Sunday, April 24, 2011

Social Media Backfire

Alright, you caved in and decided to give SM a try. You decreased your schedule by one hour a day to work on it.  What’s the difference? You are already operating at 25% less efficiency since your EMR went live three months ago. You have been tweeting, face booking, and are now following about 1000 tweeters. You look at the number of your followers…..what? 45? Must be some kind of mistake.

Any physician into social media, (or anyone for that matter) needs to get feedback along the way, and there are several routes to accomplishing this without investing huge amounts of time.

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Social Media Examiner is a great place to start your investigations. SME is a good introduction to the subject of analyzing the responses to your social media efforts. It also sets out a plan and specific applications to utilize in your quest for the million followers.

I’m not going to waste your time and mine expounding on it here. Just click on the links and you can read it for yourself.  This is not rocket science, and it is not medical school....no more spoon feeding from Health Train Express. Explore new Universes, go where no HMO has gone before, follow William Shatner to Priceline.

Politicians and Physicians

"The New Health Law: Bad for Doctors, Awful for Patients."

                                               

Writing this particular edition has been gratifying for two reasons.

1. I took the time to research and  read the material I have linked for you  and to watch these videos, expanding my knowledge base for discussing these issues with colleagues, patients, and congressional representatives.  Our representatives are often give limited, few and inadequate choices by advisors who are self-appointed experts.

2. I enjoyed organizing my thoughts about PPCA and health reform. Admittedly it is overwhelming, too grandiose, and most likely unobtainable for many reasons, and is a subject in itself which I hope to expand upon in another blog.

Take some time to read the links, and watch the videos. There is more here than one can absorb in one sitting, and no busy practicing physician has the time to dedicate to this subject, yet to not do so would be akin to a diabetic not taking their insulin…..

The Galen Institute and Docs4PatientCare are  strong proponents for a rational health reform plan based on rational, carefully thought out measures to reduce cost in health care cost,  and to maintain the atmosphere of patient-physician trust. The Galen Institute sponsored a forum in Washington D.C. during which Rep. Tom Price, MD spoke.

 

  Jason Fodeman, MD has written  a series of  papers   regarding PPACA.at Townhall.com . Jason D. Fodeman, M.D. is an Internal Medicine Resident at UCONN and a former graduate health policy fellow at the Heritage Foundation  where he studied the etiology of rising health care costs. His … read more

The Heritage Foundation

Founded in 1973, The Heritage Foundation is a research and educational institution—a think tank—whose mission is to formulate and promote conservative public policies based on the principles of free enterprise, limited government, individual freedom, traditional American values, and a strong national defense.

The New Health Law: Bad for Doctors, Awful for Patients

 

The More Things Change..

 

Obama Care on the Front Lines

 

Rep. Tom Price, MD,   gives opening remarks at the Galen Institute/Docs4PatientCare event entitled "The New Health Law: Bad for Doctors, Awful for Patients." Other videos are available.

Hal Scherz and Jason Fodeman

Rep. Tom Price, MD  U.S. House of Representatives

Jason Fodeman, MD

Hal Scherz

Richard Armstrong—PPCA cannot be repaired, it must be repealed.

Saturday, April 23, 2011

Tuesday, April 19, 2011

Fueling Medical Social Media in the Real World Today

 

Where do patients turn to for health information?

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from: Pew Research Center’s Internet & American Life Project

Hospitals and University Social Media Sites:

Johns Hopkins Medicine

Mayo Clinic

Cleveland Clinic

Henry Ford Health Systems

The University of Maryland Medical Center Index

The Online Social Media Governance Guide

The Online Social Media Governance Guide- Hospitals and Health Care

The Social Media Management Handbook

Dual Citizenship for Social Media

 

Words of Caution:

 

An article in the Annals of Internal Medicine, for April 19 Ideas and Opinions section, physicians Arash Mostaghimi, MD, MPA and Bradley H. Crotty, MD call attention to the challenges created by the expanded use of Internet tools by physicians to reach patients at work, while simultaneously using the same tools to keep in touch with friends and family in their personal lives.

Any and all physicians who use social media for private and professional work need to realize the ‘blur’ that these internet creates in segregating personal from public information. Search engines usually ignore this and cannot compartmentalize private vs. public issues.

“This online presence presents a host of challenges for physicians including the demand to “proactively review and maintain their digital lives,” and also the need to create boundaries that both protect the doctor-patient relationship and help prevent awkward moments such as fielding a friend request from a patient.

“Unlike previous advances in communication, such as the telephone and e-mail, the inherent openness of social media and self publication, combined with improved online searching capabilities, can complicate the separation of professional and private digital personae,” they write.

Physicians should assume that all posted materials are public and therefore take care to protect themselves and patient privacy. A 2010 study by the Mostaghimi and Crotty published in the Journal of General Internal Medicine showed that over 30 percent of physicians have some type of personal information on the Internet. The authors also cite research showing that 17 percent of physician blogs contain information that could reveal the identity of the patient or the doctor. They suggest that, “social networks may be considered the new millennium’s elevator: a public forum where you have little to no control over who hears what you say, even if the material is not intended for the public.”

“We’re not suggesting that physicians should be prohibited from using social media sites. Doctors just need to be savvy regarding the content and tone of what they post online. People share information openly using social media, but posts intended for one audience may be embarrassing or inappropriate if seen by another,” said Mostaghimi.

The authors go on to discourage the use of sites like Facebook and Twitter for direct communication with patients since the information is controlled by the social media companies. These types of sites, they say, should be

They advise physicians to regularly perform “electronic self-audits” of their online identity and create “dual citizenship” with a distinct professional profile intended to come up early on a search engine query.reserved for general announcements like flu vaccination.

The article was supported by an Institutional National Research Service Award and the Division of General Medicine and Primary Care. There are no reported conflicts.

Social Media in Medicine III

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Most physicians are now aware of Social Media. The game is still out if it will be incorporated into medical practice or hospitals. It has it's serious flaws in regard to privacy and HIPAA regulations. Apart from that restriction Social Media offers many choices and possible applications for a medical practice (clinic) or hospital setting,

Social media is a highly fluid niche. What began as a recreational hobby has evolved into a digital medium which has caught the eye of venture capital and others in the internet space.

Billions of dollars are being poured into startup ventures and some established media sites that have piddling cash flow at the moment. Their forecasted value is based upon world wide exposure and the attendant potential for advertising revenues. Most of the social media sites remain private equity companies while some are looking at IPOs. (Facebook).

Several social media sites have become lightening rods attracting companies building on APIs (application programming interface). (that is another story)

How are most practices dealing with this new phenomenon? It is a far cry from AOL's “You've Got Mail !!”

Many are dabbling with building their own Facebook pages, Twitter identities, and Blogs. Few physicians are either expert enough or have disposable time to dedicate to the medium personally.

image

There are several 'big time' medical bloggers such as KevinMD who are a presence enough to be inteviewed by TV media, or published in the Wall Street Journal and other classical newsprint media. His blog has attracted enough industry attention and is monetized to deliver cash flow. His posts are repeated across other blogging venues and ranks very high in Google's search algorithm, and without SEO. (search engine optimization)

Physicians are a curious lot, especially when it comes to technology. Others are more intent on patient care and have little time to devote to this area. Personally I have enjoyed exploring and using social media, but then I am retired from clinical practice.

Some familiarity is in order to plan if and when your practice should enter social media, and how you will use it.

Social media challenges medicine in it's use of arcane acronyms (abbreviations) as a 'secret' insider code. There are glossaries for Twitter acronyms and other social media sites. 1 2 3 .

Sage advice would be to have an 'expert' build your site. One of your children probably is expert at this, if not there are many teenagers or young adults who are willing to do this for very little money or for just the 'resume builder”. Elance.com is a freelancer writer web job board where many aspiring social media designers and writers congregate.

Dailly posting should be relegated to a knowledgable ghost writer. Most are willing to work for about $5.00/ day (one post) It is as easy as dictating into your PC or laptop and sending the post as an mp3 file via and attachment email or an Instant messaging file. If you don't know how to do that, ask one of your kids, or younger employees.

Motivation for Medical Social Media Sites in a survey found that 94 percent of respondents have used Facebook to gather information on their healthcare, 32 percent used YouTube, 18 percent used Twitter and MySpace 2 percent used FourSquare, a location-based website. Key findings of the NRC survey: (National Research Corporation)

  • When asked about social media's influence, one in four respondents said it was "very likely" or "likely" to impact their future healthcare decisions.

  • When asked for their level of trust in social media, 32 percent said "very high" or "high," and only 7.5 percent said "very low."

  • Respondents still backed hospital websites are the premiere source of online healthcare information with one in two preferring heath provider websites to any source. Fourteen percent preferred an integrated approach of hospital websites and social media combined. Three percent preferred only social media.

Another survey of Type II diabetic patients and weight loss surgery found that social media was used as a tool to spread information about patients' experiences with bariatric surgery and its benefits. Business intelligence company Wool.labs used its technology WebDig to track every conversation accessible on the Internet and determined the trends among diabetes patients and healthcare providers as related to options to help manage diabetes including bariatric surgery.

The study found diabetes patients who had tried bariatric surgery used social media outlets to advocate for the procedure and show how it had positively impacted their Type II diabetes. "We believe that the patient wave of support in social media has helped push diabetes surgery into mainstream acceptance faster," said Michele Bennett, chief operating officer of Wool.labs. "In this instance, we believe patients are leading the way and it will be interesting to see how far physicians and the industry will take it from here.

A report, which was conducted by the Pew Internet & American Life Project and the California HealthCare Foundation, found that only 62 percent of adults living with chronic disease go online, compared with 81 percent of adults who report no chronic diseases. Lack of Internet access, not lack of interest in the topic, is the primary reason for the gap, according to the report. In fact, when demographic factors are controlled, Internet users living with chronic disease are slightly more likely than other Internet users to access health information online and

"We can now add chronic disease to the list of attributes which have an independent, negative effect on someone's likelihood to have Internet access, along with age, education, and income level," says Kristen Purcell, an associate director of the Pew Internet Project and a co-author of the report.

According to the report, more than any other group, people living with chronic disease remain strongly connected to offline sources of medical assistance and advice such as health professionals, friends, family and books. However, once they have Internet access, people living with chronic disease report significant benefits from the health resources found online.

"The deck is stacked against people living with chronic disease. They are disproportionately offline. They often have complicated health issues, not easily solved by the addition of even the best, most reliable, medical advice," says Susannah Fox, an associate director of the Pew Internet Project and a co-author of the report. "But those who are online have a trump card. They have each other. Those who have access use the Internet like a secret weapon, unearthing and sharing nuggets of information found online."

Looking at the population as a whole, 51 percent of American adults living with chronic disease have looked online for any of the health topics included in the survey, such as information about a specific disease, a certain medical procedure, or health insurance. By comparison, 66 percent of adults who report no chronic conditions use the Internet to gather health information.

The report found that information about prescription or over-the-counter drugs is the topic that draws the most significant interest among Internet users living with chronic disease, compared with other Internet users.

 

Monday, April 18, 2011

Freedom?

Outrage on the Health Train Express

Let us all pause for a moment on this Passover Seder Night and ask “why is this night different from all other nights"?”

Listen up. We are in the midst of a budgetary crisis. Standard & Poor's is about to downgrade the U.S. Government as a reliable debtor, health care reform threatens to bankrupt  the  Government, and we are told if we do not make the changes we will go bankrupt anyway.

In  the midst of EMR arguments pro and con, transparency issues, outcome studies, and plans for ACOs from  out of Michigan comes this late breaking story from the American College of Surgeons.  I somehow or other know now why I never went after that  FACS title, FAAO was enough.

The New York Times ran this story by Tara Parker-Pope who must have laughed all the way to wherever she goes at the end of a day.

I know I and several other well known bloggers thought this was hilarious, although admittedly none (at least me) would admit to being an academic

(evil looking, discredited surgeon, tongue-in-cheek)

image(picture at least 20 years old, maybe 30)

Dr. Greenfield, 78, was the editor in chief of Surgery News when the editorial was published but resigned that position in the wake of the controversy; and not only was the article retracted, but all existence and reference to that issue were expunged from the scientific literature.  The entire issue of the newspaper was withdrawn.

Lazar Greenfield is one of the truly pre-eminent, almost legendary figures in modern general surgery.

Dr Greenfield is a Professor-Emeritus of General Surgery at the University of Michigan. In ordinary lay language that means ‘retired’.

The Valentine’s Day Massacre

 Forget chocolate on Valentine’s Day, try semen, says Surgery News editor. Retraction, resignation  follow.

IMHO, the only ones discredited is the ACS for electing him and for the General Surgery Journal for printing the article in the first place.The position is obviously one of honor given in reward for a long and dignified and respected career.  Perhaps the position should go to a younger surgeon still actively engaged in practice. The position is also obviously a ‘political appointment’, and much like political appointments, the appointee goes down in disgrace.

I hope that Dr. Lazar Greenfield (retired) is enjoying retirement, away from controversy and high risk adventure, as well as sperm counts.

I pray he is laughing out  loud  each month when he draws his pension from the bank.

And now he is truly a LEGEND, among great and famous surgeons.  All who trained with him will have an unforgettable story to tell their residents !

Saturday, April 16, 2011

EYE MD A New Blogspot

 

Just what is needed in bloggerville, another medical blog. This one is on a topic very near to my heart, after 30 years of eye surgery, treatment of glaucoma, diabetic retinopathy, plastic surgery of the eyes, and my favorite area….pediatric ophthalmology…here’s a sample…Buzz on Over to Eye MD. You will find it at http://eyeinfo4you.blogspot.com 

Here’s a “Trailer”

Eye MD

Friday, April 15, 2011

A New Blog Spot

Get ready, this blog is going to have some really cool, interesting and accurate information about the science of the visual system, clinical practice, sources for eye care, innovative treatments, and what can we  expect in the next ten years. How will Health Reform impact your Eye Health?

Warning !  Some of the  images may be disturbing. Not intended for the faint of heart.

Here is the first one !

Leave a comment:  What are these??

GML

Posted by Eye MD at 7:21 AM 1 comments

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Wednesday, April 13, 2011

So, What’s the Problem, Duh !

 

INDIANAPOLIS -- Health insurer UnitedHealth Group's earnings rose 21 percent last year and so did the compensation it gave CEO Stephen Hemsley .

The 58-year-old executive received a pay package totaling $10.8 million from the Minnetonka, Minn., managed care company. That includes a salary and performance-related bonus amounting to $4.7 million and stock and options valued at $6 million.

UnitedHealth is the largest health insurer based on revenue. Its net income climbed 21 percent last year to $4.6 billion, and its share price rose 18 percent. That's higher than the increase recorded by the Standard & Poor's 500 index in 2010.

ENUFF SAID !!!

The Billion Dollar Soap Dispenser

Kathleen Sibelius promises $ 1 billion for fighting hospital infections?  This is insane… She doesn’t even work there anymore and is a lame duck

A billion dollars, for what? Soap & Water. Sounds like the $100,000 dollar toilet (or was it a wrench?)

 

Deficit spending in the middle of political outrage….

 

Saturday, April 9, 2011

Social Media and Medicine II

 

In my continuing series on medicine and social media, Healthcare IT News has weighed in with a survey and a colorful pie chart.

What spectacular timing…..must be a resonance in the dark matter of the universe. 

Vladimir’s Blog lists the Top Social Media Sites (about a year old)

vladimir prelovac"I would love to change the world, I just don't have the source code yet."

The poll was conducted by Health IT News of it’s readers. The results:

Nearly half of the respondents think doctors should use social media as a way to foster a healthcare community.

Out of those who think that doctors should embrace social media, only 16% believe that doctors should use such platforms to connect with their patients.

Only 13% of participants think that doctors should not be using social media at all.

Many people may prefer traditional modes of communication when conferring with their doctors about medical issues. But social media is a viable method of allowing hospitals and health organizations to engage not only with patients but also with a wider community.

Making social media simple for docs

Social media sites help patients make healthcare decisions

During the next several weeks Health Train  will devote several columns for docs who want to learn more and participate in social media.

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Friday, April 8, 2011

Social Media and Physicians

 

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Most physicians are now aware of Social Media. The game is still out if it will be incorporated into medical practice or hospitals. It has it's serious flaws in regard to privacy and HIPAA regulations. Apart from that restriction Social Media offers many choices and possible applications for a medical practice (clinic) or hospital setting,

Social media is a highly fluid niche. What began as a recreational hobby has evolved into a digital medium which has caught the eye of venture capital and others in the internet space.

Billions of dollars are being poured into startup ventures and some established media sites that have piddling cash flow at the moment. Their forecasted value is based upon world wide exposure and the attendant potential for advertising revenues. Most of the social media sites remain private equity companies and some are looking at IPOs. (Facebook).

Several social media sites have become lightening rods attracting companies building on APIs (application programming interface). (that is another story)

How are most practices dealing with this new phenomenon? It is a far cry from AOL's “You've Got Mail !!”

Many are dabbling with building their own Facebook pages, Twitter identities, and Blogs. Few physicians are either expert enough or have enough disposable time to dedicate to the medium personally.

There are several 'big time' medical bloggers such as KevinMD who are a presence enough to be interviewed by TV media, or published in the Wall Street Journal and other classical newsprint media. His blog has attracted enough industry attention and is monetized to deliver cash flow. His posts are repeated across other blogging venues and ranks very high in Google's search algorithm, and without SEO. (search engine optimization)

Physicians are a curious lot, especially when it comes to technology. Others are more intent on patient care and have little time to devote to this area. Personally I have enjoyed exploring and using social media, but then I am retired from clinical practice.

Some familiarity in order to plan if and when your practice should enter social media, and how you will use it.

Social media challenges medicine in it's use of arcane acronyms (abbreviations) as a 'secret' insider code. There are glossaries for Twitter acronyms and other social media sites. 1 2 3 .

Sage advice would be to have an 'expert' build your site. One of your children probably is expert at this, if not there, are many teenagers or young adults who are willing to do this for very little money or just the 'resume builder” Elance.com  is a freelancer writer web job board where many aspiring social media designers congregate.

Daily posting should be relegated to a knowledgeable ghost writer. Most are willing to work for about $5.00/ day (one post) It is as easy as dictating into your PC or laptop and sending the post as an mp3 file via an attachment email or an Instant messaging file. If you don't know how to do that, ask one of your kids, or younger employees.

Facebook vs. Twitter . They each have their own unique attributes and application.. Why not use both? Facebook can act much like an interactive web page with fields for comments, likes, photos, friends lists and more. Twitter is much more brief, short, to the point and readers can configure their site to follow you, much like a mini RSS feed.

A brief guide to social media, by Brian Solis also elaborates on the many other social media sites available.

Hope to see some of you at my twitter feed  @glevin1 or on Facebook,  facebook.com/garylevin

 

Thursday, April 7, 2011

ACO ? Unintelligible Idea..makes no sense.

 

A Mid-Week Review with Sheryl Skolnick, Ph.D.

ACO makes no sense: Listen to this expert opinion. “We must be missing something”.  Please excuse the opening advertisement

Listen to internet radio with ACOwatch on Blog Talk Radio

EMR update from MGMA

The Medical Group Management Association just released it’s annual survey about electronic medical records. This 2011 report is based upon 2010 data.

The data represent the aggregate experience of more than 120,000 physicians in medical practice., MGMA conducted a study funded by PNC Bank, to explore the barriers and benefits of EHR adoption from 4,588 healthcare organizations.

The Study reveals:

  • Expected productivity loss during transition is the main barrier to EHR implementation, according to study participants who still use paper records.
  • Study participants are pleased with their EHRs overall, despite some not seeing an increase in productivity - Nearly 72 percent of EHR owners said they were satisfied with their overall system, but only 26.5 percent reported increased productivity since implementation.
  • Time allocation is key to a successful EHR implementation - 53.2 percent of respondents felt that they either ‘mildly’ or ‘severely’ under-allocated the training time needed during the implementation of their EHR system.

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Many consultants feel some justification from this study which confirms what is the most significant barrier to adopting an EMR.  The end-game is that many more resources, both in time, specialized personell must be allocated to the training process, and that many questions do not arise until the user is in a particular setting or event that has not be addressed. Users will then adopt a ‘workaround’ for that moment to continue their activity without interruption to call a ‘help line’, or disturb a colleague who may be more knowledgable.

A more complete report is available here:

MGMA detailed  specific recommendations and alternative methods for training physicians to use EMR.

Younger physicians now recently trained wil have some experience with EMR, however it may not translate directly to another practice. In fact users who are familiar and trained in one system often have more difficulty learning a second or even third system. Many physicians attend patients at more than one facility.

USC-LAC Medical Center         UCLA Medical Center

The ball point pen works equally well in all hospitals and clinics.

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