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Tag: Social Media

Who Is Biz Stone and What Is Twitter?

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By Fred Trotter

Yesterday, one of the founders of Twitter, Biz Stone, gave the opening keynote at HIMSS.

This is probably going to be the best keynote at HIMSS, followed by a speech from Dr. Farzad Mostashari, which will also be excellent. It goes downhill after that: there will be a talk about politics and another talk from an “explorer.” I am sure those will be great talks, but when I go to HIMSS, I want to hear about health information technology. Want to know what @biz actually said? As usual, Twitter itself provides an instant summary.

HIMSS stands for Healthcare Information and Management Systems Society. The annual HIMSS conference is the largest Health IT gathering on the planet. Almost 40,000 people will show up to discuss healthcare information systems. Many of them will be individuals sent by their hospitals to try and find out what solutions they will need to purchase in order to meet meaningful use requirements. But many of the attendees are old school health IT experts, many of whom have spent entire careers trying to bring technology into a healthcare system that has resisted computerization tooth and nail. This year will likely break all kind of attendance records for HIMSS. Rightly so: The value of connecting thousands of health IT experts with tens of thousands who are seeking health IT experts has never been higher.

It is ironic that Biz Stone is keynoting this year’s talk, because Twitter has changed the health IT game so substantially. I say Twitter specifically, and not “social media” generally. I do not think Facebook or Google+ or your social media of choice has had nearly the impact that Twitter has had on healthcare communications.

HIMSS, and in many cases traditional health IT along with it, is experiencing something of a whirlwind. One force adding wind has been the fact that President Obama has funded EHR systems with meaningful use, and made it clear that the future of healthcare funding will take place at Accountable Care Organizations (ACO) that are paid to keep people healthy rather than to cover procedures when they are sick. It is hard to understate the importance of this. Meaningful Use and ACOs will do more to computerize medicine in five years than the previous 50 years without these incentive changes.Continue reading…

Live from HIMSS12: ICD-10, Meaningful Use & Social Media

By NEIL VERSEL

There has been a lot of buzz around two pieces of news –in one case, lack of news—in the past week. Last Thursday, HHS Secretary Kathleen Sebelius responded to heavy pressure from the American Medical Association and announced a delay to the ICD-10 implementation deadline, currently set for October 2013.

Meanwhile, the health IT universe continues to wait with baited breath for Sebelius and/or leadership at CMS or ONC to publish the proposed regulations for Stage 2 of the “meaningful use” EHR incentive program. The proposal was supposed to have been out before 35,000 or so health IT industry types descended on Las Vegas for HIMSS12, but it was not to be. As with any major federal rule-making, the White House’s Office of Management and Budget has to vet every word, so it is out of Sebelius’ hands for the moment.

Rumors spreading through the Sands Expo Center and the adjacent Venetian and Palazzo hotels have pegged Wednesday or Thursday for the release date, since national health IT coordinator Dr. Farzad Mostashari is leading a session on Stage 2 meaningful use with other ONC and CMS representatives Wednesday morning, then delivering a keynote address the following day.

In the wake of the ICD-10 bombshell last week, HIMSS itself and other IT-related groups are telling their membership and anyone else who will listen not to slack off when it comes to ICD-10 preparedness. HIMSS CEO Steve Lieber noted in his annual press conference Tuesday that the official HHS statement said the department would “initiate a process to postpone the date by which certain healthcare entities” must meet the requirements. That, to Lieber, suggests the possibility of a delay for physician practices or perhaps small hospitals, but not for larger organizations.Continue reading…

Using Twitter to Deliver Health Improvement Messages

By Doc Gurley

I have decided to spam for public health.

Phone calls, text messaging, and even apps have been shown to help improve health and sustain behavior change, even in people suffering from profound mental illness. But when it comes to using these tools for public health, there are two problems. The first is that each message (whether via phone call or text) costs money. The second is that it’s quite hard to use those platforms for blasting messages to a whole population.

That’s how I ended up in what is probably a community of spammers. I registered at Black Hat World in order to get access to its forum on uploading bulk tweets, and didn’t realize what company I was keeping until I saw user names like popzzz and images of a neon green skull and crossbones and rolling lines of HTML.

I am now poised at the unique intersection of spamming and homelessness. Suffice it to say, there aren’t a lot of people stampeding to spam the homeless.

So how did I, a suburban soccer mom, former Shoney’s-waitress-turned-Harvard-trained-doc, end up in this precarious position?

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The Emperor’s New Social Network

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By Michael Millenson

You can’t get much cooler than HealthTap: slick Silicon Valley start-up, social media darling, savvy and successful backers. But when you closely examine the service HealthTap actually provides, the money and good looks fall away. Like in the fable about “the emperor’s new clothes,” behind the buzz, there’s nothing there.

OK, maybe one thing: a really risky way to get medical advice.

Here’s how a Feb. 4 New York Times article described the company’s website:

[U]sers post questions and doctors post brief answers. The service is free, and the doctors aren’t paid. Instead, they engage in gamelike competitions, earning points and climbing numbered levels. They can also receive nonmonetary awards — many of them whimsically named, like the “It’s Not Brain Surgery” prize, earned for answering 21 questions at the site.

Fellow physicians can show that they concur with the advice offered by clicking “Agree,” and users can show their appreciation with a “Thank” button.

So far, so good. But there’s more. The professional credentials of the physician answering your question, such as a board-certified specialty, are not available on the site. Instead, you get a crowdsourced “reputation level” built up by accumulating HealthTap awards, by  clicks of approval from other doctors and by other measurable activities at the site.

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Health Care Social Media – How to Engage Online Without Getting into Trouble (Part II)

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By David Harlow

I have been asked to write up some of the core takeaways from the health care social media presentations I have been giving recently, so I am sharing a version of this narrative on HealthBlawg, in two parts.  You may wish to begin with Part I.

Professional responsibility and malpractice liability

The American Medical Association has promulgated a social media policy; so has the Veterans Administration.  The two represent very different approaches.  The AMA essentially advocates proceeding with caution, and being cognizant of the damage that one’s own social media activities – and one’s colleagues’ – may do to the profession.  The VA, on the other hand, is out in front on this issue – just as it was with electronic health records – encouraging the use of social media tools to disseminate information and engage patients and caregivers in productive dialogue likely to improve overall wellbeing and health care outcomes.

Patient care should not be provided in open social media forums, but appropriate disclaimers on blogs, Facebook pages, YouTube channel pages, and the like, should be sufficient protection for providers seeking to use these tools for sharing of general advice and information.

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Health Care Social Media – How to Engage Online Without Getting into Trouble

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By David Harlow

“Why do you rob banks?”

“That’s where the money is.”

The legendary bank robber Willie Sutton, when asked, gave this straightforward response explaining his motivation.  A similar motivation may be ascribed to the early adopters among health care providers who have established beachheads on various social media properties on line.  Why be active in on line social networks?  That’s where the people are: patients, caregivers, potential collaborators and referral sources, like many, many other people, are using social media more and more.  Facebook has become nearly ubiquitous, and its user base is growing not only among the younger set, but also among the older set, who are signing up so they can see pictures of their grandkids.  In today’s wired society, on line social networking is the new word of mouth.  Word-of-mouth referrals, personal recommendations, have always been prized; we have simply moved many of those conversations on line.

Over half of Americans rely on the internet when looking for health care information.  Many on line searches are conducted on behalf of another person.  Most people expect their health care providers to be on line, providing trustworthy information – and the day of the static website has passed.  In addition, a growing subset of the population is comprised of “e-patients” – the “e” stands for educated, engaged and empowered – who seek out health care providers prepared to engage with them both in person and on line.

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From Blackberry to iPhone

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By John Halamka

Last week I retired my Blackberry Bold, removed myself from the Blackberry Enterprise Server, and began using an iPhone 4S as my mobile email, web, and telecommunications platform.

This was not a casual decision.   I’ve used Blackberry products since 1998.  The original Blackberry 850 was named one of the top 50 technologies of the past 50 years.

I receive a wireless communication approximately every 30 seconds from 7am-7pm every day.  On Tuesdays and Thursdays I receive over 1500 emails per 24 hour period.   These communications are filled with media – documents to read, presentations to review, websites to access, and streaming video.    Yes, I still use the email triage approach I outlined in 2007 but it’s a losing battle.   The volume of communication exceeds my ability to process and respond to the information.   I could cancel all my meetings, phone calls, and presentations but still fill the entire day with email communication.

I’m not suggesting this is healthy or sane, but it is the reality of communications today.

The iPhone 4S gives me a touch screen user interface to scroll, zoom, and manage my incoming messages.   I can view every document, website, and video over 3G networks.   Siri and voice recognition features enable me to manage my email by voice.   I find myself dictating responses to about a quarter of my email with amazing accuracy.

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The Digital Age and the Doctor/Patient Relationship

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By Kent Bottles, MD

The digital age has had a deep and likely permanent effect on the patient-physician relationship. I can’t tell you how many times I’ve had physicians beg me to provide them with a way to stop their patients from Googling their symptoms and diagnosing themselves before their first office visit and much to their chagrin, my answer is always the same, “You can’t stop them. Get over it.”

The internet acts as an enormous and easily accessible virtual research library for patients, granting them access on the one hand to quality, data-driven information and personal perspectives that can provide tremendous value and on the other hand to information that is no better than old-fashioned quackery.

But this access to information has not translated into improved interactions between patients and their physicians. It is clear to me that we all need help in rethinking how we can best work together, especially because I believe that we are still in the nascent stages of this age of disruptive new tools that delight some and threaten others. Time and time again I hear stories describing the ways in which this technology seems to be moving us backward instead of ahead:

· When Timothy B. Lee went to a dentist highly recommended on Yelp, he was asked to sign a “mutual privacy agreement” that would transfer ownership of any public commentary he might make in the future to the dentist.

· A TechDirt blog post reported that plastic surgeons have sued patients for their online negative reviews and a neurologist sued the son of a stroke victim for negative comments about the physician’s bedside manner.

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Is Incentive-Driven Healthcare the Holy Grail of Engagement?

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By Michael Dermer

Industry studies confirm the strong connection between healthcare costs and the ingrained behavior of consumers and providers. Ironically, consumers and providers have access to more health information, tools, programs and support than ever before; yet healthcare costs continue to increase and chronic diseases continue to affect a larger portion of the population.

The healthcare industry is at an inflection point where payers, employers, providers and consumers must all be directly involved in the effort to manage the cost of care and to improve health outcomes. A critical aspect of this effort involves the motivation and behavior of all healthcare market participants, but primarily applies to the healthcare consumer and provider at the point of care delivery.

To drive engagement in programs designed to improve health, organizations have applied both incentives and disincentives, with varying degrees of success, as part of an overall engagement strategy. Generally, the presence of an incentive leads to improved results, but most incentive designs have fallen short of their potential. But some valuable lessons have been learned.

The healthcare industry has learned, for example, that incentives can drive behavior change, and can help establish a new baseline for consumer expectations, consumption patterns and health awareness. In turn, this newfound awareness has the potential to address the root causes of the nation’s healthcare crisis, leading to a more rational care model and slower rate of health cost increases.

More importantly, the well-intentioned but haphazard evolution of the application of incentives to various healthcare initiatives has yielded a robust volume of actual performance and cost-related information that can finally provide reliable links between program participation, behavior change, health outcomes and cost savings; and all of the necessary data to determine return on investment.

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The Farmville of Health?

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By Jan Gurley, MD

Can you play your way to better health? What does it take to get people moving? That was the question kicked around (har!) at the gaming-health session at Health 2.0.

Chris Hewett’s demo of MindBloom had the room packed. He began by talking about being motivated by fear, or, instead, being motivated by purpose. You’re either running away from something, or toward something. Mindbloom is about spending two minutes every day looking at images that mean something to you, and that motivate you. One step every day is the key to enduring change. The key is sustained engagement. Many of the tools that exist today are not engaging. The core goal is to make life change fun, and engaging. As a gamer, Hewett wants to make behavior change appealling. And it needs to be authentic. I think that he is trying to make Mindbloom into the Farmville of health – a pervasive and widely appealing game, but one that happens to have a positive effect on people’s health and life. People use Mindbloom to discover what’s most important to them. A key differentiator is to take a view of the entire life. The key reason why most people want to be healthy is to spend more time with their relationships. Mindbloom just finished their public beta with 15,000 users.

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