Category Archives: Health Technology

KevinMD.com Interview re: proliferation of Health Care Social Media (“HCSM”)

Sometimes in life, all you have to do is ASK.  That’s how I managed to get Kevin Pho, MD, Founder of KevinMD.com, a/k/a “social media’s leading physician voice,” to grant me an exhaustive Interview about the increased role of Health Care Social Media (“HCSM”) in the Practice of Medicine.  The combination of our respective backgrounds as Physician and Patient made for a compelling and informative interview which covered BOTH perspectives with respect to HCSM.  Ergo, whether you are a medical professional, patient, doctor, medical school student, etc., I think you will enjoy Dr. Pho’s informative and thoughtful answers as we talked about everything from Rating Physicians on-line to integrating mobile health & Smartphones into the traditional medical examination room to the present/future effects of ObamaCare on Healthcare and discussed the prospects of using technology like Skype for Video Medical Exams and chronic illness Follow-ups.

For those of you who are unfamiliar with KevinMD.com, here are the formidable accolades and “notices” of his extraordinary career in HCSM:

  • Social Media’s Leading Physician Voice
  • KevinMD.com is the web’s leading destination for physician insight on breaking medical news.
  • Klout named KevinMD.com the web’s top social media influencer in health care and medicine. (Klout is a company that provides social media analytics to measure a user’s influence across his or her social network. The analysis is done on data taken from sites such as Twitter, Facebook, and Google+, and measures the size of a person’s network, the content created, and purports to measure how other people interact with that content.)
  • Forbes hailed KevinMD.com as a “must-read blog,” and CNN named @KevinMD as one of its five recommended health care Twitter feeds.
  • His commentary regularly appears in USA Today, where he is a member of their editorial Board of Contributors, as well as CNN and the New York Times.  His opinion pieces highlight the challenges everyday doctors face, ranging from the primary care shortage to the epidemic of physician burnout.
  • He also shares his social media insights in the upcoming book, Establishing, managing, and protecting your online reputation: A social media guide for physicians and medical practices.

I separated the January 24, 2013, Interview into 3-parts and TODAY posted all three parts at once because Dr. Pho’s answers were so succinct yet thorough that I didn’t  see the point to staggering them out.  Accordingly, the Links to all three (3) are below and consume/enjoy them at your convenience and PLEASE feel free to share any COMMENTS on my Blog.

KevinMD.com Interview re: Health Care Social Media – Part 1 of 3

KevinMD.com Interview re: Health Care Social Media – Part 2 of 3

KevinMD.com Interview re: Health Care Social Media – Part 3 of 3

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MAW PPP January 28 2013

Liz Boehm of Experia Health – Humanizing the Healthcare Experience

In this  episode of “The Healthcare Interview,” Liz Boehm, Director, Patient Experience Collaborative, Experia Health, is asked about “The Patient Experience” by “professional” patient, Michael A. Weiss.

Experia Health, a subsidiary of Vocera Communications, Inc., is a proactive company whose team works with organizations around the globe to bridge the gaps in “the healthcare experience,” restoring and revitalizing the human-to-human connections to improve patient outcomes from a variety of perspectives. In plain speak, they strive to: “Humanize the Healthcare Experience.

In this 7-minute Interview, Ms. Boehm shares her smart insights and refined expertise on the status of “the healthcare experience,” the almost PTSD-induced pressures faced by dedicated healthcare workers and explains cutting-edge Patient Social Media communication tools such as www.CarePages.com and www.MDconnectME.com.  She also details the makings and importance of what could be the first successful “closed” or “secured” social media platform for “authenticated” adolescent hospital cancer patients, presently being tested at the prestigious Radboud University Nijmegen Medical Centre in The Netherlands, for whom ongoing and safely monitored communication with one another has been made possible.

Video Summary of 2012 “Partnership w/ Patients Summit” – Kansas City, MO

A few weeks ago, I had the good fortune of being awarded a “Travel Scholarship” from the Society for Participatory Medicine and other generous sponsors to attend the “Partnership with Patients Summit” in Kansas City, Missouri (Friday, September 21, 2012 through Sunday, September 23, 2012).  Mere words can’t fully describe the inspirational experience of meeting similarly-minded people who are so passionate and dedicated toward empowering patients so that their healthcare experiences are humane, effective and affordable. Ergo, the six (6) SHORT Video Interviews below.  The Attendees included chronic patients/advocates like me, various specialty doctors, pharmaceutical executives, healthcare delivery system representatives, healthcare news reporters and social media experts adept at helping patients and providers communicate with one another.

The Summit also focused on helping Advocates become polished professional speakers so that they could reach more people with their message and get paid a reasonable fee for doing so.  To that end, the generosity displayed by experienced Speakers like Regina Holliday (also the Organizer of the Summit) and “e-Patient Dave” deBronkart was extraordinary.

Rather than write a long Blog post about all that I learned at the Summit and the very kind “Twitter people” it provided the opportunity for me to finally met, I conducted the Six (6) SHORT (i.e. 5-7 minutes) Video Interviews pasted below with folks whom I thought were representative samples of the overall Summit experience.  I wish I could have interviewed many more people but it was difficult to keep up with the fast pace of the Summit and also try to document it all on Video.  Thus, I recorded a few Interviews in-between sessions and I think by watching them you will get an accurate “feel” for the Summit experience.

I hope you take the time, whenever you have the time, to watch all, or some, of the Videos because the “Partnership with Patients Summit” was truly a collection of passionate people uniquely dedicated to improving the “patient experience.”  As a patient, I am thankful for those efforts, and as an advocate, I learned a great deal about reaching more people with my message.

Interview with Evelyn V. McKnight, AuD:  Below is a 5-minute Interview with Evelyn V. McKnight who formed the HONOReform Foundation after being infected with Hepatitis C while undergoing chemotherapy for stage III Breast Cancer in 2000 because her oncology nurse commonly reused syringes to access a multi-dose container of saline while flushing several patients’ IV ports.

Interview with Licensed Psychologist Dr. Ann Becker-Schutte: As a patient with a chronic disease for almost 30 years (i.e., Crohn’s Disease), I’ve rarely come across a Psychologist who can compassionately relate to the daily challenges I face.  However, I was fortunate to meet such a rare doctor when I became acquainted with Dr. Ann Becker-Schutte at the Summit.  Dr. Becker-Schutte is also a patient with a chronic disease (namely, Polycystic Ovary Syndrome) from which she almost died so she also has a unique perspective about “End of Life” issues. Dr. Becker-Schutte represents the other similarly genuinely dedicated providers I met at the Summit.

Interview with the ultimate e-Patient “Facilitator,” Lisa Fields: Below is a 6-minute Interview with one of the most prolific e-Patient “Facilitators,” Lisa Fields.  Besides being so pleasantly surprised to meet her in-person after 18 months of being the recipient of her Twitter “wisdom,” I was able to get Lisa to share some of her “secrets to success” regarding Twitter, Social Media, Public Speaking, PowerPoint and Ignite Speeches.

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Interview with Olga Pierce, Reporter, PRO PUBLICA, an Online News Organization: “Journalism in the Public Interest” is the tagline for PRO PUBLICA.  With respect to Healthcare stories, PRO PUBLICA “bridges the gap” between Policy and Patient through a business model of Collaboration by which they share their stories with such prominent News Outlets as “Frontline,” NPR and USA Today.  Olga was kind enough to talk with me about her role as a Healthcare News Reporter in this process.

5 Minutes w/ Patient Advocate Extraordinaire, Regina Holliday: Regina is a highly regarded Patient Advocate and, as I was to learn, she employs very creative methods to help improve the “healthcare experience” including her artistic creation of, and contributions to, “The Walking Gallery.”  In this 5-minute Interview, Regina explains the specific objectives of the “Partnership with Patients,” we discuss how “The Walking Gallery” got started and she shares valuable information about getting started as a Paid Healthcare Speaker.

Family Practice Physician with a “Neu” Business Model: In this 6-minute Interview, I chat with Dr. W. Ryan Neuhofel (“Dr. Neu”) about the innovative new Business Model he uses for his Family Medicine Practice in Lawrence, Kansas.  He doesn’t take ANY health insurance but charges his patients a nominal “Membership Fee” ($10 – $20) and then simply bills for his time in 15-minute increments.  He also utilizes a great deal of technology and Health Care Social Media so that his patients can literally have 24/7 “continuity of care.” The combination of his intelligence, passion, logic and ingenuity attributes seem to make for an excellent Family Physician.

REAL Healthcare Reform = ObamaCare + eHealth + mHealth

ObamaCare is looked upon both positively and negatively as the end-all / be-all of Health Care Reform in the United States.  It is politically charged and subject to nationwide debate and likely repeated judicial challenge.  However, it need not be so divisive as it seems to have actually inspired and triggered other significant Healthcare reforms and Healthcare entrepreneurial advancements via legitimate Free Market Solutions, namely, “eHealth” [Electronic Health] and “mHealth” [Mobile Health].  This 4-Minute Video explains this interesting and ongoing technological development in Healthcare Reform.

 This is part of my “Two Minute Drill” Series of Healthcare Videos.  The phrase is taken from the NFL, i.e., United States Professional Football, and refers to that intense time of the last 2 minutes of the end of the 1st Half, or of the Game, when teams use a no-nonsense carefully timed 2-Minute Drill to most efficiently move down the field to score points.  With Television Commercials, the 2-Minute Drill often takes 10-15 minutes of “Real Time” and thankfully that affords me the ability to still use the phrase when my succinct Videos are sometimes 4 to 5 Minutes in length.  I hope you enjoy the Healthcare Content and that it provides you with mental stimulation and creative inspiration.

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Medical Patients R Most Valuable Resource in Healthcare

The Patient “Power” of Health Care Social Media (“HCSM”)

In my Humble Opinion, I think authentic Patient participation in “Health Care Social Media” (“HCSM”) will CHANGE the Status Quo of the Oil-Cartel-like practices employed by some Health Insurers which are causing Gross Inefficiencies in our Health Care System such that prices are inflated, the quality of services rendered are either rushed or diluted and access to quality healthcare is therefore limited.  Medical Professionals and Hospitals can’t fight Health Insurers on this because that would mean biting the hand that feeds them as, for the most part; Health Insurers control every payment for goods and services rendered by them.  But, Patients inherently yield a power independent of Health Insurers such that if they join together they will have more power than the Health Insurers because without Patients there is no revenue of any kind.  However, up until now, there has been no organized “movement” for Patients to consolidate, recognize and exercise this power.  But, now they have HCSM, which is a Patient-Driven “Medium” comprised of the seemingly unlimited Social Media Platforms such as Twitter, Facebook, Podcasting, Blogging, Vlogging, Virtual Patient Communities, Yahoo/Google Groups and Healthcare Portal Websites such as WEGO Health, Web MD, Mayo Clinic Center for Social Media and Discovery Health.

The Limitations faced by Medical Professionals on the Web

Up until now, the general public was under the WRONG assumption that any Web Healthcare Initiative must have some Healthcare Clinicians or Medical Professionals attached to it for it to be successful or even noteworthy but that is just incorrect (just read about the demise of “Google Health” as they had to learn this lesson most recently) as these well-intended medical professionals are severely limited in what they can do on the Web.  More specifically, they cannot interact with individual Patients in any meaningful manner on the Web; regardless of how well-intended they are, because they are constrained by the Legal, Licensure and Ethical issues understandably mandated by their respective Licensing Boards/Organizations such that they won’t anytime soon be disseminating Individual Patient Advice on the Web as the risk to their careers and personal reputations is too great.  That said, there are some cutting-edge Medical Licensing Boards which are trying to keep up with the dynamic nature of HCSM but new social media platforms are being used for Healthcare purposes every day which make it impossible for medical professionals to keep current and gauge the firmness of their footing when they seek to go where Patients are going when they are desperate and seeking information and answers.  Sure, they can always participate with general wellness articles regarding practice specialty issues of interest to Patients or even with general industry marketing information, etc. but they are as far away from the real, or meaningful, action on the Web and HCSM as Fans are from playing in an NFL Game as they sit at an NFL Football Game and watch the explosiveness of a Kickoff Return.  Medical Professionals are merely spectators watching Patients form a bond in HCSM that is NOW the new power-base of Healthcare.

The Lack of Limitations for Patients on the Web

So, why do Patients NOW have the advantage and the Power?  Just like how Consumers have come to trust the Web for Banking, Patients all over the world are now getting more comfortable by the minute sharing their healthcare information and experiences with others via the different HCSM platforms. What sets Patients apart from the aforementioned well-intentioned medical professionals is that their information and experiences are constrained on the WEB ONLY by their own respective sense of “Privacy,” whether that is keeping some information private from their workplace or not sharing certain experiences due to a sense of embarrassment.  However, Patients in need of information or experiences pertaining to, for example, “Medication Side Effects,” who wind up getting that Answer through HCSM, when no Doctor or Google Search was able to uncover it, seem more apt in the future to “get over” the possible embarrassing or workplace awareness issues of the “means” (i.e., HCSM) for the “benefit” (i.e., the Answer which is also a part of the “ends”) of the “ends” (i.e., possible vulnerability from a Privacy perspective but also the Answer/Information).  Thus, in a classic case of the Ends justifying the Means, I see more and more “Credible Patients” within these HCSM Platforms just like Banks and Vendors are witnessing more Consumers conducting their Banking and Bill-Paying via the Web every month.

Using HCSM as a Technology-Powered Grassroots Campaign of Change

As a result, HCSM provides Patients with an unprecedented opportunity to consolidate their brethren of fellow Patients and create a Technology-powered “Grass-Roots” Campaign to help each other.  Let’s face it, almost all societal change has been initiated through some type of Grass-Roots Campaign except NOW that type of “Change-Seeking Organized Movement” is powered by Technology (i.e., Social Media) and the results have been extraordinary.  Just ask the citizens of Egypt.  If a Technology-powered Grass-Roots Campaign can overpower a long-standing United States-backed Dictatorship, it is not a stretch to envision Patients getting organized and accomplished through HCSM, especially when medical professionals are powerless to influence the insulated world of HCSM, no matter how things look on the outside in terms of the participation of medical professionals in HCSM.  I am witnessing this happening unintentionally whereby Patients are creating almost instantaneous Databases of information and experiences which similarly-affected Patients are utilizing to create Virtual Patient Communities comprised of people who share the same Diseases, Medications, Side Effects, Treatments, etc.  These Databases are enhanced by the real-time conversations afforded by such HCSM Tools as “Tweet Chats” and “Tweetups.”  (FYI – “Tweet Chats” are online conversations, typically held at a pre-arranged time, between a group of Twitter users, and using a specific Twitter “Hashtag” to identify the discussion. A “Tweetup” is an event where people who use Twitter and Tweet Chats come together to meet in person.)

Summary:  Patients utilization of HCSM to help Each Other is THE Healthcare Efficiency “Game-Changer”

In summary, the result of Patients helping other Patients through HCSM simply by sharing information and experiences will create more “Informed Patients” so that when they interact with their real-life medical professionals those “transactions” are more Cost- and Time- “Efficient” which in turn will incentivize Medical Professionals and Hospitals to encourage Patients and their HCSM efforts.  Then, soon thereafter, Patients, Medical Professionals and Hospitals will join forces and use their respective influences to put an end to the Gross Inefficiencies presently prevailing in our Heath Care System due to the Oil Cartel-like practices of some Health Insurers.  But the engine driving this Change STARTS with Patients participating in HCSM in a meaningful manner so that they are Credible similar to Banking on the Web actually working as promised for those First Adopters.  This is why Patients are NOW the Most Valuable Resource in Healthcare and their utilization of HCSM to help each other is THE efficiency “Game-Changer” we have been waiting for.  The resulting Cost and Time Efficiencies will stabilize Price, increase the quality of Service and then Access to Healthcare will be dramatically enhanced so that more people will be able to afford Healthcare and the services they receive will be of a much higher quality than they are today. Win, Win.

Healthcare Significance of Google Health’s Demise & Possible Resurrection

The words “Demise” and “Resurrection” are clear contradictions in terms just as are the phrases “Kim Kardashian” and “Reality TV Actress.”  But that is exactly what Google unexpectedly ran into with its Google Health Initiative.  What started out as a seemingly hopeful Brand Extension into the “can’t miss” social media healthcare industry, which, let’s face it, is ripe with financial and growth opportunities for a savvy, behemoth company like Google, slowly morphed into that situation in high school when you bring your unbeatable 5-man hoops squad from the local Suburban Community Center into the big city to test its mettle against pick-up teams in the playground who leave no doubt as to the street smarts required to rule the game of basketball in the city streets, where the rims have no nets and even the little guys can jam the basketball.  Even your team’s leader, the tough, rebounding 6’10” Center with soft hands and a great shot gets painfully schooled by quicker Guards who aren’t nearly as tall or as talented but they understand the “hustle” of the game.  They “get” that winning is the only thing and participating with the better players on paper is useless without understanding the lay of the concrete courts.

Google Health had no idea that the profits hidden in all mainstream healthcare ventures lie in the gross inefficiencies hidden by the Health Insurers via Oil Cartel-like business practices with assistance from regulators who also benefit in one way or another.  These secret healthcare money-making practices and companies are guarded with such deep and formidable political cover that is only rivaled by the way in which Hollywood has convinced a global audience that Kim Kardashian is even a celebrity.  I think Google Health figured this out a little too late during the “Google Health 1.0” Initiative or somewhere around the 7th pick-up game of the day when even Ken Howard would have forced his “White Shadow” basketball team to pack it in to re-tool in order to fight another day. But “Coolidge” and “Salami” would live to come back another day to teach these playground players that a true “Team” with a well-executed and practiced plan can overcome even the biggest of odds.  After all, it was a TV Show which always ended with a message.

But who would have ever thought that with all its accomplishments on the web that Google would miscalculate a “David & Goliath” competition when they are actually “the David” and some Health Insurers “the Goliath”?  Sure, there’s more to Google Health’s recent demise but conceptually I think this is what Google learned and just like Coolidge and Salami, they will be back because how many other business situations with such big upsides will they be placed in the underdog role fighting for Right in an industry such as healthcare where their success is sorely needed to change the status quo and bring about meaningful healthcare reform?  I can’t think of any unless they decide to contribute to solving our national debt crisis.

Most medical professionals believe that all healthcare-related web initiatives are doomed to fail unless clinicians or other licensed medical personnel are a visible and significant part of the plan for roll-out, development and profitability.  This would seem to be an insurmountable barrier to enter the market for a company like Google Health which provided a Patient-Dedicated Service which stored and organized Medical Records. However, with the advent of “Health Care Social Media,” or “HCSM,” as it is frequently referred to as an acronym, something unique is developing on the web with healthcare involving Patients; and Patients only.  More specifically, as I learn more about HCSM, I think Chronic Patients like me yield a great deal of Influence in these healthcare web initiatives such that when a company as large, powerful and resourceful as Google gets flustered by not factoring this into their business plan and that miscalculation jeopardizes their entire healthcare initiative, this influential role of Patients in HCSM  needs to be examined and more carefully integrated into the business plan.

The fact is that Licensed Medical Professionals cannot yet participate in HCSM on a clinical individual Patient Care basis as their Licensure Boards, no matter how skilled, can’t keep up with the speed of Social Media.  This frustrating reality is applicable no matter how well intending these Doctors and Psychologists are with respect to branching out for the sake of being accessible for their Patients, and most are that selfless with what would be even more of a drain on their most precious of limited resources,namely, time.  As a result, they would leave themselves vulnerable to too many ethical, legal and moral cases of First Impression.  The smart ones heed the warnings of their attorneys and simply use HCSM to educate their Patients about new developments that affect their Patient Care and Patient populations.  Others use HCSM strictly for marketing purposes.  But some are also prematurely talking about ROI (i.e., “Return on Investment”) with respect to HCSM and thus trying to monetize HCSM before they even understand it.  However, as Apple Computer, Inc. taught us, we need to let the wine age a bit, the market define itself, then try to monetize it.

But lest we not forget that we are mostly talking about Doctors here, so they are bound to make the same mistakes their arrogant and greedy record company executive brethren made when faced with the same apparent opportunities to which Recording Artists, and in this case, Patients, also lay claim.  Although, I sincerely hope not because the younger Doctors I have been privileged to meet in the various virtual HCSM functions I have “attended” are SO SHARP and seem SO DEDICATED to Patient Care and to realistically regulating the Health Insurers who operate within the Health Insurance Industry utilizing the same unconcerned community-minded approach as the Oil Cartels that I am doing all I can to help them play a vital role in the development and growth of HCSM (and thus the emergence and re-emergence of Patient Medical Record Organization and Storage Services like Google Health).

To understand why HCSM is strictly a Patient-Driven Medium, you need to know that the only constraint on Patients sharing information and experiences with one another in HCSM is their own respective Privacy tolerance levels.  Personally, I don’t mind the world knowing that I have the incurable and auto-immune illness, Crohn’s Disease, and as a result, I have been hospitalized over 200 times and operated on almost 20 times.  I even wrote a Book about it called “Confessions of a Professional Hospital Patient” with the hope that others could learn from me sharing my information, experiences and lessons learned as I thought THAT was the Medium to disseminate all that I had learned.  A Service like Google Health offered Patients a place to safely aggregate their medical information so that it could be accessed easily by Medical Facilities and Medical Professionals all over the world thus freeing up Chronic Patients to live their lives to the fullest and never having to worry that a skiing accident in some faraway land could wind up a medical disaster where they would have to explain their unique medical condition to Doctors who speak a different language.  Even more important, a Service like Google Health would breed confidence in this type of Chronic Patient so that he or she actually goes on that trip or relocates to another city for a great new job opportunity without fear of being separated from their medical records.

An increasing amount of Patients understand the possible, if not probable, privacy tradeoffs to sharing their information and experiences in exchange for the same about their present health problem.  When they do so, they are creating Virtual Patient “Communities” of Empowered and Informed Patients with shared illnesses, symptoms, medications, complications, side effects, etc. When these Informed Patients tap into this almost instantaneous database of empowerment and consult with their real-life Physicians, the interaction is quicker, it is less intimidating for the Patient, the Patient Care becomes more collaborative in nature, and the overall Consumer Transaction is both more efficient and cost effective.  Amazingly, not one Clinician or Licensed Medical Professional was involved with the foregoing explanation of how a Service like Google Health would help in the transformation of “Patient 1.0” into the new “Google Health Empowered & Informed Patient 2.0.”  Accordingly, while it would seem counter-intuitive that Clinicians need be present to lend authenticity to a web healthcare venture, HCSM says differently and it is this underestimation which hurt Google Health.  In essence, what Google Health lacked was a modern-day Grassroots Marketing Campaign by Patients touting how useful the Service is to Chronically Ill Patients, for example, who can now travel the world knowing that all of their medical records are in one place and they need not wait for standardized Electronic Medical Records (“EMRs”) to be adopted worldwide.  And these days, Grassroots Marketing is akin to Social Media and thus it is powered by technology so it won’t take long for other Patients to get this message and find benefits of their own in these types of Services. Then, amazingly, medical professionals will come on board because that is where their Consumer Patients are.  Remember, ROI?

Therefore, the only ones dominating the HCSM playing field are Patients sharing information and experiences with other Patients for the betterment of their own Treatment as well as for the betterment of overall Healthcare.  This Patient empowerment will have a trickle-down effect which will be the Game-Changer we have all been waiting for in healthcare.   It is not going to happen as a result of healthcare reform as our political party system won’t permit the necessary changes without the other side neutralizing the effectiveness of any positive reforms.  But there is precedent for this type of success involving counter-intuitive traditional Grassroots Marketing effectuating broad-sweeping industry changes and in all places and industries it was set by a band in the Music Industry called “The Grateful Dead.”  As a result, they are one of the top grossing concert acts of all-time and they did it “acoustically,” i.e., without Technology, just Grassroots Word-of-Mouth.   Think about the influence and power of Patients utilizing the jet stream-like growth of HCSM to publicize Services like Google Health.  For the first time in many years, healthcare would then become an industry as hip as the Mobile Phone or Computer industries and that will attract top-notch employee talent and it will strongly incentivize  Physicians and Hospitals to enter into local Provider Agreements with the demographically appropriate Patients in the Google Health-type Service.  On the face of it, it appears that by just having Patients advocating a “Google Health” type quality Service within HCSM and having that Service follow The Grateful Dead business model we Patients will help bring about the changes in healthcare we have sought for so long.   Who else but Patients should be doing this anyway?

In terms of brief background on The Grateful Dead, while other bands saw touring and playing live concerts as an expensive and never-ending personal-demon filled global road trip experience that only served to market their latest albums/CDs, The Grateful Dead turned that business model on its head and instead built up their live concerts into their primary revenue-generating vehicle.  Therefore, their investment in encouraging fans to tape concerts and share them with one another created unique commodities such that if they played 300 different concerts in a given year then they had 300 Unique Products for that year. They also redefined “Community” as not just a “Place” but more as a destination where a fan could meet other fans and partake in experiences they both enjoyed and this included the purchasing of Grateful Dead Merchandise, another huge revenue-source. The “Suits” (i.e., the record company executives who always think they know best how to market an artist’s music) were concerned that encouraging the free swapping of live Grateful Dead concerts would cannibalize Grateful Dead album/cd sales but they completely missed what was really happening.  The Grateful Dead were sharing their music with the world in effect telling fans, “Check it out.  That is what we sound like when you come to see us play Live.  Stay in touch with us and when we come to your town, tell all your  friends, then come out and watch us play.  Better yet, come along for the ride and you can experience that sound in cites all over the world and you’ll be hanging out with people just like yourself who also enjoy how they feel when they listen to our music.”  A “Suit” can’t communicate all that in a Marketing Campaign.  Only a FAN CAN DO THAT, just like only a Patient can truly promote the benefits of a Service like Google Health.

Therein lies the rub, as they say, with Google Health, because the value of that Service to Patients is almost limitless and there are various Physician Practice and Hospital Provider Integrations possible within the demographically desirable Google Health EMR-like database (but, of course, only with the Patient’s prior consent).  Therefore, Google Health needs to get its Patient-Consumers to tout its Service so that it gets picked up by the powerful HCSM “winds of change” and becomes the norm for Patients whose most effective tool against the barrage of medical paperwork, appeals, prior authorizations, submission of claims, appeal of claims, etc. is Organization.  Unfortunately, in the most recent “Patient 1.0” version of Google Health they measured their progress and charted their course by the more traditional standards, and did not invest enough time and they undervalued the use of Patients as Testimonial Marketers.  At the same time, again by utilizing the “same old, same old,” they also overestimated the acceptance of, and participation in, the Service by medical practices as if that were some touchstone of success.  Remember, HCSM is a Patient-Driven Medium so catering to the Physician crowd instead of the Patient population is like going through the Oscar “Best Actress” eligibility rules with Kim Kardasian.  There is some cosmic rationale to that conversation, and she’s gorgeous so there’s that, but unless she marries a guy named “Oscar,” she will never utter that word when discussing business and her career.  (To Ms. Kardashian’s credit, she is a VERY bright business woman who also knows this and she knows exactly who her audience is and thus who she must cater to. Services like Google Health who tap into HCSM must do the same.   Physicians and Hospitals will follow in due time.)

It took the banking industry a long time to gain widespread internet acceptance such that busy people now pay their bills on line routinely.  So now with the internet being an integral part of everyday life and HCSM being an insulated Patient-Driven movement, all a Service like Google Health has to do is re-launch with the street smarts Coolidge and Salami learned from their foray into the city playgrounds playing hoops and start a Patient Grassroots campaign run through HCSM.  Once challenged by a formidable opponent as dominate as Google, the political and regulatory hassles of hiding the aforementioned gross inefficiencies in its healthcare insurance business will outweigh the financial gain guaranteed by operating as De Facto Oil Cartels and this will make these Oil Cartel-like Health Insurers blink.  That’s why we need a company the size of “Google” to get into this industry as the Government will never be a viable player due to the ever-present potential for political influence. Once HCSM exposes these gross inefficiencies through Patent Communities and Empowered Patients, which incidentally are as closely guarded by these Health Insurer/De Facto Oil Cartels as that of the acting talents of Kim Kardashian,  that’s when Hospitals and Physicians will get fully in the Game and THEN Services like Google Health will be the NORM and our Healthcare System will be truly Reformed.

Doctor-Patient Relationship – Communication, Collaboration, Mutual Respect & Trust

Due to Health Technology and the increased focus on Consumerism in Health-care, the Doctor-Patient Relationship is changing as fast as Congressman Anthony Weiner’s explanations about his Twitter transgressions.  All jokes aside, however, this is becoming a real problem for BOTH parties as Doctors try to service (and grow) their existing Patient Populations while simultaneously deal with increasingly challenging Health Insurance Company/Payor Productivity Payment Requirements and Patients literally don’t know what to do with their sudden “Patient Empowerment” which they keep hearing about from Dr. Sanjay Gupta on CNN.  As with anything else in Life, things ALWAYS come back to BASICS.  Thus, if you focus on Simplicity and treat others the way you would want to be treated, you can’t go wrong.  But how do we do that to fortify the Doctor-Patient Relationship in a 24/7, 365-day world of Health Care Social Media (“HCSM”) in which just one negative comment by a disgruntled Patient (or one with a basic personality conflict with the Doctor) can initiate an unfair world-wide Professional Reputation attack on a Medical Professional who was just trying to do his or her job?

As an almost 30 year sufferer of the Chronic, Incurable and Auto-Immune “Crohn’s Disease,” I have  had dealings with Doctors who have possessed a broad set of great, good and bad traits such as: gifted and compassionate; poorly skilled; poor communicator; excellent but with bad bedside manners (these are usually Radiologists by the way!); arrogant; strictly business (while being  closely examined – “Michael, your Surgical Wound looks like it is healing fine but did you know that you have an outstanding balance of $249,86?”); so myopic toward their own Specialty that if an ax were lodged into my forehead and they were a Pulmonologist they would give me the “all clear;” and bad listeners.  Given this continuing eye-opening experience, I have learned that the foundation of the Doctor-Patient Relationship rests on: Communication, Collaboration, Mutual Respect and Trust.

However, this foundation is a Two-Way Street as I find the most common problem with Doctors to be their refusal, reluctance or mere forgetfulness to use their most effective diagnostic tool, i.e., LISTENING.  Often times, their failure to Listen is driven by the extraordinary Diagnostic Testing Tools at their disposal such that it is now likely that a Test Result will tell them what they think they need to know, and thus they shun all Patient expertise no matter the Disease, Duration of Disease or constructive comment from the Patient.  Doctors should know better as Patients are PEOPLE and sometimes even the most technologically advanced diagnostic test will miss something so obvious or it will pick up on something completely irrelevant such that each miss or misdiagnosis could have been quickly dismissed by the Patient.

That said, Patients have an obligation to be succinct out of Respect for the Doctor’s Available Time when they do speak, elaborate or ask questions in an unsolicited manner during a consultation or examination with a Doctor since the Doctor is up against time constraints the Patient is unaware of and as a result the Patient is only allotted a certain amount of it and therefore it must be used wisely and for that Patient’s benefit.  But when the Patient “permits” the Doctor to do his or her job, this enhances the relationship for the next interaction – whenever that will be.  This “interplay” of sorts is where the Mutual Respect notion comes into play.  As the Joe Friday character from TV’s “Dragnet” would often say or infer, “Just the Facts, ma’am.”  Patients would be wise to be mindful of that same approach during the Doctor-Patient consultation/examination.

I also think Communication, Collaboration, Mutual Respect and Trust is most solidly built when both parties are conscious of establishing “consistency” because the Doctor-Patient Relationship requires a certain “familiarity” between the two (2) to afford enough time for each to best understand the other.  Over time, this comfort with one another breeds Trust and Credibility.  [This is why changing Doctors because of changes in Health Insurance Coverage is so difficult on Patients and I think almost discriminatory against chronically ill Patients like myself who count on a long-established relationships with particular Doctors in most efficiently treating Disease flare-ups.  It is also more cost-efficient but since the Health Insurance Companies operate their businesses like Oil Cartels, they don’t care about Efficiencies of any kind for if they did we would at least see Electronic Medical Records (“EMRs”) in place YEARS AGO.]

In summary, the Doctor-Patient Relationship is Fine; it just needs to get back to Basics.  Additionally, if “nurtured” properly, this professional relationship typically gets better over time.  If it does not, however, THEN it is time for the Patient to find a new Doctor.  Conversely, when the Doctor-Patient relationship stagnates and its lack of usefulness for the Patient is NOT apparent to the Patient (and that can easily happen  for a number of innocuous reasons), the Doctor should tell the Patient that he or she would be better served by another Doctor – especially in this new Global HCSM environment in which the possibility of an almost instantaneous unfair Reputation Attack is only a Tweet or  Click away.  BTW – that’s how a Doctor should handle unfair criticism that is posted in HCSM.  If it has malicious intent, call an Attorney but if it is simply a Patient venting, just stick to certain rules, be fair to all Patients, and treat your Patients as “People” AND in the manner YOU would want to be treated if they were the Doctor and you were the Patient.

WegoHealth.com asked: “What does ‘Health Technology’ mean to Me?”

This Picture was originally Published on the following Blog:  http://www.orangejuiceblog.com/2009/06/government-healthcare-review-reprint

Kudos to the Folks at WegoHealth.com for asking the Right Question at the Right Time.

First off, I think this is an incredibly TIMELY “Topic” and excellent Discussion Starter because I find that too many people and diverse groupings of Medical Professionals are trying to quickly figure out “Health Care Social Media” (“HCSM”) simply to monetize it and capitalize on what they think are its capabilities.  IMHO they are making the same mistakes made by the music industry when the Internet first made Digital Music so easy and enticing to download.  In hindsight, a “Wait and See” attitude would have been more prudent and served those music executives and litigious artists much better in the long run as the “newness” of instant digital 24/7 access initially made for a hot consumer commodity but soon wore off. Nevertheless, more open and technologically-savvy minds than the groovy cats  in the music industry, who incidentally made more money than they should have off of the creative work of others without taking anywhere near the career risks, grew the new medium availability of music into a viable business model.   This new iTunes-dominated business also changed Buying Behaviors and Consumer Consumption of Music.  “Collaboration” for maximum benefit to all interested parties (i.e., Fans, Bands, Writers, Music Publishers, Record Companies, Apple, iTunes, etc.) seems to have been the Lesson and still  drives the end-game even if the per-song percentage payout is less than that previously generated by retail.  But adapting to, and THEN learning how to utilize, new technology are keys to survival and profitability.  That Lesson needs to be carefully  monitored with respect to HCSM, especially at this point in time when it seems to be  purely a Patient-Driven medium.  Therefore, while the end-game for HCSM and its capabilities is not yet defined, I think the more productive conversation is about “Health Technology” since THAT is what we are really talking about.  What is it?  How can we use it?  Is it different for Patients and Medical Professionals?  Is HCSM the industry of “Health Technology” or just an Application of it?

Accordingly, when posed with the question, “What do the words Health Technology mean to Me?” I instantly make a Separation between Health Technology for Patients and Health Technology for Medical Professionals.

As somewhat of a “Professional Patient” having battled Crohn’s Disease for the past 25 years with 200 hospitalizations under my belt, I first think of Health Care Social Media and the various Patient Technology Tools that are derived from “Health Technology.”   That said, however, I think the medium of HCSM will evolve into “THE” Game-Changer of Health Technology by bringing “Efficiencies” back to both the business of Health-care and to the Practice of Medicine.  The almost instantaneous database-like availability of Patient information and experiences created through HCSM allows Patients around the Globe to access what they need, when they need it, directly from other Patients in similar circumstances.  Thus, HCSM could become a Behavior-Changing medium much the same way the creation of Amazon.com changed the way we purchase Books after first reading about them in The Sunday New York Times.

In the “old days,” we’d jot down the Book Title and eventually make it to the Bookstore to purchase the book but now we spark up the Computer and with just a few clicks the book is on its way to our homes.  Audio-books have even improved upon that “Purchasing Experience Efficiency.” This type of impact would be extraordinary with HCSM and I think it is entirely possible since no one but Patients can participate in HCSM in any meaningful way for fear of Ethical, Legal and Licensure Constraints no matter how well-intended they are or how up-to-date their respective Professional Licensing Boards are with respect to the possible perils of Social Media and Health Technology.  HCSM, and some aspects of Patient-driven Health Technology “Patient Tools,” are simply moving too fast for Medical Professionals to be adequately protected from the perils of a Global Patient Population seeking medical advice 24/7.  So, if Patients take their HCSM  “Credibility” responsibilities seriously, Health Technology will have created an Amazon.com-like Clearing House of Information and Experiences which Patients can utilize to more efficiently manage their Health-care issues which in turn will assist Physicians and Hospitals in treating a much better informed and prepared Patient Population.

By way of example, I use “Health Technology” every day when I Tweet about HCSM, or seek input about the side effects I am having to Crohn’s Disease medications or ask for  recommendations about Doctors.  This use of Health Technology often leads me to Niche Health-care Facebook Pages where I learn even more detailed information.   As a Patient, I also “Subscribe” to Disease-specific email Yahoo or Google Groups which bring individual Patient stories and queries to my email in-box every day.  I try to participate in the dialogue so that I don’t “take” more than I “receive.”   I also do this with Medical “Key-Word” searches on Yahoo and Google so that at the end of each day I am up-to-speed on the latest research on Crohn’s Disease.  I also Subscribe to several Medical Podcasts and even Host my own which focuses on Living with Chronic Illness.  This helps me stay current with the latest issues I may be faced with either regarding my illness or regarding Health-care in general.  I also participate in a variety of “Tweet Chats” which are medical-related and usually comprised of such a diversified audience of folks involved with Health-care that I come away ALWAYS learning something new or at least made aware of a different perspective.  It is also fascinating to converse with people in Australia, for example, about how Health-care is faring in their country.   I also read certain Blogs and maintain one myself (Voila!) and this gives me the opportunity to share with others what I’ve learned from the above and/or it offers me the chance to share information and experience that might help others.

When I think about “Health Technology” from a Medical Professional’s point of view, I think about an exchange I had last evening with a Physician who wondered how Patients can get the best Health-care without having a Smart-phone!!  Perhaps I am narrowing the point she was making but I am trying to illustrate that we are talking about Two Completely Different Worlds when we try to explain “Health Technology” and what it means to Patients as opposed to its purpose in the day-to-day lives of Doctors, Nurses, Technicians, Medical School Professors/Students, etc.  I happen to think that is a GOOD THING because HCSM seems to be a Patient-Driven Medium whereas the Mobile Phone (and many other Technology Gadgets) seem to be efficient and effective Health Technology Tools for Physicians and Hospitals.  I do think a Smart-phone can be a GREAT aid to Physicians who are always pressed for time and thus anything which provides them with more clarity is betterment to Health-care and that is good for Patients.  Electronic Medical Records (“EMRs”) also come to mind in this side of the “Health Technology” discussion as it is an Eventuality because we must break away from the Inefficiencies seemingly favored by behemoth Health Insurance Companies and other Payors who utilize Oil Cartel-like business practices hoping that Health-care is never made Efficient such that it becomes more affordable, more effective and therefore more accessible to more people.  There is much debate about the adoption of EMRs and at this point in time I think ANY argument against them is ridiculous because if we are routinely doing Banking on the Web, and with no problems, then there is no longer a viable excuse not to use EMRs.

Other than that, I think of “Health Technology” for Medical Professionals as any Gadget or Tool which enables them to Diagnose/Treat faster and more accurately and which generally enables them to do their jobs in the most safe, effective and efficient manner.