Social media and healthcare delivery

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Dr Wayne Usher - Griffith University, EPS.
2010
Griffith E-Platforms: New media
for advancing e-health, e-business,
e-learning and e-marketing………
Continuing Professional Development or
Educational Modules.

What is the aim of this
presentation....
1. Identify current international / national trends
associated with e-health, e-business, e-learning and
e-marketing – social media, web 3.0, iPads, smart
phones and e-PHR.
2. Present a proposal for addressing the lack of
adoption – for all sectors.
3. Outline future possibilities for other key industries –
concerning the design and presentation of Online
CPD / Educational Modules.
4. Present an overview of the future and where CPD is
heading.30/11/2010
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Specifically this presentation will
address........
5 specific sectors that are fundamentally changing
due to Web 2.0 – 3.0, these are:
1. Health
2. Fitness
3. Education
4. Business
5. Marketing30/11/2010
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The beauty of modern
technology is that it is
portable across many
sectors.. In many
respects boarders are
becoming blurred, with
only the content
changing not the means
of distribution.....

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• Web 1.0 (1991 - 2003) - one way ‘push’
broadcasting; static content; ‘nice website’
• Web 2.0 (2004 - present) - interactive
engagement; network as platform;
populate the cloud via relevant digital
content; appropriately tagged by keyword,
or ‘metadata’
The evolution of ‘the web’

Traditional hospital-based
health care system
Obesity

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Paper-based personal health record

What is the future?
Web 3.0
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• http://www.ibrc.com.au/product_details.php?
product=web3_2011
12
• Web 3.0 (the future) - the semantic web (still poorly defined); though
‘smarter bots’, artificial intelligence filters; virtual or augmented reality
http://www.aimia.com.au/enews/events/newsletter/web%203%20and
%20the%20future%20of%20social%20media.pdf

We are already seeing early
evidence of the Smart Web
http://chemistscorner.com
Intelligent Filtering
Recommender systems

What is the current situation with
Australian Allied Healthcare providers
Why aren’t Australian AHPs using social media
(Web 2.0) for health care delivery?
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30/11/2010 20Dr Wayne Usher - Griffith University, EPS.
2010

Blogging
Feeding
Viewing
Professional
Networking
Open
Networking
Closed
Networking
Sharing
It’s a JUNGLE out there !
Observation
Platform

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Social Media and healthcare
in Australia
Look...
but don’t touch

Current attempts......
http://bitethedust.com.au/bitingthedust/2010/12/01/social-media-and-the-medical-profession/
“ not much out there.....”
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Social Media in healthcare
in UK
Survey of 212 Medical Students June 2010
90% used social networking sites
Blogs read frequently by 20%
Social Bookmarking rarely used
8% had their own blog

More broadly, yet similar…….
Why the low adoption
trends?

What is the general consensus amongst
Healthcare societies.. just one
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2010

General Consensus –
healthcare...........
“The College is generally interested in developing
technology to allow psychiatrists to better
provide a services to their patients, and much of
this focus today has been through the
introduction of telepsychiatry, as well as online
learning seminars to assist practising in rural and
remote areas. We haven’t, to date, had much
involvement in social media but recognise this is
a fairly new and important area”.
Policy Officer –
The Royal Australian & New Zealand College of Psychiatrists
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Those that indicated that they used Social media for health care delivery..........
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How prolific is social media and health
care delivery in Australia?
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Among the fifteen listed social media
applications, email (62.9%), Skype (22.5%),
iPhone (20.8%) and Facebook (15%) were rated
as the most frequently used social media
applications for delivering health care to patients
during the last 12 months (2009).
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2010

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How important is it for Australian AHPs to
use social media for health care delivery?
AND
How would they like education about social
media to be delivered?
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2010

2010

Would Australian AHPs undertake
educational courses to inform them as to how
to use social media for health care delivery
and practice promotion?
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What is the proposal?
Healthcare.. just one
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Can this proposal work or is it
necessary?
A Revolution in 1436 AD

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The Future...?
www.abebooks.com
“One day every
town in America
will have a
telephone!”
~ U.S. Mayor, (c 1880)
UniversityofPlymouth,2010

What are the broad aims of the
proposal……
1. To design and deliver CPD / Educational Modules
(online) which address social media applications
(web 2.0), web 3.0, online platforms, Smart phones
and PHR as mediums for :
• practice promotion and marketing,
• dissemination of health information,
• preparing for PHR 2.0, PATIENT 2.0 - 3.0 and
MEDICINE 2.0 - 3.0

2. To design and deliver Educational Modules which
will empower individuals to develop an online
‘digital footprint’.
3. To implement online tools which will give
individuals both formal and practical
demonstrations as to how to create a ‘digital
footprint’ – tailored to their own business, career
and personal needs.
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How to design the
product ?
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Simplistic model can be applied to any
organisation – business, health, fitness,
education, marketing.
EACH social media application has a number
of unique qualities......
In the case of healthcare -
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In other words …creating a ‘digital footprint’ ?
• Twitter @pacificoncology
• FaceBook ‘fan’ aka ‘like page’
• BlogTalkRadio.com/pacificoncology *
• YouTube.com/pacificoncology *
• WordPress: pacificoncology.wordpress.com/*
• Ning: integrativeoncology.ning.com *
• FriendFeed: friendfeed.com/pacificoncology
• Open CPD – Compatible to iPads, iPhones, iTunes.
Platforms (pizza base) ‘waiting’ for original digital content
(social media applications – toppings)

An added dimension….
Preparing for Personal Health Records – PHR
‘READINESS’
• The personal health record (PHR) is an electronic, universally available, lifelong
resource of health information needed by individuals to make health decisions.
• The Personal Health Record (PHR) is an Internet-based set of tools that allows
people to access and coordinate their lifelong health information and make
appropriate parts of it available to those who need it.
• People can use their PHR as a communications hub:
1. to send email to health professionals,
2. transfer information to specialists,
3. receive test results, and
4. access online self-help tools.
AHIMA e-HIM Personal Health Record Work Group. "The Role of the Personal Health Record in the EHR." Journal of AHIMA
76, no.7 (July-August 2005): 64A-D. http://www.webcitation.org/5Vlj7zE7E

Personal Health Records
100,000 users

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Microsoft Healthvault

Dossia
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RWJF Project HealthDesign
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Tolven
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What other technology is emerging for health
care delivery and practice promotion?
In other words...what is the future of
healthcare delivery and education ......
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The Future...?
• 1989: ‘The future is multi-media’
• 1999: ‘The future is the Web’
• 2009: ‘The future is smart mobile’
hof.povray.org
ccSteveWheeler,UniversityofPlymouth,2010

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mHealth
A subset of eHealth
Mobile health - delivery of healthcare services via mobile communication
devices

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“What used to take up a building now fits in my pocket, and what fits in my
pocket will fit inside a blood cell in 25 years.”
– Ray Kurzweil, inventor and futurist
U.S. Army Photo, courtesy http://ftp.arl.army.mil/historic-computers/

Producer
0%
100%
Consumer
100%
0%
Web 1.0 Web 2.0 Web 3.0 Web x.0 Web x.0+
Syntactic Web
Semantic Web
Pragmatic Web
Adapted from Francesco Magragrino 2009
MUDs/MOOs
Forums
Listserv
Personal
Webpage
Newsgroup
Wiki
Blog
Social Network
Geo Mashup
Social Tagging
Smart Media Devices
Intelligent Collaborative Filtering
MMORPGs

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Context
awareness –
See overlays of
information
about the object
in front of you....
layar.com

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• http://itunes.apple.com/au/app/everyday-
health-for-ipad/id409861489?mt=8
• http://itunes.apple.com/au/genre/mobile-
software-applications/id6020?mt=8
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Health & fitness apps
© Carol Torgan, Ph.D. 2010

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www.impigertech.com30/11/2010 74
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OpenCME is a service dedicated to providing you with an unparalleled, "always-at-
hand" choice of medical education relevant to your practice, from the world's most
highly regarded academic institutions, medical societies and thought-leading
educators.
Download an OpenCME iOS App by selecting one of the following specialties:
AIDS/HIV Allergy / Immunology Anaesthesiology Cardiology Dermatology
Emergency Medicine Endocrinology & Diabetes Family Medicine Gastroenterology
General Medicine Genetics Geriatrics Haematology Infectious Diseases
Intensive Care Internal MedicineNephrology Neurology Obstetrics/Gynaecology
Oncology Ophthalmology Orthopaedics Otolaryngology Paediatrics Pathology
Psychiatry Pulmonary Medicine Radiology Rheumatology Surgery Urology
CURRENTLY and more specifically.......2010 -

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CURRENTLY and more specifically.......2010 -

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http://au.finance.yahoo.com/news/IDEAL-LIFE-Introduces-the-bw-
813042047.html?x=0
IDEAL LIFE

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• http://masterofpublichealth.org/2010/25-
ipad-apps-revolutionizing-healthcare/
http://itunes.apple.com/app/daviss-drug-
guide/id301427093?mt=8
http://www.imedicalapps.com/tag/ipad-
medical-apps/
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People will not enter health information to
a significant degree…

…rather, the PHR platform must be populated
seamlessly and effortlessly…
Web 2.0
(collaborative, data entered by others)
Mobile technologies, SMS
Domotics,
Ambient, pervasive computing,
Intelligent car
Applications with
geospatial awareness
Electronic Medical Record (Provider)
PHR
Platform
Natural speech interfaces
Personal Monitoring Tools

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What are other government industries doing
to create a social media presence?
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Records at Financial institutions Personal Finance Records
© Gunther Eysenbach, CC-BY

How wide spread is social media usage
and health care in the 21st Century?
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Facebook and health care………………..
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Virtual Worlds: Second Life………..
IS THIS THE FUTURE OF GOLD COAST HOSPITAL ?
Welcome
to GC Uni
Hospital
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What’s happening on an international
and national level......
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• Create a Health Equalities Commission
• Create a national preventative health agency (akin to “VicHealth”)
• Set-up a regional health partnership (akin to an “ASEAN” model)
• Ensure evidence-based allocation of resources
• Make healthy food choices easy
• Complete rethink of the shape of the health workforce
• Promote better translation of Australia’s research efforts into commercial and
health outcomes
• Create a “Healthbook” web-based personal health record (like a Facebook)
http://www.webcitation.org/5YB3bqeB9

• focusing on preventative health care and health
promotion, to help keep Australians healthy and out of
hospital

PUT SIMPLY ......................................30/11/2010 109
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How ready are Australian AHPs for the
e-health revolution?
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Key market trends in digital health: 2010..
WHAT WE DO KNOW…………..
• The emergence of the ‘e-Patient’.
• The emergence of the ‘e-Health Professional’.
• Proliferation of Health 2.0 – social media for healthcare
delivery, communication, service provision and
education.
• Mobile (mhealth) will impact healthcare decisions and
delivery.
• Patient and Health Professional Communities will matter.
• ‘Health Professionals immersion’ in the digital channel
will continue to proliferate the e-health landscape.
Source: 5 Trends in Digital Healthcare 2010 ; Google Think Health

Networking North Queensland: an
e-Health Revolution in the Bush
This is because technologies and applications –
such as video-conferencing using Skype on
mobile devices
– are easier to use. “Australia has been a very
good trial location for products in the past, not
only because
Australia is far away from the rest of the world,
but also because the population is very
accepting of new
technologies, so the level of tech-savviness is
higher here.”
Growth in information technology in the
Australian health care sector has been limited
in the past decade
due to heavy regulation and tight government
control, Ray says, “but we expect this to grow
rapidly”.
“Probably the biggest single thing missing
in Australia is a key decision by governments
to build a national strategy on e-health.”
Mobile phones are being used increasingly for
guided remote self-care in Australia and
overseas by chronic
disease patients with diabetes and cardiac
complaints as well as by health professionals
in developing
nations for remote monitoring, managing
electronic patient records, training rural
professionals and
tracking epidemics.
One participant was a 14-year-old boy
whose parents struggled to get him to
record anything. “But now that he can do it
on his mobile, he
absolutely loves it,” he says.
Ray says mobile health care is critical to
developing nations. Vodafone Foundation
statistics show that
only 5% of the world’s population have
personal computers, but mobile-phone
penetration is 40%. “So
obviously, the mobile phone is the way to go
to provide e-health,” he says.
The possibilities for e-health appear limited
only by imagination and technological know-
how.
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However, NOT REALLY .......another story.......
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Physician immersion in ‘digital channel’
The Internet is a physician's 'go to' health resource
•86% of physicians have used the Internet to gather health, medical, or
prescription drug information
•The Internet far exceeds the following resources for gathering health,
medical, or prescription drug information:
– Online CME courses 78%
– Peer Reviews Journals 77%
– Pharmaceutical sales representatives 77%
– Colleagues 67%
– Books 56%
– Health-related organization/association 54%
– Magazines 35%
– Video/DVDs 20%
Base: Total Physicians n=458
Source: Hall & Partners and Google Custom HCP Study, August 2009

Recommendations.............................
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What are the challengers, myths and pitfalls
for using social media?
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• Security
• Policy change
• Education
• Dispel URBAN MYTHS
• Bridging the gap
• Where to start
• Resourcing
• Leadership
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All can be addressed through EDUCATION

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DISPEL URBAN MYTHS……
MYTH # 1
Patients are particularly likely to anticipate that
shared records will be empowering (...).
Physicians, by contrast, are especially likely to
anticipate that laboratory results will confuse
patients and that shared records will make
patients worry more. “
Expectations of Patients and Physicians Regarding Patient-Accessible Medical Records
Stephen E Ross, MD, Jamie Todd, MS-IV, Laurie A Moore, MPH, Brenda L Beaty, MSPH, Loretta Wittevrongel, Chen-Tan
Lin, MD J Med Internet Res 2005 (May 24); 7(2):e13

MYTH # 2
Preventing Medical Errors
“The single most important
way you can help to prevent
errors is to be an active
member of your health care
team. That means taking part
in every decision about your
health care. Research shows
that patients who are more
involved with their care tend to
get better results.“ (AHRQ)
PHRs can help to engage patients
in their care.
DISPEL URBAN MYTHS……

Gaps between patient and provider
needs / expectations
Credits: Selina Brudnicki & Claudette DeLenardo

An example of an individual happy to share his
health record…

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THE BIG QUESTION..........
Is this the future for 21st Century
Learning?
1.Does this OPEN access have merit for
other educational settings?
2.Can we develop 1 package for MANY…
3.Can the iPads, iPhones, iTunes, Social
Media be used for health, schools,
businesses, higher education or sporting
organisations?

Because this........is perfect for ............

The Factory Model of
Schooling Is Dying
Customization,
Collaboration, and Creation
Are the New Model

The
Networked
Teacher
Colleagues
Family/
Local
Community
Print &
Digital
Resources
Conferences
Curriculum
Documents
Social Book-
marking
Video
Conferencing
Blogs
Wikis
Podcasts
Twitter
Social
Network
Sites
Photo Sharing
Popular
Media
Whereas….
Learning tools of the 21st
century

21st Century
Classroom 2.0
131
21st Century
Educator

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135
Nodes Top-down Distributed
How Networks Evolve
as communication costs drop

136
Human Governance
Bands Kingdoms Democracies

137
Business
Single Proprietors Franchises Business Webs

138
Learning
One-on-one Classroom Informal

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http://itunes.apple.com/au/genre/mobile-software-applications/id6017?mt=8
http://www.theaustralian.com.au/australian-it/no-place-for-ipad-in-education-
revolution/story-e6frgakx-1225867929817
http://www.arnnet.com.au/article/348795/catholic_schools_keen_ipad_education/
http://www.readwriteweb.com/archives/the_ipad_in_education_colleges_give_i
pads_to_all_incoming_students.php
http://delimiter.com.au/2010/09/22/education-departments-go-wild-for-the-ipad/

What is the breadth and depth + potential for
Education……………..
Course
Development
and delivery…
academics and
students
Seminar
offerings – how
to promote
individual
business,
healthcare,
education……

What is the breadth and depth + potential for
Business / Industry……………..
Small Business Middle Business Large Business

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Griffith
Enterprise
Education, Health, IT
Product
Business Groups
2010
Australian Allied
Healthcare Industry
Partners
THEREFORE….

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http://www.healthprofessionalcpd.com/
http://exchange.telstra.com.au/?p=896
http://exchange.telstra.com.au/training/flip.html
http://edudemic.com/2010/11/harvards-must-have-guide-to-
social-media/
http://au.linkedin.com/in/heidiallen

To sum it up…………The times they are a changin

• Mayo clinic example – case study
• http://www.slideshare.net/ScottMeis/healthc
are-social-media-2009-trends-strategy-
1131605
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THE FUTURE …..the digital
footprint…One ‘vision’ for Medicine

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RECOMMENDATIONS and PROPOSAL....
assisting Australian AHPs to create their
individual healthcare digital footprint
CPD or Educational Modules for all
Australian Allied Health Care
Professionals

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2010
QUESTIONS ?

1. GCGP agenda – not aligned as such with current agenda.
2. Important to ascertain the ‘Levels of Change’ that such a product is going to
create amongst clinicians.
3. Education won’t change much on its own –a strategy or activity where clinicians
can implement something will have more of an impact.
4. Education which focuses on everything of Web 2-.0 will miss mark.
5. Better focus on a few applications – base on market research.
6. Change – engage with admin rather the clinicians – market research – incentives
need to be either educational and practical applications.
7. Clinical and Practice Promotion CPD modules combined – government vs private
practice – a need to determine the market surrounding such products .
8. Pilot in a few locations – based on impact and improvement and creates changes –
funding -identify changes via research – RHD students.
9. Market to pay for product will be difficult.
10. Free training is readily available and will compete against products which create
CPD .
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Recommendations from Industry Partner
meeting..................

• Currently have a web portal for GCGPs which
promotes ehealth initiatives.
• Three layer approach – clinicians, consumers
and research driven.
• Needs a possible collaboration to develop
educational modules / products for this – has
been flagged as next step.
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Other identified need..................

• Primary Health Care Operation – all allied health
under one operations – integrated ehealth system
–– creating electronic systems to support this
process (electronic patient records to social
media.
• MedicareLocals – 1st July, 2011 – 15 Primary
Health Organisations – total = 60
• Business opportunity.
• CPD is warranted in this process.
• Educate people about how to use the system –
consumers and professionals.
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Other identified need..................

Social media and healthcare delivery

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