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    Gonzalo Bacigalupe: "Beginning a conversation about technology, ehealth, and collaborative family health"

    December 22, 2009 - CBC Admin

    As you walk towards the nearest coffee place, what you see are people enthralled with their smartphones. You may have heard or observed teenagers enchantment with texting. You definitely know about Facebook even if you do not have an account or you forgot how to login after having lost the password when your teenage nephew told you how to open an account to check the last Thanksgivings photos.

     

    Someone may have provided with the link to reports of the Pew Internet and American Life Project published by the PewResearchCenter.  You heard of Twitter, one of the most popular social media tools, which not only helps spread the news but also shape them. In the case of the uprising in Iran in 2009, the images, video, and reports on mainstream media were, for the most part, the product of social media tools-regular citizens carrying smartphones and connected to the Internet. It is just impossible not to notice, something is happening and it seems at times just a fad. Indeed, this blog entry is also an invitation to a conversation with the author and others. Should we care? What does this "social media revolution" have to do with collaborative health care?

     

    Briefly, what is social media or social technologies? Social media is a set of highly accessible tools for anyone with access to an internet connection via phone, computer, and other digital devices.  These tools allow anyone not only to observe what others have produced (TV is a good example) but also to engage in the production of media. Through social media, we not only consume information but we also create it. In the case of health care information, it opens up the possibility for all stakeholders to engage in conversation, share information, analyze it collaboratively, and interact more efficiently. Social media tools are also interoperable, live in the "cloud", and for the most part are not attached to a particular device or software; all of which means that we do not need to have one specific device to interact with others.

     

    These tools defy the financial, geographical, and logistical barriers that exist in creating a context for ongoing interaction, collaborative learning, fast access to information, and transparency. Why do so many professionals engage so often with a social media tool like Twitter? Twitter, a form of microblogging, provides a virtual meeting platform for individuals and groups who share similar interest without a large investment travel, time, and membership dues, among many others. Besides meeting individuals you may know "in person," you also meet others online. It has the added benefit of helping busy clinicians or scholars to maintain ongoing communication without the overwhelming demand of an email inbox after a brief period of no internet activity-paradoxically, often an explanation for not adopting microblogging is accompanied by the statement: "I have too much email already".

     

    Social media tools facilitate the development of self-help and support groups. These networks of support can bring people with rare diseases together or towards a new tailored treatment modality. In the clinical-research arena, the recruitment of patients for a clinical trial would be much easier and effective with these tools than an ad in your local newspaper or an NIH sponsored website. Ease of accessibility is a tremendous and not to be taken for granted potential of these technologies.   Think of twitter as your digital bulletin board outside your office, but in the case of a social media outlet, your bulletin board is reaching many more offices and at times the world at large. But besides the ability to reach a wider audience and fast, social media tools foster innovative ways of interacting with others.

     

    Several months ago, while investigating the impact of social media on health care, I run into a threaded conversation about technology and health care or e-health. The contributors used hash tags at the start of an acronym or word in every entry. An intriguing hash tag was #hcsm. Soon, I discovered that "health care and social media" is an ongoing discussion occurring every Sunday 8-9 PM Central Time. The discussion participants are interdisciplinary: researchers and academics, social scientists, clinicians, marketing and health care business specialists, and patients or epatients . The weekly discussions provide an informal but powerful forum "strangers" to engage in dialogue about a specific and emergent subject with questions submitted by participants earlier. The power and tools to set up these virtual meeting places are not necessarily connected to an academic degree or authority, geographical location, or financial influence, but pure acumen.  In my example, the convener, @danamlewis, is an undergraduate senior at the University of Alabama whose @HealthSocMed avatar serves as the hub for the #hcsm community. 

     

    As a result, an open interdisciplinary self-regulated community is born and sustained. This is the kind of reflexive engagement that our overspecialized professional guilds or academic worlds would make very difficult or highly expensive to create. For those of us attempting to construct a collaborative health care movement, a reflective practice that values the inclusion of several disciplines, patients and their families, and the community at large makes a lot of sense. 

     

    What do you think is the impact of social media on the collaborative health enterprise?

     

    What are your thoughts and ideas as you think about the power of social media to enhance and shape the collaborative family health enterprise?

     

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    Gonzalo Bacigalupe, EdD, MPH, is Associate Professor and Director of the Family Therapy Program at the University of Massachusetts Boston;  Adjunct Research Professor at the Department of Family Medicine & Community Health, UMASS Medical School; and is Associate Editor of Family Systems & Health and member of the editorial boards of the Journal of Marital & Family Therapy, and Qualitative Research in Psychology. He can be found in twitter at @bacigalupe and @healthglobal.

     

    4 Responses to "Gonzalo Bacigalupe: "Beginning a conversation about technology, ehealth, and collaborative family health""
    1.
    December 22, 2009 at 5:18pm

    I agree that social media is a great way of promoting transparency among practitioners. Scholarly publications, conferences, and professional organizations grant clinicians a way to model, alter, and shape their views for a select audience. Social media functions in realtime and allow a forum for collaborative, and nearly unedited, input across a wide spectrum of people (who many times are a mixture of clients, providers, and other community stakeholders). This manner of conversation breaks down hierarchy and allows multi-disciplinary and egalitarian input into issues that have far too long been the domain of an educated (and sometimes elitist) few.

    2.
    December 22, 2009 at 10:14pm

    Of all the forms of social media, I'm most familiar with Facebook, Youtube, text messaging, and good old fashioned email.  Email plays the most prominent role in my professional environment and Facebook the most prominent role in my personal environment.  I have a love/hate relationship with Twitter.  I've had an account for a few months and try to tweet a few times a week to promote the blog, but it is all business.  I also end up "follow blocking" at least 3-4 porn stars per week.  I can't say I'm familiar with the Twitter environment yet.

     

    Regarding Facebook, it is the social medium that I enjoy the most, but it is also where I run into ethical and personal dilemmas most frequently.  I decided long ago that I wouldn't friend any patients, current residents, or staff who I supervise.  I have had several ex-patients track me down on Facebook and I've turned down their friend requests.  For me this is like the classic Seinfeld episode where the spheres of "friendship George" and "relationship George" were crashing together in an inseparable enmeshment.  Some things are better kept apart.  I've made some attempts at using Facebook for CFHA (please check out our official site: http://bit.ly/6ytmJr ) but so far I haven't caught a vision as to how best to use it.

     

    Email, of course, controls my personal, professional, clinical, academic, and relationship lives.  I would gladly get a computer chip implanted in my brain so I could have email projected directly on my cornea and could write and send emails using brain waves.

    3.
    December 24, 2009 at 11:23am

    This topic is a double edged sword for me.  Gonzalo, I remember the first conversation we had about this at the CFHA conference over one of the lunch time talks.  I have put a bit of thought into it since then.  I have no doubt that there are endless positive attributes to the vast, overarching concept of technology (with social media just being a part of the larger whole).  Matter of fact, I feel much more connected due to my interactions with various social medias (twitter especially).  The persistent brain buzz I have wants to refute the positives due to my innate belief that more does not make merrier when it comes to choices as well as I’m not sure that just b/c I am more connected, that I am more informed.  Said otherwise, technology has not made life simpler, it has made it more complex and it has done so by offering us more choices.  It is the old conundrum of the child in the candy store who can not make up their mind b/c there are so many choices....so the result is a lack of choosing.  Barry Schwartz (author of  “Paradox of Choice”) boils  it down to this: having more choices increases anxiety.  I salute the potential uses of social media regarding its potential abilities but I can not help to think that the overarching concept of increased use of social media and technology, like everything, necessitates moderation.  Admittedly, deep down inside I just wish people would be more interactive face to face and not have to rely on such forms of communication.  In doing so, we would be allowed the ability to be more present with the task at hand (what ever ‘it’ may be) instead of being continuously distracted by external stimulus such as texts, phone calls, e-mails etc.  Maybe it is just my simple brain’s pleas for more placidity.  I am no dinosaur and I have not delusions that progress is not inevitable, but it my efforts to progress, I’m trying t keep some of the human in the human element.  That being said, Dr. Reitz's concept of an implanted brain chip that projects my thoughts into emails and then sends them sounds like a huge time saver for sure. 

    4.
    December 25, 2009 at 8:38pm

    The specific forms may not be durable, but I believe social media are here to stay. In a few short years, social media have not simply changed but transformed communications. As someone has already noted, they are very democratizing and different communities a way to join in various conversations.

     

    If and how providers want patients/clients to participate remains to be seen. From what I've observed during the past year as an active participant in the #hcsm community on Twitter and from the perspective of a sociologist, I think these media provide an important and valuable opportunity to create communities among and between stakeholders in the labyrinthine world of healthcare. 

     

    An organization committed enough to include the term "collaborative" in its moniker needs to pay close attention to how these communications tools emerge and morph -- and they do so very quickly.  My hope is that the CFHA and healthcare associations with similar commitments not waste a lot of time debating the merits of this current reality. My hope is that practitioners, researchers, academicians, and scholars quickly learn how these social media work and seek counsel from colleagues who are using them effectively and efficiently.

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