Virtual medical conferences are here … forever.

From Len Starnes, LinkedIn profile page

Gleaning the latest clinical findings and CME from medical conferences while sitting in front of a computer in your sweatpants will be the reality for most of 2021 … if not forever.

That’s the unavoidable conclusion to be drawn from a recent webcast presented by Len Starnes, a Berlin-based digital healthcare consultant and keen observer in medical conference trends. The webcast was part of a regular series hosted by Peter Llewellyn for MedComms Networking.

Starnes predicted that all medical conferences hosted by associations or societies will be held virtually until at least the last quarter of 2021 due to the COVID-19 pandemic. And while many physicians miss the personal interaction and networking associated with in-person meetings, he said a recent survey reported the experiences of physicians with virtual meetings over the past year has been “significantly better than expected” with 92% now stating they are willing to consider attending a virtual event.

And this trend could grow. Starnes noted millennials and Gen Z’ers will comprise the majority of the physician population by 2030. He said these physicians are already more likely to attend virtual meetings and have climate change as their number one priority meaning they will be pushing for more meetings that do not require extensive travel.

As for medical societies and associations, Starnes said, those that held virtual annual conferences or congresses during the pandemic suffered “massive financial losses.” Squeezed between the increasing rates charged by virtual meeting platform companies and pressure to keep registration costs low for virtual meetings, he said, some association face extinction if they are unable to adapt to the virtual meeting format.

On the positive side, Starnes said, medical societies witnessed huge increases in registration to their congresses, in part because of the decision to waive registration fees or to dramatically lower them. He identified the European Society of Cardiology as an example of a society who offered free registration and saw the number of registrants to their annual scientific sessions triple.

Starnes noted that many medical associations are still committed to hold in-person conferences in 2021, #ASCO21 in Chicago in June being perhaps the largest and most prominent. However, Starnes predicted it would be impossible for such in-person meetings to occur prior to the last quarter of 2021 at the earliest because of continued concerns about COVID-19.

Many of the virtual medical conferences held in Europe and North America last year were of high quality, Starnes said, but he noted medical societies have significant work to do to improve the personal experience and networking opportunities for delegates.

The same is true for pharmaceutical companies. Starnes said virtual exhibition halls to date have not been “fit for purpose” and have failed to attract delegates. Much more work must be done by companies to give physicians a compelling reason to interact with them in a virtual format. He described it as “a formidable challenge” for pharma which has traditionally invested significant amounts in in-person conferences.

However, Starnes said, attracting pharmaceutical and medical technology companies to their conferences will be a major factor for medical associations as they plan virtual events in the future.

Much discussion at the webcast centred on hybrid conferences – those that provide an options for delegates to receive the same information whether they attend in-person or virtually. Starnes said few examples of this type of meeting are yet available and he could identify only two associations who plan to try this approach in 2021 – the Association for Medical Education in Glasgow in August and the European Academy for Allergy and Clinical Immunology in Krakow in July (although the virtual segment will be coordinated from Madrid). He said the logistical challenges of these types of meetings would make them hard to gain traction against either totally virtually or in-person events.

Other strategies for productively hosting virtual medical conferences were discussed, including allowing variable conference fees or “pay as you go” based on which sessions delegates chose to attend. Starnes said streaming some sessions or archiving proceedings and making them available for a period after the conference are also viable options. He said associations could productively expand the latter option by committing speakers to respond to questions posed by delegates at any time for a set period after the meeting.

Overall, Starnes said the state of play for medical conferences continues to be constantly changing and he said he expected it would continue to do so in the months ahead.

A full recording of the webcast can be accessed here.

Good virtual care – some principles

Is it appropriate to ask patients to be available during a 3-4 hour window for a virtual visit by a physician?  That was the question debated by some Canadian physicians on Twitter last week and it highlights the fact that many issues underpinning the optimal, ethical delivery of virtual care are still being worked out.

With the rapid expansion of virtual care due to the COVID-19 pandemic the delivery of ethical and appropriate care in a virtual format becomes even more important. This whole area been addressed in the most recent issue of the Canadian Journal of Physician Leadership by digital care pioneer Dr. Kendall Ho (@Kho8888) from the University of British Columbia, Dr. Ken Harris, deputy CEO of the Royal College of Physicians and Surgeons of Canada and Toni Leamon, a patient advocate and member of the Canadian Medical Association’s (@CMA_Docs) Patient Voice Group.

The authors note that with the growth of virtual care “it is vital that the health professional community carefully examine the quality of care being delivered digitally and determine when it is appropriate to use VC as an alternative to face-to-face care.”

“Although it is acceptable to challenge traditional thought, the use of virtual care should always be anchored on the principles that underpin the practice of medicine itself,” they add. “Modern information and communication technologies should only be considered as tools to facilitate and optimize care. Their use should benefit our patients and do no harm — a fundamental tenet of medical practice.”

The article look at principles of virtual care in 4 domains; clinical, medicolegal, adragogic, and social. What is outlined contains few surprising or contenious views.

For example, in the realm of clinical care, the article states: “judging whether to choose virtual care for health service delivery should be based on whether it is a reasonable or better option than in-person encounters in providing safe, accessible, timely, and high-quality health care to patients.”

Among the principles, the authors do include continuity of care – a factor stressed by practising physicians and one that can be lacking when virtual care is delivered outside of the usual physician-patient relationship. They write that virtual care should be considered “as time points in a continuous string of interventions in longitudinal patient journeys” and as such virtual visits should include a clear process for patient follow-up.

The article includes a lengthy section on the necessity of appropriately educating medical students about virtual care, noting that planning a curriculum would benefit from “co-creation with and participation of patients, caregivers, and communities.”

The issue of equity is also raised and the article notes that providers should be aware “not all patients have the same access to technology, because of variability and availability of resources or infrastructure in different communities and contexts.”

On the issue of how and when patients should be available for virtual interactions, the section on the principle of transparency states this should include “clear expectations about response times and ‘when the virtual office is open’.”

The authors conclude: “Tomorrow’s best practices in virtual care will certainly be different from those of today through technological innovation and evolution, and new understanding and lessons will be generated from expanding clinical applications. All stakeholders must be adaptive and flexible, as new technologies and VC approaches emerge.” 

(Image courtesy of Northern Weldarc Ltd)

Social Media and Healthcare 2021: The #hcldr view

Where better to find a predominately positive overview of the current impact of social media on healthcare than during a  #hcldr tweetchat?

Launched in 2012 and masterfully moderated by co-hosts Colin Hung (@colin_hung) and Joe Babaian (@JoeBabaian), #hcldr is one of the only remaining regular weekly tweet chats that deals with a broad range of healthcare topics.

Earlier this week, they hosted a chat on the current state of social media and healthcare that drew almost 200 participants including physicians, other health care providers, digital health specialists, patients and patient advocates predominately from the US but also from Canada, the Philippines and other countries.

From among the usual rapid-fire exchange of greetings and subchats emerged a strongly positive overview (with caveats) of the role of social media in healthcare. It also revealed interesting insights into the continuing evolution of how informed individuals are utilizing these platforms.

Most of those contributing to the chat indicated their use of social media has changed over the years.

Some  talked about switching their emphasis from Facebook to Twitter and LinkedIn and from using social media for social interactions to taking a more professional approach and becoming more engaged. While definitely an older cohort of social media users, some participants talked about productively having used Snapchat and now TikTok.

However, Dr. Nick Van Terheyden (@drnic1), a digital healthcare innovator and former chief medical officer for Dell, noted his use of social media has decreased significantly because the platforms have been “weaponized” to promote dissinformation. Ziva Mann (@MannZiva) agreed, adding that now without careful facilitation “venom” often seeps into social media discussions.

For the vast majority of participants, social media today seems to be used primarily for engagement and networking and for information gathering or curation. As Ottawa child psychiatrist Dr. Gail Beck (@gailyentabeck) tweeted: “I access some of the best information on many subjects from social media. I’ve ‘met’ some inspiring people and groups like #hcldr.”

Dr. Rashu Shrestha (@RashuShrestha), chief strategy officer at Atrium Heath, noted “social media has always been about connecting at an exponential scale. The value of @Twitter has evolved from basic information sharing to meaningful engagement, and much deeper dialogue.”

“Every generation will have education and information gaps and “discover” social media as a tool to learn and share more among themselves,” tweeted Dr. Meredith Gould (@meredithgould), an author and digital activist. However she later added “I believe at least one and maybe two generations of physicians and allied health workers need to depart this mortal coil before social media is fully appreciated. Young hc pros on TikTok are delivering essential info with delightful edge.”

In response to one of the tweet chat questions, participants seemed in strong agreement that social media has a role in healthcare today, particularly as a means of patient empowerment.

As Annie-Danielle Grenier (@AdanGrenier), a patient partner in Quebec tweeted, social media can help patients obtain information as well as being a place for support groups. Social media, she said, can also help healthcare professionals get their message out and learn from patients.

“I often tell patients about hashtags or social media groups that I think are good for their specific medical experiences or diagnoses,” confirmed Dr. Latita Abhyankar (@L_Abhyankar), a US family physician, in her tweet.

“While the way we use social media may evolve, it is still a valuable outlet for education, collaboration, and information. It allows us to challenge healthcare norms, advocate for patients, and support our peers,” tweeted Shereese Maynard (@ShereeseMayMba), a digital strategist.