Tag: Social Media

Social Media’s Evolving Role in Health Care

On August 23, 2011, some people in New York knew an earthquake was coming before it happened.  They weren’t psychic (as far as I know), but digital tweets from their friends in Washington, DC arrived 30 seconds before any seismic rumbles began (1, 2).  Afterwards, the U.S. Geological Survey asked people to “tweet if you felt it.” Over 122,000 people responded, providing a detailed map of activity within hours (3).  Though phones were dead near the epicenter of the quake, texts kept moving.

Welcome to SOLOMO (SOcial, LOcal, MObile) communication, connecting us instantly through handheld devices.  News now literally travels at the speed of light, with words strapped to the backs of zippy electrons. Emergency preparedness and disaster response teams are taking note, using social media to both get and spread the word.  The Red Cross has dedicated teams who monitor Facebook and Twitter (4).

While the speed of social–media communication is impressive, its volume is daunting and its content overwhelmingly messy.  Besides 300 billion emails (5), each day across the globe we send 200 million tweets(6); search the Web more than four billion times(7); and add 5,000 new blog sites to the 170 million that already exist (8). Ten million people, including the president, belong to FourSquare (9), which delivers personalized offers and local news interactively based on where you are (GPS) and what is nearby.  In the 3.5 hours we spend each day “connected” (10) we buy, sell, chat, gossip, work, cheer, complain, and advise.  We plan everything from dinner parties to Mideast revolutions, we ask about everything from movie ratings to interplanetary travel, and we monitor progress of local teams, hurricanes, and political races.

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Sharing Data on Social Media

People use Facebook, Twitter, or other social media sites as channels for self-expression. But whether updating or uploading, people are telling their social stories with only two tools: text and images.

But what if social media wasn’t confined to words and pictures, but instead, allowed users to uploaded graphs or tables? In other words, could data, pure data, become a token in our social currency?

That’s the thought contributed during a panel session at the Health 2.0 Conference in San Francisco byGary Wolf, contributing editor at Wired, and an organizer of Quantified Self, a community whose users meticulously track certain aspects of their lives, some down to infinitesimal levels, such as how they spend every minute of the day (no joke).

Wolf’s comment followed a presentation by Stead Burwell, the CEO of Alliance Health Networks, who demoed Diabetic Connect an information and community site for patients battling diabetes. Alliance spent a great deal of time (read: money) on creating user profiles that would allow visitors of the site to connect with their peers, patients who share similar experiences. But that connection, they found, was key. As Burwell said in his presentation, users not only like to receive badges and virtual rewards, they like to hand them out as well.

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The Doctor is Social

Doctors and hospitals are going social, adopting social media for professional and clinical use, based on surveys conducted in mid-2011 by QuantiaMD and Frost & Sullivan and the Institute for Health Technology Transformation (iHT2).

In Doctors, Patients & Social Media, dated September 2011, QuantiaMD and the Care Continuum Alliance report a high level of physician engagement with online networks and social media. Two-thirds of physicians are using social media for professional purposes, and see potential in the use of these channels to facilitate patient-physician communication. The survey found a cadre of “Connected Clinicians” who use multiple media sites to positively impact patient care. Over 20% of clinicians use 2 or more sites.

Only 1 in 10 physicians is familiar with one or more online patient communities, as the first chart illustrates. Among those who know about at least one community, a majority believe the sites have a positive impact on patients (either very positive or positive in the survey response). This is true across various condition categories, especially for rare diseases, cancers, chronic conditions, maternal and child health, and wellness/prevention. As one physician shared anecdotally, “Patients can share their stories, learn from others, spread knowledge, and instill hope.”

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The Social Media Doctor Is In

All around the world, businesses are getting social. Ford Motor Co. is crowd-sourcing ideas for features in future cars. Shoe seller Zappos shares Facebook “likes” with customers. Toy maker Hasbro ties Facebook videos to its Cranium board game.

Hospitals, doctors, nurses and patients would seem like naturals for social media. But they have been slow to take advantage of it because of well-founded fears of violating patient-privacy laws.

As valuable as social media can be for businesses and employees, they can also be perilous. Workers who love to use wikis and chat for personal communications or YouTube for showing off funny videos, can get in trouble when they start using them for sharing company plans or customer information.

This is particularly true in industries where information sharing is subject to government regulation. Health care is a field where strict patient-confidentiality rules have kept hospitals and doctors from embracing social media.

In a sign of the growing concern about the issue, a Westerly, R.I. hospital, just fired an emergency room doctor for posting information about a patient on her Facebook page, even though she didn’t name the patient. The disciplinary action follows sanctions against doctors and nurses in California and Wisconsin over similar issues, according to the Boston Globe.

Two physicians at Boston’s Beth Israel Deaconess Hospital recently wrote an opinion piece in The Annals of Internal Medicine that physicians should think of the Internet as the world’s elevator where someone is always listening in.

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Google + Shines the Light on the Value of Data Portability


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…

Can Blogging Be Harmful to Your Career?


I blog 5 days a week. This is my 935th post. Monday through Wednesday are generally policy and technology topics. Thursday is something personal. Friday is an emerging technology.

Everything I write is personal, unfiltered, and transparent. Readers of my blog know where I am, what I’m doing, and what I’m thinking. They can share my highs and my lows, my triumphs and defeats.

Recently, I had my blog used against me for the first time.

In discussing a critical IT issue, someone questioned my focus and engagement because I had written a post about single malt scotch on June 2 at 3am, recounting an experience I had Memorial Day Weekend in Scotland.

I explained that I write these posts late at night, in a few minutes, while most people are sleeping. They are not a distraction but are a kind of therapy, enabling me to document the highlights of my day.

I realize that it is overly optimistic to believe that everyone I work with will embrace values like civility, equanimity, and a belief that the nice guy can finish first.

If Facebook can be used against college applicants to screen them for bad behavior and if review of web-based scholarly writing can be used by legislators to block executive appointment confirmations, what’s the right way to use social media to minimize personal harm?

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Remember: Social Media is Social

A few days ago, several news outlets reported on Newt Gingrich’s unfortunate turn of phrase about our President. In a speech in Georgia he referred to Obama as “the most successful food stamp president in modern American history.” Promptly, David Gregory of NBC News called Newt on the potential racist connotations of this remark, thus precipitating a maelstrom of “liberal media” accusations from the usual suspects (here and here). And so it goes, possibly a careless figure of speech, possibly racially charged code, but everyone is now yelling and screaming about whether or not it was OK to say and subsequently to accuse.

There is a much bigger issue at stake than just the utterance of these words. While they offend me and make me think that they were spoken deliberately to elicit racial tensions, the point is that, in an obtuse sort of a way, they can be defended as non-racial in nature. Unfortunately, the speaker’s intention is not the issue any longer, so much as the fact that these words can easily be construed as racially inciting by large swathes of the population. And this is an important point: once squeezed out, much like the toothpaste from its tube, these words cannot be forced back. They will exist in perpetuity and continue to elicit visceral reactions.

Such is the nature of public discourse. Which brings me to the discussion on Bryan Vartabedian’s site about the etiquette of healthcare professionals on Twitter. The example of the particular Twitter stream from a healthcare professional who tweets anonymously under a nom de plume, precipitated a spirited discussion (see over 100 comments) about the propriety and professionalism of her messages in this public forum. While many saw her behavior as at the very least undesirable, some MDs and, more concerning, medical students, did not see a thing wrong with her eructations. Furthermore, she responded via Twitter that she was quite surprised by this tongue lashing and did not know what was so offensive in her messages.

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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…


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