I am actually in this week’s photograph, with @ChristineKraft, @ReginaHolliday, and @AlanViars , who are, in my mind, some of the best thinkers in the health care community. We visited as part of a Tweetup that was arranged by @CindyThroop. How did we get exposed to innovative ideas before the modern tweetup?

@ePatientDave was also present, radiating with excitement about his work in DC this week, as well as with radio waves from his portable Wi-Fi hotspot, to assist those of us without cell coverage in the underground venue. He’s a provider of all things good wherever he goes….

I specifically remember what Regina and the group said (in paraphrase) – “Show me the DNA of a high quality doctor.” and “Demonstrate that this/you are a doctor that I’m going to love.”

This is a very different need than “Tell me what I need to know about when to get a flu shot.” Not that patients don’t want this information also, of course.

In doing some more reading and experiencing, I thought about the outcome of social media in health care in creating engagement with the profession and health system compared to the outcome of providing information. Beth’s blog has a nice discussion about this (Engage, then Educate) in regard to the San Francisco Symphony. My hypothesis is that the principles are the same.

With that in mind, my colleague Rahul Parikh, MD, a practicing pediatrician and accomplished writer across many venues, worked on an experiment together and we’d like your feedback.

Click on any image to make it larger

This is his physician twitterfeed for patients:

This is him tweeting one way, let’s call it “standard” (more “education”):

This is him tweeting a different way, let’s call it “DNA – Enhanced” (more “engagement”):

Here’s the input we would like:

1. Do you notice the difference in the content/approach?
2. Which way would you want your own doctor. to tweet? (or a different way not shown here)
3. If you were looking to choose a doctor, does either approach draw you more to a potential physician?

Thanks for your comments in the comments, and thanks again to the patients, who continue to demonstrate that they are more than willing to help us perform well for them – all we have to do is ask.

You can also follow and tweet either Rahul (on his professional feed, different than the one above) or myself. Don’t worry, we’ll compare notes.

Of course you can still subscribe via RSS or e-mail, by going here.

Truth be told, I am the least supportive of subscribing via e-mail, and keep thinking to eliminate that option – I can’t believe that people who subscribe read the e-mail that this blog sends every day. So if you are one of those people and find yourself deleting it more often than reading it, feel free to go to the subscription page or send me a note anytime, and I’ll take you off the list. I just want you to be as efficient as possible….

“One of the most actively discussed topics in the Twitter universe over the past couple months has been the idea that teens don’t tweet – at least not as much as older demographics, and certainly not as actively as teens who use other popular social networking sites.

Now, it appears that this story may be shifting. According to new data from comScore, younger users – specifically those in the 12-17 and 18-24 year-old demographics – are Twitter’s fastest growing audience segment. “

Attached is a series of slides that recap my experience learning about home blood pressure monitoring, by trying it on myself, using an innovative device manufactured by Microlife Medical Home Solutions, Inc., called WatchBP Home. (Note: Please see my About page for my conflict of interest and independence statements)

The whole thing was a great experience in learning about the process, and learning about learning, as I tweeted my experience as I went. On that note, I discovered in putting this together that Twitter may not be the best platform, compared to a hosted blog, to use to store information that you want to retrieve later.

I overall think this is a great case study in thinking about innovation in medicine:

• is innovation in home blood pressure monitoring in bluetooth connectivity and IP addresses?
• Is it in design and coaching/guiding that empowers patients to monitor accurately and with confidence?

Of course the two are not mutually exclusive, but what’s the balance in health information technology right now? I wrote about this a bit at the last Innovation Learning Network in person meeting. Slides are below, see what you think. Comments and questions always welcome.

I’ve prepared a link cloud of scientific articles related to the device and home blood pressure monitoring in general, which you can view here.

With thanks to the team at Microlife for allowing me to enjoy this learning experience, and fellow patients Gilles Frydman, ePatientDave, and Jan Oldenburg, for a few gentle reboots of my thinking during my learning, enabled by Twitter!

If you’d like an embeddable version of these slides, you can get them here.

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.