Health Train Express: My Webcina Story

Things my father never taught me about social media…thus HealthTrain Express was born.

I still feel privileged to know I was there at the birth of medical social media. I remember the strange looks I was given when I talked about it at meetings and used it to develop my blog as a form of newsletter (for free) when I was investing time into developing health information technology.

My entrance into social media in 2004 was at a time when only some heard of social media. At the time there were far fewer bloggers and most had to have some level of nerdiness and geek quality to even know how to blog. The popular platforms such as blogger, wordpress, Drupal, and offline clients like Windows Live Journal were not much in use. To be a blogger took gumption and significant time. It was more difficult since the smartphone revolution and the iPhone in particular was not available.

Social media allowed my expansion into health organizations from Harvard, where I mixed with the Chief Information Officer of the University, and Patient advocacy groups. It empowered me to be on the patient side of the health care equation. I met artists who used their talent to create artwork at meetings based upon the topic of the meeting. One of my favorites is Regina Holladay, who was unknown at the time. I can see how SM has made her well known.

I have always been one of the USB people…I like to ‘plug and play’ and fortunately I found blogger very early on. It was not sophisticated, and I learned as time went along how to modify templates, themes, insert HTML, videos, images, and how to insert hyperlinks into my text.

My first platform, “ Inland Empire Regional Health Information Organization” blog was a newsletter for a newly forming Health Information Exchange. The readership was limited to less than 100. It was focused on our fledgling health information exchange as a source of knowledge regarding medicine and electronic medical records, and government grants to fund their implementation. It also served to connect with other HIEs and the California State-wide HIE. It was read by the Department of HHS and the newly appointed head of the Office of The National Coordinator for Health Information Technology (ONCHIT). We stimulated vision, education and eventually dug the foundation for the stimulus packages in HITECH and ARRA.

My social media experience with twitter and Facebook were non-existent. About one year ago I began tweeting and learning about hash tags. I began posting on Facebook as well to drive traffic to my blog and other publications.

Somewhere in the middle of all of this I began to freelance write, it evolved from the fact that I did not think I was a very good writer. My ideas were good, but putting it down on paper lacked the polish I saw in other spaces. I had been spending a great deal of time blogging without compensation. I decided to discover free lance writing to learn and earn online. I was compensated for researching financial news about mergers and acquisitions in the social media space publishing on Next.Inc.in . I learned to feed my blog(s) with twitter, Facebook links and now Google + links. The advent of the Google + Hangout looms large for me.

My network has expanded to artists, musicians, videographers, poets, and more, all of which I will integrate into scientific presentations for a change of pace, entertainment and to maintain interest in my audience. I see social media as a picture book of conversation and social intercourse.

I spent much time surfing blogs, and websites in addition to writing my own blog.

My life as a physician was very interesting although a bit cloistered revolving around patient care, medical technology and research via the internet. Academic search engines such as PubMed, and Web-based data repositories along with specialized references played a large role in the latter years of my surgical practice. I was an early adopter of electronic prescription writing and was a beta tester for a well known eRx program that exists today. It was featured on a now dead platform, the Palm Pilot, the ancestor of the current smartphone (without the phone).

Like social media, the hardware platform evolves with the software platforms. Which comes first? The chicken or the egg? Without a suitable platform software dies unused, and without suitable software hardware quickly becomes a useless 'brick”.

Form and function go hand in hand and in today's world PC ethnology has developed into tablet PCs and smartphones for convenience and mobility. As I predicted in my early blogs the development of EMR and HIT in medicine would lag until the mix of hardware and software allowed for a physician patient encounter face- to- face and not face- to -keyboard/monitor.

The social media millieu has followed this path to it's current position with multiple platforms accessible from a single client API.

My progress in social media has followed this same pathway. My blog at Health Train Express travels my route since 2004. It's been a self taught journey. Writing and producing content is only a small part of the journey.

Social media participants are not static...we evolve. The power of innovation and entrepreneurship has driven many bloggers, Facebook users and twitters' to monetize their publications.

Although I have been tempted to veer off in that direction my main source of income has always been medicine. I never felt the necessity to derive income from social media and enjoyed it for the chance to develop writing skills, learn more about communication and media and the use of internet technology to make my voice and opinions heard. I developed new friends in areas where I had no previous experience. The curiosity was latent, only waiting for social media to shake it into the open.

As time went on I became immersed gradually in social media, first in Facebook, twitter, and by perm linking to other blogger's spaces. Early on the comment box of a blog was a form of chat room for bloggers like me. IM chatting never caught on with me, however Skype video intrigued me early on. We reciprocated our blog popularity with a blog roll banner on our blogs.

Medical bloggers developed the “Health Care Code of Ethics for Bloggers”. The code was revised in May 2007 when HIPAA regulations became effective regarding patient privacy and confidentiality matters. The new law also encompassed health information technology electronic medical records, Health Information Exchanges

Awards and Recognition were given for the best health blog. Some bloggers aggregated other blogs into theirs and offered guest blogger positions. There was pride and esteem in the ranks. The social health blog was a very personal environment with writers respecting one another and their opinions.

Social media websites began to emerge that were limited for physicians only, SERMO, iMedExchange, and Ozmosis exist today. These sites require authentication with a state medical license which must be verified. SERMO boasts of itself as the leading Social Media Platform for doctors. It is even divided into specialty niches.

Social media sites are invaluable to large organizations in healthcare such as the Mayo Clinic and small entities such as small group practices and even solo practitioners. It is limited only by imagination, and a willingness to step off and possibly receive some criticism. It is buoyed by freedom of speech and a huge collective of supporters who headed in the same direction. It is a place where diversity is magnified and exploited for the best outcomes.

Social media lays bare the ugly side of some issues and the results produce a real electronic freedom of expression and a hope for betterment of our species. Would the Arab Spring have evolved differently without social media?

My blogging and social media content and direction not only served to satisfy me, it also provided a catalytic platform for disruptive technology in a previously “cottage industry’ of healthcare.

Social media, Health Information Technology, and mobile applications are the “perfect storm”in health related business and medical practice.

Prizes are awarded each year for the best health blog. Some bloggers aggregated other blogs into theirs and offered guest blogger positions. There was pride and esteem in the ranks. The social health blog was a very personal environment with writers respecting one another and their opinions.

Social media websites also emerged that were limited to physicians only, SERMO, iMedExchange, and Ozmosis exist today. These sites are password controlled require authentication with a state medical license which must be verified. SERMO boasts of itself as the leading Social Media Platform for doctors. It is even divided into specialty niches.

My discussions developed ”out of the box” ideas and found many shared these ideas and empowered me to share them with anyone who would listen.

My own point of view is not to blog or comment anonymously. My attitude is that anonymity dilutes the writers 'integrity' and the power of the message. Then again I don't have an employer who might look aghast at some negative commentary about the business or attitudes that run contrary to the employer or corporation's interest. Thus far I have not been stalked. However in social media that is a risk.

Google + and Google Hangouts have afforded me the ability to be broadcast on live Television News programs where the anchor person interfaced with other + Hangout-ers, and to watch artists develop paintings, share portfolio, watch and hear new budding musicians form their craft, meet with fellow hobbyists from far and near. I have even had my caricature drawn live.

Gary M. Levin M.D.

by Cliff Roth

Earlier this month I saw the Webcina offering for a contest about stories in social media. I was not sure I had much to offer, until only tonite less than 24 hours before the deadline on November 30th.

By late afternoon my daily events convinced me that I must share my story.

In my early morning hours I check my gmail accounts. They are linked to comments and posts on Google +. I receive emails from Summify which aggregates many of my networked blog feeds. I use Feedjit which details all those who come to my blog and from which countries. Social Media today sends me a report of aggregated blogs, and a summary of blogs that I have written and have been networked by Health Works Collective. I spend about fifteen minutes on tweet deck and search for #hcsm, #meded I look for medical meetings and attempt to find the suitable #tag. I use Tweetdeck and Hootsuite for posting on multiple platforms simultaneously. I find this advanageous rather than repetitive because my audience uses different platforms, few have time to read or post to all. My object is to reach the largest audience. I look at my Klout Score once a month. My progress seems to be measured as improving from a 18 one year ago to a 48, not a world record but reasonable for a single person not into marketing. (Watch out Britanny Spears and Jolina I am on your heels.

Social media is the electronic version of ‘word of mouth’, powerful and very underestimated in all fields, yet intensely personal and usually credible amongst close friends. It functions as the ‘whisper’ form of the ‘banner ad’.

Currently I am publishing a directory of #tags for medical meetings and encouraging attendees to tweet, or post on facebook and/or open Google + Hangouts for those who cannot attend important meetings.

Twitter enters Health Care Conferences: For me this is one of the most useful ideas in SM for medicine. You’re attending a healthcare conference and have one of those moments where something of real value to you was said. Or perhaps you’re attending one of these special unconferences that spur incredible creativity and innovating thought. In both cases, two issues often pop up.

“I need to make some good notes of this”, and “more people should have been here right now to hear this stuff”. The conference participants have, perhaps somewhat unconsciously, been functioning as Trojan horses. In their pockets are hidden iPhones and Androids, loaded with Twitter clients, instantly both recording what they perceive are the greatest thoughts from the conference and sharing it to the public. Information wants to be free.

Social media, like the internet in general has become a relatively free open source of information changing journal publications, and accessibility to expensive closed conferences.” (Foxepractice.com )

Eventually meeting attendees will habitually utilize social media streaming during a meeting for each speaker regarding the high points of their topic.. It will require some pre-meeting organization and direction to assign appropriate hashtags for specific meetings. Some used thus far in 2011 have been #mayoragan #aao11, #ismppem11. Tweeting and/or Myspace can be used for more than meeting at Starbucks, and/or travel advisories.

I could not have predicted in 1984, 1994 what would happen. What will it be like in 2024? I hope I am still here. I will only be 87.

I picture me sitting there with several of my great grandchildren, asking me what it was like in 2012…my answer will be “you kids are spoiled, the only things we had were the internet, smartphones, twiitter, facebook, Google + and Mark Zuckerberg. Why I can remember when Steve Jobs started Apple.

Their response: Steve Jobs? Who was that?

Its’ all relative…my parting words.

The uses of social media are only limited by your imagination.