Status Update: How Clinicians Use Social Media in Healthcare
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A basic introduction into evolution of web architecture, fragmented healthcare, rise of e-patients and a peek at how clinicians use of social media in healthcare
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Status Update: How Clinicians Use Social Media in Healthcare
- 1. Status Update: How Clinicians Use Social Media in Healthcare R E M O - T I TO A. AG U I L AR M D C o - F o u n d e r # H e a l t h X P h
- 2. “I need a selfie. I’m donating everything to social science”
- 5. Web 2.0
- 6. Web 2.0 “ the cluster of technologies, devices, and applications that support the proliferation of social spaces on the Internet” – Manuel Castells
- 8. “Nobody really knows what it means...If Web 2.0 for you is blogs and wikis, then that is people to people. But that was what the Web was supposed to be all along.”
- 11. So where’s health care in all of these? “ Nurse, please go to google.com, type ‘twitter’ in the search bar and text me the result..”
- 14. The New “Second Opinion” “I need your opinion doc. I found this on the internet. It’s metal on metal and supposed to not break for ten years. Can I use this on my new hip?”
- 15. e-patient “individuals who are equipped, enabled, empowered and engaged in their health and health care decisions”. Dr. Tom Ferguson
- 18. What does an e-patient want? • Actively participate in managing personal health • Expect relevant information and seek advice • Make treatment and provider choices based on excellent result and personal values. • Choose value added healthplans. • Build long term relationships with an excellent health plan • Act responsibly and acccept responsibility for health and healthcare
- 19. “Baldo! When is my next e-patient consultation schedule? I already have 20 who pm’ed me..” © 2017
- 21. Broad Categories of How Physician/Healthcare Professionals use Social Media •Research •Distill •Execute/Communicate •Collaborate/Engage
- 22. Research- Listening •Online networking •Crowdsourcing – Harness power of community skills to solve problems •88% use internet and social media to research biotech, pharmaceutical ---and medical devices
- 24. Accessing news and information from professional organizations J Med Internet Res 2013 (Aug 28); 15(8):e184
- 26. Twitter as a personal learning network Commitment to Scientific knowledge Gholami-Kordkheili F, Wild V, Strech D: The Impact of Social Media on Medical Professionalism: A Systematic Qualitative Review of Challenges and Opportunities J Med Internet Res 2013;15(8):e184
- 27. Distill –Simplify healthcare information for patients/public •Understand natural language/ voice of patients over social media •Public health surveillance •Improve medical and clinical education
- 28. Distill –Simplify healthcare information for patients/public
- 29. Social media as a tool for improved information sharing J Med Internet Res 2013 (Aug 28); 15(8):e184
- 31. Execute/Communicate •Organizational Promotion •Promotion of health services and programs •Patient education •Health Professionals education
- 32. What are the challenges to doing healthcare social media research? •Poor quality of information •Risks for online reputation •Breaches of patient privacy •Violation of HCP-patient boundaries •Licensing issues for HCPs/Students •Legal Issues
- 33. A 12-Word Social Media Policy Farris Timimi, M.D., Mayo Clinic Center for Social Media Don’t Lie, Don’t Pry Don’t Cheat, Can’t Delete Don’t Steal, Don’t Reveal
Notas del editor
- Yup, I’m donating these to social science. So why am I doing? Journaling everything for myself? Well, that was the initial intention. But, I realized I was contributing to something I honestly don’t know yet, something internet creator jargoned as” web 3.0” I certainly want my Semantic web identity almost similar if not exactly similar to my web 2.0 self
- I mentioned earlier, I was deep into the world wide web since 2000. And was enjoying everything that is thrown on my computer. Web design, social media marketing, Google Mapping all stuff that made me busy all thse years. It was only later, sometime 2016 that I began examining why or how I was in deep involvement with the so called future, “internet of things”. So I began the frantic reading of understanding web technologies and how I am in relation to this. Yea, I did mention these technologies earlier and I highly suggest we tackle these concepts before we even get into the how healthcare professionals are using internet and social media today. Tim Berners Lee an english scientist created the world wide web in 1989. What he created was supposed to be web 1.0, an architecture of the internet although Berners- Lee contest definitions of web 1.0 1nd 2.0 lately.
- What is web 1.0? For all of you who wasn’t born back then, its basically the same as going to the google search page and typing your search word. Or phrase. What Google would spun out is basically similar to web 1.0 . You can only read information but not edit those information. So examples of these are browsers, websites or any content provider site. The important characteristic? You can only read, not edit or write stuff on web 1. Relationship? unidirectional.
- No one know exactly what or when did Web 2.0 started. And yes, for a spider from web 1.0 era, it is such a screwed up space…Somewhat similar to asking “What Is life to you?”
- There are so many interesting definitions web 2.0 has, but Im more inclined to that by Castells (2009) a best selling author of The Rist of the Networked Society, defined web 2.0 as: “ the cluster of technologies, devices, and applications that support the proliferation of social spaces on the Internet” . He is a spanish communication professors who furthered that web 2.0 is not just about social networks because social networks have been very old forms of social organizations. Central to his definition is that these social networks process information using micro electronic based technologies.
- So for us web 2.0 is basically you commenting on facebook, twitting, instagraming and uploading on youtube. More importantly web 2.0 is a social network that accepts and process user generated content. You can write on web 2.0 so to speak. If you look at this tag cloud, you’ll notice the large tags are openness, collaboration, participation contribution all implies a large user participation in the creation of content.
- This is what Tim Berners- Lee said about web 2.0 in a podcast lately- a “jargon” . Nobody really knows what it means...If Web 2.0 for you is blogs and wikis, then that is people to people. But that was what the Web was supposed to be all along. As he envisioned it, Web 1.0 or maybe web 2.0 are just part of an evolution of the internet. And mind you, TBL is also heading the w3c foundation that is guiding the development of internet into something termed by Joh Markoff of the new york times as Web 3.0 or semantic web or intelligent web. I’m not going to even deal with web 3.0 but just a heads up, we are running fast towards that end.
- So here’s a summary of what I’ve discussed so far. If there’s one thing I want you to take home with you today, it is this. _ The web is becoming a place where user has control of almost everything except that, it grew into something intelligent it may automate most if not all we are doing now.
- So currently, there are 1ooK web 2.0 websites that cater to 1 billion users, almost half of these users, bring in content to the sites. That’s us.
- Basically, our patients are mostly web 2.0 and we are so web 1.0 in terms of healthcare using web to improve healthcare. Why?
- I really don’t know when did our healthcare system became so fragmented and siloed but others postulated that technology itself drove a wedge between healthcare providers and patients. Back in the days, a physician to be effective, socializes with the patient so much so that he or she practically knew his/her family, got invited to family dinner and events, handles exactly every sickness of each and everyone in the family door to deathbed. Everything the patient needs, he or she goes directly to the provider. These siloes talk to each other but never somehow get the job done of providing “healthcare” we once thought it should have been doing. Today, each aspect of “providing healthcare” is so specialized and compartmentalized it is even taxing just to think of “having an illness” .
- And ultimately it taxes the very patient we swore to serve. What I personally see in this set up is the “unidirectional” mode of providing care. Sounds familiar? Right. The patient barely had a say on his or her health care. It is this fragmented healthcare and the coming of web 2.0 technologies that is changing healthcare now.
- Clinic consultations like this is not new to me. This is even better if patient goes to my clinic and ask personally about my opinion. The worse is when you get private messages from friends too. 70% of US adults would seek opinion of your doctors for their healthcare needs, but majority of these already searched the internet and social media for information about their illness. Interestingly, the reverse is true. Patients would now also consult the web and social media after consulting their physician. Web 2.0 gave birth to the rise of e-patients.
- Dr. Thomas William Ferguson is an American doctor, educator, author was an early advocate of patient empowerment urging patients to educate themselves, to assume control of their own health care, and to use the Internet as a way of accomplishing those goals He coined the term e-patient to describe individuals who are equipped, enabled, empowered and engaged in their health and health care decisions.
- This we need to understand as healthcare providers.
- And these statistics also speaks about e-patients wanting more active participation in the management of their health. So silos? Where are we in this?
- Actively participate in managing personal health Expect relevant information and seek advice Make treatment and provider choices based on excellent result and personal values. Choose value added healthplans. Build long term relationships with an excellent health plan Act responsibly and acccept responsibility for health and healthcare
- Is healthcare ready to meet change brought about by web 2.0 technologies?? Where are we in our adoption of these enabling technologies? Are we on the same cause? Or are we still getting the grip of what’s taking health to Health 2.0?
- In trying to categorize how physicians should “react” catch up and gain skills in using social media to effect change in healthcare, I go back to telling a story with a picture.. Remember these categories are skills and by skills, it means “learn-able”. I won’t pretend this is exact or broad or as encompasing and defining as it should be but, from my experience, this is better than just diving straight into social media healthcare and finding drowning in a see of unknowns… What do you observe in the above photograph? What strikes you? Why do you like it? Why not? What made you hit the like button?? For most consistent photographers I knew of, these kinds of pictures don’t get a lot of “likes” and comments randomly. These pictures catches our attentions because by just looking at it, we are held by “a story” in it. One that goes beyond the superficial paper quality of the photo itself. Something hit us. And here’s the secret: The best photographers I knew follow the following set of steps, learn the skills involve in each and consistently implement such in every picture project they employ. They do ‘research” on their project. Their subject, backdrop, weather, lighting and who is the target audience. etc. They distill what they’ve learned on their project and draft an implementation strategy. When they communicate or execute, it is targetted. The 80/20 principle. They knew that 80% of impact of the pictures comes from 20% of their general audience. They network or collaborate with these people. Result? A picture that tell a story.
- Research- Listening Online networking- seek new knowledge, support, networking, updates on health and medicine. Crowdsourcing – Harness power of community skills to solve problems 88% use internet and social media to research biotech, pharmaceutical ---and medical devices
- Pinoy MD was really a social network for filipino doctors and medical students. Most do share, get information, seek peer to peer support. But networks there are prebuilt and relies heavily on web admin to do it for users. The Filipino Doctors on FB is an example of a social media network of physicians. I’m not a member of this group, but if you notice their members, its probably one of the biggest social network for Filipino MDs on Facebook. Linkedin also have a physician only groups but mainly serve for networking, job and educational searches and peer to peer support.
- As an orthopedic surgeon I am subscribe to the emailing group and the orthopedic community on Facebook. But for professional orthopedic organizations abroad, like the American Academy of Orthopedic Surgeons, I engaged via twitter. It is also via social media-blogs and twitter, that I came to engage one of the well-known orthopedic surgeons globally, Dr. Howard Luks. I’ve tried emailing other orthopods before but this was the fastest response I got so far. Five minutes, after I tweeted him a question!!
- This is my pet peeve on social media- a personal learning network to enhance commitment to scientific knowledge. I’ve already mentioned getting news feeds from professional organizations, from journals, to twitter , to tweet chats, journal clubs and YouTube. Just two days ago, I also added Periscope. Periscope is a live video streaming social media network, anchored on your twitter account. It’s like skype or viber or Google Hangout or yahoo messenger but with a greater reach, technically everyone who has a twitter account. Here I was watching a live feed of one #HealthXPh co founder Dr. Iris isip Tan a Filipino endocrinologist and Dr. Bertalan Mesko , a famous medical futurist doctor attending the Doctors 2.0 conference in Paris. I was inside the comfort of my desk here in the Philippines! Imagine how beneficial would that be to physicians in underserved areas!!
- Tis is right now a very imnteresting area for research in healthcare social media. This is also the area where our healthcare systems most lack. Understanding patients’ voice on social media- How they communicate/engage in the new platform, how do we pick healthcare issues that are not discussed inside health institutions. Sometimes, when we are able to understand patient’s language over social media, we may be able to improve public health surveillance and public health alarm and delivery systems. That way, we can improve our medical and clinical education by somehow incorporating these new languages, platforms and skills to make HCP adapatble to ever changing web platforms for health.
- These are some of the research that will be resented later before and after lunch. I encourage everyone to listen.
- Who among you here have twitter accounts? One, two, only few? Most likely, majority use it for personal purposes, right? Let me tell you a story how, I found use for twitter to enhance professional competence. About a year ago, I had a patient with a Giant Cell Tumor and a pathologic fracture of the proximal humerus. I am used to trauma cases but once in a while, I get this not so run of the mill cases. I wanted to get the current treatment guidelines for GCTs, so I can appraise the patient regarding treatment, before referring the patient to my musculoskeletal tumor colleague. I Goggled GCT treatment and links to PubMed journal articles appeared. One journal seem to be the most appropriate. I have no access to that journal so I emailed a former boss, and then tweeted the link, asking a pdf copy of that journal in the link. Within the day I received ten or so links, to a downloadable pdf copy of the said journal article. I don’t know where these people got their copies of the journal article, but I think 5 or so of those links where legit. I got the journal article because of an authentic helpfulness of twitter peeps. I was amazed and kind of excited, how fast I got the response and the ease of getting a pdf copy from colleagues globally. The information sharing on social media is tremendous. I felt that because I had access to that journal article, I was able to appraise my patient and his family in a timely manner.
- This can be easily misinterpreted as remnant of web 1.0 where in information is unidirectional. Ie from caregiver to patient only. Note that these cannot be executed properly without the prior skills and phases of researching, of listening to patients natural language over social media. By communicate and execution here I mean that content are co –created by the patients and our healthsystems, a participatory kind of system in treating patients with web technologies available.
- What are the challenges to doing healthcare social media research? Poor quality of information Risks for online reputation Breaches of patient privacy Violation of HCP-patient boundaries Licensing issues for HCPs/Students Legal Issues
- In a way, social media helped us shift these challenges into opportunities and reaffirm our commitment to our professional responsibilities. We had to ensure trust to the professions is maintained when healthcare professionals engages in social media. A 12-word social media policy by Farris Timimi of the Mayo Clinic Center for Social Media neatly summarize what our engagement should be, on social media. Don’t lie, don’t pry, don’t cheat, Don’t cheat, Can’t delete, Don’t steal, Don’t reveal. “ Because if anything is on the Internet, it isn’t private!