Med2.0 (#Med2) -- An Annotated List of Blogs from Med2.0

It has been almost a week since Med2.0.  For those that don’t know, Med2.0 is a conference about using technology in medicine to further and improve patient care and education.  This was my first time attending this conference.  What a wonderful experience!  I had the opportunity to meet some of my physician colleagues whom I had previously not met in real life, but that I knew through Twitter.  In addition, there were others with expertise in other areas from whom I learned so much.

Since the meeting ended, many have written blogs about their experience.  Below is just a smattering of blogs written by a few attendees, reflecting on the awesome experience.

Specific Situations

Hallway Conversations. This blog from @kidney_boy describes the evolution of an educational resource tool, Dynamed, which occurred as a result of a hallway conversation.

Blogging: The “A-HA” Moment about Online Histories.  I wrote this blog halfway through the conference, after reflecting on a panel session on patient blogging and on the importance of asking patients about how they use the internet to search for health information.

Healthcare Needs Social Media.  This blog, by a well-known blogger and pediatrician, Dr. Claire McCarthy, describes the importance of relationships and communication in medicine and how social media aids in improving these.

Thoughts on QR Codes. This blog by @kidney_boy describes how placing QR codes into slide presentations worked well (and not so well) for participants.

Online communities This blog, by @colleen_young, describes how communities through the internet can support individual participants.  Colleen also won an award at the meeting for her work in this arena.  Congrats, Colleen!

At the end

SketchNotes: This blog, by @cassiemc , includes a wonderful pictorial sketch that is worth its weight in gold!

E-Patient  This summary, from Joe Graedon from @Peoplespharmacy summarizes take home points from Day#2 of the conference, highlighting the Society for Participatory Medicine.

General Reflections on the Conference

Student impressions: This blog by @HodaPharm , describes Hoda’s first-time experience at the conference, with reflections on many different presentations.

Gut Check:  This blog, by @RyanMadanickMD, a colleague of mine interested in the intersection of medical education and Twitter, summarizes how he learned from people with entirely different interests.

Summary of several individual sessions. This is a wonderful summary of many sessions attended by @kidney_boy, who blogged this piece for the AJKD at @eJKD .

I am sure that more will blog about their experiences, and hope that this summary provides helpful information for those there, as well as those who were not able to attend.  Please post any comments.  Thanks.

Alex Djuricich

The "A-HA Moment" about the OH ; Blogging

I am currently enjoying my time at the Med2.0 conference in Boston.  This great group of folks  is coming together to learn and disseminate how to leverage the power of emerging technologies to help improve patient care.  It is simply eye-opening to learn and understand some things coming down the pike which will help health care professionals care for patients in the future.

I attended a session on Blogging by patients which has me thinking.  One of the points that was brought home was that patients with chronic illnesses are blogging about their experiences with having certain health conditions, and that blogging has a powerful effect on how they self-manage their illnesses.  To me, this is VERY powerful.

In another session, a focus was on how many patients are searching for online information about an illness.  I have said this many times, and will say it again here.  The medical community has a duty and an obligation to dispel mis-information which is unfortunately so prevalent on the internet, and to provide simple, truthful, meaningful messages that patients can understand.  What better way to do this than through the use of social media.

One way to know about whether patients are looking online, or posting online through a blog, is to take on online history, or OH.  We should ask patients whether they do this, just like we should take a social history when we first meet them.  This can help us learn about how patients deal with their illness, and how we might be able to best help them.

This is my "A-HA" moment about the OH.  If you are a health care provider, you should consider the importance of the OH: it will be your A-HA moment too, and it will better help you get to know your patient.  Isn't that what the Patient-Doctor Communication is all about, after all?

Computers in Patient Care

I’d like to start this blog with a comment that I am a strong proponent of using emerging technologies to help improve patient care.  I believe in the power of mobile computers to help us with patient care.  I believe that we should use technology to augment the care we provide, not replace it.  However, I had an interesting hallway conversation with one of my fellow attendings earlier this week, which caused me to reflect on this topic, and ultimately write this.

Electronic medical records are touted to help improve efficiency, to be able to collect information to help us improve the care we provide, as well as other positives that are well-described.  The government is even providing incentives to health care systems and physician practices for “Meaningful Use”.  I have believed in the power of computerized physician order entry, or CPOE, for a while, having had it at one of our training hospitals when I was training in 1994 – 1998.

However, the discussion I had the other day made me really think.  Trainees (and attendings, as well; we are not any different) spend so much of their day on the computer, and this appears to be coming at the expense of face-to-face time with the patients.  This article suggests that direct time with patients is not ideal for residents on call, and that much of the time on call is spent in front of a computer.  12% of the time was spent in direct patient care.  12%!  I am concerned about this, and I bet patients would also have similar concerns.

This article, with a drawing by a child highlighting what they see with regards to doctors and computers, pretty much sums it up: even children are noticing that doctors are “tethered” to the computer.  This has to change! 

I do believe that we can fix this.  It starts with acknowledging this “elephant in the room” (or, more aptly, the “computer in the room”).  I am currently spending a few weeks on the inpatient service at our county hospital, and had the chance to discuss this with our medical students.  We made sure that rounds on patients including going to see the patients and interact at the bedside, not just exclusively sitting around a table discussing the patients.  We discussed motivational interviewing (and demonstrated it) and getting to know patients as people.  We reflected on why all of the students went into medicine, and none said “to type information into a computer.” “Stop and smell the roses” was the take-home message of the day, the roses being, among other things, time with patients.

Please, please make sure that staring into a screen doesn’t replace sitting at a patient’s bedside.  Please make sure to talk to your patients, to look them in the eye, to ask them what they think, and to answer their questions.  It will help the patients, and it will promote the humanism that is at the heart of the patient-physician relationship.  Yes, computers and mobile tablets can help us care for patients, but in my opinion, there is a bond between a patient and a physician which should never be replaced by a computer.  Let’s not break that bond!

Faculty Learning in Social Media

It has been a great last week for me.  I have successfully returned from vacation and have come out of “email jail” relatively unscathed.  I begin a short two-week stint on the inpatient medicine service in a few weeks, and am using this week to get caught up on some important activities soon to come.

First, I am excited to be giving a Grand Rounds presentation at Columbus Regional Hospital in Columbus, IN, in a few days on social media in medicine and medical education.  It has provided me with an opportunity to reflect on all of the information I have collected on the topic over the past year or so.  We will be live tweeting the event at the hashtag #CRHGrandRounds, at 12 noon EST on 8/22/12, and I look forward to the discussions both in person and online from that.

Second, I am pleased to report that we are rolling out a Faculty Learning Community (FLC) in Social Media for IUSM faculty members.  I had the privilege of belonging to a similar FLC in the use of iPads in medical education for the past two years, and it was widely successful.  With this new project in Social Media just starting, the hope is to learn from others, and move forward scholarship with regards to using social media within medicine and medical education.  We are starting it off with a presentation on how to use Twitter in medicine, followed by applications from faculty members who want to join this FLC, starting the actual group out in October.  I am extremely honored to be leading this FLC, and hope that we can determine some real areas for research around social media and follow through on that research in the coming year.  For example, how do we best teach students and trainees about using social media without compromising professionalism?  How can physician use of social media impact direct patient care in a positive manner?

For my fellow faculty at the IUSM: please send in an application if you are interested in how social media impacts your teaching and learning!  I am curious for those faculty out there at other institutions: have you done a similar thing to these learning communities, and what were your successes and failures?  What worked well and what didn’t work so well?  Please comment so others may learn from what you have accomplished.

Transition Care

Yesterday I read an interesting blog piece about a patient struggling with the transition to adult care.  As a Med-Peds physician, I am acutely aware of this issue and attempts to improve such processes.  Our institution has a team that specifically addresses transition patients, and helps ease the move to adult care.  Here at the Indiana University School of Medicine, it is called the CYACC clinic, or the Center for Youth and Adults with Conditions of Childhood.  CYACC’s mission is to steer youth with special health care needs towards a successful adult life.  Some of my Med-Peds colleagues at Indiana University care for patients in this clinic, specifically Mary Ciccarelli, Katie Weber and Jason Woodward.  Although I personally am not involved in this clinic, I have worked with many of the people there, and feel that our institution is lucky to have health care personnel dedicated to this particular patient population.

There are other institutions which have similar clinics; a few examples include Baylor and Christiana Care in Delaware, to name just a few.  I do believe that Med-Peds physicians are a natural fit for helping manage such patients in their transition journey (and are the main drivers who direct these clinics).  Specific teams (which include other disciplines besides physicians) such as CYACC are wonderful for guiding transition patients through the health care maze that clearly exists.  By highlighting these services and serving patients, patient care can be optimized, and patients can be prepared for next steps towards independent adult life.

I am curious how many patients are aware of clinics like CYACC, and whether such a clinic exists where they live.  Please comment.

Vacation and Getting Time Away

I realize that it has been a while since my last post.  Work has certainly been very busy with many projects and deadlines.  However, currently, I just returned from a vacation in the Caribbean, in the Dominican Republic.  This is such a beautiful country, and my family and I had  a wonderful time in this paradise.  We enjoyed some quality family time, and I really only looked at email and work-related activities a few times while there.  It was actually a challenge to be “unplugged” from the world of medical education and technology.  However, I do believe that it was good to do this, and to be away from work.  I certainly know that it is healthy to do so.  Years ago, there was no option to do anything but, but nowadays, with wireless access, people can be connected 24/7, including on vacation.  I promised myself that I would try hard to check email only a few times during the vacation, and was true to my word. 

I planned for an international connection via a wireless hotspot, but apparently it did not work.   There was wireless access at our resort, but not in the actual unit where we stayed.  It was an eye-opening experience to not have it, not just for work-related things, but for social media and for keeping up on the news.  I now realize how I get my information, in “bite-size chunks” via Twitter and other social media channels such as Zite.

I felt a stronger connection to my family this past week.  My oldest daughter learned how to dive, and is getting quite good at it.  My youngest can swim without having to watch her like a hawk. Sit down meals have been great!  Earlier this week, at the beach, we met a delightful couple from New York, and had some stimulating adult conversation.

So my question for all is this: when you go on vacation, do you “unplug”, or do you continue to stay connected to work through email and other methods?  What do you enjoy doing when you do get away, and how hard is it to come back to your real world after an extended period away (for example, for one week)?

I hope that you make sure to find time for yourself to have a vacation, as it is healthy to take time off for oneself to recharge.  I certainly did so this past week!

Personal Health

This post is slightly different than my usual, focusing on personal health.  I recently received a wonderful gift for Father’s Day, a pedometer which links via bluetototh with my smartphone.  Given my interest in quality improvement, this has really helped me with measuring exactly how much I am exercising.  What I love about it is the opportunity to compare day to day, and to set and achieve different goals.  Personal accountability is a great thing.

In addition, it has been a privilege to watch my two girls advance in their dance class and learn self-confidence by performing on a stage.  This has prompted me to actually join in as well; I have taken the plunge, and began taking tap dancing lessons (for those that know me, I have two left feet, so this does not come easily to me at all).  I absolutely love this class, despite never having taken any dance lessons ever!!  It is such a great opportunity for me to get away from work (even if for a short time) and focus on myself and my own health, while learning a new skill.  But it provides the added advantage of the girls seeing their father exercise (believe me, this class is a total workout), prompting them to want to exercise more themselves.  I am not even mentioning the opportunity to get to know better the other adults also taking the class with me.

I do believe that we can better counsel our patients about the importance of exercise if we actually exercise ourselves: these are just a few ways that I have done so.  So what do you do to focus on your own health that you talk to your patients about, and what exercise regimens get you jazzed up?