Presentation: Why be Social (Media)? Kaiser Permanente School of Allied Health Sciences

With my colleague and collaborator / protector Vince Golla (@VinceGolla) I had the opportunity to:

I like to say “you can’t be social and anti-social at the same time.” My portion of the presentation (given after awesome case studies provided by Vince that we walked and talked about) was about the Why of using social media as a professional.

  • To communicate (not just “to use technology”)
  • To LISTEN (listening is the ultimate app)
  • To be present (what the people we serve expect from us)
  • To spread contagious ideas (walking meetings, respect for others)
  • To be accountable to the people we serve, which means society (because much of a physician’s education is paid for by society)

The other thing I like to say is that the people who work in health care are exceptional by definition; you have to be in a job this challenging. I could tell on our walks together and in the dialogue that there is no shortage of the drive to be there and be professional for the people we serve, across the health workforce, which includes our allied health professional colleagues.

Enjoy, feel free to embed elsewhere, comments welcome, thank you for the invitation.

We're here! And We do have one kpsahs ❤️👍 School of Allied Health Sciences w the Vincegolla

A photo posted by Ted Eytan (tedeytan) on

Professor Vince Golla at Kaiser Permanente School of Allied Health Sciences
Professor Vince Golla at Kaiser Permanente School of Allied Health Sciences (View on Flickr.com)

Just Read: Reaching the limits of open data and name authenticity: The Circle

Eggers D. The Circle. Vintage Books; 2013. Amazon.comDownload from your local library

The flash opened up into something larger, an even more blasphemous notion that her brain contained too much. That the volume of information, of data, of judgments, of measurements, was too much, and there were too many people, and too many desires of too many people, and too many opinions of too many people, and too much pain from too many people, and having all of it constantly collated, collected, added and aggregated, and presented to her as if that all made it tidier and more manageable—it was too much.

This is a spooky/sataristic fictional view of what happens when the “circle” of social media/privacy loss is completed. My reading of it was prompted by the #MakerDocsDC visit to the US Green Building Council Headquarters (@USGBC) 2 months ago, when we were looking at the brand new LEED dynamic plaque (see: MakerDocsDC: Introducing doctors to green building and LEED at USGBC World Headquarters | Ted Eytan, MD).

The book was well reviewed in the publications below, and yes it’s spooky, and causes some reflection around the notion that we may fill all of our cognitive surplus with tweets, retweets, zings, and counterzings. It’s set in a futuristic place of employment that resembles the GoogleBook campus of the future, where a new employee finds one screen on her desk multiplies to 2 to 3 eventually to 9 as her responsibilities to feed the cloud grow.

Likewise, everyone at the Circle there had been chosen, and thus the gene pool was extraordinary, the brainpower phenomenal. It was a place where everyone endeavored, constantly and passionately, to improve themselves, each other, share their knowledge, disseminate it to the world.

And then there’s the Facebook – LGBT and specifically transgender dustup, from September-October of this year. Interestingly, the reasons given for requiring “authentic names” (their term) on the social network are mirrored exactly in the fictional narrative of The Circle, written one year earlier.

No question about it, it’s tough to operate a large social network, and we’re going to have to manage the data we collect and connect it to useful outcomes (in the case of the LEED plaque, better overall health). In most cases it’s going to be worth it, and we can definitely, on balance, use more transparency in health care and in business. And…you can’t know the limits of technology unless you use it, or in other words, if you know technology you know its limits well, and part of the MakerDoc ethic is to understand technology and its limits, right? See everyone in a few days…

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Health is more than about medicine, as taught to us by…ApplePay

My first transaction. Just a pair of vanilla cones, easily walked off / not to worry.

The day ApplePay was released to the world, I happened to be with a few close friends from the Innovation Learning Network (@HealthcareILN), in Charlotte, NC. Okay, I actually crashed their dinner – it was with people from Kaiser Permanente Colorado (@KPColorado), Robert Wood Johnson Foundation (@RWJF), HealthPartners (@HealthPartners), Nordstrom (@Nordstrom), and our world famous Innovation Consultancy (@KPInnovation) – who wouldn’t want to crash?

What they probably all remember is the drumbeat of my request to find an establishment where I could try ApplePay for the first time. My first transaction ultimately happened in Washington, DC a few days later, which is probably a better place for me to enjoy such a milestone anyway 🙂 .

I remember Tim Cook introducing ApplePay on September 9, 2014 – in my mind it was presented as mostly convenience and ease – the end of the wallet as we knew it – with a little bit of security added on. I wanted to try it just because of the cool factor, because at some level I am an innovator (shh, don’t tell, I try and portray myself as early majority).

What completely caught me off guard was what happened next.

When one, then two major retailers abruptly disabled support not just for ApplePay, but all contactless payment systems over the weekend, security took center stage. And in the process fairly large banks of good will began to experience significant withdrawals…

I have posted about the bank of good will concept previously: Using social media to build up the Bank of Good Will – Businessweek | Ted Eytan, MD, which is otherwise called “Using your peacetime wisely” to build a trusted following in advance of times of crisis.

In this case one of the companies has built a sizable amount of good will based on the decision to discontinue selling tobacco, and a nice rebrand (@CVSHealth @CVS_Extra). Now, watching the twittersphere light up shows what I’d call a significant erosion of that good will, and interestingly, around the issue of “health” in the broad sense.

If you do search of comments directed at @CVS_Extra today (click here to see a realtime search of tweets directed their way), you’ll see a slight reduction in the simmer, with tweets alternating between carved pumpkins and mild to moderate what I’d call “unhappiness” about the decision to shut off contactless payments for all people, even though they’ve been working in stores for several years now. Obviously turning something off that people once had is worse than never having it in the first place.

Looking at the unhappiness though, shows that people are discounting the health rebrand based on a perceived threat to the health of their financial transactions. In other words, they are making a link between their community’s physical health (improved by making tobacco less available) and their personal financial health (degraded, by making secure transactions less available). You can see it in the tweets, several of which I’ve favorited to demonstrate this.

Link to selected tweets connecting financial health and physical health in the era of ApplePay

As I look deeper there are actually people who appear to have joined Twitter just to make their opinion known. And people who don’t even own the required equipment (Apple iPhone 6) who are unhappy.

The issue of security, as explained by Tim Cook, is that the contactless mechanism of ApplePay keeps information held by the consumer, in the consumer’s hands (or their mobile device) and does not transmit it to the retailer – a one time token is created for the purpose of the purchase. The old-fashioned swipe-your-card method transmits a credit card number to the retailer with all the challenges that ensue from that approach (including free credit monitoring, which most Americans, including myself, now have as a result…).

I’m not going to get into the why the retailers made the decision they did and why a competing system is causing grief (plenty online about that), just thought it’s useful to point out this connection from a health perspective.

Health is about wellbeing and security in all forms, including physical, spiritual, financial, that allow people to achieve their life goals.

As I am fascinatedly watching through the lens of ApplePay and the theatre that is social media, consumers are making it known in 2014 that promoting health means promoting all of it. I assume I’m not the only person seeing this (because I’m not that smart and my ideas aren’t that unique) – let me know your observations in the comments…

Crowdsourcing Medicine in the Digital Age, with Bob Wachter, MD

Bob and Ted (click to enlarge) View on Flickr.com

I got to spend time yesterday with one of the “other” social media physicians, Bob Wachter, MD (@Bob_Wachter) as he crowdsources his upcoming book, tentatively titled: “Disrupted: Hope, Hype and Harm at the Dawn of Medicine’s Digital Age.” – see: Crowdsourcing My New Book on How Computerization is Changing the Practice of Medicine in Surprising Ways | Wachter’s World for more.

I think I’ve known Bob since circa 2008 when we discovered that each other knew what a blog was and how to use it 🙂 . Bob is a bit unique in this sense in that there are not many physicians at his level of accomplishment using social media for this duration and this level of authenticity (see: Bob’s Biases | Wachter’s World). And it is true, he did coin the word “hospitalist.”

With all of this in mind, it was relatively easy to give the tour of the Center for Total Health (@KPTotalHealth) and then have a conversation about health information technology, what’s working, where things are going, what’s happening at Kaiser Permanente. I think I’m not supposed to quote everything we said here, to preserve journalistic integrity. Hat’s off / +1 / name your celebration for someone like Bob, who is crowdsourcing this work as it’s being produced. It’s definitely not the norm for authors like him. I do it for presentations whose topics are new to me (see: Crowdsource Request: Being a transgender ally and unconscious bias | Ted Eytan, MD), but really, every blog post is a crowdsource, of me, based on the feedback I get. I can tell Bob works the same way.

I will, though, pull one quote from my archives that might be useful here. It’s from this post in 2011: Now Reading: A Fortunate Man: The Story of a Country Doctor, by John Berger | Ted Eytan, MD – a book that was recommended to me… as a comment on this blog:

It may be that computers will soon diagnose better than doctors. But the facts fed to computers will still have to be the result of intimate, individual recognition of the patient.

That was written in 1966. Yes, 1966.

Two other pieces of work I recommended are:

On the above, no I am not living in the past, believe me. Jack’s leadership approach is very current and continues to guide me, and to live in the future as maybe some of us do requires that we understand where we came from. Sometimes there’s no other precedent around us.

Oh, and don’t forget, health information technology has a role to play in a healthy environment that has less carbon, but only if you do it right : #greenhealthcare part 4: Health Information Technology helps health care be green | Ted Eytan, MD

Bob is super thoughtful, curious, humble, waaaay smarter than he lets on, and open as a leader. That combined with the relationships he’s established in his work is going to make for an informative piece when it’s published. I asked him if he’s capturing his journalistic moments visually on his journey. He said he’s not. I suggest he start….

Mentors around every corner: Holly Potter and Diane Gage-Lofgren

Authentically yours, Diane Gage-Lofgren (View on Flickr.com)

In this decade, someone once said to me, “health care executives are not supposed to be on social media. The risk is too great.” To which I said, “that’s funny, Diane Gage-Lofgren (@DianeLofgren) tweets me all the time.”

In the decade before this one, someone once said in a room of leaders, “How does a health system decide how and when to be visible in the social media space? To which Holly Potter (@htpotter) said, ‘we used to have time to think about that, now we don’t'”

And here I, and a whole generation of doctors, nurses, patients, and health care leaders are, a product of their transformation(s).

As the story is told (and documented on social media, of course, (see: Presentation: Driving Total Health with Health IT and Health 2.0 (HIMSS 2010 – Atlanta) | Ted Eytan, MD), Holly and I had parallel epiphanies based on very different experiences in different (but aligned) organizations.

We came to the same conclusion, which was that our success in changing health care was going to be predicated not on telling people how perfect we are, but on letting people know what we were doing and listening as part of a dialogue.

Diane came into my life as a co-executive sponsor of the effort that supported the renaissance of Kaiser Permanente’s image at the same time it was undergoing a technology and quality renaissance. The outcome of this work is clear, Kaiser Permanente now has 9.3 million members and has the most #1 quality ratings of any health plan in the United States, and the place where I work, the Kaiser Permanente Center for Total Health (@KPTotalHealth) in Washington, DC, regularly receives visitors from all of the world who ask, “how?”

Patients included, Holly Potter (View on Flickr.com)

During Diane and Holly’s tenure, our organization became very facile with telling stories, and not on behalf of our members, with our members. Two very tangible places are the Kaiser Permanente Newscenter, which has now been re-imagined as KPShare, as well as the Kaiser Permanente Care Stories blog.

Diane brought me in to host my very first panel of Kaiser Permanente members, to speak to her organization at their all hands meeting. I still remember that day and the things they told me, especially “Of course you can mention my name in your blog, we WANT people to know what good health care is.” (see: Bringing the Patient Experience to Life : Focus on Patient Stories (Presentation) | Ted Eytan, MD).

Official ‘Patients Included’ badge View on Flickr.com

This led to even more “patients included” experiences that were not just fun, they meant something to everyone involved (see: What member / patient engagement looks like #iRetreatKP | Ted Eytan, MD). Talk about paving the way / making an imprint. Now we’re doing a lot more than bringing members to meetings, we’re involving then the way we design health care, which is a dream come true.

Holly and her team set a new pace for communication with stakeholders. Although she or her team have never (ever) told me what to write on this blog, they have kept a watchful eye over me, in the way I want to be watched – to make sure our members are supported and protected. It’s just the kind of wisdom and judgement that a physician should have in the social media space. Most physicians in the US/world don’t have this. I and my colleagues are lucky.

Humble beginnings, Diane Gage-Lofgren View on Flickr.com

Holly Potter, Setting up a new place to talk about health, in Washington, DC, 2011

Both Diane and Holly have supported myself and other nurses and doctors in connecting with patients and members wherever they are, in whatever venue they are, to further the cause of human-centricity in health and health care.

The most famous of these is of course Regina Holliday (@ReginaHolliday), who, thanks to them has an interview, done by me, memorialized in the Library of Congress (see: It’s here! The Regina Holliday interviewed by Ted Eytan StoryCorps Interview (audio) | Ted Eytan, MD).

There are a lot of other connections I have made with patients, members, that are not famous, but that were made on social media, that allowed a type of listening (by me and the health system) that was previously impossible in health care. The details of those connections will never be published here, but wow, they have been meaningful. They’ve changed my life.

Have you met or known a senior executive, at the top level of an organization, who always takes the time to acknowledge your work, say thanks in messages and in person, over and above what you expect from a senior executive? That’s Diane, who by the way is an accomplished and pretty excellent writer. In my opinion, she’s quite natural in social media as well. If I am considered as good as her, I am in good shape :).

Many gifts from Holly, this is just icing (View on Flickr.com)

Holly has, in her executive role, also set a high bar for engagement, as I referred to at the beginning of this post, by opening up new worlds and people to the health care system, who our country is just learning is and should be in the business of “health.”  Her imprint continues to this day, when people say to me things like, “actually, there is no other health system in this (health) space. Just Kaiser Permanente.”

I just learned that Diane has accepted the role of Senior Vice President for Marketing and Communications for Sharp HealthCare. 

Remember the 20th Century, when career transitions were considered abnormal and health care was opaque on top of that? It resulted in a lot of lost wisdom and innovation for the improvement of health. That’s not the century we’re in now, career transitions do happen, we can learn that there are better ways to do things, and we can want to know about them because our leaders tell us this is the right thing to do. Diane and Holly certainly helped create this new reality.

Thank you!

Now Reading: Hatching Twitter: A True Story of Money, Power, Friendship, and Betrayal

Bilton N. Hatching Twitter: A True Story of Money, Power, Friendship, and Betrayal. Portfolio Hardcover; 2013:304. (find in a local library)

Officially, I’m twitter user approximately 14,000,000 (joining in May 2008), unofficially I’m twitter user approximately 8,000,000 (joining in August, 2007). That’s out of about 500,000,000 users today, 215,000,000 who are active. And still, in 2013, the majority of people I share an industry/profession with, still do not use it. About 16% of Americans do, so we are still in early days (see: Presentation: Why be Social (Media)? BerkeleyISchool | Ted Eytan, MD, and What Internet Users Do Online | Pew Research Center’s Internet & American Life Project).

From that perspective, it was fascinating to read about what people thought Twitter was going to be, and to realize that it’s still not totally defined, any more than e-mail is today (is it for FYIs? Real communication? Something in between?).

One of the main divergent opinions was whether Twitter was going to be about personal status (“What are you doing?”) or about reporting on one’s surroundings (“What’s happening?”). Now the box just says, “Compose new tweet.”

There’s a dramatic component to the story, which I’ll choose not to summarize here, because there are plenty of reviews that do that, I’ve linked to them below.

The one question that I’m left with about leadership after reading the book is, “why is it a goal to emulate Steve Jobs?” This is what Jack Dorsey (@Jack) is portrayed as working to do.

I decided early on that I prefer the personal status approach (championed by Dorsey), because I want to see more humanity in health care. I feel the “what’s happening” model allows a person to displace themselves too much. It’s interesting with this filter to look at others’ feeds, which gives clues about authenticity, curiosity, interest in change. That’s the genius of social media and microblogging, that you can deduce these things fairly easily.

Feel free to comment on which approach you prefer (and if you can, look up your Twiter user #, just for fun).

In the meantime, here’s what I’m doing.

Presentation: Why be Social (Media)? @BerkeleyISchool

I had the opportunity in 2013 to repeat what I got to do in 2011, which is lecture at the University of California School of Information (@BerkeleyISchool) in the following course: Info 290A. Finding Health in the US: Health Care and the Information Economy | School of Information

Below are the title slides from the 2013 lecture and the 2011 lecture. Notice how times have changed? If you do our you don’t please let me know in the comments.

2013 – “Our Cities are Changing”

2011 – “Social Media Creates Revolutions”

There’s a discussion and update on the latest data about social media use, and of course a clip of Regina Holliday (@ReginaHolliday) who is the perfect example of why social media should be used for listening as much as talking. Does that theme come across? 🙂

In terms of what I learned, this current class is mostly not using a lot of social media and definitely not using Twitter very much, which tracks with the national data (from the terrific @PewInternet ) that only 18% of Americans do. It’s a good reminder to social media enthusiasts that there’s a wide gap between the do and don’t.

Rest of the slides are below, enjoy. You can also access them full screen here.

Social media adoption across the generations (charts) – 2013 update

I am having a conversation with my colleagues in the Kaiser Permanente Colorado (@KPColorado) region in August about communicating in the era of social media, so an update of the latest data of internet and social networking adoption is called for :). Luckily, the data is easy to get, easy to trend, with a trip to the Pew Internet & American Life Project (@pewinternet).

The chart above has the latest published data, from February, 2013, based on surveys done in December, 2012. (see: Pew Internet: Social Networking (full detail) | Pew Research Center’s Internet & American Life Project)

So what’s new?

  • There are more Americans using the Internet, it’s now up to 85 % across the population, mostly because it’s 56 % in people age 65+
  • There’s a slight flattening of adoption curve, meaning the generations are starting to resemble each other more in their use of social networking sites
  • As the PewInternet team points out, Twitter use has doubled since November, 2010, but it’s still only 16% across the population – not that many people as one might think

Remember, these numbers are adjusted

To look at these numbers from a health care perspective, you have to look at total population users of social networking and twitter rather than % internet users, as these are reported. The methodology of how this is done is in the 2nd slide of this deck. It mostly affects the more mature generations, since 98% of people age 18-29 use the internet now.

Trends from 2005 – 2013 – in slides below

Enjoy, feel free to use, and thank you Pew Internet and American Life Project!

Should Your Doctor Friend You on Facebook? (Quoted on Mashable)

Should Your Doctor Friend You on Facebook? (Quoted on Mashable).

As the title says, I was quoted in this piece published on Mashable.com (@mashable), written by Andrea Smith (@andreasmith).

And, she did a really nice job in my opinion, putting together the data and information I mentioned in this response to a similar article published in the Seattle Times last year.

I want to recommend the policy paper written in the article, which includes as a co-author my social media collaborator Vinny Arora (@futuredocs):

Annals of Internal Medicine | Online Medical Professionalism: Patient and Public Relationships: Policy Statement From the American College of Physicians and the Federation of State Medical Boards

This is about communication, not social media, or even technology.

The link to the Kaiser Permanente Center for Total Health is actually http://kp.org/centerfortotalhealth , but that’s easy to discover on this blog :).

Dialogue about #hcsm at the 2013 #AAMCJtMtg – Academic Medicine and Social Media

Ask us about @wingofzock, or about the future in general. #hcsm breakout at the 2013 AAMC Joint Meeting, Phoenix, Arizona, USA.

Jennifer Salopek, Bryan Vartabedian, Vinny Arora, Ted Eytan, Sarah Sonies – View on Flickr

Luckily, there’s a comprehensive Storify record of the dialogue I had the opportunity to co-lead yesterday. Bryan Vartabedian, MD (@doctor_V), Vinny Arora, MD (@futuredocs), and I (@tedeytan) were at the 2013 Association of American Colleges (@AAMCtoday) joint gathering of…. essentially the leaders of our academic medicine institutions.

A few things

  • Vinny, Bryan, and I are so aligned in our drive to communicate and promote communication, even if we are not in the same environment or passionate about the same thing at the same time. That to me is a good model for the medical profession. We are part of the same community, the same society, dedicated to making lives better.
  • Really great audience and hosting by the WingofZock team (@wingofzock), specifically Jennifer Salopek (@jsalopek) and Sarah Sonies (@ssonies), and a few special guests, most notably my mother (producer of not one but two University of Arizona-trained physicians) and Anita Samarth (@anitasamarth) – it takes a community!
  • Sponsorship courtesy of Joanne Conroy, MD (@joanneconroymd), who is the Chief Health Care Officer of AAMC. Transforming an organization requires sponsorship, and it shows great foresight to bring this conversation to this group.

Like most humans, I love to learn. I enjoyed learning from these leaders.

Slides and Storify below. Thanks for following along.

@Futuredocs & @Doctor_V" target="_blank">Social Media / Academic Medicine – co-presentation with @Futuredocs & @Doctor_V from Ted Eytan