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Tag: Social Media

Friends, with Benefits

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By JONATHAN BUSH Jonathan Bush

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

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By CAROLE HODSDON MEDecision_Carole Hodsdon

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 RICHARD REECE, MD

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

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By PAUL LEVYPicture 25

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

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By PAUL LEVYPaul Levy

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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From Twitter to Megaphones: Nine Lessons Learned about Crisis Communication

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By LISA GUALTIERI, PhDThe Great Boston Water Main Break of 2010

In Boston we took the availability and quality of our tap water for granted until May 1, 2010, when a major water pipe break interrupted water service to all Massachusetts Water Resources Authority (MWRA) customer communities in much of Greater Boston. Information spread quickly, and was updated frequently, about the problem and what to do, all the more notable because the water main break occurred on a Saturday. In this age of consumer paranoia about withheld information, the MWRA was in front of cameras and online, communicating what they knew and what they were doing. Tufts University and the Boston Public Health Commission used communication channels ranging from Twitter to megaphones to get the word out. They shared with me their behind-the-scenes emergency planning processes, their response to this incident, and the lessons learned from this short-lived crisis.

The Evolution of the Tufts Emergency Alert System

Because I learned about the broken water main in a text message from Tufts University, I spoke to Geoff Bartlett, Technical Services Manager in the Department of Public and Environmental Safety (DPES) at Tufts about their process for communicating about the broken water main. First he told me how Tufts Emergency Alert System started and evolved.

Following the Virginia Tech massacre in 2007, DPES, University Relations, and University Information Technology invested in emergency notification system technology and developed policies for when and how it would be used. The Tufts Emergency Alert System was initially intended for life threatening emergencies. In requesting student and employee contact information, Tufts made this clear since they thought people would be reluctant to participate if they anticipated inconsequential messages.Continue reading…

Why You Ought To Be On Twitter

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By MATTHEW HOLTMatthew Holt

Today we’re introducing a new feature on THCB.  Every two weeks I’ll be broadcasting a brief segment with the folks at ReachMD, the radio station for doctors that broadcasts on XM satellite radio.  If you like, you can have a listen to the inaugural broadcast here. (You’ll need to sign up first, but the process is quick and painless.) You’ll also probably want to take a minute to contribute to the quick web-based poll tied to the broadcast. Today’s, which can be found at the foot of this post, asks how healthcare professionals are using Twitter.

More than 100 million people now have a Twitter account and millions of Tweets are sent daily. The Library of Congress is archiving every tweet ever sent!

If you need catching up, Twitter is a service that lets you send very short messages called “tweets”. Anyone can “follow” your tweets, that is subscribe to your messages, and you can subscribe to anyone else’s Tweets.

Some hospitals have already started tweeting, including a few sending minute by minute updates from the OR. That may generate publicity, but it’s not the most worthwhile use of Twitter.

But what’s the use of tweeting? Should you be doing it?

The magic of Twitter is that it extends your reach. There are two ways to use Twitter – one is inbound. One of the things you can tweet is a web link. Almost all journals, media companies, and medical leaders tweet links to their articles and opinions. And other people and organizations you’re following are also tweeting articles and opinions from people and organizations they’re following. …. Now you’re seeing what a whole community of experts is looking at —with virtually no effort.

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Autism and the MMR: Finally a Retraction

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By NAOMI FREUNDLICH

Are we finally ready to close the door on the much-disputed link between the MMR vaccine and autism?

On January 30, Britain’s General Medical Council ruled that Andrew Wakefield, a gastroenterologist, had acted “dishonestly and irresponsibly” in conducting his research that established a link between autism and the MMR vaccine. And yesterday, the British medical journal Lancet finally retracted the resulting 1998 study authored by Wakefield that helped drive MMR vaccination rates in the U.K. down to the point where in 2008, measles was officially declared “endemic” in the country.

The Lancet’s editor, Richard Horton, told The Guardian “It was utterly clear, without any ambiguity at all, that the statements in the paper were utterly false,” he said. “I feel I was deceived.”

The GMC investigation, entailing 197 days of evidence, submission and deliberation  between July 2007 and  January 2010, exposed an unscrupulous researcher who falsified data, used sloppy laboratory techniques and subjected children to painful and potentially harmful medical tests like lumbar punctures and multiple colonoscopies to try and prove his notion that MMR vaccinations cause bowel disease and autism. Wakefield even went so far as to offer children attending his son’s birthday party £5 to donate blood samples.

The investigation of Wakefield and his shoddy and unethical research methods began in 2004 when British journalist Brian Deer began talking with parents of the 12 children involved in Wakefield’s study and reviewing medical records. Since then, Deer has dedicated countless hours and words to setting the record straight about Wakefield’s work—including the finding that his research was funded by lawyers representing parents who planned to sue vaccine makers for damages.

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Why America Needs a Patient-in-Chief

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By e-Patient DAVE deBRONKART

“These are exciting and very promising times for the widespread application of information technology to improve the quality of healthcare delivery, while also reducing costs, but there is much yet to do, and in  my comments I want to note especially the importance of the resource that is most often under-utilized in our information systems – our patients.”
– Charles Safran MD, testimony to the House Ways & Means subcommittee on health [Emphasis added]

Quite current, yes? No: Dr. Safran said those words in June 2004. And not much has changed.

My physician Dr. Danny Sands, mentored by Dr. Safran and colleague Warner Slack MD, heard similar sentiments from them decades earlier. And where are we today? Patients are still untapped, and we have the worst dysfunction in the history of healthcare. Perverse incentives and unintended outcomes are the rule, not occasional glitches, as costs spiral up and outcomes don’t.

As Consumer Reports recently said, in the ten years since the Institute of Medicine’s classic report To Err is Human documented as many as 98,000 deaths a year from preventable medical error, “not much has changed.”

These are signs of a system that’s governed without input from its customer – the patient.

Patients have the most at stake, but they’re invisible in Washington. We need to link them in; we need their passion, their commitment, their very-motivated contributions.

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The FDA Steps In: Regulating Prescription Drug Promotion on the Internet

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KATE GREENWOODKate-greenwood-7-16-08-compressed-200x300

The FDA has been widely criticized for not providing guidance for drug companies eager to promote their products on the internet.  Earlier this year, the FDA expressed the view that the message was what was important, not the medium, meaning that companies should simply apply the rules governing prescription drug advertising in print media to the internet.  On April 2, 2009 the agency issued Notice of Violation letters to 14 companies who sponsored links on internet search engines advertising their products; the links gave the name of the drug and, in some cases, its indicated use, without including the required “fair balance,” i.e., safety information such as contraindications and potential side effects.  In reliance on the so-called “one-click rule” — which had never actually been adopted by the FDA — the companies had put the required safety information one click away on a separate page.

In recent months, the FDA has indicated that it is open to providing internet-specific marketing guidance.  Yesterday and today (November 13th) the agency is holding a hearing on “Promotion of FDA–Regulated Medical Products Using the Internet and Social Media Tools.”  Representatives from advertising agencies, consumer groups, health-related websites, pharmaceutical companies, and search engines are scheduled to testify.

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