Healthcareshouldbetheleaderinmicrosharing. Whyisntit? 140 Health Care Uses for Twitter: Suggestions for Micro-sharing In the 21st Century byPhilBaumann,RNBSN @PhilBaumann

WhyShouldHealthCareMicroshare? [Thisebookisarepurposingofanoriginalblogpost140HealthCareUsesforTwitterpublishedJanuary16,2008.] Twittermayeitherbethegreatesttimewastingprankeverplayedontheinternetcommunity oritmaybethebestthingsinceslicedbread.It'seasytomakethefirstcaseifyoureadthe publictimelineforafewminutes.It'sabithardertomakethesecond,butI'lldomybestto makeit.Specifically,I'dliketotakeastabatoffering140healthcareusesforTwitter. Twitter'ssimplicityofdesign,speedofdeliveryandabilitytoconnecttwoormorepeople aroundtheworldprovidesapowerfulmeansofcommunication,ideasharingand collaboration.There'spotencyintheabilitytoburstout140characters,includingashortened URI.Couldthispowerhaveanyuseinhealthcare?Afterall,forexample,doctorsandnurses sharemedicalinformation,oftenshortburstsofdata(labvalues,conditions,orders,etc.). 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 2

Unlikemostotherkindsofuses(dailyexchangesbetweenfriends,thekindofwork @Comcastcaresdoes,etc.),healthcarerelatedmattersposeuniquechallenges,includingbut notlimitedto: Patientdignityandprivacy Professionaloathstodonoharm Litigationconcerns Standardsandcomplianceneeds HIPAA ThepossibilitiesthatIbelieveTwitterofferscurrentlyfarexceedstheconstraints.Thisebook won'tofferworkaroundsolutionstotheseconstraints.Ratheritwillfocusonthepossibilities becauseonceweseethepotential,wemayhavestrongermotivationstodealintelligentlywith theconstraints.Sowhenreadingthislist,don'tgethunguponthedetails,thefears,the anxietiesthatmaybeprovokedbytherealitiesofhealthcareasitispracticedtoday.It'sthe 21stCentury:let'sbeimaginative,determinedandinnovative.Let'sberemarkable. Inthehealthcareindustrythereisoftenafinelinebetweencautionandfear.Itisthefearof changesocommoninhealthcarethatIhopewecanovercome.Twittermaybeaproving groundofhowweovercomeourfears,satisfyourcautionsandextendthereachofourhealth caresystemwithwebbasedtechnologiesandcommunities. 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 3

Whatfollowsareusesthatcanbeadoptednowaswellasusesthatremaintobedeveloped. ThesuggesteduseswontnecessarilyfindtheirapplicationviaTwitteritself,butTwitter exemplifiesthepotentialofmicrosharing.Thesuggestionsformanargumentforchallenging ourselvestothinkpastastatusquowhichisfailing. Whatdoyouthinkhealthcarewilllooklikein2099?Willwestillbeusingpaperformedical recordsorwillwebeusingtechnologiesthateverybodyelsewillbeusing?Willwetranscend ouraccustomedwaysofthinkingandresocializeourselvesforhowweinteractwitheach other?Thatswhatisrequiredinthecomingageofmicrosharing.Ihopethatthislisthelpsto answerthosequestions. IfyouwanttolearnmoreaboutTwitter,pleaserefertotheTwitterResourcessectionat theendofthisebook. AllthematerialcontainedinthisfreeebookarelicensedunderCreativeCommons3.0.Refertothat documentbeforerepurposingthismaterial.Youareencouragedtosharethisebookwithothersforthe benefitofothersaslongasyoucreditthesourceback(alinktoPhilBaumann.comissufficient). 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 4

Who Is This List For? You! You,theCNOofacommunityhospitalwhowantstobettermonitoryourfacility You,theCEOofahospitalwhowantstoknowwhat'sbeingsaidaboutyouandwhatyoucandoaboutit You,thenursewhoistiredofchasingafterinformationthatshouldbeatyourfingertips You,thedoctorwhowantstonetworkwithpeersandperiscopeforthelatestadvancesinmedicine You,thedisasterresponsepersonnelwhoneedtorecruitresourcesrealtime You,theepidemiologistwhowantstotrackinfectiousdiseasesanddevelopasleekalertsystem You,healthpolicyofficialwhowantstointeractwiththepublic You,thepatientwhowantstoconnectotherswithsimilarconditions You,thefamilymemberwhowantscommunitysupport You,thecitizenwhowantsavoicethat'sheard You,whodontfallintoanyoftheabovecategoriesyet 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 5

140HealthCareUsesforTwitter 1. Tissuerecruitment(kidneyandotherorgan,blood) 2. Epidemiologicalsurvey 3. Disasteralertingandresponse 4. Emergencyresponseteammanagement 5. Supportivecareforpatientsandfamilymembers 6. Diabetesmanagement(bloodglucosetracking) 7. Maintainingapersonalhealthdiary 8. Adverseeventreportingintheclinicalsettingandotherpharmacovigilance functions 9. Emittingcriticallaboratoryvaluestonursesandphysicians 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 6

10. Alarmingsilentcodes(psychiatricemergencies,securityincidents) 11. DrugsafetyalertsfromtheFDA 12. Riskmanagementcommunication 13. Augmentingtelemedicine 14. IssuingAmberalerts 15. Issuingalertsformissingnursinghomeresidents 16. Exercisemanagementandencouragement 17. Weightmanagementandsupport 18. Biomedicaldevicedatacaptureandreporting 19. Nutritionaldiaryandtracking 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 7

20. Coordinatingpreoperative,perioperativeandpostoperativecare(among pharmacy,nursingandsurgicalservices) 21. Medicalservicecollaborationintheclinicalsetting 22. Triagemanagementinemergencyrooms 23. Censusmanagement/monitoring 24. Arrangingoutpatientcare 25. Crowdsourcingforhealthcareresources 26. Shiftbiddingfornursesandotherhealthcareprofessionals 27. Moodtracking(forpatientswithbipolarandothermooddisorders) 28. Patientcareremindersintheclinicalsetting. 29. Prescriptionmanagement,includingpharmacyrefillreminders 30. Dailyhealthtipsfromauthoritativesources 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 8

31. Locationawarenessduringcrisis 32. Occupationalsafetyresponse 33. Hazardousmaterialscommunication 34. quot;Quickanddirtyquot;diagnosticbrainstormingbetweenphysicians(e.g.'symptom clustering') 35. Clinicalcaseeducation(residentsfollowingattendings). 36. Physicianopinionsharing 37. PromotingDomesticViolenceawareness 38. RaisingChildAbuseawareness 39. USMLEpreparationformedicallicensing 40. NCLEXforpreparationfornursinglicensing 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 9

41. Recruitmentofhealthcarestaff 42. Alcoholandothersubstanceabusesupport 43. Issuingandconfirmingdoctor'sorders 44. Environmentalalerts:pollencounts,pollutionlevels,heatwaves,severe weatheralerts 45. Remotewoundcareassistance 46. Ruralareahealthcarecommunication 47. Microsharingofpertinentpatientinformation 48. Microsharingofdiagnosticresults(bloodtests,echocardiography,radiological images) 49. Internalfacilitycustomerservice(ahospitalequivalentof@Comcastcares c'monhospitals!) 50. Publishinghealthrelatednews 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 10

51. Psychiatricquot;checkinsquot;forpatients 52. Nursingmentoringandcollaboration 53. Publishingdiseasespecifictips 54. Childcaresupport 55. Fundraisingforhospitalsandhealthrelatedcauses 56. Updatingpatientfamilymembersduringprocedures 57. Livetweetingsurgicalproceduresforeducation 58. Rarediseasestrackingandresourceconnection 59. Reportinghospitalstaffinjuries 60. Trackingpatienttrends 61. Trackingdiseasespecifictrends 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 11

62. Checkinghospitalratingswithotherhealthcareconsumers 63. Providingaroundtheclockdiseasemanagement 64. Connectinggeneticresearcherswithphysicians 65. Publishingthelatestadvancesinbiomedicaldevices 66. Trackingantibioticresistance 67. Realtimesatisfactionsurveyswithimmediatefollowupforproblem resolution. 68. Issuingasthmaalerts 69. Datacollectionfortrackingfacilitypatterns(processperformance,supply chainandstaffingproblems) 70. Livetweetingmedicalconferences 71. KeywordtrackingofhealthrelatedtopicsviaSearch.Twitter 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 12

72. Postingquicknursingassessmentsthatfeedintoelectronicmedicalrecords (EMRs) 73. Improvingmedicalroundingsystems 74. Clinicaltrialawareness 75. Hospitaladministration 76. Sharingpeertopeerreviewsofarticlesofinterest 77. Connectingpatientswithsimilardiseaseprocesses 78. Enhancinghealthrelatedsupportgroups(e.g.buddysystemsfordepression) 79. Providingsmokingcessationassistance 80. Medicalappliancesupport(e.g.athome:colostomycare,infusionpumps, woundvacs) 81. Reportingmedicaldevicemalfunctions 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 13

82. Tweetingupdatestofacilitypoliciesandprocedures 83. Arrangingappointmentswithhealthcareproviders 84. Productsafetyalerts 85. Foodsafetyalerts 86. Informationonwomen'shealth 87. Painmanagement 88. Hospitalreputationmonitoring 89. Publishinghospitalsponsoredeventsinlocalcommunities 90. Communityhealthoutreach 91. Bioterrorismawarenessandpreparedness 92. Issuingupdatestohospitalservicestothepublic 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 14

93. Insuranceclaimmanagement 94. Ethical,permissionbasedfollowingofpatients 95. Microsharingconsentforsurgicalandotherprocedures 96. Patientsharingofhealthrelatedexperiences 97. Posting'breadcrumbs'offacilityexperiences(quot;Ihadabypassatthishospital anditwentwellbutthefoodalmostkilledme.quot;) 98. Patientsearchesforothersconfrontingsimilarproblems 99. Stressmanagement 100. Mentalhealthawareness 101. Postinghomelessshelterneeds 102. Foodbankresourcemanagement 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 15

103. Transmittingpatientdatatopatientswhoaretravelingabroad 104. Generatingstreamsofauthoritativehealthcarecontentonline 105. Exposingmedicalquakery 106. Microsharingdocumentationforadvancedmedicaldirectives 107. Discussingpublichealthcarepolicy 108. Developingstrongerpatientproviderrelationships 109. Trackingthesafetyandefficacyofpharmaceuticals 110. Followinghealthmarketing 111. TrackinginfluenzaalertsfromtheCDC 112. Exchanging/solicitingscientificvalidationofalternativehealthclaims 113. FollowingadhocconferencesoneHealthlikeHealthCampPhila 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 16

114. Trackingtoxicdiseases 115. TrackingHIVnews 116. Issuing/exchangingdietarytips 117. Tweetingwhatyoueat 118. Comparingnursinghomeperformance 119. Coordinatingclinicalinstruction 120. Communicatingwithnursingsupervisors. 121. Publicsafetyannouncements 122. TrackingFDAguidelineupdates 123. Trackingtheprogressofdevelopingpharmaceuticals 124. Broadcastinginfantcaretipstonewparents 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 17

125. Publishingvaccination/immunizationserviceslocations,hoursandreminders 126. ReportingadverseeventstoFDA 127. ObtaininginformationonMedicareandMedicaid 128. Casemanagementfunctions 129. Clinicaleducationcoordination 130. Facilitatingpatienttransferprocesses 131. Patientinformationretrieval 132. Reportingbreechesofuniversalprecautionsinhealthcarefacilities 133. Postingdailynursingtips 134. Exchangingphysicianhumor(wedon'twantstressedoutdocs) 135. Closingthedigitaldividewithrespecttohealthcareinformation 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 18

136. Coordinatingalliedhealthcareservicesduringpatientadmissions 137. Coordinatingpatientdischargeswithallservices 138. Postdischargepatientconsultations 139. Helpingdevicetechnicianscommunicatedirectlywithmanufacturers 140. DiscussingHIPAAreformintheageofmicrosharing 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 19

WhyCan'tHealthCareBeALeaderIn Microsharing? Theretheyare:140healthcareusesformicrosharingplatformslikeTwitter.Manyofthese arestretches,butplasticityofvisionisakeyfeatureofinnovation. Implementingtheseusescanbeenormouslychallenging(andevenimpossible)onTwitter giventoday'sconstraints.Formanyoftheseuses,othermorerobustandsecuremicro sharingplatformswillbeneeded(e.g.YammerorESME).Certainly,Twitteroffersamodelof howmicrosharingcanbeusedforawiderangeofpurposes.Ifsocialmediamarketerscan figureouthowtouseTwitter,healthcareprofessionalscanalsofigureouthowtofullyexploit microsharing. With26lettersinthealphabetarrangedwithin140characters,thereareover1.2x10198 possiblecharactercombinations.Ofcourse,thenumberofmeaningfulsentencesisfarless thanthatbutapointstandsout:there'savirtuallyinfinitenumberofshortpulsesof (meaningful)informationthatTwittercanfacilitate. Withthatkindofpower,healthcareshouldbealeaderinmicrosharing,notalagger. 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 20

ClosingNotes Whencompilingthislist,Iswamouttothefarendofthiscenturyandlookedbackuponthe wreckageintowhichourhealthcaresystemisheading.Pardonmeiftheideasarefarfetched: Ifetchedthemfromfaraway. IrealizethatIdon'texplaintheapplicationsindetailhere.Iwantthehealthcarecommunityto workthroughtheseapplications(what,youwantmetosolvealltheproblemsinoneebook?) There'salwaystimefordiscussion. IuseTwitterasametaphoricalmodelforwhatwecandowithdataexchange.Thereare entirelynewtechnologiesandcommunitiesthatwillneedtobedevelopedforthevisionshere tobearfruit.OnceyouplayaroundwithTwitter,youllcometoseeitspromisesand limitationsandthenyoucancomeupwithyourownusesfornovelkindsofmicrosharing. Thehealthcareindustryhasachievedremarkablemilestonesintheadvancementof knowledgeaboutourselves.Itshouldbeattheforefrontofinnovativeusesoftechnology,no matterhowimpossibleorabsurdthechallengeappearstoouraccustomedeyes. 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 21

TwitterResources IfyouhaveneverheardofTwitterorhaveheardofitbutwouldliketogetastart,hereisalist ofsuggestedresourcesforTwitter: CommonCraftsTwitterinPlainEnglish TwiTipDarrenRowsesblogonTwittertips YourGuidetoMicrobloggingandTwitter ChrisBrogans50IdeasonUsingTwitterforBusiness LauraFittonsPistachioConsulting TheresnoshortageoftalkaboutTwitter.Googlearound.Signup,startfollowingpeople, plungeintotheexperience,makemistakesandlearntouseTwitter.Onceyougetusedtoits nuances,youllthenbeabletoseehowmicrosharingcan,andmust,playaroleinhealthcare. 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 22

AboutTheAuthor MynameisPhilBaumannandImmanythings,includingaregisterednurse.Youcanleadme onTwitterifyouthinkIcanhelpyourcause.YoucanalsostopbyPhilBaumann.comforabit moreinfo.Forextendedconversation,emailPhil@PhilBaumann.com.(Andifyou're entrepreneurial,let'stalk!) BUTthisebookisn'taboutme.It'saboutyou. Youcanauthoramuchbetterebookabouthowtousemicrosharingandotherwebbased mediainhealthcare.Giveityourbest.Imagineif1,000ofuswrotelettersfromthefuture. Youaretheauthorofthe21stCentury. Youaretheauthorofourhealthcarepolicies. Authoraremarkablestoryabouthealthcareinthe21stCentury.Itsyourturn. 140 Health Care Uses for Twitter (cc) Phil Baumann PhilBaumann.com 23