Computerworld posted an article titled E-Health and Web 2.0: The Doctor will tweet you now. The title made me cringe, to be honest. If any medical provider would communicate with a patient via facebook or twitter on patient related topics, we’d have an avalange of lawsuits on our hands. Thankfully, it is not that bad as the article cited above describes electronic communications between doctors and patients accurately. However, the slightly misleading title still leads me to believe that some clarification on web and social media is in place.

  • Ever heard of email? It’s this killer app that spread from scientists to the rest of the world in the mid-to-late nineties. It’s not inherently secure, but there are systems that allow for secure communication and it is slowly being discovered by the healthcare world to allow patients and providers communicate with one another. Instant messaging also falls into this category and so is text messaging (txt is really a special form of telephony and we have been using that killer app for at least 50 years to communicate with our doctor). Sophisticated EMR vendors have implemented such capabilities into their systems. There are many, but Epic’s MyChart module comes to mind – for an idea on how it works, check out the various Group Health Seattle Ads: I actually only found a recent one here. Group Health Seattle implemented MyChart and secure patient to doctor communication in 2002/2003 – long before YouTube became mainstream, so I can’t find the original ads, which also shows you that this is nothing new. The key here is that patients and providers don’t use the “traditional” email systems that are often available for free by various providers on the Internet, but implement a system directly into the Electronic Medical Records app, which has the added benefit that the communication becomes part of the patient’s record.
  • Twitter and facebook are still relatively new, and are certainly not intended for any kind of point to point communication, but rather for dissemination to larger groups or “Communities of followers”. Businesses (Joe’s Pizza as much as a doctor’s office, larger group practice, or large hospital) leverage twitter, facebook, MySpace, etc. to update their customers about things they deem important. Announcing new products or services, sending links of interest, or providing patient education on general topics are all things that lend themselves greatly to twitter and facebook. By the way, the same information can be effectively distributed via email lists, but twitter and facebook allow for customer controlled opt-in and opt-out. Both sides win – customers don’t get annoying unsolicited emails and business don’t have to manage email lists. Again, evem the direct message feature in twitter does not lend itself to securely communicate with patients, hence my introductory cringing at the beginning of this blog.
  • Speaking of blogs….Blogs are also labeled “social media”. The idea is really nothing new. In the old days (by that, I mean the very old days in the mid 90s), we had to teach ourselves HTML, stand up a web site, and voila – we could get our thoughts and comments out on the web. In my mind, blogs are the great equalizer as they are very easy to use and provide the technical means to publish articles and opinions to the web (some are rants – actually, this blog could be described as a mild rant) . Blogs often allow for others to comment on the original article and that way get a nice discussion going. In healthcare, blogs play an important role as patients can discuss their own conditions with others (often anonymously by using screen names instead of their real names). This also allows for the sharing of information and the establishment of a support network. It’s the 2009 version of Fight Club without the hugging. Twitter and blogs often go together as bloggers leverage twitter to announce a new post to their community of followers. Healthcare providers can provide pro-active patient education via blog sites and use twitter to let their patients know that something noteworthy has been published.

So – none of these concepts are new or revolutionary in my mind. These are old technologies that either make the administration easier (blogs) or allow more user control when it comes to information blasts (twitter, facebook), or facilitate point to point communication (email, IM,txt). It goes without saying that both patients and providers must carefully consider their privacy (and the associated regulations) when using either of these media forms.

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