A "HealthTweep" Pulse Check

On Tuesday, December 8th, 2009 I had the please of speaking with Bryan Vartebedian, MD, a pediatric gastroenterologist, active in the social media space via Twitter @Doctor_V, his personal blog 33Charts.com, and periodic contributor to Get Better Health.

We spoke via Blog Talk Radio on his calling to medicine, pediatrics in particular and more recently his attraction to the social media space. Doctor_V has both interesting and witty insights on the medium. Some of his more recent tweets are noteworthy:

When I mention SM to other physicians they just giggle and look confused

LinkedIn may be a good first step for socially retarded physicians

Social media is the fancy awning that hangs from a building; human interaction is the bricks & mortar (a re-tweet)

For more of ‘Doctor_V’s insight, wit and early ‘do’s and don’ts’ for physicians considering a social media presence, listen in to the full interview here.

OK Tweeps in the movie ‘What the Bleep‘ do we know, the line transitioning to the theme of the flick proffers:

it’s time to get wise.

Well the same holds true with respect to the ‘resistance is futile’ health care borg aka ‘the tapeworm medical industrial complex’ economy. Our health care system is at risk of collapse; with 46 million uninsured, 25 million under-insured, primary care physicians bailing on the system daily, health care premiums sky rocketing, while benefits are being reduced and cost shifted from the plan to the employee. No one is happy with this status quo, quite to the contrary of some public opinion polls that tout we have the ‘best health care system’ in the world!

Surely we have the best high tech or ‘rescue care’ medicine that can be found. But when it comes to the ‘value proposition’ the story gets a little more complicated, and requires a bit more than sound-bytes or political grandstanding to get at the truth.

Money Driven Medicine is a primer for such a rational conversation. If we thought the Senate Finance Committee hearings followed by the debate of Chairman’s mark was exhausting, just wait for what’s in store from the special interests, and their ‘Quack-er’ proxies in the Senate during the impending floor debate of the merged bills.

So why not get current and be a part of the solution? Watch Money Driven Medicine and get WISE!

On the ‘hopium’ of health reform, where do you stand?

“I don’t believe there’s any problem in this country, no matter how tough it is, that Americans when they roll up their sleeves, can’t completely ignore.” ~ George Carlin

“Better brace yourselves for a whole lotta ugly comin’ at you, from a never ending parade of stupid!” ~ Queen Latifah

“Somebody has to do something, and it’s just incredibly pathetic that it has to be us.” ~ The ‘late’ Jerry Garcia (of Deadhead fame)

On July 30 through August 1st the Colorado Health Foundation (CHF)  held a superb conference titled ‘The New  Health Policy Landscape‘. While regrettably I was not able to attend, I followed the ‘tweets’ of @HealthSymposium, and health tweeps using the #09chs hashtag feed. According to their website the conference was ’sold out’, which was not hard to understand considering the event was  hosted at the Keystone Resort in Keystone Colorado. Can you say ‘Rocky Mountain high?’

Major Colbert ‘tip of the hat’ kudos to CHF as the event featured the following health policy wonk industry icons: Susan Dentzer (Health Affairs), Len Nichols, Ph.D. (The New America Foundation), Steffie Woolhandler, MD, MPH (Harvard Medical School) and Uwe E. Reinhardt, PhD (Princeton). For a complete list of the faculty and their presentations, click here.

Three presentations impressed me with their depth, clarity and candor. First up is single payer advocate Steffie Woolhandler, MD, MPH, who confidently presents the data establishing single payer as the sole option that can insure the now 50 million uninsured and not bankrupt the country in the process. Her audio clip is powerful, compelling and difficult to challenge on the merits of her pro single payer thesis. (Note: also on the program was Jeff Lemieux, Senior Vice President for America’s Health Plans aka ‘AHIP’).

Len Nichols, Ph.D., deployed witt and southern charm to address the problems inherent in the public option and chart the argument that viable health reform can only come from the non-ideological center (i.e., not single payor, nor pure ‘market based’ – non government intermediated -solutions). Using MedPAC and other data Nichols highlighted the imperative of reform, while also offering his vision of indicia of an incremental though ‘pluralistic solution’.

Susan Dentzer mastered the challenge of providing a recap and guide to health reform in 37 minutes; she set the tone of what was to come from a stellar cast and well orchestrated series of messages. Her introduction sets the standard for health reform context consideration; listen here.

The quality of the conference was superb and the Colorado Health Foundation’s use of social media and Twitter is to be commended. The one suggestion for enhancement is to consider live streaming the conference via uStream.tv, LiveVideo.com or other video feed server platform (afterall it was sold out). Publishing both the podcasts and the speaker presentations on their site via PDF downloads is also commendable; however, uploading the preso’s to slideshare is an option to consider as well.

The conference boldly models an open approach to sharing vital information that can and should extend beyond the reach of the paid conference attendees in Keystone. Understanding the value proposition of a ‘digital footprint’ (i.e., the deployment of social media tools and it inevitable re-distribution) and openly sharing that content vs. a proprietary content lockdown, is a brave and commendable strategy to support public health.

Thank you Colorado Health Foundation!

As has been well documented elsewhere, primarily by the oracle of social media adoption in the healthcare space, aka Ed Bennett, more institutional healthcare providers are putting a toe in the water whether via Twitter, FaceBook, YouTube or the fourth horse in the race, FriendFeed (though not tracked by Ed).

Most are lurking or “monitoring their brand” via select hashtags or semantic filters, or by following those active in the broad range of healthcare or wellness related issues. Others, and the vast majority in my experience, are primarily and sparsely “pushing content” from live surgical tweets to the press release “du jour”, i.e., our new cath lab or latest amenity addition.

Yet very few are participating at the level of engagement wherein “conversations are recognized as markets” per the Cluetrain Manifesto, in which the institution participates authentically with intent to establish and build a personal relationship with its followers or community.

Clearly hospitals and health systems are complex entities for which no one person can consistently speak both with authority and authenticity on behalf of the organization and still keep it “personal”.

By proxy prevailing institutional engagements in social media is typically conducted by a hospital or health system employee who may manage both a personal and institutional account, formally, informally or both.

In my view, the market leader aka “chancellor” in the medium of microblogging participation is @LeeAase of the Mayo Clinic, who also manages the @MayoClinic twitter account.

Lee is prolific in his educational content that is mostly directed to the internal constituency of Mayo, which is increasingly finding external interest in what Mayo is doing for their own institution’s consideration.

If you are a hospital, healthcare facility or parent system considering social media, please take the time to learn what is happening in the “Twittersphere”, and do pay attention to the evolving “agreements” of Twitter-etiquette.

As far as recommendations are concerned, here is a brief list of  ”do’s and “don’ts”:

Do:

1.  Open an account with Twitter, FaceBook, YouTube and FriendFeed, claim your name and protect your brand on these platforms (note: also recommend including uStream.tv or equivalent).

2.  Get started by following people active in the healthcare space.

3.  Study the market, read the ClueTrain Manifesto.

4.  Find a smart, insightful and motivated person to task master the social media cause internally.

5.  Do contribute to the tribe’s knowlege base; this is a young but rapidly evolving industry.

6.  Do consider participating in or sponsoring a “HealthCamp”; where the web 2.0 and health 2.0 conversation meets and thrives.

7.  Do  start tweeting!

Don’t:

1.  Do not open an account and push bursts of press releases, directly or via the many automated tools available, simply broadcasting your wares.

2.  Do not push content into the stream unless you are prepared to respond directly and in a timely manner. Twitter is about engagement not silence, whether intentional or accidental.

3.  Do not act like a silo separate from the community you serve. Be open to what your followers have to offer you, from user feedback to issues relating to cost, quality, access and other consumer experience concerns.

According Ed Bennett’s “found in cache” the the most visible and credible source momitoring the adoption of various social media platforms including the heavy hitters of Facebook, YouTube and Twitter; Twitter is now the number one platform for hospitals. 

As of March 29, 2009, the stats are:

• 128 on Twitter
• 126 on YouTube
• 82 on Facebook
• 23 Blogs

Of particular interest in the mix is the slope of Twitter penetration, which is to say in a “hyper growth” mode, consistent with Twitter’s impressive viral history. Yet, this is a phenomenon which is in the very early stages of tech transfer and user adoption.

According to the American Hospital Association (AHA) there are 5,708 registered hospitals in the US, which translates into a 2.2% Twitter share with 128 participating “Hospital Tweeps”. Clearly most hospitals, whether as entities or aligned individuals (ie., employees, consultants, vendors, docs, etc), have yet to entertain such participation.

As is historically the case, innovation in the institutional health care and/or the hospital space, is  often measured in geologic time. As institutions populated with and driven by complex “governance trees” that generally assure a slow decision making process, such an unknown and unproven new technology can only be greeted with deep skepticism and distrust. 

In the social, or perhaps more accuately termed, “new age media” space, characterized by it’s “real time”, open and unmanaged tag cloud generated buzz, potential adoption of the technology can only greeted with even more skepticism and distrust than usual. One might ask why?

I will venture to answer that question in the subject of the next blog post “Social/New Age Media: The Antithesis of Brand Control and the Advent of Hospital Silo De-construction?

In other words, can social or new age media technologies foster the accountability and transparency from hospitals that every regulated effort to date has failed to accomplish? Read the rest of this entry »

These are links supplied by various HealthTweeps today. In my experience if you’re on Twitter, and you do not have at least 10 tabs open (Chrome or FireFox),  then you are just not paying attention! So here goes (cut and paste):

“WSJ Health Blog Q&A: Mayo Clinic CEO Denis Cortese”  >> http://hex.io/afw <<

“Twitter Trumps Online Conference – Six Steps For Using Twitter For Your Conference Or Event” >>  http://hex.io/afu <<

Financial Times: “Sweet to tweet” >>  http://hex.io/aft << Feel called to blog about this one!

Matthew Holt on “Health 2.0 as a new data source” >>  http://hex.io/afx <<

Robert Wood Johnson “Taming Wide Variations in Spending Key to Health Reform” >>  http://hex.io/ag0 <<

Robert Wood Johnson “Dartmouth Atlas of Health Care: Regional Disparity in Medicare Spending” >> http://hex.io/ag1 << An Interactive Map

Please feel free to add your own.