Twitter may either be the greatest prank ever played on the internet community or it may be the best thing since sliced bread. It’s easy to make the first case if you read the public timeline [now defunct] for a few minutes. It’s a bit harder to make the second case, but I’ll do my best to make it. Specifically, I’d like to take a stab at offering 140 health care uses for Twitter.
Twitter’s simplicity of functional design, speed of delivery and ability to connect two or more people around the world provides a powerful means of communication, idea-sharing and collaboration. There’s potency in the ability to burst out 140 characters, including a shortened URI. Could this power have any use in healthcare? After all, for example, doctors and nurses share medical information, often as short bursts of data (lab values, conditions, orders, etc.).
CHALLENGES OF HEALTH CARE MICRO-SHARING
Unlike most other kinds of uses of Twitter (daily exchanges between friends, the kind of work @Comcastcares does, etc.), health care related matters pose unique challenges, including but not limited to:
- Patient dignity and privacy
- Professional oaths to do no harm
- Litigation concerns
- HIPAA
The possibilities that I believe Twitter offers currently far exceeds the constraints. I won’t offer work-around solutions to these constraints in this post. I want to focus on the possibilities because once we see the potential, we may have stonger motivations to deal intelligently with the constraints. So when reading this list, don’t get hung up on the details, the fears, the anxieties that may be provoked by the realities of health care as it is practiced today. It’s the 21st Century: let’s be imaginative, determined and innovative. Let’s be remarkable.
In the health care industry there is often a fine line between caution and fear. It is the fear of change so common in health care that I hope we can overcome. Twitter may be a proving ground of how we overcome our fears, satisfy our cautions and extend the reach of our health care system with web-based technologies and communities.
What follows are uses than can be adopted right now and uses that remain to be developed. What do you think health care will look like in 2099? Will we still be using paper medical records or will we be using technologies that other industries use? Will we transcend our accustomed ways of thinking and re-socialize ourselves for how we interact with each other in an exponentially changing technoscape?
I hope this list sparks debate to help answer those questions. Here are the suggestions.
140 HEALTH CARE USES FOR TWITTER*
- Tissue recruitment (for kidney and other organs, including blood)
- Epidemiological survey
- Disaster alerting and response
- Emergency response team management
- Supportive care for patients and family members
- Diabetes management (blood glucose tracking)
- Maintaining a personal health diary
- Adverse event reporting in the clinical setting and other pharmacovigilance functions
- Emitting critical laboratory values to nurses and physicians
- Alarming silent codes (psychiatric emergencies, security incidents)
- Drug safety alerts from the FDA
- Risk management communication
- Augmenting telemedicine
- Issuing Amber alerts
- Issuing alerts for missing nursing home residents
- Exercise management and encouragement
- Weight management and support
- Biomedical device data capture and reporting
- Nutritional diary and tracking
- Coordinating preoperative, perioperative and postoperative care (among pharmacy, nursing and surgical services)
- Medical service collaboration in the clinical setting
- Triage management in emergency rooms
- Census management/monitoring
- Arranging outpatient care
- Crowdsourcing for health care resources
- Shift-bidding for nurses and other health care professionals
- Mood tracking (for patients with bipolar and other mood disorders)
- Patient care reminders in the clinical setting
- Prescription management, including pharmacy refill reminders
- Daily health tips from authoritative sources
- Location awareness during crisis
- Occupational safety response
- Hazardous materials communication
- “Quick and dirty” diagnostic brainstorming between physicians (e.g. ’symptom clustering’)
- Clinical case education for (residents following attendings)
- Physician opinion-sharing
- Promoting Domestic Violence awareness
- Raising Child Abuse awareness
- USMLE preparation for medical licensing
- NCLEX for preparation for nursing licensing
- Recruitment of health care staff
- Alcohol and other substance abuse support
- Issuing doctor’s orders
- Environmental alerts: pollen counts, pollution levels, heat waves, severe weather alerts
- Remote wound care assistance
- Rural area health care communication
- Micro-sharing of pertinent patient information
- Micro-sharing of diagnostic results (blood tests, echocardiography, radiological images)
- Internal facility customer service (a hospital equivalent of @Comcastcares – c’mon hospitals!)
- Publishing health-related news
- Psychiatric “check-ins” for patients
- Nursing mentoring and collaboration
- Publishing disease-specific tips
- Childcare support
- Fund raising for hospitals and health-related causes
- Updating patient family members during procedures
- Live-tweeting surgical procedures for education
- Rare diseases tracking and and resource connection
- Reporting hospital staff injuries
- Tracking patient trends
- Tracking disease-specific trends
- Checking hospital ratings with other health care consumers
- Providing around-the-clock disease management
- Connecting genetic researchers with physicians
- Publishing the latest advances in biomedical devices
- Tracking antibiotic resistance
- Real-time satisfaction surveys with immediate follow-up for problem resolution
- Issuing asthma alerts
- Data collection for tracking facility patterns (process-performance, supply-chain and staffing problems)
- Live-tweeting medical conferences
- Keyword-tracking of health-related topics via Search.Twitter
- Posting quick nursing assessments that feed into electronic medical records (EMRs)
- Improving medical rounding systems
- Clinical trial awareness
- Hospital administration
- Sharing peer-to-peer reviews of articles of interest
- Connecting patients with similar disease processes
- Enhancing health-related support groups (e.g. buddy-systems for depression)
- Providing smoking cessation assistance
- Medical appliance support (e.g. at-home: colostomy care, infusion-pumps, wound-vacs)
- Reporting medical device malfunctions
- Tweeting updates to facility policies and procedures
- Arranging appointments with health care providers
- Product safety alerts
- Food safety alerts
- Information on women’s health
- Pain management
- Hospital reputation monitoring
- Publishing hospital-sponsored events in local communities
- Community health outreach
- Bioterrorism awareness and preparedness
- Issuing updates to hospital services to the public
- Insurance claim management
- Ethical, permission-based following of patients
- Micro-sharing consent for surgical and other procedures
- Patient-sharing of health-related experiences
- Posting ‘bread crumbs’ of facility experiences (”I had a bypass at this hospital and it went well but the food almost killed me.”)
- Patient searches for others confronting similar problems
- Stress management
- Mental health awareness
- Posting homeless shelter needs
- Food bank resource management
- Transmitting patient data to patients who are traveling abroad
- Generating streams of authoritative health care content online
- Exposing medical quakery
- Micro-sharing documentation for advanced medical directives
- Discussing public health care policy
- Developing stronger patient-provider relationships
- Tracking the safety and efficacy of pharmaceuticals
- Following health marketing
- Tracking influenza alerts from the CDC
- Exchanging/soliciting scientific validation of alternative health claims
- Following ad-hoc conferences on eHealth like HealthCampPhila
- Tracking toxic diseases
- Tracking HIV news
- Issuing/exchanging dietary tips
- Tweeting what you eat
- Comparing nursing home performance
- Coordinating clinical instruction
- Communicating with nursing supervisors
- Public safety announcements
- Tracking FDA guideline updates
- Tracking the progress of developing pharmaceuticals
- Broadcasting infant care tips to new parents
- Publishing vaccination/immunization services locations, hours and reminders
- Reporting adverse events to FDA (currently not available via Twitter: why not?)
- Obtaining information on Medicare and Medicaid
- Case management functions
- Clinical education coordination
- Facilitating patient-transfer processes
- Patient-information retrieval
- Reporting breeches of universal precautions in health care facilities
- Posting daily nursing tips
- Exchanging physician humor (we’re all human)
- Closing the digital divide with respect to health care information
- Coordinating allied health care services during patient admissions
- Coordinating patient discharges with all services
- Post-discharge patient consultations and follow-up care
- Helping device technicians to communicate directly with manufacturers
- Discussing HIPAA reform in the age of micro-sharing
There they are: 140 health care uses for micro-sharing platforms like Twitter. Implementing these uses can be enormously challenging (and even impossible) on Twitter given today’s constraints. For many of these uses, other more robust and secure micro-sharing platforms will be needed (e.g. Yammer or ESME). Certainly, Twitter offers a model of how micro-sharing can be used for a wide range of purposes. If social media marketers can figure out how to use Twitter, health care professionals can also figure out how to use micro-sharing.
* As of November, 2017, Twitter doubled its character limit to 280. If I have time, I suppose I could add another 140 items to this list 😉
HEALTH CARE SHOULD BE THE LEADER IN MICRO-SHARING
With 26 letters in the alphabet arranged within 140 characters, there are over 1.2 x 10^198 possible character combinations (thank you @symtym). Of course, the number of meaningful sentences is far less than that but a point stands out: there’s a virtually infinite number of short pulses of (meaningful) information that Twitter can facilitate.
With that kind of power, health care should be a leader in micro-sharing, not a lagger.
WHAT HAVE I MISSED? WHAT CAN YOU CONTRIBUTE?
I have probably missed some incredibly important healthcare uses for Twitter. I am also probably missing specific Twitter accounts that should be included as links in the list. Please contribute and I will continue to refine the list.
Visitors: please add to the list, make comments, ask questions, offer critique. It’s your health, it’s your century and it’s your right and responsibility to make this list as practical as possible. I’m doing my best to do my part. Your turn.
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[NOTE: Major edits to this list based on feedback and the nature of the content will be disclosed.]
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