“The future is integrated” – Social Media in Care Delivery

The quote in the title of the post came from the perspective of an attendee who is not a Kaiser Permanente staff member – I like the multiple meanings:

  • “integrated” in terms of the worlds of social media and the world of the nurse/doctor/care team
  • “integrated” in terms integrated care delivery – this approach has shown success, it is a good starting point for this exploration, rather than a health system that is not organized
  • “integrated” in the way an integrated care delivery system thinks every day – as the model for the future

This came in the context of the futuristic setting of the Sidney R Garfield Healthcare Innovation Center, with its replica of a digital operating room, hospital ward, next generation patient room, and of course, a patient’s home (complete with new IKEA bedroom, see the photos below). It also came from the discussion on my opening keynote (slides at the bottom of this post).

The day went really well. I am excited about several things that we were able to do, with the help of key people at the Garfield Center (@KPGarfield) , and our medical groups:

Exciting aspect # 1. Start with the member/patient story, every time

My partner at the Garfield Center, Aaron Hardisty (@aaronhardisty) introduced the “3×3” technique to me – 3 slides in 3 minutes, always starting with the member story. These were provided thanks to the kp.org team (specifically Tim Kieschnick  @timiti), and led off each presenter’s presentation

It made such a difference – the presentations went from “here’s what our team/company team is does” to “here’s Katherine, and here’s what’s not working, and how we help her.”

As a colleague reminded me a week prior, “Everything for us is about a day in the life of the member.”

This day proved that it is. Vendors, take note.

Exciting aspect # 2. Involving a Kaiser Permanente member

My inner voice told me throughout the planning, “Dave and Regina will never forgive you if you don’t,” so fortunately they don’t have to (for this, anyway). Diane McNally spent the afternoon with us. She is a 40+ year member of Kaiser Permanente, a care giver to herself, family, and friends, and has had extensive experience with our care delivery system. I was delighted that she was with us, and I love the photo that Steve Krizman (@stevekrizman) took, of Diane, the patient, in the foreground, in focus.

She said more than a few things that stuck with me (and I’m paraphrasing):

“There were many times in my care where I was willing to provide input/feedback, but simply no place or opportunity to provide it.”

(sound familiar, Dave “let patients help” deBronkart?)

and when we talked about social network mapping and the idea that we could know who the influencers of a person’s health were so that they could get better care, she turned the tables a bit when she said:

“I’m already engaged in caregiving, I hope you wouldn’t be using this approach to put more caregiver stress on me.”

So instead of using social network mapping to influence the disengaged, she made me think instead it could be used to decompress the over-engaged. Great insight.

Innovation 3. Making the Social Media Tech Demo Social

Thanks to Jan Ground (@janground), from Colorado Permanente Medical Group, Dr. Jeff Benabio (@dermdoc), from Southern California Permanente Medical Group, the Garfield Center, and National Multimedia Services, we filmed before, during, and after, and placed videos on the Kaiser Permanente internal social network, in a bandwidth saving yet quality enhancing way. We supported two-way chat and live handling of questions.

This was an internal event, less for proprietary-ness, more to keep the focus on integrated care delivery and allow those who work in it to apply their experience to what they saw.

The goal: Figuring out how to integrate the relationships people trust (with their physician/nurse/family/friends/community)

There are a lot of smart physicians, nurses, and other clinicians (hello, Physician Assistants!) exploring social media and teaching its use to the professions. Here’s a great example by Enoch Choi, MD, that I just came across (snazzy!)

The teaching and use all tend to stop at the point of sharing personal health information or providing care using these networks.

Earlier this year, when I hosted a discussion on Sermo about social media, I was surprised (really) at how many physicians interpreted “using social media as a physician” as “providing care over Facebook,” with a matching negative response. I kept trying to say, “this is not for providing health care…..”

This day was about  going to where those physicians went in their minds, into the future, visualizing a world where the health care system could be with patients in/on social networks, except safely, privacy appropriately, workflow manageably. Is such a thing possible?

Based on what I saw, yes. However, not in the way people have traditionally thought.

We opened our minds to different kinds of social networking, from quantitative crowdsourcing (where data is aggregated, not sold, and can be used in a physician-patient interaction to improve expectations), to social network mapping, to discrete data sharing from a robust social network to a robust personal health record, to enterprise social networking.

And…we had great, intense, detailed conversations from the green room to the big room. You can see from the photos above that there was a thirst for learning. The future is integrated.

With great thanks to the team at The Garfield Center and our presentation teams: @CureTogether, @MedNetworks, @JiveSoftware, and @indivohealth / @tudiabetes .

Comments/questions welcome!


Ted Eytan, MD