Print Page | Contact Us | Your Cart | Sign In
Blog Home All Blogs
Search all posts for:   


View all (314) posts »

Salud 2.0 Part Two: Broadening the Collaborative Web in Healthcare and Emerging Technologies.

Posted By Gonzalo Bacigalupe, Thursday, July 28, 2011

The second day at the Salud 2.0 Euskadi in Bilbao was as rich in content and participation as the first. Manuel Armayones, lecturer and researcher at Universitat Oberta de Catalunya and president of a rare disorder association, and Carlos Luis Sanchez Bocanegra, e-health and system administrator with the government of Andalucía, spoke about research and development from the perspective of rare disorders. Like the e-patients during the first day, Manuel and Carlos also transformed their personal plight into actively contributing to communities of patients. They are the paradigmatic situations in which professional-patient boundaries are tested, Manuel told us. A core dimension of these connected communities is the ability of patients to shape research and development. We know that social networks and the easy access to health research information makes the lives of families, with a member diagnosed with a rare disorder, less unbearable. Being able to overcome geographical barriers to reach for emotional support, medical expertise, and tailored research are central. Most important, however, is the potential for unifying across the same barriers towards eliciting clinical trials, developing new collaborations in research, and venturing into the development of innovative treatments. Several social media examples were given and the dilemmas of social participation, the role of the professional, and the funding difficulties were outlined in this presentation. Two must read books were mentioned by Carlos: e-Patients: How They can Help us Heal Healthcare by Tom Fergurson and Unlearning: Incomplete Musings on the Game of Life and the Illusions That Keep Us Playing by Alejandro Jadad.

Miguel Angel Manez financial vice-director of the Alicante-Sant Joan Health Department, reported on the efforts related to creating a social network for the professionals in the system and to coordinate all the web efforts of the health department. The challenges of moving from a 1.0 scenario to a 2.0 dynamic are not about the technological tools, but about organizational cultures. We have to be clear about what we want to achieve. Leading the transition should not be left to the information technology employees, but those in tune with the strategic goals of the organization. He utilized the songs of Coldplay to challenge us not to be afraid of the new media and to help us move a government department into a 2.0 environment. Some of the advice included: motivating people to do new and different thing, not to interfere with the free flow of information, find the natural leaders who can motivate others, and do not rely on the myth that the internet will resolve everything. He also suggested that the tools are about finding solutions collaboratively utilizing the cloud with some incentives. Miguel Angel suggested that fear of imposition, suspicion, and lack of skills are intrinsic in organizations, but this should not stop us from innovating. Finally, he reminds us that health is communication.

The Basque Country health system has been a leader at implementing a strategic plan that acknowledges chronic illness prevention and treatment as a central undertaking for the healthcare system. Economist Carolina Rubio, program director at Innobasque, acknowledging her own chronic illness has been leading the implementation of a social network for chronic illness patients to share information and support. Kronikoak Sorea relies on the notion that caring for others is also healing. Carolina mentioned that to accompany, to be flexible, to learn, and to build are key in the planning of a social network platform for chronic patients. One of the most innovative aspects of this project is the special focus on the emotional state of patients instead of the illness per se in designing the social platform to ensure participation.

Two primary care physicians, Ignacio Basagoiti at the Polytechnic University of Valencia, and Salvador Casado, assessed the adoption of technology by doctors and patients. Ignacio spoke about how doctors have to adapt to new technologies amplifying traditional social networks. If I am not an excellent physician to begin with, the social media tools will not make me an excellent one in the end. But can these tools make us better professionals? According to Ignacio, the answer is affirmative. He explored each of the tools that are freely available. He described Fernando Casado (not related to Salvador and also a primary care physician, the presenter in this panel) use of twitter to inform patients about appointment delays or useful health tips. Ignacio emphasized the amplifier role of social media to communicate, a means to relay specific goals.

Salvador Casado, after taking his shoes off, talked in a very personal way about humility. Patients want someone who cares and will help them find solutions. What do the physicians want? The same, a shoeless Ignacio told us. Patients want to wait less and to suffer less. He mentioned the usual challenges and villains in the healthcare system with the obvious consequence: burn out. Communication seems to be the solution and the social networks could be helpful. However, face-to-face communication really makes a difference. The magic of being together, like the participants in the conference who knew each other virtually, but for the first part can be together in the same room. Salvador challenged us to think of change from bottom up and to use the web 2.0 tools to address this via seven proposals: take care of yourself, humor, talk with your peers, innovate, slow medicine, eliminate the bureaucracy from your office, and flow. Casado’s talk was probably the most applauded of all and he deserved them. His call for personal accountability was clear.

The last part of the course addressed the perspective of journalists as well as how health care communications and public relations can be managed with the new media. Alain Ochoa, a journalist at Diario Medico used a photo of a sinking Titanic to demonstrate where journalism is. He called for no excuses to figure out how to move forward. The cartoon by Jesús Martínez del Vas, where two kinds of journalists look at each other, the techno savvy and the ones still caught in the traditional print outlet, synthesizes well the central point in Alain’s talk. The techno savvy see the others as dinosaurs and the traditional reporters see the others as extraterrestrials. Alain framed the new scenario not as an excuse to go back to a nostalgic form of journalism, but to embrace the digital form as a way of reaching readers. However, the implementation of any new technology could backfire and for that Alain made an analogy based on the film Robocop.

Imma Grau, researcher at the Hospital Clinic of Barcelona, described the forumclinic experience as a form of handling communication by a large hospital. The approach is based on the notion that satisfied patients will handle their chronic illness better. Imma reaffirmed the power of patient communities and their role in making healthcare collaboration a reality. Her work reminded us of how much we need systematic research related to the impact of healthcare social media tools. The health system needs to use research evidence in making decisions about how to utilize resources. Imma shared the story of patients who propose themes to deal with. Patients organized around specific illness make sense because it focuses the discussion on a common interest. What really matters to the patient emerges through the social network medium and not necessarily via the physician-patient relationship. In analyzing the data, one of the main findings is for the institution to adapt based on the patients’ conversations.

Journalist Elena Escala, from Diario Medico and TEDxSol, outlined the ways in which communication is not unidirectional and how the dialogue with readers can be uncomfortable and difficult. To witness or to be around is different from true participation. For Elena, joint collaboration and creation are the focus of the new way of doing journalism in the 2.0 era. As an example, she announced the publication of a free book in Spain: The New Health and New Patients in the Web 2.0, a joint effort that did cut through disciplines and professional silos. She challenged the audience to move the innovation out of the garage to make change sustainable. Innovation is occurring at the margins of organizations; we need to include it in the organization and with its support. 2.0 need to be more than the result of a small group of people in each healthcare institution. Incentives are needed to mainstream these innovations.

Responding to the need for creating an instrument that facilitate continuous improvement in quality of chronic illness are in healthcare Andres Cabrera, a mathematician at the Government of Andalucía and lead person at OPIMEC, the Spanish Observatory of Innovative Practices for Complex Chronic Disease Management, presented the project that utilizes many of the most innovative 2.0 technologies. The initiative born in 2008, intends to bring together communities of knowledge and practice. The pharmaceutical industry was also represented at the course. Juan Carlos Esteban, communications director at Amgen, acknowledged the difficulty that some may have at viewing a positive role for pharma in social media. According to Juan Carlos, there are obvious advantages in participating in social media, for instance with adherence to treatment (medication) in which there are applications being developed and tested. The social networks are an opportunity to educate patients and he reiterated some of the same ideas shared by others during the course. According to him, however, the fear towards entering the social media sphere varies, with institutions being very interested in implementing initiatives. The pharmaceutical industry in Spain has been much more cautious than other industrialized countries in joining social networks like Facebook or building virtual games.

The last interventions attempted to predict the future (always a difficult task, but the organizers tried) with an audience that was still fully engaged in conversation. Javier Bikandi, one of the host organizers proved that it is not only necessary, but feasible to work on innovation with the government. Mapping the social media players, Javier invited participants to review the Basque blogosphere map. Javier mapped the Basque social media landscape and the use of LinkedIn and Facebook by the government health care institutions. A community of knowledge that includes all the professionals in Osakidetza is being implemented as well as other simple web 2.0 tools like wikis. Javier pointed out to what I believe was a consensus in the meeting: the most significant challenges that innovation faces are not in the technological front, but the cultural. We have the tools; the question is how to mainstream their adoption to improve health outcomes and better the systems of care.

Gonzalo Bacigalupe, EdD, MPH (standing third from right in the front row) is an Ikerbasque Research Professor with the Vulnerability to Stress and Resilience Research Team at the College of Psychology and Education, University of Deusto Bilbao; Associate Professor, Department of Counseling Psychology, College of Education and Human Development, University of Massachusetts Boston. Gonzalo is co-senior editor of Family, Systems, & Health. His webpage is at:

This post has not been tagged.

Share |
Permalink | Comments (0)

Contact Us

P. O. Box 23980,
Rochester, New York
14692-3980 USA

What We Do

CFHA is a member-based, 501(c)(3) non-profit organization dedicated to making integrated behavioral and physical health the standard of care nationally. CFHA achieves this by organizing the integrated care community, providing expert technical assistance and producing educational content.