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Next #hcsmca chat

Wed. April 23, 2014 at 1pm ET (2pm AT, noon CT, 11am MT, 10am PT)
hcsmca = Health Care Social Media Canada more info >>

CFHI – Building patient-centred collaboratives & seeking innovations

April 4, 2014

On April 9, 2014, the Canadian Foundation for Healthcare Improvement (@CFHI_FCASS) will be co-hosting #hcsmca. Stephen Samis (@CFHI_SSamis), Vice-President, Programs; Linda Piazza (@CFHI_LPiazza), Senior Director, Education and Training; and Jennifer Verma (@CFHI_JVerma), Senior Director, Collaboration for Innovation and Improvement wrote this post to set the stage.

By Stephen Samis, Linda Piazza and Jennifer Verma

Head shot of Stephen Samis, Vice-President, Programs

Stephen Samis

headshot of Linda Piazza, Senior Director, Education and Training

Linda Piazza

headshot of Jennifer Verma, Senior Director, Collaboration for Innovation and Improvement

Jennifer Verma

In Canada and across the developed world our healthcare needs are changing. Patients are living with more chronic disease and frailty, which require very different services than currently exist. Add to this the serious fiscal crunch facing provincial-territorial health systems, where it’s no longer palatable to keep spending top dollar to achieve middle-of-the-pack results and it can all start to look rather dismal until you focus in on the points of light.

Across our country, there are innovative solutions to tackle our challenges — ways to deliver care that are centred on the patient, improve care coordination and, ultimately, deliver return on investment (where ‘return’ can be defined both in terms of health and finances).

The Canadian Foundation for Healthcare Improvement (CFHI) is working in partnership with healthcare leaders to improve the patient-centeredness, coordination and efficiency of healthcare services in Canada. We’re in the midst of launching three pan-Canadian collaboratives to support teams in implementing patient-centred innovations in their own facilities or regions. We’re uniquely positioned to do so, as an organization that has created and supported numerous cross-jurisdictional collaborations addressing a variety of healthcare issues. Our belief is that the spread of innovative ways of working in healthcare that improve patient care and value-for-money is key to future performance. All areas of the country grapple with similar problems but there are pockets of success that can be spread and scaled-up, across facilities, regions and borders.


CFHI logo


Today, we’ll focus on two of our collaboratives. The first collaborative addresses the inappropriate use of antipsychotics in long-term care, where one in three residents is administered these medications without a diagnosis of psychosis. A CFHI-supported team at the Winnipeg Regional Health Authority (@wpghealthregion) developed and implemented an approach that helped providers better use data to identify patients who will benefit from non-drug therapies to treat dementia.

The results were impressive: by training staff at one site to work together to provide a person-centered, non-pharmacological approach to managing behaviours associated with dementia, 27 percent of a cohort of residents was taken off antipsychotic medication without any increase in behavioural symptoms or a rise in the use of physical restraints. Over the course of six months, this innovation yielded cost savings that translate to a potential saving of $400,000 in six months across the region.

Read more about their work and the collaborative.

The second collaborative aims to improve care for people with chronic obstructive pulmonary disease (COPD) while reducing their reliance on hospital-based care. The INSPIRED model of care, first implemented at Halifax’s Capital Health (@Engage4Health), has reduced emergency room visits, hospital admissions and length of stay by more than 60 percent in just six months. INSPIRED provides coordinated hospital-to-home support to patients and families living with COPD, including self-management education, action plans, psychosocial and spiritual care support and advance care plans.

Read more about the INSPIRED approach.

These collaboratives help narrow the gap between the care people need and the care they were receiving in our conventional healthcare systems. CFHI is helping to make best practice the common practice.

For the April 9 #hcsmca chat, we propose the following topics about the importance of spreading innovation:

  • T1. Share examples of innovations, including social innovations, that you’ve seen improve healthcare workflow. We’re focusing on innovations that improve the quality and efficiency of services, for instance referral pathways, strategies to implement clinical practice guidelines, surgical checklists, and any number of other ways of improving the delivery of healthcare services.
  • T2. What social innovations would you like to see spread to more healthcare organizations?
  • T3. What social mechanisms can CFHI use to maximize the success of our pan-Canadian collaborative?

The Role of Social Media in Facilitating Diagnosis

March 23, 2014

This week March 26 at 9 pm ET, Canadian pharmaceutical marketers Dorothy Czylyski, MSc (@DorothyCzylyski) and Peter Janiszewski, PhD (@Dr_Janis) will moderate #hcsmca. Dorothy Czylyski has been working in the Canadian healthcare space for 15 years as a pharmaceutical marketer. Dr Peter Janiszewski is a medical writer and editor, published researcher, science blogger and an advocate of new media in scientific knowledge translation. In this blog post, Dorothy details our topics of discussion.

By Dorothy Czylyski

Dorothy Czylyski

Dorothy Czylyski

Peter Janiszewski

Peter Janiszewski

Eight years ago and 6 weeks before our wedding, my then fiancé was waking up in the middle of the night and drinking entire bottles of water, then going to the bathroom every hour throughout the day and night. He was also losing a lot of weight which we attributed to our recent obsession with the gym in preparation for our beach wedding. Everybody thought he looked great but I was worried. After a couple of days of intermittent research on the internet I advised him to see our family doctor – perhaps he had diabetes?? Lo and behold, the results came back with a diabetes diagnosis; Type 1 at 29 years old. As much as we were in disbelief that he is now living with a chronic disease, I was relieved knowing I had suspected the condition and didn’t wait to uncover it only after he suffered from debilitating pain or finding him on the floor somewhere in a diabetic coma.

In today’s world of social media and easy access to just about any type of information, this week’s #hcsmca chat will explore how social media tools hasten diagnosis and improve access to treatment for patients.

But it doesn’t end there. For patients and caregivers with online access to a plethora of health information, this means a variety of answers to a stable of symptoms. For physicians, it can mean the ability to act quicker and prescribe appropriate treatment. In my case, my fiancé was immediately referred to an endocrinologist and within a couple of days had an armamentarium of insulin, needles, and glucose monitors; along with a nutritionist and nurse that were assigned to his care.

Here is a link to a recent article in that describes the case of a mother whose child was accurately diagnosed with a rare genetic disorder by her Facebook network - How Facebook Is Transforming Science and Public Health.

In cases where patients present with unusual symptoms that are not congruent with a common ailment, physicians now have the option of crowdsourcing a diagnosis for difficult cases. Doctors can reach out to their network of colleagues all over the world through online social media tools, with the hope that someone recognizes the symptoms and can assist in pointing the physician in the right direction of a proper diagnosis. One example is Sermo, an online community for physicians that is open only to licensed MDs in the United States. Physicians can post observations and questions about clinical issues and hear other doctor’s opinions in real-time. There is also Doximity, a network for US healthcare providers that is similar to a master Rolodex where physicians can look up their colleagues and share information with them. Without the availability of such tools in the past, many medical conditions may have taken several years to obtain a correct diagnosis.

Here are some articles that offer insightful reading on the subject:

The pharmaceutical industry has also taken an active interest in facilitating diagnosis, ranging from high cholesterol and glucose levels, to rare and ultra-rare diseases. This is being achieved through social media channels like Facebook, YouTube, as well as websites that offer chat rooms for patients and caregivers. One can argue that this motivation stems from the fact that a particular company has a product available for that condition and identifying patients could mean a prescription, but helping to raise awareness of a specific medical condition is never a bad thing. Pharmaceutical companies are behind many of today’s patient support programs, where patients turn for advice in navigating their treatment as well as obtain assistance with drug reimbursement, they fund support groups and infusion clinics, and offer the support of nurse coordinators. These companies have also become active in the development of companion diagnostics for the diseases that their products help treat.

For the #hcsmca chat on March 26, 2014 at 9PM ET, we will be discussing the following topics exploring the role of social media in facilitating diagnosis:

  • T1: How has social media transformed how patients are being diagnosed?
  • T2: How is social media helping physicians diagnose their patients?
  • T3: How can social media interfere with accurate diagnosis or lead patients astray?

Protecting your personal reputation online – with guest John Rennie

March 15, 2014

Stacey Johnson is the Director of Communications for the Centre for Commercialization of Regenerative Medicine (@CCRM_ca), a Canadian centre of excellence that supports the development of foundational technologies that accelerate the commercialization of stem cell- and biomaterials-based products and therapies. In this post she sets the stage for the March 19th #hcsmca chat that she will moderate.

By Stacey Johnson

head shot Stacey Johnson

Stacey Johnson

head shot John Rennie

John Rennie

HCSMCA is pleased to welcome back science writer, editor and lecturer John Rennie (@tvjrennie) as a guest for the March 19th tweet chat. He wowed us on June 5th with his quick mind and fast fingers and we look forward to his tweets on the following topic:

T1: How do scientists and health care practitioners who communicate with the public online respond – or not ­– to those who attack them through social media?

When a company or organization is attacked through social media, the principles of crisis communications come into play to manage the situation and mitigate any damage to reputation. But imagine this: you’re a health care practitioner (HCP) or a scientist. You’ve expressed an opinion online and have hit a nerve. Now you’re being attacked online. You don’t have a communications team behind you to step into the fray. How do you respond? Do you respond?

Social media continues to grow in popularity and scientists, patients, caregivers and HCP are migrating online. The likelihood of the above scenario is growing – and many of us know someone who has been victimized this way. In my case, I know a prominent, popular science blogger (let’s call this person “Dr. Blogger”) who advocates for strict regulation of unproven therapies in Dr. Blogger’s field of research – a reasonable position for a researcher to take.

Dr. Blogger has upset a patient advocate who wants unrestricted access to those therapies and feels patients have the right to choose whether to put unproven therapies in their bodies. The patient may see the downside as throwing money away when there is no improvement and/or cure while Dr. Blogger may be worrying that the outcome could be fatal. I have read negative posts about Dr. Blogger, on LinkedIn, by this patient. To my knowledge, Dr. Blogger has refrained from responding to the personal criticism.

While it might be interesting to debate the issue at the heart of this matter, the tweet chat will aim to focus only on protecting personal reputations online.

Now let’s flip it for the second topic.

T2 Should an individual’s personal opinion, shared through social media, be the cause for discipline in his or her professional life? 

That same patient (or it could as easily be a caregiver) has freedom of speech on her side, and the truth of her convictions, but what if an employer thinks she is going too far and harassing Dr. Blogger? Should she be admonished or even fired?

In case you missed it, here is a dramatic, real world example of Twitter backlash for an ignorant online comment. Justine Sacco, a PR executive, was fired for a tweet. It isn’t in the same league as what we’ll focus on, but serves as a cautionary tale.

Please join us with your stories and solutions.

What motivates you to blog about health care?

March 9, 2014

On March 12, 21014, this week’s #hcsmca moderator Anne Dang explores blogging for health.

By Anne Dang (@AnneCCPA)

“Writing is meant to move the heart, the mind, the soul – not the page-view meter.” – Maria Popova

Photo of Anne Dang CCPA

Anne Dang CCPA

Content is king

I started my blog as a way of disseminating information, experiences and “lessons learned” during my years training to become a Physician Assistant (PA). Instead of answering X number of emails about the same topic about PAs, orthopaedics, or anything else in my areas of interest, I could address them in blog posts and reach a wider audience by leveraging my social media networks.

Whether as part of a social media/content marketing strategy of an organization, or an outlet for individuals to share their opinions, many people recognize there are audiences looking for content that delivers value, and makes their practice, business, or lives better. I personally subscribe to podcasts and blogs that talk about social media marketing, health & fitness, as well as productivity and personal development. I find myself recommending their content to others without any real benefit to myself. Seeing this process with myself and others, I realized good quality content that delivers on value gains popularity more through word-of-mouth than through investing large sums of money into marketing campaigns for content that does not provide value to its readers.

Blog to establish authority in your field 

As a healthcare professional, I can establish my reputation in my field by writing about an area of expertise or specific topic of interest. With careful research, blogging can help bring attention to quality academic papers. But you have to be careful that you aren’t merely contributing to the noise, as Inger Mewburn and Pat Thomson point out in this blog post.

Blog about what you know

Social media has given voice to the patient experience. Patients, people living with chronic disease, parents, caregivers as well as health care professionals that look after them write about living life, managing illness – in short they blog about what they know and experience. They may also give voice to triumphs and frustrations with the health care delivery system, and are sometimes picked up by local media outlets bringing awareness to overlooked and underfunded issues.

Generating content is challenging

I set a goal for myself to blog every Tuesday. For various reasons (my job, volunteering, and extra-curricular activities), this has been challenging. Building an audience and expanding influence involves generating quality content on a regular basis. When I first started off, I often found myself staring at a blank screen, hoping for inspiration to hit. But with practice, it is getting easier.

It’s worth examining your motivations for writing. I love writing, expressing my thoughts, and sharing information for the betterment of patient care and health care professionals.

Join me this Wednesday, March 12, 2014 at 1pm ET to look at our blogging practices together, answering:

  • T1: Why do you blog?
  • T2a: What challenges (or potential challenges) do you face with generating content on your blog?
  • T2b: How have you addressed those challenges?
    T3: How do you encourage engagement once the blog post has been published?

Patient Engagement: A defining moment

March 2, 2014

This week on March 5, I’m delighted to have long-standing #hcsmca member and co-founder of #hcldr chat Colin Hung lead a discussion on patient engagement. I’ll let Colin explain.

By Colin Hung (@Colin_Hung)

Colin Hung headshot

Colin Hung

Last week I had the privilege of attending the 2014 annual HIMSS conference in Orlando Florida. Every year, I’m amazed and inspired by all the innovative people, products and projects that are presented or on display. This year was no exception.

One of the trending topics this year at HIMSS14 was patient engagement. For me this was particularly exciting. For years many of us on social media, especially those of us who participate on #hcsmca and other chats, have been advocating for more patient involvement in healthcare. Together we have helped to push the industry towards true patient-centred care and truly engaged patients.

In 2012 Leonard Kish (@leonardkish), a well-respected Healthcare IT consultant, wrote an amazing blog post, The Blockbuster Drug of the Century: An Engaged Patient, that showed how patient engagement could be the “blockbuster drug” of the year. In his post, Kish provides very compelling statistics:

  • 19.74% reduction in hospital admissions
  • 25.31% reduction in bed days of care
  • 86% patient satisfaction
  • $1,600 average cost per patient per year, compared to $13,121 for primary care and $77,745 for nursing home care
  • 20% to 57% reduction in the need to be treated for the chronic diseases studied, including diabetes, COPD, heart failure, PTSD, and depression

As I was touring the HIMSS14 exhibit hall, I was reminded constantly of Kish’s post. Almost every vendor had some form of patient engagement technology. Everything from patient portals to secure communications to personal fitness monitoring were prominently displayed.

HIMSS14 Conference Hall

photo credit: Colin Hung

But by time I watched my 20th demonstration of a “patient engagement platform” (aka a portal where you can see your healthcare information in a raw, untranslated, non-understandable format) I began to wonder about the definition of patient engagement and whether or not it would be worthwhile for the healthcare IT industry to have a common definition. It’s my belief that armed without a standardized definition or widely accepted market norm, we’ll continue to see poorly conceived engagement technologies that do little more than throw patient data onto a screen.

Pat Rich (@cmaer) wrote an excellent Day 1 summary of #HIMSS14,  The patient has no clothes, where he commented about how challenging patient engagement will be to operationalize:

“…while the majority of patients will discover errors in their own records when they evaluate them, there are few mechanisms or resources in place for doctors’ offices to correct those records … and many physicians are unprepared for the impact truly engaged patients will have on their workflow.”

I believe that almost everyone would agree that becoming more involved and engaged in your own health and healthcare is a good thing. But what does being an engaged patient really mean? Is it possible to come up with a single definition that we can all agree to? I thought it would be interesting to see what the #hcsmca community thinks about patient engagement – and how we’d define it. Join us Wednesday March 5 at 1:00pm ET (GMT-5) as we chat about the following topics:

  • T1: How would you define patient engagement? What does an engaged patient look like?
  • T2: What can providers or the government do to encourage patients to become more engaged?
  • T3: What technology can help patients be more engaged in healthcare? Does social medial play a role?

Join us Wednesday March 5 at 1pm Eastern Time (GMT-5) for the weekly #hcsmca chat. See you there!

“The Blockbuster Drug of the Century: An Engaged Patient”, Leonard Kish, HL7 Standards, August 28 2012, accessed March 1, 2014
“Patient Engagement: Blockbuster Drug or Snake Oil?”, Dan Munro, Forbes, August 17 2013, accessed March 1, 2014
“Improving Patient Engagement Equal Parts Technology, Empathy”, Brian Eastwood, CIO Magazine, October 14 2013, accessed March 1, 2014
“Patient Engagement: On Metrics and Meaning”, Leslie Kernisan, The Health Care Blog, September 12, 2013, accessed March 1, 2014
“Survey: Patient engagement important but loosely defined”, Darcy Lewis, Fierce Healthcare, March 20 2012,, accessed March 1, 2014

The New Era of Digital Health

February 14, 2014

Crystal Chin (@eHealthCareers  & @_CrystalChin) and Maheisha Ravendra (@MaheishaR) will moderate this week’s #hcsmca focussed on digital health. Here they describe how they define the new era of digital health.

By Crystal Chin and Maheisha Ravendra

Headshot of Crystal Chin

Crystal Chin

Maheisha Ravendra

Maheisha Ravendra

Healthcare is evolving as more processes use and gain insight through technology. Systems such as electronic medical records, picture archiving and communication systems and clinical information systems have been implemented and are now part of the healthcare infrastructure. However, with the arrival of data science, mobile technology, wearable devices, pharmacogenomics and personal health data, a new era of digital health is emerging. These new innovations all aim to achieve better health. But it also means a whole new set of concepts and ideas.

Although there are many ideas of what digital health is, such as the “convergence of the digital and genetics revolutions with health and health care” as defined by well regarded digital health enthusiast Paul Sonnier, we feel digital health can be considered an umbrella term that includes and is definitely not limited to:

  • Health Informatics  According to COACH, Canada’s Health Informatics Association, “health informatics involves the application of information technology to facilitate the creation and use of health-related data, information and knowledge.” The short – and somewhat shortsighted – definition is the intersection between health, technology and, to some extent, business.
  • eHealth  Broadly speaking, eHealth and health informatics have been used interchangeably. However, many are probably more familiar with ehealth than health informatics. To some, the term has some unfortunate connotations but is commonly used to encompass systems such as electronic health records (EHRs) and decision support systems (DSS).
  • mHealth – Simply put, mHealth is the use of mobile technologies to support healthcare and health outcomes. It can be as simple as text-message reminders or as complex as smartphone apps.
  • Telehealth – Telehealth uses telecommunication technology to support healthcare. The Ontario Telehealth Network, for example, is one of largest telehealth networks in the world.
  • Social Media – There are plenty of ways social media is influencing healthcare; #hcsmca is a perfect example! Participants of the February 4 #hcsmca chat may remember the scholarly paper published about our community  Enabling Community Through Social Media. But did you know that social media can also be used for things like disease tracking and surveillance?
  • Big Data in Health – Big Data in a buzzword for many industries. According to IBM, big data in health is about “[leveraging] big data technology to capture all of the information about a patient to get a more complete view for insight into care coordination and outcomes-based reimbursement models, population health management, and patient engagement and outreach.”
  • Wearable technology – Wearable fitness monitors like Nike Fuel and Fitbit fall under this category of wearable health technology. These kinds of devices can be used to to track and maintain the health of wearers.

As you can see, digital health covers a wide range of topics, with many converging but diverse meanings. And this is just the tip of the iceberg. It certainly seems like we are entering a new era of digital health and health technology.

For the February 19th edition of #hcsmca, we propose the following discussion questions.

  • T1: Do you think Digital Health will have a meaningful impact on how you engage with your health and the healthcare system?
  • T2: What skills do people need to work in this new Digital Health era? Clinical, technology, or business – which is most important?
  • T3: What applications of Digital Health do you think are most important?

eHealthcareers Logo_normal

Do You Have a Health or Patient Advocate?

February 8, 2014

This week, Annette McKinnon (@anetto) and Natrice Rese (@NatriceR), patient and caregiver advocates extraordinaire and long-time #hcsmca members, will be moderating the chat. In this post they share their collective stream of conscience that led them to topics that are sure to interest all of us, especially with them at the helm on Wed. Feb. 12 at 1 pm ET.

By Annette McKinnon and Natrice Rese

Annette McKinnon

Annette McKinnon

Natrice Rese

Natrice Rese

We used the discussion from the January 22, 2014 #hcsmca chat with Christine Spencer and Emily Nicholas (@Emily_Nicholas8) from @PatientsCanada as our starting point. That chat concerned the risks and benefits of patients sharing their stories online. #hcsmca-ers talked about the power and value of the patient narrative.

After the chat, we wondered: Why did the recognized value of the patient narrative not translate into patient influence in healthcare?

The patient narrative is informed by patient experience. If the patient story is so powerful, why do patients still have no voice?

We started to think about Ann Landers and moved on to the way bloggers are a lot like newspaper advice columnists, but for very specialized audiences. This led to a series of questions that helped us find our topic.

  1. Who or what do patients and caregivers use to find out what they need to know, beyond the basics of the diagnosis, to help them figure out the I have an ideaintricacies of healthcare in chronic disease, aging, serious illness, dying, etc.?
  2. We say patients and caregivers need an Ann Landers. Who do we/you choose to fulfill this function?
  3. A patient navigator may be ideal as a co-captain or designated decision maker of your team? (An ePatient wants to collaborate, so we chose the term“co-captain”.)
  4. How do patient navigators get recognition and hence inclusion? How can patient navigators best support their family member?
  5. With respect to patient voice: Why does it feel like “them vs. us” when we attempt to learn the ropes? Where is (or how do we empower) our personal Ann Landers today?
  6. Kingston General Hospital has a patient committee giving valuable input to every aspect of patient care. Is this happening in other hospitals and facilities?

Here are two articles that inspired us:

Arnold Relman, a 92 year old surgeon, had 3 doctors and 3 lawyers in his family. Despite havinga whole team of advocates and good access since he was the ultimate “insider”, Arnold still had issues and needed advocates. He write “What is important is that someone who knows the patient oversees their care, ensures that the many specialized services work together in the patient’s interest, and that the patient [or their advocate*] is kept fully involved and informed.”

So for February 12’s #hcsmca chat, we propose the following topics about the importance of patient narrative.

  • T1. What is your definition of a patient advocate?
  • T2. Can you share an example of the benefits of having an advocate?
  • T3. How have social media groups like #hcsmca changed the patient experience?

Read the transcript of the chat. (added Feb 12)

*We added the phrase "or their advocate".