A Canadian in Vegas (#HIMSS16)

HIMSS16 SMA Badge [8339409]

For many years I have joined hundreds of my fellow Canadians in making the annual pilgrimage to #HIMSS16 to soak up the hyperbole and find out what is on the minds of those who spend their time fixated on health information technology.

Canada may have its own quaint health care system which seems to manage to provide essential medical care to all at no point-of-care cost. But trends sweeping our neighbour to the South often impact the Canadian system and this is especially true when it comes to the world of electronic medical records, digital care, patient engagement, and what have you.

Previously I have attended as a journalist for the publication Future Practice, striving to find new amusing ways to work in prayer references when talking about HIMSS while providing a 3-4 page feature summary of the entire conference for Canadian physicians.

This year – along with two fellow Canadians, Colin Hung and Glenn Lanteigne – I have had the honour of being selected as one of the 20 social media ambassadors for the meeting. Our mission is to use social media to comment on HIMSS16 pre-, during and post-meeting as well as to engage each other and other delegates in provocative ways to promote discussion and debate on key issues at the meeting.

I want to take this opportunity to talk to other Canadian delegates and find out why they are in Vegas and what they hope to bring back that will be relevant to their work within the Canadian system. I also want to try and find the one or two sessions that usually focus specifically on Canadian innovation and have been chosen as educational sessions

Also, I already know I want to try and get a better handle on this whole ‘death of meaningful use’ situation. We in Canada – while not always using the exact language and without any government funding infrastructure attached to the concept – are starting to talk about meaningful use more and more. So, suddenly announcing the demise of the concept needs some looking into especially since many US commentators also seem unclear about whether meaningful use is quite dead yet or not.

Patient engagement is the other area in which I want to see what is new and intriguing. The Canadian system also talks a good game when it comes to patient engagement but it turns out many physicians are not keen on sharing all or even some patient data with their patients. Patient portals are still in their infancy and very, very few Canadian physicians can use email to communication with patients. Having been tied to the small but effective patient advocacy community in Canada I want to see just how things are evolving in the US and where better to do this than HIMSS.

HIMSS is always fun and informative and HIMSS in Vegas extra so. So, let’s get on with it.




Speak your mind, but …. #hcsmca chat summary

Last Wednesday, 77 engaged individuals participated in a lively tweet chat at #hcsmca about whether health care professionals have the same rights to free speech when using social media as other members of society.
The impetus for this chat – which I moderated – were two recent disparate examples of what is happening with Canadian nurses and doctors who use social media. One example was that of a nurse facing disciplinary action from her regulatory body in Saskatchewan for posting details of her late father’s care on her Facebook page. The other referenced the positive response to a blog post by Ontario physician Dr. Gail Beck (@gailyentabeck) about the care received by her husband in a local hospital.
One of the points I wanted to make that was nurses and other allied health professionals who are employees of hospitals or health care institutions may face more restrictions than many physicians who are self-employed because the terms of their employment may limit their right to make public comments about their own institution.
So it is somewhat ironic that two days after the chat, The Medical Post newspaper for physicians posted a gated article quoting an unnamed Hamilton physician as stating many physicians had been threatened with the loss of hospital privileges for vocally criticizing the provincial government for recent pay cuts.
During the chat we were lucky enough to be joined by several physicians including Dr. Beck, who provided their perspective on their ability to use social media.
It quickly became clear from the comments made by these physicians and other informed observers that while health care providers can and should be urged to use social media to make comments and engage in debate, they must do so with caution.
It was noted not only that physicians and other providers all have a sacred duty to protect patient confidentiality but also that the statements made by health care providers may be scrutinized more closely and so extra caution must be taken in what they post.
To quote some notable tweets from that chat:
“Believe EVERYONE has right to speak their mind #SoMe or otherwise, but there are always consequences. This applies to HCPs too,” @Colin_Hung (#hcldr co-founder)
“As long as patients’ rights are not infringed, health care professionals should have same rights as all.” @gailyentabeck
“We have additional regulations we need to follow and more best practice to consider, but we have a voice.” @rdjfraser (nurse)
“As healthcare professional on social media, I’ve learnt to bite my tongue at necessary times (most of the time)” @Dr.WaiSun (family physician)
“Health professionals shoud lbe aware that everything they tweet is a publication for public domain. Tweet with care & confidentiality” @DrWaiSun
Most of my health care colleagues are not on #SoMe because of concerns. However in my 2 years on Twitter it’s been 99% positive. @drcchambers (psychologist and pediatric pain expert)
“Pts & HCPs should be allies. We are different views on same system. Our United voices are engine of change.” @seastarbatita (patient advocate)

While the chat just scratched the surface of this important issue for those ‘in the tent’ – be they providers or patients – it was clear the provider voice on social media is an important one that needs to be encouraged.

Health professionals: Speak your mind, but…


A Saskatchewan nurse puts a post on her Facebook page detailing some concerns (and praise) about the care received by her grandfather while in a specific palliative care unit – Facebook post leaves Prince Albert, Sask. nurse charged with professional misconduct. She now faces disciplinary charges from the provincial registered nurses association for “violation of confidentiality, failure to follow proper channels, impact on reputation of facility and staff, failure to first obtain all the facts, and using status of registered nurse of personal purposes under the Code of Ethics for Registered Nurses.

An Ottawa physician posts a blog – 2 Hospital Days – about her husband’s stay in a local hospital documenting the deteriorating conditions he experienced. She names the hospital and talks about how, with the health care system in general “staffing has been systematically decreased, equipment has not been replaced appropriately, buildings have been left to crumble and food and cleaning have been outsourced to the point that these do not meet the standards for nourishment and cleanliness that most health care professionals would want for themselves.” She is widely applauded for the post, especially by her peers.

Both of these cases are true and both have occurred within the last couple of weeks.

They demonstrate the full spectrum of the challenges and opportunities for health care practitioners of all disciplines who want to participate fully in the 21st century.

The former case provides a textbook vindication for nurses and physicians who are deeply suspicious of social media and are convinced their regulatory bodies have little tolerance for any practitioner foolish enough to use social media.

The latter case demonstrates that a credible health care practitioner voice can have a big impact through the use of personal narrative – a well-recognized strength of social media especially when it comes to telling patient stories.

It’s a complex landscape through which we walk.

All credible authorities acknowledge that extra care must be taken on social media to protect patient privacy and confidentiality. But does this extend to an individual who just happens to be a health care practitioner who wants to discuss what has happened to a family member?

Is it appropriate for regulatory authorities or associations who represent nurses to state that it is unethical for an individual to call the profession into question?

And what of issue of whistleblowing and the power of social media to document unsafe, unethical or just plain stupid activities within one’s own hospital or health region?

On January 27 at 9pm ET (time zone converter), let’s open up the #hcsmca floor for debate:

  • T1: Should health care providers have the same rights as others to express themselves on social media?
  • T2: Do you have a personal experience or knowledge of a health care colleague who has felt constrained from telling their story on social media or alternately have effectively used social media channels to document a concern?
  • T3: Is it valid to place additional constraints on health care professionals to maintain the credibility and integrity of those professions?

(This post also appeared on #hcsmca)

Photo credit: derfelphotogen on Flickr https://flic.kr/p/67UYEa

#hcsmca: The Last Waltz (or … Not Last Tango in Vancouver)

 The National #hcsmca Symposium to be held in Vancouver, Feb. 24 in conjunction with Quality Forum 2016 represents a watershed moment for Canada’ premier health care social media (hcsm) community.

Whether attending personally (and you should) or not, attention should be paid by anyone interested in how social media tools and platforms are being used in health care. Through #hcsmca, people are striving to change how health care is delivered and challenging many of the premises behind the traditional role of patients and providers in the health care system.

The symposium not only represents the first national manifestation of this virtual community “in the flesh” but also clearly marks the end of the beginning of Canada’s contribution to the national hcsm movement.

Colleen Young, the volunteer founder of #hcsmca, and behind-the-scenes driving force for its weekly tweetchats and occasional meetups, recently announced her intent to transfer her energies to other projects.

Experience in other countries has shown that health care twitter communities that depend on one volunteer organizer eventually flounder and it can be argued that the same will be true in Canada.

But this contention is challenged by the very existence of the upcoming national symposium, with plans to produce substantive outcomes (more on that in my next blog post), organized by a dedicated team of volunteers with the support of the established Quality Forum conference it precedes.

Over its six-year history, #hcscma has seen participation by almost every thought leader in hcsm in Canada as well as many global leaders in the field. It has also introduced dozens of patients, researchers and providers to the potential benefits social media in health care.

While writing this blog post, the Council of Academic Hospitals of Ontario (CAHO) published an interview with Colleen detailing in her own words her thinking behind the initiation and evolution of #hcsmca.

A few quotes from that interview do more than I ever could to explain where Colleen believes #hcsmca has been and is going.

“In the beginning, I just wanted to learn but as participation in the weekly chats grew exponentially … I could see how social media removed traditional barriers of communication in health care, how it was a valuable tool for bringing together people interested in improving the experience for patients as well as providers.”

“As #hcsmca grew and matured, and social media became practically ubiquitous, hosting a community focused exclusively on social media no longer made sense. … With the diverse knowledge pool of its members, the community leverages social media and other digital collaborative tools in an open forum to share perspectives, best practices, new ideas and solutions.”

Whether the National #hcsmca Symposium proves to just be the closing chapter to a grand experiment or – as Colleen and others intend – the initial phase of a new open approach to sharing ideas about improving the health care experience – remains to be seen.

Attend in person or comment through social media using the hashtag #hcsmca, and don’t miss your opportunity to be part of this event and evolution because that is what community is all about.