Tag: Social Media

From Twitter to Megaphones: Nine Lessons Learned about Crisis Communication

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

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

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

“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

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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Tell the FDA the whole story, please

Susannah fox

I scan menus for keywords (fig, parsnips, salmon…) and it turns out I scan Twitter the same way, looking for anyone who is talking about my favorite topics (data, consumers, information quality…)

So when I saw Jonathan Richman‘s tweet the other night, I couldn’t resist it:

Anyone ever seen data on the overall accuracy of medical information found online? Need help for some final stats for #fdasm

Short answer: No. Long answer:

The Pew Research Center’s Internet & American Life Project has been reporting on the social impact of the internet since 2000, when “information quality” on health websites was a big part of the conversation. It was the era of wagging fingers, scolding patients for straying too far outside their boundaries, and Pew Internet data was ammunition.

We released our first report about the internet’s impact on health & health care in November 2000. The Medical Library Association (MLA) contacted us, asking for research looking at how consumers decide which sites/sources to trust. With their help we created a set of questions asking first if respondents went online for health info, then asking if they look for the source and date of the info they find (the two key quality indicators according to the MLA).

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Health 2.0 Tools: The power of Twitter

Picture 31

The power of Twitter is real kids, and not for what you think. Used properly Twitter is an information filter. Exhibit A is what happened to the Von Schwebers who run PHARMASurveyor. They were a huge part of the Tools Panel which featured interoperation among 8 members of the Health 2.0 Accelerator at Health 2.0 a couple of weeks back. Then last week they were at an AHRQ conference on Drug Interactions when this happened. Erick von Schweber’s email picks up the story ..

The Chief Medical Officer of Express Scripts is doing his talk, about halfway through, and then tells this rather academic audience of scientists and researchers that there’s something new they need to attend to. It’s called Health 2.0, he says, and he puts up a PowerPoint slide with screen captures from WebMD, HealthVault, Healthline, DoubleCheckMD, etc. Then he tells the audience that the prior week he saw tweets about something new in the space, so he checked it out. He says this is the next major leap ahead in drug safety. So up comes a series of four slides, all screen grabs of PharmaSURVEYOR. And he calls us the Accelerator and explains what we do, disclaiming that he had no knowledge that we’d be there at the conference (I had moderated that morning’s session on making DDI evidence more relevant to patients and physicians; Hansten and Horn were my speakers, the guys who introduced the term “drug interaction” in the mid-sixties). He tells the audience that they must go to PharmaSURVEYOR as well as begin thinking in terms of consumer generated healthcare.

Now it just so happens that the Chief Scientist of Express Scripts but not the Chief Medical Officer had been to Health 2.0 and (I assume) seen the Tools panel demonstrations. But, and this will amaze no one, busy executives at big corporations don’t always immediately communicate all of their learnings with each other. So how did the Chief Medical Officer find out? He probably saw a re-tweet of the #health2con hash tag. That, ladies’n’genelmen, is how our kids is learning these days.

And do you want to see the incredible tools panel from Health 2.0 which contained both the accelerator integration project (in two parts), the debut of Keas, and Eliza showing the first Health 2.0 marriage? Funny you should ask.

Shutting Down Social Media? Not Here.


Paul Levy is the President and CEO of Beth Israel Deconess Medical Center in Boston. He blogs about his experiences at Running a Hospital, one of the few blogs we know of maintained by a senior hospital executive and where this post first appeared.

The following email message was broadcast last week in a Boston hospital. Of course, you can guess my view of this: Any form of communication (even conversations in the elevator!) can violate important privacy rules, but limiting people’s access to social media in the workplace will mainly inhibit the growth of community and discourage useful information sharing. It also creates a generational gap, in that Facebook, in particular, is often the medium of choice for people of a certain age. I often get many useful suggestions from staff in their 20’s and 30’s who tend not to use email. Finally, consider the cost of building and using tools that attempt to “track utilization and monitor content.” Not worth the effort, I say.Continue reading…

Groupon, Livingsocial, and digital norms

Regular readers may have noticed that I am a bit of a social media junkie– this blog, Facebook, Twitter — but I am also intrigued by social media sites that are set up only for commercial purposes. It is fun and instructive to watch the evolution of these sites.

Along those lines, a few weeks ago, I wrote about Groupon. The concept: The retailer offers a discount deal in the city of your choice, but only if enough people sign up for it.

The viral power is amazing, because after you sign up for something you want, you contact all your friends asking them to do the same so you can get the deal. Meanwhile, the retailer gets noticed by people with an affinity for his/her product or service, and gets a bundle of cash in prepayments. The folks at Groupon get some kind of fee. Everyone is happy

Now arises a new site, soon to go into business, called Livingsocial. Like Groupon, you can sign up for the deal of the day, and if enough people sign up, the deal is on; but unlike Groupon, if you get three other people to sign up for the deal, you get your coupon for free.

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10,000 US physicians have something to say and we’re not wasting time.

Today, as Congress returns to session, all 100 Senators will be listening to physicians on SERMO when they deliver the “US Physician’s Appeal” on Capitol Hill.   Wasting no time, my physician colleagues and I, armed with the over 10,000 signatures will deliver the Appeal directly to lawmakers, requesting them to include us in national health reform strategy.

We are pledging our commitment to true healthcare reform focused on the real sources of spiraling, bureaucratic costs and by doing this on day one of Congress’ return, we are telling them that true healthcare reform will only succeed IF:

  1. Tort and malpractice laws are reformed;
  2. Billing is streamlined and pricing made transparent, ending systemic support of the AMA owned billing codes (CPT Codes);
  3. The insurance industry is reformed; and
  4. Payment systems are simplified so they align with the growing need for preventive medicine.Continue reading…


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