A Question Concerning the Ethics of Social Media Presence

Facebook Business Solutions
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Question: If, as CEO of a company, you personally and passionately oppose Facebook’s Privacy policies and methods, would you withhold having any presence on the site, regardless of what it may cost you?

I’m an advocate for intelligent adoption of emerging technologies and media for individuals, non-profits and businesses. I believe they can be useful, pliant and remarkable tools as part of larger internal and external strategies. But I also believe that the uses of these media need to be integrated in accordance with the specific needs and resources of an enterprise within the larger contexts of what it means to do business.

But one matter is often overlooked, which is what I raised in the question above. What if you believe that a particular medium is run by a company who – in your eyes – has questionable or no ethical standards? Would you shrug off the matter and ultimately decide that you need to reach your customers on Facebook or Twitter or on any other medium which you don’t own and have no say in?

After all, when you set up a Facebook Page, you’re effectively entering a business relationship with Facebook – even if you don’t run ads or otherwise cut a check. Just as any smart and ethical executive would question entering a partnership with an un-trustworthy vendor, shouldn’t executives similarly consider the trustworthiness of the companies who run media sites?

I won’t answer the question here. But I would suggest, that executive leaders (and agencies) fully understand not only the properties of the media companies they use but also the ethical values and practices those companies employ.

We are living in a time when leaders must possess a minimal understanding and proficiency of emerging media. That entails not only a technical understanding of them but also an ethical wisdom and awareness.

Given Facebook’s changing policies with respect to Privacy, Healthcare executives must especially be pondering this question. As my friend Faisal Qureshi aptly stated:

@PhilBaumann if you're a Healthcare CEO you need to be thinking long and hard about using #fb in your marketing mix. #hcsm

@PhilBaumann if you're a Healthcare CEO you need to be thinking long and hard about using #fb in your marketing mix. #hcsm

Companies, and the agencies that advise them, must never forget the fundamental dividing difference between traditional media (print, radio, TV) and emerging media (Twitter, Facebook, Blogs, Forums): the former are hardware while the later are software. Hardware is relatively static and straightforward. Software, on the other hand, is pliant, elusive and unpredictable. Facebook isn’t a as much a medium as it is software. Thus the ethical thinking on media like Facebook, must take this key difference in mind.

Of all of the technologies which  our species has brought forth into the world, perhaps it’s the Question Mark which is our crowning achievement. And with that, I repeat my question to you:

If, as CEO of a company, you personally and passionately oppose Facebook’s Privacy policies and methods, would you withhold having any presence on the site, regardless of what it may cost you?

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fPatient – Ethics and Mediocrity in Healthcare Marketing

I’m not a fan of buzzwords: not only do they tire with time but they also constrict discussion and usually end up being the object of unimaginative and disconnected marketing efforts. In recent years, we have seen the emergence of the ePatient. And sure enough, we can now see that the term is beginning to be usurped by marketers. Of course, the ethics and effectiveness of that kind of marketing depends on the quality of execution.

SAY HELLO TO THE fPATIENT

A new service – which I won’t give direct attention-traction to by linking to its website here – promises to deliver revenues to healthcare organizations wishing to market to so-called ePatients. This service employs the use of a fictive patient named Sara Baker who even has a fictive Facebook profile. The bio on her profile (Page actually) discloses that she isn’t real but “represents healthcare consumers like you and me”. She is an fPatient.

Is that ethical? Is it an acceptable marketing practice to build a fake composite social object in order to facilitate the push for a product or service? There are differing opinions on that – some of which were raised on the weekly healthcare social media Twitter chat hcsm.

In my opinion, I think that the ethical standards for marketing healthcare ideas and products and services must be above board. Why? Because healthcare is a continuum, a stream, and when one part of the industry is tainted by fakery – no matter how seemingly insignificant – there’s always the chance that such fakery can leach into the stream.

One could argue that faux patients have been heavily used in traditional marketing: from billboard ads to television commercials. We perhaps can understand that kind of use given the limited nature of traditional media.

But when it comes to emerging media, especially the kind that allows conversation, it becomes critical that those conversations are honest and sincere and free of sham. That’s the key difference here: Sara isn’t conversing with consumers (someone else or some thing is) – and in spite of the tiny disclosure in her profile, there’s nothing in her stream to indicate that she’s not real – other than the fact that her status updates are droll and mechanical.

MARKETING MEDIOCRITY AND CREATIVE ANEMIA

Which raises another question: Is the deployment of fake profiles in Healthcare Marketing even necessary? Marketing not only has to be effective, it also has to be respectable. Why create a fake social object when so much more social capital can be built by simply being honest and truthful and direct? Why not take advantage of direct interaction and feedback?

Marketing in the 21st Century is evolving. The properties of emerging media are different from the properties of the unilateral mass communications media of TV, print and radio. Marketers who fail to understand those differences and invest in the time and resources to acquire the skills and proficiency for remarkable healthcare communications will eventually suffer a creative anemia.

Sara Baker can fool some people and maybe she’ll help her creators deliver some revenues to their clients. But she’s a mediocre and fake substitute for the hard work required to be remarkable in healthcare communications.

Healthcare Marketers: if you want to have a well-paying career in ten years, know that the cost of Dreck is rising. Fakery is Dreck. In today’s world, Dreck isn’t just bad copy or ugly creative design: it’s in poor social design and mediocrity of voice. Do you honestly want your name associated with Dreck?

You can debate and justify the ethics of using the fPatient ad nauseum but you’re better off investing your time in becoming fluent and proficient in conversational media. Otherwise, forget about social media. You still have some time left to benefit from traditional marketing: most of your customers probably aren’t using social media that much right now anyway. But time is running out.

THERE IS NO SUCH THING AS AN ePATIENT

The fPatient raises one final point here about labels and it’s very pertinent to the fPatient marketing.

It’s convenient to have a simple label to convey a message and make distinctions. When it comes to health care, however, language matters because how we use words influences how we think and feel and behave.

Let’s take two sentences to illustrate:

  1. “Tom is a schizophrenic.”
  2. “Tom has schizophrenia.”

By referring to Tom as a schizophrenic, his disorder is overlayed on his person. But Tom is a human being who happens to have a brain disorder. Tom isn’t his disorder. Such labeling can potentially influence how providers and others interact with him.

But by saying that Tom has schizophrenia, we are clearer in our language and aren’t confusing Tom with his disorder. Make sense?

So let’s extend this reasoning to ePatient. By referring to patients as ePatients, we encounter a similar problem of confusing the person with an aspect of their behavior.

When we say “Tom is an ePatient” what does that mean to a nurse or a doctor? If Sally is also an ePatient, does that mean a nurse should treat Tom and Sally the same with regard to their ePatiency (how’s that for a neologism)?

For when it comes to Tom’s and Sally’s use of online media and the way they speak for themselves, they can have different empowerment styles:

  1. “Tom uses various social media to acquire health care information and communicate with his providers.”
  2. “Sally scours PubMed for her healthcare information, prefers to communicate face-to-face with her providers and actively participates in online diabetes forums.”

That added layer of information is more useful to a provider: she has a better understanding of her patient’s behaviors.

How much value is there in telling a nurse or a doctor that Tom and Sally are ePatients? Perhaps some. But ultimately, providers need to know the specific and relevant characteristics of their patients. A general label probably doesn’t help much.

I’m glad that there are movements like the ePatient movement to raise awareness of the need for empowering patients. Patient empowerment is vital to health care. Responsible providers understand this.

But if words become objects in themselves and result in a new filing system, then they lose their value. Healthcare Marketers need to understand this.

WRAP UP

As I said earlier: Marketing not only has to be effective: it has to be respectable.

When it comes to healthcare communications and marketing, anything less than professionalism and excellence and clarity is Dreck. Not only is it Dreck, it can be harmful: the farther away healthcare communicators are from patients, the easier it is to lose sight of the impact of their messages.

Language matters – no less in health care. Usurping words just because they’re in style may have some effect but in the long-run, marketing and communications require innovation and creativity, clarity and honesty.

Too often, Marketers opt for what appears to be the easy road. But in a world where people can talk back and retweet and take snapshots of your work, going down the easy road may turn out to be a nightmare journey.

If you use fakery to get your message out, don’t be surprised if your message gets drowned out by the sound of your competitor’s fans who adore and respect the real patients who love their products and services.

Let’s hear your thoughts!

Note: upcoming post will be on the uPatient: the Unempowered Patient. We need to have that conversation: there are more unempowered than empowered people in the world.

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Facebook’s Hidden Hate Button – h8

Perhaps the saddest thing about Facebook (note: I do think there are good things) is that most users seem utterly unaware of the way Facebook is changing things; unaware of FB’s ever-changing Privacy settings; little idea about how expansive the recent f8 announcements could be (in fact I’d say a huge percentage of users don’t even know what the heck f8 is or what its impact may have); and perhaps wholly unprepared when their profiles and their data are streaming out in the open publicly.

Most users are using Facebook strictly to post pictures and update their status in the literal way in which Facebook was designed – no sense of re-purposing the software in broader ways. On one hand, it’s great that we can all share our experiences with each other; on the other hand it’s worrying that more users aren’t educated enough about the fundamental nature of these media to make smart connections back to their own lives.

Furthermore, if Facebook becomes the primary place where people congregate, purchase, publish and share, it will become imensely important that users are proficient and savvy and creative in using it *for* their interests as citizens and not against them.

The smallest tweaks in any software can have major implications in their use. Imagine if Facebook had a Hate button. I agree with Scoble: I hope we never see something like that. …But I have a feeling, there’s a Hate button hidden deep within our collective social experience and dynamics just waiting to surface its ugly head in the not-too-distant future.

I hope Facebook’s Fate (f8) isn’t Hate (h8).

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Instant Is Not Real-time

Facebook, Inc.
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Should Enterprise software be like Facebook? That’s a question Salesforce CEO Mark Benioff recently raised. While reading Dennis Howlett’s analysis, Dennis makes a very simple but easy-to-overlook point about the difference between instant media and real-time media. It’s an important point, one I believe gets lost in the noise and hype about social media.

INSTANT CONFUSION

One of my main focuses is health care adoption and employment of software for improving collaboration and communication among patients and doctors and nurses. It’s important, therefore, to understand the property differences between media and the different contexts, conditions and processes needed for successful deployment. What works for consumers (Facebook) doesn’t necessarily work for business.

One of the properties of media like Twitter and Facebook has to do with time. Twitter and Facebook statuses are instant (at least when there are not server errors). Instant is exactly that: immediate, without regard to relevance. Real-time, however, has to do with relevance. In an enterprise, what matters are information flows – and without context and relevance, information is just data.

Real-time is more than just anytime (which is what instant is) – I need the right information delivered at the right time within the right context throughout the right process.

This distinction between instant and real-time is critical because any software developed must take into account the purposes and needs and contexts in order to ensure proper user experience and appropriate results.

So no: I don’t believe Enterprise software should be designed like Facebook. It follows then, that any software designed for patients and hospitals and doctors and nurses must not confuse themselves with consumer applications.

BUILD IT RIGHT AND SPEAK CLEARLY

Therefore, any healthcare enterprise analogues of media like Twitter, must take into account the difference between instant and real-time. The applications must take into account the sociological and informational needs of clinical processes. Otherwise, disaster is certainly built-in.

Software lock-in is a huge problem in technology. I fear that philosophical lock-in of social media philosophy may be one our time’s greatest threats. (As an illustration of what I mean, the Privacy Is Dead mantra is, I fear, just one self-fulfilling instance of social media fallacy – it’s one of the most dangerous myths propounded and accepted by superficial thinking these days – it’s a dangerous mind-virus.)

We need a clear language when discussing technology – especially media technologies. Confusing instant with real-time is sloppy thinking. In a health care context, it’s downright dangerous.

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Healthcare’s Google-Facebook-Twitter Platform

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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?

A GINORMOUS WEB WITH NO CENTER

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.

ALL HEALTH CARE IS LOCAL

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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Google Reader Gets More Social: Here’s Who to Follow

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Just days before Facebook acquired FriendFeed, I talked about why FriendFeed is (was) an important tool. Either I was completely wrong or prescient – you decide. FriendFeed.com’s future may be in question – but the social mode it brought onto the web will likely become more ubiquitous as the social web continues to evolve. Which is why I still believe it’s an important tool.

Enter Google Reader (GR). I’ve always thought that RSS could become a powerful social tool if the right features were added. It seems that the Google Reader team is doing just that. Perhaps we’ll see a more FriendFeed-like Google Reader evolving. We will just have to see. The Google Reader team ( @GoogleReader) has its work cut out, but I suspect they’re working towards turning Reader into a powerful social informational tool.

For now, if you’re interested in “following” some smart people in your Google Reader, here is a real-time list of Google Readers from FriendFeed:

Oh, and you’re certainly welcome to follow me on Google Reader :)

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Why FriendFeed Is An Important Tool

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Today I saw a tweet by  @BonnieRN to  @bthenextstep asking why he uses FriendFeed. Most of the people I know on Twitter don’t use FF (unless Twitter gets nailed by a DoS :) I decided to help her understand over on FriendFeed and I’m embedding the post here.

I think the point about ePaitents is worth noting by those who are interested in developing ways new media can be used in health care. Those of us who are Twitter addicts (and that’s not such a bad thing), need to appreciate that there a billions of other people in the world who have completely different perspectives – people use new media in their own ways. And we need to appreciate much more fully the role cultural differences play in how people use technologies and the communities they spur.

In fact, those of us who are serious about improving health care (online or away from the keyboard) have a duty to transcend our own habits and echo chambers. New media changes everyday – like Ferris Bueller said Life moves pretty fast. You don’t stop and look around once in a while, you could miss it.

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