It’s Not Healthy To Be Nice All the Time

Good people disturb.

Nice people disappoint.

Serial killers are not good.

Serial killers are nice. It’s part of their operation.

Get the difference now?

Look at your Twitter stream over the last few days. Are your tweets nice?

On Twitter, are you really expressing what you feel and think?

When was the last time you tweeted something without any fear?

What are you afraid of?

Think about this: if a tweet can get you into trouble – at work, your business, your family – then is there not something fundamentally wong with the life and career choices you made?

If your life depends on a tweet, then perhaps you need a re-think. Just a thought. (And I bet you it’s fear that’s gotten you here. I know fear has trolled me too.)

It’s awfully nice of you to tweet links to blog posts, articles, research papers, pictures of half-eaten bread.

But when was the last time you caused a disturbance?

Who are you?? No, that’s not the answer. Who are you REALLY?

Most of the tweets I see, whenever I dip into my streams, I see people being nice – patting each other on the back, offering positive affirmations or quotes.

I don’t know about you, but I think Twitter – if it has any value – lies in the revealing of dark truths we don’t want to hear.

It lies in hearing news we don’t want to hear.

It lies in saying the things you passionately believe but don’t express yourself because you’re afraid that you’ll offend someone or lose your followers.

What a shame.

Are you a nice avatar or a good person?

Phil Baumann



The Death of Twitter

Twitter revealed a social construct within us that we never knew existed: the capacity to communicate in tiny pulses. That’s what technology does: it reveals, and then changes irrevocably our way of seeing the world.

Indeed – the tweet (in its generic conception) is now metaphor for 21st Century communications: from the ping to the mention to the call to action.

The tweet, however, is simply a feature which soon will be subsumed into other technologies.

That Twitter has enjoyed a 5 year monopoly on 140 characters says something about the nature of its breakthrough.

Twitter Inc., however, has blundered horribly by not delivering any significant innovation. Twitter by itself is…well, Twitter. Nothing to innovate there per se. But Twitter could have built out a more robust and integrating set of features and platforms and tools which could have propelled it far ahead in the social media market.

Team Twitter didn’t. It catered to celebrities, tolerated the Fail Whale and didn’t even understand its own service very well.

What’s more, Twitter plans to use half of $800 Million of funding to buy back shares. That is not a good sign of financial management. Ponzi scheme come to mind?

Google – long thought a loser in social media given its blunders and its heavy focus on algorithms – has now unsheathed a most powerful arsenal of social technologies that could well induce the death of Twitter, Inc.

Google Plus doesn’t have to kill Twitter or Facebook – it just has to accrue the adoption of everyday people and business enterprises to propel Google into the next phase of its empiric dominance in the Web.

I’ve already figured out how Google Plus – at least the premises of its features – will configure into Healthcare. It’s huge. (Now, I can appreciate why Google gave up Google Health – Google Health was bulky and the wrong path: the future of health is Social.)

It’s too late for Twitter to sell to Google – Google’s put Twitter into Check. Zuckerberg over at Facebook isn’t thinking a whole lot about Twitter I’m sure.

Apple’s going to integrate Twitter into iOS 5 – which may add some zing…but in light of Google Plus, I’m sure Steve Jobs may be tempted to put a sparrow in his hand an crush it to death.

Microsoft? Well, they spent a ton of money on Skype – which is now integrated into Facebook’s Chat feature…which now Google Plus’ Hangouts makes look like a bad joke. So Microsoft is probably a bit wary of investing in something that everyday looks more and more like a Ponzi scheme.

With no other platform but streams of teeny tweets, where will the revenues stream? Ads? Not enough money there. Subscriptions? Not enough users to lock-in. Service offerings to businesses? Better alternatives exists and will evolve – Twitter’s woefully behind, and any efforts for innovation not only must be swift: they must also be dead-on.

The death of Twitter may be a rumor, and greatly exaggerated.

But it’s awfully hard to have realistic hope when you know the patient hasn’t been given the care she deserves.

Don’t invest too much in Twitter. The opportunity cost is getting greater every day.

Phil Baumann



The Sparkly Cosmology of Twitter

SupernovaBryan Vartabedian – @Doctor_V – makes a point that Twitter, like all things, changes and won’t be the same as it was when us early adopters played in the sandbox. I see his point and agree…from a certain angle.

Twitter by definition is Twitter. If it isn’t Twitter – if it changes – it isn’t Twitter. Twitter’s eternal, cosmic and strange – an expanding universe with deep physics and principles inherent in its origins.

As time rolls on, Twitter-as-universe reels forth its productions, asymmetrically scattering tiny bits outward across a vast emptiness until they crash against each other, forming clouds of gas, energy systems, gravities.

It’s the gravities which give Twitter its most unique properties. Little solar systems form…planets…moons…satellites.

Some solar systems form and amass huge followings of orbiting planets, while other objects are wanderers wafting through darkness.

Twitter doesn’t change. The gravities do.

When you enter Twitter’s cosmology, you start in one gravity – maybe it’s a small system where the planets are of similar composition. Maybe you enter a huge varied binary system.

Wherever you enter, once you’re in, you’re part of a cosmology – some of which you’ll understand, most of which you never will.

We shall never fully understand Twitter. For just as you look out into the dark night-sky, it all looks so simple, so trivial and empty. You don’t see the endless enfolding principles that make it all happen – how the universe achieves its wonder of simultaneous randomness and causation, how it grows neutrons and waves and stars and microbes and sparrows and brains that make Twitter.

Eventually, other gravities and properties of the cosmology carry you onward and outward. Or you choose to venture into other parts of space.

When Bryan entered Twitter, he found his peculiar gravity – he entered a specific time and space after the big tweet. What’s happened for his last three years on Twitter isn’t that Twitter has changed: it’s that the cosmology of Twitter has been doing what it does: atomizes and unifies and atomizes and unifies and atomizes – endlessly.

Along your journey through the sparkly cosmos of Twitter, you’ll encounter moons, planets, stars, galaxies, black holes (that’s where most tweeters go btw). Twitter’s like an accretion disk, sucking in everything from the web and blasting it all back out to other parts of the cosmos.

And if you’re lucky, you’ll see a supernova. What’s that? A supernova is what happens when you dip into your Twitter stream and, for but a moment, you witness the brilliances – the sparkling flashes – of your fellow human beings, happy tweeters holding hands amid the lone and vast night of the web.

@PhilBaumann – @HealthIsSocial – Newsletter


Note: I was not high when I wrote this post. Maybe I shoulda been, then I feel more normal. Then again, normal is death.

Japan Tsunami and Twitter Disaster Management

Last week I asked “Would You Know How to Tweet an Emergency?”. Although I’m not an emergency responder, I hoped that we’d have more discussion about the role of Twitter in disasters. On March 8, a few days before the Sendai Earthquake and Tsunami, I tweeted:

(I realize full well how self-aggrandizing it seems to toot this, but that doesn’t matter – just go with it 😉

I’ve long thought that Twitter – frivolous a service as it seems – always had great potential for Healthcare and disaster response and management. What we need is a public discussion of how this particular medium can be used as effectively as possible.

One one hand, there is a natural flow of people working out these technologies as events arise without pre-planning. On the other, it’s important that we think ahead of the possibilities, limitations and nuances that need to be worked out.

For too long conversations about the role of Twitter have been owned by marketers and communicators. It’s a shame on two fronts: first, marketers are going to be disappointed if they invest too much hope in Twitter; and two, it overshadows potentially life-saving uses for this one-of-a-kind medium.

Let’s work on this problem. And here’s a point to think about: imagine if the use of voice for emergencies wanes and Twitter (and its analogues) become the primary medium of communication. How would that change your angle on the problem of how to use Twitter effectively?

So, here’s another appeal to my followers: please take a moment, read the post, come up with your own ideas and suggestions, and get the word out to discuss Distaster Response and Management in the Age of the Tweet.

I’m not the expert: I’m simply looking for experts to put their brains together on this one .

@PhilBaumann – @HealthIsSocial – Newsletter



Would You Know How To Tweet An Emergency?

Note: This post is a request for people to think and speak about what matters in the use of social media, and how we can collectively design and shape these media for…what matters, especially in emergency services. Please take some time and come up with ideas. If you can think of ways to make Twitter better, get them circulated. Saving a life can start with an idea. Silence can be an atrocity. (To see my 911 proposal click here).

When I ask “Would you know how to tweet an emergency?” I have two kinds of audience members in mind: people who use Twitter regularly and people who don’t.


Last week, after meeting a bunch a very smart risk managers who just haven’t kept up with developments in social media, it occurred to me: what if one of them needed to send a public message about a developing emergency? Say a terrorist attack, a fire, a missing child, an auto accident. Maybe they could use their cell to dispatch emergency services. But wouldn’t alerting followers on Twitter help to increase awareness – and do so instantly?

Another angle: what if there was an amber alert issued via Twitter or Facebook. How would someone who wasn’t using these services be able to help? Granted, it’s up to chance that she’d see the tweets or retweets or Likes, but every extra eyeball could help.

Yet another angle: for someone who still uses only a cell phone, how would they operate a victim’s iPhone or Android device if it were the only connection to the outside world? “Here, use my iPhone – call 911 and send a tweet about what’s happening.” “Twat? Twit? Huh? What’s that, how do I do that?” Time. Lost time. Time is life.

You see what I mean?

Risk management is about what you do with what you know. It’s also about what you don’t do with what you don’t know.


But here’s more: what about the rest of us, those of us who use these tools as simply part of our daily communication? Would we know how to tweet an emergency?

On one hand, it’s a pretty simple question to answer. “ALERT: 2 gunman at ABC Bakery, Springfield PA!! Patch police, stay away from area.”

But what happens after? How does communication ensue after that? Police departments have been using Twitter – and more will continue (see Lauri Stevens’ work – @lawscomm for more). If the tweeter didn’t know the Twitter account for Springfield Police, how would SP know just via Twitter, so that it could maintain contact with her?

Also: do we have a collective standard on how to handle emergencies on Twitter?

Here’s where I think a couple of things need to be worked out: 1) How the user-base naturally uses Twitter in these situations and 2) Twitter’s involvement.

So far, Twitter’s user-base hasn’t come up with a way to handle emergencies. It was the user-base, not Twitter, that made hashtags a conventional feature of Twitter. But when it comes to the psychology and sociology of an emergency, there hasn’t been much talk about what to do.


This is where Twitter may be of help – by offering tools to help emergency services.

A thought: Twitter could enable a tag system which, if used, alerts local services to the tweet automatically (based on geolocation data).

Now, such a set-up could be abused (I could see all the dummies dumping tons of hashtags onto the retweets), but it’s in Twitter’s power to exert some intelligent power of the tags it assigns.

I propose this: Twitter establish #911 as a universally understood hashtag (for U.S.), one under its control – not only meaning suspending abusers (or just blocking their use of the tag) but also linking the hashtag to the user’s geolocation and creating a network of emergency services through which to patch the data. Twitter’s API is perfect for this re-purposing.

Applications for emergency services could be created which address noise/pranks, etc.

For users who don’t have geolocation enabled, a global emergency account could message the user directing him to turn it on (even by just replying “Yes”).

As of today, #911 doesn’t appear to be used – but it makes sense, and it certainly would be easy for Twitter to promote the feature right on its website (even in spite of a lawsuit a while ago).

I’m sure there are other mechanisms Twitter could develop. But there are other considerations too – what to do in a terrorist situation where the violators are monitoring tweets.

I’m just throwing these out there. There’s no perfect solution, but things can be done. I hope people pick up what I’m getting at and continue with their ideas.

As I said: on one hand, this is an easy matter to address, and yet there are subtle issues that perhaps we need to hash-out publicly.

Just as there was a time during the telephone’s early evolution when there were no standard emergency protocols and systems, so too it is with Twitter currently.

So, again, the question: Would you know how to tweet an emergency?

@PhilBaumann @HealthIsSocial – Newsletter




MDchat on IBM’s Watson and Physicians on Twitter

One of the great things about starting and moderating a Twitter chat, is that you see the growth of a community of people offering snippets of their diverse ideas and experiences.

Last night’s MDchat – @MD_chat – was particularly of interest to anyone interested in medicine and high-tech. The two topics were:

Although the transcript may be long, it’s easy to follow (I stripped out the RTs using @foxepractice’s transcription service). Check it out [link if you can’t see embed below]:

MDchat Healthcare Twitter Transcript for February 22, 2011

As you can see, there are so many different perspectives on how today’s evolving technologies impact (or can impact) Healthcare.

Oh, and if you haven’t taken the 2hashtags pledge, consider it. For these Twitter chats show that less is more – imagine if all those tweets in last night’s chats were soaked in multiple hashtags.

If you’re interested in MD_chat, consider what nurses are doing on RNchat. These two professionals – and the other participants from all walks of life – make these chats wonderful examples of what we can do.

@MD_chat takes place every Tuesday at 9pm Eastern. @RNchat takes place every Thursday at 9pm Eastern.

@PhilBaumann – @HealthIsSocial – Newletter


Two Hashtags

Hashtags have been a valuable enhancement to Twitter’s ability to connect people and rally them around topics and ideas.

Unfortunately, hashtags have been polluting Twitter. The purpose of a hashtag is simply to demarcate a tweet into a topic. One or two hashtags should be enough to convey the essential tag of a tweet.

So today, I’m launching 2hashtags (Two Hashtags). I created the website yesterday and hope some of you get a little fun out of it.

Two Hashtags is simple: go to the site, read what it says and take the pledge if you agree. You can tweet your pledge right from the site.

I dislike “rules” in social media – but sometimes you have to try an appeal if you feel people are letting technology get in the way of clean personal connection.

It’s a matter of personal judgement, but I’d say two hashtags per tweet should be the maximum. Why? Because adding more of them is just ugly, unnecessary and counterproductive.

Here, does this look beautiful?

Some blurb about #health #socpharm #FDAsm #hcsm #hcsmeu #hcsmca #mdchat #rnchat #sm #socmed  #sxsh #OMG

This is the carpet bombing of Twitter.

Those of us in healthcare should serve as models of clear communication. <snark>I’m sure those of you who are Healthcare Communicators and PR types fully understand this principle </snark>.

Let’s keep Twitter simple, elegant and fun. Please? 🙂

@PhilBaumann – @HealthIsSocial – Newsletter


Your Last Tweet

Your last tweet. What’s it going to be?

When people look at your stream, what will they see?

Will they see endless links to serious articles expounding on the deep ontology of Twitter? 🙂

Will they see your lunch?

Will they see your lies?

Will they see any truth?

Will they see you being nice, or good? (There’s a difference.)

Will they see you?

What might they conclude?

That you were boring?

Or that you didn’t give a damn what people thought of you?

If you could now see your last tweet – and all the tweets before it – at the end of your life, would the view make a difference?

Would you want to live the exact same way?

Or would you just want to delete the account and start all over?

It’s just Twitter.



Is Twitter Turning Us Into Sparrows…Or Vultures?

You’ve heard the horrible story – the one about a young representative from Arizona, who was shot in the head.

I don’t need to get into the details. It’s all over the Web. It’s on Google.

And it’s on Twitter.

I don’t know how you feel  but I’m not all sure that this social media stuff is always healthy.

I tweeted a couple links myself when the news hit. Then wondered what value they truly conveyed.

This woman has a husband. Children. Friends. Other family.

People with feelings and problems, hopes and dreams.

Do they need any of us to tweet about what happened? Does it help them?

If it does, then by all means: we should tweet tweet tweet! Who would argue against that? Especially if you know exactly how it helps them.

But if it doesn’t – if tweets degenerate into cacophonies and orgies of slacktivism – then why bother?

Should we tweet at high volume when a woman is shot in the head? There’s no right or wrong answer, but the question matters.

A woman was shot in the head.

I never meet her, lovely sparrow I’m sure he is. I love her in some sense because she’s a part of us, of you. You love her too in that way.

We should discuss how and why these things happen – and do things that make differences.

There are times, however, when silence and stillness are the last refuges of hoping and caring and loving a world so full of hate and wreckage.

Is Twitter turning us into sparrows or vultures?

It’s OK to be quiet in the storm of noise.

For the silence of sparrows can proclaim more than their tweets.


Healthcare Hashtags on Twitter: An Interview With Fox ePractice

Twitter + Hashtags + Healthcare = Awesome.

Why? Because Healthcare has become one of the major topics of conversation and interest around the world and Twitter offers an easy-to-use, convenient and intimate way to connect, share and network.

Twitter provides one of the first media which enable global, public, instant and continuous connection where patients, nurses, doctors, students, scientists, communicators…anyone to learn from each. 140 characters may not sound like much, but brevity is wisdom’s throne.

The last couple of years have seen the rise chats related to healthcare – so much so, that it’s gotten rather daunting to know what’s where and when. Since the first healthcare-related Twitter chat, #hcsm, there have been many others that have emerged.

Furthermore, documenting these chats so far hasn’t been that easy. There have been some transcription services, but nothing very remarkable. I know, because I run two chats – #RNchat and #MDchat – and producing a clean transcript can be difficult. Until now.

Enter Healthcare Hashtags: A Social Project by Fox ePractice. The Healthcare Hastags Project is the first directory of healthcare-related Twitter hashtags and chats. According to Fox ePractice, there have already by 1,000,000 healthcare tweets tracked.

I interviewed Audun Utengen and Tom Lee, creators of the Healthcare Hashtag Project to find out more about it. It’s an important step for Healthcare’s venture into social media – in spite of Healthcare’s late entry, it’s projects like this that may help catalyze adoption by hospitals, nurses, doctors, patients and everyone else involved.

But first, a bit of back ground on Twitter hashtags and what all the fuss is about. After the interview, I’ll offer some thoughts on the future of Twitter hashtags and chats and how – or if – they’ll endure.


There was a time in Twitter’s short history, when the service was the simplest website: you squeezed in 140 characters, hit a button and it went into a stream. If someone wanted to get your attention, you really didn’t know unless you were watching every tweet in your stream – and then only if you were following the person.

Eventually, users appropriated the “@” sign used in traditional blogging to help that problem. And then Twitter eventually built the reply function into its website. And as developers built on top of Twitter’s open API, replies became much easier to notice. New users may not appreciate what they have. 😉

Another problem with Twitter back then (and even today) was finding topics and people you were interested in. Searching Twitter wasn’t very good. In fact, other than a feature called Track, there wasn’t a way to search Twitter. Then a search engine Summize came along, which Twitter eventually acquired.

Even then, though, it was hard to know where the topics and groups and people were on Twitter that might interest you. If you were interested in Diabetes, for instance, and searched the term, the results were mixed with tweets that just happened to use Diabetes. There was no way to emphasize “This tweet is intended to be about Diabetes”.

Then in August 2007, Chris Messina proposed that the “#” sign (hashtag) be used to designate groups. Thus the hashtag became a way to refine search and filter out tweets that had nothing to do with the topic.

Twitter then enabled hyperlinking on hashtags, so you could click on it and see the search results for the them.

Eventually, people realized that you could take the concept of the hashtag one step forward: as a way to rally people around a topic to conduct chats. Initially, it was difficult to follow a Twitter chat, since one had to rely on refreshing a Twitter search page for the hashtag. But services like TweetChat make it easier to keep up with chats, since they display all and only those tweets with the hashtag for the chat.

A new twist on old ways to communicate, like SMS and IRC, thus has emerged.


And that brings us to Healthcare.

Today there are a whole bunch of hashtags and Twittter Chats with some focus on Healthcare. Two popular chats, #hcsm (US) and #hcsmeu (Europe), for example, are general healthcare communications and social media chats.

More and more healthcare chats have been growing and branching into more focued territory – #RNchat and #MDchat are chats where nurses and doctors can exchange professional views and publicly and have patients contribute their prespectives. And there are even more focued chats like #hpm (hospice and palliative medicine). The number of hashtags and chats continues to grow.

So given the growing number of healthcare Twitter hashtags and tweetchats, having a service that brings order and context has come right on time.

So let’s meet the creators of the Healthcare Hashtag Project.


Several weeks ago, Tom and Audun told me that they were working on a project to gather the healthcare-related hashtags into one place in order to help providers and others in healthcare more easily find topics of interest on Twitter.

They were kind enough to show me their prototype and was I impressed with what they were already assembling. During the conversation I had expressed my disappointment with some of the transcription services and what I thought would be a good transcript aesthetic and format – and I sort of jokingly asked if they had the skills to develop their own transcription service.

Well, they pulled it off! As a result, I’ve started to use their service to generate transcripts for the chats I run (here’s an example of one from an MDchat on Alzheimer’s).

In addition to the transcription service, the service also provide some statistics.

I’ve been impressed enough with their project to set aside time to learn more about what inspired them and about their thoughts and for healthcare and social media.

First, tell us a little about Foxepractice and how you see Social Media fitting in with Healthcare.

(Tom) Fox ePractice is a division of The Fox Group, LLC, a management consulting firm that has exclusively served healthcare businesses since 1989. We’ve been noticing an ever increasing shift from traditional advertising via print media to that which is online. This shift includes not only the marketing of services provided by healthcare organizations, but a new trend of the general public sharing their health and healthcare experiences online.

The social context of these conversations are very powerful, and while some providers may find this shift to represent a loss of control when it comes to their reputation, we’ve felt that it actually provides new opportunities to highlight a provider’s strengths, and to enter into an exciting new relationship with the general public that may have countless upsides.

Besides, this trend of public sharing, brought about by what’s commonly called “web 2.0”, is sure to grow and evolve to include even more public involvement … so for providers to avoid it is a significant strategic mistake. But perhaps more than that, we feel that ignoring it is a disservice to the evolving, and more sophisticated patient who wants to better know their healthcare providers and to participate more in their healthcare decisions.

With that in mind, we chose to launch “Fox ePractice” as a vehicle to assist healthcare providers, large and small, to do more with their online presence than just have a static website talking about themselves. We wanted to help them to enter into this new, interactive environment, to control their reputations, and to become more accessible to those seeking their expertise.

(Audun) Fox ePractice was founded on our belief that the future relationships between the patients and providers will be initially be created and later sustained in the online sphere. When we started looking at the numbers it became clear that this “future” is closer than what most people realize.

The patients are already here. The majority are actively seeking health information online, researching their treatment options and researching potential providers. These patients are using traditional websites to find most of this information, but certain social media platforms are used for researching provider reputation. What’s clear is that for the most part, it’s the providers that are delaying this transition to the online sphere.

This is where we saw an opportunity to provide our current medical practice clients and others, specialized services to help them create and operate their online presence which social media is a major component.

The Healthcare Hashtags Project may be one of the most useful Twitter utilities and directories I’ve seen. What was the impetus for the project?

(Tom) I knew from my own introduction to Twitter that while on one hand the platform is pretty simple, on the other hand finding the conversations that I was wishing to participate in was a little more challenging. Hashtags helped, but I found that there were often several different hashtags being used for the same topic. I figured that if I was finding this confusing, then providers who were contemplating Twitter were likely finding it confusing as well.

Since one of Fox ePractice’s goals is to help diminish the barriers to online engagement for healthcare professionals, Audun and I decided that I should write a blog about how to find the many conversations taking place, and how to participate in them. As I contemplated that, it became all the more clear to me that there were likely many people and many conversations going on that would benefit immensely if they could only find one another.

And it was at that point that I “saw the light” … an interactive database of healthcare hashtags. We kicked the idea around a bit and felt there was some significant value in pursuing it. Fortunately there were many generous and insightful people who we had the good fortune of having met via our own use of Twitter who felt the same way, and they all helped us immensely to brainstorm and identify features that would be most useful for both providers and patients alike. We’re very grateful for that assistance.

(Audun) Twitter is such a valuable tool for providers! We’ve seen how it can foster real conversations and relationships. However, Twitter is still a “wild wild west” technology. It can be extremely noisy. Without some guidance, it’s easy to dismiss Twitter because you’ve wouldn’t know where to look for the conversations that you care about.

Like with the rest of the internet, 99.99% of all content is junk. But that 0.01% that you consider as quality, other’s sees as junk. This is what makes the world so colorful. But it creates a need for curation which creates niches, such as healthcare. It creates a need to help each other filter out the junk and promote the quality. Together with the community, this is what we try to do with the Healthcare Hashtag Project.

What are your main goals and hopes for the project?

(Tom) As mentioned, we really want to decrease the barriers to entry. Make getting into and involved in the Twitter community as easy as we can. We hope that in doing so there will be many more professionals entering into the online sphere, participating in these conversations, and helping to be a voice that provides sound information to a public that’s searching online for issues involving their health at an ever increasing rate.

We see ourselves as being at the center of the shift currently taking place, and we want to spread that to not only the providers that we serve, but to the searching patient as well.

We’re currently researching and preparing for a disease index of hashtags that will allow for patients to connect with one another, and for providers to make themselves accessible in such conversations as well. We’re really excited about this upcoming Endeavour and believe it will be very powerful.

We’re also planning to launch a database of healthcare hashtags that are specifically related to conferences. We want to allow organizers of such events to publish an affiliated hashtag with us and to announce the dates of the conference. Doing so will hopefully help to promote the tweets from the attendees so that they can be shared with the greater online community.
(Audun) We want to bring the future here now. If we can help more healthcare providers adopt social media by lowering the barrier to entry, by filtering out the junk and by promote the quality conversations, we want to do it.

Could you tell us about the kinds of numbers of tweets you’re processing? Twitter’s own search does not currently do a good job of keeping tweets in its search. Are you storing them?

(Audun) Curation is needed in order to promote quality, so at this point we are only following about 200 healthcare hashtags. People are steadily notifying us of good hashtags to follow so this number is continuously increasing. From the two months this project has been active, we have archived over 1,000,000 healthcare tweets. That’s an astonishing number! And it’s growing quite fast, proving that healthcare social media is just starting.

In addition to a listing of healthcare hashtags, the project offers a transcription service. I’ve found it to be incredibly useful in the chats I run. Do you see the service evolving? For example, do you envision or advanced features like text analysis?

(Tom) In my mind, the number one thing to address at this point, as far as the transcription service goes, is language translation. We’re experimenting with some available options, and while they may not be quite ready yet, we hope to be able to introduce this feature in the coming months.

At first I think of our friends in the European Union (#hcsmeu) and all of the different languages that create automatic barriers for a greater conversation. Then I think of the various “hcsm” organizations from around the globe … and the recent hashtag submitted to us, #hcsmglobal. We really do have the ability to shrink the world more than just a little bit. As Dr. Howard J. Luks (@hjluks) always says, “We’re all patients.” I like to imagine the benefit to patients and providers alike of easily translatable conversations/transcripts that would allow us to share on a global level.

(Audun) Most of the features of the Healthcare Hashtag Project are ideas and requests that people have brought to us. This truly is a social project. There are other transcription tools out there, but I believe we somehow can make this work better by being focused.

We are totally focused on healthcare. We have several ideas we want to play with, and once again you bring up an excellent idea with text analysis. We have limited programming talent and time resources, but we’ve evolved quite a bit over these two months, so expect many new features to trickle in during 2011.

What do you think are the biggest emerging trends in Healthcare, especially for physicians?

(Tom) Big question. From a global perspective, I’d say that it’s a mix of three things that all have a common link in technology.

First, there’s the inevitable shift to electronic health records so that health information can be easily tracked and shared.

Second, mobile technology. There’s so much happening there that can be both cost effective and an answer for how to deliver needed, quality health services to “off-site” or even quite remote locations.

The third is what we’re talking about in this interview. Human nature, technology, and innovation are going to reshape the provider – patient relationship. I believe that patients will ultimately benefit in many ways. Providers who overly resist this inevitable shift will go the way of the dinosaur.

Thankfully, there are a number of role models out there (physicians, hospitals, etc.) who are currently embracing this medium. They’re setting standards for future generations. And rest assured, there are many young medical minds who have grown up with this social behavior via technology who are already playing in the online sandbox.

(Audun) I believe we are about to start figuring out how to solve a major hurdle in healthcare, changing people’s lifestyle.

Knowledge about health is obviously not enough. Today, people have access to a wealth of health information, we have more knowledge than ever. The problem is that people are not acting on it. A simplified example is our eating habits. Why do we choose not to eat according to what we know is best for us? Bringing about a lifestyle change is one of the most difficult things on this planet. But I believe we have realized that information is not the whole solution. How to motive and incentivize people is the next step.

The biggest emerging trend in healthcare the next decade I believe will be gamification of healthcare. This is not about “badges”. But it does include social media, both large open social networks and small closed social networks. Initially it will be enabled by technology with game dynamics, geo location and mobile devices, but there is nothing stopping gamification of healthcare to also take place in the offline world. This will be an interesting space to watch.


I think what Tom and Audun have done for these healthcare hashtags and chats is pretty remarkable. Not only for what they’ve done in terms of organizing them – but also because I think their project might spur even wider adoption of social and other technologies in Healthcare.

One note about Twitter chats I’d like to make, is that there existence can be tenuous. I’m a big proponent this mode of communicating and sharing. I’m probably Twitter’s biggest fan. And I run chats for arguably some of the hardest professions to cull into social media: nursing and medicine.

Having said that, we have to realize that media software constantly emerge and evolve. Communications problems that are solved by one medium can open up a new breed of problems which another medium can replace or enhance.

With social media (or “disposable media” as I think of them), there is no stable platform. It’s all in flux.

And Twitter chats, in particular, are subject to erosion.

Just to site one reason: a user could appropriate a hashtag and barge in with automated self-promotion. And unless Twitter does something about that, there’s not much a moderator or the community can do against a determined troll.

Also: hashtags are kind of ugly and the ecosystem could be hurt by them in the long run. Especially when tweeters dump more than two per tweet. (I can only dream that Twitter limits the number of hashtags per tweet to two.) 🙂

We have to remember that the reason hashtags evolved in the first place was because Twitter didn’t (and still doesn’t) offer meta-tagging of tweets. If it does, it may displace the hashtag.

Beyond that, though, I believe that Twitter chats represent a part of larger trend in communication disruption. Nothing gets simpler than Twitter. And yet, there is a need to merge the best of the snappy brain-storming percolations of Twitter chats with deeper contemplation; content enhancement and validation; and findability.

I suspect a service like Quora might offer some insight into what that next step will be. Why? Because Quora offers a new kind of blogging platform where questions can be asked, topics formed, community built and answers voted on, with the chance that vetted answers rise to the top. This is not something you’ll get on Twitter.

For healthcare, medicine and life sciences in particular, we’ll need platforms that dovetail the disciplines evolved over hundred years of the peer-review process with the swiftness of today’s media.

I would hate for the world to think that Twitter is the answer to our healthcare problems – Twitter, after all, is a great seduction. But I do think it’s fundamental premise has an important – if transient – role to play in bringing all reasoning parties together.

I suspect we’ll see a middle-ground between Twitter and Quora – where the best of both worlds can be had. We’ll have to see what Quora does as far as an API they have yet to release. Third party application development on top of Quora, in conjunction with other services, could be very interesting.

I’ll have more to say about that in an upcoming post, but suffice it to say: Twitter hashtags and chats will be with us for a little bit longer.

Thankfully, we have the Healthcare Hashtags Project to bring some order hashtag madness.


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