Heidi Allen Digital Strategy

A little while ago I was interviewed about the work I do at BodyinMind.org.  This is a website that writes about pain research.  We started it just over 2 years ago, and now have over 9,000 unique visitors every month from over 100 countries.  That’s great you might think, but there is still the ‘So What’ factor.  Is this actually making any difference?  The jury is still out and we are trying very hard to measure whether what we are doing makes any difference at all to pain research or clinical practice.

Daniel Kraft is a Stanford- and Harvard-trained physician-scientist, inventor and innovator. He chairs the FutureMed program at Singularity University, exploring the impact and potential of rapidly developing technologies as applied to health and medicine.

Looking at this interesting diagram in the BMJ – the gist of which is something like this: in the ‘old days’ worst case scenario was viewed as self care of your medical condition and best care was to see a specialist.

The problem is: best care is also the most expensive.  But now, get this…. best care is viewed as patients self-managing, because they are more able to so in this ‘information age’.  If this is true, then better care is more accessible to more people, because it is internet based, cheaper and not reliant on seeing specialists.

It is a shift from ‘Industrial age’ healthcare to ‘Information age’ healthcare.

Policy vision of specialist driven care shifting to patient driven care as information age replaces industrial age. Adapted from Ferguson* BMJ 2010;341:c5814

What I like about it, is the fundamental shift in thinking that has taken place with the advent of the internet and social media tools.

Reference

Adoption, non-adoption, and abandonment of a personal electronic health record: case study of HealthSpace, BMJ 2010; 341:c5814

*Figure adapted from Ferguson T. Consumer health informatics. Healthcare Forum J 1995;Jan-Feb:28-33.

Thank you BMJ for making this open access, and to Mike Bainbridge for alerting me to this superb diagram.

An interesting phenomenon is occurring. Doctors are adopting smart phones at an exponential rate, even faster than the general public, a trend very surprising for a traditionally ‘technology averse’ group. A mini-revolution in the medical industry, and happening quickly it seems.

Why is this happening? One reason may be that these phones (like an iPhone or Blackberry) offer easy connectivity and computing ability and are being used to access the internet and social media sites. Traditionally, Doctors work from many different locations each characterized by high-stress inefficient paper-based workflow processes – manually filtering and prioritizing communications in each place mean that critical communications are easily missed.

MovinMeat is an ER physician (with an excellent blog http://allbleedingstops.blogspot.com/)

Potential solutions to managing an overwhelming information flow may help explain the fast adoption by doctors of this new technology, particularly of the iPhone whose reputation depends on ease of use. According to Spyglass Consulting over 90% of physicians were using smartphones to “communicate, manage personal/business workflows, and access information including medical reference materials” and showed a strong preference to the Apple iPhone (44%) to the RIM Blackberry. Here is adoption of the smart phone in general by comparison:

Share of 2010 Q2 smartphone sales to end users by operating system, according to Gartner. Source Wikipedia

Why have busy doctors taken time to embrace the iPhone? Here is perhaps a practical example of why – an iPhone application created by Peter Bentley, a researcher from University College London, that turns an iPhone into a stethoscope. Not only that, if patients have the same app, they can monitor their own heartbeat and send the results, by email (& by phone) to their doctor to analyse. According to the Guardian a free version of the app is being downloaded by more than 500 users a day.

“Experts say the software, a major advance in medical technology, has saved lives and enabled doctors in remote areas to access specialist expertise… Bentley’s iStethoscope application is not the only mobile phone programme lightening doctors’ bags and transforming their practices: there are nearly 6,000 applications related to health in the Apple App Store. The uptake has been rapid. In late 2009, two-thirds of doctors and 42% of the public were using smartphones – in effect inexpensive handheld computers – for personal and professional reasons. More than 80% of doctors said they expected to own a smartphone by 2012.”

Well.  That’s something to be sure.  It would be interesting to know if this technology takeover is happening in other health professions, and if for the same reasons.

What is FindTheBest?

FindTheBest is an objective comparison search engine that allows people to choose a topic, compare options and decide what’s best for them. FindTheBest is organized into nine broad categories including Health and each listing can be sorted by numerous key filters (have a look at the left hand side of the image below). It’s not bad!

So what does that mean in practice? I had a look at health, specifically Life Span Expectancy and Mortality rates and it gave me the results for each and every age so I could compare. So, hypothetically speaking, looking at the category of: female, age: 42.  It told me that statistically speaking a woman aged 42 has a 0.17% chance of dying and 39.57 more years to live. I compared this with stats for 20 years further on when, at age 62, she has a 0.89% chance of dying and 22 more years to live:

The take home message? This hypothetical female has passed the half way mark and has decided to eat more bananas and exercise a great deal.

Thanks to @DrVes for the spot and for the blogging tip!

A GP who is also an education professional and an expert user of social media, Anne Marie is a natural and presents a superb discussion posing some difficult questions of her readers:

How are people using social marketing in health? Now you have surgeries tweeting, blogging, opening YouTube accounts but what has social media got to do with me as a health professional?  What does ‘engagement with consumers’ using social media, ‘establishing a brand’ got to do with health and health care organisations?

Anne Marie has a real life example of a Government organisation encouraging people to use twitter to contact a sexual health nurse, Zena.  Zena is using twitter, a website and a facebook page to contact patients. But:

• What about private issues being discussed between health professional and patient on a public site?
• How to guide patients online? To use it in a safe way?

This is what this presentation is about – well worth a listen to and if you are really struck with how good this is, the comments on Anne Marie’s blog from health professionals including Zena and patients are enlightening too.

Health professionals and social media

And my two pennies worth: – I admire what this sexual health nurse is doing – not only getting her head around the technology, but putting herself out there as a professional in social media opens her up to all sorts of discussions, comments and criticisms, in a very public way.

I agree with Anne Marie’s concerns that what happens online stays online.  Forever. And from the comments from patients here it’s worth remembering how vulnerable people are especially when they have health problems, their concerns may overtake their care for privacy.

I see what professionals like this nurse are doing as advertising good information to people on a variety of networks, giving them the channels to communicate/find someone, and then taking the conversation off line.

Even if you have the best expertise in health – if you don’t use social media how are patients going to find you?

In response Anne-Marie wrote

“I agree that social media may be a useful way to disseminate contact details. But I do have grave concerns about encouraging its use a contact medium. And it may be heresy but the people who probably most need Zena’s help probably have the least access to social media in any form. This is where enabling patients to make contact by SMS is really useful. Those are 140 private characters.”