#hcsmca – Is yesterday’s future ready for tomorrow?

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The first #hcsmca  chat I remember being actively involved in took place on Jan. 19, 2011. Since that time I have been involved in a number of formal chats and ongoing conversations on #hcsmca almost continuously – and some might add even excessively.

Since Colleen Young started #hcsmca in September, 2010, the community has touched more than 8000 people (i.e. they have used the hcsmca hashtag) and contributed to arguably some of the most intelligent conversations occurring on Twitter with respect to the use of social media in health care. It has also helped introduce countless physicians, health care publicists and just plain folks with an interest to the world of health care and social media.

The virtual community has even become the subject of academic discourse with the presentation in London in September and then subsequent publication in the Journal of Internet Medical Research of work by Drs. Anatoliy Gruzd and Caroline Haythornthwaite on enabling community through social media

But at this very pinnacle of its success I have noticed something disconcerting – the number of participants in the weekly chats that make up the core of #hcsmca have dwindled sometimes alarmingly and the ongoing flow of knowledge represented by tweets referencing #hcsmca also seem to be in decline.

These signals have taken place at a time when the practical if not spiritual heart of #hcsmca, Colleen herself has taken on new responsibilities and divested herself somewhat of daily curation of the site.

#hcsmca has always been championed as a truly democratic virtual community where the moderation of weekly chats has been shared by a very large group of stalwart supporters. But some of those supporters are sometimes not as visible on #hcsmca today.

These observations raise certain critical questions about #hcsmca specifically and Twitter-based virtual communities in general

  • Does the format of #hcsmca in 2013 still meet the needs of its members
  • Has the use of social media in health care reached such a level of maturity that a virtual meeting place to educate people is no longer necessary
  • Is it realistic to expect that altruism alone can keep a virtual community going indefinitely

I raise these questions with the hopes that the #hcsmca will provide answers that I personally don’t have – but I do believe answers must be found if #hcsmca is going to continue to fluorish

 

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35 thoughts on “#hcsmca – Is yesterday’s future ready for tomorrow?

  1. There are a few challenges for me and participating in #hcsmca.

    First and probably least surprising, it’s quite difficult to find the time to sign in. On the dates when I happen to be free of meetings, I often have to choose between getting a lunch break or #hcsmca. More often than not I’m going to choose the much needed break.

    The other thing I’ve found is that as I’ve become engulfed in social media and healthcare, my interests have gone from general to much more specific. There are topics we discuss that are of little interest or relevance to me. This doesn’t mean the conversations aren’t valuable – I’m glad someone’s interested in the areas I am not – but it does make it more likely that I won’t sign in.

    I think there’s still value in meeting regularly online, however perhaps we need a restructuring of sorts. Maybe subchats based on more specific topics? Maybe we need to move to long-form communication to take our expertise to the next level? Maybe we need a team project to work on? I’m not sure what the answer is.

  2. I think you make some good points. As Alaina said, many people have to work these chats into their lives and that doesn’t always leave time to participate. As well, sometimes there are topics that are right up my alley (infection control, visual communications, human factors) and sometimes there aren’t (but still interesting to lurk).

    As to a solution… I think that perhaps maybe you’re partly right and “health care social media canada” is slowing down because it’s too broad a topic. Both “healthcare” and “social media” are big topics on their own. Some of the most successful twitter chats I’ve been a part of have a more focused topic – one covered social media in disaster preparedness and the other accessible design for those less physically able.

    Glad to see so much discussion about it!

  3. I had the opportunity to have coffee with Colleen the other day, and I likened the “death” of #hcsmca (which I think is greatly exaggerated, by the way!) to the death of rock ‘n’ roll. If you started listening to rock when bands like Led Zeppelin, The Rolling Stones or Pink Floyd were in their prime, it’s possible you’ll have no appreciation for today’s music. You may find it derivative. Often it sounds like entire riffs and melodies are knock-offs of the classics we grew up with.

    For a new generation, however, it’s the first time they’re hearing it. It feels fresh. It still inspires.

    I believe the same is true for #hcsmca. Those of us who were around in the early days may be feeling like we’ve heard it all before, and that there’s nothing new to offer. But for the new generation, it’s a new-found treasure trove of sage advice and knowledge. Some of that can come from the transcripts of discussions past, but I believe it’s important to see a wide cross-section of users with different experiences, expertise and perspectives actively engaging.

    I don’t think #hcsmca has outlived its usefulness, but I do think there are other opportunities for more fulsome discussions and interaction using another platform in conjunction with Twitter. Perhaps a portal with blogging capabilities, file sharing, wikis, virtual whiteboards, etc. And for those who have attended one of the meet-ups, there is no substitute for the networking and sharing that takes place face-to-face. I highly value the relationships I have made, and I do hope there will be more opportunities in the future.

    The biggest challenge I foresee is management and organization. Colleen has created a remarkable online community, but it requires nurturing to grow and sustain. I’m not sure a handful of #hcsmca faithful can continue to evolve the group to meet the needs of all its members, but I am encouraged to see new faces moderating occasionally.

    Thanks, Pat, for drawing attention to the elephant in the room. Hopefully it kick starts a thoughtful discussion and maybe even some potential strategies.

  4. I believe that #hcsmca is a valued forum with many wonderful hosts! members! topics. I personally feel out of my league on some of the conversations, but I wholeheartedly support the forum.

    It often falls to one or two people to create, engage, commit, participate – and Colleen is excellent in doing that.

    Personally for me, lately I feel overwhelmed, trying to take in, learn from and follow several chats…timing is an issue, real life commitments…and energy.

    I would hate to see #hcsmca fall to the wayside -.perhaps bi-weekly instead of weekly? Maybe a different time? It’s hard to say. Sometimes it’s a combination of reasons, but the need is obvious.

    #hcsmca is the first chat I ever participated in. I thought I would never understand or follow the chat, but I can….and sometimes the topic is way over my head so I stay out and lurk:)

    I am grateful to have come to know so many through this forum, and expect it will continue…and one day I hope to have some real life meetings with incredible passionate people who frequent #hcsmca.

    Best wishes, hope to attend the next chat at 1,pm Wednesday January 8th 2014

  5. Interesting questions!

    Not so long ago, I was able to meet up weekly without ever really worrying about shifting things in my schedule- but since I started getting involved in other areas (volunteering with different research projects, papers and all sorts of things I never dreamed I would be able to do!) I haven’t been as available as I once was. But I still check in, and I do read the transcripts if I can’t actively participate.

    That said- I would never have had the opportunity to branch out and work on these new projects if it hadn’t been for the #hcsmca community at large. Maybe you don’t believe me. But it is the honest truth. And I thank each and every one of you for that.

    I wonder if #hcsmca is having growing pains. That doesn’t mean that it should stop.

    Personally, I think that means that it needs a bit more space so that it can stretch a bit. The suggestions above are all potentially spectacular. I’m not sure which direction to take it, but I can say that it is an incredibly important and vital community. One that I’m not willing to set aside no matter how busy I get. There is a definite need for this to continue.

    Looking forward to the discussion!

    ~J

  6. For me, it’s been simply that my new job is keeping me focused on learning in a different field. I am still committed to some volunteer work with my former team and that will begin soon. As a result, spare time for #hcsmca during my work day is lacking except for the occasional lurking.

    I too wonder if a bi-weekly schedule might be easier. Participating in these chats has been an incredible meaningful opportunity to learn and share learning. Ditto for moderating.

    I agree with a lot of what Dave says above. #hcsmca is truly valuable and has contributed much to the growth in this field.

  7. Thanks Pat & Colleen for creating a space for critical thought & self reflection on the hcsmca community. I have a meeting during the chat, but will try to catch the tail end of it, or the transcript. Juggling many commitments during chat times seems like a recurrent theme here!

    Rob Fraser, a fellow hcsmca community member, once told me that social media is like the pager or fax machine – yesterdays innovation and invention. It will be exciting to imagine together how hcsmca can help us navigate and understand whats coming next.

    Looking forward to participating in the conversation this week –
    Karen

  8. I have a slightly different take on why I stopped participating in online chats – I found there were too many participants all trying to get their ideas into a small # of characters so there was a lot to read but no real depth. I prefer twitter conversations with 2-3 other people over a topic that comes up spontaneously.

  9. Great blog! Thanks for alerting us to this. I thought #hcsmca was merrily on it’s way and growing fast! So sorry I didn’t check in more in past months.

    I often felt out of my depth on the chats too but that’s because i’m an ill patient (not a physician!), also just coming off getting a national non-profit off the ground (brain is fried). I really feel for Colleen because this reminds me of trying to keep discussions going and interesting for all in our organization on a national level.

    I think #hcsmca is wonderful and a great resource. I try to tag some tweets with #hcsmca when it’s specific to medicine (an article, or something on national or international rare disorders). I’m not clear on what is appropriate to tag with #hcsmca that others would find helpful largely because I am a patient. Very conscious of wasting doctors and others time so I hesitate a lot.

    The suggestion above to have a blog or wiki of some sort is worth considering. I thought that was a very good idea.

    There are so many healthcare and SM related chats on twitter now. I’m not sure how to draw attention to #hcsmca. Getting anything innovative like this off the ground in Canada…I experienced it as very difficult. Canadians don’t like to speak up 🙂 Or something. I don’t know for sure. It is frustrating and I have been there.

    The one thing I do know is #hcsmca has to survive and if it hits a lull now and then, that might be okay. Colleen has built a helpful resource and connected so many informative smart people. We need to keep that going. #hcsmca is visible internationally now which is huge accomplishment! Maybe if each of us makes an effort to remember to tag tweets for #hcsmca at least once or twice a week to help keep interesting topics going. And then responses to those tweets, tagged to @hcsmca as well, might help determine what each weekly topic should be in terms of audience interest or need? Whoever has access to @hcsmca or even just reviewing #hcsmca could determine weekly topics of interest?

    I hope this helps. I’ve met some wonderful people on these chats too. But seeing the connections people in medicine make with each other, and patients orgs, really is exciting. Gives me a lot of hope for healthcare in Canada.

  10. My interest in #HCSMCA hasn’t changed, but my industry has. I used to work for an organization that was closely associated with health care and patient-focused. I am now working in biotech – and we’re a long way from having products ready for patients – so the topics are no longer relevant. (Although if you want to expand the focus to scientists rather than physicians, I’m ready to jump back in.) Plus, when I first started participating in the tweet chats, I was relatively new to Twitter and the #HCSMCA community was a valuable source of information about social media.

    I think Dave Bourne’s comments are very relevant: it’s time to find a new crop of #HCSMCA tweeters who can learn from the topics and engage in the discussions. Finding them will be the challenge, but they can carry the torch for the next few years. I don’t think that #HCSMCA has outlived its purpose, only that some of its early participants have graduated.

    Thanks for caring enough to ask the questions Pat, and a big thank you to Colleen for everything she has done.

  11. Perhaps we could set up an automated email feed that alerts people to the upcoming topics.

    While I don’t have the same amoutn of time that I used to, I would still like to participate more often than I do. I often forget to check the topic list in advance and find out too late about a topic that I definitely would have wanted to participate in.

    I also think it would be great to get more case studies.

  12. Great post, Pat. Thanks for taking the time to put your thoughts down about #hcsmca’s future. You’ve been a tireless supporter of #hcsmX communities around the world, including #hcsmeu.

    #hcsmeu, as you know, underwent a similar transition to that which #hcsmca may be on the verge of, and transitioned from a weekly tweet chat to an information-sharing hashtag in 2012 after a community poll (see http://stwem.com/2012/10/31/future-of-hcsmeu-chats-a-poll/).

    And… that’s fine. Nothing’s forever, and to speak to Alaina’s point above, as more people have joined the health conversation on the social web, so that conversation has become able to support more subject-specific chats speaking to people’s particular interests.

    I still think there’s a place for ‘generalist’ hashtags as a means of signposting people to resources and connecting/introducing them to new connections. However, the social web is now so interpolated into our working and personal lives that it has become unnecessary to consider it as isolated from our work. The diffuse, diverse connections it makes possible also renders the concept of the custodians of hashtags as ‘meeters and greeters’ redundant, to some extent.

    If numbers dwindle, then people are simply finding what they want elsewhere, or finding other conversations that speak to their specific needs in a way that they find more rewarding.

    That is neither to denigrate nor say anything pejorative about what #hcsmca has achieved, merely to acknowledge that ‘everything flows’.

  13. Pat, great blog posting and the responses here also echo the passion we all have for HCSMXX no matter the country. I was honored to host one of the #hcsmca’s and would love to again in the future. As far as participating weekly, my challenges are similar to others: time in the middle of the workday, especially when I don’t have a reminder of what the topic of the week is (and if it is relevant enough to get the boss to let me participate). Since I do work in healthcare, I have the blessing to be able to participate when the topic is relevant to my job(s). Which brings up the last challenge, personally, of working 4 PT jobs currently to make ends meet. And that also poses it’s own challenges in active participation in areas I am passionate about, HCSM being my primary personal research interest.

    I have it on my schedule this week and hope to join in on the discussions of the future.

    Stacy Braiuca, MSW, MPH
    http://www.stacybraiuca.com
    http://www.social2health.com

  14. Thanks Pat for the thought provoking post. As Andrew Spong has already pointed out the #hcsmeu went through a similar growing pain in 2012 – it seems to be part of the life cycle on social media communities.

    But let me give my personal experiences of the last few years mainly with the #hcsmeu community.

    I can hardly believe it was September 2010 that #hcsmca started. I remember the very first tweetchat. Colleen invited me to ‘drop in’ from across the Atlantic in Scotland. I believe I may have tweeted in my pjs – it was quite late in the evening here. I may also have had a G&T. I do try to catch up on #hcsmca intermittently and when I feel I have something to add my @chibbie tweets fall into the #hcsmca timeline. I hope you don’t mind and I do apologise if I my posts sound quite random sometimes.

    I had met Colleen via the #hcsmeu Friday tweetchats – digitally (not in real life) of course. That didn’t seem to bother us as we had similar interests and experiences we quickly discovered. I believe we emailed next, this escalated to Skype video chats quite quickly, and a few months back Colleen and I met in real life. That was quite a weekend.

    I have never played the part of facilitator or moderator for #hcsmeu. Hopefully just a useful and sharing contributor, but like many of the Canadian comments I have been through periods of dropping away. 2013 was a particularly low year of contributions from @chibbie. I shared this with Colleen in September when we met – yes work was incredibly busy but I felt I had nothing new nor interesting nor relevant to add to the conversations at this time. Indeed what I concluded was that after a volcanic couple of years engagement on #hcsmeu it was now being put to use in the workplace. When I had something new to add I would. It still irked me somewhat though.

    So the last 3 months or so it has been on my mind to start making sense of things again and contribute. I believe social media engagement is a cycle – we are all at different points at different times. As someone commented there are always new people, new to the technology, new to the topics at hand. What interests me, will not interest someone else. Also what starts as a broad sweeping engagement around health over a period of time becomes shaped and crystallised – we start identifying layers of topics with embedded nuggets of rough. These deserve further exploration and tweetchats are not necessarily the place to do that.

    Of course the technology is great. But for me it is just a starting place. The conversations spark ideas that need to be tested or at least put into practice. What #hcsmca community becomes is not just a place for conversation, connecting, reporting, ideas & innovation – it is becoming a learning and evidence base. We all like it and what we don’t want is for it to disappear – there is no doubt in my mind that participating in #hcsmeu and #hcsmca has been good for me. I still want and expect a lot from my interactions in the social media space. But that evidence base does not manage itself – altruism cannot keep communities going and content does not manage itself.

    Pat you ask the question –do we still need a virtual meeting space? I think we still do –people will decide whether what form of education they take from it. I remember the days before social media – professionally I felt disconnected and sometimes struggled to place what I do in the bigger health context.

  15. Pat, thank you for raising this discussion which leads to more questions than answers at this point. As some other commentators here point out – this isn’t endemic to #hcsmca. I have seen it happen to other twitter chats too. Is it a case of running out of topics? Running out of steam? And yet, the original #hcsm chat seems as vibrant and engaging as ever – or perhaps I perceive it so, as I have only just managed to join it being in the right time zone at last. I think perhaps what happens is that a complacency sets in – the novelty of connecting with other like-minded persons wears off and we end up saying the same thing each week. I have been saying for a while now that we need new voices and fresh perspectives in the healthcare social media.We have become a virtual echo chamber and I wonder how much of what we are learning is as new and exciting as it was when we first started out?. As I say, I have no answers, but I am still a big fan and proponent of the modality of the twitter chat, particularly in the way it has broken down barriers between healthcare providers and patients. I would hate to see it fade into insignificance and think that the question of how to keep it relevant, dynamic and innovative is one that we all need to address in our respective healthcare twitter chats in the coming months.

  16. Hi Pat, Colleen, Andrew and all!

    Yes it seems to me, like Andrew signified: there is a turning point in the #hcsmX communities in which a break with what was common is dawning. Having grown into comfortable contexts for exchange of views and the repetition of regular participation in chats by the same participants, there is an informal group, even a group of friends in their midst.

    However as both individuals and groups do, they develop. Comments above signify needs of specialization, growing numbers in chat that makes it more difficult to participate and, most of all growth of new personal needs by individual developments. What we have witnessed in the #hcsmeu discussion was for example, also a frustration of early on participants, who did find it difficult to further develop insights in themes of interests within a chat that was also to accommodate needs of newcomers that had obviously different but early developmental needs in comparison with those familiar with basics and longing for advanced insights. To fill in this need, it was obvious for #hcsmeu members as is immanent now for #hcsmca as well, to seek for this development elsewhere.

    In my reflections, I compared the “community” of #hcsmeu as a group falling just short of a process of formalization, as into an association, for example. Its positive character of free bindings in participation became its drawback when the group developed into an advanced state in which differentiated needs of participants went beyond the single medium upon which it stimulated its growth and attractiveness for new “members”. In the perspective of sociological science, this is no wonder: associations become into life because of the needs of participants for differentiation of solutions for different needs in light of common goals. That’s why a sports club has both training of several levels and a top team to play in leagues. Every participant may grow through the different propositions of the club to fulfill its personal needs with others, thereby keeping the group alive. But to do so, it will enlarge in a process of formalization its boundaries and means to encompass different expectations of participants. As communities on line come into existence just by the characteristics of social media formats, they run into problems when development paths of participants have grown needs that go beyond the capacities of their formats and characteristics. So far, It seems to me that the community of followers, is at that point not firm enough (i.e. not institutionalized enough, in sociological terms) to further a development that expects more energy and investment in the development of the group than participants will like to exert.. 😉

    There is a positive element however, certainly worthwhile to mention: the experience of #hcsmeu has shown that a lot of early participants/friends have been holding on to the #hashtag in order to reconnect again when someone is asking for a specific chat with them. Just look at @andrewspong ‘s last Friday’s #hcsmeu “impromptu” 😉
    There is a life beyond the hashtag and I am curious where #hcsmca is heading.

  17. Excellent post Pat, more than topical.

    It echoes Goethe’s astute observation that ‘Alles ist vorübergehend’, everything is temporary. In social media’s case it’s extremely temporary.

    I side with the opinions already most eloquently expressed that more focused tweet chats are likely to be the way forward.

    During 2013, in common with others who have posted comments here, I was impressed by certain initiatives driven by pharmas, yes really, most notably Boehringer who staged tweet chats such as #ChatAFIB and #COPDchat. Both were highly focused, in the case of #ChatAFIB, on CV disease and thrombosis in women, but differentiated from #hcsmca and #hcsmeu by inclusion of a wide range of healthcare stakeholders: cardiologists, patients, patient organizations, pharma (Boehringer itself), the medical media, and independent consultants, myself included. It was a format that I found to be both compelling and informative, and whilst I do not advocate the ‘Boehringer model’ as one that should be blindly replicated by #hcsmca, the lessons learnt are well worth studying.

    On final thought: the evolution of #hcsmca and #hcsmeu in many ways mirrors the evolution of pharma digital marketing conferences from the turn of the millennium. In 2000 we were only able to attend generic ‘eMarketing’ conferences, however, during the course of the previous decade events have become increasingly specialized, multichannel, mobile, CRM, to name but a few.

    #hcsmca is perhaps ripe for The Long Tail.

    Cheers,
    Len

  18. Wonderful topic. As many have already mentioned, it can be hard to commit to a weekly chat while bogged down with competing meetings and responsibilities. While it would seem a shame for #hcsmca to die out I think it has served its central purpose of connecting a diverse group of Canadian healthcare stakeholders online.

    When I first joined Twitter years ago I was a post-doc and brand new mom. I found Twitter to be a great place to talk about exhaustion, breastfeeding and work-life balance but the professional conversations were limited.

    Now, largely through #hcsmca, I find Twitter to be an excellent place for clinicians, scientists, patients and media professionals to connect and discuss the good, the bad and the ugly of our complex healthcare system. I often teach social media in my pharmacy classes and I’m always sure to highlight #hcsmca as an example of what my students can learn from social media. When I think of my newest Twitter followers, they include many new adopters of Twitter including experienced health professionals and new grads. Perhaps #hcsmca needs to focus more on helping new Twitter users connect with the existing community rather than the earlier adopters.

  19. Greetings! Cannot resist jumping in for several reasons — long-time involvement with the #hcsm chat and observing online health/healthcare communities for many years. I also started a weekly Twitter-based chat (#chsocm) for church social media back in 2011. Last, which should be first, I’m a sociologist and have several observations that I hope are useful.

    1) There’s a life cycle to online communities that we haven’t really been able to track until now. Back in 2010, I made some (predictive) observations in this post about the role of “elders” in the #hcsm community: http://bit.ly/K8gv4u. I stand by what I wrote then and know now that unless those with long-time involvement greet and then cultivate newcomers, an online community will die out.

    2) Many (?) hashtags, developed specifically for Twitter-based chats, have become standard for tagging content and conversation on topic. The demise of a chat need not undermine the value of a hashtag.

    3) Chats that depend on the presence, energy, and fortitude of a single moderator are difficult to sustain. Dana Lewis is an interesting exception (#hcsm chat). In the case of #chsocm chat, I held (tightly) onto the moderator role for the first 9 months because I wanted to establish tone and rules of engagement. I used that time to observe who was contributing and then tapped those people as moderators and trained them. #chsocm chat now has a team of 6 moderators and more folks who would love to take on that role. Not only has this eased the burden/joy for me, but each moderator brings a slightly different skill set and perspective. I’m hoping this will help #chsocm chat live a bit longer than three years, but if not, then okay.

    As a sociologist I’m more fascinated than dismayed when chats have a “natural death” and of course I’m super-fascinated when I see them self-destruct! In this regard I tend toward a social anarchist theory of organizations: they should last as long as they’re useful and used, then been cleared out so something new may emerge.

  20. For me, the Wed. 10 am (Pacific!) time slot has always been problematic. There are very few weeks when I don’t have meeting at that time. 1pm would be much easier to book off as lunch! Same goes for 6pm (family time!). 9 pm would be much easier. Having said that, we live in a country with multiple time zones so there is no perfect time.

    The other issue for me, which has been mentioned, is that we’ve all advanced significantly and the short Twitter format leaves analysis very slim. I don’t feel like we can collectively get into the issues using Twitter, so I would like to figure out how we could build from Twitter. As many of you know, Vancouver has created @eveningrounds as a way to do a deeper dive into issues. It’s a monthly speaker series that is community-driven. We are seeking sponsorship to try to get on a firmer track. Maybe this is something that would also help #hcsmca and to alleviate all the work falling to Colleen?

    I hope to make the chat this week for at least the first half hour! As usual I have a meeting that morning!

  21. “Has the use of social media in health care reached such a level of maturity that a virtual meeting place to educate people is no longer necessary?” Thoughtful question, and one that will likely receive varied answers. Personally, I regularly encounter patients that are eager for patient communities – offline and online – but they need a push in the right direction. Patient and family-centred care and how we understand it is constantly evolving… which leads me to believe that as long as we’re listening to and including patients and their families, we’ll continue to find engaging and meaningful topics.

  22. Great thoughts Pat. For me personally #hcsmca was my entry into the Social Media space and the power that it has to allow physicians to engage with patients, patient advocates and other HCPs. It is only natural that as all of our experiences evolve so will #hcsmca. The only practical point I would add at least from a physician perspective is that evening chats are more accessible.

  23. Thank you so much for this, Pat.

    And I was especially interested to read Meredith’s well-crafted comments as a sociologist – because I suspect that there is a predictable life cycle to most groups regardless of the purpose or topic being focused on. Long live social anarchy, Meredith!

    This natural and predictable cycle is true for online patient support groups, as I learned while writing a blog post series on the subject last year based on Israeli research published in the International Journal of Communication. There may be some parallels with #hcsmca, too. This life cycle, for example, typically includes the “distressed newcomers”, the “active help receivers”, the “passive followers”, the “relieved survivors”, the “active support givers”, and the “moving-on quitters”. It’s important to remember that observers place no judgements on those who stay the longest or leave the soonest – they seem to stay as long as they need to and not one minute more. For further info, read: http://myheartsisters.org/2013/09/04/lifecycle-of-online-groups/

    Good point about the limited future of tweetchats that depend on a single hardworking moderator, too. Dana Lewis is indeed an interesting exception to that rule – but I’m guessing that if Dana herself decided to to bow out for whatever reason, we’d see a similar unsettling shake-up in the #hcsm world, too. I am a fairly recent and not very regular visitor to #hcsmca, and my first foray was only because a phone call invitation from Colleen halfway across the country moved me to participate.. So a big THANK YOU to Colleen for her motivating inspiration and tireless enthusiasm for the project – and good luck in the future, no matter what the future of #hcsmca may hold.

    • First, always love to have my sociological observations noticed and applauded. Yes, I’m deeply shallow in that way. Next and more important, your post about the life cycle of online patient groups is fantastic and something I recently recommended (read: insisted) a few people read. Thank you for writing it and plan to see it cited soon in something I’m currently writing.

      • The life cycle of online communities was first written about by Iriberri A, Leroy G. A life-cycle perspective on online community success. ACM Comput. Surv 2009 Feb 2009;41(2):1-29.

        I wrote this tutorial about strategic community management for online health communities, which incorporates these principles, which are remarkably similar to the stages that Carolyn outlined in her post. http://www.jmir.org/2013/6/e119/

        We have definitely identified the stage of #hcsmca and now we are tasked with defining what we can do within our means, limitations and opportunities.

  24. Pat’s post has prompted many thoughts for me, although those thoughts haven’t come together into a single single cohesive theme. More like kernels of popcorn in a big bowl.

    The evolution of #hcsmca is similar to the evolution of many of us who are early adopters of social media. We cut our teeth in the safe world Colleen created, and we’ve branched out from there. A social media anthropologist will one day trace Colleen’s influence to all corners of the earth. And the space station I’ll bet.

    For me, there is great value in the broad base of people who participate in #hcsmca. There are very few forums in which patients, health care professionals, information system experts, administrators, politicians and many other interested influencers can come together and learn from each other. #hcsmca is one of those few forums. Thankfully, there is a transcript each week for those many weeks when the midday time doesn’t work.

    Ironically, I find the broad based forum of #hcsmca takes more focus and concentration than the other more focused forums I participate in. The learning is easier when the conversation is about things I can do with my next patient, or in my next clinic. But the importance of #hcsmca topics is just as significant, although often in broader strokes — how I think about things, instead of how I do things. My comments sound a bit black and white, which is unfortunate because the world is usually much more colourful. But in broad strokes, hopefully what I’m saying makes some sense.

    So, the value of #hcsmca for me? Undiminished. The format? Likely evolving. I haven’t read Pat’s comments as predicting the ultimate demise of #hcsmca, but I think Mark Twain’s ‘The report of my death was an exaggeration’ will apply to all the hcsmxx forums when we look back in a few years.

    FInally, on a nuts ‘n bolts level, do we have any analytics comparing attendance at the midday vs evening sessions? Any value in considering other times of the day?

  25. Thanks Pat for starting this conversation or, as Dave (@d_bourne) said, acknowledging the elephant in the room.

    I have remained actively silent, reading all the comments with great interest. You’ve all made very valid points worth considering.

    The Twitter platform has been a brilliant enabler to bring diverse stakeholders together. Through this medium, hcsmXX is able to capitalize on the value of the message not the messanger and initiate meaningful conversations between patients and providers, researchers and policy makers, caregivers and communicators and so many more. In my opinion hcsmXX members have paved the road for rich cross-stakeholder conversations in the more topic-specific chats such as #meded, #bcsm, #hcldr and others. In classic community platforms, it would have been a great effort to have patients take part in a conversation about medical education or oncologists contribute to a patient community without a paternalistic veil to the conversation.

    Typically in an online community, as interests diverge from beginner to more advanced, sub-communities evolve. We are seeing this, as several of you have pointed out, with the development of new hashtag communities. However, the 140-character limit is, well, limiting. Despite the diversification and use of case studies, many of the conversations dilute to sentiments we’ve been hearing for years. However, these still hold appeal for newbies for whom the message is new.

    And there is no doubt that many if not all of us have benefitted from #hcsmca from new careers to campaign ideas, project solutions to personal and professional networking. For these purposes, hcsm and all its geo-chapters are second to none.

    Rob (@rohal) touches on a point that I have often pondered. It’s true that hcsmXX’s positive character, free of heirarchy and the classic “bindings” to participation make it resistant to overlaying a formal organizational structure.

    You are quite right @AndrewSpong, this is an evolution not the demise of a community. However much a community relies on communal decision-making to steward its own evolution, we have all recognized that the time and effort to execute the changes is not shared equally.

    While several of you see hcsm as an exception, I do not. Carolyn (@HeartSisters) points out, quite rightly so, that were Dana Lewis to change the format of #hcsm, an evolution would preciptate there too. We, too, could keep #hcsmca as it is or modify with some of the suggestions made (move to an evening time slot, bi-weekly or monthly, RSS feed or email upcoming topics, etc). #hcsmca can thrive in its current state, but do we want more? If yes, how do can evolution be supported – time, effort, participation and funding?

    There’s so much more to say. I look forward to hearing more of your ideas and solutions on today’s chat.

  26. I’m not sure that talking about chatting is a valuable use of time. I like a quick link to recent research-based information. Also, item to write about that might help my clients. Truthfully, in 140 characters, I’m not sure that this the right forum for discourse. Too often, the chats end up going in the direction of how to gain more readers or followers. “Raising awareness” is one of the planks of slacktivism, and does little to engage participants in improving healthcare delivery for patients.

    Chat rooms, like Virtual Hospice.ca, provide many of us with an opportunity to make a difference in an individual’s life. How we apply the Twitter chats to our work lives is sometimes minimal.
    There is a wealth of research out there, and administrators ignore much of it, as well. I don’t like chatting on Twitter with people I do not know. In order to value the opinion of a contributor, you need to know where they are coming from, and their credentials.

    This is why I have not been participating.
    /two cents

    • Wow! That’s more than a mere two cents! For what it’s worth, over the past six years on Twitter (and 20+ with online communications) I’ve experienced chat communities as just that — communities. At this point, my most valuable colleagues, dearest friends, and best clients have come into my life via Twitter-based chats. Maybe I’m just…lucky? Blessed?

  27. Thank you Colleen and Pat for giving us this opportunity to weigh in with our thoughts on the future of #hcsmca!

    #hcsmca grew from a single seed and has flowered into a glorious garden of information, support, and engagement. Like everything, not everyone appreciates the sight or scent of a rose in precisely the same way or for the same reasons, and yet a rose is still a rose. That’s how I see the value of #hcsmca.

    Some people will take the connections they make with one another in the #hcsmca community into their lives on and offline, while others benefit from staying in the shadows to read and learn contentedly without much if any active engagement. I judge neither approach as I strongly feel that how we each view our experience in the #hcsmca community is a highly personal one.

    The fact that I do not consider the credentials of the #hcsmca participants when evaluating the importance of a conversation is actually what I find so appealing. I also feel no pressure to be an expert! Freedom from having to be specifically qualified in a healthcare field is actually quite a huge barrier that #hcsmca has been instrumental in helping to eliminate for me and I sense many others too who are not professionally invested in the healthcare community. In #hcsmca chats we are all equals and our participation is equally valued. Maybe I sound too idealistic but that is how I have been made to feel since day one during my first chat and it has been confirmed by so many good people many times since!

    Much of the beauty of the #hcsmca experience is that it is one of inclusion. We are the #hcsmca – every one of us! Colleen Young has always emphasized that fact! I feel confident about sharing openly and honestly my ideas, experience and perspective and I trust that I and my input will be valued, if not by many, by at least one person ,and that’s all that matters. I may share one tiny tidbit with another person and they with me, and that little morsel of knowledge or advice or experience may make a big difference to us in that moment, or in the future.

    I know when my late mother died I received incredible guidance and support from members of #hcsmca and #hcsm at a time when I needed it most. I was deeply grieving and felt fragile, but I was also determined to raise awareness about the needs of the elderly and how our long-term care and healthcare too often lets them and their families down. My quest for justice for my late Mom and others was met with so much support and encouragement from many in the #hcsmca community! After a couple of years I was burning out and for the sake of my own health, I decided to spend less time online. No one ever made me feel badly for making my own needs a priority, in fact, quite the opposite, I was encouraged to do so by Colleen and so many empathetic and compassionate people in the #hcsmca community. Thank you all!

    I have met many a kindred spirit through #hcsmca and I honour these connections and feel true gratitude for them. Had it not been for #hcsmca I would not have become acquainted with Colleen Young and later with @VirtualHospice. It has been a privilege for me to contribute to both of these vital online communities, and in both cases, while I feel I have received so much more than I have given, I have never felt pressured to give more than I could manage. Although, I am not able to commit to weekly #hcsmca chats, when I am absent I trust that there will be others who will participate and who will benefit from their exchanges online.

    There is an organic presence and purpose to #hcsmca which may be interpreted in countless individual ways, but I trust that the seed Colleen planted has grown sturdy roots! While the seasons may change and #hcsmca’s blossoms may vary in colour and substance, there is no doubt in my mind that many people will be drawn back time and again into this healing garden where we discover healthcare news and such hope sprouting fruitfully among impassioned and kindred spirits. Long may the #hcsmca garden continue to grow and flourish and impress!

  28. Pingback: #hcsmca soldiers on | Colleen Young

  29. Thank you Pat for this great post. Reminds us that everything has its time. Of course – people including me are tending to conserve the status quo but live is going on. So it was for #hcsmeu as well – something new will come and I now like the # and the theme-chats when they arise. What I see is that there are a lot of new Twitter users, so topics may be redundant for some of us which makes chats maybe not attractive enough to participate. Despite that the #hcsmX Hashtags are still useful and neither Facebook nor Google Plus could run over the benefits Twitter has. So keep on tweeting!

  30. Pingback: Two Highlights of 2014 that Recalibrated my World | Colleen Young

  31. Pingback: #hcsmca Time to Take a Bow | Colleen Young

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