Envisioning 2.0

Given my age, some might look at me and wonder why the topic of end of life care would be important to me.  However, it is. I see my elders aging and (since witnessing the September 11th attacks first-hand) contemplate my own mortality regularly.  This is why I am happy to support the Engage With Grace project.

According to USA Today, Engage With Grace is designed to make “one of life’s most difficult discussions easier by boiling it down to five talking points on a single, easily e-mailed and linked slide that can be shared during business events, long car rides and family dinners.”

Before learning about this project, I have had conversations with my loved ones about developing a living will.  It’s hard to contemplate the end of my life, but it is a worthwhile conversation to have.  Take the time to download the Engage With Grace slide and share it with others you care about.  Together, we can improve end of life care so and make it as positive as humanly possible.”

I’ve been quite busy recently over at HealthCareVox parsing the ongoing debate about the Health 2.0 movement.  I normally try to minimize cross posting between this blog and HealthCareVox, but I thought readers of Envisioning 2.0 might be interested in the debate and my take on it.  You can view my thoughts by clicking here and here.

The Centers for Disease Control and Prevention is hosting an innovative Web Dialogue about the use of various interactive technologies for health communication and public health. I’m honored that CDC has asked me to serve as a panelist for this event, scheduled for September 16, 2008.

CDC describes the event as an online “discussion focusing on Social Networks, Blogs, and other Web 2.0 applications and their uses in health marketing and public health. Participants will share examples of how they have used these applications and hear from others about ways of using these new channels of communication. The dialogue will open at 9:00 a.m. and remain open until 7:00 p.m. (EDT).”

A few good friends, including Nedra Weinreich and R. Craig Lefebvre will also serve as virtual panelists for the event. To learn more and to register to participate, please click here.

A few weeks ago, the Kaiser Family Foundation hosted a forum where a panel of bloggers and experts discussed the “growing influence of blogs on health news and policy debates.”  I took the time to listen to the event’s podcast  on my way home from work one day and found it to be interesting and somewhat informative.  However, in many respects I was disappointed by the session.  I  list the primary reasons for my disappointment below.

1.    Lack Of Data: I think attendees of the event would have been well-served by an overview of the current state of the health blogosphere.  Specifically, data points from Pew on the number of Americans writing health blogs and case studies focusing on instances where they have influenced mainstream media coverage (there are many) would have been very helpful.  Several members of the audience had questions along these lines, which (unfortunately) went unanswered.

2.    Lack Of Diversity:  The panel was staffed by members of the media, high-level political aides and representatives of think tanks.  I was happy to see John McDonough on the panel, as he was interviewed for a report my firm developed back in 2006 on the health blogosphere.  However, there are many other individuals that have had a significant influence on the development of the health policy blogosphere.  One of them is Joe Paduda who launched the Health Wonk Review.  It would have been nice to see people like this included on the panel.

3.    Lack of Strategy: I found Secretary Michael Leavitt’s talk on why he decided to start a blog fascinating.  However, I kept wondering when he was going to focus more on the strategic thinking behind HHS’s various forays into the blogosphere.  For example, he started blogging during the HHS’s pandemic flu initiative.  What was the impact on that effort on communications with the Department’s stakeholders?  How did the feedback provided on the HHS blog influence policy?  In addition, the Secretary is using his blog to bypass traditional media sources in order to ensure the Department’s perspective reaches its key stakeholders.  How effective has that effort been?  Has his blog influenced reporting on HHS in the blogosphere and mainstream media?

These are just a few of the questions I was left with after the Kaiser event.  I’m sure that Kaiser will continue to focus on health blogging in the future.  While this session was a decent introduction, I’m hoping that in future years they dig a lot deeper.

Earlier this week, Harris Interactive released the latest edition of a tracking poll focusing on the number of Americans who go online to find health information.  The big surprise this year was that “only” 150 million US adults had reported using the Internet to find health and medical content this year.  In 2007, 160 million Americans reported conducting online health research.

Harris cautioned readers not to get too excited about the poll, saying: “The difference between this year’s and last year’s survey results . . . are well within the possible sampling error.”  Overall, there are still a lot of Americans turning to the Internet for health content.

In light of these results, I found a comment by Humphrey Taylor, chairman of the Harris Poll, especially interesting.  He said: “[Currently] there are no objective measures of how accurate and reliable . . . online information actually is.  [However], it seems that the Internet is positively contributing to the quality of health care.”

I found this commentary intriguing because of the results of a national survey my firm Envision Solutions released yesterday.  Kelton Research, a well-regarded polling firm, conducted the study.  Thirty-eight percent of Americans say they have doubted a medical professional’s advice because it conflicted with information they found online.  Alan Brookstone, author of CanadianEMR, said the results confirm “what most doctors are already finding in their practices.”  Brookstone suggests the Internet may be having a negative impact on the patient-provider relationship.  My belief is that online information is causing Americans to view providers’ advice critically, which in some cases may actually benefit relations between patients and medical professionals.

Examining Perceptions Of Patient & Health Provider-Generated Online Content

Research published earlier this year by iCrossing tells us that trust of the Internet lags behind its popularity.  Given this, we decided to examine Americans’ perceptions of health information published by providers and patients on blogs, online forums and other Websites.  We wanted to determine whether it is appropriate for us to assume that content created by patients is viewed as highly trustworthy.  We found that Americans are much more likely to trust information developed by medical professionals.  Except for the young, most US adults did not list patient-developed content as one of their most trusted health information sources.

Overall, this study provides us with helpful information we can use to better understand how Americans view online health content and how it influences medical decision-making.  To download a summary of the survey results, please click here.

I enjoy reading Dr. Benjamin Brewer’s regular column in the Wall Street Journal. He has a great way of highlighting issues while providing a valuable reality check. In the latest installment of “The Doctor’s Office” Brewer talks about why he is shutting down efforts to communicate with his patients electronically. He lists many reasons why he decided to take this action, but two stuck out for me.

o Patient apathy: Over time, Brewer realized that many patients still preferred to contact him via telephone when they had a problem or needed a consultation.

o Inconvenience: Worried about patient privacy laws Brewer installed an expensive system that would have required patients to memorize a new password and jump through a few hoops to contact him. This proved to be a non-starter with patients who preferred to be contacted via plan-vanilla e-mail – despite the fact that it is less secure.

In the end, Brewer might have benefited from some basic research. Brewer admitted that he never surveyed his patients to find out if they wanted to communicate with him via e-mail. This was a bad idea.

Communications might have been another problem. Did Brewer communicate aggressively about the new service (and its benefits) with his patients? His column indicates that he may not have. Like many others, he thought that if he built it, they would come. Unfortunately, things don’t work that way.

Overall, this is an interesting column that sheds light on some of the barriers faced by physicians in smaller practices seeking to use innovative technology.

See what readers think of this column by viewing the Wall Street Journal’s online forum.

I came across an interesting editorial in today’s New York Times that I thought was very interesting.  Paul Krugman notes that the “predictions of ’90s technology gurus are coming true more slowly than enthusiasts expected — but the future they envisioned is still on the march.”

He provides an example of how digital technology is transforming the music industry.  Faced with declining revenues from traditional sources, musicians are giving away their main product (music) in exchange for increased touring and licensing fees.

Are these trends influencing the health industry in the same way? Perhaps not.  Clearly the main products provided by medical professionals will continue to be very highly valued – at least until we have machines that can do a better job.  In addition, there is still a great need for people with the ability to gather, analyze and explain various types of health data.  So, I don’t see these health-related “products” given away any time soon.

However, we are seeing that health professionals are having to react to lay people who are using digital technologies to find and exchange information.  This is shaking up the traditional hierarchies within the health industry and we’re still trying to figure out what the impact will be.

The unknown road is often the most exciting one, wouldn’t you agree?

A New York Times article focusing on the upcoming Wii Fit got it right. Seth Schiesel, author of the story, noted: “Wii Fit could be the right choice for exercise amateurs trying to get in shape in the living room.”

And that’s exactly the right message.  With millions of Americans struggling with obesity, Wii Fit (and gaming platforms like it) might be an answer to public health experts’ prayers.  If games help more people get moving, we might start to see health great benefits down the road.

Given the excitement about the Wii Fit, it is fitting that the Games for Health conference took place earlier this month.  A press release about the conference noted four trends that are helping health gaming enter the mainstream.  They are:

-Video games are helping people recover from physical and mental illnesses.

-Exergaming is kicking into high gear

-Major health care providers like Humana are focusing on games

-Medical professionals and first responders are using games for training.

All in all, this is very interesting stuff.  Learn more about the Games For Health conference by clicking here.

Earlier this year, my firm Envision Solutions and The Medical Blog Network launched the first global survey of healthcare bloggers. Today, we released the results of this poll, which will be discussed during the Healthcare Blogging Summit this afternoon in Washington DC.

Following are some key results of this survey:

- Many bloggers are writing for altruistic or personal reasons, i.e., to share their experiences or educate others

- A number of bloggers hide their identity to protect themselves, friends, family, patients and careers

- Many respondents view their fellow bloggers’ statements with a critical eye. However, they are confident most bloggers will make it easy for them to access a range of perspectives via their blogs

- About half of those contacted by PR professionals write posts based on information they receive from them

- Respondents are split on whether running advertising compromises the integrity of healthcare bloggers. However, many are willing to invite advertisers to appear to their blogs

Click here to download the full results of this survey.

Over the past year, we have witnessed significant changes in the healthcare social media landscape – especially in the blogosphere. Healthcare providers are beginning to embrace blogs as a means of sharing information and their experiences with colleagues, patients and the general public. Major healthcare organizations, including the Centers for Disease Control and the publishers of the journal Health Affairs have launched Weblogs to facilitate dialogue about important subjects. These developments are cause for celebration.

However, fully embracing social media means much more than simply starting a blog or launching a podcast. It requires making a commitment to engaging in open and honest dialogue with stakeholders. Transparency and honesty are highly valued in the social media arena. However, this requirement has led many players in the healthcare system to fear it. Another reason is that many do not understand why social media is important or think those developing user generated content will have much impact on the healthcare system.
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