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Next #hcsmca chat

Wed. April 1, 2015 at 1pm ET (2pm AT, noon CT, 11am MT, 10am PT)
hcsmca = Health Care Social Media Canada more info >>

Innovation: The Prescription for Healthcare

March 26, 2015

By Sarah Downey, Chief Executive Officer (@SarahEDowney1) of Toronto East General Hospital (@EastGeneral)

How do ideas in healthcare take shape? How does one idea become a best practice? How do ideas stick?  How do we as a system make healthcare better for patients? How do we learn from mistakes?

#hcsmca April1 chatIn the spirit of collaboration and partnership, on Wednesday, April 1, 2015, Sarah Downey (@SarahEDowney1), CEO of Toronto East General Hospital, will moderate an #hcsmca tweet chat with CEOs and other executive team members from the Joint Centres for Transformative Healthcare Innovation on promoting innovation in healthcare. In its second year, the Joint Centres is a partnership between six large community hospitals with a goal of sharing innovations focused on improving quality and value in healthcare. The six partner hospitals and CEOs that will be participating in #hcsmca include:

During this hour we will discuss how ideas take form, how we can attempt to learn from failure and the importance of sharing of best practices between organizations. Please join us as we discuss the importance of creating a culture of innovation, one where not only best practices are celebrated, but also failures are recognized and learned from. All welcome.

Topics for #hcsmca April 1, 2015 at 1pm ET (time zone converter).

How is Innovation Born? The Creative Process of Innovation

  • T1a: In what areas of healthcare would you like to see more innovation happen?
  • T1b: How can we make innovation a part of our daily way of thinking?
  • T1c: Does social media have a role in helping organizations and HCPs be more innovative? How?

Learning from Mistakes: Creating a Culture Where It’s Okay to Fail

  • T2a: What does a culture of failure look like to you?
  • T2b: When should we treat failures in healthcare as opportunities for learning instead of performance management?
  • T2c: Should healthcare organizations be more public about their failures through social media? What are the implications?

The Importance of Sharing Ideas between Organizations

  • T3a: What is better for healthcare: Open sharing of ideas between organizations or developing ideas behind closed doors? Why?
  • T3b: Imagine a world where all providers & patients share ideas via social media. What would this look like?
  • T3c: What great work is being done in your organization that you wish could be spread to others in healthcare?

The Quantified Self and Your Health

March 17, 2015

By Alice Peter, Director, Population Health & Prevention Unit, Cancer Care Ontario (@CancerCare_ON)

headshot Alice Peter

Alice Peter

I’ve recently become interested in a movement known as the Quantified Self, which inspires self-knowledge through self-tracking with technology. There are many digital tools that can help us track our physical activity and diet as well as monitor and measure things like air quality, sleep, mood, logic and memory.

I know that health monitoring plays an important role in maintaining wellness and preventing disease,and I’m always interested in learning more about how we can leverage new tools to improve our personal awareness and overall health. Digital tools may be a great resource to help us better understand our health habits and provide us with the information we need to have meaningful conversations with our health care providers.

Many people don’t know that as many as half of all cancers could be prevented by eliminating known risk factors. We can take action to lower our risk of developing cancer and chronic disease by not smoking, limiting alcohol consumption, maintaining a healthy weight, eating a diet rich in vegetables and fruit, and participating in regular physical activity.

quantified self logo

Colorectal cancer is one specific cancer with many ties to lifestyle factors. As March is Colorectal Cancer Awareness Month, this seems like the perfect time to talk about healthy habits as a prevention method. At Cancer Care Ontario, we’re encouraging people to quit smoking, consume alcohol moderately if at all, to eat well, get moving and take action against colorectal cancer today. We’re also spreading awareness about our latest innovation: My CancerIQ.

My CancerIQ is an online tool that allows you to assess and better understand your risk of developing colorectal, breast, cervical and lung cancer. It includes a series of risk assessments that estimate your risk of cancer compared to other Ontarians like you. While the tool won’t tell you whether or not you will develop cancer, it can help you focus on specific changes you can make to lower your cancer risk and live a healthier life.

We hope you’ll join us on March 25, 2015 at 9 pm ET (time zone converter) to discuss the quantified self, self-tracking and using digital tools to track your health and take action against cancer and chronic disease.

Topics for this week’s chat include:

  • T1. Do you use digital tools to track your health?
  • T2. How do you use the data you collect to make healthy choices?
  • T3. How do you share the data you collect with your doctor? If you don’t, why not?

Medical Research, Recruitment & Social Media

March 16, 2015

By Parminder Basran (@Psbasran)

Parminder Basran

Parminder Basran

March 18 transcript

Whether your department head, daughter, or doctor – like it or not – social media is here. Sooner or later you will learn about Facebook, Twitter, Instagram, Google+ (or whatever). Some of you beyond a certain vintage may lament over your pre-internet brain (to steal a phrase from Douglas Copeland). But if you’re involved in healthcare and play some role in research, you should take pulse on Social Media in the Medical Sciences.

While not early adopters, medical researchers in public and private institutions are becoming more engaged with the social media and its utility in medical research. And while quality peer-reviewed open access journals have provided a means of disseminating research, scientists still struggle with finding the right avenue, separating the need to diseminate research with the need for publishing in ‘high impact’ papers, and making their research more accessible to the public.

Social Media Tools for Research

Within the confines of the academic medical community, can social media be used as a tool for research? Over the last 5 years, there has been an explosion in the types of tools and software that can be used to connect researchers among and outside disciplines. And as much as I’d love to see lynx and traditional mailing lists continue, the fact is that that they have limitations. Can social media fill that void?

In addition to Twitter and Facebook, tools such as LinkedInResearchGateGoogleScholar, Mendeley, and a host of others can provide opportunities to share data, communicate through forums, and rate and comment on articles. Indeed, it brings forth an interesting question on how medical research can be judged. (For example, a recent #hcsmca discussion challenges the notion traditional publications methods with the question : Is Academic Research a Dead Man Walking?)

But while these tools may hold value, time is precious, particularly in the field of medical research. So there has to be some evidence of a significant benefit if choosing to invest in the exploration of social media tools, and that benefit must extend well beyond from those gained from traditional research methods. Social media aggregators and digests show some promise in this regard: such as public tools like Flipboard that can amass a variety of social media channels into a single graphical interface, to ones directed squarely for professional medical organization like Sosido, that can digest scientific information for healthcare professionals in a variety of invasive and non-invasive ways.

Social Media Tools for Outreach

There are some great examples how organizations are using social media for sharing medical research to the general public. But what about individual researchers? A recent PLOS article explored how biologists and physicists view ‘outreach’. In the United States, about 5% of academic researchers are involved in some type of outreach. And of those, there may be some evidence that those 5% are more successful researchers. Whether the two are correlative is interesting, but whether there a causal link is much more interesting. The metric of ‘success’ is certainly up for debate.
But again, time is precious: it is the biggest barrier for any medical researcher. Just this week, our centre had a few illnesses, rendering my plans to strap down finish up writing a few lingering papers impossible.

Is it worth the effort to explore and expand the use of social media tools for the medical researcher? Probably. So where can I get the biggest bang for my buck?

On March 18 at 10am PT (1pm ET) week’s #hcsmca chat we explore the relationships between social media, medical research, and the researcher.

Our first question explores the impact social media has, and continues to make, on medical research.

  • T1a: Generally, has social media positively –or negatively- impacted medical research?
  • T1b: Are there examples of how social media has positively/negatively impacted medical research?

Second, we ask how medical researchers are using social media.

  • T2a: How are medical researchers using social media for their research from discover, recruitment to dissemination?
  • T2b: Have you ever discovered clinical trials or been recruited for research participation via social media?

Third, we delve into the specific tools they might use in their social media.

  • T3a: What social media tools are most prevalent in medical research?
  • T3b: What social media tools are most prevalent in outreach?

This post was originally posted on Parminder Basran’s blog Medphyz and republished here with permission of the author.

Read the March 18 transcript.social media medical research

Academic Research & Innovative Scholarship: Summary of #hcsmca chat #210

March 8, 2015

On March 4 Shoshana Hahn-Goldberg (@HahnGoldberg), Post-Doctoral Fellow at OpenLab (@UHNOpenLab), Dr. Howard Abrams, Director at OpenLab and Dr. Kathryn Parker, Director Academic Affairs and Simulation Lead at Holland Bloorview joined #hcsmca to talk about innovative scholarship and alternatives to traditional peer-reviewed publications. They kick started the discussion with the blog post Is Academic Research a Dead Man Walking? – be sure to also read the comments.

Below Shoshana created this graphic summary. You can also read the complete transcript of chat #210.

What was your biggest take-away from the chat? Is it captured in the summary? If not, add it to the comments.

summary of chat 210 on innovative scholarship

What motivates #hcsmca members’ participation? An analysis of our Feb 4 chat

March 6, 2015

By Sarah Gilbert (@_sgilbert_)

headshot of Sarah Gilbert

Sarah Gilbert

It’s been a month since I co-hosted my first #hcsmca chat with Colleen in which we discussed and promoted my research on the #hcsmca community, in particular, what motivates people to participate, or not, in #hcsmca. Since last month’s chat, I’ve conducted interviews with #hcsmca community members (still recruiting), reviewed relevant literature, followed the hashtag and lurked on #hcsmca chats, and watched the live stream of the panel at #hccmty. But I’ve also taken time to reflect on our on February 4th (see transcript) discussion.

At Colleen’s suggestion, I copied the tweets from the chat into a spreadsheet and began by dividing them into two columns:

  • observations and thoughts on motivation
  • suggestions (such as publication venues and questions to ask during interviews)

As I organized the tweets into these categories, I noticed commonalities between community members’ observations and thoughts on motivation. To have a more solid grasp on what aspects of motivation were important to the community, I began to methodically review each tweet and assign a particular theme as I observed it. This is an analysis technique broadly known as content analysis and is often used in the social sciences when analyzing text. In total, I assigned 9 themes to 67 tweets – many of the tweets had more than one theme.

#hcsmca members mentioned a variety of aspects which motivated them to participate in the community. The most frequently mentioned motivator discussed in the chat was having a shared interest. What brings #hcsmca members to the chats is a common interest in a specific subject, and members wish to connect with others on the topic. The second most mentioned motivating aspect was access to diverse people and diverse perspectives (although this may be confounded by a sub-conversation on the role of diversity in communities, it is nonetheless an important aspect of participation). The third most frequently mentioned aspect was the media: that is, Twitter itself.

The affordances of Twitter allow people to discuss a topic of interest through a shared hashtag, provides a forum for synchronous conversations, and features like RT and favorites allow for immediate feedback and recognition. After media, building networks and relationships were also mentioned as motivating factors. These aspects were often mentioned in conjunction with other motivating factors, such common interests; for example, building networks was discussed as a way to access diverse perspectives on shared interests. The opportunity to learn from other members was also noted as a motivating factor, as was the importance of having a voice in the community. Finally, strong leadership and advocacy were highlighted as important motivating factors. See below for a pie chart of motivational factors discussed in the tweetchat.

pie chart of #hcsmca Feb 4 tweets

Here’s a word cloud of the sample of texts used to identify motivational themes. I removed the #hcsmca hashtag and all user names. Given our recent discussion on participant involvement in research:

  • Do you see any themes that emerge from the conversation?
  • Does the word cloud paint a different picture of the conversation than the pie chart?

Word cloud of #hcsmca Feb 4 chat

Another interesting component of the discussion was brought up by community member who inverted the question “why do people participate in online communities” by asking “why don’t people participate in online communities?”

In response, some members cited a lack of knowledge: both of the media itself and the benefits that people can attain from participating in communities, but many agreed that it can be difficult to find the time to participate in communities as fully, as broadly, and as often as they’d like.

I’ve already interviewed 9 community members who participate in #hcsmca in a variety of ways – from primarily listening, to peripheral participation, to leading discussions and to taking on leadership roles within the community. They’ve also told me about the many different reasons why they participate (or not). I’d like to thank those who have had the time to speak to me already – it’s been incredibly interesting for me to learn from you and I look forward to diving into the analyzing the interviews!

I’m still recruiting participants: my goal is to interview between 20-30 community members. Interested? Please email sagilber@mail.ubc.ca.

Transparency: How much information should you find online about a health care professional?

March 5, 2015

On March 11 at 1pm ET, The College of Physicians and Surgeons of Ontario (@cpso_ca) returns to consult with the #hcsmca community to ask “What do patients need to know about physicians to make informed health-care decisions?”

By Maureen Boon (@maureenboon) and The College of Physicians and Surgeons of Ontario (@cpso_ca)

The (CPSO) is currently looking to expand the information available about physicians on its website. We already include a wide variety of detail on a doctor’s profile, including his/her location, education, specialty area(s), languages spoken, and the results of any discipline findings. We’ve also recently added other details, including findings of criminal guilt, bail conditions, and any reinstatement conditions on his/her licence. Now, we want to make amendments to our bylaws that would allow us to add even more to a doctor’s online profile. Specifically, we want to add:

  • Cautions-in-person: The CPSO may order a caution-in-person when addressing a complaint. Short of a referral for discipline hearing, this is one of the most serious outcomes we can order. We issue a caution-in-person when we have a significant concern about a doctor’s conduct or practice that can have a direct impact on patient care, safety or the public interest if it is not addressed.
  • Specified Continuing Education or Remediation Program (SCERPs): The CPSO may order a SCERP to upgrade a doctor’s skills when we’ve identified serious care or a conduct concerns. SCERPS are only ordered in those instances when we believe that remediation is necessary and we could not reach a voluntary agreement.
  • Criminal Charges: The proposed by-law contemplates that all Criminal Code and Health Insurance Act charges will be posted on a doctor’s profile when they are known by the College. Information that will be posted includes the fact and content of the charge, the place, and the date of the charge (where known). This information will be removed either after an acquittal or a criminal finding which would replace the fact of the charge.
  • Licences in other jurisdictions
  • Discipline findings in other jurisdictions

In order to amend the bylaws, we must first consult widely with the medical profession, healthcare organizations, and the general public. That is why we are running a public consultation on these issues until April 1, 2015, and why we are engaging the #hcsmca community on March 11 for its perspective.

CPSO graphic representing transparencyThese issues are not straightforward. We need to ensure that we’re striking a good balance between a patient’s right to know important information about a doctor and a doctor’s right to privacy and fairness. On the one hand, in-person cautions and SCERPs have traditionally been considered educational in nature, and when a doctor is given an opportunity to improve his/her practice or conduct, the best outcomes usually emerge in an environment of confidentiality. Similarly, criminal charges may involve allegations against a doctor that have nothing to do with the practice of medicine. On the other hand, how does a regulator manage this balance of transparency and fairness in an environment where the public expects more openness from all institutions?

With these challenges in mind, here are four topics we’d like the #hcsmca community to explore with us on March 11 at 1pm ET ((check your timezone).

  • T1: Is there such a thing as “too much” transparency? How do we strike a balance between pt’s right to know and fairness to the doc?
  • T2: Should in-person cautions be on a doc’s profile? What are the risks/benefits of including this info on the website?
  • T3: If we order a doc to undergo specified continuing ed, should that get listed on his/her profile? Again: risks v benefits?
  • T4: Should criminal charges against docs go on their profile, even if they appear to have nothing to do with the practice of medicine?

Is Academic Research a Dead Man Walking?

February 28, 2015

On March 4, 2015 at 1pm ET (timezone converter), #hcsmca will be co-hosted by OpenLab (@UHNOpenLab), a design and innovation shop dedicated to finding creative solutions that transform the way health care is delivered and experienced, and the Teaching and Learning Institute at Holland Bloorview Kids Rehabilitation Hospital (@BloorviewPR). Moderators Shoshana Hahn-Goldberg (@HahnGoldberg), Post-Doctoral Fellow at OpenLab, Dr. Howard Abrams, Director at OpenLab and Dr. Kathryn Parker, Director Academic Affairs and Simulation Lead at Holland Bloorview wrote the following blog to set the stage for the discussion about innovative scholarship and alternatives to traditional peer-reviewed publications we hope to inspire on this week’s #hcsmca chat.

By Shoshana Hahn-Goldberg, Dr. Howard Abrams, and Dr. Kathryn Parker

headshot Shoshana Hahn-Goldberg

Shoshana Hahn-Goldberg

headshot Dr. Howard Abrams

Howard Abrams

headshot Dr. Kathryn Parker

Kathryn Parker

An #hcsmca discussion about innovative scholarship and alternatives to traditional peer-reviewed publications

There is a revolution occurring in healthcare. This is partly being driven by need (demographics of an aging, increasingly educated population) and opportunity (distributed health information technology and very rapid innovation cycles).

Is traditional academic research and its currency of peer reviewed publications still the right model to test and disseminate innovative models of care?  Especially in complex interventions where the scientific method of holding all things constant except the intervention is unrealistic in the messy real world, negates the active learning and innovation cycle inherent in the innovation process, and risks concluding that no effect means “not necessary” rather than “necessary but not sufficient”.

So there are two separate but related issues that arise from this;

  1. Is there another model of “proof of concept” that we should recognize or develop in order to assess the validity of the rapid innovation in health care that is necessary, and is in fact occurring among free-living human beings?
  2. Is there an alternate form of peer review that is better suited to the new requirement for rapid assessment and dissemination of new models of care, or has this academic model already died and just doesn’t know it yet?

Traditionally, research papers undergo peer review before publication, which generally takes about eighteen months to go from submission to publication1, and this estimate does not include the time it takes to prepare a manuscript or that a manuscript may need to be submitted to several journals before it is accepted. The result is that research disseminated through peer-reviewed journals is often several years old. One could argue that the peer-review process is slow, stifles innovation, and lacks transparency2. One could also argue that the peer-review path is not the best way to get the information to all the desired audiences and there are certain types of research where peer review is not necessary. In these cases, there are potentially many other ways to disseminate the research, such as through various forms of media.

There are two main roles of scholarly journals and peer review:

  1. An archive of validated research in a field – Most people would agree that getting it right, through the care and effort of peer review, outweighs the need for rapid publication when viewing these journals as our archive of knowledge1.
  2. Communicating research among others in the field – Speed and interactivity are much more important for this role. Peer review may be less important, as experts in a field can make their own decisions about validity1.

Two trends, open access and social media, have the potential to change the peer review process2. Some new models of peer review are developing, such as comment crowdsourcing, where anonymous peer review is replaced with public reviews that can include the reviewer’s reputation (as determined by peers) to weight the review score. Open publishing platforms such as PeerJ and the Journal of Participatory Medicine employ concepts such as invited moderation, post-publication comment, post-publication measures of quality and impact, and community-based review2.

abstract representation of innovative scholarship

Another publishing route is through preprint sites based on the arXiv model. Information is disseminated rapidly, but papers submitted are not subject to traditional peer review. Mendeley, with over 34 million research papers, also incorporates an academic social network. PaperCritic, which works in tandem with Mendeley, allows scientists to review each other’s work2.

These innovative systems have potential; however, although many have already been around for several years, they are not as widely used as we would expect. With the innovation cycle increasingly rapid, the traditional approach of academic research and publication may not meet the needs of current challenges. Will there always be a place for it?

Discussion Topics:

In a world where increasingly more people are actively participating to improve their health, often collectively, open access methods will be required to disseminate research results.

  • T1: What role(s) do social networks play in peer-review, when more people now participate in improving their health?
  • T2: What can replace traditional peer-review and provide credit when dependent on academic structures for support?
  • T3: When is peer-review not desirable? For which audiences? For which projects? What are better options?
  • T4: How does knowledge created through non-traditional research get shared? What is “peer review” within this context?
  • T5: What are risks to abandoning peer review? Should e-patients be made aware of peer review versus social media review?

References:

  1. Solomon DJ (2007). The role of peer review for scholarly journals in the information age. The journal of electronic publishing 10(1).
  2. Pickard KT (2012). The impact of open access and social media on scientific research. The journal of participatory medicine 4.