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)

"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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Social Media and Physicians

 

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

 

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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.

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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Google's Larry Page May Pull Back on Health Portal: WSJ

 

eWEEK.com reports: 

 

As part of a corporate streamlining, Google co-founder and incoming CEO Larry Page may reduce resources for Google's personal health portal, according to The Wall Street Journal."One project expected to get less support is Google Health, which lets people store medical records and other health data on Google's servers, said people familiar with the matter," the WSJ article states.

"Google Health will just become a basic service without much support. Over time without strategic interest from a senior leader, it will basically become a tool for developers," Shah predicted.

That gives me such a warm feeling ! This is an apt announcement as to why MDs do not trust PHRs, and EMRs

"I think it would be a political and PR nightmare for them to kill Google Health. That's why I don't think they  would say we're pulling the plug completely on it," Moore said.

Google Health or PHRs may not affect the market for EHRs (electronic health records), according to Shah. (Wrong !)  This move will set off many warning bells to both doctors and patients alike. If a huge profitable enterprise like Google which has many books of business cannot or will not support digital information in the healthcare space, what makes anyone believe that smaller niche EMR companies can or will survive over the long run.  What happens when the exponential growth rate and profitability decreases or disappears when incentives end?

EMRs demand long term plans and commitments from vendors. Anyone looking at a company which provides a critical infrastructure for a practice should do a thorough financial biopsy of the company and get advice from financial experts.

Weak standards and lack of consumer interest have hurt adoption of PHRs, according to Chilmark.

Schmidt introduced Google Health at the HIMSS (Healthcare Information and Management Systems Society) conference on Feb. 28, 2008. Since that time, Google has treated the site as a "sandbox" and invested more in its Android mobile platform, Moore said.Microsoft's health care effort may be more organized overall than Google's, despite struggles by both companies in PHRs, experts say. Microsoft, unlike Google, has a chief health care strategist, Shah noted.

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OBAMACARE.MEDICAID FOR ALL

Chuck Wilder interviews Dr Richard Amerling President of the American Association of Physicians and Surgeons (AAPS), and Director of the Outpatient Dialysis at Beth Israel Medical Center. Dr. Amerling is the author of Physician’s Declaration of Independence.”ObamaCare Endgame: Medicaid for All”

Here are the interviews: LINK

Wilder also interviews other opinion makers, Seton Motley President of Less Government, Editor in Chief StopNetRegulation.org A publication of the Center for Individual Freedom. "House Votes this Week to Reverse FCC Net Neutrality Power Grab" (www. lessgovernment.org) ................................. Jim Gilchrist Founder and President of the Minuteman Project, Jim is a veteran of the U.S. Marine Corps and recipient of the Purple Heart award for wounds sustained while serving with an infantry unit in Vietnam, "A look at the report:Federal Agents Told to Reduce Border Arrests, Arizona Sheriff Says" (http://www.minutemanproject.com/) ............................... Richard Amerling, MD is a nephrologists practicing in New York City. He is an Associate Professor of clinical medicine at Albert Einstein College of Medicine in New York, and the Director of Outpatient Dialysis at the Beth Israel Medical Center. He is Director of the Association of American Physicians and Surgeons. Dr. Amerling is the author of the Physicians' Declaration of Independence."ObamaCare Endgame: Medicaid for All" (http://www.aapsonline.org/medicare/doi.htm). ............................Katharine DeBrecht Author and staff writer for the Tea Party Review

Too many physicians endorse the “single payer” concept. Some are legitimately frustrated by the increasing difficulty in getting paid by private insurance companies and so called “health maintenance organizations.” My response is, “What if the single payer is Medicaid?” Unless ObamaCare is defeated in the Supreme Court, or defunded/repealed by Congress, we may soon be in a position to answer that question.
It has become clear that a major goal of ObamaCare is massive expansion of Medicaid. It mandates that states increase Medicaid eligibility, and provides temporary funding to this end. Medicaid rolls in many states have already swelled due to the prolonged recession and high unemployment. According to CNNMoney: “Strapped states are scrambling to address Medicaid's ballooning costs before the federal government cuts back a critical source of funding this week. Medicaid is one of state's costliest burdens. And the weak economy swelled the rolls to record numbers. Nearly 49 million people -- or almost one in six Americans -- were covered by the safety net at the end of 2009, the latest figures available

Furthermore, federal control of private health insurance and the bureaucratization of private medicine under ObamaCare will lead all private insurance down towards Medicare and Medicaid levels.

Medicaid is an excellent example of a failed government program. Even a cursory look at Medicaid should convince any rational person that government has no business being involved with health care. It was created in 1965-66 as an “add-on” to Medicare, the major entitlement passed as part of the Great Society under LBJ. While Medicare bribed physicians with “usual, customary, and reasonable” reimbursement (and a long-forgotten pledge not to interfere with care), Medicaid payments to physicians were, from the outset, pathetic. Thus, Medicaid was set up as a third tier system; one that would relegate its beneficiaries to hospital emergency rooms and clinics, rather than to private medical offices. Medicaid payments to physicians to this date in most states are well below the cost of care. The minimal participation of private physicians in the Medicaid program, which was by design, doomed the program to provide very expensive, fragmented, low quality care. How can a program that virtually excludes private physicians now be expanded and hope to succeed? Obviously, it cannot.

ObamaCare mandates an increase in Medicaid physician payments to Medicare levels in the hope of inducing more doctors to participate. This might have worked ten or fifteen years ago when Medicare payments were decent. Now, through price controls and cuts, they too, barely cover the cost of treatment. Also, the boost is temporary; payments revert to current levels after two years. Why would doctors take on Medicaid patients under this scenario? Many will not participate.

Medicaid is a fiscal and humanitarian disaster, providing fragmented, lousy, and expensive care. It is a welfare system and enslaves participants in permanent poverty. Rather than expanding, it should be cut. The federal government should rescind all rules regarding Medicaid and return to the states their share of funds as block grants. States should be free to develop their own approaches to health care for the needy. One such approach, proposed by my colleague, Dr. Alieta Eck in New Jersey, offers free medical malpractice insurance to physicians who donate four hours per week to charity care. Let fifty solutions blossom in the fifty sovereign states!

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T.E.D. General Stanley McChrystal

You should wonder what is General McChrystal doing on the Health Train? Hopefully by the time you have disembarked I will have conveyed to you the analogy of his leadership in the military and health care. He spoke at T.E.D. In Long Beach CA in 2011.

General McChrystal, of course is the former commander of U.S. And International forces in Afghanistan. A four-star general, he is credited for creating a revolution in warfare that fuses intelligence and operations. The analogies of changes in warfare and healthcare are immediately apparent.

The environment has changed. Health care is dispersed...using chat, video phone calls, complex communications, and may not be face-face.

1. Leadership

2. Technologies

3. Inversion of expertise, many changes at lower levels (digital)...Leadership experience.

4. Increasing reliance on electronic media places barriers for leadership, hands on.

5. Generational differences, shared purposes with different expertise, experience, vocabulary.

6. Ranger commitments to each other....Physician commitments to patients.

7. Addressing the possibility of failure, in a goal but not as a professional.

Does this sound familiar?

1. Challenges to leadership altered and magnified by generational changes.

2. Explosive and disruptive technology changes in diagnosis, delivery of care, and in technology, media and data storage, as well as process.

3. Challenges of senior health care givers and professionals obtaining expertise in #4. Inversion of electronic and media knowledge in juxtaposition to clinical expertise by senior physicians.

5. Generational differences in education and training processes, with a requirement of shared purpose in patient care and wellness.

6. Physician-patient commitments and physician-physician-hospital institution commitment and or patient care. (will this be the ACO?)

7. The possibility of failure? ACCA, ACOs. A non-system failure has already ocurred, it was not a goal, but the lack of a clearly defined endpoint.

8. Are we prepared for another failure? Was medicare a failure? Success or failure can only  be  determined in the context of time and setting. Medicare was designed in the early 1960s when there were fewer seniors eligible, and there were fewer diagnostic and therapeutic interventions as choices. continued…………..

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