sought to explore and quantify the barriers that get in the way of people taking their DMTs as prescribed. As part of the validation process we also showed the questionnaire to some local MS patients to ensure it was easy to understand. In December of 2009, we sent out an invitation to 1,209 carefully selected patients and asked them to complete the MS-TEQ. Within just two weeks, we had complete responses back from 442 patients, a 37% overall response rate.

The MS-TEQ addresses three areas: 1) MS-TEQ Barriers: the barriers faced by patients that stop them from taking their meds as prescribed (e.g., forgetting), 2) MS-TEQ SEs:  the side effects they experience (e.g., injection site reactions), and 3) MS-TEQ Cope: coping strategies they use to try and cope with these side effects (e.g., using an ice cube to reduce pain and itching). Our analysis found that for every 10 points on the MS-TEQ Barriers scale, patients did not take 10% of their medication as prescribed. However, we also found cause for hope; every coping mechanism they used to try and ameliorate their DMT side effects had a positive effect of 4% on the proportion of their DMTs that they took as prescribed.

At the conference’s poster session, we got a lot of interest from attendees and gave away all of our handouts and copies of the questionnaire, so you might be seeing the MS-TEQ in a clinic near you any day now! Our hope is that the questionnaire will help patients and their healthcare providers to understand why someone is struggling to take their medication as prescribed, and to give them a way of measuring this over time. We are currently preparing a manuscript to submit to a peer-reviewed journal to share our findings with the rest of the academic community.

Do you have trouble taking your MS disease-modifying therapies as prescribed? Check out our treatment database. Thousands of our members have written evaluations of the drugs used in MS, including advice and tips on how to stay adherent to your medication to improve your outcomes.

Last week the PatientsLikeMe R&D team published a study entitled “Sharing Health Data for Better Outcomes on PatientsLikeMe” in the Journal of Medical Internet Research (JMIR), the leading open access peer-reviewed journal on health care in the Internet age. The study aimed to find out direct from our users how they were using the site and whether the information they’d learned was helping to influence their interactions with healthcare providers, their decision-making, and ultimately their outcomes. Because JMIR is an open-access journal, you can download the whole paper for free here, but here are some of the highlights from the 1,323 patients that completed the survey:

• Almost all of our patients (94%, N=1,249) were diagnosed when they joined the site; an important factor in joining a community of “patients like me”
• The majority of members (72%, N=952) agreed that the site was helpful for learning about a symptom they have experienced (check out our symptom reports to see what they’re learning!)
• Many respondents (57%, N=757) agreed that the site had helped them to understand side effects of their treatments (check out our treatment reports to find out more!) and 42% (N=559) found the site helpful in finding another patient with experience of taking a specific treatment for their condition
• Patients who used the site more perceived more benefits. We gave each patient an “engagement score” from 0-4 based on how many features of the site they’d used; we found that the higher the participation, the higher the benefit. Correlation doesn’t necessarily mean causation though, so it could be patients who share more get more out of it, or it could be that patients who have already benefited from the site are more willing to participate. Interesting hypothesis for a follow-up perhaps?
• Nearly a third of patients (29%, N=388) had printed out their profiles and shared them with their doctor; two thirds of users (66%, N=871) said their healthcare team were supportive of them using the site. More controversially, we were interested to find that overall, 12% (N=151) said they had changed their physician as a direct result of information received from PatientsLikeMe; that number was twice as high in fibromyalgia (21%)!
• In the spirit of openness we also made available (in de-identified form) all of the open comments we received at the end of the survey on how we could improve the site, both positive and negative.

This was the first study to quantify the potential benefits that users of the site can experience; we hope to discover more about how these change over time and what benefits are perceived by users of our newer communities such as epilepsy and organ transplants.

Last Fall, PatientsLikeMe introduced our Quality of Life (QoL) tool which is displayed on the profiles of members in the HIV community.  By answering a few questions, patients can see how HIV is impacting them - physically, socially and mentally.  Today, this same QoL measure is used by thousands of patients across the HIV community and other communities, such as Epilepsy and Organ Transplants.

PatientsLikeMe Research Scientist, Michael Massagli, recently spoke with us in a PatientsLikeMeOnCall^TM podcast interview about the goal, outcomes and benefits to measuring your quality of life. Listen here:

“[In the HIV community], we’ve taken a look at the relationship between QoL and CD4 level and find the average score of patients with CD4 below 200 is significantly lower for physical, mental and social well-being.  People with the most comprised immune systems have worse quality of life, across all 3 domains, than other patients… “

To date, several of our members have at least three QoL scores on their profile.  Mike says, “Multiple uses of the QoL instrument by the same person over time helps researchers determine how small a change in QoL scores is meaningful to patients or important enough to evaluate how a treatment is working.”

Adds R&D Director, Paul Wicks, “We all know that measuring disease is important; tumor size in cancer, blood tests in cardiovascular disease, or frequency of seizures in epilepsy, for instance. Increasingly though, clinicians and researchers are coming to realize that these measures don’t give the whole story; they’re missing the real impact of a condition on patient’s ability to function. You might have high blood pressure but it doesn’t affect your life at all, or you might have a relatively low amount of pain (as measured by, say a 0-10 pain scale), but it could be interfering with your work life a great deal.”

So have you completed a quality of life survey recently?  If so, you’ll also notice a cool new feature on the site that helps you better understand how your quality of life compares to others.  When you take 5 minutes to answer the 24 questions in the survey, here’s what you’ll see:

As Mike says in his podcast, this is just the beginning.  Stay tuned for more about quality of life measurements.

Since the launch of the PatientsLikeMe Transplants Community in March, more than 1400 patients have come together to share and learn from their transplant journeys. Thanks to our partnership with the National Kidney Foundation serving New England, BionicMan was one of the first transplant recipients to sign up and played a critical role in helping us shape the community before it was launched.  Recently, we interviewed BionicMan to learn more about his transplant journey, his experience with PatientsLikeMe, and his participation in the U.S. Transplant Games.

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	(PatientsLikeMe) You’ve been a member of PatientsLikeMe since we started testing the transplants community months ago. How did you find out about PatientsLikeMe?
	(BionicMan) I found out about PatientsLikeMe from National Kidney Foundation serving New England.  I think it has benefited me because I like to talk to people and give them the benefit of my experiences.
	(PatientsLikeMe) With both a heart and a kidney transplant, how has your life changed over the years?
	(BionicMan) As both a heart transplant (1992) and kidney transplant (2007), my life has changed in so many ways.  I try to live life to the fullest each day, and appreciate every moment I have with my family. Over the years I have had a few setbacks, like CML and colon cancer and the amputation of my left leg just below the knee, but I have been able to overcome all these things and inspire many people.  I wouldn’t change anything, and I will never ever give up.
	(PatientsLikeMe) What is one thing you think patients waiting for an organ transplant should know?
	(BionicMan) People heading into a transplant should know they are making a lifelong commitment to their health, and they must take care of the Gift of Life they are about to receive.  Just like everyone else, not everyday will be great, but it sure beats the alternative.
	(PatientsLikeMe) You’ve attended the U.S. Transplant Games before.  What was that experience like and would you recommend other patients attend?
	(BionicMan)I would definitely recommend going to the U.S. Transplant Games for every transplant recipient.  It is like being in a city of transplant recipients. Whether you are real athletic or not, you will enjoy the experience, meet people you will be inspired by and remember your whole life. No matter what is going on in your life, you will see people with more problems than you, yet they have overcome.  You will definitely cry at your first Opening Ceremonies, but your life will be changed forever.  You will also get to see the real heroes in Organ Donation - Donors and their families. One of my proudest moments was during the 5K road race at the Games. I was doing the race in a regular transport wheelchair after losing my leg and before getting my prosthetic, and while rolling past a photographer, he said to me  - “From Stump to Hero!”
	(PatientsLikeMe) Great quote!  Thanks for sharing with us and the community, BionicMan.

Four years ago this Spring, PatientsLikeMe launched the ALS community with very specific goals in mind - to help patients like you take control of your disease, share and learn from one another, have a voice in real-world research and inform the companies that make your drugs and can improve your care.  Together, we have come so far as a community in making those goals, those dreams happen.  Today, to close out ALS Awareness Month, we want to honor that journey by highlighting some of the milestones you as a community have achieved.

As many of you know, the journey started when PatientsLikeMe was inspired by Stephen Heywood, a young man diagnosed with ALS when he was only 29 years old. His brothers Jamie and Ben, and long-time friend Jeff Cole, built PatientsLikeMe and its flagship ALS community to help Stephen and other patients like him. After four years since launching the ALS community, more than 4,500 of you - our PALS - are still sharing your data and experiences to help others. Along the way, we’ve lost some of our friends, including Stephen, but their contributions live on in the data they’ve shared with us to help further the understanding of this disease.  Jamie recently said it this way: “the desire is that this disease should no longer kill, but we do our best to help people live with it today.”

Thank you for living with it today and sharing those experiences with your fellow PALS, industry, researchers…all of us.  You are truly making a difference.

• Spring 2006: The ALS community launches!
• February 2007: PatientsLikeMe wins its first scientific award for a poster describing our work in ALS at the British Neuropsychiatry Association AGM in London, England.
• July 2007: Your contributions lead to PatientsLikeMe’s first scientific discovery. PatientsLikeMe publishes a paper in Acta Psychiatica Scandinavica showing that some PALS experience uncontrollable bouts of excessive yawning; an unusual symptom twice as common in the bulbar-onset form of the disease compared to those with a limb-onset.
• December 2007: Your sharing of real-world experiences helps PatientsLikeMe make a big splash at the International ALS/MND Symposium in Toronto, Canada. The team gives its first platform presentation to show off the website, and your health data, to ALS researchers, scientists, and clinicians.
• February 2008: An Italian study finds that the drug lithium carbonate slows the progression of ALS. Many of our PALS begin taking the drug, and so with your help, PatientsLikeMe embarks on our own observational study of the drug by launching a novel tool on the site.
• May 2008: Your voice in research is heard loud and clear.  PatientsLikeMe publishes its first survey in the European Journal of Neurology, showing that while 90% of PALS were warned about physical symptoms of their condition, only 10% were warned about possible psychological consequences, and two-thirds wanted to be told.
• November 2008: PatientsLikeMe’s Paul Wicks and Jamie Heywood once again attend the International ALS/MND Symposium to give an overview of the history of ALS online, and present our very first findings from the lithium study. Even though we were only presenting preliminary data, there was a lot of buzz about this new and interesting approach to conducting research - with you, the patient, in the driver’s seat. We also gave a few sneak-peeks at upcoming features for the site.
• December 2008: PatientsLikeMe and some of our fellow PALS are spotlighted in  two major media stories (CBS Evening News with Katie Couric and BusinessWeek) helping to raise awareness about ALS.
• April 2009: Following the discovery of another gene for ALS in February, PatientsLikeMe adds the ability for patients to enter and use their own genetic test results to find other patients like them with our genetic search feature.
• May 2009: In response to a request from one of our patients, Cathy Wolf, the PatientsLikeMe research team carried out a study to extend the scale, something we call the ALSFRS-EX (Extension), which helps capture functional changes in patients with advanced ALS.
• August 2009: Thanks to you, PatientsLikeMe now has the largest dataset of patients with Primary Lateral Sclerosis (PLS) and Progressive Muscular Atrophy (PMA) online than ever recorded before. We shared this data back to the community through an upgrade to our ALS charts.
• October 2009: The ALS community and all that you’ve shared is the focal point of Co-founder Jamie Heywood’s powerful talk at TEDMED, called “The Big Idea my Brother Inspired.”  In the presentation, he describes the creation of the site, preliminary results of the lithium experiment and shows some of our most advanced tools still in development.
• December 2009: The power of sharing your health data is highlighted in the PatientsLikeMe presentation at the 20th International ALS/MND Symposium in Berlin where the PatientsLikeMe research team unveiled our next round of analyses on the lithium study.  The team also presents preliminary results of our genetics tool, and a commercial project exploring emotional lability in ALS, undertaken with our partners Avanir Pharmaecuticals  (see “how we make money“).
• January 2010: PatientsLikeMe rolls out new profile charts in the ALS community to help you, the patient, understand your own profile better and tell your story more effectively.
• April 2010: PALS continue to team up to raise awareness and money for ALS research online and off.  This video highlights your participation in the PatientsLikeMeinMotion(TM) program.
• May 2010: This month we see the release of a study carried out in collaboration with our partners at the NEALS Consortium investigating some of the barriers to research participation that some of you may experience.  Additionally, all your contributions to the lithium study have been collected and analyzed by now, and the PatientsLikeMe research team submits it for peer-review publication to a leading journal.  Thanks to you and your peers, this final paper highlights the potential of new ways of collecting and analyzing data in ALS to advance clinical trials and find faster cures.
• May 2011: Just imagine…

The following message was sent this morning to all members of PatientsLikeMe.  Please read what we have to say about openness, sharing and its privacy implications and join the conversation.

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Dear PatientsLikeMe Members,

What are the privacy implications of sharing in this open, online community?  We talk a lot about this and, as a company, strive to be transparent about the risks and rewards to sharing here.  Two recent events have prompted me to reach out to all the members of PatientsLikeMe to ensure we all understand openness, sharing and its privacy implications.

The first event happened last month when a patient asked us to remove all the data on his/her profile from the system.  The member wrote:

“The reason I’m leaving is I feel I didn’t fully understand the privacy impact of having all my health information for practically anyone in the world to see.”

We rarely receive a request like this, but since receiving this one, I have thought about it every day.   We do not want anyone to be surprised by the impact of sharing data on PatientsLikeMe.  We believe in openness, but we also want people to knowingly make the choice to be open with their health information.

This brings me to the second event.  Recently, we suspended a user who registered as a patient in the Mood community.  This user was not a patient, but rather a computer program that scrapes (i.e. reads and stores) forum information.  Our system, which alerts us when an account has looked at too many posts or too many patient profiles within a specified time interval, detected the user.  We have verified the account was linked to a major media monitoring company, and we have since sent a cease and desist letter to its executives.

While this was not a security breach, it was a clear violation of our User Agreement (which expressly forbids this type of activity) and, more significantly, a violation of the community’s trust.  Your Account Information (e.g. your names and emails) was NOT in danger of being stolen.  It is likely that the forum information that was “scraped” would be sold as part of that company’s Internet monitoring product.  In fact, we sell a similar service, PatientsLikeMeListen^TM, to our clients so they better understand the voice of the patient.

What does this all mean to you?  What can you do?

1. We recognize that people write very personal things in the forum and often use real names.  In any growing network of tens of thousands of members, there is no way to ensure that information you share in the forum or on your profiles will not be read by others.  Know that the information you enter in our system is shared (unless we tell you it is private, like full name and email in your Account Information).  It can and will be read by other patients, the PatientsLikeMe team, researchers, and others that use PatientsLikeMe, including our partners with whom we share de-identified data.
2. Please weigh the benefits of sharing and the amazing value you all create in helping each other versus the risks of people, unknown to you, reading your posts.  Your input helps PatientsLikeMe and our partners learn about your disease and make better products to meet your needs.
3. Learn and understand why we value openness.  If you haven’t, please read the Read This! FAQ.  If you want to know how we make money, you can take a look at this FAQ or go to our Partners Page and know that we sell your data and insights (but not your identity) to our customers.
4. Consider the value of being part of the PatientsLikeMe community and make the right risk decisions for yourself.  Together, we can really change the way diseases are treated and managed by putting you, the patients, in the center of healthcare.  We can hold companies accountable for the strengths and weaknesses of their products and also help make those products better - but that requires openness and that is your choice.

We welcome your comments and questions and we love feedback. This has been posted on our blog, which is a good place to dialogue, as is the forum.

On behalf of the entire PatientsLikeMe team, I want to thank you for being part of our communities and sharing your experiences.

Sincerely,
Ben Heywood
President and Co-founder, PatientsLikeMe

Did you know there are more than 4,500 patients in the PatientsLikeMe ALS community sharing and learning from each other every day?  Outside of our community, patients are also teaming up to raise awareness and money for ALS research. Here is a highlights video of ALS members who have participated in our PatientsLikeMeInMotion^TM program, stepping up to give back to the community.

We are proud to announce a new partnership between PatientsLikeMe and the National Kidney Foundation serving New England.  In the beginning stages of developing the PatientsLikeMe Transplant Community, we worked together with the National Kidney Foundation serving New England to give interested patients an opportunity to share their transplant journey and help shape this new community.  During this beta phase of the community development, kidney recipients alongside lung, heart and liver transplant recipients,  became incredibly engaged and were excited to share their experiences.  Thanks to all those patients who stepped up from the start, as well as those who have since joined our site!  With more than 1,300 members (to date), the Transplants Community is creating new knowledge about patients’ real-world transplantation journeys.  A special thanks also goes out to the National Kidney Foundation serving New England for partnering with us early on to spread the word.

Through this exciting partnership, we will continue to work with the National Kidney Foundation serving New England to find ways for everyone to “give back.”  PatientsLikeMe will be giving back through its PatientsLikeMeInMotion^TM program designed to support members participating in offline fundraiser events.  Similarly, we will be joining forces (as an official t-shirt sponsor) with the “Team Mid New England” at the 2010 U.S. Transplant Games to help raise awareness of organ transplantation.  Stay tuned for more details to come.

To kick off the partnership, Molly Cotter (who manages nonprofit development at PatientsLikeMe) sat down with Andrea Savisky, President of the National Kidney Foundation serving New England, to ask a few more questions about their organization, their upcoming events and our partnership.

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	(Molly) What is the mission/goal of the National Kidney Foundation?
	(Andrea) The National Kidney Foundation, Inc. (NKF) is a voluntary health agency dedicated to preventing kidney diseases, improving the health and well-being of individuals and families affected by these diseases, and increasing the availability of all organs for transplantation. 2010 marks the Foundation’s 60th anniversary, and it’s 20th year as organizer of the U.S. Transplant Games.
	(Molly) PatientsLikeMe is proud to be official t‑shirt sponsor for “Team Mid New England” at the 2010 U.S. Transplant Games in Madison, Wisconsin.  How and why do patients get involved? Can any organ transplant patients get involved?
	(Andrea) The National Kidney Foundation U.S. Transplant Games® is a national, Olympic-style competition presented every two years. More than just a sporting event, the Games unite thousands of people from across the country, who have been touched by organ donation and transplantation, and offer social and support programs for recipients, donor families and living donors.  As the single largest event promoting organ, eye and tissue donation, the Games serve to foster the health and fitness of its participants, while showcasing the success of transplantation, highlighting the vital need for more organ and tissue donors, and honoring donors and donor families. To receive information on Team Mid New England, email me.Competitive events are open to ALL recipients of life-supporting transplants, as well as to living donors, who are eligible to compete in selected events in their own division.
	(Molly) Your 2010 Boston Kidney walk is this upcoming weekend (May 16, 2010).  What is that event all about and how has National Kidney Foundation used those funds raised to help patients?
	(Andrea) The National Kidney Foundation’s Kidney Walk is a non-competitive walk focusing on education and prevention of kidney and urinary tract diseases, and awareness of the need for organ donation. The Kidney Walk presents an occasion for dialysis patients, organ transplant recipients, donor families, living donors, the medical and business communities, and the general public to celebrate life and create lasting community advocacy and long-term support for the Foundation’s mission.While raising funds for the National Kidney Foundation’s programs and services, the Kidney Walk provides an opportunity for family, friends and colleagues to participate in an inspiring, community-based event.  To register for the Boston Walk, create a team or to make an online donation and support the mission of the NKF visit our website. (Note:  If you’re a member of PatientsLikeMe participating in this year’s event, check out how to be sponsored through the PatientsLikeMeInMotionTM program)
	(Molly) Some of your U.S. Transplant Games team members were the first to join our Transplants Community (launched in March 2010).   Why were you so willing to work with us to spread the word about this new community?
	(Andrea) Transplantation can allow people to live healthy and happy lives. While it is true that some important problems are behind clients once they are transplanted, many new challenges will arise. To stay healthy, one has to adapt and pay attention to the various changes to their health, while planning for and responding to them accordingly.Although the NKF’s “People Like Us” movement brings together transplant recipients, living donors, potential donors, people with chronic kidney disease, donor families and caregivers to be empowered, educated and encouraged to be their own best advocate, we felt that PatientsLikeMe aligned with our vision and empowered patients to take an active role in their health and helping others who are traveling along the same path.
	Thanks Andrea.  We’re looking forward to working with the National Kidney Foundation serving New England to help patients share their experiences with their transplant journeys and have a voice in advancing research.