1-8-10 Community E-Newsletter/Call
Hello and Happy New Year—We’re looking to kick off “Twenty Ten” with a 30 minute OurMed Community call to catch you up and get you involved in this project promising a significant non-profit and unbiased contribution to medicine and consumer knowledge on health. Please join us at 2pm Eastern time.
Agenda / Talking Points:
A: Volunteer Recruitment Update
B: Technology Update
C: Holiday Fundraising Campaign Results
D: Accounts with OurMed - Who wants one? They're free -- forever.
E: Posting on OurMed.Org
F: New Articles on OurMed - What to write about?
G: 10 Trends in Health Care Journalism Going into 2010
H: HealthGrades.Com: A For-Profit Rating Site
I: Studies Show Cardiovascular Devices Often Earn FDA Approval Without High-Quality Clinical Data
J: OurMed Pioneer Bios
Time: Friday (Today) : 2 - 2:30pm EST
Call in Number : 712-775-7000
Passcode : 634011#
If you would like to opt out of these emails, please let me know. Thank you for your continued interest in the OurMed initiative--we couldn't make this happen without your participation and are grateful for you pitching in!
Greg Miller, ED at OurMed.Org
OurMed YouTube Video: http://www.youtube.com/watch?v=zqgYfFxEkLk
A: Volunteer Recruitment Update:
Thanks to Vanessa Moore, we’ve had some professional help in posting and recruiting OurMed content, tech and fundraising volunteers. The Founding Framer Program is the center of the incentive strategy. This program enables volunteers who are inspired by our mission to produce free and non-biased medical information to be OurMed Pioneers -- Individuals contributing more than 100 hours will be honored as the Founding Framers of a global health reform community on a webpage to appreciate their hard work and service to Healthcare. An OurMed Founding Framer Certificate of Appreciation will be awarded upon successful completion of 100 hours of service to the OurMed cause.
B: Technology Update:
Over the holidays, our tech team of Vincent Navarro, Florence Devouard, Dr. Stephen Press and Stan Kachnowski have been cleaning house on the site’s many articles and spam. Special thanks to Dr. Press for his efforts has a new “Sysop” to battle the spambots that are using clinical sounding titles but filling them with garbage. According to Vincent, the site is now “squeaky clean”. Vincent also has been doing the final run-through of the OurMed contract with our selected website vendor, Blueliner. We will be scheduling a design meeting in January to start the process to build the new website!
C: Holiday Fundraising Campaign Results:
OurMed’s first annual fundraiser is still on with four donors racking up $245. You can donate and add your name to the list here:
It took Wikipedia several years to get significant donor contributions and here’s a report after 9 nine years on this past holiday campaign:
Wikipedia’s annual fundraiser ended on January 5th 2010, having raised just over $8 million. For the fiscal year to date, the total (through January 5) was almost $9.5 million. According to the Wikimedia Foundation's press release, in 2009 there were over 230,000 donations, and the average gift was $33. The fundraiser ended 10 days before the original projected end. Thank-you banners have run on the projects for a few days, linking to a letter from Jimmy Wales.
This was the largest fundraiser in Wikimedia's history, surpassing last year's fundraiser both in money raised ($2 million more this year) and number of donors (125,000 donations were received during 2008 and 2009). Statistics comparing the last three fundraisers can be found here.
Source: The Wikipedia Signpost (http://en.wikipedia.org/wiki/Wikipedia:Wikipedia_Signpost/2010-01-04/News_and_notes)
D: Accounts with OurMed – Who wants one? They’re free – forever.
OurMed's accounts are free, easy to get and really make you apart of the community. Be one of the early pioneers to own one.
Click here to get started now: http://ourmed.org/index.php?title=Special:Userlogin&type=signup&returnto=Main_Page
Once you have one, you can share your background with the community by filling out the User page.
E: Posting on OurMed.Org:
Now that you have an account--Use it to nudge the OurMed movement forward! You can write about nearly anything, just keep your comments about new ideas, health and medicine.--It's really important that OurMed gets off the ground using a communities collaborative approach to building it, just as Wikipedia did nine years ago.
Please click on this link to make a small post about whatever's on your mind. You can suggest articles, design or features that you'd like to see on the site. http://ourmed.org/index.php/New_Ideas_for_Site
Most Active Authors in the past month are:
F: New Articles on OurMed – What to write about?
Changes or additions can be made easily with our WYSYWIG editor (what you see is what you get), making it much easier than Wikipedia and cutting the volume ramp up rate to the new site significantly faster.
At times posting new material my be difficult to give attributions for so it may be easier to publish previously published work
Alternatively, you can choose content from one of the many free content ("copy left") sites such as much of the content on:
1) NIH's National Library of Medicine and PubMed
4) GanFyd: (original medical wiki site that says Medpedia copied them and boasts 2000 site visitors per day)
To post a new article, simply goto: www.ourmed.org/index.php/ARTICLENAME
G: 10 Trends in Health Care Journalism Going into 2010
By: Gary Schwitzer | January 01, 2010
1. This year we were treated to some terrific series and special projects, such as:
• The New York Times "Evidence Gap" series - exploring medical treatments used despite scant proof they work and examining steps toward medicine based on evidence.
• The Milwaukee Journal-Sentinel "Side Effects" project - An occasional series examining doctors, drug companies and conflicts of interest. The latest entry is here but there are links to the entire series in the left column on that page.
2. Some blogs have become powerhouse pockets of high quality health care news and information. Just two examples out of many are The Carlat Psychiatry Blog and GoozNews.com. And it's great to see Pharmalot.com back in business. Some major news organization's blog efforts are noteworthy, such as the Wall Street Journal health blog. If you're looking for consistently high quality coverage of medical research, MedPageToday.com is a good place to bookmark.
3. Network television health news was consistently so flawed that we stopped doing our rigorous reviews of their efforts since after 3.5 years and 220 stories we had seen and commented on plenty. See our posted explanation. We're not ignoring TV news. We continue to use this blog to comment on what we see. But we're not going to apply the rigorous process of transcribing the newscast, then asking three different reviewers to apply 10 criteria to the stories. We've moved on to reviewing other news organizations' efforts, where perhaps our efforts may have more of an impact.
4. We continue to find many news stories that give an incomplete, imbalanced view of many screening tests. News coverage of the US Preventive Services Task Force's new recommendations for mammography screening in November was the most problematic I've seen in my entire career.
5. Related to #4 above, we continue to see many news stories that are governed more by emotions and anecdotes than by evidence. Such stories do not train news consumers to be good evaluators of evidence, either.
6. The cutbacks, layoffs and buyouts in newsrooms have clearly done damage to the quality of health journalism in many sectors. We know how difficult are the circumstances for many of those left behind trying to cover these complex issues. See my report on the state of U.S. health journalism published by the Kaiser Family Foundation.
7. In December alone we commented on at least a half dozen stories that were clearly pulled directly from a news release with no sign that any independent vetting or independent journalism took place. We don't know if this is a sign of the economic times, but we find it appalling.
8. An updated look at the first 900 stories reviewed on HealthNewsReview.org shows that:
• 71% fail to adequately discuss costs.
• 71% fail to explain how big (or small) is the potential benefit.
• 66% fail to explain how big (or small) is the potential harm.
• 66% fail to evaluate the quality of the evidence
• 60% fail to compare the new idea with existing options
9. You don't need to work in Washington to cover health policy and healthcare reform. These stories -- on new treatments, tests, products and procedures -- one at a time and when piled on top of each other -- start to give a picture of why the U.S. spends a far greater percentage of its GDP on healthcare than any other country but without the outcomes to show for it. And journalism often doesn't make the picture any clearer -- often failing to challenge claims about expensive unproven technologies while focusing on the potential benefits and ignoring the potential harms. These are healthcare reform stories -- whether you realize it or not.
10. There continue to be some terrific training opportunities for healthcare journalists -- most notably the NIH Medicine in the Media workshops held each spring or summer and the MIT Medical Evidence boot camps. The Association of Health Care Journalists has national and regional conferences and workshops that emphasize training, and, in 2010, they will publish a guide for journalists on how to report on medical studies.
We know that in 2010 Washington reporters will be busy covering the politics of healthcare reform. But in any city or town in this country there are rubber-meets-the-road health policy issues about how healthcare decisions are made, about what we're paying for in health care, and about quality issues. Each day, each week, and each month stories could do a lot of good by starting to educate news consumers that in health care, more is not always better, newer is not always better and screening tests don't always make sense.
Here's hoping for even baby steps of progress along those lines this year.
H: HealthGrades.Com: a for-profit rating site
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I: Studies Show Cardiovascular Devices Often Earn FDA Approval Without High-Quality Clinical Data
By Reed Miller, Heartwire
December 30, 2009 (San Francisco, CA and Boston, MA) - Two separate reviews of cardiovascular device premarket approval (PMA) applications to the FDA identify weaknesses in many of the studies that supported the PMAs, but the studiesâ€™ authors appear to disagree on the definition of a "high-quality clinical trial" [1,2].
In the December 30, 2009 issue of the Journal of the American Medical Association (JAMA),Dr Sanket Dhruva (University of California, San Francisco) and colleagues report their findings from a systematic review of the 123 publicly available summaries of safety and effectiveness data (SSED) for 78 PMAs for high-risk cardiovascular devices that the FDA approved between January 2000 and December 2007.
"The findings in this study raise questions about the quality of data on which some cardiovascular device approvals are based. There is a balance between getting new drugs and devices to market quickly and ensuring the evidence of benefit is sufficient before FDA approval and marketing," Dhruva et al say. "However, the bar for evidence of benefit should be higher for devices because they are implanted and cannot simply be discontinued, as drugs can. In addition, although devices can be lifesaving, they also have great potential for risk and adverse events."
About 27% of the 123 studies reviewed by Dhruva et al were randomized, and 14% were blinded.
Just over half of the total end points measured in the studies included a control comparison, and 31% of the controls were retrospective. About 88% of the end points were surrogate measures of effectiveness, and 78% of the studies showed a discrepancy between the number of patients enrolled in the study and the number analyzed for the primary outcomes. Only 80% of the 123 SSED summaries report the number of participants enrolled in the study. The average number enrolled was 308 patients.
The authors highlight that 65% of the PMAs were approved based on a single clinical study. The average number of studies listed in the SSED summaries for each PMA was 1.6, with a range from one to five.
Dhruva et al identify several potential sources of bias in these studies. Retrospectively selected controls or post hoc analysis may allow for the selection of control groups or end points that favor the device. Surrogate end points may not be reliable predictors of actual patient benefit if they are not linked to a clinically meaningful end point. Composite outcomes, which are also common in cardiovascular trials, have been shown to comprise individual end points that often vary in clinical significance and do not contribute equally to the composite measure, they point out. Also, a discrepancy between the number of enrolled patients and the number analyzed for the primary end point raises the possibility that the study has been biased because patients with less favorable outcomes were lost to follow-up.
PMAs represent the FDA's most rigorous device approval process for devices that are often necessary for sustaining a patient's life but also carry the highest risk because they are usually implantable and often permanent. Yet, "although there has been recent scrutiny of evidence used in the US Food and Drug Administration drug approval process, less attention has been paid to the approval process for medical devices. Medical devices are less likely than drugs to have demonstrated clinical safety before they are marketed," Dhruva et al argue.
Separately, Dr William Maisel (Beth Israel Deaconess Medical Center, Boston, MA), director of the Medical Device Safety Institute, and scientists at the FDA's Division of Cardiovascular Devices, Center for Devices and Radiological Health reviewed all of the original cardiovascular device PMAs that the FDA ruled on between January 1, 2000 and December 31, 2007 to assess the quality of clinical investigations submitted by manufacturers. Results of their study were published online December 29, 2009 in the American Journal of Therapeutics.
Unlike the study by Dhurva et al, which was based on only the publicly available SSEDs, Maisel and the FDA researchers had access to the entire submission file for each PMA.
In total, the researchers evaluated 88 cardiovascular device PMAs--77.3% of which were for permanent implants--encompassing 132 clinical studies with a total of 37Â 328 study subjects and 29Â 408 device recipients. The average age of the patients was 61, just over one-third of the subjects were women, and over 86% were white.
For this study, Maisel and colleagues deemed the effectiveness and safety end points to be "high quality" if they were clearly defined and associated with a specific time point for analysis. High-quality subject accounting was defined as at least 90% of the original cohort accounted for at study conclusion.
The researchers deemed the primary effectiveness end points, primary safety end points, and subject accounting to be high quality in 81.8%, 60.2%, and 77.3% of pivotal studies, respectively.
They note that key cardiovascular comorbidities were infrequently reported. For example, coronary artery disease was reported in about 51% of studies, diabetes was reported in 37%, and tobacco use was reported in only 32%. The patients' race was reported in only about 15% of cases.
The authors also broke out their results by type of cardiovascular device--interventional, electrophysiological, or surgical--but caution that there are a wide variety of devices and study designs within each group.
What makes a trial "high quality?"
Maisel told heartwire that he believes the authors of the study in JAMA appear to be inappropriately applying the definitions of quality for drug studies to device studies. "Devices are not drugs. There is no one size fits all.
"It's hard to generally characterize devices and lump them all together. So when we were thinking about how to measure quality, we tried to pick things that we felt should apply to every device no matter what type of device," he explained. "That's a little bit different from the JAMA article, where they talk about things like randomization and blinding and number of studies [as indicators of quality]. We thought about those things, but we didn't think that any of them [should be] applied ubiquitously to all devices."
The relatively low percentage of surgical-devices trials with high-quality end points underlines the difficulty of studying this type of device, Maisel said. They are particularly challenging to study because it is difficult to randomize patients to surgery vs nonsurgery and/or blind the patients or physicians. Surgical devices are "a great example of how randomization and blinding aren't the measure by which quality should be measured. Because, for surgical studies, it's just extremely difficult to do that. It's impractical and in some cases, unethical."
But that's not necessarily an excuse for researchers of surgical devices to collect only poor-quality data, Maisel said. "There's no reason that, prior to conducting the study, you couldn't predefine the effectiveness and safety end points and pick the time at which they're going to be studied. So despite the challenges and the diversity, we think the quality measures that we picked should apply equally to surgical devices."
Maisel also pointed out that, compared with drugs, a lot more useful information can be collected in nonclinical trials. "There are things that you can learn about devices by doing engineering studies or bench testing. Sometimes you can learn more about them on the bench than in real life. Examples would be repetitive-motion testingÂ .Â .Â .Â or for devices that need to convey electrical currentÂ .Â .Â .Â you can push them past the extreme to test their limits. Device approval is based on more than just the clinical trials."
In a set of "talking points" provided to heartwire by FDA spokesperson Meghan Scott, the agency acknowledges that the study by Maisel and the FDA scientists "identified several problems with clinical trials in support of cardiovascular device PMAs, including: suboptimally defined safety and effectiveness end points, poor patient accounting, and incomplete collection of important patient comorbidities [that] make device safety and effectiveness assessments more challenging."
However, the FDA makes many of the same criticisms of the Dhruva study that Maisel raised.
According to the FDA, Dhruva et al "did not fully consider the feasibility of device clinical trials as well as the totality of the evidence available to the agency in PMA submissions. Congress has recognized that devices are not drugs and that device trials require consideration of unique design considerations. The standard drug metrics used to assess quality need to be modified appropriately for assessment of clinical-trial quality for devices."
The FDA argues that "the Dhruva study assumes that the length of the study is associated with the quality of the data. However, the key issues are the clinical-trial question that needs to be assessed and the optimal time point for assessment." For example, vascular-closure devices that that seal the femoral-artery puncture site need to do their job almost immediately to prevent major bleeding, so a short follow-up period is the appropriate study time frame, not a weakness of the study.
The FDA also rejects Dhruva et al's contention that measuring surrogate instead of clinical end points necessarily undermines the validity of trial results. "Appropriate use of valid surrogate and composite end points allows trials to be of a reasonable size and duration such that safe and effective medical devices can reach patients and providers in a timely way." For example, a trial of a device in a relatively low-risk population that specified death as the primary end point would need so many trial subjects to achieve statistical significance that "timely completion of the study with results relevant to patient care and before the device would likely become obsolete would not be feasible." The FDA also points out that it already evaluates composite end points to ensure that each component of the composite is supportive of the overall finding based on the composite.
Summaries of safety and effectiveness appear to be lacking
The FDA also argues that the study by Maisel and the FDA scientists provides a more accurate picture of the quality of studies reviewed by the FDA because it is based on the full PMA filings and not just the SSED summaries. According to the agency, SSED summaries "reflect the intensive review performed by the FDA lead reviewer, statistician, clinician, and engineer.
However, in no way can it be used as a 'surrogate' for examination of the actual reviews."
One of the coinvestigators of the Dhruva study, Dr Rita Redberg (University of California, San Francisco), told heartwire that her group relied on the SSED summaries because FDA's own guidelines for creating SSED summaries state that they are "intended to present a reasoned, objective, and balanced critique of the evidence that served as the basis of the decision to approve or deny the PMA."
"It is highly unlikely that a trial would have been randomized or blinded, for example, and that fact would not have been included in the SSED," Redberg points out. However, she said that she and her colleagues certainly support greater access to complete information from FDA reviews.
"SSEDs are the only FDA-reviewed evidence availablefor clinicians, and they form the sole basis of data that canbe used for systematic reviews and guideline development. Thisstudy reinforces the need for improved access to complete FDAreviews for both pharmaceutical and device data," Dhruva et al argue.
FDA commits to continuous improvements
FDA says it is implementing several recommendations based on the study by Maisel and colleagues. In the future, study end points for safety and effectiveness must be clearly defined in the PMA, with a specific statement regarding the time point at which they will be evaluated and the relative contribution of each component of a composite end point. Also, PMA sponsors will be required to clearly and accurately detail their patient accounting practices in order to ensure interpretability of study results, according to the agency.
Redberg agrees that "clear and consistent guidelines on the strength of evidence--type of primary end point, number of patients, length of follow-up, and study design, such as randomized or blinded, would all help to strengthen the evidence base on which the FDA approves these important devices."
In addition to committing to supporting more broad evaluations of clinical studies that support PMAs, the FDA is working with stakeholders to increase participation of women, children, and minorities in clinical trials. For example, the agency has hosted workshops with academic physicians, industry, and other experts to discuss strategies for incorporation of gender-specific analyses in PMA applications, and the FDA is currently developing a guidance document on increasing enrollment of women in clinical trials. An example of its effort to improve research of devices for children is the planned workshop on pediatric heart-valve development scheduled for January 12. The FDA is also participating in the Duke sudden cardiac arrest think tank that directly addresses enrollment of minorities in sudden-cardiac-death trials.
1. Sanket D, Bero L, Redberg R, et al. Strength of study evidence examined by the FDA in premarket approval of cardiovascular devices. JAMA 2009; 302: 2679-2685. Kramer D, Mallis E, Zuckerman B, et al. Premarket clinical evaluation of novel cardiovascular devices: quality analysis of premarket clinical studies submitted to the Food and Drug Administration 2000â€“2007. Am J Ther 2009; DOI:10.1097/MJT.0b013e3181ca8105. Available at: http://journals.lww.com/americantherapeutics.
Authors and Disclosures
Reed Miller, Journalist
Reed Miller joined theheart.org in 2009 after nearly a decade covering the medical technology industry, most recently as a senior editor for Elsevier's The Gray Sheet. He has been to more FDA advisory panel meetings than he cares to count. At Elsevier, he has also contributed to In Vivoand The Pink Sheetand spent a year as a managing editor for HCPro in Marblehead, MA writing about drug and device industry regulation and compliance.
Source: Heartwire © 2009
J: OurMed Pioneer Bios:
Vincent Navarro (OURMED TECH)
212 444 2633
Research Specialist @ Weill Medical College
Online Database Manager @ Scientists Without Borders
I have done basic science research for over 15 years in the area of prostate cancer. During this time I have had the privilege of working on the development of monoclonal antibodies targeting prostate cancer from concept through clinical trials. This has afforded me a keen insight into development process of therapeutic drugs. In addition, a strong interest in computers has seen me pursue a graduate degree in computer science in addition to my undergraduate in Chemistry. As a result I have designed and developed a clinical trials management system in my laboratory. I am currently the Online Database Manager for Scientists Without Borders. There, I am responsible for the administration of the database and development of the web portal.
Eileen McGinn, MPH, Certificate in Aging (OURMED CONTENT)
Worked in international health and development for 25 years, including several years living in Africa and Asia. Currently PT Research Manager for Nathan Kline Institute, working on the interrelation of poverty and mental health and health equity for persons with disabilities. PT tutor for immigrant high school students at Manhattan Comprehensive Night and Day High School. Volunteer work for many different agencies, including health, disability, immigrant, women's, peace, international. Have written for various websites on health issues. Especially interested in translating technical work into comprehensible language, community-based participatory research and the Capabilities Framework for development and justice.
Geoff Hayden, MD (OURMED CONTENT, RECRUITMENT)
email@example.com 615.479.6499 (Cell)
I am a practicing Emergency Physician, splitting time between NYC and South Carolina. I have been in academic practice since 2005 (Residency at Vanderbilt University, Fellowship at University of Pennsylvania), with an emphasis on resident education and emergency ultrasound. My interest in OurMed.org stems from a dissatisfaction regarding the abysmal state of preventive care and a general lack of health care coverage in the U.S. I see OurMed.org as an essential resource to connect patients to health information and health providers.
I imagine my role with OurMed.org in terms of producing content, recruiting other physicians for ongoing contribution, and assisting Greg with the development of a user-friendly, comprehensive clearinghouse of useful health care information.
Geoffrey E. Hayden, MD, FAAEM, FACEP
Adjunct Clinical Professor
Vanderbilt University Medical Center
Department of Emergency Medicine
Piedmont Medical Center
Emergency Department Attending
222 South Herlong Ave
Rock Hill, SC 29732
Vanessa Moore (OURMED RECRUITMENT)
MVanellen@aol.com 914-665-4534 (home) 914-751-9758 (cell)
Vanessa Moore is a native New Yorker who brings 7 years recruiting experience to the Ourmed recruitment effort. She would like to leverage her experience recruiting volunteers to Ourmed, a forward thinking and progressive approach to disseminating unbiased healthcare information to the public. Sh914-665-4534 (home)
914-751-9758 (cell) MVanellen@aol.com
e has worked in both corporate and nonprofit settings including a consulting engagement for the Department of Education and most recently at the Westchester Independent Living Center, an advocacy group for people with disabilities. She studied Social Sciences at the Lincoln Center campus of Fordham University.
John Volpe (OURMED TECH)
My background is primarilyin accounting, finance and business operations, primarily in the financial services industry. While I'm not a technical professional, I have participated in and managed numerous technical and business projects, primarily involving financial systems. I also worked as a management consultant for a Virginia based company that I did consulting work for the federal and state governments. I am currently retired. In addition to playing tennis and engaging in other physical activities, I volunteer my time and an Account Director with an NYC based organization that provides service grants in the form of a volunteer project team that manages strategy, financial, marketing and development projects for non-profits. My interest in this project is really from the perspective of someone who is a consumer of medical information and is interested in the efficient delivery of medical information to the public.
Greg Miller, ED at OurMed
Have 17 years of Corporate Finance and Marketing experience for Fortune 500 companies including nine years abroad (Germany, England and Japan). I've been here in New York since 1996, always passionate about developing new brands, ideas and products. Did Marketing Analysis for ANA, a Japanese Airline, Finance for Cablevision's HD Satellite business and Revlon. Since 2005, I've been inspired by non-profits, created New York's Dance Parade and have worked on OurMed since the Fall of 2008. I'm inspired by the transparent, non-profit approach to the democratization of healthcare. OurMed has a small office at Columbia Medical Center's Audubon Business and Technology Building--Come by and visit us!
3960 Broadway (Entrance on 166th Street) Suite 301
o (212) 740-1850
c (917) 627-7155
Watch the OurMed Presentation: http://docs.google.com/present/edit?id=0Ad4ohgeyfGzCZGRoNnFuNW1fMzljMmh2OW5jdw&hl=en
OurMed's Board of Directors:
Florence Devouard, OurMed Board Member firstname.lastname@example.org
Florence Devouard served as one of the elected representatives to the Board starting June 2004, and was the Chair of the Board from October 21, 2006 until July 16th, 2008. Florence was born in Versailles (France). She grew up in Grenoble, and has been living since then in several French cities, as well as Antwerpen in Belgium and Tempe in Arizona. She holds two masters, one in Agricultural Sciences (a 5-year degree in agronomical engineering (Diplome d'Ingénieur Grande Ecole) from ENSAIA and the other a postgraduate degree (DEA) in Genetics and Biotechnologies from INPL.She has been working in public research, first in flower plant genetic improvement, and second in microbiology to study the feasability of polluted soil bioremediation. She was employed until 2005 in a French company, to conceive decision-making tools in sustainable agriculture. She is now a consultant in Internet Communication Strategy. She joined the Wikipedia adventure in February 2002 and is known as a contributor under the pseudonym Anthere. Florence is 39, and lives in Clermont Ferrand with her husband Bertrand and her three children, Anne-Gaëlle aged nine, William eleven and Thomas two. On May 16 2008, Florence was made a knight in the French National Order of Merit, proposed by the Ministry of Foreign Affairs as "chair of an international foundation"
Alex Fotopoulos, OurMed Board Secretary email@example.com
Alex Fotopoulos has served on the board since October 2008. He attended Rutgers College in New Brunswick, NJ and then received his Juris Doctorate degree from Southwestern Univesity in Los Angeles, California in 1990. He has experience as a litigation attorney and as an entrepreneur. He has held held positions as an attorney and as part of the management team of such high technology companies including AT&T Wireless, T-mobile, Nextel, Metricom, GTE Internetworking as well as small local start-up ventures. He is a licensed Attorney in New York, New Jersey and California.
Stan Kachnowski, OurMed Board Chair firstname.lastname@example.org
Stan Kachnowski is one of America’s distinguished scholars in healthcare information policy and management having taught e-health and healthcare e-business for nearly 20 years. He has authored over 100 scholarly papers and presentations for the world’s leading journals and societies in healthcare technology management, informatics and e-governance. In 2003 he was elected as a Fellow in the Royal Society of Medicine in the United Kingdom for his research with the National Health Service in using handhelds to track patient data. In 1996 he was elected to the US-based College of Healthcare Information Management Executives. Stan is currently a visiting professor at the Indian Institute of Technology, New Delhi, India.
Oleta McHenry, OurMed Board Treasurer Newsgirl_fl@hotmail.com
Oleta McHenry was born in Washington D.C. and grew up in Ohio. After graduating high school, she briefly attended Wright State University in Dayton, studying Political Science. She transferred to St. Petersburg College in St. Petersburg, FL and received her A.A. degree in Liberal Arts. Oleta earned her B.S. in Accounting from Florida Metropolitan University in Clearwater, FL in 2006.
Oleta worked for the Pulitzer prize winning newspaper, St. Petersburg Times as a circulation manager. After receiving her degree in accounting, she worked briefly in the insurance industry before joining the Wikimedia Foundation as the fulltime accountant of record. While at the Wikimedia Foundation, Oleta helped put in place accounting practices that would help the company in growth and development. She did not follow Wikimedia to San Francisco and now works for a large medical supply company managing the General Ledger for several regions within the United States. Oleta resides in St. Petersburg, FL and works as an accountant.