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Tag: Facebook

Doctorology: Communication. It’s All Good

“Doctor’s office; please hold.”

You’ll never hear that when you call me. Never. You’ll also never get an automated answering system (I’m just referring to office hours, of course. Evenings and weekends the phone goes to Google Voice. More on

that below.) We are also in the middle of a communication revolution. There are now so many other ways patients can contact me other than the telephone, the silly thing is almost becoming obsolete. I took amoment the other day just to go through all the various ways patients contact me.

Telephone

Still the most reliable fallback. Most synchronous form of communication: both parties willing and able to talk in real time. After hours, Google Voice (free) transcribes messages and texts them to my smart phone. As a rule, patients do not call my cell phone, although I’m not shy about giving out the number. Then again, those who have my cell number usually use it for…

Texting

At the moment, it’s just a few patients, but I anticipate more and more of them will partake as time goes on. It doesn’t happen very often, and so far it’s never been inappropriate. Med refill requests and pictures of kids’ rashes have been the mainstay so far. I like it. By it’s very nature, the people choosing to text me understand the limitations of synchronicity, ie, they don’t get bent out of shape if I don’t answer them right away, and they understand that it’s just for relatively minor issues. I also use it to communicate simple quick questions to specialists with all the same mutual understandings (minor issues only; response time unimportant).

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Making Good Health Care Companies Great

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Who am I? Why am I here?  Does it really matter anyway?  Bestselling business author and corporate historian Jim Collins(“From Good to Great”, “Built to Last: Successful Habits of Visionary Companies ”) has made a career by asking executives unused to such introspective philosophical questions to stop and think about the fundamental assumptions at work in their businesses.  Collins has found that the most successful companies (think GoogleAppleMicrosoft, probably notFacebook) learn to ask the key questions that keep them focused on what they’re supposed to be doing and teach them to avoid making the mistakes that cause lesser, more mortal companies to trip up over their own feet.  Not long ago THCB was on hand to catch Collins and bestselling author (“Getting Things Done”) David Allen speak at an exclusive invitation-only healthcare forum hosted by the Denver-based Breakaway group. In this interview, Breakaway group CEO Charles Fred talks with THCB founder Matthew Holt about his organization’s innovative and very successful approach to teaching healthcare professionals to work with new technologies.

Facebook May Grant Researchers Access to Study Data

Because nearly one billion users produce a lot of data, Facebook has had a hand in publishing more than 30 research papers since 2009, including research (.pdf) that may link social-networking activity and loneliness.

But outside researchers have been unable to validate those studies because Facebook refused to release the underlying raw data, citing the need to protect users’ privacy. Now Facebook is considering changes to its policy. Nature News reports:

Facebook is now exploring a plan that could allow external researchers to check its work in future by inspecting the data sets and methods used to produce a particular study. A paper currently submitted to a journal could prove to be a test case, after the journal said that allowing third-party academics the opportunity to verify the findings was a condition of publication.

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Physicians Aren’t (Feeling Very) Social

There were two interesting developments in the field of social networks for healthcare practitioners last week.  The first was the publication of a paper in JAMA “Variation in Patient-Sharing Networks of Physicians Across the United States”.  The second was the sale of Sermo Physician Network to WorldOne for an undisclosed price.  Sermo had raised $40+m in venture capital prior to sale, making a bet that social networking for physicians could drive value to pharmaceutical and financial firms based on disclosing interactions between members of the network.

If physician behavior and prescribing activity are key to your healthcare business, I think it is important to understand the relationship and differences between these two events.

Sermo bet hard on the Facebook model – physicians would interact on social networks, share knowledge and insight, and third parties could benefit from getting access to those interactions concerning their products or services.  Sermo had also begun expanding its revenue model by providing paid content and sponsored education programs to network members, trying to capture “digital” dollars from life science companies.  Pharma companies are desperately trying to gain advantage through digital advertising campaigns to influence physician prescribing behaviors, and multi-channel marketing efforts including the development of web sites for branded medications.

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Hospitals Finding Patients On Google and Facebook

When the University of Pennsylvania Health System sought new patients for its lung transplant service last year, it turned to Facebook and Google.

The results of the $20,000 advertising campaign on the websites exceeded administrators’ expectations.

During a few weeks in August and September, more than 4,600 people clicked on the ads and 36 people made appointments for consultations. One of those is now on the hospital’s lung transplant waiting list, and several others are being evaluated, hospital officials say. While the response may seem small, each transplant brings in about $100,000 in revenue.

“We wanted to test the theory of how successful a digital marketing campaign could be,” said Suzanne Sawyer, the health system’s chief marketing officer. “It was like looking for a needle in a haystack,” she said, noting only about 60 lung transplants are done each year in Philadelphia, where the health system is based.

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Why You Are (Probably) Already Using The Most Powerful Digital Health App

Among the most frustrating dilemmas facing patients – and physicians – is when doctors are unable to assign a specific diagnosis.  Just having a name for a condition can be remarkably reassuring to patients (and families), providing at least a basic framework, a set of expectations, and perhaps most importantly, an explanation for what the patient is experiencing.

Sara Wheeler, writing in the New York Times in 1999, poignantly described the experience of traveling through “the land of no diagnosis.”  Ten years later, the NYT featured a story called “What’s Wrong with Summer Stiers,” about another patient without a diagnosis – and about a fascinating initiative at the NIH, the “Undiagnosed Disease Program” – specifically created to meet this need.

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The Facebook-ACO-Military-Industrial Complex

Investors just ponied up well over $100 billion for a piece of the social media giant Facebook. While Mr. Zuckerberg and his co-founders deserve a hearty congratulations, I find some eerie parallels between Facebook and accountable care organizations.  The similarity does not bode well for either business model.

1. The users are not the customers: Facebook sells its users to marketeers.  ACOs sells its patients’ health care utilization to insurers.

2. It’s the data and it’s not yours: Facebook’s targeted ads are constructed off of prior usage patterns. ACO’s shared savings calculations are built off off actuarially determined health care utilization patterns.

3. Sovereign hostility: Washington DC views information technology and health care as distractions from the true task at hand: restoring the U.S. manufacturing base.

4. Do you care, really? Now that the wunderkids in charge of Facebook have made their millions, it remains to be seen if they’ll work as hard in delivering value to its users.  Ditto for all the salaried docs working for ACOs, who no longer have to arrive early, skip lunch and stay late.

5. The long term: Yahoo once was the darling of internet investors.  Even if ACOs have initial success, is a better care model being developed as you are reading this?

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Seriously: Is Digital Health The Answer To Tech Bubble Angst?

As an ever increasing amount of money seems determined to chase an ever greater number of questionable ideas, it’s perhaps not surprising that inquiring minds want to know: (1) Are we really in a tech bubble? (2) If so, when will it pop? (3) What should I do in the meantime?

I’m not sure about Question 1:  I’ve heard some distinguished valley wags insist we’re not in a tech bubble, and that current valuations are justified, but I also know many technology journalists feel certain the end is neigh, and view the bubble as an established fact of life – see here and here.  The surge of newly-minted MBAs streaming to start-ups has been called out as a likely warning sign of the upcoming apocalypse as well.

I have the humility to avoid Question 2: as Gregory Zuckerman reviews in The Greatest Trade Ever, even if you’re convinced you’re in a bubble, and you’re right, the real challenge is figuring out when to get out.  Isaac Newton discovered this the hard way in the South Sea Bubble, leading him to declare, “I can calculate the motions of heavenly bodies but not the madness of people.”

I do have a thought about Question 3, however – what to do: reconsider digital health — serious digital health.

Here’s why: Instagram and similar apps are delightful, but hardly essential; most imitators and start-ups inspired by their success are neither.  It doesn’t strain credulity to imagine investors in these sorts of companies waking up one day and experiencing their own Seinfeld moment, as it occurs to them they’ve created a portfolio built around nothing.

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Crafting a Social Media Policy

Today’s Computerworld has a great article about the issues of mixing social media and healthcare.

As hospitals and clinics formulate social networking policies, there are three broad considerations.

1.  Given HIPAA and HITECH privacy and breach rules, how can you best prevent the disclosure of protected healthcare information on insecure social media sites?

2.  Given the distraction factor and productivity loss that can occur with social media, how can you best align the benefits of groupware communication while minimizing the negatives?

3.  How can you reduce the security risks of malware embedded in games and other applications that are downloaded from social networking sites?

To date, Beth Israel Deaconess has focused on #1, ensuring that our employees do not post data to social networking sites in violation of state and federal laws.

We’ve not yet completed a  policy covering #2, although several hospital sites and departments are discussing the issue.

We’re developing a pilot for #3, including blocks on selected websites, Facebook add-on applications, and personal email.

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The Lifesaving(?) Technology of Facebook

When most of us think about Facebook, the first phrase that comes to mind probably isn’t “good Samaritan.”  Facebook is an easy way to keep in touch with friends, and it can be a gigantic time-suck, for sure, but last week the site did something that could truly benefit a lot of people. On May 1, Facebook launched an initiative to encourage users to become organ donors, and within 24 hours there had been a spike in the number of people volunteering their body parts for the good of others.

California’s registry saw almost two months’ worth of people sign up within the first day after the Facebook put up the feature.

Organ transplantation is one of the miracles of modern medicine, but there simply aren’t enough organs to go around for all the patients who need them. According to the United Network for Organ Sharing (UNOS), there are 72,900 people on active lists waiting for an organ. Compare that number to the 2,263 transplants that took place between January 2011 – 2012. Last year, more than 6,000 people died waiting for an organ.Obviously, increasing the number of organ donors could have a huge impact on the number of transplants – and on the lives of thousands of people.

Why don’t more people become donors? Some object on religious grounds, but the biggest obstacle is inertia. Most of us who sign up to be organ donors (I’m one of them) do so when we renew our driver’s license, by checking a box on a form saying we want to donate our organs. If you don’t mark the form, it’s assumed you don’t want to donate. Most people only encounter this choice every few years, when their driver’s license is up for renewal, and it’s hard to think about such a decision while standing at a Department of Motor Vehicles counter.

Some countries, such as Spain, Australia and Germany, have opt-out systems. It’s assumed that you are willing to donate unless you’ve said you prefer not to. Rates of donation in those countries are sometimes higher than in the US, although some presumed-consent countries have much lower rates. (Factors other than the number of donors, like the availability of surgical facilities and transplant surgeons, can affect the number of actual transplants in different countries.)

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