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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.

Doximity

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

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:

Facebook

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

Blog

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:

Blogs

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.

Connected Health Trend Countdown: #10 M&A Meets Engagement

Top Ten

Connected Health is that always dynamic space where we connect patients, providers, insurers, and the health community at large in an effort to deliver quality care that is not confined to the mere 1% of time patients spend in the clinic care setting.  It’s healthcare that braves the whirlwind of daily life with the goal of providing guidance and care when it is needed at home, at work, at school, in the community, and, even, around the world.

2014 will be an exciting year for those of us that make Connected Health our mission.  Please join us as we count down the top 10 Connected Health trends that are expected to greet us this year.   Today we kick off the list with:

Trend #10: M&A Meets Consumer Engagement

Hospitals across the United States are currently swept up in an avalanche of mergers unlike any we have seen in the last two decades.  The small regional hospital is becoming an endangered species in this time of giant hospitals systems. The number of acquisitions has surged in the past four years and continues to grow at a fast pace.  In 2012, the number of deals was more than double that seen in 2009, and it is predicted that within the next five to seven years approximately 1,000 of the nation’s 5,000 hospitals could seek out a merger.

mergers

Image Source: New York Times, “New Laws and Rising Costs Create a Surge of Supersizing Hospitals,” August 12, 2013

These consolidations are being driven by a confluence of powerful forces.  Affordable Care leads the pack but other goals of merger include:

  • Increase negotiating clout with insurers
  • Improve care
  • Reduce costs.  However, some economists and health insurance companies worry that this trend could raise healthcare costs.

So how does this rapidly condensing healthcare environment impact Connected Health?  The impact is largely two fold:

Combined Voice

As mentioned above, by combining, hospitals can reduce costs in terms of back-office activities.   One of the back office costs of note to Connected Health is the public facing voice. Healthcare organizations that merge legally also need to merge brands, content provided on the public facing website(s), social media profiles, etc.

A typical evolution is as follows:

  • larger system acquires a smaller regional hospital
  • the amount of content and collaboration with patients served by that small regional hospital increases due to higher available investment through consolidation.

Simply put, the big systems often provide better content and communication through the public website and social media than a small regional hospital is capable of providing alone.

Larger Population Net

What does this combined voice mean in terms of population health?  Whether it is a national chain of hospitals across the country or a grouping of hospitals in a specific geography, providing more and better web content and more outreach through social media can have a profound impact on managing wellness throughout a population.

Let me provide you with one of my favorite recent examples. Forrest Health, once a single hospital, is now a family of five hospitals in southern Mississippi. Where social media is concerned, they get many things right.  Their Women & Children outreach is my favorite.  They use social media to parlay news, health insights, and community spirit throughout their population.  These efforts are then well tied to multiple “hard wired” in person outreach programs including a popular club for preteen and teen girls called Spirit Girls and another for young girls called, prepare yourself for an abundance of cuteness, the Sweet Teas.

Please stay tuned for the remainder of our series to see what trend reaches the #1 spot.  Comment below on what you think the biggest trend could be.

 

Using Hashtags for Cancer Care

Mark Polly, Director at Perficient, recently wrote a blog post on how we can use hashtags to help make cancer information more searchable for those that need it.

Over Time

 

Over on Symplur.comDr. Michael Katz talks about connected health care.  In this blog post, Hashtags in Cancer Care: Embedding Meaning in Digital Health, he proposes a more formal set (“ontology”) of hashtags for cancer information.  While hashtags have traditionally been a means of spontaneously organizing Twitter  tweets, I think Dr. Katz’s idea has a lot of merit.  Let me explain why I think this.

To read Mark’s full blog post, click here.

 

 

 

 

 

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Getting Started Connecting with Patients Online

In our new Perficient Perspective, “The Driving Force of Social Media in Healthcare,”  Dr. Marcie Stoshak-Chavez discusses the increasingly social world of healthcare. In it, she discusses the value of connecting with patients online – but how do healthcare providers begin to establish this relationship? According to PwC’s Health Research pharma-social-mediaInstitute, early a third of consumers has used some form of social media for healthcare purposes and that number is sure to grow as our dependence on mobile technology increases.

Perficient will be hosting a webinar on July 31st, “How to Convert Unknown Consumers into Patients Using Social Media” to discuss the value in engaging with patients online. Join us to learn how to communicate with target markets, attract new consumers, manage communication tools, and influence patient behavior via online communities. Numerous articles have explored the idea that engaged patients are not only more satisfied but better manage their health, which reduces care costs. The value to healthcare providers to connect with their patients online is evident. Now is the time to cultivate an online engagement strategy in order to attract and retain patients.

e-Patients Enhancing Health Through Social Media

Each day millions of pieces of information are shared over social platforms. There are over 400 million Tweets and 2.5 billion items shared on Facebook each day – and these are just two of many social networks. Healthcare has not ignored this shift to social and is working towards integrating these various networking channels with health information to lead to a healthier population. Our new Perficient Perspective, “The Driving Force of Social Media in Healthcare,” gives insight on the increasingly social world of healthcare from practicing physician and Perficient director Dr. Marcie Stoshak-Chavez.

Marcie answers several timely questions on how social media can be a boon to providers, how it has had an effect on communication between physicians and patients, and how doctors can use social networking to their advantage. There are many different aspects of healthcare that can be tied to social media and patient engagement, including telehealth, remote monitoring, and the quantified self. Marcie’s unique role as both a practicing physician and a business consultant allows her to see these variations on traditional care from both sides of the fence.

A video series with Perficient’s Martin Sizemore gives additional thoughts on driving patient engagement through social media and networking. Knowing your audience and tailoring the delivery is key, and knowing which technologies healthcare organizations should be focusing on to communicate with patients will be critical. Meaningful use requirements  are spurring patient engagement by using patient portals, mobile phones, and remote monitoring to engage patients and lower costs. Mobile phones are also making self-tracking quicker, easier, and more interactive, which can be leveraged for preventative health measures. These preventative health measures can be used towards population health management, along with online communities for chronic condition support.

View the Perficient Perspective with Marcie and Martin here.

Would you co-design your website with patients?

This question has crossed my mind numerous times since I read about the Blue Button Co-Design Challenge last month.  The Blue Button Co-Design Challenge is being used to give patients and patients by proxy a voice in how they access health data and how they want to then use it.  Real patients for product feedback and iteration will be available to developer teams of providers, data holders, and entrepreneurs ready to usher in the next age of view, download, and transmit.crowdsourcing-cartoon

This got me thinking.  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.

Top Technology Trends in Healthcare – June 2013

The healthcare IT field is rapidly developing and changing. Emerging technology and updated regulations put pressure on healthcare providers and health plans to stay ahead of the curve. Perficient creates a monthly list that explores some of the current topics and issues in health IT. This list examines the most talked about issues and technologies that are currently affecting the industry.

HCBlog Top5 Trends

ACOs and Patient Centered Medical Homes

An ACO is a group of healthcare providers that partner under a payment and delivery reform model that become collectively accountable for the full continuum of care for a population of patients. This reform model ultimately ties reimbursement to quality metrics and reductions in the total cost of care for the patient population. Patient Centered Medical Homes (PCMH) focus on improving the quality of care delivered by creating a health care environment that facilitates communication between the patient and their physician, allowing patients to receive and understand the care they need when they need it.

Telehealth and Remote Patient Monitoring

The healthcare industry is experiencing revolutionary changes stemming from the rapidly shifting role of the patient within the continuum of care. This is resulting in high demand for easier access to healthcare professionals, access to online medical information, and alternatives to traditional care. Telehealth allows for the transmission of medical images, video, audio and information related to diagnosis and treatment can be stored and sent from the provider’s computer or mobile device via secure data exchanges. Remote Patient Monitoring allows patient’s health data to be sent electronically to a provider who then can analyze it and respond with appropriate recommendations.

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Social Digestion: Social Media and the Thinking Organization

Sometimes social media is too popular for its own good.  The fun and frivolity of finding Mini Oreo Peppermint Cheesecakes on Pinterest (that exists) or figuring out what the Official Grumpy Cat is up to on Facebook (he exists too) often get in the way of conversations regarding the real collaboration problems faced by the healthcare enterprise.  Whenever social media enters the conversation as a potential solution to the healthcare collaboration problem, it is often brushed off as that “cute thing they tweet about.”

enterprise-social-media-innovation-knowledge-sharing

But, what is social, really?  Social is a way for communities of people to digest large volumes of information quickly.  We live in an
information rich world, and data overload is this digital world’s greatest side effect.  Way back in 2008, a technology research firm called IDC tried to account for all of the 0s and 1s that make up the current store of digital data.  They found that in 2007, the world had amassed 161 billion gigabytes of digital data.  If each byte of data is one character in a book, then 12 stacks of books could have been piled up from the Earth to the Sun with the digital data collected at that time.  But that data growth keeps expanding exponentially.  By 2010, those 12 stacks reached from the Sun to Pluto and back to the Sun.  From now until 2020, the digital universe will double every two years.

Yes, this information comes in many varieties.  Some people (read: me) really want to know what Grumpy Cat is up to.  However, we see these masses of big data in the healthcare enterprise daily.  Clinicians need to wade through the mountains of medical research that impact care decisions daily.  Researchers need to find and figure out the facts and figures that impact public health.  Within the organization, employees need to find the information they know exists among the applications, content, and knowledge workers grouped in different, often hidden, locations across the organization.

Many people believe that social media is the instigator of this data overload.  I am of the belief that, instead, social media was our collective response to this overload of data.  The amount of data available is so vast and so complex that we can only digest it as communities of people interested in similar topics.  Instead of being that “cute thing”, social media becomes mission critical to the healthcare organization living in fast moving times.  A healthcare enterprise enabled by social would have:

  • Departmental sites that are transformed into dynamic community hubs with quick ways to call, interact, and filter information
  • Care coordination across multiple settings with activity feeds that can track care processes across the care continuum
  • New mediums for knowledge dissemination, which becomes particularly important during a disaster

These are just a few examples, and there are plenty more.  What are some of your favorite examples of the healthcare enterprise enabled with social?

Get Social at HIMSS 2013

The #HIMSS and #HIMSS13 hashtags have been generating more and more buzz as we pass the two week mark before the show opens. The annual HIMSS conference is a very social event, and the long list of Tweet Ups and Tweet Chats reflects this. Here are a few of the social media events that Perficient will be participating in:

 

Monday, March 4, 2013:

Join some of the most influential women in health IT to discuss industry trends and effective communications strategies. The conversation will focus on the unique challenges and advantages for women in health IT, and best practices for integrating blogging and social media into your efforts. Hosted by Jennifer Dennard (@SmyrnaGirl), Melanie Hilliard (@MHCHIME) and Julie Moffitt (@HIEChick).

Don’t miss the SearchHealthIT and Health IT Exchange’s Tweet ‘n Meet at HIMSS13 at the W Hotel New Orleans’ Whiskey Blue bar. Hosted by TechTarget’s dedicated resource network and online community for health IT decision makers,  SearchHealthIT.com and theHealth IT Exchange, the editorial team, contributors and Twitter followers will be on hand, ready to mingle. Hosted by Jenny Laurello (@jennylaurello @HITexchange).

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