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

Analysis of pharmacy-centric blogs

We’ve seen analyses of blogs by physicians & nurses [1], medical bloggers [2], etc.  However, the excellent article “Analysis of pharmacy-centric blogs: Types, discourse themes, and issues” by Jeff Cain (@jjcain00) is the first analysis of pharmacy-centric blogs.  It appears in the the new issue of the Journal of the American Pharmacists Association and presents a balanced view of the pharmacy blogosphere.  It found that social media promotes transparency (except for authorship).  It also recognized that the degree of disinhibiton in the Web 2.0 world may have contributed to a substantial number of these blogs containing negative content about patients, pharmacy, and other healthcare professionals.  Cain and Dillon categorized 136 pharmacy-related blogs into: news, personal views, student oriented, career focused, etc.  Blog posts were also scored as positive (e.g. demonstrating empathy, supplying helpful drug information), negative (e.g. complaints, foul language), or neutral.  Cain and Dillon asserted that despite three of the top four blog themes being negative, these blogs likely had no real impact on the public perception of pharmacy as their readership “likely does not extend beyond the personal acquaintances of the bloggers and others in the profession”.  Overall, they found a variety of blog types with a preponderance of negative and derogatory posts.  Some primarily positive ones were identified as well.  The authors suggested the personal view blogs may be best used to educate student pharmacists and the profession about issues they will face.

@kevinclauson

[1] Lagu T, Kaufman EJ, Asch DA, Armstrong K. Content of weblogs written by health professionals. J Gen Intern Med 2008;23(10):1642-6.
[2] Kovic I, Lulic I, Brumini G. Examining the medical blogosphere: an online survey of medical bloggers. J Med Internet Res 2008;10(3):e28.

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

National Pharmacy Organizations Form eHealth Collaborative

It is encouraging when something brings all of the major pharmacy players together. In this case, it is the Pharmacy e-Health Information Technology Collaborative, and it is comprised of the Academy of Managed Care Pharmacy (AMCP), Accreditation Council for Pharmacy Education (ACPE), American Association of Colleges of Pharmacy (AACP), American College of Clinical Pharmacy (ACCP), American Pharmacists Association (APhA), American Society of Consultant Pharmacists (ASCP), American Society of Health-System Pharmacists (ASHP), National Alliance of State Pharmacy Associations (NASPA), and the National Community Pharmacists Association (NCPA).  It has also been announced that the Collaborative will have Tom Menighan, BS Pharm, MBA, ScD as Chair and Shelly Spiro, RPh, FASCP (@shellyspiro) as Director.   

The information volley from APhA seems to indicate the Collaborative will initially be focused on the electronic health record (EHR).  That makes sense for now given the mandatory nature of EHR adoption and the financial incentives and disincentives tied to its use.  I’m also heartened to see the formation of this group given the warning signs for pharmacy in the ‘meaningful use’ criteria (which will apparently undergo some minor revisions to “correct a few inconsistencies”).   My hope is that after the Collaborative tackles the admittedly daunting task of EHR implementation, that it turns its attention to other facets of eHealth in which pharmacy is underrepresented and lacks much of a voice.

@kevinclauson

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

Influx of Foreign Pharmacy Graduates

A  paper of ours titled, “Global Education Implications of the Foreign Pharmacy Graduate Equivalency Examination” was just published in the American Journal of Pharmaceutical Education.  It was the brainchild of Dr. Fadi Alkhateeb, who suggested we examine the history and trends of the Foreign Pharmacy Graduate Equivalency Examination.  It was an interesting topic for me as we have an International PharmD program at my University and I have recently been involved with the interview process for those candidates.  My hope is that the review sheds some light on the process and highlights the development of the Big Five candidate countries (i.e., India, Phillipines, Korea, Egypt, Nigeria).  The paper also covers some of the potential for future research in this area.  I think it will be of growing importance as we continue to see an influx of foreign pharmacists looking to practice in the US as well as learn about the the practice of clinical pharmacy to take back to their home countries.

@kevinclauson

How Informatics Will Change the Future of Pharmacy

I recently gave a presentation at the Nova Southeastern University 21st Annual Contemporary Pharmacy Issues program with the above title.  I uploaded the deck to Slideshare and it can be accessed by clicking the image or here.

 

 @kevinclauson

Issues with translating prescription information into other languages in pharmacies

(Click image above to view larger version)

There was a recent news item taken from an article in Pediatrics examining what happens when computerized language assistance services (LAS) are imperfect.  It focused on the erroneous translation of prescription information from English to Spanish in pharmacies in New York and possible consequences.  That was similar to an aspect of our LAS research we highlighted in an interview in The Oncology Pharmacist several months ago.  We are examining related problems as well, including low- and high-tech solutions to varying issues with LAS (e.g. automated LAS kiosks, natural language processing, pictographs).  In December 2009, we presented a poster of the results of a national survey of the use of language assistance services (sometimes called language access services) in community pharmacies.  One of the major concerns in using LAS cited by pharmacists (52.1%) in our study was about mistakes made with translations (written) and interpretations (verbal).  Their concerns appear to be at least somewhat justified based on the results of the Pediatric study.  This is a contributing factor as to why almost half (49.8%) of pharmacists in our survey who have LAS fail to notify their patients of its availability.

@kevinclauson

Federal Pharmacy Forum, PAHO, OAS, APhA and Other Acronyms

 
 

I love living in South Florida, but after this week DC may be my new mistress.  I find the magnitude of what is going on here bordering on unbelievable.  I’ve been here previously, but have never really had an opportunity to take a look around.  I was also struck by the sheer volume of living history in DC.  There are some pretty good restaurants as well from Matchbox (introduced to me by @lostonroute66) to Zaytinya.

Having just returned from a health promotion conference in Puerto Rico, I was able to visit with several folks at the Pan American Health Organization (PAHO) to explore opportunities during this visit.  Some I had met here previously and some were new to me.  There was a common thread throughout the PAHO folks in that they are driven, but warm people…and it is always nice to see the face behind @eqpaho.  I also learned a lot about the Organization of American States (OAS).  I met with a couple people there as well to discuss some upcoming projects.  Finally, I had the opportunity to open the second day of presenters for the Federal Pharmacy Forum.  The Forum directly precedes the American Pharmacists Association (APhA) Annual Meeting (thashtag #apha2010).  The Forum was very much an eye-opening experience for me as the attendees were primarily military pharmacists and technicians with other representatives from the Federal sector as well.  I presented “Debunking Myths About Generational Use of Social Media and Healthcare“.

The keynote on the first day of the Forum (Ginny Beeson) did a great job of laying the groundwork for a dialogue about generational considerations in military pharmacy.  There were also several other topics particularly of interest to me including telepharmacy in the Navy (apparently each branch has a different certification body making widespread rollout across branches almost impossible), pharmacoeconomic studies, medication therapy management (MTM), deployment of pharmacists and the current state of practice of US military pharmacy in Afghanistan.  It definitely made me more thankful for the setting I operate out of and appreciate the challenges of this segment of the profession.

Overall it was a great visit, I learned a lot (including how little I thought I knew), and am looking forward to my next visit.

@kevinclauson

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