Posting here…because Dave “@epatientdave” deBronkart haz things to say.
Hospitals are examples and metaphors for the iatrogenesis of our entire provision of health care.
Health is social. Not media.
When I started Health Is Social, one of my aims was to bring a mash-up of disparite elements of style, philosophy, nursing, humor, grief, and green knives to the public discussions on Healthcare and Technology. (What’s a green knife? Listen here after the post if the above embed doesn’t work.)
At the time, Social Media in Healthcare was still a nacent topic. So it was natural for me to pick-apart the predominate views on Social Media (SoMe) – views which I considered superficial, mimetic, nauseatingly repetitive, and downright misleading. The superficiality was especially disturbing.
The funny things is: “Health Is Social” wasn’t about SoMe. No. Quite the contrary: it was about propounding ideas that call us back from a technologic-centric view of Health and Healthcare to a human perspective.
Yes, “Health Is Social” included “Healthcare Social Media”. In the prior years, I had started the first clinical chat on Twitter. (I am proud that of all the Healthcare professions, it was Nursing that got that “prize”. Sadly, physicians were behind, so I started the first chat for physicians. I mention this in case you think I’m a Luddite – no: others should have started these chats. Why didn’t they? Perhaps they’re the Luddites. Just sayin’ 😉
But what I’ve been doing with Health Is Social has been lost on some readers: I invert styles in ways that confuse. For instance, I’ve written posts that seem serious, and yet are utterly sarcastic. Why? Because I felt it was important to point out some of the narrow-thinking ways of the social media “gurus” – and this narcissistic-superficial way of thinking has infiltrated Healthcare.
Examples of such weird behaviors include:
- Repeating the matras: “Social Media is revolutionary” – “It’s all about conversation.”
- Failures to acknowledge the need for HCPs to fully understand the pitfalls of using SoMe: not just from their own professional standing, but also the harm they may cause patients.
- Superficiality in appreciating the Iceberg of SoMe (the tip is deceptively simple)
- Embarrassing self-promotion – Much of my “schitck” on Twitter is a way to illustrate to followers how weird self-promotion looks. Much of what I saw what was ultimately narcissistic and addictive behavior (and yes, these media do lead to addiction, but that’s a whole other topic).
- Healthcare Marketing ideas in the context of SoMe seemed to be uninformed by experience – and, again, seemed superficial and imitative of a lot of the popular online personalities who got lucky with Technorati back in the day.
- Sycophantic behavior – too many clicks had started to form, and many important voices were being drowned-out by the loud chirping from those whose voices were probably the last to hear. If at all.
In my head, the list went on.
Now, this is all the ‘negative’ side of Health Is Social (trying to wake people up from the ‘dopery’ so common on social networks). That is, a counter-weight was needed. And you know what? People subscribed and shared and loved what I was doing. Yes, loved. That doesn’t happen much online, and I’m every grateful to those who engaged me via email and Skype and AFK (Away from the Keyboard, aks IRL).
The “postive” side? Well, that was about waking people up to the promises of technologies within the context of very human ways of processing the world.
It’s important for us to be passionate – truly passionate – about speaking our minds.
Do you want to know why Healthcare is so messed up in our country? It’s because nobody is angry enough (in a good way). We’ve been sitting back and accepting things without question.
It’s unacceptable to have uncritical thinking in Healthcare. As we march deeper into the 21st Century – a Century of economic, cultural, political, technological tumult), we need to take time-outs to THINK before we act. Let’s not just do things because others are doing them or just to feel like we’re doing something.
If you look at all the Revolutions of the last several hundred years, they all started out as utopias and ended in catastrophe. If only a little more thinking were done, perhaps we wouldn’t have had gulags, and concentration camps, and domestic violence. That’s an exaggerated reference in this context, but the mechanics are the same.
Social Media is not ‘revolutionary’. People are.
Social Media is not healthy. Wisdom is.
Social Media is not poetry. Poets are.
Social Media is not social. A playground is.
Play more. Tweet less.
[For an accompanying sound version of this post, listen here.]
This is a cross post from my article published in LinkedIn Today. Apparently Phil Baumann is a top 150 “Thought Leader” on LinkedIn (write-up here in Wired) – up there with Richard Branson, Barak Obama, Mitt Romney, David Cameron, Reid Hoffman, T. Boone Pickens, and other people who are actually famous. Don’t ask me how I got picked for it. Maybe I do know what I’m doing after all.
Anyhoo, here’s a SoundCloud with some insights into mashing-up different disciplines to make things better – like customer service.
The original post is here. I’ll be on LinkedIn more often – it’s a far more valuable network than Twitter. I’m on LinkedIn here. And you can follow the other 149 “Though Leaders” here. Oh, the irony. 😉
@PhilBaumann – @HealthIsSocial
The True Story:
Hospital: “This is a hospital, we must do something! If we don’t do something, something bad will happen.”
Doctor: “There’s nothing more to be done. The patient can go home – the illness is under control and her body’s natural processes will work in tandem with our treatments.”
Hospital: “Look: We are not the hospital that does not do something. We are the hospital that does not do nothing.”
…And that night, after the glasses of sad wine, the good doctor sank into the bed and dreamt of violent revolution.
– Phil Baumann
It’s easy to get wrapped up in the heat, intricacies, and excitement over the politics, economics, and technologies of Health Care (and Healthcare – know the difference).
But you know what? We still need brains and hands to do important work.
It’s important for the right kinds of brains to enter life-long nursing and medical careers.
Right now, however, we are approaching a catastrophe in education – and from two ends: supply and demand. Both the supply of educational resources and the demand of the new generation for serving in Health Care are decreasing.
Today’s physicians don’t feel like they’re doing what they signed up to do.
Today’s nurses don’t feel like they’re doing what they signed up to do.
Each are fighting unnecessary wars with unnecessary people who subjugate the industry with their unnecessary idiocies.
Furthermore, we not only need a new generation of dedicated, educated, and well-trained HCPs, but we also need a new – pardon the expression – industrial complex of how Nursing and Medicine work with each other for the benefit of patients.
I can’t tell you how priceless it was for me to be able to attend an occasional lecture by a physician during nursing school.
But that’s not nearly enough.
Yes, nursing and medicine are different fields – and there are reasons for some of the barriers between them.
But the membranes that separate these professions must be much more osmotic than they ever have been.
Finding ways to better inter-mesh nursing and medical education would produce more educated nurses and physicians. It may be a higher up-front cost to do, but the long-term yields would be well worth the capital.
You can do all sorts of financial reform in Healthcare.
You can do all sorts of things with technologies in Healthcare.
That’s all welcome, of course – if done elegantly.
But none of that will convey Health Care to the places it needs to go if we don’t have a running supply of nurses, physicians, and other HCPs.
Slavoj Zizek wrote a book a few years ago titled “First As Tragedy, Then As Farce”.
You don’t have to agree or disagree with Zizek’s mashup of Hegelian/Lacanian analytics of our Century’s problems.
But, given the state of Healthcare, it’s an apt description of where we’re heading.
Think about that phrase as you reflect on Healthcare today. How many times have you encountered the Farce?
It’s absolutely farcical that there are Hospital CEOs who wouldn’t have the slightest clue about moving a patient from a bed to a chair.
It’s absolutely catastrophic that we are entering crises of shortages of *willing, able, and supported* nurses, physicians, and pharmacists.
I’ll take Zizek’s quirky phrase and advance it forward for Healthcare and what we can expect:
Healthcare: First As Farce, Then As Catastrophe.
Healthcare has been late to using social media. It appears, on the surface at least, that the industry is finally catching-up.
Conferences on Healthcare Social Media are popping up. A Healthcare hashtag is born every minute. Experts, gurus, and consultants are everywhere now.
So too is the overpromissing.
Healthcare Communicators and Marketers are being sold these promises.
Consumers are being sold these promises.
Healthcare providers are being sold these promises.
What are these promises?
Increased ROI! Improved outcomes! Better provider-patient relations!
Yes, social and digital technologies can move these dials.
No, they don’t solve the fundamental problems that marketing, clinical challenges, HIT conundrums, and other concerns involved in Healthcare encounter every day.
There’s an assertion that is made on almost every Twitter chat, HCSM conference, and blog that’s been blindly ripped-off from the early days of social media ‘wisdom’: “social media is about people!”
It is? Really?
Well then, if social media is so much about people, why are we talking about social media?
Do you see the fallacy of cloudy rhetoric here?
Let’s not get carried away by platitudes and the over-promising of what are ephemeral software.
Twitter may be cool and all. And it may have its promises.
But let’s be careful about the dopaminergic effects of these trinkets on our minds – and on our perceptions of their true promises on their impacts on Healthcare.
For you see, the focus of my words here is this: as long as we dwell on the over-promises and the teenage fascination concerning these technologies, then the more we overlook whatever potential they have to improve patient care, medical and nursing education, information flows, and healthcare technological development.
I can’t say that what you’re seeing on Twitter and hearing at conferences is all Snake Oil.
Then again, get-rich schemes come in all styles.
Indeed, health is a social process – absolutely, from the cellular networks of our bodies to the hands we hold at childbirths and funerals.
Social software? Try to be serious: They’re just on/off switches.
And they’re aren’t necessarily all that good for your health.
Do medical students, residents, and faculty need to learn certain modalities with respect to their use of social media?
I think it’s an important question to address (same applies to nursing and other allied professions – more to come in future posts, of course).
I’ve developed a long list of categories, sub-categories, and topics which will help the current and future generation of medical professionals to safely and effectively use social media in their education, research, peer-to-peer and student-faculty collaboration, continuing education, the protection of patient safety, their clinical practices, the extension and high quality patient care, and many other uses of social and other digital software and hardware.
Before I start to publish this material, I want all of us to put down the “social media in Healthcare” mantra for a bit.
Because there are much more fundamental principles that need to be collated and integrated and valued with respect to the participatory nature of medicine.
- Patient Safety (words can hurt)
- Patient Safety (dignity is easy to violate)
- Patient Safety (privacy matters)
- Patient Safety!!!
- Critical Thinking
- Communication and Collaboration
- Continuing Education
- Pedagogical Excellence
- Highest Commitment to Ethics
- Continual Development of Inter-professional Collaboration
- Participatory Medicine
- Shared Decision-Making (this is really tough – lots of nuances/dilemas)
- Ethics, Ethics, Ethics
- Reality Tunnel Awareness
We all live in our own reality tunnels, don’t we?
It can be awfully hard for us, as individuals, to get out of our own reality tunnels – or to go down ones we just don’t want to enter.
It’s exponentially more difficult for groups of people, institutions, and entire professions to get out of their own reality tunnels the farther they go down them.
This premise is especially true in Medicine.
In Medicine – as in Nursing and other health care professions – some practices and theories are so engrained that we don’t know how or when to challenge them. The tunnels become holy portals to the gods.
The Scientific Method must always guide Medicine.
But Medical professionals should never confuse their reality tunnels with science.
Never fear to wonder if you’re in the right tunnel.
The question mark is the most powerful medical device in the world.
I plan to talk more about the Reality Tunnels of Healthcare.
In the meantime, you can watch Robert Anton Wilson, as embedded above.
So I downloaded a mood-tracking app. Guess what: it drove me nuts. “Ding. How are you?”. #mHealth
— Phil Baumann, RN BSN (@HealthIsSocial) June 14, 2012
I’m not a big fan of the Quantified Self movement – more on why in a future post. But I do think having a pulse on some data about your health and wellness can be valuable.
I also believe that our moods are both symptoms and causes of good and bad health.
Furthermore, I’m very curious about the essence of the relationship among software and patients, providers, and other medical systems.
Now, as far as monitoring moods, there is a lot more than just experience sampling. A fundamental problem of measuring moods is the observer phenomenon. Asking “What’s your mood right now” runs the risk of influencing the qualitative response.
I’ll spare my longer views of how to build the “right” app for tracking moods (and beyond moods, the full spectral array of relevant data required to robustly capture affective dispositions).
Anyway, I downloaded one of the many mood-tracking
devices apps for iOS – I won’t name it because this post isn’t about the product per se. It’s about a fundamental problem with all healthcare apps that require any kind of routine or non-routine interaction from the user.
Specifically: the reminder. Initially, I found the pings to be bells of mindfulness so-to-speak. The app had an elegant way of recording my mood at a given time. Even the alarm was calm: a soft bong on a singling bowl. Good enough.
But it didn’t take long for it to become totally annoying. I had to turn it off. And when I went back to the history it recorded, it didn’t provide much useable data to interpret into meaningful decision-making material.
If a physician ordered me to download the app and stick to her prescribed protocol for reminder settings, there’s a good chance I’d go ape-berserk.
Think about patients with clinical affective mood disorders. It’s not a joke to conjecture that apps like these could conduce a patient to cycle upward into hypomania – or even full mania.
When thinking more seriously about these apps (should we call them ‘medical devices’? – see this for that question), we need to understand not only the pathologies and the surrounding environment, but also the *software*.
This is new territory. It’s not enough for us to just say “these are tools, let’s fit them into healthcare”. No, we need clear definitions and understandings.
Specifically, we need to know a lot more about the essential relationships which software play in health care – this is new land.
We know what a pill does. We know what an implanted asset does. We know what a surgical procedure does. In short, we know a good deal about how patients relate with these traditional assets.
But software is different.
Software is pliant, fickle, ramifying, mutable.
If done right, software can be enormously beneficial.
If done wrong, it can be annoying.
Worse, it can be adverse.
Technology shouldn’t drive us nuts.
– Phil Baumann