Blog

#MDigitalLife is a WCG program designed to learn from and to showcase physicians who are blazing new trails in the digital world – changing the way that medicine is practiced and better health is realized.  You can find previous posts here.

“The sum-total of medical knowledge is now so great and wide-spreading that it would be futile for one man to … assume that he has, even a good working knowledge of any large part of the world. The very necessities of the case are driving practitioners into cooperation.  The best interest of the patient is the only interest to be considered, and in order that that the sick may have the benefit of advancing knowledge, union of forces is necessary.”

– William J. Mayo, MD – Commencement Address at Chicago’s Rush Medical College in 1910 (as Quoted in Bringing the Social Media Revolution to Health Care; ed. Lee Aase)

“What’s old is new again.”  As the American healthcare system continues to evolve, William Mayo’s words are more true than ever … Healthcare is a team sport – and the contiuum of care for patients is critical.  The ability to provide that kind of holistic care is at the center of David Pate’s vision for the future of St. Luke’s Health System.

There’s no question that Dr. Pate is a communicator.  After taking the reins as St. Luke’s Health System chief executive officer in 2009, he started doing a series of roadshows for employees, physicians and St. Luke’s various boards (SLHS comprises seven hospitals and more than 100 clinics across Idaho and eastern Oregon). To meet personally with all of the groups in the system took two weeks of his exclusive time and attention – but even then, he knew that he was only reaching 10% of his audience at best.  Additionally, he saw that the health system was changing so rapidly that no number of roadshows or quarterly and annual reports would be able to keep up in a meaningful way.  He saw the need to do something different.

“When it comes to social media, I want to be clear that I don’t have all the answers. I acknowledge my mistakes and learn from them. But we believe strongly in our mission, and want to share it with everyone in our community.  There is simply no other way that I can reach so many people so quickly – social media has become a critical part of our communication strategy.”

David Pate, M.D.,J.D.

CEO, St. Luke’s Health System

Starting a blog is no small undertaking – especially for someone in as visible a position as Dr. Pate.  He’d heard stories about people who started blogging, but couldn’t keep it up for one reason or another.  He’d also seen business leaders who had arranged to have a “ghost-written” blog, but whose employees could see through the ruse from a mile away. So before jumping in with both feet, he wanted to make sure that he really understood both the commitment required as well as the mechanics for maintaining momentum over time. His communication team (who, by the way, are clearly critical to Dr. Pate’s process) told him that he needed to consider a few things:

  • He’d have to produce meaningful updates, and do so frequently enough to keep people’s attention.
  • The blog had to be in his voice. His staff could make suggestions and proofread, but there could be no question: Dr. Pate would be the author.
  • And the big question: Whether to make it public or private, so that only employees could read it. A public blog posed IT and other challenges that the system had not previously faced.

The decision was made to share the blog as broadly as possible, and Dr. Pate’s Prescription for Change was born.  He describes the blog’s purpose nicely on its “About Page:”

“I have been looking for more ways to reach our physicians and employees. I thought that the blog could be a way to reach people that I might otherwise miss through other communication venues.

Also, I have reviewed our employee survey results and am aware that employees want to know more about senior leadership’s vision and strategy. This is particularly important at a time when we are going through unprecedented change.

Finally, we are working to provide even greater transparency to the public. After all, the community owns us. While not everyone will agree with everything I write in this blog, I hope that everyone will appreciate this and other attempts we are making toward that end.”

Initially, Dr. Pate committed to publishing every two weeks. The volume of information he wanted to share with the St. Luke’s audience, however, quickly drove a switch to a weekly publishing schedule, and he’s maintained a pace that’s much closer to two posts per week, nearly eight per month. And there’s no question that he’s the author, though he acknowledges that he gets great inspiration and recommendations from his communications team, other SLHS employees, and members of the community. And, in keeping with Dr. Pate’s approach to communications and to live out the message of transparency he believes is critical to making meaningful change to the healthcare system, the blog is public – and has a growing national following.

One of the things that’s helped Dr. Pate to keep the blog moving is that it’s inextricably intertwined with the system’s core mission (its “Triple Aim): Better health, Better care, Lower costs.  His topics tend to gravitate toward a few key themes:

To the latter area, Dr. Pate found that people who write or post online tend to “take extreme positions and hammer them all the time.” He knew from his own experience that most people are smart enough to know that there’s more than one side to every issue – especially around a subject that’s as complex and controversial as healthcare.  As a result, Dr. Pate tries to present all positions, and really help people understand different perspectives on these issues.

“When you work at SLHS, people are going to ask you YOUR positions on healthcare issues.  As a physician, lawyer, and the leader of a health system, I believe that I have a unique perspective … and one that allows me to give – to the best of my ability – a non-biased perspective.  Then, I can introduce St. Lukes’ position and explain ‘why’ with some meaningful context.”

David Pate, M.D.,J.D.

CEO, St. Luke’s Health System

Over the last month, Dr. Pate and the St. Luke’s team have had an opportunity to show how impactful the blog can be.

Because Dr. Pate and the St. Luke’s board believe that the key to providing the best healthcare possible within their community means having the broadest meaningful “footprint,” they’ve been structuring to ensure that they can serve their patients across the continuum of care.  This has led to some fairly significant acquisition activity over the past few years.  In the course of acquiring a regional medical group (Saltzer Medical Group), their major competitor filed an injunction in an attempt to stop the process. St. Luke’s subsequently was featured in a New York Times piece concerning changes in healthcare delivery nationwide.  [A Hospital War Reflects a Bind for Doctors in the U.S.]

Dr. Pate says that he spent over 90 minutes with the NYT reporter, helping to paint a picture of how important it is for SLHS to be able to broaden its footprint in order to meet its “Triple Aim.”  But what happened instead is that the St. Luke’s story was used as a lead-in to argue against “big corporate healthcare.”  Though none of the examples cited later in the article were related to St. Luke’s, they were made to appear to be “guilty by association.”

The report scratched the surface of the challenges being faced by health systems; that much is clear from the volume and variety of comments the article generated when posted to The Times’ website. Normally in that kind of a situation, the CEO in question couldn’t do much more than fume and fret – with no outlet to share his side of the story.  But what happened in this instance is that Dr. Pate DOES have an outlet to share the whole story – with a “built-in audience” he’s spent the last year diligently growing.  And it’s also an outlet where that audience has grown accustomed to hearing Dr. Pate objectively discuss some of the most difficult issues in healthcare.  His response, ‘ … The far more interesting story is, What if?‘, is absolutely worth a read. As are the comments – which feature physicians, patients, employees and members of the community sharing in telling the St. Luke’s story.

At this point, you might still be feeling a little bit skeptical.  After all, we’ve seen “big healthcare” misbehaving on a pretty regular basis over the last several years, right?  Just because SLHS has a great PR spokesman in Dr. Pate doesn’t necessarily mean that he’s telling the whole truth, does it?  Well, maybe not.  We usually don’t have any way to tell – we just have to take the stories we’re served, and try to ascertain the truth as best we can.  But Dr. Pate’s blogging has done something else for us … it’s given us a history.  Its shown us some things about his character and the sincerity of the St. Luke’s mission – things that have nothing to do with the Saltzer Medical Group or the New York Times.

Take a look at some of that history:

“I have been at various positions on this at different points in my career.  I worked in a large, urban, county Level I Trauma Center when I was a resident in training, and I saw many people who came into the emergency room largely because they put themselves in situations that endangered their own health, such as drug overdoses, automobile accidents due to alcohol, the end stages of alcoholism, people shot while committing crime, people with sexually transmitted diseases who knowingly took significant risks, and the like.

When I was tired and overworked, there were times I wondered why the county should have to pay all the costs of people’s poor judgment, and why I should have to be up in the middle of the night taking care of them. I’m ashamed to admit it, but it’s true.

I matured and gained life experiences. I got older and found that I didn’t take care of myself as I should have. I gained weight, and became obese, and have been fortunate not to have medical consequences. I had a family member with a drug addiction and realized it truly was a disease, rather than a character flaw. Visiting my family member in rehab, I met youths who were addicts, many of them with piercings and tattoos.

I am ashamed to say that previously I would have judged those young people negatively without even knowing them. When I really took the time to talk to them, I realized that many of them had gone through life experiences that I could not have imagined. They were incredibly smart, nice, and fun to be with, but damaged by life’s circumstances. They were overcoming incredible challenges just to sober up or get clean and to participate in their own recovery. I realized that my outlook had been poorly informed, naïve, and unfairly prejudicial.”

Dr. David Pate, excerpted from Looking at the Patient’s Part in Health – July, 2012

Or, try this one:

“Health care is a legal right for some people under certain circumstances, but it is not an across-the-board legal right for everyone. That is a matter of law.My personal morals tell me that some health care is a right, but not all health care. And ethically, I believe there are limits to the health care that people are entitled to. But in a way, all of this is the easy part. The hard part is how we pay for it for those who cannot do so, if it is indeed their right.

I realize that many will not agree with me, but I hope that this has at least added to the conversation. It is my earnest hope that the Triple Aim work we are doing here at St. Luke’s is going to succeed, so that there are fewer who are unable to exercise their rights to health care.”

Dr. David Pate, excerpted from Health Care: Right or Privilege – May, 2012

That history gives me a chance to know Dr. Pate in a way that I otherwise couldn’t have done without working side-by-side with him, or if he were a personal friend.  And I’m not afraid to say that a person who can express – candidly, objectively and compassionately – those kind of opinions, beliefs and doubts is more likely to be doing so again in the Saltzer Medical Group case.  And the publicly expressed opinions of his audience would indicate that they feel the same way – and by the way, the injuntion was subsequently denied.

Did you notice, too, that every comment expressed on the blog gets a personal response from Dr. Pate?

“Not every comment requires a reply – but I do it in any case.  It takes time and effort for people to comment, and I want them to know that if they invest that time, I’m going to give them a personal response.”

David Pate, M.D.,J.D.

CEO, St. Luke’s Health System

That kind of commitment to putting his money (and in this case, his time and attention) where his mouth is speaks volumes – and it speaks well for the people served by St. Luke’s.

Keeping up with Dr. Pate:

Dr. Pate’s Prescription for Change blog

@DrPateStLukes on Twitter

Dr. David Pate on LinkedIn

St. Luke’s Health System on Facebook

St. Luke’s Health System on YouTube

Year end is always a great time to look back and assess what worked and what didn’t from a business perspective. This includes marketing campaigns, content efforts, social media engagement, sales activities, etc. In particular, reviewing which posts on your corporate or personal blog resonated can be a helpful way to better understand your customers’ and prospects’ interests. Not only is it a good reminder to focus on what works (you’ll notice that four of the top ten blog posts are list based), it’s also an excellent time to catch up on content that we may have missed in the hustle and bustle of our busy day to day lives.

In conjunction with this post, I put together a similar post calling out our top 10 social media posts of 2012. Because our roots (and many of our customers) sit in the health care/pharma space, I thought that it was only right to compile a list of the top 10 health care/MDigital life blog posts as well. And to be clear, what my colleague, Greg Matthews, has done with his MDigital Life project has been nothing short of amazing (just read a few of his posts to get a better sense of the project). In addition to Greg, we are also lucky enough to have former Washington Post blogger and current head of media outreach, Brian Reid, contributing to our blog. You’ll notice that Greg and Brian pretty much dominate our top 10 list and that’s among a group of several other very capable bloggers.

Onto the top 10:

  • Call for Submissions: WCG Hosts HealthCare Social Media Review #3 Next Week by Greg Matthews (14,887 views | 75 Retweets) – Greg’s formal call for submissions on behalf of the Health Care Social Media Review (HCSMR) awards. Goal is for people to nominate physicians using social media in an innovative way. Apparently this struck a nerve!
  • HealthCare SocialMedia Review #3: The Digital Doctors Edition by Greg Matthews (12,884 views | 77 Retweets) – Greg’s 3rd edition of the Healthcare Social Media Review — a wrap up of the work submitted on the subject of “Innovative Uses of Social Media By and For Physicians.”
  • 14 Ways Pinterest Can Improve Health and Medicine by Brian Reid (5,660 | 113 Retweets) – What do you know? Social media and health and medicine really can work together. Brian Reid goes into great detail about photo sharing site, Pinterest’s role in this post.
  • #JPM12: 4 Charts Showing J.P. Morgan’s Twitter Impact by Brian Reid (4,267 views | 85 Retweets) – Brian talks about the growth of the use at Twitter (and its impact) at the 8,000 person health care/PR conference put on by J.P. Morgan every year in San Francisco.
  • Remembering the WSJ Health Blog, and What It Can Teach Us by Brian Reid (3,992 views | 82 Retweets) – Brian shares three lessons learned about why journalism is difficult and lessons learned from the death of the WSJ’s health blog.
  • Kent Bottles, MD – The MDigitalLife Interview by Greg Matthews (3,843 views | 61 Retweets) – An interview with Dr. Kent Bottles, a Senior Fellow at The Thomas Jefferson University School of Population Health in Philadelphia (among many other things). During the interview, Greg talks to Dr. Bottles about his use of social media.
  • John La Puma, MD – the MDigitalLife Interview by Greg Matthews (3,269 views | 20 Retweets) – An interview with Dr. John La Puma, an MD focused on internal medicine. During the interview, Greg talks to John about his use of social media and the influence of his dad who wrote ad copy for a living.
  • Dr. Bryan Vartabedian – The MDigitalLife Interview by Greg Matthews (3,220 views | 46 Retweets) – Greg interviews Dr. Vartabedian, a pediatric gastroenterologist who studied at the University of Massachusetts. Over the last three years become one of the leading thinkers on the the role of social media in medicine.
  • The FDA and Social Media: What the Headlines Got Wrong by Brian Reid (3,116 view | 47 Retweets) – Brian’s gentle criticism of the Food and Drug Administration’s (FDA) announcement back in January providing guidance on how companies may respond to inquiries about off-label use of marketing drugs and devices. Unfortunately, the announcement was more of a non-announcement.
  • Dr. Howard Luks – the MDigitalLife Interview by Greg Matthews (2,686 views | 37 Retweets) – Greg’s interview with Dr. Howard Luks and how he is using video to better communicate with his patients.

The themes that are emerging are a) interviews with doctors using social media are of interest b) the impact of social media on health care is also resonating with anyone in the health care space. Is there a post on the WCG blog that you really liked this year that’s not on the list above? If so, feel free to include in the comments below.

 

#MDigitalLife is a WCG program designed to learn from and to showcase physicians who are blazing new trails in the digital world – changing the way that medicine is practiced and better health is realized.  You can find previous posts here.

When you see the word “revolution,” what do you think of?  Washington crossing the Delaware?  The liberation of Tahrir square?  Whatever visual is called to mind, it probably wasn’t of white-coated physicians waving pitchforks or employing guillotines.  But it was the images of Tahrir square that pushed a family doctor in southern California to pick up a rallying cry on behalf of another group of downtrodden people – the family physician.

Now let’s try another visualization:

  • Cardiologist
  • Oncologist
  • Surgeon

They’re heroes, right?  They save lives! They can come to the rescue when things look bleakest – and literally change the world for patients and their families.  Now one last visual exercise:

Family doctor.

Is she a lifesaver? Will she be the one who steps in moments from disaster and steers your acute episode back into normalcy?  I’m guessing that your vision probably had more to do with runny noses, tongue depressors and antibiotics.  Are your visions accurate?  Maybe.  Are they fair? Definitely not.  And the reason why is going to become abundantly clear over the next few years.

An accidental evolution

Our medical system, by and large, was created in a time where acute episodes were our biggest concern … An outbreak of cholera here, a farm accident there … The doctor’s main job was to fix me up if he could – and if not? Too bad for me.  But now, our standard of living is so high, and our medicine and technology so good, that it’s not the acute care episodes that are our biggest problem.  It’s the “lifestyle diseases” – the chronic illnesses like type 2 diabetes, heart disease and COPD, that consume the lion’s share of our health care dollars.

Jay Lee, a family physician in Long Beach, believes that those factors, along with our changing notions of reimbursement under the Affordable Care Act, are going to shine a spotlight once again on the value of the family doctor – and he’s part of a revolution designed to bring visibility to that cause.

Jay has worked at community health centers throughout his career, and along the way picked up a masters degree in public health from Harvard.  And it was Jay who, prompted by the Arab Spring, started using the hashtag #FMRevolution to pick up on a theme started by a group of residents a few years ago.  Those residents, according to Jay, were “fed up with being told that they were either too smart or dumb to be going into family medicine.”  They wanted to bring a visible “attitude of legitimacy” to family medicine that’s slowly been eroded in the era of the specialist.  They printed up some t-shirts with clever messages like, “Use your whole brain – become a family physician” or “The President has a family doctor – why don’t you?” and wore them to a 2009 meeting of the California chapter of the American Association of Family Physicians (AAFP).

What was old is new again

These enterprising residents also reprinted an article written by Dr. G. Gayle Stephens – 30 years ago – describing family medicine as a form of counter-culture.  Family doctors were trying to establish the legitimacy of the specialty back then … a fight that is heating up again today.  And social media could prove to be the biggest difference-maker in terms of the movements ability to truly take off.  It’s already getting mainstream notice: At last year’s meeting of the American Association of Family Physicians, the board all got started on twitter, and the president (Glen Stream) mentioned #FMRevolution in his keynote address.

I asked Jay what he hoped for from the movement.

“I want every family doctor to wake up every day and say, ‘I’m going to make the world a better place today.’  I love the personal philosophy of astrophysicist Neil deGrasse Tyson: ‘Before the day ends I will have learned something new about the world and done at least one thing that reduces suffering in the world.’ I find that kind of approach really inspiring – and I hope that other family doctors will too.”

Nothing inspires people like winning

There have been times when the #FMRevolution looked a lot more like a real battle than a philosophy.  Jay related a story to me about the CEO of hospital system who decided to cut its family medicine residency because it was “too expensive.”  An immediate dialog started on twitter and other social channels. Soon, the name of the CEO and the phone number for the hospital had been published and calls started to pour in – from inside and outside the medical community. The general sentiment was that “This is bad for our community. We can’t let it happen” Ultimately, the CEO was called in to justify himself to the County Supervisors – and within six weeks they had reversed his decision.  The incident called attention to the power of social media to move mountains, even in a staid field like medicine, and it gave confidence to the fledgling movement.  “But,” Jay cautions, “it can’t always be about fighting fires.  We’ve also got to plant forests – we’ve got to create a system for family medicine to thrive.”

I am Spartacus

When I asked Jay if he was the leader of #FMRevolution, he hesitated for a moment.  “It’s not like that. As far as I know, I was the person who started the hashtag. But I don’t consider myself to be the leader.  I may be A leader.  But this isn’t an organization in the traditional sense – its guerrilla warfare. None of us has the authority or expertise to address every issue in every place in the country – because healthcare is intensely local.  But people, in their communities are inspired and encouraged to get engaged. I hope that FMRevolution will provide things like affinity, a sense of esprit de corps,and broad strokes direction … but each member defines what it means for her and her community.”

Jay believes that the current system has fostered an attitude among physicians that their proper place is in the exam room, practicing medicine on their own.  Anything else is perceived as politics – and that’s a dirty word.  But he feels that that attitude has been a failure – and caused a vacuum of leadership among clinicians that’s contributed to the sorry state of today’s health system.

“If we don’t take responsibility as individuals in the markets where we work, health reform is bound to fail.”

Meeting a band of guerrillas 

One of the most satisfying aspects of the #FMRevolution journey for Jay is that he’s run into some kindred spirits who’ve had a tremendous impact on each other.  He referenced three others with whom he’s been most involved in “plotting things.”  His fellow co-conspirators:

Mike Sevilla – a family physician from Ohio who runs the Family Medicine Rocks blog and podcast

Ben Miller, a clinical psychologist and professor of family medicine at the University of Colorado School of Medicine; and

Mark Ryan, a family physician from Virginia who writes the “Life in Underserved Medicine” blog

It’s a full agenda for Jay.  He spoke at a meeting of the Society of Teachers of Family Medicine in November – a conference that was focused on all aspects of Practice Improvement.  His topics included negotiation and conflict resolution (is there any irony in the concept of Revolutionary as Peacemaker?) and – not surprisingly – the role of social media in improving medical practice.  He has a paper on the subject that’s currently in peer review.  And there’s no doubt that there will be much more to come.

Some people find it intimidating to be asked for a “summary statement.”  Not Jay.

“We’re just now getting to critical mass … but I keep thinking about how to create – or at least enable – change.  I’m reminded of Newton’s second law: Force = Mass * Acceleration.  In social media, the inherent amplification replaces acceleration.  And we’ve got mass!  There are 105,000 members of the AAFP.  If they were all on twitter, tweeting once per day … tell me we couldn’t make a difference!”

Keep up with Jay:

Web: http://www.familymedicinerevolution.org/

Blog: http://www.familymedicinerevolution.org/blog/#.UMfHxpNdfMk

Twitter: @familydocwonk

LinkedIn: www.linkedin.com/pub/jay-lee/37/198/770

And with the #FMRevolution: @FMedRevolution

Back in October, WCG unveiled the MDigitalLife database at the Mayo Clinic. The database consists of 1,400+ physicians who are active on Twitter, and has already surfaced a boatload of valuable information about how doctors are using Twitter to connect, learn and educate.

In addition to the learning already outlined, MDigitalLife.com holds tremendous potential for exploring the discussions around specific disease states. For the sake of demonstration, we decided to take a quick snapshot of how physicians are using Twitter to drive the conversation around Breast Cancer.  By leveraging the top keywords, we were able to identify the doctors mentioning Breast Cancer topics most frequently on Twitter.

*- Breast Cancer query terms available in full report.

Simply identifying the Top 20 (out of 250+) physicians who are shaping the conversation on Breast Cancer immediately provides value. It allows us to develop a custom lists, scan for trending topics, curate content and better understand the key issues driving the conversation.

Digging a bit deeper can provide even more insight in to the nature of the dialogue and what content is really resonating.  Analyzing 33,545 tweets from these 20 physicians and using total online shares as a proxy for resonance, we can quickly identify the Breast Cancer links shared via Doctors’ tweets gained traction.  The online outlets hosting Top 100 most shared links show that Doctors are linking to a mix of content, spanning mainstream news, cancer advocacy organizations and physician blogs.

Lastly, we know from the original MDigitalLife analysis that doctors linking to their personal blogs have larger followings, are more likely to be followed by their peers and generally drive more engagement on Twitter. Digging into the Breast Cancer links that were shared most online, we’re able to identify doctors who are creating content on their personal blogs and how they’re connecting within the digital ecosystem via Twitter. Content ranges from commentary on recently released research to detailed posts helping patients make informed decisions about diagnosis and treatment.

These examples give only a flavor for the depth of insight that can be gleaned from the MDigitalLife database on the topic of Breast Cancer. The breadth of specialties and volume of content housed in this tool offer an incredible range of opportunities to better understand how doctors are using Twitter to educate, learn and engage with their target audiences.

———-

MDigitalLife is an ever-growing database (currently over 2,000) of U.S. doctors on Twitter, matched to their NPI (National Provider Identifier number). To our knowledge, this is the only database linking doctors using the Twitter platform to an “official” data set. As of this writing, we’ve  captured over 1.5M tweets from those doctors, allowing an unprecedented ability to scan for trending topics and relationships, broken out by specialty, gender, geographic location and dozens of other criteria.

The initial findings from this data were presented at the Mayo Clinic on October of 2012 in the form of the slide deck embedded below; it contains a full suite of statistics derived from the database itself and some high-level analysis showcasing how the data could be used.  For more information, visit MDigitalLife.com or contact Greg Matthews.

An artist-turned-ePatient advocate.  The Food Service director for a public school system.  A multi-award-winning filmmaking team.  What do they all have in common?

First, they’re going to extraordinary lengths to change healthcare in America – starting at a grassroots level.  Second, they’re all a part of the Fast Forward Health Film Festival in San Francisco tomorrow night (Tuesday, October 30).

“Storytelling is a centuries old method to pass down information to generations. Stories involved emotion, purpose and answers. All the things we need to be plugged into now in order to make sustainable impact and change across the spectrum of health. The FastForward Health Film Festival (tickets here) was created when Andre Blackman and David Haddad came together from similar backgrounds in health communications, economics and policy and with aligned passions around the great innovations happening around the world. They noticed that the traditional health fields were not highlighting the absolutely positive things going on in the health landscape and we wanted to change that.

With a focus on showing the stories of these change makers, they sincerely hope to inspire and motivate others who care about health and positive social impact, to take part in: building important things, partnering with others doing great work and supporting them through time or financial donations. They’ve had the fortune of holding two great events in Washington DC and New York City – the initial launch event in DC (which was sold out in 4 days of word of mouth only promotion) and participating in Social Media Week’s Health/Wellness track in NYC.

Fast Forward Health’s film lineup is amazing … but I’ll get back to that in a moment.  Your participation on Tuesday is about more than the films.  It’s about engaging with others in the community who care – passionately – about health, and who have a crazy belief that they can change things little by little.

When you show up at the Delancey Street Screening Room (600 Embarcadero) at 6:00 on Tuesday, you’ll have a chance to mix and mingle with many of those people.  Both David and Andre will be there, as will a number of special guests (The Hub San Francisco, The American Public Health AssociationCNN and TheNextWeb will all be represented, for starters).  There’ll be food and drink served (all included in the $5 admission price) – because, as Andre says, “when we break bread and share a drink together, it’s a symbol of what we’re trying to do with Fast Forward Health.  Food and drink is a huge determinant in our health, and we wanted to have a tangible reminder of that as a part of the festival.”

In between each film, you’ll get to hear from folks who are doing big things in innovating health … people like:

The films aren’t to be missed … starting with Regina Holliday‘s unbelievably powerful story of patient empowerment, 73 cents:

Cafeteria Man is documentary about team in Baltimore that’s reshaping the city’s school lunch program:

Escape Fire looks at alternative ways to break down the healthcare system for rapid change.  This multi-award winning film (and selection for the 2012 Sundance Film Festival) just hit theaters a few weeks ago – but you can see it at Fast Forward Health in an amazing context.

ESCAPE FIRE: The Fight to Rescue American Healthcare (Trailer) from Our Time Projects on Vimeo.

All in all, this looks like a night not to be missed … The tickets are going fast, but you should still be able to get yours here.

I’m really excited to see where Andre and David will go with the festival, because its storytelling foundation has really been striking a chord with all kinds of audiences.  I’d also be remiss if I didn’t call attention to the need for sponsors … for more information, click here … and much appreciation is due to the sponsors of the San Francisco event: The McKesson FoundationHealth 2.0CrowdTilt, and Tides. Andre and David also wanted to extend a shout out to Practice Fusion and RockHealth for all that they’ve done to help guide and promote the festival.

Even if you can’t make it Tuesday night, follow Fast Forward Health on Twitter and like ’em on Facebook.  And don’t forget to tell your friends!

I had the honor of writing my first guest post on “the first blog in medicine” – KevinMD.com – last week.  That post was written in advance of my announcement at the Mayo Clinic’s Scientific Session about the debut of MDigitalLife.com – the first known database of twitter-using physicians to matched to an “official” data source – the NPI (National Provider Identifier) database.  That post is reprinted in its entirety below.

————————-

It’ll be no surprise to the readers of this blog that physicians’ use of Twitter and other social media has been exploding over the last couple of years.  But it may surprise you to know how hard it is to really analyze that data.

Last year Dr. Katherine Chretien of the VA Medical Center in Washington, DC, published an eye-opening study in a JAMA letter.  Until that point, all we really had were anecdotes and survey responses – certainly not the same as analyzing what physicians were actually doing and saying on Twitter.

By leveraging a strong research team, Dr. Chretien was able to narrow a list of 523 potential author candidates to a final group of 260.  The team then looked at the last 20 tweets from each author – a total of 5,156 were included in the study.  This study was and is a big deal.  It answered a lot of questions – but perhaps the most important one was whether physicians, when using social media, would be more prone to share confidential patient information, or to share anything unprofessional in nature (e.g., used profanity or made discriminatory statements).

I know that I breathed a sigh of relief when the team found that only 3% of tweets contained any unprofessional material.  Don’t get me wrong – any amount would be too much.  But as a physician friend of mine likes to say, “we’re a lot worse at the water cooler and in the elevator than we are online.”  The point is that by publishing a credible study in a credible outlet, Twitter for physicians had become suddenly more acceptable.

My colleagues and I have been following thousands of doctors on Twitter for the last few years … and have gotten more and more interested in finding out what we could learn from them if we were to try to automate some of the very difficult process of sourcing and analyzing their Twitter posts at a much larger scale.

To that end, we have created a database of nearly 1,400 U.S. doctors (to date) on Twitter and – this is critical — linked them to NPI (National Provider Identifier). To our knowledge, this is the only database linking doctors using the Twitter platform to an “official” data set. We’ve  captured over 400,000 tweets from those doctors over a 5-month period in 2012, allowing an unprecedented ability to scan for trending topics and relationships, broken out by specialty, gender and location.

  • The specialty mix is a near-perfect match with the overall US physician population; no specialty varied by more than 3% from between our data set and the country’s doctors as a whole.
  • Our geographic mix was also very close; 49 states indexed within 4% of the overall physician population in that state. Only California strayed outside that number; Californian physicians over-index by 7% in terms of their Twitter usage.

Having been satisfied that we had assembled a reasonable data set, we’ve spend the last two weeks poring through that data looking for insights and patterns. Here are a few of our top-line findings:

  • These are active users. They tweet over 2x per day on average.
  • Twitter is a part of their work-day. More than 50% of tweets are sent between 9am and 5pm (in the physician’s local time zone)
  • They have an audience. 2/3 have at least 150 followers (the median is 306)
  • They connect to each other. More than 1/3 of the doctors are followed by at least 20 other doctors in the database.
  • The most-followed physician by those in the database was none other than Kevin Pho; followed by nearly half of the doctors studied.

What’s more interesting, of course, is the substance of their tweets.  We examined a sample of tweets related to 3 therapeutic areas: diabetes, breast cancer and prostate cancer.  Perhaps not surprisingly, 83% of specialties mentioned diabetes in their tweets … though it’s interesting to note that pediatricians discussed it among the most frequently (behind only internal medicine and family medicine doctors).  I suppose that’s a sign of the times – childhood obesity and the earlier onset of diabetes is very much on the mind of the physicians who care for our kids.  It was also interesting to note that prostate cancer was as widely discussed as it was … 70% of specialties mentioned it in their tweets.  Much of the volume there was driven by this summer’s controversy about the validity of the PSA test as a means of lowering morbidity;  In fact, 43% of the tweets about prostate cancer between May and September were related to this specific issue.

Although we’re only six weeks into what will almost certainly be a years-long process, it’s been fascinating to discover – in a scientific and quantitative manner – how innovative physicians are leveraging social media tools like Twitter to improve the health of their patients, to grow their practices, to connect with their peers, and to create a platform for influencing the future of healthcare.

We’re already looking to work with some of the most prestigious healthcare institutions in the world, including the Mayo Clinic, to glean deeper insights from this data.  But as I go into my first presentation of this material, I’d love to know: What are your biggest questions?  What are the thorny problems you’re trying to solve that would benefit from a deeper look at the physician’s perspective?  It’s my hope that we’ll be able to solve some of them together.

I’m really excited to be in Rochester, Minnesota this week at the Mayo Clinic’s Social Media Summit.  Two years ago, the folks at Mayo (led by healthcare/social media thought leader Lee Aase) formed the Mayo Clinic Center for Social Media – an organization dedicated to helping people all over the healthcare industry learn how social tools and methods could be used to help people (and healthcare businesses) be healthier.  They’ve set up a really cool microsite to enable anyone to follow along with the conference … you can access it here: http://smw.socialmedia.mayoclinic.org/ (you’ll need to sign in with your twitter or facebook account).

One of the best things about a program associated with the Mayo Clinic is that some of the best minds in the country will come together and share their learnings with the group.  As the conference kicks off (I’m live-blogging from the conference floor), I thought it would be great to share some thoughts about the future of healthcare and social media as expressed by some of the speakers at the conference.

So without further ado, meet our Mayo Clinic Social Media Summit speakers!

Dan Hinmon – Principal, Hive Strategies

Vince Golla – Digital Media and Syndication Director, Kaiser Permanente

Dr. Ivor Horn – Associate Professor of Pediatrics (and MDigitalLife Alumna), Children’s National Medical Center

Ashley Howland – Social Media Manager, Baylor Health Care System

So let’s get started with our Q&A ….

In the context of your company or organization, what are your goals as they relate to social media? (e.g., Patient education? Practice building? Community service? Physician/Medical Education? Risk management/mitigation?)

Dan: Hive Strategies has been helping hospitals engage patients through social media for a couple of years now, and it is becoming increasingly clear to me that the ability to build patient communities will be crucial as health care transformation changes the way we care for patients. The way we market health care will change dramatically in the next 5-7 years, and the better we understand these community-building skills, the more successful we’ll be.

Vince: We’re looking to increase physician engagement for one, but we’re also really focused on how we can increase and harmonize social media engagement on a very large organization.

Ivor: As an organization, I think the goals of Children’s National Medical Center for social media are to serve as a tool to connect and build relationships with parents, patients, and other partners. Children’s National aims to be a resource for families and the community regarding children’s health and healthcare.  As an individual, I am specifically interested in engaging minority communities around issues of child health, including those that related to health disparities.

Ashley: I would say all of the above with a huge focus on patient education! We use our social media channels as a resource of health information–tools and tips that people can apply and use in their own lives. We also use social media to converse and engage with our communities to find out what kind of information they are looking for, what kind of experience they are having with us, etc. Social media has also proven to be a helpful customer service/patient satisfaction channel. We have been able to address some of our patients’ concerns as well as hear their feedback.

What are the biggest obstacles your organization faces in terms of enhancing its social/digital presence and interactivity?

Dan: Time. There is so much to understand, learn, and do that it seems like a never-ending process. In a world of information overload, focusing on the essential gets harder and harder. I look forward to hearing about this year’s big ideas in health care social media.

Vince: Agreeing to a single or aligned tools and platforms to maximize spend and measure impact.

Ivor: The biggest obstacles to social and digital presence in health care, in general, is a level of risk aversion among the medical community.  Organizations do not clearly understand the benefits for social/digital media yet.  There is the  question, “What is the ROI?” From a physician perspective, they are unlikely to be rewarded for their time investment in social media, though some organizations are changing this.  The combination of time commitment with little institutional support limits the number of providers participating on a significant level.

Ashley: Measurement. Like everyone else, we are trying to figure out the best way to track and measure our efforts in the social media space. We try to focus more on “Return on Engagement” (ROE) rather than “Return on Investment” (ROI) because ROI is difficult to measure. While we have many tools to track engagement, likes, followers, share of conversation, etc., it would be nice to have an efficient way to do it. Currently, we are using several different platforms. Once we figure out the best strategy for measurement, we will be able to better prove our worth and hopefully secure more resources for our efforts.

What are the most important healthcare/social media trends you see in the coming year? 

Dan: Emerging technologies will provide even better tools to integrate social media with patient care. There will be increased emphasis on integrating social media with traditional and digital marketing.

Vince: Systemic physician engagement, increases in ability to engender quick, aligned engagement regardless of location in organization

Ivor: There is a move from “Are you using social media?” to “Are you engaging your community through your use of social media?”  There is a shift toward measuring  impact.  Are we influencing behavior?  Are we educating our families more effectively?  How are we using social media to improve health communication?

Ashley: Online patient communities are a trend that is hopefully here to stay.

Also, being an advocate of organizations allowing employee access to social media sites, I am anxious to hear if the “blocking” trend is finally fading out. Are health care organizations still afraid of opening access or are they finally embracing it?

What are you most hoping to gain from your attendance at #MayoRagan this year?

Dan: This is my second year attending the conference and one of my strongest impressions from last year was the amount of energy in the group. I am really looking forward to meeting and interacting with so many people who are eager to share successes and explore fresh ideas. It’s going to be a great conference.

Vince: I’m looking to engage with some of the really sharp people here to do some “pressure tesring” our systems and finding other successful practices.

Ivor: To engage in dialogue about 1) reaching underserved and minority communities via social media to impact health behaviors, and 2) investing in physicians as media communication partners.

Ashley: I am hoping to learn more about social media measurement, enhancing physician involvement in social media and the success of Mayo Clinic’s (and other health care systems’) online patient communities.

And finally, I’ve recorded a video to introduce the conference … THAT’s how excited I am to be here. 😉

Posted on behalf of Damion White.

I don’t often feel like I am witnessing a revolution that is about to happen. It is a rare and exhilarating feeling to find yourself at a threshold – in the same space and in the exact moment – connected to anything or anyone destined to have a significant impact on the world. I felt exactly like this less than 48 hours ago.

Before he departed for the #MayoRagan Summit, Greg Matthews and I chatted about his work leading the development and launch of MDigital Life. MDigital Life is a Big Data capable, social media analytics tool with onboard data visualization platforms. It is the newest product in a growing line of innovative proprietary offerings developed by W2O Group and its subsidiaries.

To avoid droning on about what MDigital Life is – Greg explains it in the embedded videos and you should watch them – I’ll just say that I am honored to be among the first to share knowledge of this advancement with the rest of the world. More than it is a potentially revolutionary innovation in data analytics technology, MDigital Life represents the manifestation of Greg’s passion for channeling solutions in healthcare communications that benefit physicians and patients, and the vision and entrepreneurial spirit characteristic of W2O’s culture and models.

We are just moments away from the official introduction of MDigital life. Within the hour, Greg will deliver his address at the MayoRagan Summit in Minnesota. Tune in via Twitter, #MayoRagan (or #MayoRagan2012) to learn more.

#MDigitalLife is a WCG program designed to learn from and to showcase physicians who are blazing new trails in the digital world – changing the way that medicine is practiced and better health is realized.  You can find previous posts here.

“I do interact with patients online (though not my own, of course) … I like to hear the stories about health issues they’re facing, and to follow their journeys … It helps me to understand what patients expect – or at least hope for – from their doctors.”

Danielle Jones, M4 (Medical Student), 4th Year

We’ve focused a great deal in this series on the role that physicians play in educating their patients.  But Danielle Jones, a 4th year medical student at Texas Tech, had a lot more to say about how patients have been educating her. “We’re all patients at some point in our lives – we’re not just doctors and med students.”

Danielle was an early adopter of twitter (she opened an account at the advice of her husband, who works in technology and had picked up quickly on the potential of the tool).  She’s always been passionate about fertility issues, and soon realized that Twitter was used actively by patients who were going through IVF treatments.  As she listened to their conversations, she began to understand their experience more clearly … and then to extrapolate how valuable that understanding could be as a physician.

Our twitter-using readers will know that it can be a place that’s very much about talking – often to the point of self-aggrandizing.  But Danielle recognized that it was an incredible place to listen and understand – and to engage with others. “I don’t use my twitter account solely for medicine.  I like to use it for people who interact.  It’s not necessarily about people who write a great blog or are skilled marketers – it’s about people who are willing to have an engaging conversation.”

In Danielle’s case, that engagement might be about DIY home repairs, or design, or furniture restoration. But more and more often, it is about medicine – and the changing relationship between doctors and patients.

“Patients aren’t going to come into the exam room and tell you that they’re frustrated because you’re 30 minutes late and will only spend 5 minutes with them.  But they’ll tell twitter. Sometimes we get so involved with the medical aspect of being doctors, we forget that there was once this whole world that we didn’t understand.  The doctor’s experience is an abstraction to a patient – they don’t know what’s going on behind the scenes.  It’s a good reminder of what things were like for us before we started studying medicine.”

Danielle Jones

Twitter also became a place where she could learn from other physicians who were exploring the potential of social media as a mechanism for becoming more effective doctors.  She’s had a lot of wonderful influences that started on twitter, including (but definitely not limited to) the following:

  • Bryan Vartabedian and Wendy Sue Swanson – “They are two of my favorites.  They’re really active and engaging and share great information.”
  • Daniel Kraft – “He’s so sharp – I’ve had an opportunity to meet him, and came away really impressed.”
  • Natasha Burgert – “She shares really great information – but she’s also so down-to-earth and genuine that people really respond to her.  That’s inspiring.”
  • Nick Bennett – “He’s done some guest-blogging on Mind on Med (he did a series about Medical Education in other countries). Some of his articles on my blog have gotten more traffic than mine, and he’s always incredibly responsive to comments and questions.”
  • Natalie Silvy – “She’s a med student in the UK who co-founded a twitter-based journal club, and has written about medical education on my blog.”
  • Brittany Chan – “Brittany and I go to medical school together, and she’s my partner in crime in terms of advocating for social media.”

When Danielle started medical school, she found that there was so much reading and studying that it didn’t provide many outlets for creativity.  As a result, she decided to start blogging.  Her blog, Mind on Med, was never designed to be a “marketing piece.”  It was always about having a place to express herself – on almost any subject.  But it picked up a quick following, and it wasn’t long before people started to take an interest in her perspective.  She was selected from a pool of applicants to be a reviewer for Iltifat Hussain‘s iMedicalApps.  And Doximity, an emergent physician’s community – asked her to join them as an advisor relative to reaching medical students.  That led to an invitation to join a Doximity-sponsored conference in California – and to sit on a panel with none other than Wendy Sue Swanson and Bryan Vartabedian.  “I felt about 2 inches tall sitting next to these two people who’d had such a great influence on me.  It was an incredible honor to be able to spend that time with them.”

Danielle has consciously avoided promoting her blog among her fellow med students – though some of them have mentioned to her that they read it.  And nearly all of them have been positive about the notoriety it’s gained her with iMedicalApps and Doximity.  But it also caused her to gain the notice of the medical school administration.  When Danielle started medical school, the only mentions of social media were cautionary tales – “Don’t share patient information!  You could go to jail or get kicked out of school!”  That differs pretty widely from her own viewpoint, which she articulated brilliantly here, in her post entitled, “What Medical School Doesn’t Teach Us.”

The Dean of the medical school knew that there was more to it than that – and asked for Danielle and Brittany to join an advisory board on social networking. The board is working on creating a social-media-friendly set of guidelines for medical students, and hopes eventually to have some curriculum elements adapted to be more even-handed in portraying the potential of social media. That role prompted a sponsored trip to the Stanford MedicineX conference (the brainchild of Larry Chu, MD being held this year from September 28-30th in Palo Alto).  Danielle and Brittany are hoping to be able to come back to school with some great new ideas and case studies that will move the mission forward.

With all of the well-received recognition Danielle has received for her work in social media, it may not surprise you that she plans to continue it through her residency, internship and into professional practice. But it has surprised a lot of people in the medical community.  As I’ve come to understand it, the process for applying for residency is something like rushing a sorority at a Texas state college – on steroids#.  And the conventional wisdom is that you shouldn’t do anything that’d rock the boat for you during the application process.  Many med students are counseled to shut down all of their social media accounts until the process is complete, lest something that they’ve done might rub an interviewer the wrong way.

When one of her fellow students asked Danielle when she planned to shut down her blog prior to the residency application process, she was shocked.  And not a little bit offended. That emotion prompted her to write a piece called, “5 Reasons Danielle Jones and Mind on Med Won’t Disappear during Interviews.”  That post got a lot of attention in the medical community – especially after it was picked up by the leading blog in medicine – Kevin Pho’s KevinMD.

It’s good to know that conventional wisdom isn’t going to hold Danielle back.  Her view of the doctor-patient relationship may just be the template for the future. As the gulf between patients and physicians has done nothing but expand for the last 30 years, Danielle is bridging it – though she’d never claim that distinction.  Not everyone involved in infertility discussions online welcomes a medical student into their midst.  But most are really pleased that a future physician would care enough about what they’re going through to join them.  Danielle has had a chance to cry with women who’ve lost a pregnancy, celebrate with those who’ve become moms, and encourage those who’ve had to endure setbacks and disappointments along the way.

 “I don’t know that I really thought about how beneficial it’d be to connect with these folks online.  But once I started interacting with them, I was just blown away.  Infertility is one of those things that just takes over a person’s life. They need to be able to talk about it with people who care … and it’s so hard to really hard to understand someone’s journey until you’ve gone through it with them. These people share so much of their lives with one another, and I’m incredibly grateful that they’ve allowed me to share that experience with them.”

Would you want Danielle Jones to be your doctor?  I would.

You can keep up with Danielle here:

  • Blog: MindOnMed.com – I haven’t mentioned it yet, but one of the reasons that Danielle’s blog has achieved such popularity is that it’s both thoughtful and funny as hell.  Consider it a must-read.
  • Twitter: @DanielleNJones