The Rise of Google + and Hangout in Healthcare.

Imagine this if you will (and this is not imaginary).  I am sitting at home quite comfortably on a Google + hangout and suddenly a window appears from a Live newscast in Colombia Mo. 

Suddenly I am in the midst of a live news program where I am asked a number of questions about medicine, health and reform.. Sarah Hill (an Emmy Award Winning News Person is one of a few broadcasters who use Google + Hangouts regularly during their broadcast day to obtain opinion and comments from viewers like you and me. My sense this is just the beginning of a new iteration of social media.

Social media in general and healthcare in particular has reached a significant audience, and even more important, active participants. The rise of the hash tag and understanding of how it works and is used makes the millions of seemingly endless tweets somewhat more organized according to readers’ interests.

Hash tags are really quite simple and they allow a selective view of recent tweets according to your interest. The challenge is identifying the best one(s)  for your search. There are some directories available. In healthcare the Foxegroup has a good resource for #hcsm (healthcare in social media). A Google search for hash tag ((N) where N is the area you are interested in will bring up some other resources. That is for the incoming stream you read.

When posting you can also identify the general group you target in addition to using the @ sign. You can use multiple hash tags. It is also possible to search for an individual twitter stream such as #glevin1.  Try that to follow my stream of unconsciousness on twitter.

I have been accused of being a hash tag scrambler using multiple tags. One must be cautious to leave a space between the tags otherwise the software will  concatenate your hash tags into a meaningless string of words.

Hash tags can also be added to Facebook entries, Google+ entries as well as tweets.

Each week I read more and more about the growth of social media in healthcare and medicine.

The addition of Google + and the Google + Hangout adds a new dimension to social media in terms of intimacy and face-to-face-time in a way that Facebook failed to capitalize upon.

My Google + Stream will soon offer the “Medical Hangout” on Thursday evenings, 6PM PST. I am looking for outgoing visionaries in the Health 2.0 space from an international audience. I am certain you have something to offer, even if it is a negative opinion.

If you are reading this, place me in your Google + circles to receive an invite to my hangouts.

Meanwhile I have just realized it’s time for me to submit my social media story to Webinar. I might win a prize if I win the contest.

LiveJournal Tags: blogs,twitter,facebook,webcina,G+ #hcsm

del.icio.us Tags: blogs,twitter lists,facebook,webcina,G+ #hcsm

Social Media Update for HTE

 

Update on the Blog Format and Widget Add-ons:

Readers may notice I have re-instituted the “Feedjit” feed. I did not realize how useful it was in tracking who tracks me. I have missed it. It opens a new social media tool for true personal communications with those with similar interests.  I do attempt to reply to all who email, tweet, friend, circle me on G+. During December I will be filtering my responses to those who have not responded to  me in the past year. I know how busy you all are, and I am sure those readers will not miss me. If  you have followed me in the past six months and want to be retained contact me. 

2011 has been an eventful year, like 2010,2009, and beyond. For those of you who blog and/or do SM it is never a dull moment. For me it is a breath of fresh air to belong to the SM stream. (it saves a lot on gas). Look for me on my favorite venue, Google Hangouts.  I can be found almost at any time between patients, surgeries, and my regular time is at 6PM PDT Thursdays.

Googlel + Hangout Example: Live Stream from KOMU Lecture at University Journalism Class

 

I can also be found frequently on KOMU’s NBCs news casts with Sarah Hill each morning. Circle Sarah Hill or Me on Google + and receive an invite to attend and/or participate. (only 9 get in so join early as soon as you see the invite.  I try to post the hangout a few minutes early on  twitter. Search for my tweet at #glevin1 If you cannot join the hangout there is often a live stream on #glevin1 

This year I will continue my ‘rants” on healthcare reform, and introduce new media for bloggers, a series of Google + hangouts which will include several prominent health bloggers. I also invite you to apply to participate in this ground breaking  health cares social media #chasm on twitter.

Topics may range from health reform to expert opinions on patient advocacy, participatory medicine,  and we also may introduce a ‘TED SM

In all it will be another exciting year in #chasm. I am looking for a global presence in participation.

del.icio.us Tags: social media,google hangout,G+,#hcsm

LiveJournal Tags: social media,google hangout,G+ #hcsm

Happy Thanksgiving Health Train Express

 

       

It is a Happy Afternoon here after Tom Turkey has donated a mega-dose of tryptophan to me and I descend into an endorphin sea of pre-somnolent horizontal meditation. As I pass from consciousness a stream of thought occurs about the past years blogs, social media and how to wrap up 2011, and worse what planned and unplanned revolts, reforms, recalls, and revolting decisions will affect medicine and health care.zzzzzz in 2012.

Wake me up when the pie is ready.

Tomorrow the “Elephants” and “Asses” can resume hostilities while the country burns.

LiveJournal Tags: gop,democrats,congress,thanksgiving,deserts,elephant in the room,turkey

The Farmer’s Donkey & The Well

One day a farmer's donkey fell down into a well. The animal cried piteously for hours as the farmer tried to figure out what to do. Finally, he decided the animal was old, and the well needed to be covered up anyway; it just wasn't worth it to retrieve the donkey.
He invited all his neighbors to come over and help him. They all grabbed a shovel and began to shovel dirt into the well. At first, the donkey realized what was happening and cried horribly. Then, to everyone's amazement he quieted down.
A few shovel loads later, the farmer finally looked down the well. He was astonished at what he saw. With each shovel of dirt that hit his back, the donkey was doing something amazing. He would shake it off and take a step up.
As the farmer's neighbors continued to shovel dirt on top of the animal, he would shake it off and take a step up. Pretty soon, everyone was amazed as the donkey stepped up over the edge of the well and happily trotted off!
MORAL :
Life is going to shovel dirt on you, all kinds of dirt. The trick to getting out of the well is to shake it off and take a step up. Each of our troubles is a steppingstone. We can get out of the deepest wells just by not stopping, never giving up! Shake it off and take a step up.

 

What is that all about here on the Healthtrain Express? Who is in the well? Patients? Doctors? Bureaucrats? Government?

Perhaps we all are and should be shoveling the dirt underneath us and not at each other.

 

LiveJournal Tags: donkey,patient,doctor,bureaucrat,government

A Lesson from Richard Feynman

 

Some of you may recognize this man, as well you should. Feynman was a well known physicist who often thought out of the box. Feynman was a powerhouse in the world of theoretical physics, During his lifetime, Feynman became one of the best-known scientists in the world.

Feynman was a keen popularizer of physics through both books and lectures, notably a 1959 talk on top-down nanotechnology called There's Plenty of Room at the Bottom and The Feynman Lectures on Physics. Feynman also became known through his semi-autobiographical books (Surely You're Joking, Mr. Feynman! and What Do You Care What Other People Think?) and books written about him, such as Tuva or Bust! (wikipedia)

What does any of this have to do with Health and Medicine and Doctors?

The Map of the Cat Conundrum:

 

Anyways. As any Feynman fan will remember, he decided to drop out of Physics for a while and check out BiologyThe story goes something like this:

“A map of the cat, sir?” she asked, horrified. “You mean a zoological chart!” From then on there were rumors about some dumb biology graduate student who was looking for a “map of the cat.”

When it came time for me to give my talk on the subject, I started off by drawing an outline of the cat and began to name the various muscles.

The other students in the class interrupt me: “We know all that!”

[Now THIS is my favorite part!]

“Oh,” I say, “you do? Then no wonder I can catch up with you so fast after you’ve had four years of biology.” They had wasted all their time memorizing stuff like that, when it could be looked up in fifteen minutes.

This is the harbinger of what is occurring in healthcare and many sciences as well. No longer are we required to fill our cerebral cortices with dribble that will mostly be lost in time. Our efforts will be toward truly cognitive skills developing constructs with analytics. There will be few places without access to terabytes of stored data, tables, charts, algorithms,  transforms, calculus, spreadsheets and the like.

The stigma of referring to a database in front of the patient will turn to “doctor aren’t you going to look that up to be sure it is correct?

        

Referring to a social media hash tag or a Google circle for an instantaneous second opinion from a #hcsm or #ophth or #intmed friend will become common place. 

 

And that my friends is the power of how social medial will transform your daily dabblings in healthcare

 

LiveJournal Tags: Richard Feynman,physics,emr,health,doctors,socialmedia,facebook,twitter lists,G+

Wal-Mart and Your Health Care

 

It’s just a matter of time. As you exit your local Wal-Mart or SuperWalmart notice the Optometrist and the Optical Shop.

Fairly soon you may also see ‘The Medical Clinic”adjacent to the ‘eye department’ with Dr Joe Smith’s name plate inserted in a sliding name holder.

Wal-Mart wants to be the nation’s largest primary care provider. And no doubt, unless the public refuses to use it, that will come about.

At the moment it is easy enough to  walk into any Rite Aid or CVS pharmacy to obtain flu inoculations. They will even bill your insurance. The CVS Urgent care clinic has a better EMR than many primary care physicians.

Have you noticed when calling for a prescription from Rite Aid the telephone voice tree gets in a ten second spot announcement for it’s lineup of immunizations. I have even had an automated telemarketing machine call me at home to get a flu shot scheduled at CVS soon.

Wal-Mart's public comments revolve around lowering their own employees health expenses.  We used to do that in “occupational health”, an internal department of most industries.

“Analysts said Wal-Mart is likely positioning itself to boost store traffic – possibly by expanding the number of, and services offered by, its in-store medical clinics. The move would also capitalize on growing demand for primary care in 2014, when the federal health law fully kicks in and millions more Americans are expected to have government or private health insurance.”, so says Julie Appleby and Sarah Varney in The Health Care Blog

Wal-Mart distributed an RFI (Request for Information) recently to determine how vendors could be used to lower health care costs. Wal-Mart's request goes even further, asking possible partners to provide information on how they would oversee patients with complicated chronic conditions, including asthma, HIV, arthritis, depression and sleep apnea.

LiveJournal Tags: cvs,minute clinic,walmart

Occupy Health Care

The  #“Occupiers” of healthcare also need a medical home and/or a primary care physician.  Despite the government (state and/or federal) push to form accountable care organizations (ACOs) this will be very difficult to accomplish.

Ignoring the very real barriers to #ACOs (except for some large healthcare entities like Mayo Clinic, Henry Ford Hospital, Cleveland Clinic and Kaiser Permanente) the shortage of primary care physicians,is the leading challenge for this “homeless person”. i(e GPs Family Doctors and some internists as well as Ob/Gyn and Pediatricians which may also be counted as primary care,)

If this person has a smartphone he can indulge in participatory medicine and social media in medicine #hcsm via facebook, twitter and G+, ask questions of friends and communicate with some care providers.

The concept of “Occupy Wall Street carries over to health care, with the same outrage as those demonstrating in all the cities, where the healthcare issues also reveal huge disparities in healthcare availability and affordability.

The situation now approaches a critical mass with each section of society claiming “I pay enough, not me !)  Unions want more, employers want less, employees circle the wagons with the latest demonstration project, Medical Savings Accounts, HMOs and empty promises by all concerned.

Several aspects of Obama care have already gone into effect, however there remains a real possibility large portions will be rescinded.. The law was written with a non-severability clause,  ie, all or nothing. That’s a huge CATCH 22. 

         

Although many states and others have raised issues, including constitutional law it appears that the judicial branch of the U.S. thus far has offered little if any relief from Obama Care. It will undoubtedly make it’s way to the Supreme Court of the land.

Prominent congressional representatives are offering measure to repeal all of part of the Patient Protection and Affordability Act

LiveJournal Tags: PAPCA,Obamacare,Supreme Court,Repeal Obamacare,Occupy Healthcare

The End of Medicine as We Knew It, R.I.P.

Does the message here operate when we face unwanted or unexpected changes. Do we grieve for that which we use daily and come to ‘love’.

Am I sticking my neck out? Don’t shoot the messengers 

     

Am  I a messenger or a heretic? Perhaps a little of both. I am always open to changes, however my first reaction to a new idea or product is enthusiasm tempered by a bit of hesitancy until I see which way the wind will blow.  My decisions inevitably depend upon a proven technology and adoption. Too many times I have invested in great possibilities that can not or are not self-sustaining, become obsolete, old in short time, or created more problems than are solved.

This applies to technology in diagnostic and therapeutic machines, as well as cost containment, HMOs, PPOs, ACOs Machinations about EMR, HIT, incentives and penalties, deadlines for adoption that are never realistic, and all the machinations of a far distant decision making process inside a ‘beltway’.

Despite serious reservations and outright negative commentary, physicians see some or all of these adopted, and continue to practice medicine, with each change creating more frustration built upon previous layers of negative results, and negative ROI.

Does it really matter? Can medicine as we know it survive or do we just let it R.I.P. ?

Perhaps this is just my Sunday morning ennui

LiveJournal Tags: change,obsolesence,R.I.P.,HMO,ACO,technology,emr,hit

The Integration of Social Media and Participatory Medicine: The Meaning of the ePatient Movement: Part I

 

A key component of cost containment in medicine and healthcare is wellness and compliance with treatments using educational courses, advocacy in groups of specific illness and support organizations to encourage patients with or without devastating illness.  This is particularly true in orphan diseases where a disease is uncommon or even rare, and chronic illnesses such as degenerative neurologic diseases, inherited diseases and cancer.

How can social media platforms such as twitter, blogs, facebook and G+ contribute to this effort?

Hospitals are integrating these functions into their web sites

“As units of analysis, the authors first identified different types of online media formats utilized by each hospital (eg, blogs, instant-messaging, audio clips, and video clips etc.). After identifying media formats, patient health information content (eg, disease information, symptom checkers, and health education) was identified within each media format.”

 

In a recent study of 14 hospitals:

‘The 14 hospitals, ranked in order, include: (1) Johns Hopkins Hospital, Baltimore; (2) Mayo Clinic; Minnesota; (3) Massachusetts General Hospital, Boston; (4) Cleveland Clinic; (5) Ronald Reagan UCLA Medical Center, Los Angeles; (6) New York-Presbyterian University Hospital of Columbia and Cornell; (7) University of California, San Francisco Medical Center; (8) Barnes-Jewish Hospital/Washington University, St. Louis; (9) Hospital of the University of Pennsylvania; Philadelphia; (10) Duke University Medical Center, Durham, N.C.; (11) Brigham and Women’s Hospital, Boston; (12) University of Washington Medical Center, Seattle; (13) UPMC-University of Pittsburgh Medical Center; and (14) University of Michigan Hospitals and Health Centers, Ann Arbor.[13]”

(author)

This study in The Journal of Participatory Medicine is  heavily skewed with major academic hospitals already ranked in the upper echelon of hospitals and all in major metropolitan areas, and the results do not truly indicate the overall adoption rate throughout the country. However since hospital web sites are online the information is easily accessible to the public.

The study also emphasizes the importance and necessity for broadband internet access throughout the country as a major public health imperative. It should also serve as a driver for either federal or state funding from public health agencies as part of their operating budget.  The use of internet media and social media may serve to decrease public health education using other media.

Blogs:

 

Social Media:

Analysis of Social Media Platforms used by surveyed. Hospitals

Broadcast media:

Web Enabled Communications

Mobile Apps

Citation: Gallant LM, Irizarry C, Boone G, Kreps G. Promoting participatory medicine with social media: new media applications on hospital websites that enhance health education and e-patients’ voice . J Participat Med. 2011 Oct 31; 3:e49.

Physicians should note that Social Media is here, and most likely will stay. The APIs (Application Platform Interfaces) are designed for users to layer their own specific software needs over the social media websites. It would seem that hospitals and physicians can easily integrate a social media site into their EMR. EMR vendors may choose to integrate SM into their products as well, with special attention to HIPAA regulations.

Next on Health Train Express:

All about ePatientDave

LiveJournal Tags: dalai lama,epatientdave,social media,participatory medicine

Social Media? The Answer to the Doctor’s Lounge

Patients and hospital staffs alike, as they walk by the Doctors lounge must wonder what transpires in those cloistered spaces, somewhat akin to boardrooms, VIP lounges, and even without “Private” or “Do not Enter” signs, the unwritten social understanding is this is a special place for a select few.

Social media is the opposite, where anyone can enter unless a specific block is used for a message. Pandora’s box has been opened, and not all the things which come out are bad.

Humans have a primitive need for social contact.  We even see this in higher species of the animal kingdom, grooming, verbalization, family groups, mourning, hunting and more.

In fact when denied this contact humans undergo mental and behavioral changes that become destructive. Studies have shown that restricted social contact and/or isolation at critical stages of development create the inability to relate to others.

There appears to be no danger of social isolation among twitter, FB and G+ fans. The phenomenon carries over to medical meetings and the use of smartphones for mHealth apps

It is just about time for the annual mHealth Summit near Washington, D.C. The event will feature keynote speakers, such as John Stratton COO of Verizon Wireless and Qualcomm CEO Paul Jacobs

The inclusion of these notable executives illuminates the importance of reliable mobile access and the improvement of smartphone speed such as LTE and 4G to facilitate the transmission of medical images. Because cellular phone technology is not secure this will require new encryption software, possibly similar to that used by the military to ensure compliance with HIPAA regulations.

del.icio.us Tags: twitter,facebook,google +,verizon,qualcomm,mhealth

Public Health and Nutritional Supplements

 

del.icio.us Tags: public health,apha11,nutritonal supplements,pom,weight loss,youth,celebrities

The American Public Health Association is meeting today in Washington, D.C. Public health has taken on a new meaning, with much more visibility and a proactive campaign which has captured the market place. Many entrepreneurs see the opportunity for profit in marketing healthy foods.

Nutritional supplements are one area of much controversy. For healthy people there are few dangers except for overdoses of Vitamin A and Vitamin D.Nutritional supplements are very loosely regulated and patients cannot be certain of what or how much “active ingredient” is present in a dose.

One spin off that is beneficial is the mindset of those using supplements and the associated discipline of a healthier life style, exercise and weight loss. One cannot rule out the psychological factors in operation by using a supplement.  Is this a form of hypnosis?

Some celebrities offer this as their recipe for youth, good looks, or weight loss, muscle building, and increased stamina. Their ‘celebrity’ often increases their reach and ‘credibility’ no matter if they are an actor, sports figure or successful entrepreneur.

You can follow the tweets from the meeting at #apha11.

Me, I am going to drink my carrot juice, and later have a POM wonderful !

 

 

Healthy People.go offers this list of Leading Health Indicators

Valley of The Dry Bones

 

The View From Here

Valley of the Dry Bones??

Today I am redirecting Health Train Express to “The View from Here”, another web site which I reserve for opinion on current events in medicine and in other socio-political controversy. Join me in a different kind of rant.

The fork in the road leads us the choice of which desert landscape we will proceed to from here.  In the far distance lies the mountain,

This photograph was taken in 2003 while residing near Palm Springs in Desert Hot Springs.  It was a unique time in my life while recovering from a heart surgery and a spine problem.

Disconnected from most concerns of modern times it brought me back to pioneer times. There were several old abandoned miner communities where we lived in a primitive cement block house on a sand dune.

Dry Gulch Road  Desert Hot Springs, CA 2003      Lower House

The View From Here

My spouse called this place “The Valley of The Dry Bones” (Ezekiel, 37:1-14)

Is America, like Israel in the Valley of the Dry Bones ? 

No one can quite explain why we are in this place of dysfunction and chaos despite what some of the supposedly brightest men who speak without wisdom tell us.

The problems are deeper than financial balance sheets, or political correctness. The Occupiers on Wall Street seem to know this to be true. So our educational system despite critics must be doing something right, or perhaps they are so ineffective in brainwashing our young people that their common sense can tell them right from wrong.

Health Train Express cannot exist in the present economic morass and social upheaval of “Occupy Wall Street” and the events of the past decade leading to our present stagnant economy and our morale, without rendering an opinion of an ‘old physician"’

The opportunity to introduce and give a head start to my other blog from Health Train Express is important because regardless of mandates by Obama care it is doubtful the mandates can or will be implemented in full.

Today I am redirecting Health Train Express to “The View from Here”, another web site which I reserve for opinion on current events in medicine and in other socio-political controversy.  Join me in a different kind of rant.