The journey into the (officially scientific) exploration of healthcare social media would not be complete without a look into the realm of healthcare specific networking sites that I’ll playfully call “medicinal sites.” These are closed sites that are aimed exclusively for those with either a certain designation or disease state.
In today’s lineup, we will explore two specific sites. One of these sites is meant for physicians and the other is meant for patients.
Although Doximity was not mentioned in the University of British of Columbia study that spawned this blog series, I am going to start here for good reason. Although they are a relative newcomer to the space, Doximity has experienced very strong growth. Last year Doximity doubled their network to a total of 250,000 members, which is 25% of all physicians in the US. What I find fascinating about Doximity is that it was started by the AMA. It’s oftentimes the case that, in the David vs. Goliath world of social media, hip start ups are the ones that people want to follow. The AMA now finds themselves in a situation where they have more users of their social network than they do actual members.
Doximity does a few things right. It’s most popular features, beyond making upgrades that make the user interface more like Facebook or LinkedIn, include:
PatientsLikeMe is a site where e-patients can collaborate with one another in a peer-to-peer supportive setting. The site was launched in 2004 by the family members of an architect that contracted amyotrophic lateral sclerosis (ALS) at the age of 29. They had originally raised millions, literally, in a failed attempt to find a cure for ALS. They also created this patient social network to go along with that effort.
PatientsLikeMe now has over 200,000 members with groups for approximately 1,800 disease states. The most popular networks are neurological diseases such as ALS, multiple sclerosis and Parkinson’s, but there has been growth in members with HIV/AIDs and mood disorders like anxiety and depression. Cancer, with its numerous subtypes, has been a more challenging group to tackle. I have found that these subtypes often form their own online patient communities. You can find a list of these on e-Patient Dave’s website, which I definitely recommend you visit if you want to learn more about how patients are using social in life altering ways.
One of the most incredible things about PatientsLikeMe is not as obvious. Let’s consider a typical patient journey: we get sick, we go to the doctor, the doctor captures data during that visit including family history, bloodwork, scans, biopsies, etc. Then there is the follow up appointment. Perhaps a follow up call by a nurse. But as I often say, that’s only 1% of the story. It is the other 99% of the time when that patient is out there in the real world that matters a lot. So, where do we get all of that data that takes place during the “meantime”. PatientsLikeMe is often heralded as the producer of the most compelling clinical data the health care industry has ever seen for this reason.
As compelling as this data may be, it’s only a speck of sand on the beach. There is far better data capture to be had by socially integrating patient and physician in a meaningful way. This takes me back. Way back. To a post I actually wrote in 2011. What I said then will be where I end here today:
“Patients are online. Physicians are online. However, these two groups are running in different social circles…this presents a true medical problem.”
Direct secure messaging (DSM) is a transmission standard promoted by the Office of the National Coordinator for Health Information Technology that meets the Meaningful Use Stage 2 requirements of electronic health records (EHRs). It works much the same way as regular email, but the message is encrypted, which prevents unintended use of the protected health information that is included within. DSM can be used to send patient information among physicians, among provider organizations and to other 3rd parties, including patients.
Healthcare providers have been using direct secure messaging for care coordinating for a while but there may be ways to use it more fully to reduce readmissions, reduce unnecessary testing and procedures and even increase provider productivity. Some benefits may include:
Once HIEs are fully implemented, query based networks will provide robust data exchanges, but DSMs will continue to be valuable especially for smaller practices and hospitals that do not have the means to implement sophisticated EHRs. Read the rest of this post »
HIE, clinical data, quality measures, financial and claims data along with healthcare analytics – what does it take to decrease readmission rates in nursing homes?
There is so much attention these days on making the most of all of the clinical and financial data regarding healthcare, hospital readmission costs and reimbursement, but do we really know what changes can or will make a difference?
It has been a long time since I have done bedside nursing, but I can remember how often I would have one or more patients assigned to me who had come from a skilled nursing facility, long-term care facility or “nursing home.”
The American Health Care Association (AHCA), the largest association representing skilled nursing care centers in the country, reports that every year, nearly 2 million Medicare beneficiaries are readmitted to the hospital within 30 days of being discharged, at a cost of $17.5 billion. Of readmissions, one fourth are skilled nursing care patients, receiving post-acute care (recuperative or rehabilitative services).
According to the recent Office of Inspector General (OIG), Medicare Nursing Home Resident Hospitalization Rates Merit Additional Monitoring report, in Fiscal Year 2011, one quarter (24.8%) of Medicare residents in nursing homes were transferred to hospitals for inpatient admissions, at a cost of $14.3 billion for the hospitalizations. The hospitalizations were required for a wide range of conditions with septicemia the most common. While the majority (67.8%) were transferred to hospitals only once, 20% transferred two times, 7.2% transferred three times, and the remaining 5% transferred four or more times. Of the Medicare costs for hospitalizations in FY2011, care for a nursing home resident cost an average of $11,255 per hospitalization, which is 33.2% higher than the average Medicare hospitalization ($8,447). Read the rest of this post »
A few years ago, I transplanted my family from the south to Washington DC. I love the Capital, for its history, its influence, but we quickly realized we had left Mayberry and arrived on Jupiter. Horns honked and people moved around briskly. Maybe it was us – our naiveté — or maybe it was the community we had arrived in. But we quickly realized: “If you order french fries, you get french fries.” And only french fries. Months of dining out were spent, only to find that our presumed “condiments” were not standard with our order. We would have to ask for them and specify the quantity. French Fries and 2 ketchups, please.
Well I clicked my heels three times and eventually moved us back to our Mayberry. It’s been three years and my son and I will still giggle together when we order french fries and see someone going out of his or her way to offer ketchup. And when we say “Yes, Please”, we get several packets.
Consulting in Healthcare is no different. We’ve grown accustomed to the “build to spec” approach. You get exactly what you asked for.
I’m thankful to be a part of Perficient and the Oracle Healthcare Business Intelligence team. We share a common philosophy – understand what the customer wants to achieve, coach and advise available options, design and deliver a solution that fulfills their NOW problem and simultaneously prepared them for the next 5 years. It’s not just a report – it’s Healthcare Analytics. Read the rest of this post »
Thus far we have covered both blogs and microblogs as we walk through the official scientific study that was completed by the University of British Columbia on the uses of social media in medicine and healthcare. Today we move into the wide world of social networks. Ask ten people in the know to define what a social network actually is, and you will get as many answers. The study provides a legitimate definition as follows:
Social networking sites are defined as Web-browser and smartphone accessible services that allow users to create social connections in a public or semi-public form (through the use of profiles) in order to share information updates with other site users.
Today we will focus on a current leader in social networks:
Here are some fancy facts on some pretty neat uses of social networking sites in the practice of medicine and healthcare:
One of the great features of social networks like Facebook, which have yet to be used much in healthcare are third-party applications. Here we integrate application programming interfaces (APIs) into Facebook. This allows outside software and data to be visualized and tied directly to the social network. Candy Crush is likely the most popular third-party application at this time if I had to wager. We have a long way to go until health apps are actually helpful in Facebook. In fact, less than 30% of listed applications in the health category are real. The rest are spam. Of the ones that do exist, many focus on weight loss, smoking cessation, fundraising, and health education on specific conditions. From what I can tell those are dwindling. In fact, of the three mentioned in the study, only one still exists.
In an attempt to reach as many people as possible all at once, social networks are no longer the “up and coming” medium. They are the “here and now”. There are many ways that Facebook is being used in medicine and healthcare, and there are still much open opportunity.
As healthcare organizations prepare for full scale integration of electronic medical records through EHR and enterprise wide data warehouse initiatives, identity resolution is a priority for everyone.
A Master Person Index (MPI) is a solution intended to solve the common problem where multiple systems or applications within the organization gradually become inconsistent with the most current data. When this information changes and only one system is updated, the MPI solution ensures that the change is propagated to all other systems to create the single best view. The MPI may be found at the single system level, facility level, enterprise or health information exchange (HIE) level. A “person” in the healthcare context may be a physician, patient, member, payers, etc.
Data management is one of my favorite subjects and I’m very excited about the evolution of MPIs for identity resolution, as well as, other Master Data Management solutions. But let’s focus on the benefits of the Master Person Index. Read the rest of this post »
Joan Rothman, Director at Perficient, recently wrote a blog post about the new landscape of healthcare marketing:
You see the commercials on TV, the alluring websites, digital advertising in airports, on billboards, on the radio, in magazines, everywhere. Let’s face it, the war for patients in healthcare is in full swing. Whether you are a hospital, a physician, a pharmaceutical company or any combination thereof, you are now operating in a highly competitive environment. Frankly, it was inevitable.
The shift from company to consumer is happening everywhere, and healthcare is no exception. To read Joan’s full blog post, click here.
A former boss of mine, who happened to be the CFO of a large academic medical center, used to say the phrase “no margin, no mission” all the time. I’m not sure I really took the time to understand it at that point in time, but I have since then, “grown up”. My understanding of the intricacies of determining true profitability is now burdened by the awareness of how many different business transactions occur in the hospital setting and how hard it really is to capture each correlated business transaction at the same point in time.
Still, producing a monthly income statement is one thing, and there is certainly no shortage of guidance whether considering GAAP or public sector fund management reporting requirements, but how do we merge the clinical effectiveness discussion with the finance and accounting discussion?
In my view, these two areas converge at the decision support team who have been supporting contract management and costing activities for decades. Perficient views the costing activity as an enabler for business to deliver strategic advice, moving away from low value transactional activities, through increased focus on:
In this blog series, we are highlighting the social media categories presented in “Social Media: A Review and Tutorial of Applications in Medicine and Health Care.” This was a study conducted by the University of British Columbia, which offers an extensive digest of the vast uses of social in medicine and healthcare. Today we’re going to talk about the emergence of Twitter as an important communication medium in this industry.
The study correctly titles Twitter as a “microblog.” With microblogs, we take many of the same concepts found in my previous post about blogging, namely community and collaboration, and we widdle them down to 140 characters or less. Twitter is that place where communities of people that are interested in a similar topic, be that interoperability or Oscar night, digest a lot of information quickly together. I rely on Twitter heavily to keep me up to date on everything related to #hitsm (health it), #hcsm (healthcare social media), #mhealth (mobile health) and #connectedhealth (I’m sure you’ve got that one without need of assistance).
The study gets extra points for classifying three broad categories of tweeting styles:
According to the study, there have been over 140 documented uses of Twitter. I’ve not met the person that is actually documenting these uses, but some favorite examples include:
As mentioned above, the use of Twitter at conferences is powerful. Not the least of these examples is taking place this week in Orlando at the HIMSS conference. At these conferences, Twitter is used to enhance learning through real-time interaction. See for yourself by following the #HIMSS14 thread.
Do you remember therbligs from your Operations Management class?
The word therblig was the creation of Frank Bunker Gilbreth and Lillian Moller Gilbreth, American industrial psychologists who invented the field of time and motion study. It is a reversal of the name Gilbreth, with ‘th’ transposed. Therbligs are 18 kinds of elemental motions used in the study of motion economy in the workplace. A workplace task is analyzed by recording each of the therblig units for a process, with the results used for optimization of manual labor by eliminating unneeded movements. (Wikipedia)
I remember, and it was a lifetime ago. But then again, the Gilbreth’s were turn-of-the-century industrial psychologists who invented the field of time and motion study. I consider them the founding parents of Industrial Engineering.
So why are we talking about therbligs in Healthcare?
Ah, young Jedi, the time has come to learn our lessons much the same way that the industrial giants like Ford, Carnegie Steel and General Electric learned 100 years ago during Teddy Roosevelt’s administration. These early lessons became the standards of the mid-century boom in manufacturing and production output.
So the healthcare technology space has finally gotten to its tipping point. In order to survive, the healthcare industry will need to invest in Industrial Engineering principles and it will need to do product line, service line, episodic, acute and outpatient time and motion studies.
Earlier this month, I happened upon an actual scientific study of the use of social media in medicine and healthcare conducted by researchers at the University of British Columbia. The study was fraught with terms such as “positivistic epistemologies” and “critical-interpretivist theory” to add the requisite ambiance one finds in such studies. All kidding aside, I did find the study to be a great singular digest for how healthcare is using social. However, while the study provided a good written history on each facet of social media, it did not go as far as to provide advice on the most effective uses of social. This is where I’ll step in.
In this series, I will share some interesting tidbits found within the study for each category. I’ll also highlight recommendations for the correct tactical use of these mediums. We start with:
The study defines blogs as “communal websites where opinions on any number of topics are voiced to create communal, collaborative dialogues.” I really love this definition because it relies heavily on the terms “community” and “collaboration.” The general direction of this definition towards the “we” and away from the “me” points us to one of the main mistakes healthcare bloggers tend to make, which we will discuss further below.
As mentioned in the study, these are the most common hospital uses of blogs:
If I had it my way, tactic #1 would largely go away, and 2 and 3 would be used with great precision. Since blogs are about communities and collaboration, there is very little room for those that wish to crow about themselves endlessly. Treating a blog like a media room, where press releases are repurposed for web, is not the way to go. A person or organization should generally not talk about themselves in first person (or third person for that matter). Instead it is about disseminating information that your intended community would find useful. For healthcare organizations, one of my favorite topics is preventative medicine, which highlights all of the small things patients can do to make a big difference in their overall health.
There are only a few instances where healthcare organizations have been “self focused” successfully. This is typically done through sharing positive patient experiences. Yet, again, the organization is not talking about themselves. They are sharing the journey a patient has had through illness or wellness and sharing that with others that may find this information helpful. As a result, I feel that sharing patient experiences is very much in line with disseminating healthcare information to an interested community. Here are two of my favorites:
Henry Ford: Gail’s Video Blog
There have been a few healthcare organizations that have been successful at recruiting patient guest bloggers. Henry Ford’s blog for their Bariatric Center is one of my favorites. On this blog, Gail records her bariatric surgery journey over the course of a few months. Blogs like this are great because there is no sharper lens for viewing the true patient experience than through the eyes of the patients themselves.
Mayo Clinic’s Piano Foyer Video
This one was quite a viral social media accident (as most things that go viral in social media are). An orchestra had performed within the Mayo Clinic atrium, but weren’t scheduled to retrieve the piano until a day or two later. Enter Fran and Marlow Cowan, who were visiting Mayo Clinic as patients from Ohio. There they found this grand piano sitting by its lonesome and decided to do something about it. Jodi Hume, another guest seated in the atrium at the time, found the pair so entertaining that she recorded them and uploaded that video to YouTube.
To date the video has been viewed almost 10 million times, and Mayo Clinic’s name is right there in the title for all to see. Mayo Clinic has since asked the couple to return for a second performance, which can be viewed here:
Any questions on blogging? I’d be happy to answer them in the comments section below.
I’ve waited 20 years for my Treasure Map. Yes, a map with hidden passages, remote islands and an “X” to mark the spot. As kids, some of us hunted in our yards looking for buried treasures. Kids today use smart phone apps for activities like “Geocaching” to explore public and urban spaces. What do we use in Healthcare?
Many of us desire a chest full of clinical outcomes, protocol conformity, activity based costing, provider scorecard, genomic studies, Pharmacogenomic markers, Adverse Event analysis, and coordination of care analytics.
But lately, we have been lost – adrift at sea, hopping from one raft to another, and from one stranded island to the next more barren island. We’ve bought point solutions that offered the holy grail for a niche activity, all while knowing the vendor or the quick fix would evaporate before we had achieved broad-based adoption.
Oh, I’ve been there – tasked with implementing the pet project for a clinical director or department chair. I’ve no sooner got the data in and one cycle of analysis out, than the provider champion would change their focus and the solution implemented didn’t transfer to the next project. (Sigh.) Read the rest of this post »