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The health story of the year (if not in the mainstream media) and other end-of-year assessments

It’s that time of the year: for making lists of media lists. (After the list of lists below, the bottom section of this post covers recent discussions about social media and health).

In recent times, we’ve had:

• An insight into the world of health PR, from US health journalism watchdog Gary Schwitzer, who has been stashing the health-related PR that landed in his office this year for this compilation.  This probably represents only a fraction of the PR material swamping health reporters in mainstream media, given that Schwitzer is a blogger not known for promoting PR.

• The ten most viewed Indigenous reports at Australian Policy Online.

• The best five health and medical books for the year, according to the Informed Patient column at the Wall Street Journal (which understandably have a US-flavour).  The one that caught my eye is Your Medical Mind: How to Decide What Is Right for You by Jerome Groopman and Pamela Hartzband, described thus: “This book by physicians who happen to be married uses compelling patient stories to show how people make treatment decisions when evidence and advice is often-conflicting.”

• High-protein diets and superhero workouts were two of the most sought-after topics on the Internet in 2011, according to a New York Times report of a Google analysis. At the NYT, the most read health stories were about happy relationships, alternative therapies, the brain and mental health.

• The top 10 analyses of media coverage of health issues, according to Schwitzer’s HealthNewsWatchdog blog.

Craig Silverman’s entertaining and mortifying list of media mistakes of the year (which mostly focused on US media but did include some Australian glitches).

Correction of the Year went to the Charlotte Observer:

A front-page story in some editions Monday incorrectly referred to Osama bin Laden as Obama. In the same story, a photograph cutline wrongly said two aircraft hit the same tower of the World Trade Center. The planes hit different towers.

This wins for the combination of the Osama/Obama slip and a very embarrassing related mistake about 9/11, that almost every American would recognize as wrong. All of this in the year that marks the tenth anniversary of those attacks — and in the same story, to boot. A front page story.

Silverman also featured a few Australian items, including this from the Eastern Courier (Australia):

Footnote: Last week’s column revealed that I was the third born of the four Abraham children, which was news to my brothers and sister. For the record, I was the second born.

Drug development headlines of 2011, from The Scientist.

And no doubt there are plenty more such lists in circulation and preparation.

***

Croakey’s own list of 2011 notables has only one entry.

My pick for the year’s most far-reaching health news story (leaving aside climate change and poverty, which Richard Smith has identified as among the great failures of the babyboomer generation) is one that has had little coverage from mainstream media, but which features regularly in online writings and conversations.

It is the impact of social media upon health and health care.

This year has brought an upsurge in the health sector’s engagement with blogs, Twitter and other forms of social media, although of course formidable barriers remain.

One of the year’s notable events for those with an interest in social media and health was a forum convened in Sydney by the Hospital Alliance for Research Collaboration (HARC)   that featured Lee Aase, director of the Mayo Clinic Center for Social Media.

In summary, Aase said that:

• The Social Media Revolution is the defining communications trend of the Third Millennium

• Every organisation is now a media organization

• Every communications initiative should have a social media component

• Mayo Clinic’s experience provides concrete examples of benefits for patients and opportunities in providing in-depth patient information about diseases and management; public health campaigns; synergy with traditional media; harvesting community wisdom from staff and patients; and increased efficiency.

• All health care organizations and professionals must be aware of these tools and should consider ways to productively apply them

• Patients will be engaged in social media even if health professionals are not

• Choosing to not be involved leaves the field to those who many not have the patients’ interests at heart

• Failing to harness these tools effectively means foregoing an unprecedented opportunity for achieving health benefits

You can read more from Aase in this piece for The Conversation, in which he argues that social media will transform health care, and that “hand-wringing about the merits and dangers of social media is as productive as debating gravity”.

In an interview with ABC radio’s Dr Norman Swan (@normanswan), he gave examples of how Mayo Clinic is using social media to improve the safety and quality of health care. Not to mention as a marketing and branding tool.

***

Other discussions at the HARC forum

Social media consultant Hugh Stephens and I also spoke at the forum (you can listen to the presentations here).

Hugh Stephens wrote the short summary below of his presentation:

1.         Professional Development benefits of social media. I’ve seen a number of situations where social media has revolutionised the way that we can learn and engage about cutting-edge medical practice. This is particularly important in rural and regional areas where the ability to seek out other healthcare professionals’ “tips and tricks” is difficult. The tools here include blogs (there are many now!), twitter and Facebook, and allow users to keep more on top of the current news and research than ever before.

2.         Closing the circle of health. There is a continuous loop in health between caregivers, patients and family / friends / caregivers / significant others. Social media allows us to further close this circle and incorporate advice and engage with all these groups at all stages of healthcare. How do we let everyone have their say? How can we benefit the patient/family experience of a hospital stay or a chronic illness through online engagement? Many great questions to ask and answer.

3.         People are already talking about you. If there is one simple reason to get involved in social media, consider this: people are already blogging/tweeting/reviewing your practice/hopsital/professionalism. And you need to actively monitor and engage with these people to further close the circle of health.

4.         Negative information is already out there. While the Australian healthcare sector has been slow to take up social media, the pseudoscience and alternative practitioners who may have little evidence behind their cause (think homeopathy for chemotherapy) don’t have the same qualms. And for the purposes of ultimately benefiting health and increasing healthcare seeking, we need to get into these spaces and inject quality evidence-based advice and information.

Social media will continue to play a huge role in healthcare and in the wider community. We need to be proactive as healthcare professionals and organisations to fill the gap in order to increase the health of people worldwide.

***

A summary of my presentation (Melissa Sweet)

The potential benefits for social media in health include:

• fostering innovation

• synergy with the Gov 2 agenda – potential for wider community to value-add as co-producers

• breaking down silos/hierarchies within and between organisations, professions, bureaucracies, sectors

• assisting change management

• challenging power imbalances

• creating greater transparency

• creating broader communities of interest.

But there are clearly huge barriers. Just reflect upon what Lee’s vision might mean for your organisation, and how it works. Some of the barriers to realising the vision are:cultural/organisational; and resources/capacity.

One of the challenges is to look at the organisational level what can facilitate the vision, who – what type of people – can be empowered to drive it.

I pitched three ways social media might be used to improve health and health policy in Australia.

1. Health Watch

 

 

 

 

 

 

 

 

 

 

 

 

 

There is plenty of rhetoric about the need for a broader focus to health policy and for more concerted action on the social and broader determinants of health.

But how to make this happen?

Maybe social media could help – as a journalist I find Twitter an invaluable source of related material from around the world. It provides a constant stream of useful news in this area that hardly ever hits the mainstream media headlines. The social determinants of health have an active Twitter-based lobby, and social media is enabling the extension and strengthening of networks in this area.

The suggestion is to set up HealthWatch, a social media campaign to highlight the health impact of broader policies.

I spent this morning on the phone doing interviews about mental health reform – a glaring example of why such a campaign might be useful. In recent times there have been headlines about problems with domestic violence, child protection, and the lack of support in schools for young children struggling with developmental delays and other such problems.

HealthWatch could help highlight the health implications of such problems. Perhaps they might be more likely to get attention, rsources and action if reframed as a health issue?

2. OurHealth

 

 

 

 

 

 

 

 

 

 

 

 

 

One of the many unknowns of recent health reforms is how Medicare Locals will play out.  The concept seems to provoke great hopes, expectations and cynicism in equal measures.

Long-term, perhaps there are opportunities for Medicare Locals to engage with their communities in much more honest and open debates about health – the factors that contribute to community health, the inequities in health, and the allocation and returns of health spending.

OurHealth – please note that this is not about “My Health” in the way of the unfortunately named My School or My Hospitals initiatives – OurHealth is not about broadcasting health information as has been the tradition of most health agencies, but about a two-way exchange of expertise and information.

It would tie in neatly with the Gov 2.0 agenda which acknowledges the potential of the wider community to value add – for both public and for commercial gain – when government processes are opened up and data is made freely available.

3. Healthy SM Times

 

 

 

 

 

 

 

 

 

 

 

 

 

Once upon a time, a suggestion for an S and M Times might have had very different connotations…

As someone who specialises in covering health, it’s impossible for me to keep up with the rapid pace of development in social media and health.

It is an exponentially expanding field.

A wealthy and wise organisation or individual could do a great service to the sector by seeding the HealthySMTimes – to provide independent news and analysis of developments in social media and healthcare.

These are three rather off-the-cuff and perhaps pie-in-the-sky suggestions for how social media could be harnessed for healthy policy and communities.

I was delighted to hear of this symposium because it has been my impression that the health sector has been slower than some others to engage with the potential benefits of social media – framing it largely as a risk management problem than a potential health booster.

Perhaps the Royal College of Nursing’s recent social media guidelines – which acknowledge the potential risks but equally stress the potential benefits – may signal a sea change is occurring.

***

Feedback and comments on the Forum

Clinical Excellence Commission Chief Executive Prof Cliff Hughes:

“I think that what we learnt from our experiences with Lee Aase and the panel is that social media is an effective, relevant and easily applicable tool to improve communication – not only about our patients but to our patients. The opportunities to drive change are here and now. As Hugh said, it’s all about starting with you.”

***

Dr. Kishan Kariippanon (@yhpo), public health blogger and social media expert:

Lee Aase is an artist improving the quality of communication between health professionals and clients for his organisation. From Lee’s talk at the 7th HARC Forum it became clear that there should be no fear or dismissive attitude towards innovation or commonly rejected as ‘reinventing the wheel’.

He took what was called a ‘fad’ and turned it into a priceless tool. He took social media and turned it into a platform for strengthening the relationship between client and doctor, thereby improving patient outcome without the billion dollar budget and a room full of scientists and policy makers. Anyone can innovate!

I see no harm in reinventing the wheel because what I gathered from Lee’s talk is that, the intent to innovate, to improve the status quo and the expected outcome is not a linear process. Embarking on a mission to reinvent the wheel will not result in another similar wheel being created but will open up a whole new arena of possibilities. If innovation was a linear process, then the future can be predicted through a mere mathematical formula. The word innovation will also cease to exist.

We can no longer demand based on our rights for any resource from anyone either because we can now create our own bank of knowledge through collaboration and social media makes this possible.  The young people at the Youth Health 2011 Conference in Sydney were talking about their ‘right to good and accurate information’ to be made available but in reality, social media gives us the ability to investigate, connect, collaborate and bring out the truth for our peers without the need to demand from anyone. It makes us interdependent instead of dependent.  It is no longer about rights and demands but about seeking the truth through collaboration and being open to critique and possibilities.

I hope that we can draw together people like Lee both from within our country and beyond to consult not merely about the technicalities of social media but of its intrinsic ability to generate solutions through sharing ideas and making knowledge available to everyone regardless of their background.

I would like to see Dr. BJ Fogg from the Stanford University Persuasive Technology Lab address the 8th HARC Forum.

More on the forum (including pix) from Kishan here.

***

Dr Pieter Peach (cross-posted from his blog, written after the forum)

I’m confused about the potential utility of social media in health, and I suspect I’m not alone. I’ve been struggling for a term to help me articulate my feelings towards the use of the terms “social media” in the context of “health” and “healthcare” for a while.

Struggling to the point where I’d avoid conversations for fear of the inevitable twitch in my left eye as I recognise, yet again, that I simply can’t compartmentalise the concepts as well as I’d like.  This is despite malignant curiosity leading me to use most major new communication and technology trends around since Boyz II Men groupies were still teenagers.

Following almost every discussion around the use of social media in health (and healthcare) I’m left with a recurring feeling that people are taking part in the one same conversation, using identical words, but talking about different concepts.  I’m sitting here at the kitchen table after a weekend of anaesthetising unwell patients, trying to crystallise in my own mind what these different concepts are, and how they relate to these unwell patients, their well relatives, and the staff caring for them.

I’ve recently understood that “social media”, “health”, and “healthcare” are best described as a “suitcase words”.  Artificial intelligence researcher Marvin Minksy described “suitcase words” as words containing many different concepts. These evolve to improve the efficiency of daily conversations, but can be singularly unhelpful when trying to match these jumbled concepts to real actions and outcomes. I feel it’s the difficulty in matching of words and concepts during these conversations to real improvements in outcomes that hopeful, but confused, clinicians are struggling with.

Minsky talks about unpacking these suitcase words into the smaller, more actionable concepts.

Lets start with the term “social media”.  These can be roughly unpacked into public networks based on common interests (twitter.com), private networks based on social and organisational relationships (Facebook.com, yammer.com), or mixed public/private networks (google+).  Social media in its essence is networked multi-directional content. Email and chat channels, widely available since the early 90′s fit this description, but various factors have meant that the network effect fuelling the uptake of newer communication tools never developed to the same extent.  Content creation and distribution has since become more efficient with advancements in technology and evolution of culture, and now almost anyone can create content via their affordable devices and data plans with a unique human behaviour that has been “shaped” to share.

What about the word “Health”?  Are we talking about wellness and its tremendously broad determinants, or are we discussing the management of illness (healthcare).

What about “Healthcare”? Lets unpack this to slightly more focused suitcase terms of quality of care, productivity, and branding (staff and patient recruitment).

At a recent Sax Institute forum entitled “Bringing the social media revolution to healthcare“, I sat in a mixed audience of administrators, clinical staff, journalists, private hospital body representatives, marketers, and various other stakeholders in healthcare.

We listened to Mayo Clinic‘s experience of exposing their already successful brand to the unpredictably stormy seas of social media.  I came away thinking that social media led to positive improvements in Mayo Clinic’s brand, as well as improvements in patient outcomes through distribution of information to patients for which Mayo Clinic had the expertise to manage.

I spoke to attendees whose primary interest was in organisation branding and its potential for staff and patient recruitment and who thought primarily about twitter, linkedin, and facebook.  I spoke to health promotion practitioners whose primary interest was in assessing sentiment and promoting behaviour shaping to improve population health through tools such as twitter, facebook, and youtube. The benefits flowing from the evolution of communication has been obvious to private healthcare services and health promotion researchers because their primary roles are to assess sentiment and shape behaviour as marketers, and that’s what the two-way mass communication platforms of twitter and facebook are particularly good for.

I spoke to administrators in healthcare organisations thinking about how to grapple with privacy, legal, and productivity risks. Why their staff would want access to youtube, twitter, SMS, facebook, what they are likely to overshare, and what social media policy documents need to be put in place.

Unwell people are beginning to think about tools to help them connect to people with shared experiences (patientslikeme, curetogether ), illness information produced by experts (mayoclinic, Wikipedia, quora), and the people and services that help them get well (ratemydoctor), as well as tools that improve communication with their clinicians (hellohealth, healthvault, teleconferencing).

Healthy people have picked up on the potential of tools that connect them with people and information that keep them healthy.  They think of twitter and blog streams dealing with nutrition, exercise, and wellbeing. They think of socially connected health metric applications that they hope will positively shape their behaviour (the eatery, runkeeper, dailymile, trackyourhappiness).

Clinicians’ interests at this point in time seem to be in the understanding the implications of social media tools to them and their patients. They are, for good reasons, unable to provide specific clinical advice through public networks, and the vast majority of clinical staff have no access private organisational communication networks that may improve productivity within their organisation. The default position for people directly responsible for the health outcomes of others is one of well-deserved skepticism. They are unable to crystallise in their own mind which of the jumbled concepts in “social media” would help them do their job better.

Over the next few years communication tools will evolve and clinicians will be given access to communication networks with more appropriate privacy controls for the information being exchanged.  Discussions will also start to focus on narrower and more relevant concepts, and as this happens, the use cases for clinicians and the problems these connected technologies are able to solve should become clearer.

Note: I’d like to attribute the concept of “suitcase words” to @arcwhite and the clarification of behaviour “shaping” vs “change” to @yhpo and @bjfogg

***

Abbey Wright, Communicator for the Hunter Urban Medicare Local (which has social media form, see YouTube clip below)

Health care social media has an international guru and his name is Lee Aase. As a health care communicator, it takes a bit to astound me with a presentation, given that I’ve seen hundreds.

But at the recent HARC Forum, Lee had the room in the palm of his hand, inspiring even the most rigid of organisations to change their stance on social media.

As a member of the newly announced Hunter Urban Medicare Local (formerly GP Access), we’ve been striving to reach some social media heights ourselves, and have found that by embracing social media, we can go a long way.

An example of our recent success is a pain management YouTube clip we developed to allow people to understand why some suffer chronic and persistent pain.

With a respectable 30, 000 hits, recommendations from Stanford University and requests to translate the video into several languages, we’re happy with where we’ve come so far and we look forward to seeing where social media can take us.

But it’s clear that Australian health care social media is years behind the States when it comes to not only innovation, but acceptance of social media.

A key example of this is some of the comments we’ve had from our YouTube clip.

Great video! I’d love to show it to my patients but our access to YouTube is blocked,” is the standard response.

Lee Aase of the Mayo Clinic urged those in attendance at the HARC Forum to change their social media policies, or in many cases, make one.

His stimulating presentation showed the audience that health care social media doesn’t have to be boring or always have a point, but that a cute video of an older couple playing the piano is sometimes exactly what you want attached to your brand.

In the future, we at Hunter Urban Medicare Local look forward to seeing how social media will be used for further education, preventative medicine, the integration of primary health care providers and also, a bit of fun.

• You can follow Hunter Urban Medicare Local on Twitter @HUMedicareLocal

• You can follow Abbey Wright on Twitter @abbey_with_an_e

[youtube]http://www.youtube.com/watch?v=GsycMbQAUVI&feature=youtu.be&a[/youtube]

***

Perhaps 2012 will bring some indepth explorations of social media, by both the mainstream media and the powerbrokers in health.

To end on a Twitter-thought from public health researcher Julie Leask:

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