Cast & Curious

Tag: healthcare social media

  • How healthcare social media campaigns may improve provisions of health in a devolved health system

    The lack or ineffective social marketing strategy (supply side barrier) and lack of information on benefits and availment process (demand side barrier) are a few of the identified restrictions to the use of health services in complex decentralised health systems such as the Philippines.

    The Department of Health (DOH) is the lead agency responsible for the regulation and supervision of the country’s health system. It manages national policies, develops national plans and establishes health technical standards and guidelines to regulate the country’s health sector.

    The Local Government Code of 1991 devolved the provision of health services, particularly at the primary and secondary levels, through the local government units (LGUs). Hence, health service in the Philippines is managed through provincial, municipal and barangay local government offices. Provincial and district hospitals are the responsibility of provincial governments while the Rural Health Units (RHUs) and Barangay Health Stations (BHS) are managed by municipal government units.

    Complex internal developmental differences among geopolitical regions hamper provisions of health two decades after the implementation of the local government code. Less developed regions usually suffers most of the negative effects of institutional fragmentation. These least developed regions also is the least likely to recover or lags behind because it lack or poorly manages resources and is usually inefficient in allocating health resources.

    Cetrángolo et al identified supply and demand side barriers that restrict the use of health provisions in the Philippines. The lack or ineffective social marketing strategy and lack of information on benefits availment process are included in these restrictions. Grundy’s echoed the same observations in a local study.

    This author has practiced for more than ten years in areas with health units ran by local governments and in urban center with health institutions ran by DOH. While there are LGUs with efficient and effective local health councils who clearly benefitted from the devolution of health, other regions aren’t as fortunate. Case in point,  the WHO Safe Surgical Checklist.

    The WHO Safe Surgical Checklist 2009
    The WHO Safe Surgical Checklist 2009

    The WHO Safe Surgical Checklist is the single most cost effective way of minimising post operative complications reducing death and morbidity by at least 36% on the average. No other cheap, readily and sustainably implementable guideline (except maybe the handwashing guide) had so much impact on health as this checklist.  It has been incorporated into standard DOH standards operating room “toolset”, requiring every hospitals with operating rooms to incorporate such checklist in their standard operating room manuals. Yet many hospitals who have operating rooms rarely take advantage of this readily available and cheap guideline. Why is that?

    Cognisant of these complex problems, efforts has been made in the past two decades to either strengthen  or amend the local government code that devolved health provisions to LGUs. Bills calling for returning provisions of health back to the national lead agency (DOH) are now pending in the House of Representatives. It is not the purpose of this article to weigh the complex pros and cons of such amendments. Until such amendments or repeals are enacted into law, we have to deal with effectively delivering health down to grassroots level in the context of a decentralised health system.

    An effective social media campaign may narrow regional differences in the provisions of health and address the two barriers I mentioned at the start of this article.

    Join #HealthXPh this Saturday August 26, 2017 9pm Manila time as we discuss how a social media campaign may improve provisions of health in the context of a devolved health and regional developmental differences.

    • T1. Is there a role for social media as social marketing strategy for effective provisions of health in a decentralised health system?
    • T2. If you are the chief social media strategist what will your primary strategy be?Targeted? Regional? National?
    • T3. How would you measure the effectiveness of such healthcare social media strategy? Indicators? 

    Please give your final thoughts on ways by which social media could be a part (or not) of the social marketing strategy for health units or agencies in a decentralised health system like the Philippines.

    References:

      1. Cetrángolo,O., Mesa-Lago,C., Lazaro,G., Carisma,S. Health Care in the Philippines: Challenges and Ways Forward. 2013
      2. Grundy J1, Healy V, Gorgolon L, Sandig E. Overview of devolution of health services in the Philippines. Rural Remote Health. 2003 Jul-Sep;3(2):220. Epub 2003 Jul 1.
      3. Haynes, A.B., Weiser, T.G., Berry, W.R., Lipsitz, S.R., Breizat, A.H.S., Dellinger, E.P., Herbosa, T., Joseph, S., Kibatala, P.L., Lapitan, M.C.M., Merry, A.F.: A surgical safety checklist to reduce morbidity and mortality in a global population. N. Engl. J. Med. 360(5), 491–499 (2009)
      4. Atienza, Maria Ela L. 2004. “The Politics of Health Devolution in the Philippines: Experiences of Municipalities in a Devolved Set-up.” Philippine Political Science Journal 25 (48): 25–54.10.1080/01154451.2004.9754256

      

  • Metric Matrix: How should we measure the impact of social media on clinical excellence?

    “What for? Can we achieve what we ought to achieve in healthcare without social media? We did that in the past, there’s no reason we can’t do that today!”

    After tooth combing available researches online, the above hypothesis seem logical.  There’s some evidence showing social media adding value to healthcare, but these are mostly qualitative studies. Qualitative studies  do not undergo rigid testing of hypothesis characteristic of a good scientific research.

    On the flip side, the absence of disputing evidence does not necessarily mean the hypothesis is valid.  It is just that we don’t have a metric yet to demonstrate the validity of that hypothesis. Such is the case for social media in healthcare.  To import metrics from other fields may also be too simplistic given our superficial understanding of social media behaviour of health stakeholders in relation to healthcare.

    Fortunately social media is considered a disruption in many fields, including healthcare. Desirable disruptions effectively short changes  accepted norms and processes usually in non conventional ways but achieve same or even better goals with uncanny efficiency. The true value of some disruption maybe demonstrable a later time when technology catches on.

    So let me state my alternative hypothesis. Social media might be a way to improve healthcare. The millions of social media users today couldn’t be just a technological spike. The use of social media in healthcare is self evident.

    Healthcare stakeholders engage each other on social media. Patients seek health information and find support groups on social media. Healthcare professionals have virtual communities to share knowledge and network with peers. Healthcare professionals seek social media in the hope of increasing scholarly activities such as research or to recruit population for larger studies. Healthcare organizations use social media for rapid information dissemination as well as engaging other healthcare stakeholders.

    The bottomline for engaging healthcare stakeholders are for me threefold- improve patient outcomes; achieve clinical excellence for healthcare professionals and humane, sustainable, fair provisions of quality healthcare for institutions. If somehow we have a way, a metric for demonstrating social media adding value to these three bottomline perhaps we have a way of sustaining or disputing my hypothesis.

    Let me focus on physicians clinical excellence for now and explore ways of showing impact or value of social media.

    A qualitative study by Kotwal et al showed the following determinants of clinical excellence in a hospital medicine: communicating effectively, appreciating partnerships and collaboration, having superior clinical judgment, being organized and efficient, connecting with patients, committing to continued growth and development, and being professional and humanistic “.

    Thus for social media to have an “impact” on physician clinical excellence, it has to demonstrate a significant significant improvement over time in any (or all) of the determinants from the baseline measure.

    There have been studies on social media as a communication, information dissemination tool in medicine. In the US for examples, Mishori et al looked at the adoption of twitter as an information dissemination platform of 3 big medical association networks. These 3 communities are growing but there’s  limited interaction within and across communities. Information dissemination is below its perceived potential. While the primary objective of the original goal seem to have been met, the study is critical on whether information dissemination alone constitute health “engagement” . Measuring how much engagement is attributed to social media in healthcare via this platform is another area ripe for research.

    • T1. What is healthcare engagement and how would social media add value to it?

    There is evidence showing healthcare professionals create virtual communities and share knowledge on social media. These same virtual communities exhibit what Rolls et al termed as clinicians’ tribal behaviours that may in fact limit the sharing of knowledge across communities. The impact of these virtual communities and the extent of collaboration and sharing of knowledge via social media should be another good area for research in healthcare social media.

    • T2. How would social media improve offline collaboration among healthcare professionals? How should we measure this?

    How does physician trust peers on social media? Panahi et al  found that the “majority of participants established trust on social media mainly through previous personal interaction, authenticity and relevancy of voice, professional standing, consistency of communication, peer recommendation, and non-anonymous and moderated sites.” Healthcare professional credentialing over social media

    • T3. Is social media a valid platform for credentialing healthcare professionals? How do you check peer’s credentials over social media?

    Standardized metrics for measuring the impact of social media to these determinants has yet to be developed. But the bottomline of all these- social media adding value to healthcare vis a vis clinical excellence, is that it adds up value in improving patient outcomes. Thats another area ripe for research.

    Join us this Metric Matrix Saturday March 11, 2017 9PM Manila time as #HealthXPh discusses how should we measure the impact of social media on clinical excellence among healthcare professionals?

    • T1. What is healthcare engagement and how would social media add value to it?
    • T2. How would social media improve offline collaboration among healthcare professionals? How should we measure this?
    • T3. Is social media a valid platform for credentialing healthcare professionals? How do you check peer’s credentials over social media?

    REFERENCES:

    1. Househ M. The use of social media in healthcare: organizational, clinical, and patient perspectives. Stud Health Technol Inform. 2013;183:244–248
    2. Kotwal S1, Peña I, Howell E, Wright S.J Defining Clinical Excellence in Hospital Medicine: A Qualitative Study.Contin Educ Health Prof. 2017 Winter;37(1):3-8. doi: 10.1097/CEH.0000000000000145.
    3. Rolls K, Hansen M, Jackson D, Elliott D. How Health Care Professionals Use Social Media to Create Virtual Communities: An Integrative Review. Eysenbach G, ed. Journal of Medical Internet Research. 2016;18(6):e166. doi:10.2196/jmir.5312.
    4. Panahi S, Watson J, Partridge H Fostering interpersonal trust on social media: physicians’ perspectives and experiences Postgraduate Medical Journal 2016;92:70-73.
    5. Mishori R, Singh LO, Levy B, Newport C. Mapping Physician Twitter Networks: Describing How They Work as a First Step in Understanding Connectivity, Information Flow, and Message Diffusion. Eysenbach G, ed. Journal of Medical Internet Research. 2014;16(4):e107. doi:10.2196/jmir.3006.
    6. Griffiths F, Dobermann T, Cave JAK, et al. The Impact of Online Social Networks on Health and Health Systems: A Scoping Review and Case Studies. Policy & Internet. 2015;7(4):473-496. doi:10.1002/poi3.97.
    7. Houry D, Swahn MH, Hankin A. Social Media, Public Scholarship, and Injury Prevention. Western Journal of Emergency Medicine. 2014;15(5):565-566. doi:10.5811/westjem.2014.5.22754.
    8. Thackeray R, Neiger BL, Smith AK, Van Wagenen SB. Adoption and use of social media among public health departments. BMC Public Health. 2012;12:242. doi:10.1186/1471-2458-12-242.

  • How should healthcare professionals respond to a medically related social media posting?

    If you were the medical professionals in these two examples, how would you respond to social media postings related to your actions?

    • Case # 1: A medical intern was captured on a cellphone video, was ate bedside of a patient, holding a phone on his left hand and a paper ( a referral letter? ) on the other hand. This video was posted on Facebook with a caption (in Filipino language) “Are all doctors like this?…My patient is near death and he still does this?”
    • Case # 2: A physician regularly conducting medical missions in one hinterland wrote several letters to local government authorities regarding the unusual prevalence of Hepatitis B in one tribe of local indigenous people. He asked for help to the same authorities for years. He related help never came from the government sector. As a last resort, he posted his difficulties on Facebook.  This Facebook postings did receive a ton of encouragement and support. What’s more scathing though is the few “negative comments”. The physician is clearly devastated.

    What’s common in these two examples?

    Trial by publicity spinoff

    First, the healthcare professional’s medical actions went public via a social media site. Second, while both healthcare professionals received encouragements and support, the negative comments hurt more in both cases.

    Negative publicity

    “Negative publicity” is one reason why healthcare professionals shy away from social media. Negative publicity take toll on personal and professional life. The reality is someone- somewhere and somehow, will post something about our medical actions online. It’s simply a question of “when”.

    Key components of a social media response

    A previous tweetchat about protecting online reputation summarises two key components of a social media response- a prompt but well thought out reply. A prompt, well thought out social media response could only come from a personal or institutional social network strategy.

    Social Media Response Strategy

    The recent spate of healthcare related negative comments online urges us to examine deeper these response strategies.  Vanderbuilt University Medical Center developed a Social Network Response Guide for healthcare professionals on how to respond to social media postings related to their profession. You can find that algorithm here.

    Dr. Iris Isip Tan adapted  this Social Network Response Guide for UPCM/ PGH in developing their own social media policy.

    vanderbuilt
    Vanderbuilt University Medical Center Social Network Response Guide as quoted and modified by Dr. Iris Isip-Tan for use of UPCM-PGH in developing their own social media policy ( Photo courtesy of Dr. Iris Isip- Tan)

    The end goal of this guide is for the healthcare professional to have a calibrated response using the strategy of transparency, timelines for thinking and responding, a more personal tone and credible sources.  How we implement this algorithm to our own specific case is one of the main goals of this tweetchat.

    Join us this Saturday July 9, 2016 9 PM Manila time as we discuss how should healthcare professionals respond to social media posting related to the profession
    Our aim for this upcoming chat is to provide template guides for healthcare professionals in responding to social media postings related to our profession.

    • T1: How should healthcare professionals respond if the social media post about him or her is “positive”
      T2: How should healthcare professionals respond if the social media post about him or her is “negative”
      T3: How should healthcare professionals act if you are not directly related to the social media post or posting is not within your area of expertise.

    Join the discussion via twitter, using the #HealthXPh in all your tweets, answering the above topic questions, from 9-10PM Manila time July 9, 2016.

  • All Set for the 2nd #HealthXPh Philippine Healthcare Social Media Summit (#hcsmph) at the PICC

    We are doubly excited!

    Since #HealthXPh started three years ago, the co-founders have been creating venues for stakeholders to explore the use of disruptive technologies in healthcare. This is our core objective- educate health professionals and patients, let stakeholders explore disruptive technologies such as social media to better healthcare in the Philippines. #HealthXPh took advantage of social media platforms- blogs (healthxph.net), twitter (@healthXPh), Facebook, Google, G Hangouts, Linkedin, Periscope and the like, to achieve this core objective. We’ve spoke and sent influencers to local and international conferences on disruptive technologies. Our engagement strategy included consultancy to health organizations on matters of social media and other disruptive technologies. We even have provided insights on social media etiquettes for policy makers and institutions. Our conversion call to action endpoint is that all health stakeholders will ethically use beneficial disruptive technologies to improve the Philippine healthcare landscape.

    The success of the first #HealthXPh Healthcare Social Media Summit in Cebu last year was proof social media is taking Philippine healthcare in a sweep, whether stakeholders like it or not. As #HealthXPh’s maiden summit, we structured the conference as an introduction to social media health, providing inspiration, stories, education, advocacies and ethical dimensions to a burgeoning disruptive health technology. We’ve learned a lot of insights and opportunities from the first summit, heralding the uniquely workshop styled second summit this 2016.

    In this upcoming second summit in Manila on April 21, 2016, #HealthXPh will be bringing the discussion a step further into the healthcare social media landscape . “From click to brick” (this year’s summit tagline) will teach participants ethical, practical and hands on social media skills to level up their healthcare portfolio. #HealthXPh will hope to teach participants basic social media skill and align it with their healthcare goals. Again, as part of our engagement strategy/conversion/ call to action timeline, we want healthcare stakeholders to be at ease, confident and ethically guided with the use of social media to achieve healthcare goals.

    We partnered with top notch healthcare organizations, providers and stakeholders- DOST-PCHRD, Health Informatics, 101 Health Research, UP Medical Informatics Unit and Philippine Alliance of Patient Organizations, to host this event. We’ve prepared an A-list of speakers, pioneers in the use of social media in Philippine Health. We have pre selected summit participants, key influencers to efficiently deliver summit objectives. We hope to receive feedback and insights into the success of this summit so we can improve on our goals in the upcoming discussion platforms.

    The summit program can be accessed by downloading mobile android app, here. Here’s a preview of the summit program.

    I am inviting all healthcare stake holders- health professionals, patients, advocates, policy makers, ethicist and health disruptive tech influencers to attend this summit. We are still accepting walk ins but you will be transferred to another track if your tack of choice is already filled. So hurry!

    Summit registration is free, but you have to signup and answer questions in this link. Lastly show up early for the summit. If you received confirmation letters to attend and but will not be around before summit tracks begin, we will give the slot to the waiting list for that track.

    We will be live streaming the summit on our different social media platforms- blog, twitter, facebook, periscope and web ex. Follow summit proceedings on twitter by using hashtag #hcsmph and #healthxph with corresponding track subhashtags.  Webex, Google Youtube live,  live streaming will be provided on HealthXPh.net. The summit will be live too on Periscope.

    Disclosure: #HealthXPh is a healthcare startup co -founded three years ago that provides social media platform for discussion and exploration on the use of disruptive technologies to improve Philippine healthcare. The author co-founded #HealthXPh.

  • Cutting the Noise and Listening to Patients Voice on Social Media

    “Who voices out the patients’ side on your social media healthcare discussions?”

    Inclusive Health
    #HealthXPh was founded on an idea that various healthcare stakeholders particularly the patients, will finally have a voice in the discussions of health on various social platforms. In fact #HealthXPh believed social media will bridge the gap between patients and healthcare professionals in the discussions of health. How #HealthXPh would do this has been our most challenging task since the early days of our social media engagement. We have few success in the past, enabling patients and patient advocates to talk on various social media health forums but never a consistent engagement that we projected over two years ago. We wanted patients to actively engage healthcare professionals and other healthcare stakeholders in the discussions of health on social media platforms.

    Social media divide?
    Social media is a game changer in all aspects of human endeavours nowadays- politics, governance and even health. Internet and social media undeniably democratised access to health. The upsurge of social media discussions on health among patients is evident. Apart from few, rare exchanges we see on social media in developed nations, discussions between patients and healthcare professionals barely took off. Why?

    Culture? Cyberbullying? Privacy or confidentiality issues? No one really knew.

    In this edition of #HealthXph tweet chat we’re interested in the answer to this challenge. We’re crowdsourcing ideas to help engage more patients in our discussions of health on social media. #HealthXPh wants to hear the “patient’s voice” too.

    T1. Should there be a “patient voice” on social media discussions about health?Why or Why not?
    T2. What are the challenges to engaging patients on social media?
    T3. In what ways can we improve patient engagement on healthcare social media discussions?

    At #HealthXPh we’d like to hear your voice! Join us on our discussion this Saturday February 20, 2016 9:00PM Manila Time as we discuss how to cut the noise and listen to the patients voice on social media.

    (Photo by Ashley Clements. Licensed under Creative Commons View this photo on flicker https://www.flickr.com/photos/19933120@N00/46637163/ )