An Interview with #hcsm Founder @danamlewis

In the last 18 or so months since I blogged about health care and social media from a nurse’s perspective, I’ve seen a jump in interest in how we can mashup healthcare and the Web. Every new territory needs its leaders. One such leader is my friend  Dana Lewis who founded a Twitter chat focused on social media in health care communications. The chat is called Healthcare Social Media and uses the hashtag  #hcsm to rally participants in a weekly conversation Sundays at 8:00pm Central. She recently won the 2009 Excellence in New Communications Award from the Society for New Communications Research.

Dana started #hcsm out of conversations she had with communications consultant  Arik Hanson (a great man to follow on Twitter, especially if you’re interested in 21st Century Public Relations). Twitter chats offer a way for people with shared interests to exchange knowledge and advance a field of study. After starting #RNchat, I gained an appreciation for how these chats are moderated. Dana’s moderation has been an important inspiration and model. So I decided to interview her and it’s my pleasure to bring you the interview.

[UPDATE: Dana made a comment about one of the many people who helped her with #hcsm which I want to highlight. Here’s what Dana had to say about  Tom Stitt, CEO of Aperial:

he and his company Aperial have given #hcsm it’s home away from Twitter & tons of technical support. There are dozens of others who have contributed to #hcsm and supported the development of the model, but he’s at the very top of the list!

Tom has been an important contributor to the healthcare social media community and I agree with Dana that his efforts deserve special recognition.]


You’ve developed quite a following with the Health Care Social Media Twitter chat . Tell us about yourself, your passions and your goals.

DANA: I have a motto: “Doing something for someone else is more important than anything you would do for yourself.” This applies to volunteering for the American Diabetes Association, building the healthcare communications community on Twitter to break down barriers in the industry, and everything else that I do. I am a senior at the University of Alabama graduating in May with two bachelors degrees in Public Relations and Political Science from The University of Alabama. Currently, one of my immediate goals is full-time employment when I graduate, but I don’t believe my full-time experience in communications should be any different from my other experiences in that it will ultimately benefit people both now and in the future.

What got you interested in social media and health care?

DANA: My interest in social media and healthcare mostly stems from my interest in health – which started when I was diagnosed with type 1 diabetes during my freshman year in high school. I have always been a communicator and very passionate about making sure everyone has the ability and right to share their voice. Social media is a natural fit for this passion because it gives me – and everyone else – the tools to share our ideas and insights. Healthcare is obviously a daily part of my life with diabetes, so it is a seamless integration with my other thoughts and experiences on the Web.

As someone who recently started a Twitter chat, I can appreciate the little challenges of moderating and running them that may not be apparent to participants. What have been yours? Tell us about your approach and the tools you use to pull of the chats.

DANA: My biggest challenge for moderating a Twitter chat is spammers – but not in the traditional sense. I have a extremely low tolerance for shameless self-promotion. Personal promotion on occasion is pushing the edge; but companies who tweet to the hashtag about their product, service, clients, etc. are definitely spam. We started as a single conversation, but #hcsm has grown into a community and I am sensitive to protecting it from those who want to “monetize the ROI” of their Sunday evenings.

Other challenges include those who don’t understand the purpose of #hcsm, and get frustrated that we aren’t discussing healthcare reform or their speciality. Because we have such a diverse community (students, doctors, lawyers, non-profits, HC orgs, marketers, etc.), we have a diverse suggestion of topics and thus a diverse discussion. Sometimes those new to the conversation don’t see direct relevance of the first topic and try to flame the discussion so they can talk about something they understand.

My approach is simple: I use to log in to  @HealthSocMed to moderate the discussion. I put out the links to FAQ posted on our site & past transcripts, and try to answer any questions I can about the goals and workings of the discussion on Sunday nights. Participants are the ones who submit topics for discussion; I pick an average of 3-5 for each evening, toss them out, and we have a great conversation!

What’s been the feedback from the community about #hcsm? What value do you think participants derive and how do you think these kinds of chats will evolve?

DANA: The feedback from the community has been incredibly positive and supportive. There is always room for improvement, and we definitely have improved the way #hcsm works since it started back in January. #hcsm gives everyone the opportunity to open-source their problems or questions about the industry and anything related to healthcare communications and social media. There has been nothing like it to my knowledge on Twitter or elsewhere. By using Twitter, it breaks down the age, experience, geographic, and other barriers that often hinder an open dialogue. Anyone and everyone can participate and add value to #hcsm, which is the value in itself.

Chats are going to continue to evolve. We may shift from using Twitter to other tools, but the idea behind #hcsm to break down barriers and to build a conversation will remain the same.

Is PR dead?

DANA: It’s far from dead; PR has shifted, but I think this is a benefit for all. Instead of one-way push information from every channel possible, we have shifted our mindset to adapt and allow for relationalizing communication with different groups of people. I personally love figuring out how I relate to different groups of people; this is why I have a natural love of PR. Those who may be stuck in the traditional mindset of pushing information need to adapt – but the same applies to marketing & many other fields that involved communication and reaching people. PR is continuously evolving and will continue to adapt to the needs & desires of the publics that we relate to.


Health Care is a very wide field and there’s no shortage of opportunities for integrating social software into the various niches of what we refer to as Healthcare (as an industry). The rapid evolution and expansion and infiltration of the Web means that the industry is going to have to pay attention and invest efforts into understanding the radical shifts which electronic connectivity is inducing in the world.

In my opinion, the most cost-effective use of these media right now is using them to convene groups of bright people to explore, share and advance ideas which make differences. Twitter chats represent a novel approach to cultivating the world of fresh ideas and we owe much gratitude to leaders like Dana Lewis who are showing us, every day, how to forge ahead through the dangerous opportunities the Web is weaving in front of our eyes.  Follow, thank and retweet her.

Thank you, Dana!

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Zen and the Art of the Tweet

I’ve been thinking a lot about the nature of our collective mindfulness lately. Every month, millions of more people are increasing their connectivity to the Web. Facebook’s gravity keeps swelling. Twitter continues to flap upwards in users. Mobile devices and operating systems continue to evolve and proliferate. It seems every week a new feature or service or gadget makes a debut.

The Web is not only expanding like a universe but it’s also infiltrating every nook of our daily lives. And it’s expanding and infiltrating at an accelerating pace. What effect is all this happening on our capacity to attentively engage with life? What disciplines and skills and understanding do we need to acquire as the Web continues its unstoppable inflation?


Thousands of years ago certain cultures around the world discovered and cultivated the art of breathing mindfully. In some cases, entire religious traditions grew out of these practices.

Our brains and sense-organs are powerful attention-devices. Our minds are always teaming with thoughts, feelings, hunches and visions. Even asleep, our brains actively stream profuse experiences like dreams. It’s how we survive.

But our very powers of attention and awareness and cognition can distract us from the present-moment happenings of our lives. We’re always breathing, but rarely notice unless we pay attention. And this presents us with a fundamental observation about life: if we’re constantly processing the relentless influx of internal and external sensory data but never focusing our full attention on what happens, how alive are we? For to have a meaningful life, we must feel alive – otherwise we’re just automatons obligated to the patterns made by others and the larger external world.

Being aware of the present moment is the easiest and hardest thing to do. Try it: sit for 5 minutes and pay attention to nothing but your breath. How many times did your mind wander from that simplest of tasks? If you can’t pay attention to your life right now, when do you expect to do it? After you die? In some other world?


Some Buddhists have a phrase for how our minds endlessly flit from one thought to the next:  Monkey Mind. One aim of meditation is to “tame” the Monkey Mind. Not so much to control it, as to pay attention to it – and, in the process of paying attention to a fast-moving mind, paradoxically slow it down to a point where the present moment reveals itself most fully.

Of all social networking sites, perhaps Twitter best exemplifies the electronic version of Monkey Mind. The tiny bursts and pulses of text and hyperlinks stream through the world like flashes of thought across a busy mind. Twitter’s a powerful way to connect with others and receive news and important or trivial nuggets of information. And yet, if you’re not paying attention, it’s easy to get sucked into Twitter Mind – an energetic state of dopamine excitation, where the sense of time is lost.

As more of us use these tools, how do we maintain our sense of mindfulness? How do we tame Twitter Mind? Few of us practice any sort of traditional meditation to discipline our Monkey Mind. Now we have social media. The Social Web is like an extension of the neocortex. It may sound crazy to think that our brains have a new layer, but it’s not a bad way to think about the kind of world the Web is making.

We will need to understand more about the effects of the Web on our brains, on our attention and our ability to feel fully alive between the sliver of light between birth and death that was entrusted to us.


When was the last time you felt the beating of your heart? The breath in and out of your chest? The sound of rain falling on leaf-mush?

Do you know why you’re on Twitter? How long you’re on Twitter?

The Art of the Tweet – if there is one – is this: using the medium to learn something about our world and sharing your unique view of it with us mindfully. Life without mindfulness is a life lost. Twitter may increase your awareness of the world around you but only your mind supplies your life with meaning. How are you  maintaining your mind?

Tweets are like raindrops falling into a stream. So are the moments of your life. Are you paying  attention, or something more expensive?

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Healthcare’s Google-Facebook-Twitter Platform

Image representing Facebook as depicted in Cru...
Image via CrunchBase

Can’t we just have one place on the web where all of us around the world can congregate to acquire reliable health care content, connect patients with each other, have conversations, trade experiences and otherwise partake in the vastness of health care?

That certainly is a dream – an idea which many patients and families and professionals ponder. After all, Google, Facebook and Twitter respectively demonstrate the power of Search, Social Media and Real-time Connection to accomplish a whole host of objectives. What if we had a health care version of such a triad, unified into one platform? Is it do-able? Or, perhaps more importantly, is it necessary?


As tempting as it may be to have a mega health care social platform, I think such a hope is wrecked by the reality of the Web. The Web is an ever-expanding confluence of machines and people and protocols and media. Like a consciousness, it has no Center, no single brain cell that we can point to and say Here it is, the center of our mind! And yet, like a consciousness, it produces the seamless experiences of awareness and connection and action which we view through our browsers and mobile devices and wherever else the Web infiltrates.

Perhaps the very model for any Web platform for health care communities of content and people lies right in the artful sciences beneath health care itself: the evolutionary underpinnings of networks of the tiny cellular gadgets that supply our lives. Yes, our bodies do have central nervous systems, but life owes itself to the vastly distributed cascading of events which aren’t necessarily centrally-controlled. That is, after all, the wonder and power of our universe’s serendipity. The web of life may be metaphor for the web we started spinning years ago.

So I wonder if our primary challenge in weaving a Health Care Web is understanding the nature of evolutionary systems. That perhaps we need to overcome our linear and strict architectural ways of thinking and building, and seek organic views of the Web.

Historically, in our efforts to wage war against dangerous bacteria and viruses, we have taken a decidedly mechanical approach: discover a vulnerability and attack it. It works, for a time. But then subtle mutations succeed and replicate and the vulnerabilities of our tiny enemies become strengths and we start to lose the war again.

So just as we may need radically different approaches to infectious diseases – approaches which advance natural processes versus stemming them – so too may we need a radical re-think in how we work with the Web. Rather than hoping to overlay a single giant complex that dominates the landscape like a Big Mother, we aught to consider the power of local networks and communities, learn to harness de-centralization and discover how to cull order out of chaos.

In many regards, we already are doing these things. Those of us who use media like Twitter have learned to appreciate the value of curation and we’re always seeking out and playing with toys which help us streamline and enhance our consumption and production of information. Patients seeking health-related content or community similarly need ways of finding the right channels.

Perhaps, then, a key feature of health care online is providing media which improve the skills of patients in how to best derive order of out of chaos and separate verifiable fact from dangerous idiocy. How to accomplish such feats? One way is through individual, localized efforts on the part of patients, providers, technologists, librarians, entrepreneurs – charged with large boluses of initiative and courage.


What we may need at the large scale isn’t a giant Google-Facebook-Twitter mashup for healthcare. Maybe what we need are media and tools which connect social graphs of people and databases and communities; which enable face-to-face communities which can be weaved back into the Web; which give permissions to patients and family members to port their data however they see fit; which enable providers to be bright facets at the critical nodes of key connections; which integrate emerging technologies and re-mash them into usable interfaces for expedient and curated information.

The fact about online health care communities is that they are, well, communities. Which is to say that their success depends on the particular dynamics and values of the communities. A service which offers forums for different health-related topics may house an amazing Diabetes group but fall short on Schizophrenia. Furthermore, patients and family members experience illnesses in their own unique ways: what may be a great community for someone with breast cancer may be ineffective (or even dangerous) for another.

We have many ways to go with the Health Care Web. We can’t necessarily busy ourselves with one silver bullet. So I offer one tip to the general public: advocate for change at the local level, using public social media to inspire passionate tribes of talented change agents. We can do that much now, without having to wait for the FDA or some other governmental agency to figure out how to hit the update button on Twitter, let alone how to piece together a Health Care Web.

If we can’t get our own family physician to connect with us on just one social medium, how can we connect the multitude of patients and providers globally?

What do you think? Is a Google-Facebook-Twitter Platform of Health Care achievable? Is it even necessary? Perhaps most importantly: is it something we should even desire, or fear?

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