Monday, December 24, 2012

Web 2.0 and Social Media for Cardiologists - one-click solutions

I was preparing for my presentation at a major medical conference in India.  The presentation is on use of Social Media for Physicians.  The conference is focused on mostly cardiology topics for general internists.  The organizers asked me to make sure the talk was practical and could leave the attendees with some easy to follow take home points.

As always the challenge with a presentation is knowing your audience.  I did not have a good feel for this, not having attended this conference before.  I struggled to select the appropriate content for the presentation.  I needed to show them what was possible, and then what they could do to get started.

I decided to give them some highlights on using Google Reader to stay current with medical (cardiology) literature and use of Twitter to network with cardiologists and to get updates and insights.  To make it easy for them to get started I created

  • An OPML bundle of cardiology journal feeds and
  • A Twitter list of cardiologists to follow - this post by Larry Husten was very helpful to get started.
Having gone through that effort, it is probably worthwhile to share these for others to use and share.

Getting your cardiology journals delivered to your "doorstep"
  • Get started with Google Reader
  • Then subscribe to 11 top cardiology journals and 3 blogs with one click.  (Click on subscribe)
  • Go to Google Reader and all 11 journal feeds should be available at one place.  These can be tagged and shared on Twitter, FB or Google+, Tumblr etc and also be searched!
RSS Feed Bundle or 11 top Cardiology Journals

Getting your cardiology fix on Twitter
Twitter List for Cardiology Updates

So there you are - 2 quick one-click solutions to introduce cardiologists into Web 2.0/Social Media.

A conversation with @Allan Palmer on Google+ made me realize that this might have come across as a final solution for the attendees.  I need to stress that this is just the first step. There are several frameworks for understanding why some people are late to adopt IT innovations.  The Technology Adoption Model is based on:

  • Perceived Usefulness and 
  • Perceived Ease of Use

The Diffusion on Innovation theory by Rogers adds that an innovation must be easy to try, and its use should be visible to others (peers).  

Based on these frameworks, one would seek to provide late adopters an easy to use approach to try these tools, and allow them to see other colleagues using it.  Ideally one would add some hypothetical cases to illustrate the utility.

Thus for this conference, I could create an example of a patient on a statin who has questions about adding niacin to the regimen or a patient with history of coronary artery disease who is on a betablocker and getting severe fatigue from it.  These would lead to recent articles on these topics and conversations on Twitter and blog posts about these studies.

Sunday, December 9, 2012

Confessions of an Early Google+ Adopter

Google+ has had the best features of FB and Twitter with granular control to fine tune of the stream, ability to get to know folks from all over the world with similar interests, no ads, ability to have longer coherent discussions, very few of the "I ate a bagel for breakfast" posts, combined with the integration with Hangouts and Google Drive for collaborative document authoring and video conferencing.

With the launch of Communities, there are even more possibilities for collaboration and sharing but there is a serious possibility that we will see the influx of businesses and marketers.  Lets keep our collective fingers crossed!

Don't ban mobile devices from meetings; leverage them!

Just read a post on Techcrunch "Tech Is Making Meetings Worse, It’s Time For Digital Hat Racks" which recommends that we should make people check in their mobile devices before starting a meeting.  The author Nir Eyal feels that there are only rare occasions when attendees actually use their devices in a productive manner and thus these act as distractors.  
From Techcrunch linked to

This is issue is very similar to faculty members complaining about their students not paying attention during class, spending time on Facebook or texting instead.

My response to this post is that one can have very productive meetings when we use devices appropriately.  I find that meetings can be excellent working meetings when we have laptops and other mobile devices and use them purposefully.  I am involved in several standing meetings through out the week which follow the following model:

  1. The team has a shared folder on Google Drive
  2. Before each meeting, a document is created in the shared folder - the title is the date of the meeting
  3. Participants populate the document with agenda items prior to the meeting
  4. During the meeting one laptop is used to project the Agenda document on the screen
  5. At least one other person uses another device, usually a laptop to load the same document and edit it collaboratively.  This device is often passed around among the attendees depending on who needs to edit it.
  6. During the meeting we use the devices to
    1. Look up information - rather than assigning the task to someone to look up after the meeting and thus postponing the decision making to the next meeting
    2. Communicating - often via email or alpha pagers (yes we still use those) - send message to get answers or more information.  
    3. Project data or web sites 
    4. This information is entered into the agenda document which essentially becomes the meeting minutes.
  7. Since everyone has access to the document, no minutes need to be emailed, or approved.  
  8. While a lot of work does get done during the meeting, we of course make decisions about projects and this is captured on Trello.  We use Trello as a project management tool.  This serves to bridge the meetings by creating a list of to dos for each project and assigns these to a team member.  Team members review Trello between meetings and use this to organize their work and then update the agenda document for the next meeting.
This model has worked very well for us and we have expanded it to create a Google+ circle of team members.  This allows us to do hangouts for meetings where someone is unable to attend in person and also continue the conversation between meetings.  

The same model can be adopted for learning sessions, but the faculty need to be aware of and comfortable with technology tools that can help improve the learning experience and make the process more active, fun and efficient.

Monday, December 3, 2012

Getting my Google ecosytem on an iPhone 5

If you have been following this blog, you saw that our workplace recently switched from a BB to an iPhone. While the iPhone 5 is a wonderful device, the BB clearly was excellent for what it did - email, phone and BB messaging, connecting to resources behind our corporate firewall etc.

Playing around with the iPhone, I have been trying to customize it to suit my daily workflow.  Here is a snapshot of where I am right now.  Clearly this will evolve as I use it more and as new apps become available or existing apps get updated.

Chrome works better for me than Safari as it keeps track of my favorites and recently closed tabs and tabs on my other devices.  It allows me to share to Google+ easily (no workarounds like this).

Gmail app works much better than gmail on the iPhone mail app as it lets me do labels and organize in Gmail more easily.

I have been using Google Voice since it was "Grand Central" or something similar sounding.  It has terrific features and I still trying to figure out the best way to integrate it with iPhone 5 and iMessaging.  Unlike an Android device, the iPhone does not allow automatic calling via Google Voice.  So right now I have both on my the Phone and GV on my home screen.

Of course, I have a link to the Google Maps mobile web page but also have the iOS Maps app but that will go away as soon as the Google Maps gets released for iOS 6.

I also have a shortcut to the mobile Google reader web page on another screen.

I am probably being a bit passive aggressive about this but I think there is at least some logic behind this?  And yes I should be catching up with my e-mail rather than blogging!

Saturday, December 1, 2012

Why don't we see patients in our pajamas?

Professional identity and social media are being hotly debated ever since the rise of Facebook.  The topic raises questions about how physicians should  behave on social media.

The fact is that social media is bringing to the forefront something that has been around for ever.  Lets look at some of the background literature on this.

Goffman in 1967 wrote in the "Interaction Ritual - Essays on Face-to-Face Behaviour;
"Every person lives in a world of social encounters, involving him either in face-to-face or mediated contact with other participants.  In each of these, he tends to act out .... a pattern of verbal and nonverbal acts by which he expresses his view of the situation and through this his evaluation of the participants, especially himself. Regardless of intent, he will find that he has done so in effect.  The other participants will assume that he has more or less willfully taken a stand, so that if he is to deal with their response to him, he must take into consideration the impression they have possibly formed of him."
"When an individual appears in the presence of others, there will usually be some reason for him to mobilize his activity so that it will convey an impression to others which it is in his interests to convey"
Schlenker wrote about Impression Management and self-presentation:
 "Impression management is the goal-directed activity of controlling or regulating information in order to influence the impressions formed by an audience.  When people are trying to control impressions of themselves, as opposed to other people or entities, the activity is called self-presentation."
Schlenker goes on to discuss that self-presentation does not have to be Machiavellian or purely there for self-advancement or self-prormotion.
"Self-presentation is a fundamental feature or characteristic of interpersonal experience.  It is inconceivable to discuss human social behavior without employing the concept.... we package information to help audiences draw the right conclusion.  This packaging is a pervasive feature of interpersonal behavior."
One must be aware of how people are perceiving and responding to our self-presentation so that we can deliver the package to meet the appropriate goal - something that does not have to be deceptive or immoral.  It may take as much social skill to create an accurate self-presentation as a misleading one.

This fact has been highlighted by the popular press with books like, "How to win friends and influence people" and "Getting to yes".  Social media has truly brought this home into every minute of our awake state.

Sherry Turkle in her NY Times op-ed talks wistfully about the loss of conversation for mere connection.
"Texting and e-mail and posting let us present the self we want to be.  This means we can edit.  And if we wish to, we can delete.  Or retouch: the voice, the flesh, the face, the body.  Not too much, not too little - just right.
She laments how we are getting comfortable with the intrusion of technology into "real" life
"We expect more from technology and less from one another...We use technology to define ourselves by sharing our thoughts and feelings as we're having them.  
Nathan Jurgenson has coined the term "Digital Dualism" for this separation between online and offline and calls it a fallacy.
"Instead, I want to argue that the digital and physical are increasingly meshed, and want to call this opposite perspective that implodes atoms and bits rather than holding them conceptually separate augmented reality."
And in the Atlantic he writes,
"Emile Zola stated back in 1901, 'You cannot claim to have really seen something until you have photographed it.'  Today, we joke, 'It did not happen unless it is posted on Facebook.  Photography caused a global sensation around the new possibility: to document ourselves and our world in new ways, in greater detail and in lasting permanence."  
Just as photographers who may not be able to look at a scene without imagining how it would look through a camera's viewfinder, today's digital native may perceive "reality" by how it could be posted on Facebook.  Our parents took photographs on vacation trips and did looooong presentations at dinner parties with Kodachrome slides!  We now take photos with our smartphones and post these instantly on social networking sites.

But every time we do this, we are doing impression management and more specifically self-presentation.  We are constantly creating, modifying and managing our identity in the social networking space.  We are consciously or subconsciously aware of our environment and our perceived audience and have have an impression of how they perceive us and how each share in the social space affects that perception.

This again is just an extension of our life as usual.  Physicians wear a white coat and/or a tie or other appropriate clothing when they see patients.  Why don't they wear their pajamas?  There is a perception of what patients think a physician should be wearing.  This has been drilled into us often subliminally as we go through medical schools and residency training.  It may be difficult to break out of that mold.
But we dress differently when we go to watch a football game or to the grocery store.  Thus physicians clearly have a sense of self-presentation for different environments and perceived audiences.

So why do we have all these cases of unprofessional conduct in social media?

Firstly the problem in case of new entrants to the profession might be due to them not recognizing that the rules of engagement are now different.  Some of the folks who saw them as a college kid now might expect to see them as a future doctor.  But more importantly they now may have a new audience that perceives them only as a future doctor.  This is a problem if they have not locked down their social media profile and thus may be visible to the public.

Secondly, any person can make a slip and in a momentary lapse forget to don his social media white coat when interacting on a public forum.

I would suppose that when there is a wide gap between the baseline persona and the self-presentation situation, a person would find that environment more stressful and if not careful, is more likely to commit a bigger lapse of professionalism.

This leads to a question of why can a person not be "himself" (if there is such a thing), instead of having to don all these different personas?  I guess one should study mindfulness or Engaged Buddhism where Thich (Thay) Nhat Hahn preaches how to be truly happy,

"To be beautiful means to be yourself. You don’t need to be accepted by others. You need to accept yourself. When you are born a lotus flower, be a beautiful lotus flower, don’t try to be a magnolia flower. If you crave acceptance and recognition and try to change yourself to fit what other people want you to be, you will suffer all your life. True happiness and true power lie in understanding yourself, accepting yourself, having confidence in yourself."