American Voices - Aligned for Health
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Kaiser Permanente has released the results of a new data analysis focused on how physicians, health reporters and policymakers talk about health. The analysis found significant differences among the ...

Kaiser Permanente has released the results of a new data analysis focused on how physicians, health reporters and policymakers talk about health. The analysis found significant differences among the three groups studied, underscoring a need for greater alignment among key influencers around pertinent health issues impacting Americans. The data will be presented today at an expert panel discussion event sponsored by Kaiser Permanente's Institute for Health Policy. The event, "American Voices--Aligned for Health," will be held at the Kaiser Permanente Center for Total Health in Washington, DC.

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  • 81% are internet users (Pew Online Health 2013(US adult population is ~ 240MM http://datacenter.kidscount.org/data/acrossstates/Rankings.aspx?loct=2&by=a&order=a&ind=99&dtm=416&ch=a&tf=867So 195,000,000 are internet users … and 68,000,000 self diagnosersTwitter Users: http://techcrunch.com/2012/07/31/twitter-may-have-500m-users-but-only-170m-are-active-75-on-twitters-own-clients/Twitter
  • 68M Americans are diagnosing themselves or their loved ones … about half will then go to see their physicians.
  • 3,200 MDs154 Journalists458 Members of the 112th US Congress
  • Those numbers are hard to comprehend …so let’s think about it like this. The first rigorous study on physicians’ use of twitter was published in 2011, and used about 5,000 tweetsLet’s put that in the context of something more tangible than a tweet. Let’s imagine it as a house.
  • Mount Vernon is a lovely local place – and a pretty big one too. Let’s say the 5,000-tweet study is Mount Vernon (9000 square feet)
  • When MDigitalLife made its debut at the Mayo Clinic at the end of October, 2012, it had 403,000 tweets.
  • Relatively speaking, that’s like the US Capitol – checking in at Almost 600k square feet
  • But the 2.3M physician tweets in this study takes us back to my old stomping grounds …
  • It’s the equivalent of a Sears Tower worth of data – and growing every day.4.4M square feetPhoto http://www.flickr.com/photos/jigsaw/479101383/ by Maciek R
  • Over 300,000 News Articles … which makes a really big difference. Sometimes the 140-character limitation of a tweet makes it harder to analyze for context … but there’s no such trouble with the articles and white papers we see online.
  • By my count, the latest Sunday New York Times had a little over 300 articles.… So this many articles is equal to about 1,089 Sunday New York Timeshttp://www.flickr.com/photos/binarydreams/251690096/ by Jeff Myers http://www.flickr.com/photos/binarydreams/
  • So we’d have to read every one going back to 1992! http://www.flickr.com/photos/keithwj/3425577/ by Keith Jenkins http://www.flickr.com/photos/keithwj/In fact, if we hired someone full time … to do nothing but read the data we used in this analysis …
  • It’d take over 8 years.
  • We started with the CDC’s Diseases and Conditions listing … but we didn’t just want to cover illness. We wanted to cover all aspects of health.
  • Not really. And if we’d left it that, we could all say, “that’s interesting,” and go on about our business.It’s when we start looking a little deeper that things get interesting. When we can start quantifying those difference as opposed to just recognizing them
  • These are the most-discussed diseases and conditions by DoctorsThere’s something that they all have in common at some level … and it’s that when people are properly educated, they can generally improve their chance of avoiding them altogether.
  • These are the most-discussed diseases and conditions by DoctorsThere’s something that they all have in common at some level … and it’s that when people are properly educated, they can generally improve their chance of avoiding them altogether.
  • Top Linksnpr.org16medpagetoday.com15latimes.com9alvinblin.blogspot.com7annals.org7jwatch.org7medscape.com7usatoday.com7wsj.com7penispowerbook.com6aafp.org5ascopost.com5youtube.com5
  • Americans are more than twice as likely to die from lung cancer vs breast cancer, but Physicians mention breast cancer 4x more frequently. The disparity is even greater for journalists and congressmen.2009 Stats, USCS http://apps.nccd.cdc.gov/uscs/toptencancers.aspx
  • Mortality stats – heart disease http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_06.pdf; AIDS http://www.cdc.gov/nchs/data/dvs/deaths_2010_release.pdf
  • The media focuses their tweets on HPV much more than doctors. They tweet about conservative public officials who are skeptical of its benefit as well as more public health oriented tweets to generate awareness. It is very rarely referenced in relation to cervical cancer.Doctors discuss HPV in only 4.2% of their vaccine conversations. They mention its potential in preventing cancer and urge vaccination.
  • Also Palliative careSocial media and its impact on healthcare
  • The media talk about the expansion of medicare and medicaid radically more than physicians do …Celebrity health issues are frequently shared by the media – usually for the public good (e.g., Paula Deen and her diet)
  • http://www.flickr.com/photos/kirstelisa/3567711866/ by kirstelisa http://www.flickr.com/photos/kirstelisa/http://www.flickr.com/photos/silverstack/8058364924/ by SilverStack http://www.flickr.com/photos/silverstack/
  • A greater percentage of Congress’ healthcare tweets focus on these terms, which include "health insurance" OR copay OR medicare OR medicaid OR obamacare OR "universal healthcare" OR "single payer" OR insurer OR "health plan" OR "pre-existing condition" OR "insurance exchange" OR "medical insurance"
  • 32% MDs link to a personal blog or website, 38% link to a practice website, 9% link to a business and 2% link to a medical resource.
  • After plastic surgeons, orthopedic surgeons were the second highest of any % at 78.5% of practice links, followed by Dermatology at 77% of practice links. The specialty with the highest % of personal blog/website links is pathology at 66.7%. The specialty with the highest % of business links was is Anesthesiology at 22.7%. The specialty with the highest % of Medical Resource links is also Pathology at 22.2%.
  • The average ratio for all twitter users is 1:1. http://thenextweb.com/socialmedia/2010/09/30/twitter-statistics-82-of-twitter-users-have-less-than-350-followers/The average ratio for our MDs in 1.1 : 1.
  • Percentages represent the percent of MDs within that category that have at least 20 MDs from database following them.What are the implications for different uses of twitter?  Engagement vs. Filtering vs. Newsgathering vs. Spamming
  • % of MDs followed by at least 20 other MDs by specialty: Pain Medicine 50%, Family Medicine 49%, Pediatrics 45%508 of 1397 36% were mentioned at least once by another physician in the data set

American Voices - Aligned for Health Presentation Transcript

  • 1. American Voices – Aligned for HealthGreg MatthewsFebruary 26, 2013 Contents are proprietary and confidential. #AVA4H | @chimoose1
  • 2. My use of twitter allows me to expand the diversity of my network, and therefore my knowledge in my areas of interest : prevention, diversity/equity, integrated care, and Washington, DC (the #epicenter!). It also allows me to model open leadership as a physician, and promote this approach among my medical and nursing colleagues. Ted Eytan Family Medicine, Kaiser Permanente twitter.com/tedeytan linkedin.com/in/tedeytan tedeytan.com Contents are proprietary and confidential. #AVA4H | @chimoose2
  • 3. Internet users are searching for health info 72% 140 Million American AdultsPew Internet and American Life – Online Health 2013 3 Contents are proprietary and confidential. #AVA4H | @chimoose
  • 4. Self-diagnosis is mainstream 35% of internet users are considered “self- diagnosers”Pew Internet and American Life – Online Health 2013 4 Contents are proprietary and confidential. 4 #AVA4H | @chimoose
  • 5. Twitter is an information accelerator • 25% of physicians use social media daily as an information source* • Facebook has passed 1B users; • Twitter has surpassed 500M UsersJournal of Medical Internet Research – September 24, 2012 5 Contents are proprietary and confidential. #AVA4H | @chimoose
  • 6. Tweets Over Time Trending steadily upward45004000350030002500200015001000 500 0 1 11 21 31 41 51 61 71 81 91 101 111 121 131 141 1516 Contents are proprietary and confidential. #AVA4H | @chimoose
  • 7. The American Voices study7 Contents are proprietary and confidential. #AVA4H | @chimoose
  • 8. AVA4H Data Sets 2.3M 132,108 464,272 218,934 36,300* 71,606*Journalist-written articles 8 #AVA4H | @chimoose
  • 9. 5,0009 #AVA4H | @chimoose
  • 10. 10 #AVA4H | @chimoose
  • 11. 403,00011 #AVA4H | @chimoose
  • 12. 12 #AVA4H | @chimoose
  • 13. 2,300,00013 #AVA4H | @chimoose
  • 14. 14 #AVA4H | @chimoose
  • 15. Not just tweets this time … 326,84015 #AVA4H | @chimoose
  • 16. 16 #AVA4H | @chimoose
  • 17. 17 #AVA4H | @chimoose
  • 18. 18 #AVA4H | @chimoose
  • 19. Making Sense of the Data19 Contents are proprietary and confidential. #AVA4H | @chimoose
  • 20. Topical Breakdown• CDC Disease list• Broad Health Topics from Subjects’ tweets20 #AVA4H | @chimoose
  • 21. What we Learned21 Contents are proprietary and confidential. #AVA4H | @chimoose
  • 22. At the highest level … Health Education Business of Health Politics of Health Contents are proprietary and confidential.22 #AVA4H | @chimoose
  • 23. At the highest level … Health Education Business of Health Politics of Health Contents are proprietary and confidential.23 #AVA4H | @chimoose
  • 24. Strongest Focus Areas Healthcare Conversation Topics 100% 90% 23% 15% Percentage of Healthcare Conversation 80% 47% 5% 70% 10% 15% 60% Treatment 6% 22% 50% Research 40% Prevention 27% 11% Policy 30% 64% Business 20% 14% 33% 10% 6% 0% Doctors 2% Media Congress24 #AVA4H | @chimoose
  • 25. Where education makes a difference25 #AVA4H | @chimoose
  • 26. Making a comeback Contents are proprietary and confidential.26 #AVA4H | @chimoose
  • 27. A new #1 Vaccine-Preventable Diseases27 #AVA4H | @chimoose
  • 28. Doctors armed for combat Contents are proprietary and confidential.28 #AVA4H | @chimoose
  • 29. Disease Conversation Volume Over Time 100 90 80 70 60 50 40 30 20 10 0 Diabetes Breast Cancer Prostate Cancer29 Contents are proprietary and confidential. #AVA4H | @chimoose
  • 30. The PSA Controversy 36 117 Doctors who state an opinion are more than 3:1 Against the USPSTF’s 182 ruling on PSA Tests Negative Neutral Positive30 Contents are proprietary and confidential. #AVA4H | @chimoose
  • 31. The Voice of the Patient Matters31 Contents are proprietary and confidential. #AVA4H | @chimoose
  • 32. Doctors discuss Breast Cancer and Lung Cancer 100% 90% 80% 70% 60% Breast Cancer 50% Lung Cancer 40% 30% 20% 10% 0% Mortality/1,000 Conversation Frequency32 #AVA4H | @chimoose
  • 33. HIV/Aids and Heart Disease 100.0% 80.0% 60.0% 40.0% AIDS/HIV Heart Disease 20.0% 0.0% Contents are proprietary and confidential.33 #AVA4H | @chimoose
  • 34. Vaccines - HPV HPV makes up 18.2% of media vaccine conversations 100% 4.2% 90% 18.2% 80% 70% 60% 95.8% 50% 40% 81.8% 30% 20% 10% 0% Doctors Media Other Vaccine Conversation HPV34 #AVA4H | @chimoose
  • 35. Content Gap Analysis Methodology Corpus 1 Corpus 2 • The Content Gap Analysis is a statistical comparison of word frequencies between 147 documents 80 documents two corpora of text 1,789 words 917 words • These two corpora are typically either: • A subset of one corpus compared against the Word Frequency Word Frequency whole corpus medicine 10 vaccine 6 • Two distinct corpora compared directly ƒ(x) drug 8 medicine 6 vaccine 7 drug 4 against each other vaccination 7 vaccination 3 wellness 6 health 2 • The outcome is a list of words that appear in both corpora with an associated Word G2 “oddness” score that medicine 3.42 denotes how much more (or drug 2.81 less) each word appears in vaccine 1.14 one corpus versus the other vaccination 1.1235 #AVA4H | @chimoose 35
  • 36. Interventions – MDs and the Media36 #AVA4H | @chimoose
  • 37. The untouchable – and the social?37 #AVA4H | @chimoose
  • 38. Medicaid and Mandela38 #AVA4H | @chimoose
  • 39. High Risk/Low Effort • Doctors discuss 67% more than the media; • 483% more than congress39 #AVA4H | @chimoose
  • 40. Insurance and reimbursement• Congress & the media lead the way in exploring how we’ll pay for care in the future• Physicians, while concerned about patients’ access to care and the viability of primary care, can be better informed 14% 48% Doctors 38% Media Congress40 #AVA4H | @chimoose
  • 41. Aligning communications – what’s next?• Patient-centeredness first• Create more robust and transparent networks (inter- and intra-group)• Build consensus on the balance between “most important health stories”• Monitor progress with a public “dashboard”41 #AVA4H | @chimoose
  • 42. Thank you #AVA4H | @chimoose
  • 43. AcknowledgementsAnalytics Design – Seth Duncan (@PRResearch)R&D Lead – Matthew Hager (@iSmashew)Analyst – Kayla Rodriguez (@Kaylarodrigue11)Analyst – Dan Zhao (@denzelzhao)Analyst – Emma Ferguson (@EmmaAnAnalyst) #AVA4H | @chimoose
  • 44. #AVA4H | @chimoose
  • 45. Appendix #AVA4H | @chimoose
  • 46. Physician Profiles 78 % identify themselves clearly as such in their twitter bio 32 % link to a personal blog or website 80 % contain a URL in their bio46 Contents are proprietary and confidential. #AVA4H | @chimoose
  • 47. How are MDs using their accounts? Bio URL Distribution 6.90% 1.90% 93 % of all Plastic Surgery 37.70% URLs are links to their practice 31.90% Business Medical Resource Personal Blog/Website Practice47 Contents are proprietary and confidential. #AVA4H | @chimoose
  • 48. Twitter and the MD Workflow Localized time Morning Workday Work PM Evening Overnight (0500 – 0800) (0801 - 1200) (1201 - 1800) (1801-2300) (2301-0459) 18 % 21 % 31 % 8% 22 % 31% 21% 22% 18% 8% 0500-0800 0801-1200 1201-1800 1801-2300 2301-045948 Contents are proprietary and confidential. #AVA4H | @chimoose
  • 49. The Connected Physician49 Contents are proprietary and confidential. #AVA4H | @chimoose
  • 50. Ratio of following to followers Ratio of Following to Followers 32.40% Median 21.50% Ratio 1.1 : 1 16.20% 14% 6.70% 4.90% 2.80% 1.60% 0.- .1:1 .11-.2:1 .31-.7:1 .71-1.5:1 1.51-3.0:1 3.1-11.0:1 11.1-100.0:1 100.1-2808:150 Contents are proprietary and confidential. #AVA4H | @chimoose
  • 51. MDs Most likely to be followed by peers* 25% 53% Personal Blog/Website 27% Business/ Organization All_Doctors No Bio URL practice 34% 40% *Percentages measure MDs followed by at least 20 others in the data set51 Contents are proprietary and confidential. #AVA4H | @chimoose
  • 52. How connected are online physicians? % 34 of all MDs are followed by at least 20 MDs Pediatrics Specialties who Emergency are followed by Medicine other MDs Family Medicine52 Contents are proprietary and confidential. #AVA4H | @chimoose
  • 53. Mining the Data A sample • Breast Cancer: (breast AND (cancer OR carcinoma)) OR (inflammatory AND breast) OR (inflammation AND breast) OR (breast AND (metastasis OR metastic)) OR (duct AND (carcinoma OR cancer)) OR (lobe AND (carcinoma OR cancer)) OR "DCIS" OR "LCIS" OR (estrogen AND receptor AND positive) OR "HER2" OR (breast AND MRI) OR (breast AND biopsy) OR (breast AND ultrasound) OR "mammogram" OR "mammography" OR "tamoxifen" OR (aromatase AND inhibitor) OR "exemestane" OR "trastuzumab" OR "Herceptin" OR "lumpectomy" OR "mastectomy" OR "komen" OR "BRCA1" OR "BRCA2” • Diabetes: "Diabetes" OR "Mellitus" OR "Insipidus" OR "Diabetic" OR "Gestational" OR "blood glucose" OR "Blood Sugar" OR "NIDDM" OR "IDDM" OR "LADA" OR ("Antiduretic Hormone" OR "ADH") OR ("Arginine Vasopressin" OR "AVP") OR "oral glucose tolerance" OR "fasting plasma glucose" OR "glycated hemoglobin OR HbA1c OR A1c" OR "insulin" OR "SMBG" OR "hyperglycemia OR hyperglycemic" OR "biguanides" OR "Sulfonylureas" OR "Meglitinides" OR "thiazolidinediones" OR "alpha glucosidase inhibitor" OR "GLP-1 agonist" OR "DPP-IV inhibitors" OR "DKA" OR "HHS"53 Contents are proprietary and confidential. #AVA4H | @chimoose
  • 54. Diabetes & Breast Cancer – Sample Search Contents are proprietary and confidential.54 #AVA4H | @chimoose