Idea2010: Communitiesof Care: Strategic Social Interaction Design for Healthcare: Amy Cueva

Communities of Care: Social Media in Healthcare Amy Cueva Mad*Pow @amycueva

Introductions, Agenda & Why I <3 Healthcare UX

Regina Holliday
@ReginaHolliday | http://reginaholliday.blogspot.com

The Healthcare Landscape

People Organizations State of health Influencers Interactions Objects Healthcare Landscape

A healthy caretaker

One managing a chronic condition

Social Media in Healthcare

This presentation
Social media defined
How it could help
The current landscape: examples
Ideas and opportunities
Risks, considerations & barriers
Success and failure
What have you seen?
What do you hope to see?

Please?
I know some stuff. I bet you all know more.
Make a comment or ask a question.

Social media…
is content created by people (UGC)
is based on user participation
includes social networks
is an umbrella term…
integrates technology & social interaction
are tools for sharing and discussing information among human beings

Under the common definition
Wikis : Wikipedia
Blogs/Podcasts: SME, with comments
Microblogs : Status updates, replies/comments
Forums : Niche, patientslikeme
Social networks : Facebook, LinkedIn, Twitter
Social sharing: YouTube, Flickr

Under an extended definition
Text : email, SMS or MMS, instant messenger, instant chat, secure message box
Voice : phone, voicemail, tele-conferencing skype, online audio recording
Video & Hybrid: video, webinar, video-conferencing/chat (online appointments)

Communication access points
Phone: Traditional, mobile, skype
Mobile/handheld: Multiple platforms
Computer: Personal or Dr. Office
Kiosk: Hospital or Dr. Office
Print: Fax, snail mail.
In person: Humans With or without tech
Via sponsors: Insurance, hospitals, providers, government, corps, orgs

Communication characteristics
Live or asynchronous
1 to 1 or 1 to many
Inbound or outbound
Proactive or reactive
Required or desired
Channel switching/coordination

Why social media for healthcare?
Doctors are outnumbered: There are many more patients than doctors.
Frequency & access: How often do you have access to a doctor vs. access to a computer, phone or mobile device?
The information is out there: In our minds, in websites and DBs. Tech and SM frees the info, makes it searchable/shareable.
We have the tools: Healthcare is behind.

Why social media for healthcare?
People care: They are motivated, there is a strong sense of community, karma, give and take.
It is already happening: The Pew Internet and American Life Project Survey says 61% of Americans go online for health information, with a majority turning to user-generated content.

How it could help
Informed, prepared, and empowered patients
Convenient access points, higher engagement
Emotional support
More persuasive, social proof

How it could help
Timely, robust, and different information availability and sharing, CDL, EMR, EHR, PHR
That one detail
Collaboration and coordinated care
Ongoing and more frequent interactions
Interventions, outreach
Drug adherence, biometric feedback

Ideas & Opportunities

Relationships, Frequency, and Access Track Reflect Become aware Encourage Achieve Celebrate Intervene Reach out Share Visit Inform Communicate Coordinate Escalate Obtain data Self Friends & Family Community Care Team Organizations

PHR & Social Media
PHR data feeds profile
Profile becomes matching system
Rich profile attracts relevant people, objects, interactions
Social media enables interactions
Data makes interactions more meaningful
Interactions produce data

Connecting Self
Wii Fit
PHRs, HRAs
Health Tracking Tools: iPhone Apps, SMS Trackers, health journals
patientslikeme: profile, tracking
SugarStats: Tracking

Promoting Positive Reflection
Baseline data is being gathered and the people are helping each other.
Can the system:
Help the user to notice and track the positive
Reinforce the positive in order to promote repetition
Provide guidance, include support team and introduce professionals at certain points
Track behaviors through and integrate with native communication channels: email, text messages, instant messages, twitter, facebook

Journaling
Take pictures of your food – nutrition and portion size analyzed for feedback
Take pictures of your walk – it get’s reflected back to you
Personalized outreach messages, communication plan to yourself

Patient Collaboration
Ning: Anyone can create a community on any topic, photo & video sharing, forum, blog, profile
Google Health Groups: Anyone, any topic, forums
RevolutionHealth : Forums, rate doctors
patientslikeme: Forum, profile, blog, status update, comment
SugarStats: Forums
Daily Strength: Forums, information, trackers
Twitter: Text, email, online

Enabling & Informing Patient/Doctor Interactions
PHRs, EMRs, EHRs
American Well: Immediate connection online or phone
RelayHealth: Web Visit (Form), Secure Messages
hellohealth : Email, IM, and Video Chat
patientslikeme: Forum - some caregivers participate
Healthcare Magic: Instant Chat, Request Phone Call
AthenaHealth: Automated and live communication
Twitter: Text, email, online

Enabling & Informing Patient/Doctor Interactions
Dr. and patients can log in to review lab results and xrays, via screenshare or live appointment
Log in to take a pre-visit questionnaire, fill out forms, and create questions for your doctor
View doctor’s notes from visit, (OpenNotes) and follow up care plan, track against it
Dr. access to your health journal
Ongoing dialogue with Dr: check in to review progress, leave notes, system can escalate, interventions
Connect with Dr. online via email, instant chat, SMS, online visit

Care Team Collaboration

Influence of the System Hi there.
How can the system do work for the user and for the doctor, bubbling up the most important information?
Can the dialogue the system has with you improve the quality of interaction you experience with your doctor? Can it become a healthcare interaction unto itself?
Can the system match people with similar traits, match people with specialists?
Can the system assist with forms? The patient could fill out forms ahead of time, so they don’t have to do it in the waiting room. Their answers can yield recommended questions, next steps, tests, etc.

Bringing it Together
There is information in many places, and holistic health portals with caregiver communication integration are starting to happen.
Take a mashup, portal or Blackboard approach: The patient’s entry point to all of their health care providers, personal supporters, communities, and health information w/ integrated digital communication and support tools.
Who will do this? Each doctor could have their own virtual office, health insurance companies, or PHR providers could push forward.

The content is the conversation. Designing Social Experiences:

Socio Cybernetic Model for Conversation

You can’t design the conversation But the interface can mediate, guide, inform the conversation The interface can encourage or discourage certain types of behavior - through identity, reputation systems, game mechanics... Social Media Design Basics

Start with the high-level strategic goals and objectives for the site – then answer: why community? What kinds of engagement do you want to encourage on your site? What is the desired outcome? There is no end-state! This will help map out your strategic direction. Why Community?

Rather than pursue Social Media strategies based on fashion, as designers we need to think about how we want the site to engage with people — who want to engage with each other and create architectures, features, and functionalities that creates a path for participation Ask: where is the community going to go? Participation Vision

Social Experience Design Considerations
Create articulated contexts
Design for identity
Interests, Passions, Goals
Presence
Groups, Tribes, Cohorts
Trust

Social Experience Design Considerations
Reputation
Conversation
Spheres of Intimacy
Privacy
Governance
Serendipity

In the end: community members will own it
Once designed, communities of care are not in the hands of those that funded, designed, built it - it must be handed over to patients and the community - letting go is the hardest thing
Shift thinking from “What it does” to “What people are doing and saying”
Create a system so that it can become what it will mean to each person, and as a result, service the community
“ The street finds it’s own uses for things”

Risks & Considerations
Get me one of those!: Select channels and solutions based upon relevancy and appropriateness as opposed to popularity
Blind deployment: Ensure user involvement in the design process and a solid strategy
Bad information: How will quality of information be measured, ensured, sustained, moderated, handled?

Risks & Considerations
Crisis mgmt: Set expectations, know when to react, and react appropriately
Legal action: Anticipate problems, understand audience expectations, explore potential uses and misuses, design for them
Stagnation: Plan to support and measure ongoing participation, contribution, and nurturing/guardianship

Potential Barriers
HIPAA
Legal
Probability of positive and clearly quantifiable results
Time and investment required
Lack of understanding or fear
Governance & operational support

Creating a social media strategy
What is our objective?
How will we measure success?
Who will be interacting? What will they want and expect?
What channels/media/technologies will best support the interaction?
Will this design work?
How much will this cost? How will it be supported?
What is our implementation and evolution plan?

What have you seen?
What has worked well?
What hasn’t?

What do you hope to see?
What will we see next year, or in 5 years?
What has inspired you?

Questions?

Design Challenge

Idea2010: Communitiesof Care: Strategic Social Interaction Design for Healthcare: Amy Cueva

by Amy Cueva on Oct 04, 2010

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