Author: Brian S McGowan, PhD

RESOURCE: Trends in Twitter Use by Physicians at the American Society of Clinical Oncology Annual Meeting, 2010 and 2011

Abstract

Purpose: Social media channels such as Twitter are gaining

increasing acceptance as mechanisms for instantaneous scien-
tific dialogue. Professional medical societies such as ASCO are
using social media to expand the reach of scientific communica-
tions at and around their scientific meetings. This article exam-
ines the how Twitter use by oncologists expanded at the ASCO
Annual Meetings from 2010 to 2011.

Methods: In both years, tweets that were specifically gener-
ated by physicians and that incorporated the official meeting
hashtag were harvested from the public domain, and a discourse
analysis was performed by three independent raters. Follow-up
surveys were conducted to assess physician attitudes toward
Twitter and its potential role in clinical practice.

Results: A combined total of 12,644 tweets were analyzed for
2010 and 2011. Although the number of physicians authoring
tweets was small (14 in 2010, 34 in 2011), this group generated
nearly 29% of the total meeting dialogue examined in this analysis in
2010 and 23% in 2011. Physicians used Twitter for reporting clinical
news from scientific sessions, for discussions of treatment issues,
for promotion, and to provide social commentary. The tangible im-
pact of Twitter discussions on clinical practice remains unclear.

Conclusion: Despite the 140-character limit, Twitter was suc-

cessfully used by physicians at the 2010 and 2011 ASCO Annual
Meetings to engage in clinical discussions, whether or not an author
was on site as a live attendee. Twitter usage grew significantly from
2010 to 2011. Professional societies should monitor these phe-
nomena to enhance annual meeting attendee user experience.

RESOURCE: An Interactive Internet-Based Continuing Education Course on Sexually Transmitted Diseases for Physicians and Midwives in Peru

Abstract

Background: Clinicians in developing countries have had limited access to continuing education (CE) outside major cities,
and CE strategies have had limited impact on sustainable change in performance. New educational tools could improve CE
accessibility and effectiveness.

Methodology/Principal Findings: The objective of this study was to evaluate an interactive Internet-based CE course on
Sexually Transmitted Diseases (STDs) management for clinicians in Peru. Participants included physicians and midwives in
private practice drawn from a census of 10 Peruvian cities. The CE included a three-hour workshop for improving Internet
skills, followed by a 22-hour online course on STD-syndrome-management, with subsequent educational support. The
course used case-based clinical vignettes tailored to local STD problems. Knowledge and reported practices on STD
management were assessed before, immediately after and at four months after completion of the course. Statistical analysis
included parametric tests-linear regression multivariate analysis, paired t-test and repeated measures ANOVA using SPSS
14.0. Of 1,071 eligible clinicians, 510 agreed to participate, as did an additional 132 public sector clinicians. Of these 642
participants, 619 (96.4%) completed the course, and 596 (96.3%) took the four-month follow-up evaluation. Physician and
midwife scores improved from 64.2% correct answers on the pre-test to 77.9% correct on the four-month follow-up test
(p,0.001). Most participants (95%) found the online course useful for their work needs. Self reported STD management
practices did not change.

Conclusions/Significance: Among physicians and midwives in Peru, an Internet-based CE course was feasible, acceptable
with high participation rates, and led to sustained improvement in knowledge at four months. Further studies are needed to
test it as a model for improving the training of physicians, midwives, and other health care providers.

Set-it-and-forget-it Social Learning Tools via MyPubMed

I took the time a few years ago to set up a series of saved searches using PubMed. The fact that I was able to do this quite effectively despite not being a medical librarian plus having to navigate Pubmed’s less-than-perfect interface, suggests that you could probably do it too!

As a result, several time a week I receive an alert to all of the new publications that may be relevant to my search. Some days I have a chance to peruse them, some times I do not, but on most Mondays I enjoy flipping through a list of ‘What’s new in medical education?” or “What’s new in social media AND learning?” as I am enjoying my breakfast. The beauty is that I have leveraged a set-it-and-forget-it tool

RESOURCE: The blow-by-blow reporting on the IOM's Learning Healthcare System simulcast

For some it might be of value to scroll through my notes of the simulcast to quickly get a sense of how the session unfolded.

Here are my tweets beginning at 10:00 AM on 09/06/12 ( the archived webinar can be found here)

I have highlighted a few posts that had me scratching my head…for both good and not-so-good reasons.

  1. Video feed is now live at @theIOM’s simulcast of the #bestcare report on the Learning Healthcare System: http://t.co/2HFRBsEJ
  2. Beginning the #bestcare session w/ ‘turn your cell phones off’ is not the best tone…healthcare is increasingly mobile, no? #socialQI
  3. Very distinguished panel. Did I miss the experts representing the patient perspective? Sorry if I did. #bestcare #socialQI
  4. Clearly a good sign that there is a defined hashtag #bestcare for the @theIOM’s meeting and simulcast! Thanks! #socialQI
  5. Fineberg kicks off the meeting to introduce the topic, ‘…the core dilemma of the US healthcare system..” #bestcare #socialQI
  6. Fineberg: ‘77% of likely voters would support research to improve the quality of the US HC system’ –> tis the season #bestcare #socialQI
  7. Fineberg: both political parties have platform elements that speak to the need to improve HC quality #bestcare #socialQI
  8. Fineberg: a HC system that improves on a continual basis = A learning healthcare system #bestcare #socialQI
  9. Chair Mark Smith now at the mic to cover the highlights of the report #bestcare
  10. Smith: Stakeholders participating in this report was broad, making the effort rewarding and challenging #bestcare #socialQI
  11. Smith: we were tasked to define the characteristics of an effective and efficient healthcare system, provide solutions #bestcare
  12. Smith: our path forward includes addressing the complexity of care at Pt, HCP, organization levels #bestcare #socialQI
  13. Smith: complexity: docs in primary care interact w/ 229 clinicians in 117 practices just for the medicare patients #bestcare #socialQI
  14. Smith on complexity: patients with diabetes might me on as many as 19 medications… #bestcare #socialQI
  15. Smith: a 30% increase in average income over the past decade has been all but erased w/ a 76% increase in HC costs #bestcare #socialQI
  16. Smith on complexity: the average surgery Pt is seen by up to 17 HCPs during their hospital stay #bestcare #socialQI
  17. Smith: knowledge is rarely turned into best practices and practice is almost never turned back into knowledge #bestcare #socialQI
  18. Smith: 4 new tools at our disposal 1) computing power 2) connectivity 3) management science 4) collaboration/teamwork #bestcare = #socialQI
  19. Every element that Smith has presented is integral to the #socialQI model for healthcare improvement #bestcare
  20. Smith characteristics of this learning system: 1) informatics driven 2) Pt/HCP Partnership 3) incentives 4) culture #bestcare = #socialQI
  21. Smith on foundational elements (needs): 1) digital infrastructure must be improved, more capacity, knowledge management #bestcare #socialQI
  22. Smith on foundational elements (needs): we need to move beyond purpose-built systems for study and assessment #bestcare #socialQI
  23. Smith on foundational elements (needs): 2) Care improvement targets and clinical decision support systems #bestcare #socialQI
  24. Smith on foundational elements (needs): ..not good enough to get CME 30 days after the learning needs #bestcare #socialQI
  25. Smith on foundational elements (needs): 3) patient preferences & shared decision making 4) community links/connection #bestcare #socialQI
  26. Smith on foundational elements (needs): 5) care continuity 6) operations/management science in healthcare #bestcare #socialQI
  27. Smith on policy: begins with incentives…transparent marketplace dynamics where high quality care works for payors…#bestcare #socialQI
  28. Are we to believe that transparency & marketplace dynamics can exist along side open & connected care? #competition #bestcare #socialQI
  29. “We are highlighting the knowledge complexity and its impact on the quality of healthcare” #bestcare #socialQI
  30. I wld like to hear a major jrnl editor comment on the issue of closed access publishing restricting knowledge flow. #bestcare #openaccess
  31. Seems that one of our major problems is the reliance on peer-review publication models for sharing evidence. ineffective #bestcare #socialQI
  32. Q for Redberg: will Archive of Internal Medicine move to an open access model, or pre-pub evidence sharing ala arXiv? #bestcare #socialQI
  33. At an individual state level the complexities are felt in different ways. Important to deconstruct these needs #bestcare #PPACA
  34. RT @theIOM: Jones: In the end, there has to be a focus back on patients and families  #bestcare –> great validation for #spm #s4PM #SDM
  35. “What constitutes a learning healthcare system? it is science first.” …we need more evidence. more logic…and better filters! #bestcare
  36. Cassell: “but the reality is that even w/ great data, best practices take 10-15 years to translate to standard practice” #bestcare #socialQI
  37. Cassell: “interaction w/ pharma requires a delicate balance 2 ensure expertise & openness…COI, CME, & support r needed” #bestcare #CMEchat
  38. Smith on incentives & culture: ‘culture of America as a whole is above my pay grade…” #bestcare #socialQI
  39. Smith on incentives & culture: “in some ways US HC is some of the best we have ever known…” …this is the irony #bestcare #socialQI
  40. Smith on incentives & culture: “we need to pay HCPs for the best quality and most affordable care provision” #bestcare #socialQI
  41. Smith on the culture of medicine: ‘”Medicine needs to become longitudinal, outcomes-based, and cost aware…” #bestcare #socialQI
  42. From the floor – sounds like there is a chapter on patient and caregiver engagement supporting #bestcare #socialQI #SPM
  43. Q on the floor: how do we move the culture of healthcare to engage empowered patients nationally? #bestcare #socialQI
  44. Jones: we need to have strong leadership, leverage the passion of HCPs to help people, find the right incentive models #bestcare #socialQI
  45. It is important to remember that there are examples of new collaboration models among Patients, HCPS, Researchers #bestcare #socialQI
  46. We must connect the best practice examples of collaboration. In a sense we need a community of community builders. #socialQI #bestcare
  47. My thoughts on rapid learning: What if learning, doing, and sharing were one action in healthcare? http://t.co/szq7alok #bestcare #socialQI
  48. More thoughts: The real value of networks lies within the community http://t.co/3nmE0ylm #bestcare #socialQI
  49. We need to learn more about the personal connectedness of HCPs. “Variation in Physician Networks” http://t.co/fgNcGAlp #bestcare #socialQI
  50. Seems to be very little nuance in the discussion around evidence-based medicine and personalized medicine. thoughts? #bestcare #socialQI
  51. Q from the floor: What are the new competencies for understanding quality science, virtual networking, informatics? #bestcare = #socialQI
  52. Smith commenting on the evolution of new social networks & communities of stakeholders…& the new skills needed. #bestcare #socialQI #huge
  53. There’s little doubt that the #CMEchat community has been firmly cast among the critical stakeholders based on @theIOM’s #bestcare report
  54. The question is whether the CME community has the skill set and vision to meet the call of @theIOM’s #bestcare report #CMEchat
  55. We talk about evidence-based approaches to education & learning, but learners, planners, faculty are creatures of habit #bestcare #inertia
  56. By my count speakers mentioned CME as much as a half-dozen times in @theIOM’s #bestcare webinar. Pretty striking call to action. #CMEchat
  57. The webcast of @theIOM’s report, “Best Care at Lower Cost: A Learning Healthcare System” is now available: http://t.co/BlYoIgj0  #bestcare

CLASSIC POST: Re-engineering the Data Stream from Meetings to Medical Practices

Here is a brief excerpt from our latest Medical Meetings cover story:

For some in the medical community, the frustrations and the inadequacies of the CME system described above are glaring, and many have begun to engineer their own personal workarounds. But homegrown efforts and small peripheral technology solutions aren’t going to fix the inefficiencies and failures of the current knowledge stream. 

While “need” and “education” are defined locally, an efficient flow of new medical information into practice requires a re-engineering of the very system of data collection, review, publishing, and subsequent dissemination and education. This means the central players in the medical community—the societies, associations, research institutions, and educational providers—must evolve as well, embracing the parallel movements of rapid-learning healthcare systems and social learning.