Analysis of pharmacist generated Twitter content

Click image to enlarge

A tweet by Katherine Chretien (@MotherinMed) that her new article on physicians & Twitter has been published in JAMA served to remind me that I forgot to blog the poster presentation of our project, “Analysis of a national sample of pharmacist generated Twitter content”  that was presented at the 45th Annual ASHP Midyear Clinical Meeting in December in Anaheim.  I did remember to send a tweet with a link to the image at the time (#ashpmidyear), but the rest escaped me.  The poster is the PharmTwitter project that @markhawker and I and a couple NSU students worked on and represents an earlier stage with preliminary results.  As an aside, we prepared a ‘conventional’ version of this poster for the meeting as well and then put it to a vote among the project team members as to which one to use at the conference.  The vote ended up being a tie, so we had to use a tiebreaker.

Hopefully the full results will be coming soon via a journal near you (hint: it’s won’t be JAMA).  All comments, as always, are welcome.

@kevinclauson

Medicine 2.0’11 at Stanford – Call for Abstracts

The Medicine 2.0 World Congress on Social Media and Web 2.0 in Health, Medicine, and Biomedical Sciences is one of the most valuable conferences I have ever attended.  It has been the meeting in this arena with the clearest focus on actual research and evidence for Medicine 2.0 issues and also offers the best opportunity to connect with other researchers, clinicians, e-patients, business and policy people.  In fact, the very first Medicine 2.0 Congress was where I was introduced to (and/or first met IRL) so many people who went on to become research collaborators, colleagues, and friends. 

In the spirit of that original meeting, I am excited for this year’s Medicine 2.0 at Stanford (September 16-18, 2011).  I have always appreciated the fact that Medicine 2.0 has truly been an international gathering, but am happy to see that it is coming to the United States for the first time.  I am also eager to see another first,  the one-day Stanford Summit at Medicine 2.0, which will directly precede the Medicine 2.0 Congress.  The Summit is lining up to have an incredible array of moderators and panelists.

Given the quality of the attendees and the opportunities for discussion/dissemination of your research (and networking), if you are working in this field I would strongly urge you to respond to the Call for Abstracts, Presentations, Interactive Demos, Startup Pitches and Panel Proposals for Medicine 2.0 at Stanford.  The deadline for submission is a (rapidly approaching) March 1st, 2011.  You can click on the link for the Call or start the process by watching the overview below by this year’s Conference organizer, Dr. Larry Chu.  Also, feel free to contact me with any questions and I look forward to seeing you there!

@kevinclauson

Medicine 2.0 Call for Abstracts from Larry Chu on Vimeo.

Soapbox 2.0: Use of blogs by pharmacists

I saw a tweet by John @Poikonen that alerted me to the fact that a second article in as many weeks has been published on pharmacy and blogs.  Two pharmacy students (Justin Elkins and Chilla Goncz) and I authored “Use of blogs by pharmacists“, which appears in the new issue of the American Journal of Health System Pharmacy.  We identified all blogs that were pharmacist-authored, active (i.e. posts in the last 3 months), and written in English.  Blogs focused on pharmacy, but not written by a pharmacist were excluded.  Forty-four blogs were identified that fit those criteria.  We used the most recent 5 posts to assess the blogs based on six categories (e.g. practice based topics, identifying information, positive language, critical language, professionalism and miscellaneous). 

Most pharmacist blogs (68%) were written anonymously (versus 43% in Lagu’s study of physician and nurse blogs).  Pharmacist bloggers were equally represented by community (43%) and non-community settings (43%); the practice settings of the remainder were indeterminable.  These blogs most commonly used positive language to describe the profession (32%), other health care professionals (25%), and patients (25%).  Critical language was more commonly observed in descriptions of patients (57%); almost half of all posts contained profane or explicit language (48%). 

Most of the blogs (71%) contained mentions of pharmacologic therapies and current healthcare events (66%).  We also noted that 25% of these bloggers had a Twitter account (relative to 11% of the general population in the same timeframe per Pew).  Out of the 11 pharmacist blogs that were ranked by Technorati, all but two were primarily of a ‘ranting’ nature (e.g. Angry Pharmacist, Angriest Pharmacist, Your Pharmacist May Hate You).  Interestingly, the only two ranked, but non-ranting blogs were written by non-US pharmacists. 

Our full AJHP article lists all of the 44 blogs and while it is not open access, my hope is that via ASHP Connect and rapid response that this list of pharmacist blogs can be updated and curated using our article as a starting point.   

@kevinclauson

Three Perspectives on Using Twitter

Recently I have seen another round of the cyclical deluge of posts, pointers, and tips telling people what Twitter is meant for and ‘instructing’ them how they should use it. Most of this advice is invariably wrong simply because there is no certain way that Twitter should be used. It is impossible. Even Twitter doesn’t know what it wants to be when it grows up yet.

However, there are three perpectives about using Twitter that I believe have real merit.  The ties that bind all three are that each touches on a range of uses for Twitter and the tones are personalized and/or contemplative, rather than authoritative.

1. How I Use Twitter as a Killer Filtering App by @Doctor_V [Nov 3, 2010]
    Concise, clean approach that recognizes the fluid nature of the tool and how it can be employed

2. Twitter: filter, suggestion box, idea machine, window by @SusannahFox [Oct 18, 2010]
     Four featured functions of Twitter including example accounts that support each method used

Both of those posts, like all good blog posts, have a number of comments that really add value.  The third perspective is…well, it’s a little different.  I first watched it on my phone and felt like I was watching a cross between Phil Laak and Mike Caro. @AndrewSpong aptly characterized it as “structured free association”.  Just keep your hands inside the car and hang on for the ride that is:

3. The Four Modes of Twitter: Focused, Filtered, Serendipitous and Random by @PhilBaumann via @HealthIsSocial [Oct 29/Nov 4 2010]

I have collected these three perspectives here as a resource for those trying to figure out if it makes sense for them to use Twitter or those trying to get a better idea of Twitter’s utility or lack thereof. The first two perspectives are particularly well-suited for healthcare professionals, researchers, academicians, and students. The third offers more of a James Joyce exploration of the potential of Twitter and is not for the faint of heart. I believe all three have value and hope you find the same.

@kevinclauson

Two Billionaires, The White House, The Rockefeller President and mHealth

The title of this post is shorthand for four of the keynote presenters at next week’s mHealth Summit (follow at #mhs10) in Washington DC.  In addition to these four keynotes by Bill Gates (@BillGates), Ted Turner, Aneesh Chopra, and Judith Rodin, there is a great lineup of speakers and moderators.  There is a dizzying array of tracks and talks to choose from, but for me there are a handful that are particularly relevant.  These include  Najeeb Al-Shorbaji, who directs KMS at the World Health Organization, @SusannahFox of Pew Internet & American Life and e-patients.net, who is asking the right questions and always has cool new data right around the corner, Matthew Holt (@boltyboy), who is behind THCB and Health 2.0 [and who will hopefully be bemoaning Chelsea dropping points the Sunday prior], @JoshNesbit whose video about Frontline SMS I regularly use in my informatics course and who presents one of the most compelling cases for mHealth [seriously, you may be dead inside if it doesn’t speak to you on some level].

I am also really eager to hear from @HajovanBeijma from Text to Change and Susan Dentzer, who has been very forward thinking as EIC at Health Affairs, as well as to meet Walter Curioso, whose work I have long admired.  Since some of the biggest issues facing mHealth deal with scalability, policy, and interoperability, the mHealth Summit promises to be particularly useful as this conference brings together most of the stakeholders necessary to enact change.  I am looking forward to it.  I plan to be livetweeting and possibly liveblogging some, but I may very well get caught up in the presentations and discussions so I can’t make any guarantees.

@kevinclauson

ULP Digital Pharma Nine Notables

Two-thumb typing on telephone at twenty to thirty thousand feet while things are still fresh in my mind from Digital Pharma East.

Digital Pharma was the first Pharma-centric conference I’ve attended.  My usual professional meeting haunts are either focused on HCPs or are a blend of healthcare industry and technology.  I wasn’t completely certain what to expect other than I would likely be among the minority as a ‘representative’ from academia and pharmacy.  That’s plenty of preface, onto the Notables

Notable Keynote
As much as I enjoyed keynotes by Ian Talmadge, Dr. Bertalan Mesko (@Berci), etc., the one that completely floored me was delivered by Dr. Ian Morrison (@seccurve).  It was the perfect blend of style (his seamless comparison of Pimp My Ride to the state of US healthcare) and substance (holistic view of drivers of medication non-adherence).  Spot on observations, great timing, and natural, unforced humor.  The clip on his site does not do him justice. 

Notable Conversation
@LenStarnes is just a really interesting cat. I found him to have a fascinating global perspective, wealth of experience, and he is a darn good storyteller in his own right as well as being a fellow ZX81 owner.

Notable Attendee
Phil Cranch (@cranchtweet), MSPharm, MComm at The Crystal Agency.  He was the only other self-identified pharmacist there who I saw and tied for my fave Aussie.

Notable Anniversary
Congrats to the folks at Pixels and Pills who are a very precocious, collective one.  Remarkable energy, nice approach, no doubt headed for great things.

Notable Recruit
You just watch, I am totally going to figure out a way to poach @Shwen Gwee and get him back to academia where he belongs. Academia needs more driven people who are also savvy.  Don’t worry; I’ll still let him help the ExL Pharma folks.

Notable Transparency
None. I detected no transparency of note. I get that it’s canine-devour-canine and all that, but still a bit disappointing.

Notable Mobile Experience
I can’t help but think if I had talked to @CynthiaNorth 6 months ago that it would have cut off about a month of prep time for our mHealth research protocols and that we, in turn, would have added perspective and experience that would have enhanced their patient adherence piece.

Notable Connection(s)
My post. My rules. Multiple parts to this Notable. @PhilBaumann of Health is Social may just end up being the first social media healthcare futurist. I feel like Dr. Mike Sevilla (@doctoranonymous), despite his notoriety, is underrated as a presence especially given his remarkable longevity. Dr. Bryan Vartabedian (@Doctor_V) simply gets the need for rigorous research in this area and authors a thoughtful, relevant blog.  After speaking to Gilles Fry (@gfry) a few times, I finally figured out a one-word descriptor for where he resides on the ‘Rage Against the Machine’ to ‘Endearing Curmudgeon’ continuum: Fierce.

Notable Omissions
See above re: rules and limits. Somehow digilicious by @JaeSelle did not fit into the Nine despite a potent combination of sculptor, visual enthusiast, and embracing the inner geek.  And where was @jonmrich curator of the Social Media Wiki?  Great googly moogly that thing is useful.  I planned to thank him for those efforts and to tell him to cheer up.  Health literacy, while not omitted from the conversation, was limited to cameos.  Civility seemed to be omitted at a handful of sessions.  Barely activated patients and hesitant healthcare professionals would have made fine additions to some panels to give a fuller picture.  I did not omit any of the stargazing targets.  However, I’ve obviously omitted at least one great connection, one great conversation, and one great find.

@kevinclauson

Stargazing at Digital Pharma East

I am really looking forward to the 4th Annual Digital Pharma East coming up on October 18th in Philadelphia.  In addition to presenting, I plan to do some major stargazing while I am there.  I don’t mean ‘star’ in the manner of the cult of celebrity.  I am defining stars as people who have something really valuable and/or interesting to say.  It feels a little mercenary to go with the express intent of cherry picking knowledge from experts given the themes around sharing – but I guess that’s just part of the allure.

I’m also very much looking forward to reconnecting with Berci Mesko (@Berci) who I have not seen in a couple years, talking shop with social media flag bearer Bryan Vartabedian (@Doctor_V) who will likely be pressed for time from Co-chairing the event, having a face-to-face chat with Phil Baumann (@PhilBaumann) whose mind works unlike any other I’ve encountered in this space, meeting Gilles Frydman (@gfry) who is the final piece of the ePatient trinity, as well as Shwen Gwee (@shwen) who has both tweet cred and does great work.

In addition to those folks, I may be most eager to see presentations by representatives from Comscore and Within3, along with Cluetrain Manifesto author Doc Searls and futurist Ian Morrison.  Needless to say, I am planning to see every single presentation on the final day, which is dedicated to mobile/mHealth.  The rest of the time, it’s just a question of which Stream.  Finally, I am curious to see how the unconference activities and #SocPharm sessions play out relative to previous HealthCamp events I’ve seen.

As for me, I’ll be presenting “Social Media Research: Partnering with Academia”.  The link to the slides on the Digital Pharma conference site will be provided here after the presentation and will be available beyond that at SlideShare as per.  I’m curious to see the reception given that the composition of the audience is pretty different than who I have been interacting with recently.  I definitely have a (relatively) longstanding interest in the subject as one of the first articles we published on the topic was “Legal and regulatory risk associated with Web 2.0 adoption by pharmaceutical companies” in the Journal of Medical Marketing.  We’ve also published several other studies on interactions between different healthcare professionals and representatives from Pharma.  Ultimately, I am banking on the fact that I actually do what I will be talking about and have some concrete takeaways for those interested in the topic.  I’m also optimistic that using an audience response system and building in time for discussion will help make it legitimately interactive.  We shall see.

Overall, I am looking forward to reconnecting and making new connections, planting the seeds for future research collaborations, and learning from area experts that are rarely available in this concentration.  I hope to see you there, hear your thoughts, or cross paths via #DigPharm (or whatever the hashtag ends up being)!

@kevinclauson

Driving Change with mHealth

Click image to view slides

This should be a really interesting semester since it is first time I will be teaching “Consumer Health Informatics and Web 2.0 in Healthcare” in the College of Medicine – Biomedical Informatics Program and in the College of Pharmacy (COP).  This is the third time I have taught this elective in the Masters of Biomedical Informatics (MSBI) Program, but it is the first for Pharmacy (and obviously the first time concurrently).

The COP elective is more traditional as it primarily meets in a classroom; however, it does have some hybrid aspects in that some of the lectures will be asynchronous Tegrity sessions.  The plan is for the students to view those on their own and then have discussion-driven classes following those.  I am also using an audience response system during the COP course to try and promote student engagement.  It is a course delivered via live, interactive video to two of our sites this semester (i.e. Fort Lauderdale and West Palm Beach).  One of the most exciting aspects of the COP course is the calibre of the guest lectures who have agreed to participate this semester.  It is a bit experimental as the guest presenters will be contributing lectures via asynchronous recorded lectures, live via videoconference (e.g. Skype) so that we can also have live Q&A, and live in-classroom. 

For the MSBI offering, it is built to accomodate students in a much wider geographic distribution.  Most of the students this semester are in Florida, but there are also students spending much of their time in places as far as Saudi Arabia.  Regardless, South Florida lends itself to a very diverse population and so there is a strong international presence in most programs anyway.  Because of this distribution, the course is basically delivered online through the use of asynchronous sessions and Live Sessions.  This is a really interesting course due, in part, to the heterogenous nature of the students.  Even though the program is housed in the COM, it allows for varying types of students seeking their Masters.  So far I have had students with backgrounds including practicing pharmacists, physicians, nurses, and scientists along with teachers, businesspeople and computer science experts.  It makes for some pretty lively discussions as the range of experience and expertise among the students can be eye-opening!

So that is a pretty long preface to say that I have posted the slides from one of my favorite lectures of the semester – mHealth.  I think there is enormous potential for mHealth.  I am also happy to be involved in a panel on this topic at the American Society of Health-System Pharmacists Midyear Clinical Meeting in December of this year.  Please feel free to share any feedback you have about the scope, contents, or emphasis of this slide deck.  Every semester in this course I add and delete lecture topics and then tweak and update the existing ones – so your opinions are all welcome.

@kevinclauson

Wikipedia isn’t good enough for anybody except nurses?

The verdict is in.  The quality of health information in Wikipedia is inadequate as a sole source for pharmacists [1], medical students [2], dentists [3], and patients [4].  However, it is good enough for use by nursing students [5]…well, sort of.

Determinations about adequacy are based on studies which evaluated the freely editable, online encyclopedia based on characteristics such as reliability, scope, and accuracy.  A clear consensus has emerged from that body of literature collectively rendering a decision that Wikipedia is not a suitable resource for high level consultation or citation.  The use (and citation in particular) of Wikipedia by healthcare students and professionals seems to irk practitioners and educators moreso when there are high quality alternatives, suggesting the perception that citing Wikipedia in those cases simply reflects a lack of awareness and laziness.  To be fair, Wikipedia founder Jimmy Wales has been unwavering in his stance that no encyclopedia should be used as a reference source for college level work or above. 

All of this leads to the most recent paper on this topic in Nurse Education Today [5].  It, too, is an assessment of health-related entries in Wikipedia.  However, it is notable for two reasons.  First, it differs from almost all the other articles in that it uses a methodology driven by compiling and analyzing the citations from Wikipedia entries rather than the content itself.  Second, the difference in language between the abstract and conclusion is fascinating.  The abstract closes with:

The quality of the evidence taken obtained from the 2500 plus references from over 50 Wikipedia pages was of sufficiently sound quality to suggest that, for health related entries, Wikipedia is appropriate for use by nursing students

Whereas the conclusion of the article is:

Whilst it is acknowledged that Wikipedia citations should be treated with some caution, the results of this modest study suggest that Wikipedia does have a role to play as a source of health related evidence for use by nursing students.

While this type of journal article ‘abstract-text dissonance’ is not completely rare [6,7] it is exacerbated here due to this article’s findings conflicting with every other study on the topic – at least based the abstract.  It also magnifies the problems that can occur when people draw conclusions based on only reading an abstract.  This has long been an issue for busy clinicians desperately trying to stay current.  However, today biomedical journal abstracts are easily accessible by anyone via PubMed (but the full-text usually remains shrouded by subscription access).  Dissemination of these abstracts is even more rapid, sometimes occurring real-time through tools like Twitter, Facebook, and email.  As healthcare professionals, we need to be careful not to fall into the trap of taking a shortcut and assuming skimming an abstract will allow us to critically evaluate a study.  The onus is also on us to help educate aspiring e-patients avoid these same missteps.

Overall, it’s quite possible that the contribution made by the Haigh article may be more significant as a teaching tool than as a piece of the research puzzle regarding the quality of Wikipedia.

@kevinclauson

P.S.  If you have gotten this far, it means you have not fallen prey to a similar phenomena with blog post titles – kudos!


[1] Clauson KA, Polen HH, Boulos MN, Dzenowagis JH. Scope, completeness, and accuracy of drug information in Wikipedia. Ann Pharmacother. 2008 Dec;42(12):1814-21.
[2] Pender MP, Lasserre KE, Del Mar C, Kruesi L, Anuradha S. Is Wikipedia unsuitable as a clinical information resource for medical students? Med Teach. 2009 Dec;31(12):1095-6.
[3] Stillman-Lowe C. Wikipedia comes second. Br Dent J. 2008 Nov 22;205(10):525.
[4] Leithner A, Maurer-Ertl W, Glehr M, Friesenbichler J, Leithner K, Windhager R. Wikipedia and osteosarcoma: a trustworthy patients’ information? J Am Med Inform Assoc. 2010 Jul-Aug;17(4):373-4.
[5] Haigh CA. Wikipedia as an evidence source for nursing and healthcare students. Nurse Educ Today. 2010 Jun 19. [Epub ahead of print]
[6] Ward LG, Kendrach MG, Price SO. Accuracy of abstracts for original research articles in pharmacy journals. Ann Pharmacother. 2004 Jul-Aug;38(7-8):1173-7.
[7] Pitkin RM, Branagan MA, Burmeister LF. Accuracy of data in abstracts of published research articles. JAMA. 1999 Mar 24-31;281(12):1110-1.

Pharmacists’ duty to warn in the age of social media

Healthcare in general and pharmacy in particular, is still finding its way with social media.  One of the least developed elements of Health 2.0 remains the legal aspect.  A few years ago several of us starting discussing scenarios in which a legally valid pharmacist-patient relationship might be created based exclusively on Web 2.0 mediated interactions.  This discussion has been aided, of course, by social media.  Also, as part of an interactive panel at Medicine 2.0 a couple years ago we posed this question (attendees’ responses here).

This discussion has recently been formalized as a Commentary published along with Matthew Seamon PharmD, JD and Brent Fox, PharmD, PhD (@Brent_Fox) in the American Journal of Health System Pharmacy.  An accompanying podcast has also been produced for it by AJHP.  Ideally the article and podcast help promote dialogue and encourage the profession to think proactively on the subject.

@kevinclauson