Technology and Healthcare Communications


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Lecture to MPH class at Stony Brook University

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  • There has been a great evolution in eCME and technology-based CME Technology has always played a role in CME Increasing use of technology to deliver CME continues to be seen There are roles for technology beyond just delivery and evaluation in CME
  • Let’s talk about how physicians communicate their ideas to each other to inform their practice of medicine. The production of knowledge in medicine is still dominated by traditional formats such as journal articles, print textbooks and e-books, and conferences like this one. Physicians also communicate informally in their daily work through conversations; meeting for coffee, talking about patient care, individual cases and teaching residents. This process of talking, having conversations, in a community of practice is critical for physicians. Making knowledge through conversations, sorting through ideas and research, is a process of understanding, being critical, and applying information in a meaningful context, what Lave and Wenger call a “community of practice”. doctors, in general, are constantly communicating with one another about medicine whether formally (journals, conferences, meetings, CME sessions, etc) or informally (on the floor, during breaks, online, at home, etc). Because of this, Web 2.0, which epitomizes constant communication, is a natural tool for doctors to use.
  • Doctors are social, and the practice of medicine is inherently social. And this is where Web 2.0 offers some direct and immediate opportunities for physicians. Put simply, Web 2.0 creates conversations. The software or tools – such as blogs and wikis – facilitate socialization. To be a good doctor, you need to know a lot, and medical education does a terrific job of teaching those facts. But a doctor needs to be able to communicate, especially with patients, what we might call a good bedside manner. Beyond that, doctors need to have methods for lifelong learning, and a digital means to process information through conversations. A new axiom I am using these days is that all knowledge begins with conversations, from an excellent book written by a librarian called “Thinking for a living: the coming age of knowledge work”. I recommend it highly if you are interested in the idea of a knowledge based economy. “ Socialmedia is NOT a fad, it’s a fundamental shift in the way we communicate.”
  • Physicians are embracing social networks as well. In a study done last year, 60% of physicians were interested in participating in physician only social networks.
  • So what is the social impact of web 2.0? Blogging for example is a stimulus for discussion, and to help physicians direct their knowledge management routines and current awareness. There are a number of useful educational blogs that I recommend to physicians: 1) Dr. Ves Dimov’s Clinical Cases and Images blog. There are other useful blogs by other physicians, such as and a Stanford medical student’s blog called Over!my!med!body which provides a lot of insight into what med students are thinking and observing in their training. And of course librarians that are interested in searching are set up to help physicians find information, which is integral to doing their research.
  • Clinical cases and images blog, which was featured in the December 2006 BMJ.
  • There are a number of medical wikis in development, and here are a few good examples. i.e . AskDrWiki produced by the Cleveland Clinica is a good free source of x-rays, and other general medical information; FluWiki which is also physician developed is set up to help communities prepare for an outbreak of influenza; Ganfyd, a general medical wiki, stands for “get a note from your doctor” and is expert-moderated, which is to say that only phyisicians approved by the editor can contribute and edit entries; and PubDrug and wikisurgery are also worth looking at in some detail for the kinds of information they offer.
  • What these numbers demonstrate is that physicians are taking advantage of the tremendous opportunities CME activities provide for medical practitioners to keep up with new information affecting the delivery of medical care. While ongoing participation is required by most physician state licensing boards and the licensing boards for other types of healthcare providers, such as physician assistants and nurse practitioners, both groups have the freedom to choose what types of programs they attend and in what mediums.
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