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#TexasHIMSS: MD Anderson’s Consumer Driven Cloud Based Solution

MD Anderson uncovered a potential problem.  Their physicians were using non-approved cloud based storage programs that they “may or may not” have been using to share PHI.  I will note that they use a pretty broad definition for “consumer driven”.  I define consumers as the target market that, in this case, a healthcare provider must engage to generate revenue that impacts the bottom line.  The inside of the organization collaborates with “consumers” outside of the organization.  That’s, perhaps, because I come from the business world where “consumer driven” is defined as “offerings, plans, or strategies motivated by customer demand or expectations.” In this case they were targeting physicians and not patients.  Yes, anyone who consumes a technology is a “consumer” of that technology, but that would basically make the entire technology world as a whole “consumer driven” because every technology is created with someone and their problem in mind.

SBEXRF-00017872-001Now that I have stepped off of my soapbox, below you will see the three steps they used to solve their problem using cloud based technology.

Step 1: Analysis and Planning

Used support of network and desktop teams.  Reached out to a few employees and received positive feedback.  Need to establish an appropriate scope.  Decided it was naïve to say that they couldn’t put the data they use in that system.  They went forward assuming it would include PHI.  Worked with desktop and network teams to identify actual target technology.  Engaged Information Security early.

Step 2: Prototype Pilot Implementation

MD Anderson used the following process to implement their pilot

  • Implement gradually and with care.
  • Evaluate surveys and usage data.
  • Pilot with a mixed user base, prototype with power users and set end user expectations

Pilot program tips were to address security concerns early, take the time to test support and administrative tools, and don’t forget about the support staff.

Step 3: Support and Marketing

Partner with key groups for support.  Advertise that these services are available.  For internal collaboration I often suggest you communicate these new tools “7 different times in 7 different ways”.  In MD Anderson’s case this included advertising the tool on their very own television station and using the help desk to document users that they knew were already using cloud based storage (perhaps inappropriately) and targeting those users.  One of the ways definitely need to be a training program that highlights any self-service functions built into the new program.

#TexasHIMSS: Mobile Health at Rockdale Medical Center

At Texas HIMSS today I was able to view a use case for Enterprise Mobile.  That’s the term I use to describe the use of mobile devices internal to a healthcare organization.  In this case, Rockdale enabled a single point of workflow across disparate data sources and care locations to enable physicians via a mobile platform.  This platform involved native mobile OS BYOD, medical device drivers, SSO, and Security.

Infographic-Doctors-Prescribing-More-Mobile-AppsWhat drove the adoption of this mobile technology?  There were three main reasons.

  1. Supports compliant workflows: They learned that doctors were using their cellphones to take pictures of images and then texting them to other physicians that were not onsite to get their opinions.  This obviously gave compliance officers a heart burn.  So, they wanted to make the right thing the easy thing by providing a high quality mobile platform that was HIPAA compliant.
  2. Improves care coordination: Data silos are a problem.  We all know this.  This mobile platform provided physicians with access to data in a single application.  They had this access no matter where they were when they needed this data.  This expedited the speed of care in emergency situations.  I’m sure it also answered the common call from physicians: “I go from room to room to room all day. If it is not on my mobile device, then I don’t care about it.”
  3. Encourages engagement: There is 91% US adult adoption of mobile technology.  As a result, these mobile platforms leverage the use of equipment that physicians are already familiar with.  This fact encouraged engagement and interest in the program.   For those of us that make implementation of technology in healthcare a habit, easy physician adoption of technology is pretty awesome.

Analytics have shown that the technology is highly utilized by Rockdale physicians.  It has also provided a competitive advantage in their provider heavy location of Atlanta.  Among other goals, Rockdale’s next steps are to partner with their local EMS and establish objectives to improve the quality of patient care in the Emergency Department.

#TexasHIMSS: Reaching Teens with Digital Health

During a breakout session at Texas HIMSS today, I attended “Reaching adolescents through electronic health portals:  Lessons from the field” by Peggy B. Smith, MA, Ph.D.

While I normally lean towards the positive in providing insights from these breakout sessions, being a presenter is no easy feat, I must start with a couple of not so positive qualifiers.  “Patient portal” was not really discussed during this session.  Rather, “digital means of communication”, such as public websites and social media, is a more appropriate definition of the technologies discussed.  Fair enough on the surface.  However, not knowing the difference between public and secured technologies created a real problem when the presenter spoke of how HIPAA creates barriers to providing teens with health information via digital means.  The patient portal, used thoughtfully, can assuage these privacy concerns.  I feel that the presenter should have understood this.  Her lack of knowledge on portal was amplified when I asked a question related to the timing of the data she collected in Approach 2, mentioned below, in relation to  Meaningful Use Stage 2.  She did not know what  Meaningful Use Stage 2 was.

istock_000037708720smallWith that being said, I will carry on with insights from the session that I did find insightful.  To present these in the correct context, I will mention that digital health in adolescents presents a number of quandaries for the healthcare provider.  While most healthcare decisions and procedures can and do involve parental consent, not all can.  I involved my colleague Dr. Marcie Stoshak-Chavez in defining what decisions and procedures do not involve parental consent.  As she mentioned, although healthcare statutes vary by state, procedures for sexually transmitted diseases, pregnancy, contraception, psychiatric disorders, and drug or alcohol abuse typically do not involve parental consent and include additional privacy rules that exclude parents.  

Since teens can and do use digital technology, and technology is often used by consumers to collect information because of the anonymity involved, it is quite apropos to discuss using digital health means, such as patient portal, when providing care for teens.  This becomes a much more important conversation in those areas of care where parents should not, by law, have a seat at the table.  Of course, it must be considered that oftentimes the devices teens use are not actually owned by them.  This also must be considered.

Essentially, digital health provides the most obvious form of communication between provider and teen.  However, there are many constraints.  What follows are three areas of study that Peggy Smith provided:

Approach One: Web based platform for sexual health for at-risk youth

This method involved avatars named Tiff and Ty that were available for anonymous questions on sexual health via a clinical website (read: not portal).  This research was a qualitative assessment that evaluated the anonymous questions that were submitted via the website.  There were a total of 916 queries received.  Six major question types  were identified in order of frequency:

  • Cost (Might seem surprising at first, but makes sense in decision making that does not include parents)
  • STD testing
  • Birth control
  • Personal health concerns
  • Parental consent and confidentiality
  • Sexual health misconceptions

Some of the questions included, “Does it cost to have a regular check up and pap smear?” and  “I was wondering if yall had HIVSTD testing available and how much it would cost?”  and “Can I come in for birth control and will my insurance voer the cost for it?”

Approach Two: Evaluation of the adoption of electronic platforms by public health professionals 

This method involved studying decision makers for technology platforms within the healthcare provider industry.  This study wanted to understand to what extent public health professionals, the ones making the decisions, were familiar with electronic messaging and what their attitudes towards acceptance of these platforms were.  This is the one where I must mention that the data was collected in 2011, which predates Meaningful Use Stage 2.  I would guess that these figures would be much higher now, but it is interesting to see how failing we were in adoption of these technologies without the financial incentives.  I must also point out that it is likely that the researchers did not describe these digital care methods in the context of portal, since they did not understand the difference between web and portal.  If I were a decision maker, then that would have painted my answer in this case.

At the time of the study, only 37% of decisions makers stated that they currently had these systems in place.  Only 15% of these decision makers stated that they had future plans for implementing these technologies.  Recurrent themes in the research included a lack of confidence in the processes surrounding digital health, the depersonalization of healthcare, and the concerns for privacy.  It is also interesting to note that there was a stated difference in age cohorts.  Older decision makers were less likely to move forward in developing digital health infrastructure than their younger counterparts.

Approach Three: Global portal for information across continents

The method here was to use the upgraded website to provide a number of health education tools.  These included a presence in social networking, a short message service, and health education webisodes.  These webisodes targeted 16 and 17 year olds that were mostly Latino.  They used the concept of “Edutainment” (education + entertainment) to provide information on topics such as HIV testing.  Story ideas were based on real stories, contained entertainment value, provided context of audience lives, and focused on characters and their relationships.

There wasn’t much information provided on the impact of this approach other than to point to the “issues that HIPAA presented” when it came to public websites.  Again, knowing the difference between public website and portal would be helpful here.  Also, one information session participant commented that providing webisodes like this would have astronomical production costs.

Reaching Teens with Digital Health

Teen health education can oftentimes be a divisive topic, but the debates on this topic will not make these issues go away.  In fact, it has been proven via cost data that limiting healthcare to teens generates a major drain on the healthcare system.   With all of these facts in mind, do you believe technologies like patient portal can be used effectively in the area of teen health?

#TexasHIMSS: “Godfather of PCMH” & the Future of Medicine

I am at Texas HIMSS this week in Dallas, Texas.  The opening keynote was provided by IBM’s Paul Grundy who has also become known as the “Godfather of the Patient Centered Medical Home”.  He provided a good overview of the history of efforts surrounding connecting data to care.  Towards the end of his chat he defined how healthcare will transform in the near future.  Here are his thoughts, and I would love to hear yours:

  1. dallas 1Healthcare will become more data driven: This is clearly at the heart of what Paul Grundy, and the patient centered medical home movement, is passionate about.  The driving question here is “Where is the data and how does it impact care at the elemental level?” with the goal of having all data available and able to act upon.
  2. Every person will have a plan: This is an interesting one for me.  My mind immediately harkened back to the Connected Health Symposium a couple of years back when Joseph Kvedar, MD spoke of using genetic data for personalized preventive medicine.  You can read my post about it here.  There is also a post by Dr. Marie Stoshak-Chavez on whether we will ever see personalized preventative medicine in the future.
  3. The delivery system will be team based:  Check out this piece on the core principles and values of team based care.  They correctly point out that care has not always been a team sport.  In the “good old days” meaning “still happening today sometimes” all care was curated by the doctor as the “all knowing sage”.  The complexity of modern healthcare provides us with a situation where the entire team needs to work together harmoniously to provide care quality.  This brings us to….
  4. Managing a population down to the person:  Here is what I hope is the “patient centered” part of PCMH. It my (not so) humble opinion, the healthcare of the future will not reach its fullest potential until it is truly patient centered.  This means that the patient needs a seat in team based care.

What are your thoughts?  Do you think he nailed it, or are there some holes in his vision of where medicine will evolve into the future?

Participatory Medicine Meets Participatory Design

Most times when the word “participatory” enters my lexicon it is closely followed by the word “medicine”.  I’m a fan of participatory medicine.  If you don’t believe me, then you can look here, or here, or here for written proof.

Participatory medicine is a care model in where the role of the patient is active, enabled, and emphasized.  Participatory medicine requires the “mindful” inclusion of the patient in the care delivery process.  When you see online patient communities forming, then you see participatory medicine at work.  You will also witness shared decision making, patient participation on the treatment team, and evidence based patient choice.  The director of the U.S. National Institutes of Health has been quoted as saying:

As opposed to the doctor-centric, curative model of the past, the future is going to be patient-centric and proactive. It must be based on education and communication.

These are the types of sentiments that make someone like me very happy.  The fact that I get to play a role, even though quite small, in this movement is the kind of intrinsic motivator that gets me up each day happy to do my work in Connected Health.

hands-raised-participateIn Connected Health we design technologies meant for patient engagement.  They are the communication lines that extend outside of the eight minute patient visit and into the lives of patients wherever they are when healthful decision making counts.  As a result, another participatory term set is beginning to exit my mouth more frequently.  That is, namely, participatory design.  Participatory design, also known as cooperative design, emphasizes active inclusion of all stakeholders, even those that do not know how to use Photoshop, in the design process.  Key to this end is the end user.  In our case that means the patient.  By using participatory design, we are able to create environments that are more responsive and appropriate to a patient’s cultural, emotional, spiritual and practical needs. User empowerment is built into the core of this process.

So, what if patients were crowd-sourced more regularly to solve all of those challenging patient engagement issues?  For example, many of the biggest challenges I see on provider websites occur because it is challenging for an employee of a health system, the ones actually making the final decisions, to release their mind from the confines of their day job.  This usually means that the content of the public website is architected in the way that employees see the organization: by department or facility.  Problem is, this gets in the way of patients trying to find the information they need to be more healthful.  Patients shouldn’t have to navigate 5 layers deep to find content specific to their condition or health concern.  Patients won’t work that hard.  Instead, the hub of digital patient engagement should have, at its core, the patient user experience.

Not being new to the public website creation rodeo, I’ve found the process and final product to be greatly improved through the addition of patient voices throughout the entire website design process.  I’ve never met two patient populations that are the same, so while there is general advice on tailoring a message to patient needs, insight should always be collected from the target market in question.  This insight informs the nuts and bolts of information architecture and the engagement of graphic design.

As a result, a one and done approach to patient feedback is good.  An iterative approach to patient feedback on site design is better.  Co-designing a site with patients?  I would love to see that on every provider website.  By using participatory design to reach out to patients in the beginning of the relationship, with the website that engenders a culture of participation, then it makes it that much easier for that participation to be embedded throughout the entire collaborative care model.

The Social Support Group Coming to a Provider Near You

What are the benefits of online patient communities?

I find myself answering this question quite a bit lately.  It struck me this week that I have never answered this question on the blog.  But, first things first, what is an online patient community?  Online patient communities are, essentially, condition specific socially enabled support groups.  These networks provide patients with an opportunity to connect with those that are experiencing similar challenges.  Together this collective of voices provides helpful discussion and the sharing of resources.  By their very nature, their benefits are many.  However, when they are organized by a trusted authority in care, namely healthcare providers, the benefits grow quite dramatically.


So, here is my list of the benefits of online patient communities.  Have any more to share?  I’d love to hear more from your experiences in the comments section below.

  • Social provides connections to those that are not mobile.  Let’s just be honest, appointment scheduling conflicts and transportation difficulties are typically a part of the patient experience.  It is oftentimes the case that patients and patients-by-proxy (caregivers) cannot physically attend a support group.  Any opportunity to lift barriers during the course of treatment is a welcomed reprieve from everyday turmoil.
  • Patients-by-proxy are more likely to open up.   According to Pew research, while 33% of patients participate in online patient communities, more than half of patients-by-proxy do so.    In that same survey, 34% of these caregivers actively read patient commentary about a specific medical issue online and 22% of those caregivers actively reach out to those that might have similar concerns.
  • Online patient communities provide support without bounds. Social networks are used, quite frequently, by the retail and consumer goods industries for consumer outreach purposes.  I don’t know of a loyalty program  stronger than one that could be used to save lives.     Social communities are a fabric of ties that lead to sources of support, information, and collective experience.  The goal of these communities is to foster communication between those without knowledge and experience to those that can “mentor” and provide support.  More informed patients are healthier patients.  Some of the tangential benefits of this enablement include: 1) Better understanding of health and medical conditions, 2) Improved recall of the care plan, 3) Feeling more in control of care, 4) Taking better care of themselves, and 5) Better adherence to medications as prescribed.

There are some additional benefits for the healthcare provider as well:

  • Better sample groups mean better research.  For those researchers aimed at helping through analysis, online patient community demographics are actually a more accurate representative sample of a given patient population than can be found in a traditional support group.  There are two studies that back this claim up.   One study looked at an online patient community specific to scoliosis.  Researchers found that the members of this community had similar demographics to the scoliosis population as a whole.   Another insight is taken from the fibromyalgia group on PatientsLikeMe that showed this group to be representative of those with that condition at large.  Why is this?  Breaking down geographic boundaries is a great way to also break down the socioeconomic and cultural chasms that often exist in traditional groups.
  • Time efficiencies in group care. Check out any online patient community and just underneath the surface you will find the voice of the members mentioning that they were unable to get the medical information they needed from their clinician.  So, these patients often turn to Dr. Google.  Using these communities, clinicians can provide accurate information is a mass customized format to an entire community of similar patients.  This is particularly helpful in those instances when new information or alerts need to be provided to the entire population at one time
  • Strengthens the partnership between patient and provider.  Let’s just be honest, a typical physician schedule does not often leave time for participating in support groups.  With a provider sponsored online patient community, a clinician, in the form of the community manager, is on call 24/7.  Provider sponsored clinicians that act as patient advocates to address general and condition specific questions to the entire community are a valuable asset.  Many clinicians are surprised at how different the questions patients will ask in online patient communities are from those they will ask in the doctor’s office.  For example, migraine patients will often ask Dr. Google “will I die from this?” while physicians rarely if ever hear that question in the office.
  • Social synchronization with care protocols.  When these social features are enabled through the patient portal, patients become truly enabled with knowledge.  There, within a single view, patients can take their new found knowledge and then apply that knowledge to their care protocols.  This experience can be taken a step further through gamifying that experience.  For more information, please check out “Healthcare Gamification: Is it time for Physicians to prescribe gaming to patients?” and “Beyond Gamification: Revolutionizing Healthcare with the Quanitifed Self“.

Getting Scientific About Healthcare Social Media: Medicinal Sites

© elkor 2009The 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:

  • An API that enables “Facebook Connect” for easy authentication
  • A built in recruiting tool called Talent Finder
  • A continuing medical education (CME) platform
  • A “digital fax line” that allows physicians to receive their faxes (I know…don’t get me started) through their network via a personal fax number


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.”

Getting Scientific About Healthcare Social Media: Social Networks

shutterstock_126905108Thus 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:

  • Researchers found that most common type of groups on Facebook were peer-to-peer networks centered on specific medical conditions These groups fall into four broad categories including:  1) fundraising, 2) awareness, 3) marketing, an 4) general support
  • Researchers often join these groups as a means of disseminating information.
  • With the good come the bad.  While there are plentiful examples of epatients using online patient communities to support one another through illness, there are also a select few that self-aggregate in “negative-behavior support groups”, which are typically focused on the promotion of alcohol consumption.
  • Here’s an idea I’d love to import.  In Taiwan a well-known emergency physician blogger created a public group on the topic of improving patient wait times in the ER. The group went viral in less than a month.  A majority of emergency department staff from around Taiwan joined the group and commented.  The group got so much attention that the Minister of Health and his staff joined the group and commented directly.  As a result, the minister began making visits to ERs in ten different cities with a promise to improve funding to reduce wait times in collaboration with the Taiwanese Bureau of National Health Insurance.

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.

  • Get Up and Move: (no longer exists) allows users to challenge their friends to engage in physical activity and report on it after they have completed it
  • START: (no longer exists) Brought to you by the American Heart Association, this app allows users to answer questionnaires on the topic of cardiovascular health and upload the data to a health portal
  • HealthSeeker: this is a diabetes app that provides health education and the ability to win points as an incentive

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.


Getting Scientific About Healthcare Social Media: Microblogs

hashtag3-ccIn 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:

  • Substantive Tweets: a tweet that is independently understandable (e.g.,  title of a paper or blog, a brief comment, and a link to the publication)
  • Conversational Tweets: fragments of a new or ongoing conversation that draw on professional or personal interests or comment on current events. (e.g., there is no greater example of this than the Twitter discussion at HIMSS (#HIMSS14)
  • Hybrid Tweets: substantive and conversational at the same time (e.g., “let’s discuss patient engagement tonight at Sidewinder Coffee”)

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:

  • The Pennsylvania State College of Medicine has used Twitter to augment peer-to-peer and instructor-to-student learning by stimulating topic discussions, providing feedback on critical thinking, conducting course evaluations, disseminating writing prompts, soliciting class responses, and monitoring student progress.
  • A junior doctor and a medical student started a Twitter Journal Club that functions in the same manner as traditional journal clubs, except that the means for discussion is Twitter. By using a combination of blog posts, where the paper and discussion questions are posted in advance, along with the hashtag #TwitJC, students, doctors, and anyone interested in the subject can engage and interact in a meaningful way.
  • Live tweeting surgeries and medical procedures.  Henry Ford Medical Center was the first to live tweet a surgery back in 2009.  Swedish Medical Center in Seattle has used this tactic very successfully.  One notable example was an overnight tweet up they did on sleep disorders.  Those impacted by sleep problems were able to watch what happens during a sleep study.

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.

Getting Scientific about Healthcare Social Media: Blogs


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:

  1. advertise facilities
  2. share positive patient experiences
  3. feature well-known physicians who treat celebrities
  4. disseminate disease-specific information for patient education

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.

App Annie Ranks #mHealth

app_annieFrom the fun-loving portal chap that brought us Find a Provider tools that don’t make babies cry (read: Mark Polly), I bring to you a ranking of Mobile Health apps by App Annie.  App Annie a ranking app that uses app store analytics and market intelligence to rank and visualize an app’s download, revenue, ranking, and review data.

But first some mobile health statistics:

  • 91% of US adults have adopted mobile technology (Source: Pew study)
  • 91% of adults keep their phones within arms reach 24/7 (Source: LeadersWest)
  • 75% of US adults even bring their phones to the bathroom (Source: Digiday, 2013)

As you can see, people really like their cellphones.  This love has brought us a bounty of mobile applications, and healthcare is no exception.  Here, I have listed for you, a ranking of those mobile health apps brought to you by App Annie.

Health & Living

Here we are looking at just Heath and Fitness.  Health insurance companies have been investing a great deal in this space for good reason.  As you can see, there are four large health plans that show up in the top 100 apps.  Who else is ranked in the top 50?  Think apps like Nike Fitness Club, Weight Watchers, Fitbit, Period Tracker, Baby Bump, and White Noise Lite.

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Switching over to the medical category we, not surprisingly, have Epic’s MyChart ranked #4, which is primarily charged by all of their healthcare provider customers that offer the MyChart app to their patients.  As shown below, the Mayo Clinic shows up at 106. There are 105 other medical apps more popular that the venerable Mayo Clinic.  These apps include WeedMaps, FRWeed, Epocrates.

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Other applications that are ranked higher in this category include:

  • #201: Novant Health
  • #369: Cleveland Clinic Today
  • #730: Spectrum Health
  • #818: Florida Hopsital ER Wait

The Bottom Line

So, what does this mean for hospitals and health plans considering mobile apps?  If you are a health plan, then you likely need a mobile app in order to take advantage of location services for pharmacy, find a provider, etc.  If you are a major health system, then you can also leverage the large number of potential users by providing a mobile application.  Others might consider specialized mobile applications that are specific to tasks like requesting appointments, refills, location based facility mapping, or information on specific diseases or chronic conditions.  With all of the data pouring in on the success of text messaging programs for health, you should be looking into these programs as well.

Virtual Ideation Sure Beats a Conference Call

globe-bulbBeing a consulting firm, here at Perficient we have a “live anywhere, work anywhere” culture.  What that means, essentially, is that while I live in Cincinnati, the colleagues that I work with daily live in places like Chicago, Phoenix, Atlanta, Houston…the list goes on and on.  Add to that all of the places we travel to work with clients, and you can bet that if there is a metropolitan area in this country, then there will be a critical mass of Perficient employees located there.

Since my coworkers are spread across this country, on a day-to-day basis I take part in a bunch of conference calls that span three different timezones.  As a result, this made viewing the video “A Conference Call in Real Life” the funniest thing I have viewed so far this year.

With the sounds of coworkers caught in tunnels and barking dogs dancing in my head,  I was quite happy to attend a session by Merck on Virtual Ideation during the IBM Connect conference in Orlando.  Like any company in life sciences, Merck is a company that grows based on ideas that spur innovation.  Without those ideas, Merck cannot compete effectively in their marketplace.  As a result, it behooves Merck to invest in better ways to ignite ideation in a global economy riddled with the dreaded conference call.

These facts behind them, Merck realized that a virtual collaborative ideation approach would be a major competitive advantage.  To make virtual ideation a reality, Merck leveraged the strength of virtual community engagement to effectively cover selected research topics in breath and depth using the Lab of the Future.  The virtual event concept IdeaBoost was used to activate and tap into the collective intelligence of a worldwide community within the confines of a four day virtual ideation event.  I’ve seen unstructured enterprise social collaboration become a powerful tool for healthcare organizations across the country.  Where IdeaBoost differs from traditional enterprise social is in the structure placed around it.  IdeaBoost essentially combines enterprise social with a pre-determined timeframe combined with effective moderation and analysis.

How do you push breakthrough thinking? 

IdeaBoost has three phases, which include:

  • Set the Scene: Making virtual ideation a success requires a great deal of prep work.  Merck conducted a “mega trend analysis” and recorded interviews with industry experts and customers in order to create a “springboard” towards new business opportunities.  Participants of IdeaBoost were able to take in this information in the days and weeks leading up to the event.
  • Identify & Refine Opportunities: This is where all of the voices that spur innovation collected together using social collaboration technology.   Merck had a total of 300 people “attending” the virtual ideation event.   In order to organize and make true meaning of this large collaboration effort, Merck had 3 moderators available for each IdeaBoost theme.  These moderators were behind the scenes helping shepard dialogue into complete ideas. Moderators were expected to commit to 3 x 1.5 hour training sessions, complete their individual preparation, and then moderate the four day event.  Merck found it effective to have all moderators in the same room during the four day event.  The closest example I can think of to these moderators would be the moderators of tweet chats.  If you would like to see one up close and personal, then please attend the weekly #HITsm (healthcare IT social media) tweet chat that takes place every Friday at noon Eastern.  Message me on Twitter if you’ve never tweet chatted before, and I’d be happy to show you the ropes.
  • Evaluate Opportunities: After the four day virtual ideation event was over, a team of Merck analysts combed through the “catalogue of ideas” to get a better sense of the true number of possible outcomes.  They combined this with market research to evaluate the size of the opportunity with a probability of success.  In a force ranked order, each idea was given an action plan.

Ultimately, this catalogue of ideas was then fed into R&D to create products that Merck can bring to the market.  Merck also learned through the IdeaBoost process that virtual ideation wasn’t just about getting ideas.  Through this process, Merck employees were able to learn what working socially really means.  They immediately found value from enterprise social in their daily work through learning together and understanding the knowledge across the organization.  It was shown to be an “eye opening” experience for the 300 individuals participating in the event.

Merck simply reinforced the notion that diversity fosters creativity.  Using enterprise social, when you bring diverse groups together ideas will naturally flow into the every day life of your organization.