I’m shocked, shocked to see live tweeting going on at this conference

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One has to have some pity on the American Diabetes Association.

This highly prestigious and influential organization drew the wrath and scorn of Twitter aficionados worldwide last week when they asked people to delete tweets about their scientific sessions showing images from presentations at the meeting (Medscape has a nice gated account of the fiasco here).

Some pity … but not a whole lot because we are in the latter half of the 2010s after all. Live tweeting from medical conferences is not just the norm but a now, a well-established form of knowledge transfer.

A lively twitter chat at the Philippine-based #healthxph last Saturday showed just how unanimous social media advocates have been in condemning what the ADA attempted to do.

The rationale used by the ADA was that they were just protecting the copyright of presenters and as such could not permit photographs of presentations which often contain as-yet unpublished data. Following the events of last week the ADA said they would be re-evaluating their policy, and so they should.

In a world where major medical conferences (including the ADA) go to some trouble to establish hashtags and encourage people to tweet from their meetings, policies which restrict this free flow of information and ideas are doomed to failure.

The ADA is not alone in fighting a rearguard action to restrict wider circulation of information presented at their meetings. More than once in the last six months I have been at meetings where repeated attempts to ban taking photos of presentation images have been made. In addition, I have heard speakers ask people to not more broadly circulate some but not all of their remarks (“Then, I adulterated my lab mate’s Petri dish so as to render his experiment invalid. Oh, but please don’t Tweet that.”)

Having attended medical conferences for 40 years, it is clear social media is dramatically changing the world within which such conferences operate.

Conferences are often financially important for the organizations that host them so it is logical to see them wanting to restrict the benefits of hearing presentations to those who have paid to attend. The fact this is no longer possible or even necessarily desirable could render moot the business model upon which these meetings are based.

Alternately – and this is a scary idea raised by someone at the #healthxph chat – conference organizers could start blocking transmission from the conference rooms during presentations so live tweeting would be impossible.

In the #healthxph chat I made two other points that bear repeating, I think.

  • Since attendees to a meeting are going to repeat the information they hear anyway, wouldn’t you rather have them do so through direct images of your data rather than rely on their scribbled notes.
  • If you are presenting at a conference for reasons other than the broader dissemination of your findings, then you are probably in the wrong place and in the wrong business.

Finally, there are still some grey areas. While mobile phones and other devices make it impossible to prevent taking images from presentations, there is a stronger case for banning live transmission of talks through Periscope or Facebook due to more significant issues of copyright.

Even though only a minority of medical conference delegates make use of social media, live tweeting is changing this very fundamental channel for the dissemination of medical information. How it will all play out, remains to be seen.

(For another excellent view of this issue please read @JBBC (Marie Ennis-O’Connor)’s: How The American Diabetes Society Unleashed The Streisand Effect

Social media and hospitals: Now more than just pretty pictures

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For leading hospitals, the use of social media tools and platforms has moved from giving in to the demands of the head of marketing to at least have a Facebook page, to a recognition that use of social media can add value throughout the enterprise.

This evolution beyond using social media to post nice pictures and videos of hospitals doing good things has occurred rapidly since the emergence of the first social media platforms a decade ago and holds great potential for health care institutions who want to communicate effectively with their patients.

This is my conclusion following an extensive review of the literature on social media use in North American hospitals and interviews with experts both in Canada and the U.S. who confirm this trend. This work was done on behalf of Lakeridge Health in Oshawa, Ontario as part of a review to improve patient experience at that institution.

While they acknowledge the huge potential for social media in the health care setting, leaders in health communications also recognize that social tools and channels represent just another series of communications options and should be used only as appropriate.

The only comprehensive survey of social media use by U.S. hospitals published by University of Pennsylvania researchers in 2014 showed 94.4% of the more than 3,300 hospitals polled had a Facebook account and just over half had a Twitter account. Anecdotal evidence suggests the same is true of Canadian hospitals.

“There are some really creative people out there who are finding ways to use these tools to engage patients and get their messages out,” said Christina Thielst, a Santa Barbara, California-based hospital administrator, consultant and author who has been following the use of social media by health care organizations for more than 30 years.

Ann Fuller, VP for volunteers, communications and information resources for the Children’s Hospital of Eastern Ontario, was quoted in 2013 as saying: “In Canada, in health care we’re at a point where most hospitals accept the role of social media for branding and communication, but only the lead adopters are using it for patient engagement and for clinical use.”

Since that time, she says “a lot of the perceived risks and threats of social media have lessened” yet, she adds, while “everyone agrees that social media can and should be used, and there are benefits to it, some of that stigma still exists.”

“It’s not about creating a community and trying to integrate those experts into it. It’s using social media to come up with a new platform for doing what they already do—such as engaging patients. It’s another way of bringing people together,” said Dave Bourne, a former communications director for Baycrest and the Scarborough Hospital and now director of communications for Sienna Senior Living.

But despite the most popular social media tools having been around for a decade or more, the optimal use of these tools in hospitals has yet to solidify.

“I don’t think anybody has nailed it to the point where there are best practices,” said Bourne.

Those looking for a leading Canadian hospital with regards to social media could do far worse than to study the experience of the Michael Garron Hospital in Toronto. That institution has taken an incremental approach and changed the hospital culture to slowly integrate social media into many of the hospital’s functions. Elements of that approach include

  • Publication of a policy or guidelines to assist hospital staff in the appropriate use of social media
  • Training of the senior management team as a group in how to use common social media tools such as Twitter.
  • Ongoing education and support from the communications team to assist any staff in using social media
  • Integrating social media tools into a new proactive approach to patient engagement which included aggressive timelines for dealing with patient concerns.
  • Integrating social media use into a new, more responsive approach to leadership

While social media remains an important and innovative set of tools for telling stories about the good things a hospital can do, it is clear that the most innovative institutions are also using those tools to facilitate both internal and external engagement with the communities they serve.

As Isabel Jordon, a BC-based patient advocate and chair of the Rare Disease Foundation, says: “the way I would like a hospital to use social media is to reach out to people to find out what we want from them; if there are going to be changes or something new coming down the pipe—to reach out and engage us before something is going to happen.”

(P.S. Anyone interested interested in publishing a more extensive analysis of this research please feel free to get in touch)

 

 

 

Mind the gap: social media and #meded

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Two small but intriguing Canadian research studies have documented the wide gap between teachers and students and educator users and non-users in their perceived value of social media as learning tools in medical and health education.

The studies were presented at this year’s annual meeting of the Canadian Conference on Medical Association (#CCME16) and the research involved two leading physicians in the social media and digital health world in Canada, the University of Ottawa (uOttawa)’s Dr. Aliraza Jalali and the University of British Columbia (UBC)’s Dr. Kendall Ho.

The uOttawa study conducted by medical education researcher Dr. Safaa El Bialy with Jalali evaluated feedback from 72 medical professors and 63 second-year medical students on their use of popular social networking sites (Twitter, Facebook etc.).

The UBC study presented by second-year medical student Karan DSouza evaluated feedback from 270 health educators at 8 global institutions on their attitudes towards the use of social media in teaching.

The uOttawa study found the medical students were about three times more likely to use the social networking sites for medical education than the professors (67% vs. 23%).

While 94% of students said they felt the sites facilitated learning, only one third of the professors said they used such sites in their teaching practices.

Despite established social media platforms being more than a decade old, El Bialy and Jalali noted “some of the educators did not even know about social media use for educational purposes” and many expressed concerns that such sites were distractions and promoted time wasting.

Just as the uOttawa study documented the gap between medical students and professors, so the UBC study showed sharp differences in perspectives between educators who use social media in the classroom and those who do not, in a variety of countries.

That study documented that health educators globally have concerns about the lack of guidance and support for using social media for educational purposes and also the lack of evidence showing the value of such tools. Even among those using social media in teaching, only 11% said they had received training in using social media for teaching.

DSouza and Ho also echoed the uOttawa study in their introduction when they noted “students have already adopted social media informally to share information and supplement their lecture-based learning.”

They also documented that adoption of social media is not consistent within faculties, even at the same institution.

Both research teams provided suggestions on how the use of social media in the classroom could be encouraged and facilitated.

(Artwork by @Aga_ta_ta on display at CCME16)

 

Flying to #HIMSS16 and into the future

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I can’t think of a better book to read en route to HIMSS16 in Las Vegas than Dr. Bertalan Meskó’s (@berci) latest book My Health Upgraded: Revolutionary Technologies to Bring a Healthier Future.

A Hungarian physician and geneticist, Meskó has crammed a lot of the future into his relatively short career and is a much sought-after speaker on the potential offered by bio-technical innovation.

In this latest self-published book, Meskó takes a conversational approach in attempting to answer “the 40 most exciting and interesting questions” people have asked him about the real impact of innovations we will be hearing a lot about in Vegas, such as wearables, 3D printing, robotics, and precision medicine.

These questions range from “Why would you measure your ECG at home,” to “Will we 3D print or grow organs?”

When it comes to using new monitoring and personalized health devices and apps, Meskó knows of what he speaks. He has measured his ECG at home, had his genome sequenced while doing his PhD, as well as regularly monitoring his own fitness, mood and sleep. When it comes to the Quantified Self, Meskó is he.

Meskó was also one of the pioneers to see earl on the potential for social media to improve health and health care delivery and each chapter of the book includes handy Twitter hashtags relevant to the subject matter, as well as some specific discussions about how social media are transforming health care.

While promising a balanced assessment of the innovations he references, Meskó is an optimistic believer in how technologies can transform individual lives and improve the delivery of health care and this comes through clearly in his work.

This is not a weighty academic tome or an objective health technology assessment but rather a very personalized riff on the potential of biotech in health. Meskó’s own voice comes through clearly throughout.

When I started this book my only major disappointment was to discover it was first published last September! The future moves fast in Meskó’s world and as such some of the many companies and apps mentioned by Meskó may already be defunct or revised out of all recognition.

Still, the book is an excellent airplane read for those soon to be hitting the exhibit hall at HIMSS.

(My Health Upgraded can be purchased here)

 

 

 

#hcsmca made manifest

hcsmcaAttitudes can turn platitudes into vision statements or words to live by.

That’s the alliterative thought I come back to when ruminating on the #hcsmca symposium held in Vancouver two days ago.

As the most solid manifestation to date of a health care social media community that has existed almost exclusively in a virtual world, anchored by a weekly tweetchat, the one-day conference can only be seen as a huge success. More than 170 registrants attended from all sectors of the healthcare world (patients included, of course) and many were the first time IRL meetings (and associated selfies).

The meeting was organized totally on a volunteer basis and the hybrid unconference core of the meeting was based on ideas coming from the hcsmca community itself (at one point, I tweeted – “Hey ma, we crowdsourced a conference”). Thousands of tweets were posted and a live feed allowed those outside of Vancouver to view and comment.

Not that the meeting lacked star power, as it hosted both Stanford MedX conference founder Dr. Larry Chu and director of the Mayo Clinic Center for Social Media Lee Aase together on the same panel for possibly the first time ever.

I blogged a few times in the lead-in to the meeting about what we hoped to achieve from all of this:

#hcsmca National Symposium in Vancouver: The Last Waltz

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

#hcsmca: The Not so Hidden Agenda

Whether we succeeded remains to be seen.The continued existence of hcsmca and in what form remains uncertain given the planned withdrawal of community founder and guardian Colleen Young. One of the conference organizers Robyn Sussel made a telling point when she suggested a Canadian organization or institution should step up to support hcsmca in much the way Mayo and Stanford support their successful social media initiatives.

And as for the deliberations from the meeting, many on paper can appear as rather vague statements of general intent.

“Proceed until apprehended” and “power shouldn’t equal respect’ and were the two ideas that resonated most with delegates in voting at the end at the end of the conference, rather than any concrete and practical suggestions for change.

Similarly, some of the best tweets captured what could appear as cute sayings (Colleen’s “We can improve health care 140 characters at a time” comes to mind).

But those of us who live on Twitter and within the (current) 140-character limit know that even short statements voiced as tweets can build relationships, support networks, and create environments that support and make change.

And there is nothing wrong with the conference delegates voicing overwhelming support for the rather vague proposition of including patients in all planning and initiation of social media initiatives involving health if they go back to their respective clinics, institutions or government departments and actually do this.

As I said at the start, it’s the attitude and approach to these ideas and statements that what will count.

So, we will see.

A Canadian in Vegas (#HIMSS16)

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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.

 

 

#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.

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