Social Health on line
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Social Health on line
Telecare, telemedicine, eHealth, social health, etc. are ways of providing support to health care on line: opportunities, costs and examples
Curated by rob halkes
http://www.healthbusinessconsult.com
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Why Do Healthcare Professionals Find Social Media Useful?

Why Do Healthcare Professionals Find Social Media Useful? | Social Health on line | Scoop.it

Via Plus91
rob halkes's insight:

Nice Overview: WHy do healthcare professionals find social media useful!

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Why the Doctor Won't Text You Now | Digital Pharma Blog

Why the Doctor Won't Text You Now | Digital Pharma Blog | Social Health on line | Scoop.it

For a growing number of people, the main way to communicate with people, both personally and professionally, is through their smartphones. While digital communication has become widely accepted, there is one place where its adoption is lagging: health care. U.S. News and World Report points to a Nielsen survey that shows that the vast majority of medical professionals in the United States do not use e-mail or text messages to communicate with their patients.

Physicians welcome new forms of technology in their practices, and smartphones seem like a logical way to improve patient engagement, patient adherence, and patient empowerment. So why don’t more doctors text or e-mail their patients? The fact of the matter is that the reluctance of physicians to embrace digital communications with their patients has little to do with technology.

Doctors want to offer the best possible care for their patients but, like anyone who provides a service, they also want to be paid for it. Doctors can easily submit a claim for an office visit or a medical procedure but, as U.S. News explains, the insurance system is not currently set up to reimburse a doctor’s digital communication with his or her patients. But that is starting to change, healthcare reform has shifted insurance models toward compensating doctors for the quality of the care, as well as patient outcomes. But insurers still need to formally recognize these communication changes.

Regulatory restrictions are another barrier to doctor/patient digital communication. Under the federal Health Insurance Portability and Accountability Act, healthcare providers must take steps to ensure the privacy of patient information. Some forms of digital communication are just not secure enough to meet HIPAA requirements. With some effort, a physician can find a telecommunications and software services that meet federal security requirements, but the burden is on the physician to find these providers.

Even though digital communication with patients has a long way to go, changes are on the way. Demand is driving the IT sector to develop new technological solutions. “The generation of young and digitally native doctors will help expedite this process,” U.S. News says.

While digital communication has become widely accepted, there is one place where its adoption is lagging: health care.

rob halkes's insight:

The digital future of care seems to be self evident, but innovators often run hard to the walls of everyday practice. Innovation in care can only come about if the three basic perspectives in care: medical, patient and organizational/financial will be taken into account. See here: http://bit.ly/businessofhealthcare
To ignite collaboration between healthcare stakeholders to that end, co-creation is conditional: http://bit.ly/co-creation-in-care

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Telemedicine Trends 2016

Telemedicine Trends 2016 | Social Health on line | Scoop.it

HIMSS study shows telemedicine software solutions poised for growth in 2016

Originally posted on Nov, 2015

Although organizations in the United States are still trying to optimize the use of current telehealth solutions, telehealth is undoubtedly poised for continued growth in the U.S. (and many other countries as well). Telemedicine is gaining momentum as it has proven to increase access to care and reduce costs via teleconsultations and remote patient monitoring. U.S. consumers are beginning to use wearable devices to track and collect their personal health data. Over time, we will see more of a willingness to share that data with healthcare providers and intermediaries.

The Healthcare Information and Management Systems Society (“HIMSS”) conducted a survey on telemedicine adoption in the United States. The survey polled 276 healthcare decision makers and physician executives. Brendan FitzGerald, research director at HIMSS Analytics, discussed the results with some of us last week. Here are some highlights of the survey’s findings, of those engaged in telemedicine:

  • 70% utilize a two-way videoconferencing system.
  • 57% use a hub and spoke model (audio/visual only between originating sites)
  • 49.7% are using a patient portal or application-focused patient engagement (services delivered via portal with mobile or desktop access)
  • 20% utilize concierge services (i.e. eVisits and online consults)
  • The number of respondents engaged in remote patient monitoring in the home decreased from 38% in 2014 to 30% in 2015.
  • 52% are still uncertain about future investment in telemedicine; 28% polled are not increasing their current investment; 20% are planning on future investment on top of their current program.
  • 26% are planning to expand their telemedicine programs to add other specialties in the near future.
  • 34% are engaged in telemedicine primarily to develop a service that increases access and integrates care across rural areas; 22% are focused on developing a service that reduces overall costs for their organization; 18% are seeking to develop specialty services not otherwise available in the region.

The HIMSS Analytics survey can be found here.

You can contact ABISA, a consultancy specializing in solo and small group practice management by visiting them at ABISALLC.com.

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rob halkes's insight:

Although different names are given to eHealth, like telemedicine is one of them, Its growth in healthcare is unavoidable.

E.g. see here how:
(http://www.healthbusinessconsult.com/telemedicine-ehealth-mobile-health/)

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Perceptions of e-Health, e-Health Literacy and Psychosocial Health, as Predictors of e-Health Use Among Caregivers of Children with Special Healthcare Needs

Perceptions of e-Health, e-Health Literacy and Psychosocial Health, as Predictors of e-Health Use Among Caregivers of Children with Special Healthcare Needs | Social Health on line | Scoop.it

Conclusions: Caregivers of children with special healthcare needs have notable levels of psychosocial challenges and those challenges are associated with their e-health resource seeking. Although e-health interventions, including ones that focus on child health education and caregiver support, may be the future of healthcare, a concerted effort is needed to educate caregivers about the benefits of e-health.


Objectives: In this study, we explored the relationships between the psychosocial health of caregivers of children with special healthcare needs and their e-health use. Additionally, the analysis examined moderating effects of a caregiver's perceptions of e-health and his or her e-health literacy on the associations among four domains of psychosocial health and e-health use.

Materials and Methods: To date, 313 caregivers of children, 12–18 years of age, with special healthcare needs have been recruited. Covariate-adjusted multivariable regressions determined associations between psychosocial health domains of caregivers and e-health use. E-health literacy and perceptions of e-health were further tested as moderators of the relationship between psychosocial health and e-health use.

Results: Among the caregiver population, 31% had problems with social functioning, 36.1% with communication, 43.3% with family relationships, and 46.3% with worrying for their child. After adjusting for demographic variables, e-health use was associated with poorer levels of social functioning, communication, worry, and family relationship.
E-health use was also associated with e-health literacy. Perceptions of e-health significantly moderated the relationships among social functioning, communication, and e-health, with the relationship being significantly stronger in caregivers with more positive perceptions of e-health.


rob halkes's insight:

Perceptions of eHealth of caregivers, in this case: parents, influence its appreciation and use. Indeed as the researchers conclude: a concerted effort is needed to educate caregivers before its use, and based on our own experience to make the provision of ehealth ingrated in the care delivery process and to implement the needed accommodation in the organisation of healthcare.
See also here: eHealth the Introduction  Great research - we should have more of that!

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Survey: 41 percent of consumers have never heard of telemedicine | mobihealthnews

Survey: 41 percent of consumers have never heard of telemedicine | mobihealthnews | Social Health on line | Scoop.it

Forty-one percent of consumers have never heard of telemedicine, according to a new survey of 1,200 consumers conducted by Survey Sampling International on behalf of HealthMine. That number goes down for millennials, just 30 percent of whom say they haven’t heard of telemedicine, but it goes up for the 45 to 64 age group, 46 percent of whom hadn’t heard of telemedicine.

HealthMine is a consumer health engagement company, and as such has a stake in gauging consumer awareness of health technology trends.

“Telemedicine has the potential to deliver convenient and affordable basic healthcare to people of all ages,” Bryce Williams, CEO and President of HealthMine said in a statement. “Wellness programs can be the place where consumers are educated on the best way to access healthcare services, whether it be through a doctor’s office, emergency room, urgent care center, or telemedicine visit. Plus, telehealth is evolving to more than telephone visits. Soon, your smartphone will be a stethoscope and more.”

In the survey consumers were asked whether they would use telemedicine if it was offered by their physician as an alternative to traditional doctor visits, and whether they understood when it was best to use telemedicine. For the second question, “I’ve never heard of telemedicine” was included as a response option.

Overall, 45 percent of respondents said they would use telemedicine if it was offered, 16 percent said they wouldn’t, and 39 percent weren’t sure. The number who said they would use telemedicine rose to 58 percent for millennials (25 to 34-year-olds) and dropped to 37 percent for 55 to 64-year-olds. However the difference was mostly in how many were unsure — the portion of each group that answered “no” was 15 percent for millennials, 17 percent for seniors, and 16 percent for all age groups in between.

Forty-three percent of total respondents said they knew when it was best to use telemedicine, 16 percent said they didn’t, and 41 percent said they hadn’t heard of telemedicine. Fifty-two percent of millennials and 46 percent of 35 to 44-year-olds felt they knew when to use telemedicine compared to 38 percent of 55 to 64-year-olds and just 34 percent of 45 to 54-year-olds.

Earlier this month, a 500-person survey from TechnologyAdvice found that some 35 percent of consumers said they would likely choose a virtual visit over an in-person one. The survey also found that 56 percent of respondents would be somewhat or very uncomfortable conducting a doctor visit using a telemedicine offering. On the other hand, 75 percent of people said they would not trust a diagnosis that a doctor made over a video visit, or would trust it less than if they met with a doctor in person.

rob halkes's insight:

Very inspiring data found in asking consumers whether they knew of "telemedicine"! Disappointing numbers indeed. BUT: the positive sight is that doctors and health insitutions now still have the opportunity to introduce it the right way!
Maybe you want a first introduction in ehealth? See here

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Hashtags to Access Health Information

Hashtags to Access Health Information | Social Health on line | Scoop.it
Health Hashtags Research - Can We Make It Work?

People deserve access to safe, reliable health information online. Doctors have an ethical obligation to help make the internet easier and safer. Will health hashtags help or not?

 

On June 1st, I presented data on the growing use of the Cancer Tag Ontology (CTO) at the American Society of Clinical Oncology’s annual meeting. Here is the poster:


Analyzing 531,765 tweets from over 70,000 users through December 2014, we found that CTO use is increasing. 93% still come from tags with active chats. We didn’t do any formal statistical analysis, but it’s interesting to see how each tag has different stakeholders using them.

At the meeting, ASCO attendees from all backgrounds expressed interest and came to the poster: patients, advocacy organizations, doctors, industry. Beyond the scope of the study, I learned more from discussion with Symplur: as of early May, 62% of NCCN-designated cancer centers have used CTO tags at least 25 times. The five biggest users: Dana-Farber Cancer Institute, MD Anderson Cancer Center, Lurie Comprehensive Cancer Center, Memorial Sloan-Kettering Cancer Center, and UCSF Medical Center.

 

Despite the great response, we need more research on whether hashtags help. Originally, I focused on creating meaning and community-building by patients and advocates. Collaboration with doctors like Deanna Attai has worked great for #bcsm, but #pancsm was started by doctors. It has been active and useful, just different. What will work best? Read on here: Symplur

rob halkes's insight:

A very inspiring and intriguing initiative at the same time. Patients need to be informed about information concerning their diseases and how to cope with it. Still, how can we help them without bias to get the right meaning for them. We do not want to patronize patients, but it is not wrong to know that they might need support. doctors might be the first trusted source to turn too.
At the other hand the doctors themselves might have trouble to acquire  enough of the latest insights for their own profession.

Let's be honest the speed of research and new insights is one of the trends that disrupt our routines of professional work.
Disruption looks good to create innovation and progress but how can patients and healthcare providers adapt themselves? There is need for help. To begin with the recognition that help is needed.

This is to be found in this initiative by Matthew Katz. @subatomicdoc

Gr8!

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Key Digital Health Trends for EU Pharma - Manhattan Research

Key Digital Health Trends for EU Pharma - Manhattan Research | Social Health on line | Scoop.it
Key Digital Health Trends for EU Pharma Marketers- Manhattan Research

Via Alexandre Gultzgoff, COUCH Medcomms, Celine Sportisse, Olivier Delannoy, Thierry Le Magny
rob halkes's insight:

How fast is heathcare realy changed?

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Making Sense Of The Internet Of Things

Making Sense Of The Internet Of Things | Social Health on line | Scoop.it
Editor's note: Matt Turck is a managing director of FirstMark Capital. The he emerging Internet of Things — essentially, the world of physical devices connected to the network/Internet, from your Fitbit or Nest to industrial machines — is experiencing a burst of activity and creativity that is getting entrepreneurs, VCs and the press equally excited.

The space looks like a boisterous hodgepodge of smart hobbyists, new startups and large corporations that are eager to be a part of what could be a huge market, and all sorts of enabling products and technologies, some of which, including crowdfunding and 3D printing, are themselves far from established.

(Click to enlarge)

The chart [..] is an attempt at making sense of this frenetic activity. From bottom to top, I see three broad areas – building blocks, verticals and horizontals:
Building Blocks

The concept of the Internet of Things is not new (the term itself was coined in 1999), but it is now in the process of becoming a reality thanks to the confluence of several key factors.

First, while still challenging, it is easier and cheaper than ever to produce hardware – some components are open sourced (e.g. Arduino microcontrollers); 3D printing helps with rapid prototyping; specialized providers like Dragon Innovation and PCH can handle key parts of the production process, and emerging marketplaces such as Grand St. help with distribution. Crowdfunding sites like Kickstarter or Indiegogo considerably de-risk the early phase of creating hardware by establishing market demand and providing financing.

Second, the world of wireless connectivity has dramatically evolved over the last few years. The mobile phone (or tablet), now a supercomputer in everyone’s hand, is becoming the universal remote control of the Internet of Things. Ubiquitous connectivity is becoming a reality (Wi-Fi, Bluetooth, 4G) and standards are starting to emerge (MQTT).  The slight irony of the “Internet of Things” moniker is that things are often connected via M2M (machine to machine) protocols rather than the Internet itself.

Third, the Internet of Things is able to leverage an entire infrastructure that has emerged in related areas. Cloud computing enables the creation of “dumb” (simpler, cheaper) devices, with all the intelligence processed in the cloud. Big data tools, often open sourced (Hadoop), enable the processing of massive amounts of data captured by the devices and will play a crucial role in the space.

rob halkes's insight:

Great overview of the concept of the "internet of things" IOT See the chart! or this one from Quartz

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Changing the life of patients, together! | LinkedIn

Changing the life of patients, together! | LinkedIn | Social Health on line | Scoop.it

Philips, Salesforce.com and Radboud university medical center (Radboudumc) are collaborating to develop cloud based technologies to deliver better patient-centered clinical applications. Earlier this year, Philips announced its alliancewith CRM company salesforce.com to develop an open, cloud-based health platform integrating the data of medical devices and data from personal devices and offering applications. Philips at the same time announced the first two clinical applications to run on this platform that allow doctors and other caregivers to monitor patients with chronic conditions in their homes. REshape will be using this new Philips HealthSuite cloud-platform and its applications to further develop and implement its innovative patient services, creating an environment in which patients are equal partners in care delivery.

Lucien Engelen, Director at REshape, says that in the past years, REshape has been actively experimenting with a number of innovative digital tools. The most ambitious of these is Hereismydata™, a combination of a personal health record, a community system for patients, caregivers and families and a connectivity tool for all kinds of medical devices and apps, fully embedded in the clinical process. “Our pilots and clinical trials made it clear that traditional hospital software does not offer all the required functionality to share device and treatment data in a secure way. Therefor the patients themselves should be able to own (at least a copy) of their own records. [...]

Radboudumc is the first European academic hospital to use the new Philips HealthSuite platform for actual clinical usage. One of the first pilots will be patients with the chronic condition COPD. They will be monitored with devices such as the Health Patch, a small sensor worn on the chest that enables clinical-grade remote monitoring. Pilots involving patients with heart disease, diabetes and pregnancy will follow in the next months.

“We are witnessing an explosion of personal medical data”, Engelen says, “but the real challenge is to integrate this data in the systems that doctors and other caregivers are actually using in their day-to-day processes and to make sure that doctors and patients can trust the data.” ...

rob halkes's insight:

Maybe we are witnessing a true partnership between health care professionals, a hospital, technology provider and patients here! I guess there are not too many examples of such alliances, whereas they from the basis and also conditional alliance to make it effective to better health outcomes!  I for one do wish them the success they deserve!

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The Empirical Foundations of Telemedicine Interventions for Chronic Disease Management

The Empirical Foundations of Telemedicine Interventions for Chronic Disease Management | Social Health on line | Scoop.it

New Evidence Points to Outcomes and Cost Benefits of Telemedicine in Managing Chronic Diseases

New Rochelle, NY, September 10, 2014  Congestive heart failure, stroke, and chronic obstructive pulmonary disease (COPD) are three of the leading causes of death in the U.S. The use of telemedicine to help manage chronic diseases such as these can yield clear benefits including fewer and shorter hospital stays, fewer emergency room visits, less severe illness, and even fewer deaths, as reported in a study published in Telemedicine and e-Health, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. The article is available free on the Telemedicine and e-Health website until October 10, 2014.

Rashid Bashshur, PhD, Gary Shannon, PhD, and Brian Smith, MS, led a team of clinicians and researchers from the U.S. and Canada that included Telemedicine and e-Health Co-Editors-in-Chief Charles R. Doarn, MBA, and Ronald C. Merrell, MD, in the study entitled “The Empirical Foundations of Telemedicine Interventions for Chronic Disease Management.” The advantages enabled by telemedicine derive from its ability to help patients become more involved in their own care, facilitate continuous monitoring and early detection of new and recurring symptoms, and allow for prompt responses to worsening illness.

“The integration of telemedicine into healthcare adds great value in managing chronic disease both for patient and provider,” says Co-Editor-in-Chief Charles R. Doarn, MBA, Research Professor of Family and Community Medicine, University of Cincinnati, Ohio. “Dr. Bashshur has presented this work to both the U.S. Congress and the Congressional Budget Office, and with concomitant efforts by the American Telemedicine Association and others, the Congress may finally move telemedicine forward as an important element in healthcare for all Americans.

rob halkes's insight:

Great research and readings regarding the effects of ehealth!

Still free download till October 10th Here

Indeed, what we already guessed finds now its foundatoins in research. there's no way back. and the way forward is paved with lots of wuestions and issues how to do best. Luckily enough everyone, each institute of health care providers may find its own way. But remember cooperation is at the heart of it. You're not alone in providing care any more !

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Researchers develop app to determine if a patient is faking alcohol tremors

Researchers develop app to determine if a patient is faking alcohol tremors | Social Health on line | Scoop.it

A group of researchers in Toronto have developed an app that aims to measure a patients alcohol withdrawal tremors and determine whether they are real or fake.

A statement from the University of Toronto explains that tremors, which are caused by alcohol withdrawal, are commonly treated with sedatives, but addicts sometimes fake tremors to get prescriptions for the medications.

In order to prevent doctors from prescribing drugs to patients who aren’t actually going through withdrawal, PhD candidate Narges Norouzi, Mount Sinai Hospital emergency physician Bjug Borgundvaag, and University of Toronto Associate Professor Parham Aarabi developed the app, which is still being studied — it’s not FDA-cleared or available commercially.

To use the app, patients hold a phone in their outstretched hand with the app opened on the screen. The app will then set a timer and measure the patient’s tremors for a period of time. The frequency with which the user’s hand shakes is measured, based on the iPhone’s accelerometer, to determine whether the patient is actually experiencing tremors.

“Our app may also be useful in assisting withdrawal management staff, who typically have no clinical training, and determining which patients should be transferred to the emergency department for medical treatment or assessment,” Borgundvaag said in a statement. “We think our app has great potential to improve treatment for these patients overall.”

While developing the app, the researchers conducted a preliminary study at three Toronto hospitals: Schwartz/Reisman Emergency Medicine Institute at Mount Sinai Hospital, St. Michael’s Hospital, and Women’s College Hospital. During the study, the app analyzed tremors from 49 patients and 12 nurses who attempted to replicate the symptom.

Read more at the blog here

rob halkes's insight:

It looks for instance by this example, that we are really in the stage of "Brainstorming mobile technology": exploring whatever we can create to be used mobile... And yes we can ;-)

But, imagine for a moment what a patient, and for that, also his care providers, need to coordinate, handle, organize data flows and review of them, to enable functional use of all those apps and applications.. Got it? - Indeed, let's begin integrating and organizing packaged applications! ;-)

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How often do consumers use digital health tools? This graph will show you

How often do consumers use digital health tools? This graph will show you | Social Health on line | Scoop.it

A chart by Parks Associates followed up an infographic on consumer's use of digital health tools this week with a chart showing how frequently they used them in the past year.

As the use of digital health tools continues to become common practice in people’s lives, it’s always useful to quantify that. An infographic released this week(displayed below) showed that 60 percent of households have some sort of digital health device — such as a digital scale or glucometer. Although 25 percent used digital health apps, only 27 percent used their healthcare provider or insurer’s website. That seems like a low number to me, especially when you consider the push by payers and providers to improve patient engagement on multiple levels.

Thanks to a request from Matthew Holt of Health 2.0, market research business Parks Associates did a drill down to add more context on how frequently people look up health information online and how often they used a device to track their health patterns.

The point was to add some more color beyond the original survey’s finding that 38 percent looked up health information online or through an app. That seemed a little low considering Pew Research has said that 72 percent of Internet users looked up health information in the past year. Parks decided that the actual amount is probably higher than 38 percent but was influenced by the way the question was asked.

The graph also serves as a useful reminder that the growth of digital health in everyday life is likely to be in small steps. The most frequent use of digital health tools seems to average out at three times a month. It’s encouraging that the use of apps to manage a health condition tops the list since it demonstrates the most engagement. It’s also interesting to see the frequency of telehealth interactions with healthcare professionals.

Since Parks Associates is open to requests, I’d like to see a comparison chart next year to see how 2014 numbers stack up.

I’ve included the original infographic here. [ See also here ]

rob halkes's insight:

Consumers' searches on line for health services.

Mind you that you're there ;-)



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How the demands of healthcare delivery are superseding the privacy debate

How the demands of healthcare delivery are superseding the privacy debate | Social Health on line | Scoop.it
Recent press coverage in the UK about harried GP practices offering patients Skype and email consultations in order to address the estimated 50 million occasions during the last year on which it was not possible for NHS service users to schedule face-to-face appointments have taken many by surprise.

Only a few months ago, concerns about the ‘safety’ of using VOiP services such as Skype in a healthcare setting were being brought to the privacy debate that focused on the UK’s forthcoming electronic health record system.

“What if Skype calls are intercepted, or recorded?”, it was asked.

Such questions are seldom posed as a duty of care with regard to safeguarding the security of novel forms of patient access to provider services, but as a means of evading the hard work involved in redesigning existing provider workflows.

VOiP is neither more nor less secure than any other existing means of patient-clinician interaction.

Overlooking the fact that patient consent is customarily taken to include all forms of provider communication unless expressly stated, from a logical standpoint it makes no sense to say that VOiP calls are less private than medical records left open momentarily at a GP’s reception, or an overheard telephone call between a doctor and their patient, or a patient-clinician conversation that might be audible through a door during a consult, or an intercepted or otherwise lost piece of correspondence such as a test result.

Technology has the ability to reduce the cost of delivering healthcare, and can be utilised effectively in order to reduce the personal and economic burden of care in single-payer healthcare systems.

It’s just a shame that this has had to be pointed out 50 million times in the UK, at an untold human cost to patients and their families.

rob halkes's insight:

Remarkable, but still complicated. From a direct user need, one will be happy to learn opportunities for care in using social media and VOiP. Still, from a formal perspective of guarding privacy it is a more difficult discussion. I would say let providers and technicians work for better connections?

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Michael Seres's curator insight, July 30, 2014 12:43 PM

I was involved in starting skype clinics in my hospital. At first no one wanted to know but due to patient demand they have become common place. More common sense thinking like this is needed. It is a great use of a COST FREE resource.

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Social media and healthcare quality improvement: a nascent field

Social media and healthcare quality improvement: a nascent field | Social Health on line | Scoop.it

Editorial from BMJ
Social Media and Healthcare  quality improvement: a nascent filed

Two articles1 ,2 describe the use of social media to describe or potentiate healthcare quality improvement. Taken together, these articles point to an exciting—but still nascent—trend. We hope that these two pilot studies will be taken as a call to future research rather than as definitive reports.

The first article1 describes the proportion of emergency department (ED) patients who consent for researchers to download their Facebook and Twitter data. The novelty of this study lies in its underlying premise: accessing patients’ social media data could, in theory, permit better awareness of patients’ health status and risks, and thereby permit real-time interventions and improved patient engagement. To our knowledge, this study is the first to show the acceptability, feasibility and limitations of accessing patients’ social media data. It thereby gives hope that incorporating social feeds into healthcare may be possible.[...]
The second article, ‘Measuring patient-perceived quality of care in U.S. hospitals using Twitter’2 extends others’ work using social media to measure or evaluate healthcare. Twitter has previously been shown to provide real-time monitoring of conditions such as viral and foodborne illness,5 mental illness6 and substance use.7 ,8 The study by Hawkins et al,2 showing a correlation between patient sentiment and readmission rates, has findings that are similar to Kilaru et al's9 recent article in this journal that analysed Yelp reviews. While these methods provide insight into a variety of patient characteristics and behaviours, they are nonetheless limited and subject to misinterpretation. [...]
Another major limitation for both of these articles is that we still have problems accurately interpreting the meaning of social media. [...]

Finally, both articles touch on—but do not provide answers to—the spectre of privacy. In the first paper, among the 50% willing to engage in discussion, privacy was the primary reason for people refusing to share their data. The authors note that in general, public supports purpose of using social media data for health research, accepting it without consent (compared with their lack of support for marketing research, done with their consent)—but this paper suggests attitudes change when it's an individual's data that's being requested, during that individual's emergency. These findings are similar to those of others’ findings regarding patients’ privacy preferences for electronic health information.13 [...]

All of these limitations aside, we are enthused by these papers. Together, they help lay the foundation for further efforts integrating social media into electronic health record (EHR) and healthcare... See it in pdf

rob halkes's insight:

Good to see good BMJ research on the use of social media and healthcare qwuality improvement. No easy connections between the two, but prmising developments! Privacy is indeed a case in point! Authors Megan Ranney at @meganranney and Nicholas Genes at @nickgene warn for high expectations  but do dream of options and possibilities. Gr8!

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Dignity Health Improves Asthma Outcomes with Use of Digital Health Technology | Business Wire

Dignity Health Improves Asthma Outcomes with Use of Digital Health Technology | Business Wire | Social Health on line | Scoop.it

Dignity Health, announced results from a randomized controlled study which demonstrated that the use of digital health technology improved asthma control. The study, “Effectiveness of Population Health Management Using the Propeller Health Asthma Platform: A Randomized Clinical Trial,” was recently published in the Journal of Allergy and Clinical Immunology: In Practice.

The Propeller Health Asthma Platform utilizes sensors, mobile applications, and analytics to monitor short-acting β-agonist (SABA) and inhaled corticosteroid use in real-time. The platform provides detailed information about patterns of medication use and notifications about patients with worsening asthma control.

“The research demonstrates that the benefits of telehealth go beyond monitoring medication adherence, but can also identify patterns of risk and impairment. This additional information may allow more timely interventions and enhanced asthma management,” said Dr. Rajan Merchant, the principal study investigator and physician at Dignity Health’s Woodland Clinic Medical Group. “Although additional study efforts are needed, digital health is promising to help improve care and asthma control.”

Currently, more than 40 percent of both adults and children in the U.S. report uncontrolled asthma, according to recent studies. Current guidelines recommend monitoring of SABA use and assessment of asthma control. Electronic monitoring of SABA use provides an indication of poor asthma control.

More than 495 adults and children enrolled in this study. The results found that the total amount of SABA use, and the total number of days when SABA was needed, was lower in the group using the Propeller Health Asthma Platform compared to the patients receiving routine care. Furthermore, a significantly greater increase in the Asthma Control Test was demonstrated in adults with uncontrolled asthma in the intervention group compared to adults with uncontrolled asthma under routine care.

rob halkes's insight:

ANother example of telemedicine working to results. There is indeed more than technology needed, like an organised integrated care path. See here!

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A Telemedicine-Based Intervention Reduces the Frequency and Severity of COPD Exacerbation Symptoms

A Telemedicine-Based Intervention Reduces the Frequency and Severity of COPD Exacerbation Symptoms | Social Health on line | Scoop.it

Conclusions: A telemedicine-based symptom reporting program facilitated early treatment of symptoms and improved lung function and functional status.

Background: Patients with chronic obstructive pulmonary disease (COPD) may not recognize worsening symptoms that require intensification of therapy. They may also be reluctant to contact a healthcare provider for minor worsening of symptoms. A telemedicine application for daily symptom reporting may reduce these barriers and improve patient outcomes.
Materials and Methods: Patients hospitalized for a COPD exacerbation within the past year or using supplemental O2 were approached for participation. Patients received optimal COPD care and were given a telecommunication device for symptom reporting. Initial symptom scores were obtained while patients were in their usual state of health. Patients were randomly assigned to an intervention group or a control group (usual medical care). The control group patients were instructed to seek medical care if their condition worsened. The intervention group symptom scores were assessed by a computer algorithm and compared with initial values. Scores 1 or more points above the initial score generated an “alert,” and patients were reviewed by a nurse and referred to a physician who prescribed treatment.

Results: Eighty-six patients were screened; 79 met entry criteria and were randomized (intervention group, n=39; control group, n=40). Twelve patients submitted five or fewer symptom reports (5 intervention; 7 control) and were excluded from the analysis. Daily peak flow and dyspnea scores improved only in the intervention group. There were no differences in hospitalization and mortality rates between groups. No serious adverse events were reported.

rob halkes's insight:

Confirming expectations about eHealth effectiveness is needed. Implementation based on these insights is crucial. EHealth applications intervene in delivery processes and make education of participants, professionals and care givers, necessary.

See here: eHealth the introduction.

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Modern Doctors’ House Calls: Skype Chat and Fast Diagnosis

Modern Doctors’ House Calls: Skype Chat and Fast Diagnosis | Social Health on line | Scoop.it

The same forces that have made instant messaging and video calls part of daily life for many Americans are now shaking up basic medical care.


TACOMA, Wash. — One night, when her face turned puffy and painful from what she thought was a sinus infection, Jessica DeVisser briefly considered going to an urgent care clinic, but then decided to try something “kind of sci-fi.”

She sat with her laptop on her living room couch, went online and requested a virtual consultation. She typed in her symptoms and credit card number, and within half an hour, a doctor appeared on her screen via Skype. He looked her over, asked some questions and agreed she had sinusitis. In minutes, Ms. DeVisser, a stay-at-home mother, had an antibiotics prescription called in to her pharmacy.

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The same forces that have made instant messaging and video calls part of daily life for many Americans are now shaking up basic medical care. Health systems and insurers are rushing to offer video consultations for routine ailments, convinced they will save money and relieve pressure on overextended primary care systems in cities and rural areas alike. And more people like Ms. DeVisser, fluent in Skype and FaceTime and eager for cheaper, more convenient medical care, are trying them out  [..]
But telemedicine is facing pushback from some more traditional corners of the medical world. Medicare, which often sets the precedent for other insurers, strictly limits reimbursement for telemedicine services out of concern that expanding coverage would increase, not reduce, costs. Some doctors assert that hands-on exams are more effective and warn that the potential for misdiagnoses via video is great [..].
While telemedicine consultations have been around for decades, they have mostly connected specialists with patients in remote areas, who almost always had to visit a clinic or hospital for the videoconference. The difference now is that patients can be wherever they want and use their own smartphones or tablets for the visits, which are trending toward more basic care.[..]
Advocates say virtual visits for basic care could reduce costs over the long term. It is cheaper to operate telemedicine services than brick-and-mortar offices, allowing companies to charge as little as $40 or $50 for consultations — less than for visits to emergency rooms, urgent care centers and doctors’ offices. They also say that by letting people talk to a doctor whenever they need to, from home or work, virtual visits make for more satisfied and potentially healthier patients than traditional appointments that are available only at certain times.[..]   
...

When the doctor appeared on her screen, she told him her symptoms and, holding her iPad close to her face, showed him her painful tooth and the swelling in her jaw.

“I was in so much pain, I didn’t care that it was weird,” Ms. Sickmeier said. “He got right to the point, which was what I wanted. He prescribed antibiotics and called them into an all-night pharmacy about 20 minutes away.”

Washington State gave a victory to the industry in April when Gov. Jay Inslee, a Democrat, signed legislation requiring insurers to cover a range of telemedicine services if they already cover those services when provided in person. But the new law, which made Washington the 24th state to ensure reimbursement for some telemedicine services, does not cover virtual urgent care outside a medical facility.

Still, the law “opens the doors with a lot of our payers,” said Matt Levi, CHI Franciscan Health’s director of virtual health services. He added that some insurers, like Molina Healthcare of Washington, the state’s largest Medicaid plan, were starting to cover virtual urgent care, though the law does not require it. [...]

Some large insurers are starting to pay, too. UnitedHealthcare, the nation’s largest insurer, announced in April that it would cover virtual visits for most of its 26 million commercial members by next year, citing the shortage of primary care doctors and the cost of less than $50 per virtual visit.[...]

Virtual urgent care visits are undoubtedly less expensive than trips to the emergency room, said Dr. Ateev Mehrotra, a professor of health policy at Harvard Medical School, who has studied telemedicine.[..]

CHI Franciscan’s virtual urgent care program contracts with Carena, a private company in Seattle that employs 17 physicians and nurse practitioners to do virtual consultations in 11 states. Among CHI Franciscan’s patients, the most frequent users are women ages 25 to 55, and the most typical diagnoses are bladder infections, upper respiratory tract infections and pinkeye.

Users are prescribed medication about 40 percent of the time, said Beth Bacon, the company’s vice president for consumer affairs. Most visits take place on weekends or between 5 p.m. and 8 a.m., she said, when doctors’ offices are closed. Like other virtual urgent care programs, CHI Franciscan’s emphasizes that it is not for medical emergencies, advising customers on its website to “call 911 or proceed to the nearest emergency room” if they have chest pain, difficulty breathing or other potentially life-threatening symptoms.

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rob halkes's insight:

Early applications of telemedicine / ehealth will struggle with experimental features of it. The benefits and profits to all stakeholder indicate the necessity of sustained effort. Along with necessary changes in healthcare as it is now, there is an effective outcome to be expected.

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Curely - Rely on Curely for everyday health concerns

Curely - Rely on Curely for everyday health concerns | Social Health on line | Scoop.it
Rely on Curely for everyday health concerns Watch Video HOW IT WORKS Curely brings board-certified doctors around the world to your fingertips. CHOOSE YOUR DOCTOR Browse through a list of board-certified doctors and select your doctor by specialty, price, and language. DISCUSS YOUR CONCERNS WITH YOUR DOCTOR Chat with a doctor immediately or send a …
rob halkes's insight:

"Curely" A doctor in your phone, on line. Again a new platform for distant help and support. I would be very much interested in evaluation data by patients ;-)


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The Empirical Foundations of Telemedicine Interventions for Chronic Disease Management

The Empirical Foundations of Telemedicine Interventions for Chronic Disease Management | Social Health on line | Scoop.it

Abstract

The telemedicine intervention in chronic disease management promises to involve patients in their own care, provides continuous monitoring by their healthcare providers, identifies early symptoms, and responds promptly to exacerbations in their illnesses. This review set out to establish the evidence from the available literature on the impact of telemedicine for the management of three chronic diseases: congestive heart failure, stroke, and chronic obstructive pulmonary disease. By design, the review focuses on a limited set of representative chronic diseases because of their current and increasing importance relative to their prevalence, associated morbidity, mortality, and cost. Furthermore, these three diseases are amenable to timely interventions and secondary prevention through telemonitoring. The preponderance of evidence from studies using rigorous research methods points to beneficial results from telemonitoring in its various manifestations, albeit with a few exceptions. Generally, the benefits include reductions in use of service: hospital admissions/re-admissions, length of hospital stay, and emergency department visits typically declined. It is important that there often were reductions in mortality. Few studies reported neutral or mixed findings.

rob halkes's insight:

Mind you: the evidence says about telemedicine: "Generally, the benefits include reductions in use of service: hospital admissions/re-admissions, length of hospital stay, and emergency department visits typically declined. It is important that there often were reductions in mortality. Few studies reported neutral or mixed findings." So ehealth is on its way of fundamental recognition!

Want to know what it is: See "What is ehealth?"

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Most Wearable Devices Will Fail .. | Richie Etwaru

Most Wearable Devices Will Fail .. | Richie Etwaru | Social Health on line | Scoop.it

Wearables are anything but sensible, from first hand observation they are somewhat silly, as they are trying to solve a problem that can be solved by a myriad of simpler and more passive mechanism.

If you were at CES, you could not have missed a new category of computing called "wearables." This category of devices can be described as the FitBit gone mad. Wearables currently come in three main categories: health trackers, watches and glasses. In each of these categories some if not all devices are pivoting to solving the world's biggest health problems.

Almost daily, I see a new wearable device launched, and while they all are minimally viable products, they continually get sillier and sillier. We are seeing everything from wearable necklaces (like necklaces were never wearable) earrings, shoes, clothing and many other bodily accruements being outfitted with small computers/biosensors, low voltage needs and high connectivity. Like clockwork, every new device no matter how silly, calls out to the world with press releases, tweets, YouTube videos and multiple pounds of the manufacturing firm's proverbial digital chest reckoning how disruptive some new wearable product is.

My observation is that we have bastardized the word disruption. Most wearables are disturbing mankind under the once well-intended charter of disruption.

While a minority of humans continue to wear these devices past the first few months of purchase, most folks (like myself) stop wearing after the nostalgia has worn off. I gave up my FitBit after about six months, my pebble watch in about six days and my Google GLASS, well I got over that bad boy in about six hours. I got over them the same way I got over my first CASIO watch, which doubled as a calculator in high school; said watch plus calculator was disturbing my life. Disruption does not have to disturb.

Good disruption is change without disturbance.

The hypothesis is simple, wearing something on my body that is not confortable, fashionable and delivering more value than it disturbs me is not a sustainable value proposition. So the big question is what will become of wearables? Clearly the movement of computing to the edge of the network will continue, and the connecting of things/biosensors that are not computers (Internet of Things) will continue. Wearables currently position themselves as trying to solve health's biggest problems. [..]

Read the full article!

rob halkes's insight:

Reflective critique is always good. But I guess the way forward in health care to the triple aim (better care, better outcomes , less costs) is not as simple as to claim that disruption by wearables might go on without disturbance.

In healthcare  "digital', e-health, telemedicine  and sensores will have to large an impact on the way health care is organized and paid. My claim? Disruption will not succeed without disturbance!

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Why LinkedIn Is Ideal for Healthcare Professionals

Why LinkedIn Is Ideal for Healthcare Professionals | Social Health on line | Scoop.it

LinkedIn has become a staple social media outlet for professionals across the board, and now more than ever, people are actively using this platform to share information.  One and a half million LinkedIn members are sharing content and sixty-five percent of users have increased their consumption over the past year. This drastic increase is now being called “the content revolution,” and is a phenomenon that should not go unnoticed by healthcare professionals.

The healthcare industry can take advantage of what marketers have already been doing and utilize these social media sites for digital marketing.  LinkedIn recently released their 2014 Professional Content Consumption Report which surveyed over 2,700 users about their interactions with the site.  As ninety-one percent of those surveyed list LinkedIn as their number one choice for professional content and the average user spends eight hours a week on LinkedIn, connecting with these content revolutionaries is an excellent way for healthcare professionals to network and share valuable insights and information.

Present novel information, or information that will assist in decision making. Fifty-six percent of users feel it is the easiest way to find professionally relevant content.  Posts that present new and helpful information will be viewed and shared at a higher rate.
        Use this platform to spark discussion. Fifty-one percent of users feel the main benefit of LinkedIn is the potential for sparking conversations.  Content revolutionaries will share content that they feel evokes a response, and this content is more likely to be shared across other media platforms as well.
        Ensure that sharing this content would benefit a user’s professional network. Sixty-two percent of users use LinkedIn to build relationships with colleagues or clients. Network building is one of the main draws of this platform, and content revolutionaries are likely to share information that aids in building relationships.

    Format the content so it can be easily consumed on a mobile device. Users often need information at their fingertips and forty three percent of members visit this site on their mobile device.
    Publish content that users want to share to enhance their professional brand. Some of the main benefits to using LinkedIn are that it increases member visibility, enhances a member’s professional brand reputation, and positions a member as an innovator.  Content revolutionaries are most likely to share content that fulfills these needs.

For healthcare professionals to be most effective on LinkedIn, they must deliver information that content revolutionaries are seeking. In order to ensure that content revolutionaries share and consume healthcare professional’s content, it is important to present new, timely and discussion-worthy information.

Providing content beneficial to a professional’s network or brand, as well as providing small, easily “digestible” pieces of content will help increase the likelihood that the information is shared.

- See more at: http://scottpublicrelations.com/the-content-revolution-why-linkedin-is-ideal-for-healthcare-professionals/#sthash.8j1Uflgn.dpuf


Via Plus91
rob halkes's insight:

Is my own experience as well..

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Helen Adams's curator insight, November 24, 2014 9:31 AM

I've been suggesting LinkedIn to my clients as a social media channel to reach HCPs for some time. 

Ignacio Fernández Alberti's curator insight, November 24, 2014 11:02 AM

AÑADA su visión ...

Art Jones's curator insight, November 24, 2014 2:22 PM

"As ninety-one percent of those surveyed list LinkedIn as their number one choice for professional content and the average user spends eight hours a week on LinkedIn, connecting with these content revolutionaries is an excellent way for healthcare professionals to network and share valuable insights and information."

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Propeller Health (Asthma/COPD) raises $14.5M | mobihealthnews

Propeller Health (Asthma/COPD) raises $14.5M | mobihealthnews | Social Health on line | Scoop.it

Madison, Wisconsin-based Propeller Health, formerly known as Asthmapolis, has raised $14.5 million in a round of funding led by Safeguard Scientifics with participation from return backer The Social+Capital Partnership. (..)

The smart inhaler company’s devices and companion apps offer geographic mapping of inhaler use and asthma triggers as well as adherence tracking and early warning alerts for COPD patients.

The funding supports the mission we are already on: to bring sensors to the full variety of the inhaled medications that are used for chronic respiratory disease,” Propeller Health CEO David Van Sickle told MobiHealthNews in an interview. “We are already well down that path… but the respiratory pipeline is fairly active. We are seeing new medications, therapies, and form factors.”

In May Propeller received FDA clearance for its COPD offering. The new platform aims to help users prevent so-called “asthma attacks” or similar lung inflammation symptoms caused by COPD. The Propeller Metered-Dose Inhaler measures a patient’s use of their rescue inhaler. That data is automatically compared to a patient’s baseline and to general clinical guidelines, and the app can alert care teams if an attack seems likely. 

“In addition software development, as we take on more COPD programs, we have a broad spectrum of demographics that we have to cover with our products and services,” Van Sickle said. “So we are building out teams to support the usability and experience of not only kids with respiratory disease but elderly folks with respiratory disease, caregivers, new enterprise teams for care managers which are on their own evolving with the times and new healthcare arrangements.”(..)

Propeller is seeing a lot of interest in COPD programs, Van Sickle said, partly driven by the market forces in healthcare incentivizing providers to reduce readmissions for COPD patients in particular. (..)

rob halkes's insight:

Chronic diseases: the floor for researching these key questions:

  1. how should we choose what deivces/wearables, their functions, their userfriendlines;
  2. how should the process of delivering care be redisigned to what medical and patient criteria; and
  3. how should we get it payable/affordable?
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Healthcare Tweeting Tips | HealthWorks Collective

Healthcare Tweeting Tips | HealthWorks Collective | Social Health on line | Scoop.it

By Marie Ennis-O'Connor @JBBC

Twitter is a conversation, and just as you observe conversation etiquette in real life, when it comes to healthcare tweeting there are unwritten rules, too.

If you are new to Twitter becoming familiar with these rules will ease your transition into its culture; if you are already a seasoned tweeter, take this opportunity to see how you score on your Twitter etiquette.

  • Rule #1 Be polite at all times

Being courteous to those who follow you is the first rule of Twitter etiquette. Apologize if you make a mistake and never get drawn into a public argument.  If someone wants to argue with you on Twitter either ignore them or if they have a genuine grievance take it offline.

  • Rule #2 Keep it professional

Twitter is an excellent way to allow your personality to shine through your tweets, but you need to strike the right balance between the personal and professional. The standards expected of health care professionals do not change because you are communicating through social media. Posting inappropriate photos and using explicit language is definitely not on.  Be professional at all times; avoid flippancy or irreverence which may be misconstrued. 

  • Rule #3 Acknowledge your followers

As much as possible respond to those followers who engage with you and thank those who "Retweet"(RT) your updates in a timely manner.  Use their real name whenever you can. 

  • Rule #4 Learn the etiquette of following

You are under no obligation to follow every person who follows you. Following a large number of people indiscrminately diminishes your credibiltiy. Be selective and only follow those you genuinely want to engage with and who add value to your Twitter feed.  Similarly not everyone will want to follow you and that's ok. Never call someone out for not following you. Finally don't be the kind of follower who follows someone in order to get them to follow back, and then immediately unfollows. 

  • Rule #5 Use "Direct Message" (DM) for personal conversations

Whatever you post on your Twitter timeline is visible to everyone (whether they're following you or not). If you are engaged in a private conversation with someone on Twitter, use the "Direct Message" (DM) function to communicate. If you want to get in touch with someone about a business opportunity, contact him or her by email.  

  • Rule #6 Avoid overt self-promotion

While Twitter is a good place to promote your healthcare expertise or service, too much self-promotion will lose you followers. It’s ok to share your own content, so long as you balance it out by sharing content from others too.  Some social media experts suggest following the 80/20 rule - posting content for your followers 80% of the time and for yourself 20% of the time  - but there are no hard and fast rules on this.   In the same vein constantly retweeting people who praise you makes you look boastful and self-serving.  

  • Rule #7 Always credit your sources

Be transparent. If you tweet an idea or opinion that originated with another Twitter user, give them credit. Clicking "Retweet" (RT) on a user’s Twitter update allows you to share it with your followers. Alternatively you can manually retweet the post (add "RT" or "via" followed by @ the user’s handle) and add your own comment or insight. If you abbreviate the original tweet add "Modified Tweet" (MT). Adding HT (meaning "Hat Tip") to acknowledge a user who has pointed you in the direction of something interesting is considered polite.  

  • Rule #8 Shorten your links

Shortening long links in your tweets makes for a more streamlined experience for you and your followers.  Use a url shortener like bit.ly which also gives you useful realtime information about who's clicking your Bitlink.

  • Rule #9 Forgo automated services

Do not use automated tweets to thank new followers when they follow you. You may do it with the best of intentions but an auto-DM (automatic direct message) is often viewed as spam. Never auto-DM a link to your website or service. 

  • Rule #10 Ask for Retweets sparingly

It’s ok to ask for a "Retweet" (RT) once in a while, but constantly seeking RTs from your followers is annoying for them.

  • Rule #11 #Don’t #overuse #hashtags

A hashtag is a popular way of creating and monitoring a conversation around a particular health related topic.  To create a hashtag, simply place the # symbol before a word but don't over do it. Placing too many hashtags in your tweet is visually unappealing and may make your tweet look like spam.

  • Rule #12 Don’t flood your Twitter feed with multiple tweets

If you do a lot of catching up on blogs and other online content first thing in the morning, it is easy to flood your Twitter feed with multiple links. Using a scheduling tool will help you manage a steady trickle of valuable tweets throughout the day, rather than deluging your followers with a downpour all at the same time. If you're going to be live-tweeting or taking part in a healthcare chat it’s polite to let your followers know that you will be tweeting more than usual. Stick to your allotted 140 characters; spreading your thoughts over multiple tweets can be off putting. 

  • Rule #13 Add value to the healthcare conversation

When you share a link to an article, go beyond the headline to add your insight. Contribute your expertise to one of the many health related Twitter chats.  You will find a full list of health hashtags via Symplur's Hashtag Project.


None of the above rules are mandatory and you will likely see them flouted every day on Twitter. However by following these unspoken rules of Twitter etiquette you are on the right path to attract new followers, engage more meaningfully with your existing followers and enrich the online healthcare conversation.


rob halkes's insight:

Great guidelines for tweeting in health care!

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Carlos Martins's curator insight, September 6, 2014 1:28 PM

Great healthcare social media tips!

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The Digital Divide and Personal Health Records: An Outdated Misconception

The Digital Divide and Personal Health Records: An Outdated Misconception | Social Health on line | Scoop.it

One misconception clinicians and policy-makers have about a Personal Health Record is that it is a luxury available only to a wealthier minority and that, as a result, anyone promoting it is somehow turning their back on a whole segment of the population. The desire to improve access is one we at PKB fully support; we therefore strongly believe that this interpretation of PHRs is outdated and bad for patients. This is why the UK government, for example, has a Digital First strategy for the NHS. Digital services should be offered as the default, rather than delaying because of fears over access. In fact, if we look at the numbers, access is at remarkable levels already.

A study recently released by Ofcom, as part of an effort to “scorecard” internet and mobile infrastructure, access and speed in the UK, found the UK is a leader. It scores a whopping 81% of individuals accessing the internet at least once a week.

...

rob halkes's insight:

Yes, we are definitively connected with one another no excuse anymore for reluctance on ehealth ;-)

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Wikipedia, Twitter, facebook, and YouTube: uses in health

Wikipedia, Twitter, facebook, and YouTube: uses in health | Social Health on line | Scoop.it
Wikipedia, Twitter, facebook, and YouTube: uses in health


Via Andrew Spong
rob halkes's insight:

Great overview !

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ChemaCepeda's curator insight, July 31, 2014 9:09 AM

¿Qué usos podemos dar a cada red social aplicados a la salud? Interesante gráfico con las ventajas y desventajas de cada una