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Tag: Social Media

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…

Insurers Flat Foot Their Way Into the Social Media Era

A couple of related pieces caught my attention today: @HealthPlan: How insurers use social media and Insurers are scouring social media for evidence of fraud. Slowly but surely health plans and other insurers are stepping into the world of social media and it’s interesting to see how they are doing it.

Health plans seem to be following along the lines of other big, bureaucratic organizations that cause customers a lot of frustration through poor customer service. Here’s an example of a Twitter exchange between Humana and a customer:

Sept. 23, 2010
@MrAndrewDykstra: Dear Humana, you’ve ruined my day. Worse, my wife’s day. Way to CYA. I’m paying you to cover mine. #NotHappy

Sept. 24, 2010
@HumanaHelp: @MrAndrewDykstra I’m sorry to hear about your frustration, is there anything I can do to help out?

@MrAndrewDykstra: @HumanaHelp You were kind and didn’t give my wife the run around, I appreciate that. 3/3.

Sept. 27, 2010
@HumanaHelp: @MrAndrewDykstra Thank you, let me know if you need any customer care.

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Twitter: An Essential Tool for the Physician Executive

Every morning at 5:30 AM, I am at my computer scouring the Wall Street Journal, the New York Times, the Philadelphia Inquirer, and other news sources for articles about health care and wellness. These articles are then summarized in 140 characters with a link to the original article and tweeted. As of today there are 3070 followers of my informal aggregated health care news service, and I hear about it if I am late or slack off on the job. My twitter community depends on me, and I depend on them.

Twitter has transformed my professional life as an independent physician executive consultant-keynoter who advises health systems and medical groups. Twitter is the main tool I use to monitor the latest developments in the world of health care delivery, payment reform, and physician integration.

I follow about 1,000 health care professionals on twitter, and I often learn about developments in real-time long before they hit the newspapers and journal articles. A few months ago, I was preparing a keynote for a Governance Institute Conference on Social Media for Hospitals and Doctors. One of the people I follow on twitter mentioned a Deloitee Touche white paper on just this subject. I looked it up and included some of their findings and recommendations in my talk (http://ow.ly/29QZy). Without my twitter community, I would probably have never seen this valuable resource.

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Facebook Saves Woman’s Life: Newt Gingrich and Reality-Based Healthcare Systems Planning

I’ve seen at least half a dozen links to the op-ed coauthored by Newt Gingrich and neurosurgeon Kamal Thapar about how the doctor used information on Facebook to save a woman’s life. (It was published by AOL News. Really.)  In brief, a woman who had been to see a number of different health care providers without getting a clear diagnosis showed up in an emergency room, went into a coma and nearly died.  She was saved by a doctor’s review of the detailed notes she kept about her symptoms, etc., which she posted on Facebook.  The story is vague on the details, but apparently her son facilitated getting the doc access to her Facebook page, and the details posted there allowed him to diagnose and treat her condition.  She recovered fully.

Newt and Dr. Thapar wax rhapsodic about how Facebook saved a life, and sing the praises of social media’s role in modern medicine.  (I’m not sure how this really fits in with Newt’s stance on health reform, within his 12-step program to achieve the total replacement of the Left … but, hey, nobody has the patience these days for so many details anyway.)

Regular readers of HealthBlawg know that I would perhaps be the last to challenge the proposition that social media has a role to play in health care.  However, I think Newt got it wrong here.

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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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The Race is On for the Next Generation of Healthcare

I continue to be amazed at the speed at which the mobility and portability of healthcare is developing. It is readily apparent that the technologies, devices and other innovations that we always knew would transform the delivery, consumption and administration of healthcare—but that always seemed years away—are in fact now here.

It’s kind of like that car commercial from a few years ago that asked why we’ve never actually seen the cool and futuristic concept cars that auto manufacturers have teased us with over the years; except in this case, all of the neat and futuristic stuff is right there just waiting for us to put it to good use. It’s called telemedicine, at the risk of oversimplifying, and combined with the change that has actually been legislated for healthcare over the past year, it’s putting the system on the threshold of an entirely new era.

For example: Remember the dark ages of, say, 1998 or 2000 when patients were given heart monitors to wear and then had to phone their doctor to report the various data? Well, it’s pretty safe to say that we can relegate those to the same time capsule as the VCR and the rotary telephone. Fast forward to today and you’ll find wireless, Bluetooth-enabled devices that can deliver the same information—and a lot more, in fact—in real time, 24/7. How about unlimited geographic boundaries for the delivery of medicine? Think of a lung specialist in Philadelphia rendering his expertise to a patient in rural Australia without leaving the comfort of his desk chair. Tired of being handed a clipboard and then interrogated about your medical history every time you see a new doctor? What if that information—in more breadth and detail than you can remember or are probably even aware of—was delivered to your doctor long before you even showed up for your appointment? And how about if, afterward, it was updated automatically and then followed you to your next specialist appointment?

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The Next Big Thing for Doctors

By

The Future Just Happened,
by Michael Lewis, 2001

As a consultant to the Physician Foundation, a not-for-profit 501 C-3 Organization representing physicians in state medical societies, as a sometime futurist, and as someone who has written extensively about innovation in Innovation-Driven Health Care (Jones and Bartlett, 2007) and in 1475 blogs in Medinnovation, I have been asked: What is the next big thing for doctors, and how should they react to it?

The next big thing for physicians will be Medicare fee cuts in the neighborhood of 50% by 2020 as mandated by the Affordable Care Act, and the next big clinical innovative response for doctors will be encouraging patients enter their own data, their own chief complaint, and their own medical histories before seeing the doctor to compensate for fee reductions.

Ceding a Traditional Physician Function to Survive Economically

Doctors will have to cede a traditional function – taking a history – to patients to become more efficient to survive. Payers – including Medicare, Medicaid, and private health plans- will demand standardization and restructuring of the medical history to achieve consistency in medical records. Patient-entered information may be disruptive. Doctors will have to change practice flow patterns to adjust to reality of lower pay. The need for greater productivity will drive this change.

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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.

Social media interlude

Two items about social media.

1) I often get the question in interviews, “How much time do you spend on your blog and other social media?” I often answer, “You wouldn’t think of asking me how much time I spend on the telephone, and it is a lot less efficient than social media.”

Think about it this way. A major advantage of social media is its asynchronicity. The person or people with whom I am communicating do not have to be doing it at the same time as I do. Another advantage, of course, is the broader reach of social media, being able to be in touch with dozens, hundreds, or thousands of people.

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