How a Mood-Tracking App Drove Me Nuts

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

484-362-0451

Facebook Is A Mess

Facebook is a mess. It really is. All the insane features that always change. No security – at any moment, data can just vanish – or appear in places it shouldn’t.

The worst part: for all of the features and filters and options, you have no control of, or equity in, any of the design. Every.single.Page is the same – hundreds of millions of the exact same cargo boxes of Walmart blue and white and Lucinda.

One long train heading for a wreck, and we’re either the passengers or the innocent bystanders.

I  hope that there is never ever going to be a “Facebook for Healthcare”. You think Healthcare is a mess now? Imagine what it will look like as it gets Facebookitized.

Imagine Love having to conform to Facebook’s algorithmic architectures.

Please do not make the mistake of thinking that these are “just tools” – they are forces in this world: their impact is completely independent of their content.

When people talk about Facebook or Twitter on TV, the radio, at the supermarket – you don’t usually hear about the content in those media, do you? You hear talk of the media themselves.

We are at an important moment in the evolution of technology – and the way it’s packaged (Facebook is a package: you are meant to fit into it, not the other way around). Well-designed technology goes with the grain of human endeavor, not against it.

We shouldn’t try to figure out how to fit Healthcare into social media. It’s supposed to be the other way around.

After this Social Media phase we’re in right now – and it will end, even if it takes a decade or more – we will come to appreciate the beauty of owning the only thing we can own and design on the web: our own domains – and even that is a tenuous proposition.

Yes, having different spokes and nodes are important – I get all that – but this, what’s being built under our passive consent, this is madness.

The Problem With Social Media and Healthcare Marketing

Yes, you can market, communicate, and build community with patients and their loved ones using social media.

The problem, however, is that the center and circumference of online media are predicated on peer-to-peer connectivity.

If Healthcare marketers and communicators break that geometry then brands tarnish, returns vanish, and frustration levels creep.

I”ve talked with all sorts of organizations – I’ve even been asked to interview for Healthcare digital media positions in last couple of years (companies are starting to create these sorts of positions).

These are good organizations with smart and kind people running them.

A common temptation I sense in many of Healthcare organizations, however, is to go the “safe” route – the well-known, tried-and-true practices of 20th Century Marketing.

But playing “safe” that way is actually playing with fire.

The concentric and overlapping circles of peer-to-peer connectivity are like rings of fire.

If you want to “play it safe” in Healthcare marketing, public relations, and general communications, you will eventually get burned when you jump into to the rings of fire without fully mastering – and realizing – the prowess of the supple musculature and passion demanded of 21st Century pressures.

So many traditional PR pros – with outstanding skills and experience – have serious troubles making the flip to today’s communications and community-building. I hear this complaint all the time from those Healthcare PR and marking pros who have completed the other half of public relating and are doing well with social media.

So, a few practical tips:

  • Don’t ask patients, er consumers, to Like you.
  • Tweeting and Facebooking are not marketing nor communicating nor building.
  • Don’t be lazy about content creation.
  • Learn more about Search algorithms.
  • Develop CRMs amenable to today’s nebulous networks.
  • Put the on-the-ground communications before online syndication and engagement.
  • Critical: Hire smart people with Healthcare backgrounds – if you stumble upon a physician or nurse or other HCP who is not only tech-savvy but also adaptive and who can learn new things: grab her or him! If not, your competition just scored a huge advantage and you’ll regret your decision when you realize what you let pass out through the door.

I understand the concerns – and fears – executives and managers of Healthcare organizations. Their concerns are rational, while the fears are not. Unfortunately, organizational fear often holds more sway than rationality.

But history has shown, over and over, how so many companies that faced changing conditions simply refused to step back, brave self-critical analyses, and profoundly apprehend and exploit a changing world.

In the end, patients will bear the costs of fearful leadership in today’s participatory communications – safety belongs at the bedside, not the boardroom.

The problem of Healthcare and Social Media Marketing is within you. So is the solution.

More crudely: You are the problem.

Good news (maybe): You are the solution.

@PhilBaumann@HealthIsSocial

484-362-0451

Folk Photography As Digital Therapy

Sister Swans by Phil Baumann
Sister Swans by Phil Baumann

Facebook paid $1,000,000,000 for the photo app Instagram. I won’t get into what’s behind that valuation. For that I refer you to this.

I would like to suggest, however, that the kind of digital picture-taking technology which Instagram represents offers a chance to partially offset the attention-fraying effects of our increasingly digital lives.

I don’t go as far as to say that using Instagram is “photography” – to me, photography is an art, one honed by years of experience and maybe training. So I’ll use the phrase “Folk photography” to refer to these application-based picture-taking tools.

From my vantage, I see the world becoming more immersed and enmeshed in digital connectivity. There are gains to this – and there are losses.

It’s getting harder and harder to slow the pace of digital life if you don’t invest effort in being purposeful and selective in the resources technology consumes.

Digital folk photography can be a way to convert the power of tech from time-consumption to therapeutic creation.

Life goes by us so faster. Faster when we don’t take notice.

There’s something therapeutic (in the general sense of the word, not necessarily its clinical use) about slowing the world around you down by opening up your eyes and ears. Services like Instagram and Snapseed provide ways of taking advantage of this slowing-down.

I’m not just talking about whisking out your iPhone and taking a more of pictures of your kid’s birthday party than just being pressent for the moment in that moment.

I’m referring to using these devices as a way to be more aware than the tech itself permits you to be aware. We need ways of wresting back control which these tools take from us (with our permission).

What’s more, Instagram’s filtering process gives you an opportunity to spend time focusing on a folk creation. No, it’s not epic photography – and it’s not so much the actual product that’s important.

It’s the process.

Even taking the time to play around with filtering a picture with Snapseed, or with Instagram’s native filtering, offers an opportunity to be more focused and appreciative of what you’re doing. This kind of play gives those photos more value – they don’t just get jammed into a server to be forgotten.

For people dealing with clinical depression, or loss, or post-traumatic stress – anything painful or numbing – I think that using these technologies these ways could be immensely therapeutic – I won’t advise this as clinically therapeutic. For that, we need research.

But in a general sense, perhaps the Healthcare industry – from mental health to rehabilitation – aught to take notice of the potential therapeutic benefits of folk photography in our digital time.

@PhilBaumann@HealthIsSocial

484-362-0451

Will the Like Button Weaken Emotional Resilience?

Within the homeostatic range of healthy ego-drive is our need to be liked – loved in fact.

It’s a healthy mechanism with which we’re all born. As we grow older, our egos learn to respond – or react – to positive and negative events.

If one of us grows up with all too many bruises, it’s quite possible that the ego develops narcissist defense mechanisms (which don’t necessarily make the whole person a narcissist).

Children who grow up without witnessing, or who grow up isolated (physically or emotionally) are more left to their own to develop defense mechanisms: from deflation of the ego to inflation of the ego.

Think: if you’re abandoned or feel helpless, inventing a grandiose ego has its advantages. It helps the child from laying down and utterly giving up on life…but it also ultimately self-defeats.

So often, Depression sets in because people’s egos have taken hits. A lover leaves, and the ego breaks down. A job is lost, and the ego’s self-value deflates.

This is why witnessing during the childhood years is so vital. Bad things happen to us as we grow. How we cope depends on genetics and environment. But if we’re surrounded by others who can help us through our wounds, it’s more likely that the ego stays in its homeostatic domain.

The problem, however, with our egos:  it goes the other way too. Too much inflation of the ego is a setup for its own weakening. An inflated ego, just like a balloon, loses its resilience to popping as the tension of its surface increases. The balloon’s taught sensation, like that of an ego, might feel resilient but its tension is its very lack of resilience.

As our children grow up in a world of Facebook and Twitter and other social software that foster the “Like” behavior, what happens to ego-resilience?

As our children spend more time connected via electrons, and less via touch and pheromones, the chances increase that their isolation-evolved defense mechanisms turn against them. All that Liking, and no sense of inner Love.

Software which seamlessly invokes a mentality of “being Liked” can invisibly inflate the ego’s need for more and more and more.

What’s the effect of all this expectation (especially when this expectation sinks into the unconsciousness)?

Think about the events over your life – if you could go back, what events and what kind of people could have made your life right now healthier?

It’s OK to develop narcissistic mechanisms in the short-run to protect yourself. Eventually, however, we have to outgrow them and replace them with resilience – which is the ability to remember that you are not a function of what happens to you. You are much more than the fascinating mechanism of your ego.

What’s not OK, is living in a surrogate sibling environment that conditions you to believe you are a function of what a little blue button signifies.

I don’t know about you, but if I were sixteen again, I’d choose one kiss on the lips over a 100 Billion Likes.

May my son feel the same way when it’s his time.

@PhilBaumann@HealthIsSocial

484-362-0451

Placeme: A Creepy Model for Healthcare Information?

Data, information, interpretation and decision-making are among the vital components of prevention, diagnosis, management and treatment.

The problem we have today is how to gather and manage the data that our bodies radiate.

In order to solve this problem, we have to surmount other problems – which are not just technological but also behavioral, cultural and financial.

But if you want an idea of what an extreme version of data-collection might look like, check out the application Placeme.

Now Placeme is *not* a Healthcare application. What Placeme does do, however, is to continually (in almost real-time) track the places that you visit. No check-ins; no need to enter and data – the application simply runs in the background and does its magic.

When you think about that (from the cultural perspective of today), that’s creepy.

And yet, this “creepy” model is the future. It represents the technological and cultural arc that social software is throwing us. We can fight it (and should in order to flesh out the nuances so we can ensure safety) but in the long-run we shall have to accept the trend and work accordingly.

So think of Placeme in terms of what the ‘Quantitative Self’ movement is attempting to achieve. Let’s call a Healthcare analogue of Placeme Healthme. For example:

  • Recording glucose readings (from a ‘tweeting’ glucometer)
  • Cardiomuscular activity (pulse monitoring)
  • Environmental sensing (pollutants, pollen count, barometric pressure, etc.)
  • Visits to healthcare facilities (‘tweeting’ EMRs)
  • Social-bonding activities (support group meetings, online discussions, etc.)

The list of possible ‘Places’ goes on.

It’s a ‘creepy’ model in the sense that once this kind of collection begins, your life is being measured.

I’m not a big believer in applications for Healthcare as big parts of solving our problems.

Rather, I’m in favor of robust approaches that integrate the whole process of Healthcare Care – not just at the individual level, but also at the public level.

The problems in Healthcare are not the problems in front of us.

If we want to tackle the overal disease of bad health, we need to tackle the fundamental problems of Civilization Design.

What does Civilization Design mean? It means layering into the designs of our buildings, regulations, technologies, customs, etc. an understanding of their possible health and behavioral consequences.

In the meantime, however, models like Placeme – as creepy as they are – can help us intuit what’s possible.

What technologists who wish to develop Healthcare analogues need to do is to work with others in Healthcare to better understand what data is relevant.

That’s the hard part: sorting the relevant data from the irrelevant data.

That’s a major problem the Quantified Self movement has. The other is that it’s Self-based.

Healthme needs to be both. A technology that continually gathers an individual’s relevant data while integrating the world-wide pool of other relevant data to prevent, diagnose and treat the right problems at the right time within the right process.

@PhilBaumann@HealthIsSocial

484-362-0451

 

A Pocket Guide to Social Media for Physicians, Nurses and Other Smart Heroes

This is the super condensed Pocket Guide to Social Media for Physicians, Nurses and Other Smart Heroes.

  1. Figure out how social media platforms and tools work – you can do this on your own. To get started, Google keywords, like “social media”, “Twitter”, “Facebook”, “Blogging”, “Youtube”, “API”, “Hashtags”, “Google Places”.
  2. Use your imagination to figure out how these media can be re-purposed in Healthcare, networking, professional development or anything else that interests you.
  3. Reflect on topics such as: Ethics, bedside manner, HIPAA, patient dignity, professional development, peer networking, collaboration.
  4. Become a better professional: call a patient or colleague whom you haven’t seen in a while and ask “How are you?”

There it is: your Pocket Guide to Social Media for Physicians, Nurses and Other Smart Heroes.

Now this isn’t intended to be a sarcastic post: these tips are simply about the rudimentary elements of being literate in the 21st Century.

The truly difficult parts of doing social media in the long-term while achieving success – well that’s something that comes from experience, determination and surrounding yourself with other smart heros.

The guide is available for download here and here.

@PhilBaumann@HealthIsSocial

Draping the Patient with the Social Medium

If physicians, nurses and other practitioners are going to work with patients via Social Media, should they at least know how to drape them?

What does it mean to “Drape the patient with the social medium”?

Two points to note about draping (as surgical procedure and metaphor):

  • Patients are susceptible to harm
  • Media cultivate vectors of infectivity

Social media are not sterile fields – unlike non-absorbable paper, or muslin, there are no finite end-points for these media. You can’t create a 1″ inch border so-to-speak.

Anytime an HCP approaches a patient, she brings along her experiences, skills, world view, prejudices, brilliance, blind-spots…and ideas.

What’s fascinating about social media is that each medium bends in its own way(s) – at the speed of light – the communication and presence of the HCP.

The most common error about the intersection of Healthcare and Social Media is this: that the online world is analogue to the offline world. This is a superficial – and dangerous – view.

It’s not that HCPs need to work in a sterile manner if they are to work with patients via a particular digital medium. It would be ridiculous to take the metaphor that far.

Rather, HCPs need to grasp that digital draping – as metaphor – can guide them in having a robust awareness of their communications, interactions and judgements.

For just as surgical draping is also a frame-of-mind to heighten awareness, social media draping is a professional (even if informal/human/humorous) demeanor of practice.

It’s not enough to work these problems out on blogs – we do need research and much more critical thinking (not over-thinking…but critical thinking) in how HCPs relate with patients (and in their general digital presences).

The flip side here, though, is that it’s easy for the social medium to do the draping – in turn, masking from the provider certain key clues as to the problem she, reasoning with the patient on the other side of the medium, must work to solve.

Every transaction online is a simulacrum. We are creating billions of tiny simulacra everyday. The Healthcare simulacra embedded within social media must be understood as such, lest simulations get confused with reality. (More on this in a future post.)

The speed of the medium is directly proportional to the absorption of the message, but inversely so to its interpretation.

@PhilBaumann

 

 

The Unfortunate Misappropriation of “Social Health” by Social Media Hypers

“Social Health” – just like “Social Business” – has become a lazy buzz-phrase for social media in Healthcare. This is a problem.

Social Health refers to how people relate to others, and the resulting overall health impacts on individuals – from unrequited love to having fun with friends to violence.

It also refers to the health of populations in their realationships within themselves and with other populations. Societal Health, if you will.

It’s a vital concept: our health does not transpire independent of our social environments.

To steal this phrase as a handle for social media is to misunderstand social media – and, more importantly, Health.

Media are just media. Do social media have roles in Healthcare? Yes. But that’s not the point.

Let’s not displace Social Health in our eagerness to make everything about social media.

When Healthcare professionals use this phrase, it’s rather concerning. Disturbing, to be blunt.

It would like confusing love with a telephone.

Thank you,

Phil Baumann