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Next #hcsmca chat

Wednesday February 10, 2016 at 1pm ET (2pm AT, noon CT, 11am MT, 10am PT)
hcsmca = Health Care Social Media Canada more info >>

Moving forward with EMRs

February 5, 2016

By Dr. Darren Larsen (@larsendarren)

dr-darren-150px-X-150pxWe have come a long way in Canada in getting physicians to adopt digital records systems in the form of office-based electronic medical records (EMRs). In Ontario alone, over 11,600 physicians (both family doctors and specialists) have EMRs in their practices and are using them with varying levels of sophistication. For many of us physicians, the EMR is our lifeline to our patients. It is the environment in which we spend almost all of our day, recording the patient story, reading and thinking about test results and communicating with our peers externally through the creation of referrals, and internally with messaging systems.

Some clinics are starting to push the boundaries of basic use, though, and this is where the power of digital records systems becomes apparent. This is not easy work. The thinking required to move to mature EMR use takes reflection and solid dedicated effort on behalf of physicians, nurses and the staff they employ and is often done off the side of the desk. Advancing to the mature use of EMR presents change management challenges, changing the way we work. How do we convince medical personnel of the benefit of moving forward? How do we make the work palatable in the face of all the other demands facing them every day from the clinical, business and system perspective? How do we do all of this in an already strained system with fewer and fewer payments for participation?

There is a tendency to look to our American neighbours in their advancement of EMR maturity, but models there have been built on massive incentive payments without necessarily a view to how the change can be sustained.

On February 10 at 1pm ET (time zone converter), @OntarioEMRs is hosting the #hcsmca tweetchat to explore barriers and opportunities in the advancement EMR as it applies to both primary care and specialist care. We are posing four big questions to advance the conversation and gather great ideas with the #hcsmca community to help promote change.

  • T1: How do you use EMRs now? What do you value in them? As a health professional, patient, researcher, etc.
  • T2: What would the EMR of 2030 look like? Where do we need to get to?
  • T3: What could/should be done w/ the vast data in EMR systems to improve patient care, relationships & the healthcare system?
  • T4: How to move forward/promote the advanced adoption and use of mature EMR systems?

Announcing the National #hcsmca Symposium’s Scholarship Winners

February 3, 2016


We’re happy to announce the scholarships recipients

Organizers of the first-ever National #hcsmca Symposium immediately realized three things:

  1. Canada is big
  2. Vancouver isn’t exactly centrally-located
  3. Some members of the #hcsmca community may need financial support to attend– members like patients, caregivers and students

So we, the organizers (listed halfway down this post) developed a scholarship program. We co-created scoring criteria and invited applicants to tell us about their involvement with #hcsmca, how they use communications technology for health, why they want to join us in Vancouver. A committee of patients and caregivers reviewed the applications and, ultimately, the number of scholarships we offered was based on the event’s sponsorship income.

And the six scholarships winners are:


#hcsmca Scholarship Recipients


Thanks to our sponsors, we are able to provide the scholarship recipients with funding to pay for travel, accommodation and registration in full and in advance. Also, thank you to BC Patient Safety & Quality Council and the Quality Forum for making all the travel and accommodation arrangements.

With additional sponsorship, the event will be able to offer more scholarships. Here is more information if your organization would like to join the National #hcsmca Symposium as a sponsor.

We look forward to meeting these six scholarship recipients – and everyone else from the #hcsmca community – on February 24 in Vancouver. If you haven’t registered yet, do it soon. Space is limited.

Chat Summary 249: Health Care Professionals: Speak your mind, but …

January 31, 2016

This post was originally published on Pat’s blog Days of Past Futures.

By Pat Rich (@pat_health)

On Wednesday, 77 engaged individuals participated in a lively tweet chat at #hcsmca about whether health care professionals have the same rights to free speech when using social media as other members of society. Read the complete #hcsmca chat 249 transcript.

twitter chat announcement #hcsmca Jan 27 at 9pm Eastern

Photo credit: derfelphotogen

The impetus for this chat – which I moderated – were two recent disparate examples of what is happening with Canadian nurses and doctors who use social media. One example was that of a nurse facing disciplinary action from her regulatory body in Saskatchewan for posting details of her late father’s care on her Facebook page. The other referenced the positive response to a blog post by Ontario physician Dr. Gail Beck (@gailyentabeck) about the care received by her husband in a local hospital.

One of the points I wanted to make that was nurses and other allied health professionals who are employees of hospitals or health care institutions may face more restrictions than many physicians who are self-employed because the terms of their employment may limit their right to make public comments about their own institution.

So it is somewhat ironic that two days after the chat, The Medical Post newspaper for physicians posted a gated article quoting an unnamed Hamilton physician as stating many physicians had been threatened with the loss of hospital privileges for vocally criticizing the provincial government for recent pay cuts.

During the chat we were lucky enough to be joined by several physicians including Dr. Beck, who provided their perspective on their ability to use social media.

It quickly became clear from the comments made by these physicians and other informed observers that while health care providers can and should be urged to use social media to make comments and engage in debate, they must do so with caution.

It was noted not only that physicians and other providers all have a sacred duty to protect patient confidentiality but also that the statements made by health care providers may be scrutinized more closely and so extra caution must be taken in what they post.

To quote some notable tweets from that chat:

While the chat just scratched the surface of this important issue for those ‘in the tent’ – be they providers or patients – it was clear the provider voice on social media is an important one that needs to be encouraged.

Why the #hcsmca Symposium is Patients Included

January 29, 2016

By Isabel Jordan (@seastarbatita)

Isabel Jordan

Isabel Jordan

For me, being involved in #hcsmca exposes me to an incredible diversity of voices. These voices include patients, caregivers, healthcare providers, researchers and healthcare communicators, and others who can’t be easily pigeon-holed into clear categories.

Weekly conversations punctuated by commentary throughout the week has allowed me to make connections, some of them very strong, with people that I simply would never have gotten to know. What’s more, I believe that we have all been able to expand each other’s view of the realities of our healthcare system, providing care and living with health conditions. Social media let us speak to each other plainly, concisely and connect meaningfully. It doesn’t matter that you are at work, taking a break between patients or clients and that I am at home looking after my son wondering when I will hear from one of his health care providers next. We are all, together, having a conversation about the meaning of better health care and community; titles, jobs, heck, time of day, fall by the wayside.

However, in the world of conferences and in person events, it’s tougher. For too long those health care conversations have been held about patients but not with patients. To be frank, if we are going to get to the solutions that work best to improve health care, we can’t afford to not to include the voices of patients and caregivers. We hold a wealth of knowledge and experience that we want to offer, and we don’t want to be kept outside closed doors.  

Even with the best of intentions, it can be difficult for conference organizers to make their events inclusive of patients and caregivers. It takes more than just saying, “hey everyone, come on in.” Patients and caregivers face real and systemic barriers to attending medical conferences, not just cultural ones.

Recognizing these barriers, the Patients Included charter was created to help conference organizers structure their events to welcome and integrate patients and caregivers from planning, to speaking and attending. The Patients Included charter outlines 5 clauses facilitating authentic patient participation – patient participation that is meaningful and will make the conference better for all participants.


The 5 charter clauses are the starting point to get patients in the door. And I say starting point because I think that once conference organizers start including patients, they’ll recognize the value and grow that inclusion in subsequent years.

Deciding to take the online #hcsmca model offline to a National #hcsmca Symposium is incredibly exciting. And we made sure we met all 5 clauses:

  1. I, as a caregiver, am a member of the Symposium Planning Committee. Patients reviewed the scholarship applications. The event is an unconference. All attendees are involved in the planning and design. 
  2. Patients and caregivers are attending, speaking and leading sessions at the symposium.
  3. Scholarships were awarded to 2 patients, 2 caregivers and 2 students. Travel and accommodations have been arranged and paid for. With additional sponsorship, we will add more scholarships.
  4. Accommodations will be made where necessary.
  5. The main stage will be livestreamed. Virtual participants can also follow #hcsmca. Notes and pictures from the break-out session will be open-access.

For the #hcsmca community, Patients Included recognizes what we already know – patients and caregivers are valuable contributors to our diverse community. Sure, those that attend benefit, but really, the whole community benefits from their inclusion. Even if I, as a caregiver, say so myself.

Don’t miss this event. 


Preparing for #RareDiseaseDay: Do stories change anything?

January 28, 2016

By Emma Rooney (@blumencasey)

Headshot of Emma Rooney

Emma Rooney

A rare disease is an uncommon disorder that on its own affects a minute percentage of the world’s population. Despite this rarity, when you look at rare diseases together, the list of identified diseases grows beyond 7,000 conditions, the highest percentage of these genetic. Rare Disease Day was started in 2008 by EURORDIS (the European Organization for Rare Diseases) to place a spotlight on this often neglected health priority. According to the patient advocacy organization Global Genes, rare diseases affect 350 million people worldwide. While rare diseases are extremely diverse, many people living with a rare disease confront misdiagnosis or having no diagnosis, nonexistent treatment options, and major inequities in accessing care and support. Rare disease groups have a history of banding together and forming umbrella organizations to share best practices and be more effective in working to strengthen the rare disease community. Rare Disease Day invites broad community participation and is a vital opportunity to campaign for global awareness.

This year’s Rare Disease Day comes up on leap day, Monday, February 29th. Patient Voice is the 2016 theme, a fitting selection at a time when rare disease patients, spurred by technology, are connected and contributing to healthcare like never before. Where facts and figures can easily be ignored, sharing stories has always been critical to getting voices heard. You’ll be hard pressed to find anyone saying that patients shouldn’t be listened to. Storytelling has become a much loved buzzword that we can all get behind.

Feb 3 chat blog_My Normal

As a rare disease advocate, producing Emma’s Garden: Growing with Gaucher, a digital story of growing up with type 1 Gaucher disease, was a meaningful way to share my patient experience. I later recorded a letter to my parents expressing what the storymaking process had been like and my gratitude to my family for being involved. On many occasions, stating that my interests lie in storytelling has proved to be the perfect conversation opener. In contrast, despite equal passion in presentation, asking for a donation, explaining involvement in lobbying efforts to access a new treatment, or trying to sell research experience, from having been a test subject in clinical trials, has enlisted far less support. Even people who seem never to have given much thought to the world of rare diseases can tell me of an astonishing rare disease story they saw in the news.

Patients are telling rare disease stories all around us. We have a growing number of dedicated rare disease news sites. Rare disease patients are invited to speak at medical conferences and events and to participate on advisory boards. Patients are actively sharing their stories through blogging, social media, online support communities, and crowdfunding platforms. Every website you visit now has a “share your story” button and marketing firms are hunting down engaging patient talent on behalf of the biotech and pharma industry. Rare disease stories have become prolific.

As we count down to Rare Disease Day, patient stories will naturally be encouraged and the reception to stories positive. We also have an opening to think critically about how stories get acted on. Health blogger Annette McKinnon drew attention to this on Twitter stating,

twitter poster_Feb 3 hcsmca

So on Wednesday, February 3rd at 1pm ET (time zone converter) join the #hcsmca weekly chat to discuss how stories can change things.

In the chat we will cover:

  • T1. How do patient stories impact the rare disease community?
  • T2. How can we better value patient stories and respond to the insights shared?
  • T3. What benefits should patients look for from contributing their stories?
  • T4. What stories are missing from the rare disease community and how can we encourage different voices?

Here’s a developing list of where to find online stories from rare disease patients. You are invited to add your favorite sources and places to share stories.

Health Care Professionals: Speak your mind, but …

January 22, 2016

By Pat Rich (@pat_health)

headshot Pat Rich

Pat Rich

A Saskatchewan nurse puts a post on her Facebook page detailing some concerns (and praise) about the care received by her grandfather while in a specific palliative care unit – Facebook post leaves Prince Albert, Sask. nurse charged with professional misconduct. She now faces disciplinary charges from the provincial registered nurses association for “violation of confidentiality, failure to follow proper channels, impact on reputation of facility and staff, failure to first obtain all the facts, and using status of registered nurse of personal purposes under the Code of Ethics for Registered Nurses.

An Ottawa physician posts a blog – 2 Hospital Days – about her husband’s stay in a local hospital documenting the deteriorating conditions he experienced. She names the hospital and talks about how, with the health care system in general “staffing has been systematically decreased, equipment has not been replaced appropriately, buildings have been left to crumble and food and cleaning have been outsourced to the point that these do not meet the standards for nourishment and cleanliness that most health care professionals would want for themselves.” She is widely applauded for the post, especially by her peers.

Both of these cases are true and both have occurred within the last couple of weeks.

They demonstrate the full spectrum of the challenges and opportunities for health care practitioners of all disciplines who want to participate fully in the 21st century.

The former case provides a textbook vindication for nurses and physicians who are deeply suspicious of social media and are convinced their regulatory bodies have little tolerance for any practitioner foolish enough to use social media.

The latter case demonstrates that a credible health care practitioner voice can have a big impact through the use of personal narrative – a well-recognized strength of social media especially when it comes to telling patient stories.

It’s a complex landscape through which we walk.

twitter chat announcement #hcsmca Jan 27 at 9pm Eastern

All credible authorities acknowledge that extra care must be taken on social media to protect patient privacy and confidentiality. But does this extend to an individual who just happens to be a health care practitioner who wants to discuss what has happened to a family member?

Is it appropriate for regulatory authorities or associations who represent nurses to state that it is unethical for an individual to call the profession into question?

And what of issue of whistleblowing and the power of social media to document unsafe, unethical or just plain stupid activities within one’s own hospital or health region?

On January 27 at 9pm ET (time zone converter), let’s open up the #hcsmca floor for debate:

  • T1: Should health care providers have the same rights as others to express themselves on social media?
  • T2: Do you have a personal experience or knowledge of a health care colleague who has felt constrained from telling their story on social media or alternately have effectively used social media channels to document a concern?
  • T3: Is it valid to place additional constraints on health care professionals to maintain the credibility and integrity of those professions?
Photo credit: derfelphotogen on Flickr

National #hcsmca Symposium Lands Out West: Why Vancouver?

January 20, 2016
city scape of Vancouver

Photo credit: Michelle Preston, BC Patient Safety Learning System

By Robyn Sussel, and Evening Rounds

headshot Robyn Sussel

Robyn Sussel

Why is the first national symposium of the #hcsmca community being held in Vancouver?

#hcsmca was founded in Toronto by Colleen Young, making Toronto its birth place. However uptake quickly spread and active #hcmsca members came from across Canada, even open to input in French due to the many bilingual participants involved.

So why Vancouver?

One of the many great strengths of #hcsmca is its diversity and also openness to experiences beyond Toronto — including tweet chats on telehealth and e-health for rural settings and how social media communities can support people who have poor access to a family doctor, to name just a couple. In fact, when looking back through the list of topics over the five year life of #hcsmca, most of them are universal to Canadian patients, health providers and health communicators —  and not at all Toronto-centric!

So it was no surprise to me when I floated the idea of holding a national conference in somewhere other than Toronto that Colleen and others in the community jumped at the opportunity. They felt that holding the meeting in Vancouver actually demonstrated the strength of the connections we have formed through our virtual community — and could also afford people in Western Canada an extra opportunity to attend such a watershed event.

Our organizing committee has a strong contingent from Vancouver but we are from across Canada. In addition to myself, the organizers are: Marina Bastawrous, Toronto; Janelle Chung, Vancouver; Colin Hung, Toronto;  Isabel Jordan, Squamish BC; Lori Last, Vancouver; Leah Lockhart, Vancouver; Trish Paton, Edmonton; Pat Rich, Ottawa; Kevin Smith, Vancouver; and Colleen Young, Toronto.

Another reason why Vancouver is a logical location, is that here in Vancouver we pioneered an in-person “off-shoot” of #hcsmca that we called “Evening Rounds.” Evening Rounds was created three years ago after several successful “west coast” #hcsmca tweet ups. The people who gathered really wanted more opportunities to learn and share experiences in health care and digital technologies. Co-founded by Dan Hooker, Alissa Sadler, Sean Cranbury and myself, Evening Rounds was fashioned as a monthly speaker series and networking meeting with my firm (Signals) and Providence Health Care as co-sponsors. So we have a local active and engaged community that will play host to our colleagues from east of the Rockies! I encourage any Evening Rounds regulars to quickly get registered for the #hcsmca event!

And finally, the last and very important reason why Vancouver makes sense is that the BC Patient Safety and Quality Council stepped up to support a one day event in conjunction with their annual Quality Forum. The logistical support of this forward-thinking and digitally savvy group ensured that this dream  — cooked up by a few #hcsmca-ers scattered across Canada  — came to fruition. We are very grateful for their support.

I’m not even going to mention that Vancouver in February is probably the most pleasant spot in the country with all the snow safely ensconced in the mountains. And that’s because I’m going to write another blog post on all the wonderful things to do in and around the city towards the end of February.

While you’re making your travel plans, I would really encourage you to also attend the Quality Forum 2016. While some of the content and case studies are from BC, like #hcsmca, the topics are all very transferable and translatable across the Canadian health care landscape. Registration fees are very reasonable, and as an attendee from past QF’s I know you will learn a great deal.

If you haven’t yet registered for the #hcsmca symposium, please do so quickly as space is limited to just 150 people. You can also access discount room rates at the gorgeous Hyatt Regency Vancouver.

As the moderator of the day’s event, and an ambassador for Evening Rounds, I look forward to welcoming you to my city on February 24th.


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