The Impatient e-Patient and Health 2.0

After researching Health 2.0 and social media for a client, this marketer (and sometimes e-patient ) now realises we've come along way from the initial heady days of WebMD. Perhaps you relate to my response to the  promotional video here: I was all "pumped up", ready to get online and make an appointment with my doctor. But unless you're in 5% of the population, that probably isn't possible.

The video, like much like the Media, tends to focus on the exciting pioneers and outliers - the purple cows that make  good story-telling.  The story inside this post on SocioSphere3 captures my own patient reality alongside a market analysis of whose connecting the Health 2.0 dots. 

Health 2.0: The Glass Half Full

Web 2.0 and social media promise to bring about a new, more intimate, humane and authentic level of communication between companies and their customers. And healt care is not excluded.

A January 2008 report from iCrossing reported that 34 percent of Americans turn to social media for health research, particularly those in the Millennial (19 - 34 year old) age group.

And as the E-Patient video above shows well, there ar e a host of new interactive health tools, from drug rating sites where patients can laern about drug interactions, online patient support communities like PatientsLikeMe and OrganizedWisdom to numerous personal health widgets.  One of my personal favorites in Health 2.0 tools is Medpedia, where authoritative medical opinions coexist alongside contributions from patients with a chronic illness. Real life meets expertise. Superb!

for a more comprehensive list of Health 2.0 resources, check out Medicine 3.0's excellent post, 25 Excellent Social Media Sites for Your Health or the regularly updated Health2.0 wiki.

The doctors themselves are joining the internet renaissance. According to Manhattan Research's "How Digital is Shaping the Future of Pharmaceutical Marketing" the average physician currently spends about eight hours a week using the Internet for professional reasons, a significant jump from only 2.5 hours in 2002. Even better yet, the report claims 64% of doctors own smart phones and are using them t oconnect with patients around the clock.

According to Ed Bennett's well-known Hospital Social Network List, the hospitals are responding too.

Health 2.0: The Glass Half Empty

Some have called hype on Health 2.0 And it doesn't escape my attention that several of the companies listed in the video and out on the Health2.0 wiki are out of business or are struggling to survive.  But in my view  these are not signs of hype so much as the usual zigzag upward curve associated with technology adoption.

The greater disparity to me is that The Great New World of Social Media is missing from my own physician's office site and hospital site. Maybe like me, you find your doctors aren't online for consultation.  Maybe like me, your doctors do not blog like Dr. Parikh on Salon or Dr. Marchetti on Medpundit.  Instead my patient experience is better described in Dr. Dr. Tom Ferguson's seminal E-Patient's white paper,

" ...For our first generation of E-Patients, going to the doctor's office is all too frequently a Kafkaesque experience of going back in time to when the internet did not exist.".

But here's what really turned on the neon sign inside my brain: All thes sophisticated tools coming on baord -- and yet I still can't send a simple email message to my doctors?

Apparently I'm not along: From a 2008 survey, CNNHealth reported that 49%-55% of Americans want to be able to email their doctors.

This backs up an earlier Pew Internet & American Life Project surveying e-patients desires they have of services from the medical community. Among the most frequently asked-for were:

• Doctor-to-Patient email
• How to determine the correct tests and treatments
• More in-depth information about the quality of care provided
• The ability to schedule doctor appointments online
• Direct internet access to online doctors
• Free access to online medical journals
• More information about drug interactions
• Online diagnostic tools or "symptom finders"
• Access to my medical records and test results
• Better ways to connect with local resources

While many self-help online patient tools are available today, it seems there are challenges in paving the last mile between E-Patients and E-Doctors.

Challenges for Doctors

1. Doctors are Busy

The notion that primary care physicians and surgeons have the time to learn the tools, tweet to patients and peers, likes in the face of the reality of busy schedules. Not every doctor can be expected t obe like pediatrician DrGreen.com, who chats online.

2. Doctors have Limited Knowledge of Social Communities and Tools Available

The wealth os social technologies and useful sites in healthcare is vast and continues to grow weekly.  Knowing the resources and matching the right social networks to a patient base is a time-consuming task.  how do gastrointestinal surgeons lean about The Colon Club to tell patients?  Would more pediatricians have Facebook sites if they knew about the vast number of Millenial moms out there on that site?

A comment left on a health care blog captures the tech knowledge gap well,

"As an executive for  an iPhone-based physician's software company I also see [physicians] grappling with a bewildering array of technology, trying to determine what is worthwhile and what could be an expensive waste of time."

3. Patient Community Management

Many doctors are sometimes loathe to have their reviews posted online, fearing bad reviews. One of my own doctors Vitals.com rating suffered from a patient who misunderstood an allergic reaction to a bandage as a problem with the surgery itself. My doctor simply didn't have the time to go online and correct the misleading choice of words. (Note- in the social media world, responding to this public criticism is actually one of the beset opportunities to correct and respond. In doing so, a doctor can show a broader community of current and prospective patients that you care about the quality of your service and work.

4. Office Staff are often Untrained in web 2.0 and Social Media Tools

5. Health insurers don't reimburse doctors for online consultation.

While insurance companies are starting, it is far from common practice.

At least one populations of MDs  may be underestimateing the business value of the new patient engagement tools to their disadvantage.

Challenge to Boomer-Age Physicians

Many Boomer-age doctors wit mature, pre-Millenial age patient may think they have an installed base comfortable with their legacy communications tools.  And yet a physician that graudatied from medical school  10-25 years ago still needs to stay competitive with today's new "social-media-ready"  medical school graduates.

 Two medical practices embodying the spirit of the new wave of "E-Doctors" are Hello Health and Personal Pediatricians.  Having received quite a bit of media attention, Hello Healthy's tech savvy group of physicians in Brokkly offer appointment setting from smart phones, email, instant messaging as we llas online video consultation.  As a patient, you can login to their website from your own home, creae an account, list your history of medications and medical history.  The win for teh patient is less time i the waiting room. The win for the doc is less paperwork -- leaving more time for staff to focus on service to patients.

Another great example: Dr. Natalie Hodge and her virtual office concept, Personal Pediatricians.  With the help of sopisiticated IT tools, she works mostly via her Apple iPhone. Dr Hodge claims this allows her to spend more time with patients, including visits to their homes.

Wha'ts most interesting about these two concierge practices is that each has developed their own software platform, essentially spin-off businesses, to bring other doctors into the technology fold.  Hello Health's Myca venture provides a web-based software platform that will allow other physicians and their patients to use the Hello Health online tools, including electronic health recoreds.   Personal Pediatricians provides physician affiliates with similar capabilities, calling their online environment "a cloud-based house call".

As the websites of these new-wave services explain, these services promise "to increase care provider coordination while maximising doctor-patient engagement, both offline and online."

These doctor-designed web platforms are still in their embryonic stage. Will the doctor founders be able to manage both their practices and their IT platforms?  Manage customer service?  I'm hopeful --- especially as both services would seem to have an immediate appeal to recent medical school graduates.

But it still seems there's a gap in bringing highly talented , but less IT-savvy doctors forward into the new E-Patient community.

A Social Media Concerge Service for Doctors?

For doctors graduating from medical school more than 10 years ago, it seems a useful service would be social media training and support tools specifically for physicians. I am not talking here about the technical task of connecting physician websites into Facebook, LinkedIn, etc social networks. There are score of web developers to do that.  I am talking about a part technology guide, part trainer, yes, perhaps even part health community liaison for physicians and specialists.

Such a social media concierge could provide customizable services such as:

• Identifying Patient Communities and New Tools Emerging   Doctors across different disciplines, particularly specialistswith distinct patient  profiles, need to know what social networks their patients are using as well as what new productivity-enhancing tools exist that might be incorporated into their practice. Where do Type I diabetics trade information? What are the names of  the most influential weight management blog?

While Medical IT  conferences and scores of physician-centric Health  2.0 websites exist today, social media concierge would provide more focused services to integrate tools into workflow.  for instance, a cardiac surgeon's web practice might be matched to talented internet surrogates covering cardiology on OrganizedWisdom. These surrogates provide a wide realm of specific health information - far more than any single doctor or his staff could provide on their own.

• Physician and Staff Office Training. As a third party dedicated to knowing and tracking the new social media tools and online resources, the concierge could train both doctors and  their staff on the best set of services.

• Online Reputation Management By scanning the myriad of patient social networks and doctor review service, a concierge service could keep track of physician reviews and patient ratings, alerting a practice to any complaints which should be addressed.

Connecting the Docs to Connect the Docs

 

Will physician portals like MycaHub become the new online doctor offices?  Will medical schools include social media Health 2.0 courses?

However, the future unrolls, social media and mobile technologies are no panacea: It will take time to interweave these tools seemlessly into the larger fabric of the healthcare system and for doctors and patients to fully appreciate their benefits. Hopefully there are many more impatient e-patients like me!