• D.C. Summer Jobs Contractor Fired for Posts on Twitter – washingtonpost.com – I believe this speaks to having a good policy and guiding use of social media rather than not permitting it all.

• 5 Terrific Twitter Research Tools – Twitter analysis may well become a new industry. Could have lots of uses in health care.

I am back from Grand Rapids, Michigan, site of the 2009 Innovation Learning Network in person meeting, at Steelcase University Learning Center . It’s a beautiful facility and a great place to bring some of our nation’s leading health care organizations and innovation experts together.

I was given the opportunity to attend by Kaiser Permanente to think about the place of innovation and learning about innovation in medical groups, and was not disappointed. I did not leave the meeting with the answer to the question, “how should a medical group (or any group of clinicians) involve innovation in their activities to learn to be better clinicians and deliver excellent care?” I did leave feeling that the question is important to explore, though.

First some specifics:

Our #ILN09 twitterstream shows what we did step by step. On the second day, we were treated to a closer look at the work of the Steelcase Nurture team, from the way they approach their work to the “why?” it is important. Part of this tour included a very enthusiastic look at the products, given to us by Libby Ferin, Director Experience Marketing & Communications.

The thing that I noticed both in Libby’s comments and even in things like which books were selected to be placed in the showroom was an integrated belief in the importance of the role of the patient and family in care. She referred to a prototype hospital room not as a patient room, but as a patient/partner/family room.

In the room itself, note that the patient and family have a view into the electronic health record that is tied to the role of the person in the room (based on a sensor located at the room’s entrance). Every room has spaces for families to engage, in recognition of the fact that “visiting hours” are long-ago concept. The lights over the sink that blink until new visitors wash their hands are a great way for patients and families to be involved in infection control efforts in a soothing way….

Clearly, we were touring a product showroom (and I don’t endorse any third party products or services on this blog, see my about page about conflict interest and independence of financial ties), the essence of my impression is that an organization in an industry outside of health care can be a model for health care organizations in reinforcing the best ways to work with patients and families.

The look at the products was tied to a look at the process, which includes two terms I haven’t heard before, but celebrate: “Evidence Based Design,” and “Participatory Design.” We know there is evidence-based medicine. Now that participatory medicine is becoming a part of health care, it has an analog in another industry, this is good.

As an aside, I really liked the way the Nurture design team presented their process, by printing out the slides and taping them to a board. It’s simple, sets expectations for the audience, and forces a focus on images and feelings rather than words:

What are some specific content things I took away from this meeting?

1. Where is design in the HIT stimulus package? Much like a municipality might have an “arts tax” on public works, I think that a portion of the resource going to place technology in health care should be devoted to supporting the richest environment for its use. This is everything from placement, to lighting, presence or absence of sound (Kristen Juel from Kaiser Permanente hosted a fascinating conversation about the role of music in health care settings).
2. What is the role of innovation/design in the success or failure of personal health care? Amy Tenderich has been a leader in thinking about this for diabetes. What about high blood pressure, an activity that is highly recommended but poorly practiced? We saw a great case study of how the “fridge pack” for soft drinks dramatically increased the consumption of aluminum. What’s the “fridge pack” for home blood pressure monitoring?

And on the deeper question…innovation in health care and among clinician groups: I think there’s a role for both learning about the techniques of innovation and applying them to solve problems in health care, and patients and those who care for them (physicians, nurses, allied health) should be involved, especially those closest to the patient(s) and their families.

I don’t know of organizations outside the Innovation Learning Network supporting exploration of this question and some of the answers, so from this perspective it was a great experience. If any of the readers of this blog know of other organizations stimulating these discussions, please feel free to post that information in the comments, or your answer(s) to the question about how and why medical groups or clinicians should integrate innovation learning and skills into their work.

In 2009, you can learn a lot about what’s going on in an environment (a conference, a person’s life), by looking at their status updates. Nice analysis by Chris Hogg.

• ACP Internist, April 2009 – Twitter: a medical help, hindrance or hype? – As quoted in the article, I believe what I said, that I’m not 100% sure how Twitter will impact the care experience of the present/future, but I think it will somehow.

• D.C. Homeless People Use Cellphones, Blogs and E-Mail to Stay on Top of Things – washingtonpost.com – Pointing to the ubiquity of connectivity. Think Twitter for condition management.

• The Psychology of Twitter | World of Psychology – Informative article and nice display of Tweets from empowerment supporters Jen McCabe Gorman and ePatientDave to boot.

Surgeons send ‘tweets’ from operating room – CNN.com

Dr. Craig Rogers, the lead surgeon in the Henry Ford surgery, said the impetus for his Twittering was to let people know that a tumor can be removed without taking the entire kidney.

“We’re trying to use this as a way to get the word out,” Rogers said.

This is great! Now, let’s twitter people successfully managing chronic illnesses with the support of their friends and family. I’m still working on my twitterBP-bot, got a little sidetracked…..

• Twitter under the microscope, from HP labs – even when using a very weak definition of “friend” (i.e., anyone who a user has
  directed a post to at least twice) we find that Twitter users have a very small number of
  friends compared to the number of followers and followees they declare. This implies the
  existence of two different networks: a very dense one made up of followers and followees, and
  a sparser and simpler network of actual friends.

• Understanding HP Lab’s Twitter Research – A few months ago, I spent an entire day with the HP Labs group in Palo Alto, they’re responsible for the R&D and innovation that goes into their thousands of technology products on the market. I was pleased to see this deep dive scientific research on Twitter by Bernardo A. Huberman, Daniel M. Romero and Fang Wu.