Wednesday, February 17, 2010

Social Media and Medicine: Let's get #hyperlocal!

So after 16 months of blogging, twittering and social bookmarking how do I find social media to be useful to my work as a GP? Ummm. Well, I don't really....yet. Let me explain.

Early 2009: Phil Bauman's post on 140 Healthcare Uses for Twitter caused a lot of excitement. Then there was talk about surgeons twittering from operating theatres. It all left me a little bit cold. I couldn't see how I would use social media to support my work as a GP. But then I came across a review by Richard Smith from the BMJ in 1996, "What Clinical Information do Doctors Need" which helped me understand my resistance and the potential. To summarise there are three kinds of informations that doctors need
  1. Information about the patient
  2. Information about disease and management
  3. Information about local services to help manage the patient's condition.
I could (and might) do a whole other blog post about how social media might be useful in direct interactions with patients. In medicine we are trained almost exclusively for synchronous communication with patients. When I am in the same room as a patient we can usually communicate so much better. Speaking on the telephone is the next best thing and has the added bonus that it is much more convenient for the patient.  But as I say this needs a lot more room to explore so I'm not going to focus on this now, but safe to say, I am unclear as to see social media could help me gain information about patients at the moment.

Next, there is information about diseases and management. I'm a generalist, and I work in the UK and in a practice with several other doctors. For many conditions such as diabetes or cardiovascular disease, my management is determined by national guidelines, which are then tailored to individual patients through shared decision making. I will often look for information about these more common and less common conditions, and I will use sites such as TripDatabase which will find me relevant research papers and guidelines quickly. But I don't bookmark the information I find there. Why would I? The next time I need some information about that condition, which may not be for a few months, I will search again because the evidence may have changed. Now, this is different to how I use social bookmarking for my work as an educator or as a student (I'm registered for an EdD). Social bookmarking is useful for infomation that I have come across through serendipity (perhaps through Twitter), or because I am specifically looking for information that I don't have time to completely study now but want to be able to find again. But my infomation needs in clinical medicine tend to be more just-in-time. I don't think that I am so alone in this and it probably explains why I have found it hard to find delicious doctors
(Should I be reading generalist journals to keep up to date? The RSS feeds of the BMJ, NEJM and the Lancet swamped my google reader and made me feel inadequate! But here is somewhere where social media is useful. If you have any interest in what is happening in the big medical journals sign up to the RSS feed from Richard Lehman's Journal Watch blog. He writes with wit, and cuts to the chase.)

And lastly there is how social media could be useful with regards to information about healthcare services locally. This is where I currently feel the largest gap, and not uncoincidentally, where I feel social media could contribute most. Back in 1996, Richard Smith pointed out that this information is often diffuse and rapidly changing. Doesn't that sound like something that social media could grapple with? Well, next month I am going up to Glasgow to meet people interested in gathering information that is diffuse and rapidly changing and that could help people living with long-term conditions. 

I'll tell you more about the ALISS project and what they are hoping to achieve when I get back. Then we can start thinking about how we can all get useful #hyperlocal information. What do you think?

PS. By last summer @drves was referring to me as a "Web 2.0 sceptic". But I was so enthused about this last year that I actually started a new blog to try and get some discussion going.