Doctors are increasingly sharing procedures on Periscope. For the uninformed, Periscope is an in-line Twitter application that facilitates live, personal broadcasting. Most recently, an achilles tendon repair from Ohio State was ’scoped’. I thought it sounded pretty interesting, but I got there too late. The party was over and the video was gone.
The use of Periscope in the OR is the next iteration of live tweeting. The argument with live tweeting was that it was educational. But the reality is that it was a new way for a hospital to have its 15 minutes of fame. On the Visibility-Value Continuum, many of these events have tilted toward visibility.
And when it comes to Periscope and operative procedures, what’s new may be what’s old again.
Admittedly, broadcasts are more interesting than live tweets. But what’s more educational is the enduring nature of a recording that can be seen, linked to, and commented on months later. This would be a recording on YouTube or Vimeo. Periscope, on the other hand, fits into what might be referred to as an ephemeral media. It’s a piece of viewable information that disappears after a time.
Before choosing Periscope as a medium, I might first ask myself whether this is an event that needs a live, in-line broadcast? Or would it be better served recorded and published.
Live has its draw, for sure. And there are things about Periscope that make it valuable. It’s real value may come from the fact that it’s just easy. Even if I wanted to, the process of finding and uploading to a YouTube Channel can be a small chore that raises the barrier to sharing. And for heavy twitter users like myself, Periscope is part of my workflow. Perhaps more importantly, it’s where my audience is.
When it comes to (free open access) medical education, enduring content that’s searchable and retrievable is where the money is. Live has its place, but I’m concerned that it could be more for visibility than value.
Health care’s race to the consumer was met with some chatter last week with the announcement that LabCorp will allow patients to order their own blood tests.
This is good, but consumer lab testing can be a tricky proposition. Numbers and results devoid of context are only numbers. Outside of the body from which the number comes and divorced from the patient’s story, these numbers may represent data more than information. Empowerment in this case is relative
Some tests are remarkably sensitive, specific and precise for over the counter sale. Some aren’t.
Celiac disease is a good example. The interpretation of celiac serology can be challenging at best. Beyond basic serology, HLA typing is conceptually dicey. And in the absence of clinical context, weighing results with presentation to deliver a plan can be dicey.
But as medicine marches toward the precise, this ambiguity will become less of an issue. Celiac disease will be diagnosed with solid endpoints. A nanofleck of blood will deliver answers that will require less clinical overlay.
Yesterday on Twitter I suggested that doctors had officially been marginalized. Or maybe we can decide how marginalized we’ll be. Until consumer testing and interpretation is so good that patients will stop looking to clinicians for help, It will be up to physicians to figure out where they fit among a patient and her data.
Not long ago I was reviewing a piece of patient education material that was due for revision. It was long, dry, and read like my seventh grade health ed textbook. It didn’t work.
These writers and editors understand how to shape and present information. They’ve made a science of editorial design and a business of understanding how people consume information. They recognize that how we deliver information is as important as the content itself.
But as far as I know, these tactics have never been translated to patient communication. Health communication is critical. Yet we rarely think about how we put together what we need to get across.
The best sites …
- Make it short. The more we write, the harder it is to get a reader through to the end. If patients never consume it, there’s no chance they’ll get what they need.
- Make it subdivided. Break writing up into major subheadings and points. This sort of editorial design makes content easier to navigate and understand.
- Use killer headlines. Pique the curiosity of the reader or patient.
- Write like we speak. It’s time to rethink the requisite 4th grade level writing that has dominated patient education. Look at the voice of the best writers on these sites and you see a human, approachable voice that’s real.
- Make their stuff compelling and useful. While this is easier said than done, we should make what we write engaging and practical with applicability to the consumer.
We’re so used to seeing poorly designed health information that this idea might be hard to process. But perhaps it’s time we took a lesson from the textbooks of the most trafficked content producers on the web and apply it to helping a patient understand what they need to know.
I’m planning to experiment with an editorial reformatting of some of my materials based on what seems to work. I’ll keep you posted.
Increasingly, my life is about finding signal. Noise grows by the day. So who I listen to has become important. Tuning for value has become a new preoccupation.
So I thought I’d share a few of the people who do a brilliant job creating a clean, valuable signal for me. This is not a ‘best of’ list, but rather a sampling of individuals who do a great job of finding and sharing great information on digital heatlh. I mean, a remarkably good job. Instead of looking at them through the lens of who to follow, think who to study. Personally, I’d kill to have a look at the information workflow of these folks.
So check ’em out. I’ve added a few comments about what makes their work remarkable.
If you’re in digital health and you can only follow one person, this is the guy. Dave is the founder of AliveCor and he curates around digital medicine and personal health technology. Beyond an inventor, he’s a tireless information consumer and he has an eye for what’s important. I don’t know how he does it. He selectively advances and promotes his remarkable AliveCor product but does it in a way that’s balanced. For entrepreneurs who want to understand how to build value while respectfully promoting what you’ve got, study Dave.
Topol is the Dean of Digital Medicine. Beyond his visionary leadership and capacity for synthesis, his ability to find unusual bits of information related to digital medicine makes his contributions key. He shares little, but what he shares is really important. Super high signal to noise ratio. I read everything source he shares. Until you’ve read both of his books, you are risking irrelevance.
Of the several hundred I follow on Twitter, one of my fav and most valued is Joyce. An NIH-funded pediatrician scientist with a passion for design, what she shares has changed how I see my world. I have fallen in love with thinking about design and so much of what Joyce brings inspires me in this way. How she finds what she finds is beyond me. I’ll add that my best memory of Stanford MedicineX 2014 was spending some time in front of a whiteboard with Joyce.
Kingpin at NostaLab, John does a tremendous job of finding unique information related to digital health. He has the keen capacity for finding information in sources that are varied. I think part of the success stems from the fact that he is willing to look beyond the traditional sources. I think John understands that when you read whatever else is reading, you’ll think like everyone else. He thinks and curates differently. I’d like to learn more about John’s information workflow.
Entrepreneur, advisor, and intellectual midwife of the digital health hashtag, Paul Sonnier is on his information game. While it’s conjecture on my part, I suspect that Paul thinks about digital health while in the shower. Like John, Paul has a nose for unusual sources. If it’s something important in digital health, Paul typically has his finger on it. He is the founder of a massive group of Digital health thinkers on LinkedIn. Paul actually promotes this list on his Twitter feed but he does it, like Dave Albert at a level that’s balanced and unobtrusive. I would suggest you join his group if you have any inclination toward digital health..
Brian’s the Director of Government Affairs at Medicity. If you have any connection to health information-technology you probably follow Brian. While I don’t consider myself an IT person, I can keep my finger on the pulse of what’s happening by simply checking in occasionally on the things he shares.
So there you have it..
People wonder how they can build an audience on Twitter or beyond. The recipe’s simple: create value for people much like these folks do. Give them something they can’t get anywhere else or deliver it in a way that’s unique. If you’re interested, I once shared 4 Ways to Create Value with Curation.
Remember that Twitter can be used for many things. In my world, Twitter is used to filter information from smart, resourceful people. For others, however, Twitter is a cocktail party or a convo tool. Some use Twitter for nothing other than to push notify new blog posts – a modern RSS. For many, Twitter is a combination of these things. In shaping this discussion I didn’t want to create the appearance that Twitter is only for information filtering.
So who’s on your list? More importantly, why? And how to do think about who you listen to?
These very pale learned men in the banner picture are the courtesy of the National Library of Medicine and Flickr.
Google announced yesterday that they’re breathing new life into health search. In an effort to move from an information engine to a knowledge engine, Google will soon be offering information specially curated by physicians from within The Knowledge Graph. For a company that’s declared itself less-than-invested in health care, this is a fascinating step.
Here are a few things I might have added to Google’s press release:
Before now, Google was sewer of health misinformation. While we like to think about Google as the provider we never had, it’s unfortunately a steaming sewer of influence built to sell you stuff based on your search history. Fortunately for Google, the average patient consumer has been lead to believe that unicorns and fairies magically and objectively deliver the best information. Google’s new move for more supporting knowledge is a step in the right direction for health consumers.
Algorithmic intel doesn’t work for health so we’re turning to humans. After spending billions on machine learning, Google is telling us that a room full of Mayo Clinic doctors are smarter than the room itself. This makes sense. As we face rising levels of information, we need human sensibility and contextual application that can only come through curation. How we make sense of information is, in the end, more important than the information itself.
We don’t do health and so we’re afraid you’re going to sue us. Google’s official release is dripping with open-ended disclaimer language that reflects their dyspeptic feelings about sharing health knowledge (Be empowered…but not empowered enough that anyone gets in trouble). This reminds me of the days when we all believed that the distribution of health information represented a personally accountable relationship between content producer and consumer. If they begin using ‘call 911’ disclaimers I’ll be more concerned.
Medical information becomes dated faster than you can hit refresh. Knowledge is changing almost as fast as medical information. Vetted content is good but everything we understand about health and disease is changing fast. Static information not subject to continuous review is doomed to remain just that. And managing knowledge is something very different from programing algorithms.
If you want patient input, you’re on your own. Doctors are good for certain kinds of information. Patients are also good for certain kinds of information. It isn’t clear how this might work, but I’d like to see how Google plans to bring the patient voice into the mix. This type of product offering without patient input likely isn’t sustainable.
I’ll think about this as Google evolves as a health knowledge engine. Stay tuned.
I took the picture above during a presentation at the NYC Google headquarters in 2014
Not long ago I read a blog post and subsequently posted a comment on Twitter. It seems that I read one thing but the writer of the post had suggested something else. It lead to a brief back and forth. Nothing ugly but the publisher was unnerved. I had simply responded to something that was clearly unclear.
So who’s responsible?
While a reader bears some responsibility to understand what’s in front of them, a writer carries the greater responsibility to be understood. And just as the customer is always right, what the content consumer understands is ultimately all that counts.
I know this because in my own fast moving world I’m frequently misunderstood. As the person working to transmit ideas, the failure is almost invariably on my shoulders.
As it should be.
For years we believed that Google would bring us the information we need. Tom Krazit at Gigom suggests that the party may be over. Search has become so algorithmically corrupt that its hard to understand or believe what we’re getting.
The thing that gets me is that we’ve become such informed consumers in so many other areas of our lives. We buy organic vegetables, we obsess over miles-per-gallon in our prospective cars, and we demand that our artificially valuable gems weren’t touched by desperate violent gangs before they reach our fingers. Yet we assume that the information being presented to us by the content aggregators of our day is the information we really need to see.
Eli Pariser had it right in The Filter Bubble: “Personalization filters serve up a kind of invisible autopropaganda, indoctrinating us with our own ideas, amplifying our desire for things that are familiar and leaving us oblivious to the dangers lurking in the dark territory of the unknown.”
Funny that in the early days we blindly told patients that the search engines were full of nonsense. Maybe we were right.
I taught at in an educator certificate program at Baylor College of Medicine recently. We were doing a hands-on drill on digital footprint and reputation management. When discussing our findings, one of the attendees concluded that just because you post something doesn’t mean someone will read it. This, of course, created a priceless opportunity for discussion.
Few realize what it takes to successfully deliver a message or idea. And fewer recognize the level of consistency necessary to establish a platform for the delivery of those ideas.
I’ve seen this over and over. Doc launches a blog or social property with weakly-conceived, me-too stuff no different from what’s available. It delivers little so none of it ever sees more than a few human eyeballs. Doc becomes disillusioned and walks away.
When you commit to writing or recording, it needs to deliver something that helps your reader or viewer. It’s about value.
Audience of significance is earned and should never be assumed. And it takes years of consistent stuff to draw even a small following.
I came across this tweet this morning from digital health mogul Chris Boyer. He got me thinking.
It’s interesting how we all see the terms of public dialog. Of course, when I hear follower, I think Jim Jones and Kool-Aid.
I get the audience concern. We once lived in a world of audience and broadcaster. The broadcaster broadcasted, the audience listened. For some the term implies paternalism, a concept anathema to the libertarian bias of networked publics.
For many, audience implies size. We’ve been brainwashed by the industrial age belief that an audience has to be big. It’s interesting that John Steinbeck saw himself as writing for an audience of one.
Dan Gillmor has referred to all of us as the former audience. Those people who react to, participate in and even change a story as it evolves.
I’m okay with audience. But it depends on the context of what I’m doing.
I see two things in the public space: content and conversations. Either we are making and sharing stuff, or we’re talking about the stuff that other people make and share. When I create ideas or share them, they are distributed to a group of folks who have elected to listen to what I have to say. This could be seen as an audience or a group of followers. This is the one-to-many element of my public presence. When I’m having a conversation it’s a near-synchronous exchange and I tend not to see that person as my audience.
My Twitter feed is a good example. Some dialog, some narrowcasting. Some connection with friends and colleagues, some publishing for an audience.
Perhaps we see audience as somehow detached and anti-social. Some believe that social tools are all about the chit chat. Twitter as cocktail party. But new media are as much about publication as they are about repartee. Public media have evolved such that each of us, in the absence of any dialog, can be the broadcasters of our own ideas. We are, in effect, on stage when we publish.
So I suspect audience is inevitable, whether we like it or not.
Do you have an audience, followers or both?