Ethics and Health in Social Media

We don’t talk much about the ethics involved with social media, especially in Healthcare where it matters most.

Why not?

Is because everybody is so absorbed with “how to use social media to______”?” that ethics isn’t even a thought?

We developed schools of ethics because ethical issues can be hard to spot on the surface. A general “be kind, be good” doesn’t cut it. No matter how good we are, it can be easy for us to commit ethical slips.

What are the ethics of following patients on Foursquare (a geolocation service)? Yes, geolocation has it’s place in health care and crises. But isn’t it a bit weird that hospitals would follow people’s check-ins, especially when most check-ins have nothing to do with any kind of health care?

What are the ethics of scouring public posts, tweets, status updates, etc.? Can researchers mine public data without any ethical restraint just because that data are public?

We aught not carry a dismissive attitude about what doors social media are opening up.

Just because a tool creates a new opportunity for you, it doesn’t mean you have to use it.


The discourse and assumptions and philosophies we adopt right now – today, this very year, this very moment – will forever shape the kind of civilization we make. Let’s call it ethical lock-in.

Do you not realize how transformative this age – this momentous, changing-right-before-your-eyes age – we live in is becoming every day?

Do you not see how Twitter can be used by the charming Hitler’s of the world to lead us into destruction? Remember: evil empires always slip in theough the cracks unfilled by dismissive peoples. Tweet by Hilter:


Adolf Hitler


RT @.FDR The only thing we have to fear is fear itself. << Except…Adolf Hitler, bit*ches! LOL

March, 1933 via UberTwitter

The above tweet sounds absurd: but it’s physically possible – had Twitter been around in the 1930s, it would have shaped the course of history. I don’t mean any offense or lightening of history – the point is that a dictator could very easily use these media to exploit entertainment and spectacle to throw his evil into the shadows under the guise of “that whacky guy”. Would you follow Hitler on Twitter? It’s an ethical question: follow him and you help build his “following” and thus boost his ego and possible reach; block him and you might not see what he’s up to.

What are the ethics of a hospital following patients? No right or wrong answer per se. But there are ramifications to following on Twitter – I can use software to see who a hospital follows (and who follows a hospital), map out all the connections, mashup dashboards of content – metadata – and use that for purposes nobody even considered when they hit the follow button. Just a thought. What if an insurance company did exactly that?

Do you not see how boundaries on Facebook can be easily violated?

Do you not see that a conversation in an elevator is not the same thing as a tangle of @ replies on Twitter? We do not live in a linear universe – the online world is *not* necessarily a mirror of the offline one: to believe that is an error of logic –

Do you not see how geolocation services can open wide the chance for governments to achieve their long-dreamt hope of the perfect Security State?

Do you not see how the Facebook Wall might be like Plato’s Wall? This is important – for if we do not understand our reality, how can we form ethics?


I’m not saying these media are all bad.

I am saying that we owe it to ourselves to think critically.

But I suspect that our dopamine receptors may be getting too full to deal with the hard brain-work which all ethical discourses require.

Hurry – the window for us to create healthy and democratic spaces on the Web is fast-closing.

An unhealthy and unethical civilization creates unhealthy and unethical people until it vanishes.

Healthcare professionals (including marketers) have a duty – and a right – to scrutinize the ethics of how social media is used; how they influence our health; and how to ensure that social media’s deceptive simplicity ramifies and complexifies ethical matters we take for granted.

If you truly love social media and don’t think this is a big deal, then why would you be afraid to have your ideas filtered through the rigor of critical examination?

The question mark is the ultimate social medium.

@PhilBaumann – @HealthIsSocial – Newsletter


Mission Statements in the Age of Social Media

The issue of social media policies in Healthcare and Pharma often come up. There are different angles to consider – employee behavior, risk management, privacy, regulatory considerations.

Often, the approach is based on the idea of integrating social media into strategy. But I think that’s an incomplete view. For today’s technological conditions might be so disruptive that they actually may call into question the very strategies – and mission – of an organization.

So here’s a video – a kind of Business 101 if you will – which hopefully will help make clear the importance of re-visiting the *mission* before trying to just merge social media into strategy and formulating policies. It’s about 8 minutes, but I think you’ll find this to be important if you’re vested in the future of your organization in the age of social media [link]:

Please note: that by “mission statement”, I don’t just mean the formal written document in most companies’ publications. A “statement” is a state of mind (ment – mentation – mental).

Here are the two examples of corporate mission statements I mention in the video. Note the gaping differences in usefulness and meaningfulness between Google’s and Pfizer’s:

Google’s mission is to organize the world‘s information and make it universally accessible and useful. (emphasis added)

We will become the world’s most valued company to patients, customers, colleagues, investors, business partners and the communities where we work and live.

I explain why these differences matter when trying to figure out how to make sense of today’s technologies and the impacts they have on every facet of our lives and businesses. (As an aside: Pfizer’s (PFE) current share price is approximately 3% of Google’s (GOOG). Just sayin’.)

What’s your Healthcare mission? And how might technology affect it?

How might the production of molecules that go into our bodies be affected by new technologies? How might the missions of the companies that make them need to change if they are to succeed? (Think: new ways to collaborate, research, recruit, organize, manufacture.)

How might the emergence of social networks of genomic information open up new kinds of missions?

Are you considering a) how to integrate something new into existing strategies, or b) how new things might be changing the mission and its derivative strategies, tactics, policies and resource management?

Do you think it might be smart to consider the later before jumping into the first? The later requires much less work and resources than the first. The later just needs a few healthy brains to find.

Ah, there’s a mission for ya. 🙂



Healthcare, Democracy and Social Media Freedom

Democracy is the a result of healthy civilization.

Healthcare is the result of democratic civilization.

Democracy and Healthcare are deeply interconnected – each depends on the other one.

The Internet, and social media in particular, are enabling inter-connections in new and yet-to-be understood ways.

So here’s a question at the heart of the intersection of health and social media: Does Social Media create and foster Democracy?

Since social media enable anybody in the world to express themselves, it would seem that they would engender democratic institutions. But Democracy is more than just freedom of speech.

Democracy involves the active participation of awakened, critical and astute citizens.

The problem with social media is that it can create the illusion of connection and voicing and democracy. Social media are no exceptions to the long history of power struggles, class warfare and the emergence of totalitarian states.

The Internet will have its states too – right now, we’re having a hard time visualizing that reality.


The Twitter revolution in Iran in 2009 wasn’t much of a revolution. Those brave Iranians who took to Twitter may have voiced themselves to the world, but their lack of a cohesive ground strategy was their downfall. Twitter, in fact, may have been a distraction and a deadly weapon in the hands of the dictatorship.

The point I wish to make is this: everyday, people go online to seek content, networks and applications which promise to help their lives. As Healthcare networks extend and enhance traditional Healthcare, how everybody participates must not devolve into some medieval cacophony of misinformation and miscommunication.

You see, what patients want from Healthcare is to be treated like human beings, like citizens, like participants in a Democracy.  Phrases like ePatient and Empowered Patient, etc. are really about the democratization of Healthcare.

That democratization involves the collaboration of all parties involved in care.

If Social Media Freedom leads to something other than Democracy, the kinds of extensions to traditional Healthcare which the Web promises won’t work out well.


Democracy is a permanent revolution. So is Healthcare – from the science underlying it to the practices powering it.

In order for this permanent revolution to work right, we need renegades from all corners of health care (not just Healthcare). Doctors, nurses, researchers, case workers – all must be literate in accordance with today’s standards of Web literacy.

I would argue in fact, that in light of the dangers facing Democracy from the Fascism of cacophony and Illusion of Democracy, healthcare professionals have a duty to learn how these evolving technologies impact our lives.

The Freedom of Social Media isn’t really a Freedom of the People.

It’s a Freedom of Technology.

And Technology’s agenda is utterly different from Democracy’s.

What we do with the Freedom of Social Media has everything to do with the present and future of Democracy and Healthcare.

@PhilBaumann@HealthIsSocialFreedom Fighting Front

Healthy Media

It’s so true that it’s a tired cliche: The medium is the message.

Marshall McLuhan’s proclamation almost 50 years ago has everything to do with our time.

Media are no longer intermittent parts of our lives.

Print, radio, television – you turned them on, you turned them off. You did the turning.

Today’s media – they stay on.  They’re sleepless faeries. They do the turning.

Each of these media has their own unique properties, possibilities, limits and uses.

What are the messages of these media? The media themselves.

The message of Social Media is Social Media.

So if the medium is unhealthy – addictive, misinforming, infiltrative, distracting – the message is unhealthy.

Those of us who want to make the best use of Social Media for healthcare, need a clearer language about how we can make the Web better for patients, providers, researchers, etc.

When we’re discussing the intersection of Healthcare and social media – whether a particular medium is good/bad for in a particular context – perhaps we should ask “Is this a healthy medium?”


It’s hard to understand what it means to claim “the medium is the message” because we’d like to think that the container and the content are different. The medium is the medium, we think.

Let’s think of it this way: What’s the message of a petri dish of bacteria? It’s the medium: the petri dish of bacteria.

The message of a gene is…a gene.

Healthy Media are those media which produce healthy messages. They propagate health.

The message of Healthy Media is Healthy Media.

If you’re looking for Healthy Media online, you’re looking in the wrong place.

So: what are Healthy Media? –

The cells in your body.

Your body.


You are a healthy medium propagating the message of you.


Sometimes the messages falter – bits and parts of you break-down. It may hurt. It may depress. It may kill.

But: there you are, all the while a propagating medium of health.

Can – and does – Social Media play an important part of staying and becoming healthy? Yes. And no. So you take the best and propagate the best.

But Social Media is not Healthy Media. It’s its own medium.

You, on they other hand, are a true social medium.

A healthy social medium.

What’s the message of your body? What messages are faltering?

Can you find other healthy social media – other you’s – to connect, share and help each other?

Because if you can do that, then you are building a network of Healthy Media.

Social Media isn’t the right phrase in Healthcare.

It’s Healthy Media.

You never thought of this before, but Medicine is about propagating Healthy Media.

Health Care keeps the Healthy Medium well; fixes it when it falters; and dignifies it when it dies.

You, my friend, are it!

You are a healthy medium.

You are the message of health.

The message of health is you.

@PhilBaumann@HealthIsSocialHealthy Messages from Hermes


Fred Wilson, John Doerr and Mark Zuckerberg

If you’re in healthcare and do anything with technology, communications, marketing, professional collaboration, information systems or advocacy, then you need to understand the big ideas and things will make this century tick.

Web 2.0 Summit 10 ends today but video of the good stuff is available online. One of the videos is included in this post below.

Three of the most influential people in technology today are venture capitalists Fred Wilson and John Doerr, and Facebook co-founder Mark Zuckerberg.

Fred Wilson has invested in some of the biggest technologies, including Twitter, and blogs and tweets extensively. John Doerr is similarly influential, investing early in companies like Google. He hasn’t tweeted much (unlike Fred Wilson, he turned down investing in Twitter), but since Twitter is the Borg sucking everyone in, you can follow him here.

Mark Zuckerberg, as you know, is founder of Facebook. Whatever some of us may think of Zuck, he’s emerging as someone who may end up holding the information of the largest gathering of human beings ever assembled. (Repeat that in your head and think about the implications.)

During Web2.0 Summit, these three men exchanged views. I strongly recommend you set aside an hour to watch each.

You ask: Why? And what in the world does this have to do with Healthcare?? Because these are the players who are shaping our world, helping to manifest the technologies which will have everything to do with Healthcare: from information systems to social media to the Internet of things.

Here’s Zuck [link]:

Here are Fred Wilson and John Doerr [link]:

Keep an eye on people like these. What comes out of Silicon Valley and San Francisco is having, and will continue to have, enormous impact on what you do. If you’re not paying attention to a changing world, it probably won’t pay much attention to you.


In Defense of Healthcare Executives Wary of Social Media

It’s 2010. You work for a hospital, clinic, healthcare marketing agency, or an association. You know social media is now a staple of doing business (because it’s 2010).

But: you can’t do much for your organization largely because your executive leadership is wary of social media.

Executives often think differently than others in organizations. It’s what they’re paid to do (well, at least that’s what some boards of directors believe).

So what can people who want to bring their organizations into the 21st Century (because it’s 2010) do?


Business isn’t a dirty word. Dirty business – that’s what’s dirty.

Fact: Healthcare needs to be funded. That doesn’t mean that money is the only motivation for getting things done – in fact, money-as-motivator reaches diminishing marginal returns rather quickly. (Check this out to see what I mean.)

It’s unlikely that you can just tell executives things like this: Social Media is about conversation, engagement, relationships. In fact, if you say things like that, you’ve probably set your chances of persuading C-suite many steps back.

Tread carefully with social media guru talk in C-suite: very few of them have any experience with working with executives in the Enterprise.

Rather, you need to think more like an executive yourself. It’s called empathy – and empathy with senior leadership will get you farther than frustration.

So let’s get executively empathic.


Markets are conversations. But executives don’t view them that way typically.

Still: it’s markets where strategic visions must begin. Specifically, markets include not only where end-consumers are, but also where information-customers are. Identifying all of your information-customers is vital to configuring social media efforts maximally.

So here’s what champions – that’s you – need to articulate for executives and other wary levels of management:

  • Our market(s) need us to __________…__________.
  • We currently use __________…__________ to meet those needs.
  • We measure success by __________…__________.
  • We improve on our processes by __________…__________ every day/week/year (circle one!).

This is just elementary business analysis. It’s something that should be done routinely.

Now, once these questions are clearly laid out, the next step is to see what problems you have left to solve.

Executives need solutions to existing problems. No problem, no solution. Make sense?

So here’s what champions need to explore before making their case to C-suite (in fact, it’s what champions need to do so they know why social media matters):

  • We are not doing __________…__________ for or with our markets.
  • Our current strategy does not include these opportunities because __________.
  • After careful consideration, we believe __________…__________ will enable us to round out our efforts.

If you as champion aren’t able to answer these questions, how do you expect C-suite to listen to you?

Forget social media – nobody needs it.

Think like an executive, act like a strategic ally.

You can get ideas on the value propositions of 21st Century Healthcare communication by attending our upcoming Webinar Healthcare Social Media: Perspectives in Practice. Learn more and sign up here.

A Simple Question About Twitter’s World Role

Imagine a world where everyone is on Twitter (or whatever similar service is around in a few years, federated or otherwise). In theory everyone would be connected to everyone else, directly or indirectly. What kind of world would that look like?

Here’s what I’m getting at.

There are two extremes with Twitter:

  • Nobody follows anybody on Twitter (zero connectivity)
  • Everybody in the world follows everybody else (hyper-connectivity)

What would the world look like when everybody’s connected via Twitter? And if you factor in Twitter’s future evolution (geolocation services, etc.), what kind of influences would that have on culture, business, education, healthcare, technological evolution, warfare, governance, global and local politics?

But there’s an area between those two extremes. One where a substantial portion of the globe is variably connected with the rest. Everyday, more and more people in the world are stepping in that direction – with the theoretical limit asymptotically approaching pure hyper-connectivity.

It may be easy to roughly imagine what the world would look like at both extremes.

But it’s the middle area that’s perhaps most interesting. And somewhat mysterious.

What happens as we connect more and more will absolutely have something to do with our individual and collective health, for good or ill.

We’ve only just embarked on a journey whose story has yet to be told.

So here’s the simple question about Twitter’s World Role:

What will our world look like when half of the world’s population follows itself on Twitter while the other half follows nobody?


Sign up for our Webinar: Healthcare Social Media: Perspectives in Practice:

Exciting Opportunities in Healthcare Social Media Open Now!

Here are a few of the exciting opportunities that are currently wide open for ambitious and talented applicants:

  • Clinical Research
  • Provider Collaboration
  • Curation of Evidence-Based Content
  • Patient Customer Service


As more and more people tell their stories, converse with others and emit data about their lives, the pool of information pertinent to clinical research will continue to swell.

Developing ways of finding and organizing the data will provide enormous value to researchers, from seeking participants to monitoring the wild. I’m pretty sure that there a few enterprises willing to pay for these kinds of services.


In practice, physicians and nurses can’t spend their day on Twitter and Facebook and blogs and forums.

But: they do need productive and reliable ways of collaborating on cases; alerting each other to critical needs; monitoring patient data and progress; coordinating care; and sharing experiences and knowledge and wisdom.

Social media certainly provide possible to solutions to these problems. But Twitter and Facebook aren’t the right places to look.

iMedExchange offers a view of what’s possible.

New kinds of social media will need to be developed. For more on what this means, read Instant Is Not Real-Time.


The amount of data and information on the Web is virtually infinite. Worse, the amount of bad data and information probably exceeds the good.

How to provide the best information at the right time? In a world where information speeds like lightening and attention spans are straining, it will become critical that platforms are developed which deliver the right information at the right time in the right context.

The future of content opportunities lies in curation. I’d argue that Curators will be among the new kings and queens of the Web. Opportunities for healthcare are out there for someone to fill.


Patients want connection and service and provider availability.

The continuum of care is vast. Competent healthcare doesn’t start in the ER. It starts at home.

Building platforms that enable patients and providers to connect in safe and mutually-agreeable ways is a huge gaping opportunity for developers.

Facebook and Twitter weren’t designed with healthcare in mind.

Currently, there’s all sorts of talk on how to use these media in provider-patient relations. But the possibilities are constrained by the designs of these platforms. Facebook for example is such an unstable and unpredictable platform, that providers are understandably nervous in incorporating them into their practice.

Not to mention, the issue of boundaries has yet to be worked out. New kinds of social platforms that take account of the healthcare ramifications of social relations from the start will go a long way toward getting buy-in from providers. Hello Health is a great start but there’s still opportunity for development.


Years ago when I started thinking about the possibilities of repurposing emerging media into health care, I met a lot of resistance from colleagues and hospital administrators. Back then, talking about healthcare and social media was a lonely business. #HCSM and #HCSMEU and #RNCHAT weren’t around.

I understood: very few people in healthcare even heard about Twitter or RSS or any of this other nonsense (I use that word affectionately). But I also could palpably feel a sense of resistance – in fact, in some case I was met with something along the lines of outright anger. Crazy, huh?

But now, it’s become obvious that we are becoming increasingly connected and these media are staples of contemporary communications.

There’s so much that we can do with Technology. But we also need Art. Art gives us fresh perspective and reminds us of what we’re capable of.

Just like Health, Creativity is Social.

It can also be financially rewarding. 🙂



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Ativan for Healthcare Social Media

Ativan for Healthcare Social MediaPatients want: connection…support…wisdom…help.

Healthcare providers (should) want: patients to get and stay well.

Given this simple and mutually beneficial set of conditions, it would be reasonable to conclude that the Healthcare and Life Sciences industries would fawn over emerging social and digital media.

Overall, however, the industries appear to be very anxious about treading into social media. Of course there are solid and valid concerns: HIPAA, FDA regulations, boundaries, patient dignity, proprietary information, etc. But concerns are different from fears. And therein lies a key opportunity for change agents within the industries to better reposition themselves with respect to social and digital media.


…Well, technically one could hook a bomb up to a Twitter account, message it and BOOM.

Other than that, it’s unlikely that providers are playing with anything more risky with social media than they are with surgery or liver-damaging pharmaceuticals or implantable devices or admissions to hospitals with high infection rates.

If ever there was an industry that had to manage high risk, it’s the healthcare and life sciences industries.

And perhaps it’s because of the need for conservative risk-management that what should be a culture of concern has become a culture of fear.

Fear can drive you in the wrong direction. Fear can reinforce your prejudices. Fear can replace strategy with blunder.

Every single day, smart business leaders orbit and fall into the gravity of fear.

Fear is one of the most common cultural traits of many enterprises – not just healthcare.

An organization that can overcome its fears is an organization that has a healthier view of the world. It can discriminate between true concerns and false alarms. It isn’t afraid of change because it’s accepted the fact that the world is utterly composed of change.


Addressing Fear – personal and professional – is one of life’s biggest challenges. It would be nice if there were a magic formula for treating fear. Ativan can treat Anxiety, but it doesn’t treat fear. If it did, every day would be casual day in the most conservative of organizations.

So what can be done to address fear? Well the most important step is assessment.

In every meeting, everybody should go around the room and ask “What are we afraid of?” If the answer is No to a demand for change, find out how much of a part fear plays.

Find out the underlying cause of the fear – is the object of the concern valid or based on a misperception? Is ignorance or awareness at work?

Do the decision makers understand the full picture of what’s at stake? That is: Do they know that nothing in life is without risk?

If you want to know what the Ativan for cultural fear is, here it is in one word: Understanding.

The proper response to a world that looks terrifying isn’t fear and denial and blocking it out. The proper response is to face it, figure it out and go forth.

In a world which is becoming increasingly connected, there is little room for fearful savants.

Today’s healthcare leaders need to be courageous polymaths.

by @PhilBaumann

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