Play Marketing


It’s a great word, isn’t it? Simple. Elegant. Direct. Fun.

When you play, you’re going with the the natural streams of time and life.

You can play with anything actually – you just have to know how. You need skills, knowledge, experience.

You can even play with your health. People do it everyday.

It’s the way you play that makes differences.

If exercising isn’t playful, it’s unlikely to be a lifestyle.

If reflecting on your life isn’t playful, it’s unlikely to be happy.

Why does healthcare marketing fail so often? Is it because people are being asked to do work instead?

Why do social media and mobile devices attract so many people? Is it because they’re work? Or are they play?

The media we work with today are play media.

People love to play. So play.

Push marketing may be dead.

But I say Push Play is the way to go.

A little Push in healthcare marketing is OK – in fact it’s needed.

It’s just that what you push should be playable.

You couldn’t give me a plaything with television or radio or print.

You can do that now. You can push it to me in a tweet actually.

It’s not Social that’s going to do the lifting in Healthcare marketing. It’s Play.

Play is the missing link between traditional and social media.

Play is healthy. Health is playful.

Market play.



Touch or Tweet?

Before digital – before tools – was the digit. The original digit. The finger.

The fingers could touch, could point, could gesture, could fashion – the tip of one could even make love. Wonders of bone and fascia. These fingers, these first digits, made the first tools, the first paintings, the first languages, the first civilizations.

And now, the ultimate bringing-forth of our fingers, the binary grip of the digital age – the all-or-nothing fascism of zero and one – is poised to render its ancestors into feeble vestiges of natural selection.

The tweet is now metaphor for the rapidity of technological selection and point-to-point connection. The tweet seeks to replace the touch.

Healthcare is now poised to seek out new ways of patient care via digital technologies.

But as it does, what happens to touch – which is more than just skin-to-skin, but eye-to-eye, mouth-to-ear, heart-to-heart?

What happens when we decide to tweet more and more, and touch less and less?

To touch or to tweet? There’s a question.

For we are entering an undiscovered country: if we lose ourselves in tweets and lose touch of each other, how shall we grasp what matters most to us all, the other human digit: our dignity?



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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