Heidi Allen Digital Strategy

Very glad to see the American Medical Association Policy on the use of social media.  At a basic level says – it’s OK to use social media, and here are some guidelines.  Guidelines are important, not least to protect clinicians (as to what can go wrong and why read this candid and personal interview with Dr. Flea, ex-medical blogger losing a malpractice lawsuit because of his blog).   Here is the start of their policy

AMA Policy: Professionalism in the Use of Social Media

The Internet has created the ability for medical students and physicians to communicate and share information quickly and to reach millions of people easily. Participating in social networking and other similar Internet opportunities can support physicians’ personal expression, enable individual physicians to have a professional presence online, foster collegiality and camaraderie within the profession, provide opportunity to widely disseminate public health messages and other health communication. Social networks, blogs, and other forms of communication online also create new challenges to the patient-physician relationship. Physicians should weigh a number of considerations when maintaining a presence online:

Cracovia Sacra early 16th century

The rest of the guidelines include

• keeping patient information confidential
• keeping physician information confidential
• keeping professional ethical boundaries when interacting with patients online
• ensuring that in posting content they and their colleagues act professionally to maintain reputations of patients and colleagues

For a good write up on these points see Ted Eytan on KevinMD’s blog. I would love to see something like this for the Australian Medical and Health Professions.

The Case of the tweeting Kidney Patient

has casued a small whirlpool of a debate happening. The summary of the case is:

a kidney patient was tweeting about their kidney transplant on twitter

the hospital monitored the tweets, and passed one comment onto a consultant when it was clear the patient hadn’t understood something about the treatment (the consultant had never used twitter before)

The consultant then brought the subject up with the patient at the next face to face meeting
Both the consultant and patient were embarrassed but the patient was also grateful to have access to a consultant directly and help.

Here is the debate: is this Ethical?  Interference? A good outcome? Invasion of privacy? ?What were the consultant/hospital thinking? ?Opportunity for online-education? Is ‘surveillence med’ socially unacceptable?

The comments are worth a read: for example Anne Marie Cunningham, a GP and medical educator, is questioning whether this response was an invasion of patient privacy (I hope Anne Marie does one of her thoughtful blog posts on the case), @snippetphysther, a physical therapist, thinks by using twitter the patient chose to make their experience to be public.

My take, as a non-clinician, is also that tweets are in the public domain and with proper use, good education for all can come of a dialogue online, as long as personal details are not included.  The Mayoclinic’s use of social media may be one way of seeing this in action. Nevertheless , we have had this debate before (in the case of the sexual health nurse using social media to contact patients) and I’m not sure how I would I feel if a hospital/clinic I had just attended were monitoring my twitter stream.  Would I change what I was sharing online I wonder?

IAmReedSmith posted the following chart: Who from the hospital should tweet

These are small numbers but it shows that, in this particular population and not necessarily representative, 55% of patients and family members would like nurses and caregivers to tweet. On the flip side, does a nurse wish to be inundated with questions from patients? Some do as in the case of Zena the Sexual Health Nurse.

For more on this subject see The case of the Twittering Kidney Patient by Dan O’Connor

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.”

After evesdropping into the conversation Doctors were having about their use of social media, I came back to thoughts in a previous post on how a busy clinician would use social media – and speculated that there are two ways it can be used – in actual clinical practice and as an information source.  It’s all very well to theorise, but is it actually the case?

This from Vegard Ølstørn, a manual therapist in Norway:

I started blogging as a manual therapist in February 2010. I wanted to do this because of mainly three things. I thought that was a way of keeping myself professionally updated. My thought was to write down a summary of interested things I read, write down how I am working, what I am thinking about my work and maybe present exercises I give etc. This way I put some pressure on myself to think twice why I do what I do.

My blogging is also done as information to my patients before or after they see me. Google listings for advertisement is important, and if patients read how I work before they come to see me, I think that is a positive start. I am also planning to use the blog as a resource for patients, where they can read about exercises and things I have presented after treatments.

Lastly, blogging also builds my professional brand amongst my peers. Other clinicians can comment on my way of doing things and interesting discussions hopefully comes out. I find it interesting to read how other clinicians solve their daily challenges, so it is nice to share my view on things.

Status today is that traffic to my site is increasing and I have got both new patients as well as interested clinicians from my blogging. For the word ‘manuellterapi’ I am scoring 4th in the Norwegian google search, so the traffic is increasing. I like it.

I really liked the quote by Dr Mike (@sandnsurf):

“Blogging can be lonely. Especially lonely if we constantly rely on viewer stats, page rank and comment counts to justify the time we take to document our cogitations …but I am surfing the blogging wave to taste the salt water; feel the rush of wind in my face; and brush up against dolphins…not to observe from the beach, ice cream in hand, blistered by the rays of apathy and indifference.”

Thanks Vegard, and if you have a case study that you would like to have included contact me.

I have been approached by Allen & Unwin, Book Publishers, to use some less traditional ways to connect with readers – and using a newly published book seems a good place to start.  This is an experiment, an ongoing project over the next 3 months open to change and trialling things depending on your feedback. Will using Social Media make any difference at all?  I like the Publisher, Elizabeth Weiss, I like the book and am happy to be involved.

The Clean Industrial Revolution: growing Australian prosperity in a greenhouse age published 3 weeks ago, written by Ben McNeil known for his work on climate change and energy policy in Australia (Sydney Morning Herald, The Age, The Australian Financial Review, The Australian and The Canberra Times, radio and television appearances).

Ben also recently joined Twitter, started a blog and is doing a book signing at UNSW bookshop on Wednesday where I hope to interview him.

To see how news of The Clean Industrial Revolution spreads on social media channels like Twitter, Facebook or Friendfeed, we’ve opted to give a 27% discount on the book – we want the discount to be big and different.

I have signed copies of the book to give away, 9 copies every month for the next 3 months. Signed books will be given for new ideas, comments, suggestions, feedback.

First thing, while I’m waiting to meet Ben, is to think of a hashtag for twitter that can also be used as a code to get the discount on the Publisher’s website.  Suggestions welcome (preferably something to do with the subject matter), and whichever suggestion we use will get the first of this months free signed copies.

We would like to start this officially by Friday, so I’ll need suggestions for #hashtags before then.

Some excerpts from the book:

In 2007, I was in Canberra as a young scientist pushing the scientific case for action and learning very quickly that the government was completely blind to the gravity of potential threats to Australia beyond just the environment.  At a high-level meeting in the Cabinet room, as I looked in awe around me, all I could see was a sea of grey hair and suits clustered around the biggest table I had ever seen.

Sitting to my right was the Prime Minister, John Howard, the Minister for Education and Science, Julie Bishop, the Environment Minister, Malcolm Turnbull, and the Minister for Industry, Ian Macfarlane.  Scattered among the rest of the Cabinet were the heads of every science, research technology and education body in Australia.

Before my presentation, three of Australia’s most influential climate scientists presented an exhaustive report of recommendations on how Australia could actively respond to the emerging climate of change.  As I stared down the Cabinet room I wondered why the two most senior government minsters responsible for the economy and foreign policy were not in the room.  Where were the Treasure and the Foreign Minster?  It seems for many years the Australian Government reflected a broad and dangerous public misconception about combating climate change:  that is it has nothing to do with Australia’s long-term economic prosperity or national security.

This book has one overarching theme: that climate change and our over-reliance on fossil fuels will put Australia’s economic prosperity, not just the environment, at great risk.  The only way to boost the prospects of stabilising our climate, and grow Australia’s economy in a world that will move away from carbon, coal and oil, is to slash carbon emissions and foster a new, clean low-carbon industrial revolution.  These new Australian products and technologies will be craved in a world short on oil and high on carbon and would position Australia as a leading clean-tech hub for a growing Asia.

Dont forget to leave your ideas for a codename/hashtag reference for people to use.  The best we’ve come up with is #GreenCollar…

Declaration: I will at no point be receiving any money from sales of this book.