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Tag: Facebook

The Right to Be Forgotten

At the end of January, the European Commissioner for Justice, Fundamental Rights, and Citizenship, Viviane Reding, announced the European Commission’s proposal to create a sweeping new privacy right—the “right to be forgotten.” The right, which has been hotly debated in Europe for the past few years, has finally been codified as part of a broad new proposed data protection regulation. Although Reding depicted the new right as a modest expansion of existing data privacy rights, in fact it represents the biggest threat to free speech on the Internet in the coming decade. The right to be forgotten could make Facebook and Google, for example, liable for up to two percent of their global income if they fail to remove photos that people post about themselves and later regret, even if the photos have been widely distributed already. Unless the right is defined more precisely when it is promulgated over the next year or so, it could precipitate a dramatic clash between European and American conceptions of the proper balance between privacy and free speech, leading to a far less open Internet.

In theory, the right to be forgotten addresses an urgent problem in the digital age: it is very hard to escape your past on the Internet now that every photo, status update, and tweet lives forever in the cloud. But Europeans and Americans have diametrically opposed approaches to the problem. In Europe, the intellectual roots of the right to be forgotten can be found in French law, which recognizes le droit à l’oubli—or the “right of oblivion”—a right that allows a convicted criminal who has served his time and been rehabilitated to object to the publication of the facts of his conviction and incarceration. In America, by contrast, publication of someone’s criminal history is protected by the First Amendment, leading Wikipedia to resist the efforts by two Germans convicted of murdering a famous actor to remove their criminal history from the actor’s Wikipedia page.[1]

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Pharma, Social Media & Common Sense


By the numbers, pharma’s usage of the social media to drive corporate, brand and disease management objectives has never been greater. But how robust are pharma’s channels and programs on Facebook, YouTube, Twitter and other networks?

Consider a few table stakes for digital communication generally:

  • Tell the whole truth and nothing but
  • If applicable, open comments but police spam and abuse (a concept FB now enforces for all unbranded health pages).
  • Support the brand you have while you build the one you want.
  • Stratify messages, channels and audiences to support that strategy.
  • Develop and monitor KPIs, some qualitative. It’s not just about the money.

Now consider a few typical characteristics of pharma social media content these days:

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Google + Shines the Light on the Value of Data Portability

By VINCE KURAITIS

It’s understandable that a healthcare delivery system would have a mindset and business objective to keep referrals within its network of care providers. Businesses have a right and an obligation to try to hang on to their customers.

It’s a different issue whether closed or walled garden HIT is an acceptable means toward that end.

Outside of healthcare, we understand and can accept that businesses used closed, proprietary IT as part of their business model. Apple has designed their iPod with an eye toward incompatibility and high hassle factor in not being plug-and-play with other music players and systems.

IMHO, however, healthcare is different. Keep your proprietary business model away from my body and gimme my damn data.

Google+ v. Facebook on Data Portability

We are witnessing an important dynamic begin to play out between FB and Google+. I note a significant difference in mindset and policies toward data portability.

FB seems to have a mindset to maintain customer data within its walled garden as much as possible. For example, when G+ first opened, I remember seeing an early article about how easily to import some of your FB data into G+; hours later I read an article how FB had plugged this leak. Deleting your FB account is difficult — there are articles walking you through the 634 steps you need to go through.

G+ seems to be built on a diametrically opposing mindset. You can download your data. You can export your data and import it into another social networking site. You can easily delete your G+ account and wipe out your data.Continue reading…

The Dual Online Identities of Physicians

Like everybody else, physicians are expanding their online personal identities. At the same time, they are trying to comply with codes of conduct that help consumers trust them and their profession.

There’s no problem so long as the personal online activities of physicians don’t jeopardize their obligations as professionals, which means that there is a problem, unfortunately.

In a recent study for example, 17% of all blogs authored by health professionals were found to include personally identifiable information about patients. Scores of physicians have been reprimanded for posting similar information on Twitter and Facebook, posting lewd pictures of themselves online, tweeting about late night escapades which ended hours before they performed surgery, and other unsavory behaviors.

As I mentioned Monday, medical students and younger physicians who grew up with the Internet have to be particularly careful, since they had established personal online identities before accepting the professional responsibilities that came with their medical degree.

Medical schools, residency programs and teaching hospitals can help young professionals manage their dual lives online. Some have implemented curricula and policies that foster appropriate use of social media, but surprisingly these programs are not widespread. In a recent study of medical schools that had experienced at least one incident in which a student used social media inappropriately, only 38% had adopted formal policies to handle future incidents. An additional 11% reported they were developing such policies. We can do better than this.

Non-teaching hospitals, CME providers and professional organizations like the American Medical Association can also help providers navigate the online world. The AMA’s recent guide to Professionalism in the Use of Social Media provides helpful guidance in this regard.

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Ten Rules for Health Care Organizations Interested in Using Social Media

Include social media like “Facebook” or “Twitter” in health care business plan, and you’ll probably prompt glazed looks from the average health care administrator. Those who recognize the terms will want to know what they have to do with filling up that new heart catheterization suite or increasing referrals to their infusion center.  They’re too busy with marketing flotsam like “Top 100” billboard campaigns or convincing the local news media to mention that newly renovated lobby. These functionaries look, but they do not see.

Case in point: during a recent work-out at the local fitness center, the Disease Management Care Blog  witnessed two elder women chatting while speed-walking on side-by-side treadmills.  Down the row were two younger women on side-by-side exercise bicycles, also chatting.  The difference was that the two younger women had ear plugs in place, their cell phones out and were simultaneously texting.  All four women were continuously talking at the same time, but that’s not the point.  The point is that two-way web-based cellular communication is fast becoming a 24-7 standard for tens of millions of people.  Those two elders may currently command greater purchasing power, but those texting youngsters is where the future lies.

As mentioned in yesterday’s post, health care organizations that realize that they need to get the attention of the two women on those exercise bikes will find it extremely challenging.  That’s because those ladies will have to “opt-in” and agree to “friend” or “follow” you.Continue reading…

Facebook Misstep Costs RI Physician Fine, Job

In recent years many health care providers and managers have told me, time and again, that the health care world is accustomed to managing confidential patient information, and therefore doesn’t need much in the way of social media training and policy development.  This week brings news that should make those folks sit up and take notice.  A physician in Rhode Island, who was fired for a Facebook faux pas, has now been fined by the state medical board as well.  The physician posted a little too much information on Facebook — information about a patient that, combined with other publicly available information, allowed third parties to identify the patient.  The details of the story are available here and here.

The key takeaway from this story — and the Johnny-come-lately approach to health care social media taken by the Rhode Island hospital in question and the Boston teaching hospital that the Boston Globe turned to for comment — is that prevention is the best medicine.

Facebook and other social media are a fact of life, and cannot be ignored by health care providers and organizations.  They can even be used as a force for good.  As one example, take note of the recently-announced initiative by my colleague, Dr. Val, to start up a peer-reviewed tweetstream, @HealthyRT.  At he very least, health care providers and organizations should be monitoring social media for mentions so that they can reach out, as may be necessary, to address health care and public relations issues.Continue reading…

Could Facebook be Your Platform?

My guess is you’ve probably never asked yourself this question. A quick preview:

  1. Technical barriers aren’t the limiting factors to Facebook becoming a care coordination platform.
  2. Facebook’s company DNA won’t play well in health care.
  3. Could Facebook become the care coordination platform of the future? If not Facebook, then what?

1) Technical barriers aren’t the limiting factors to Facebook as a care coordination platform.

Can you imagine Facebook as a care coordination platform? I don’t think it’s much of a stretch. Facebook already has 650 million people on its network with a myriad of tools that allow for one-to-one or group interactions.

What would it take to make Facebook a viable care coordination platform?

  • More servers to handle the volume — not a problem
  • Specialized applications suited for health care conditions — not a problem
  • Privacy settings that made people comfortable — more on this later
  • A mechanism to identify and connect the members of YOUR care team — really tough, BUT this is NOT a technological problem, but a health system one

Suppose you are a 55–year-old woman who is a brittle diabetic. Your care team might include a family physician, an endocrinologist, a registered dietitian, a diabetic nurse, a ophthalmologist, a podiatrist, a psychologist, and others. Ideally you’d have one care plan that coordinates the care among members of the team, including you.Continue reading…

Let’s Face(book) the Hard Truth About Healthcare

‘In the time when new media.

Was the big idea.’

These two lines at the end of the album track  ‘Kite’ earned U2 a place in a recent list of suspect popular song lyrics. Some Health 2.0 vendors are also struggling to get ‘social media’ to rhyme with  ‘healthcare’ but will no doubt carrying on trying to do so. With Goldman Sachs throwing $1.5 billion in Facebook’s direction it makes sense for anyone in the online health business to position themselves as close to the social media company as possible, on the off chance that they will be able to pan a few nuggets out of the fast flowing stream of cash.

While no doubt some of the funds the bank is putting together will be used for healthcare related applications it is not immediately obvious what Facebook can do that Google and Microsoft have not already tried. Both these companies are trying to sell to healthcare providers whose business models if they do exist are confused and, in some cases failing. One way to gain a better understanding of the healthcare market is to view it as a mathematical equations that can be solved by eliminating one variable at a time.

So What If The UK’s National Health Service Did Not Exist?

You log on to NHS.uk and are greeted with a message saying “Sorry, this service has been discontinued. The UK government can no longer afford to provide you with healthcare.” And that is it, apart one last piece on advice. “Please take care.” This presumably aimed at Darwin Award candidates who were hoping to break the land speed record using fireworks and a skateboard and fully expect the local hospital to fix any resulting damage. Also perhaps directed at anyone with a grumbling appendix thinking of entering a baked bean-eating contest. (More about these people later.)

So what difference would it make if there were no healthcare provider? For a start everyone in the UK, apart from the 1.3-million ex-NHS workers, would be £1600 a year better off. A young person leaving school would have saved enough to pay for their university education. A young couple in their mid twenties would have saved enough to put a down payment on their first house. OK average life expectancy would fall and the last couple of years (or most likely months) of a person’s life would probably be more unpleasant, but the proceeding sixty five or so years would be a lot better. There, two of the government’s major economic headaches eliminated in a stroke – an unfortunate turn of phrase in this case. With an extra £100 billion per annum sloshing around in the economy most of the 1.3 million former NHS employees would be able to find new jobs.Continue reading…

Friends, with Benefits

What if one doctor could “friend” or “link in” with another for the purpose of patient exchange? Today when we hear people talk about clinical integration, they’re talking about financial integration…literally owning every stage of the treatment of a patient just so that the data created from that care can be integrated. That kind of thinking has fostered a proliferation of miniature Kaiser Permanente-like health organizations across the country–each with their own multi-hundred-million-dollar proprietary system to hold their data all in one place.

I think owning a lab is an expensive way to integrate the data from that lab into a common view of a patient—let alone “owning” a cardiologist! Furthermore, as the nexus of health care moves ever further away from the hospital ward and towards the home, owning every point of health care delivery will become increasingly difficult, if not impossible. So what’s the alternative? It’s the same one that gives us integrated credit ratings and the ability to walk up to any ATM in the world and still get money from our own account. It’s a market for clinical information exchange enabled by social networking-type technology.

When you think of it, Facebook and LinkedIn present integrated pictures of all the people you’ve touched in your life or work as soon as you log in. And over time you see how that integrated picture of your life or work life improves.

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Waving goodbye to Wave

Google recently announced that it was abandoning Wave, a multimedia social media collaboration tool. I’m sorry about this, as I thought it had great potential. That being said, I never used it, so perhaps I was typical. Pete Cashmere writes on CNN Tech:

Wave was perhaps the prototypical Google product: Technically advanced, incredibly ambitious and near-impossible to use.

Its demise is the canary in the coal mine for Google’s social networking plans: Facebook is destined to build the Web’s next wave, as Google continues to tread water.

Meanwhile, let’s take a look at what is going on at Facebook and elsewhere, courtesy of EduDemic. I offer #6 (regarding Facebook) and #10 (regarding Twitter) especially for those hospitals and other companies who choose to block these media on their servers, in the hope they will consider how fruitless that is.

  1. The average Facebook user has 130 friends.
  2. More than 25 billion pieces of content (web links, news stories, blog posts, notes, photo albums, etc.) are shared each month.
  3. Over 300,000 users helped translate the site through the translations application.
  4. More than 150 million people engage with Facebook on external websites every month.
  5. Two-thirds of comScore’s U.S. Top 100 websites and half of comScore’s Global Top 100 websites have integrated with Facebook.
  6. There are more than 100 million active users currently accessing Facebook through their mobile devices.
    Over at Twitter:

  1. Twitter’s web platform only accounts for a quarter of its users – 75% use third-party apps.
  2. Twitter gets more than 300,000 new users every day.
  3. There are currently 110 million users of Twitter’s services.
  4. Twitter receives 180 million unique visits each month.
  5. There are more than 600 million searches on Twitter every day.
  6. Twitter started as a simple SMS-text service.
  7. Over 60% of Twitter use is outside the U.S.
  8. There are more than 50,000 third-party apps for Twitter.
  9. Twitter has donated access to all of its tweets to the Library of Congress for research and preservation.
  10. More than a third of users access Twitter via their mobile phone.

Paul Levy is the President and CEO of Beth Israel Deconess Medical Center in Boston. Paul recently became the focus of much media attention when he decided to publish infection rates at his hospital, despite the fact that under Massachusetts law he is not yet required to do so. For the past three years he has blogged about his experiences in an online journal, Running a Hospital, one of the few blogs we know of maintained by a senior hospital executive.

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