Future of Healthcare Twitter Chat

On Thursday (10/8/09), frog design hosted its third live one-hour conversation on Twitter. The chat was inspired by the Fast Company.com article produced by frog entitled “The Future of Health Care is Social"(PDF), which emphasized that networked devices and connected people will ultimately lead to better health.

The chat brought healthcare professionals and thought leaders, reporters, bloggers, and designers together for a lively discussion that offered provocative insights on the article. Participants in the chat took a critical look at how “health and life science technology solutions [could] one day become a natural part of our behavior and lifestyle” and the incentives and social networks that would make this viable for adoption.

We will be doing another Twitter healthcare chat soon so please stay tuned to this blog and follow @frogdesign on Twitter for more details.

Thanks to everyone who participated in our third Twitter chat exploring the social future of healthcare.

 

A recap/summary of #futureofhealthcare chat on 10.8.09 (our third installment of #froghealth Twitter chats).

LeighFazzina Hey @frogdesignHC - R U doing this chat 4 market reaserch? What's ur sole purpose 4 this chat? Do please be tranparent.

babjopa @LeighFazzina related to article i wrote that was published in Fast Co http://bit.ly/31Y8dc - want to open the dialogue

 

Q1: How can networked devices (mobile apps, wireless sensors, home health, telemedicine, etc) help improve health?

sushilbansal Q1 Absolutely, Networked devices + connected people = Better health + Lower costs

jsperber @frogdesignHC Q1: well, to start, they "meet people where they are at" - should make it easier to connect.

jsperber @frogdesignHC Q1: assumes these devices speak the same language. that there is some sort of continuity.

VinceKuraitis @frogdesignHC Yes, but today devices are not "networked".

rebekahco Q1: I wonder if this question should be reversed though. Does the motivation to improve health have to come first?

ANewCLOUD Q1: The connections are not b/w data and devices but instead b/w people. It starts at ME or ME 1.0.

rebekahco Q1: After there is motivation, networked devices can make it easier to keep momentum for healthy behaviors to grow

ctmarcom Q1 elec med records help give all docs better info, can prob work mobile apps into that as well (like Rx list)

sushilbansal Q1- So there's an opportunity to create a "network platform" for devices tied with EMR systems

ANewCLOUD @rebekahco Agree. Appears that bigger challenge for folks may be individ responsibility, rather than technology.

whatifwhynot Q1 - How? More rapid info collection, transfer & dissemination reduces delays, adds time-based value.

CTalarico Q1 technology helps to reduce mistakes and workarounds, in turn increasing quality of care

jsperber @frogdesignHC Agree with @rebekahco. Goal of 2.0, though, is to aid in this motivation. make it easier to care.

babjopa @whatifwhynot data over time and trend analysis, w/ proper data visualization can lead to more informed health decisions 

USPC_ Q1 - Are we talking about technology doctors use or information we can find via the internet? 

william_stone Q1 4 conditions that aren't well-known, it's the community of pts & caregivers who spread the word.

sushilbansal Q1- We will need to define 'meaningful data' to be xmitted between devices

deremer Q1- Maybe my heart could tweet status updates...

babjopa @deremer ha ha ha! how robotic. 

sushilbansal But technically possible - RT @babjopa @deremer ha ha ha! how robotic. 

deremer Q1- Biggest thing is data from tech for personal use vs. aggregated public use...I think we SHOULD share our data

william_stone Q1 We need to distinguish between SM networks (patient use) & devices with social applications (EMRs).

babjopa @william_stone same is true for well known conditions. coupling of networked devices & connected ppl is powerful indeed.

william_stone @babjopa Ur right. But at least well-known conditions will usually be correctly diagnosed by primary care physicians.

whatifwhynot @babjopa Right info, right place, right time with the right tools. Motivation and incentives are key.

jsperber @william_stone a good point. often conflated when I am reading about social media and health, but a much different user.

LeighFazzina @frogdesignHC Such devices should be assiting in healthcare communications. Healthcre communications is a part of it.

intel_lisa Q1-data is important. putting it in the individual's context is paramount

kaleemux Q1 networked devices can help improve health via ambient health awareness & monitoring; better data; prevention model 

 

Q2: How can connected people (social ntwrks, mobile, video conf, share data with family+friends) help improve health?

whatifwhynot Q2 - a critical question for us sandwich generation-ers.  

VCBH When will ubiquitous computing become the "Medical Home"? 

ANewCLOUD @picassojk2 Q2: Question with connected people is what is the point of aggregation: WebMD, FB?

frogdesignHC Illnesses commonly treated online today: sinus, cold, flu symptoms, urinary infections, coughs 

whatifwhynot Q2 - a personal health record or portal would seem to be key.

LeighFazzina Q2: Connected people can improve health by staying educated in healthcare and improving on thier healthcare literacy. 

USPC_ Doctors complain/joke now that patients come in knowing so much data they don't want to take advice from them.

JimAngstadt Sounds like @HOUSEonFOX RT @USPC_ Drs complain patients know so much data they don't want to take advice from them. 

frogdesignHC illnesses commonly treated online today: sinus, cold, flu symptoms, urinary infections, coughs

babjopa Q2 - heard a lot about social contagion (good and bad) of health at health2.0 conf #health2con

LeighFazzina Q2: 40 million US people read at or below 4th grade reading level! HUGE health literacy problem in US!

VCBH Q2 - Health habits are infectious. RE: Obesity, smoking shows epidemiological link to what we see as "acceptable".

babjopa @VCBH completely agree! framingham study verifies this. also check out the book "Connected"

ANewCLOUD @picassojk2 Q2: # of sites trying to aggregate @ Health 2.0 was amazing! We're already on Internet!

jsperber @LeighFazzina I think the key word here is "connected" people. my question is what %age of people are we talking about?

picassojk2 picassojk2@jsperber You bet! :) Cite is: "Telemedicine and eHealth" (Journal)

frogdesignHC picassojk2@jsperber You bet! :) Cite is: "Telemedicine and eHealth" (Journal)

picassojk2 53% of patients between the age of 25 and 34 are influenced by social media when it comes to healthcare decisions

babjopa Q2 - power of support networks and/or competition can lead people to change their behavior, comparing self to others

picassojk2 picassojk2@ANewCLOUD Q2: Inspiring to hear about aggregation or at least common stds!

babjopa @ANewCLOUD point of aggregation is just social support & having a team-based approach to heatlh (not just me)

ANewCLOUD @babjopa Exactly! By reorienting to ME, I can aggregate everywhere and anywhere, not just WebMD or some other web page.

sushilbansal Also, data analytics and research RT @ANewCLOUD point of aggregation is just social support & having a team-based  

ANewCLOUD @sushilbansal Those analytics can be more powerful if I am disaggregated from my data, creating anon mosaics.  

LeighFazzina Q2: Average America comprehends between 4th and 7th grade, cant read a prescription bottle and cant follow drs orders.

RonLedford_CPA Q2 stop with literacy rates. These same people can breakdown strategy in sporting contests - it is about motivation.

dinaberman Q2 connecting info for all: docs, patient, caregiver = better info = better decisions = less stress = better health

rebekahco Networks of people have huge potential to change the way clinical research is done

 

Q3: What are the hurdles that need to be cleared to bring about adoption and a future like this?

ANewCLOUD @frogdesignHC Q3: To achieve this, the interface to the Internet & each other can no longer be just web pages.

picassojk2 frogdesign@HCANewCLOUD Agree completely! Needs to be multi channel, device, location

RonLedford_CPA Q3 Attention is scarcest resource. I don't need health specialist until sick. Motivation key 2 comprehension.

VCBH Q3 - Mental models and financial models need--and are--shifting. It happened first in banking, publishing, gaming, etc.

sushilbansal Q3- Costs, Credibility, too much discussion, too many cooks in the kitchen...  

babjopa great quote fr @SusannahFox at health 2.0 "Connected patients are going to be an early warning system" #heatlh2con 

JimAngstadt RT @picassojk2: 53% of patients between 25 and 34 are influenced by social media for healthcare decisions

jsperber @frogdesignHC Q3 Some semblance of common language is needed. Not ICD-9/SNOMED-ish, but some ability to cross platforms.

jsperber @frogdesignHC Of course, I am not a programmer. Perhaps common platform is already there? 

william_stone Q3 Old debate. Should medical research be available via open access? If so, who pays? How should HC knowledge b spread?

ANewCLOUD @frogdesignHC Q3: New ecosystem is not only a health domain issue, but educ, fin svcs and beyond, like article notes.  

sushilbansal Q3 - If we are serious, as first step we can eliminate 'paper clipboard' by having PHR on driving license like card ...

USPC_ @picassojk2 How are they influcened now? Which meds to take? What to ask the doc? etc.

VCBH @picassojk2 18-34 age demographic is also the group that has the least contact with traditional healthcare.

frogdesignHC @jsperber Less about common platform and more about flexible access points  

jsperber @frogdesignHC 100% agreed re: flexible access points. but if all the data can't be joined, it's useless.

ANewCLOUD @jsperber Bingo! Governed access should not move data into new silos, like Google Health, but connecting where it is.

JimAngstadt RT @frogdesignHC: illnesses commonly treated online today: sinus, cold, flu symptoms, urinary infections, coughs

babjopa @william_stone "who pays" - there's the rub! much to be said about how compensation and incentive structures affect this

VCBH "Who pays?" = 1st question, "For what?" is 2nd. Pay-for-service or click or outcomes or performance or population mgt?+

sushilbansal @ babjopa @ANewCLOUD @william_stone 'who pays' is answered by introducing efficiency through 'e-clipboard' 

william_stone @babjopa I've had several discussions with people on both sides of the issue (PLOS & Elsevier). VERY diff perspectives 

ANewCLOUD @sushilbansal LOL! The dreaded clipboard... I talk about those here... http://bit.ly/1Yupw

RonLedford_CPA Q3 Don't forget "trust" - who is on the other side of the technology? Dr, Gov't, etc. 

babjopa @RonLedford_CPA good point! and also trust in the technology - is it accurate, reliable.

ANewCLOUD @RonLedford_CPA You are correct... social is all about a trust latticework.  

KateLWilson RT @VCBH: @picassojk2 18-34 age demographic is also the group that has the least contact with traditional healthcare. 

rebekahco Q3:Biggest hurdle is having tools that make being healthy easy & exciting. Who "enjoys" healthcare now? 

babjopa @rebekahco agree! saw a lot of great demos at health 2.0 conf that bring some delight into managing health #health2con 

lskphilly Q3 one big hurdle is FDA developing workable guidelines to enable proper education from pharma 2 patients

VCBH

babjopa @VCBH right on! integration has to be meaningful, not just a huge data dump (predictive health analytics, data vis)

VCBH Consequently, clear user experience--on-line and in-person--lower thresholds to communication. Rx and IT need UX!

picassojk2 @VCBH 18-34 age may be impacted by 255 hospitals in the US use social networking tools and 167 have Twitter accounts.  

ANewCLOUD Government is aggregator of a social contract. Facebook is an aggregator, as is WebMD. Where should aggregation occur?

RonLedford_CPA @ANewCLOUD To date I don't think anyone has come up w/ a good answer. People congregate where they want to.

ANewCLOUD ANewCLOUD @RonLedford_CPA Exactly. I have same person in LInkedIn, FB and Twitter... makes no sense...

ANewCLOUD ANewCLOUD @RonLedford_CPA So if we congregate where we are. I shouldn't have to go to website to find you.

USPC_ @babjopa @RonLedford_CPA Do we know where the information is coming from now? How will we continue to feel confident?

VCBH Next gen health care worker physically in their community as broker with tools and data of medical connectivity, access.

william_stone @LeighFazzina Y aren't more ins providers supporting healthy lifestyles via rebates that help people BECOME "connected"?

deremer We need to share with less effort and more privacy...isn't that what twitter is all about 

babjopa @deremer AND we need to get data w/ less effort (not a lot of manual entry). devices & health apps should be seamless 

RonLedford_CPA @babjopa I can see that happening and that trust will stay an issue for people.

ANewCLOUD RT @babjopa: @deremer AND these health issues are not just limited to this domain. Standard must cross boundaries.  

 

Q4: When do you think this vision will be realized (if at all)?

VCBH Q4 Mobile, social med will come as Gen Y becomes responsible for managing Baby Boomers.

RonLedford_CPA Q4 Long term and multi-generational. I often wonder where the penetration point is for changing behavior? Moms? 

babjopa Q4 - much of it is in market (wireless devices, social networks). other things may be years off (interoperability) 

ANewCLOUD @babjopa There is much talk about patient-centric. This revolution must be patient-driven. Locus of control must shift.

babjopa @RonLedford_CPA That's why the article is on "Susan". it's amazing to see # of seniors online. adoption is exponential.

ANewCLOUD @babjopa The vision from your article and new design/interface along with move beyond web destinations are vital.

ANewCLOUD @babjopa @RonLedford_CPA My wife's parents and mine came online for Skype and their grandkids!

babjopa @ANewCLOUD @RonLedford_CPA exactly. health doesn't take place online, so the tools and networkshould be portable too. 

RonLedford_CPA @ANewCLOUD And I am still struggling to get mine online. I keep telling them it is FREE. My Dad deletes my texts.

william_stone @ANewCLOUD @babjopa This is y features like "Summaries for Patients" from Annals of Internal Medicine r so useful.

RonLedford_CPA @babjopa when I was growing up Mom ruled & was the primary care giver. BTW, awesome article; a lot of food for thought. 

intel_lisa Q4-Vision won't happen til outcomes are rewarded & prevention seen as THE most important part of healthcare.  

frogdesignHC @intel_lisa Agreed! Prevention is starting to be rewarded by insurance providers 

babjopa @intel_lisa spot on! 

ANewCLOUD @JimAngstadt It's all about the Net, but the net is not web pages or cloud computing. The net is about people.

JimAngstadt @ANewCLOUD: Definitely agree - the net is about people. My point was more, we can't broadly reach people without the net

RonLedford_CPA @JimAngstadt US is becoming Handheld-centric. Twitter & FB are an app on my BBY not a website. 

JimAngstadt @RonLedford_CPA BBY, iPhones - Beyond broadband, the U.S. has a 'looming spectrum crisis' Read: http://bit.ly/15xOyv  

ANewCLOUD @JimAngstadt Yes. We're on same page. Net is vital to connecting people!

VCBH Q4 Health is still a relationship game based on conversation, empathy, knowledge, coaching--these need to guide ad

babjopa @RonLedford_CPA & move beyond just handhelds. devices, clothing, environments, etc will be wired, ubiquitous computing!

 

Q5: Do the correct incentives exist for people to move healthcare into a social, networked and non-clinical environment?

frogdesignHC This year, 39% of doctors said they’d communicated with patients online, up from just 16% five years earlier.

william_stone No1's brought up the laws on how 1 talks with patients. IRBs dictate what can & can't b said. What'll their role b here?

rebekahco Q5:Incentives work out when the focus is on health and NOT health "care" (this is why Kaiser and Mayo are succesful) 

picassojk2 @LeighFazzina Stat:255 hospitals in the US use social networking tools and 167 have... is from: Telemedicine and eHealth 

VCBH Q5 Large healthcare IT companies need to adopt social model, build into products, etc. However, may be threatening! 

wzwn6d @VCBH Some are (uCern) people don't remember that hospitals spent a ton of $ in the last decade on IT and have small ROI 

wzwn6d @frogdesignHC Provider incentives must change for a material change in how patients and providers communicate.

ANewCLOUD @frogdesignHC Cool article. Cool Twitter forum. Great ideas. Gotta go... Keep up the vision Frog!  

VCBH Thanks to @frogdesignHC @babjopa and all for stimulating conversation on social media and medicine. 

wzwn6d @frogdesignHC When you are desperate for medical help, privacy is a small issue. See: PatientsLikeMe  

intel_lisa Incentives exist for non-clinical healthcare once a relationship has been established, trust built.

deremer BTW, we need to just do some of this stuff. We can't expect gov or industry to do it for us