Social Media in Clinical Practice by Bertalan Meskó [Book Review]

13 09 2013

How to review a book on Medical Social Media written by an author, who has learned you many Social Media skills himself?

Thanks to people like Bertalan Meskó, the author of the book concerned,  I am not a novice in the field of Medical Social Media.

But wouldn’t it be great if all newcomers in the medical social media field could benefit from Bertalan’s knowledge and expertise? Bertalan Meskó, a MD with a  Summa Cum Laude PhD degree in clinical genomics, has already shared his insights by posts on award-winning blog ScienceRoll, via Twitter and Webicina.com (an online service that curates health-related social media resources), by giving presentations and social media classes to medical students and physicians.

But many of his students rather read (or reread) the topics in a book instead of e-learning materials. Therefore Bertalan decided to write a handbook entitled “Social Media in Clinical Practice”.

This is the table of contents (for more complete overview see Amazon):

  1. Social media is transforming medicine and healthcare
  2. Using medical search engines with a special focus on Google
  3. Being up-to-date in medicine
  4. Community sites Facebook, Google+ and medical social networks
  5. The world of e-patients
  6. Establishing a medical blog
  7. The role of Twitter and microblogging in medicine
  8. Collaboration online
  9. Wikipedia and Medical Wikis
  10. Organizing medical events in virtual environments
  11. Medical smartphone and tablet applications
  12. Use of social media by hospitals and medical practices
  13. Medical video and podcast
  14. Creating presentations and slideshows
  15. E-mails and privacy concerns
  16. Social bookmarking
  17. Conclusions

As you can see, many social media tools are covered and in this respect the book is useful for everyone, including patients and consumers.

But what makes “Social Media in Clinical Practice” especially valuable for medical students and clinicians?

First, specific medical search engines/social media sites/tools are discussed, like (Pubmed [medical database, search engine], Sermo [Community site for US physicians], Medworm [aggregator of RSS feeds], medical smartphone apps and sources where to find them, Medical Wiki’s like Radiopaedia.
Scientific Social media sites, with possible relevance to physicians are also discussed, like Google Scholar and Wolphram Alpha.

Second, numerous medical examples are given (with links and descriptions). Often, examples are summarized in tables in the individual chapters (see Fig 1 for a random example 😉 ). Links can also be found at the end of the book, organized per chapter.

12-9-2013 7-20-28 Berci examples of blogs

Fig 1. Examples represented in a Table

Third, community sites and non-medical social media tools are discussed from the medical prespective. With regard to community sites and tools like Facebook, Twitter, Blogs and Email special emphasis is placed on (for clinicians very important) quality, privacy and legacy concerns, for instance the compliance of websites and blogs with the HONcode (HON=The Health On the Net Foundation) and HIPAA (Health Insurance Portability and Accountability Act), the privacy settings in Facebook and Social Media Etiquette (see Fig 2).

12-9-2013 7-40-18 berci facebook patient

Fig. 2 Table from “Social Media in Clinical Practice” p 42

The chapters are succinctly written, well organized and replete with numerous examples. I specifically like the practical examples (see for instance Example #4).

12-9-2013 11-19-39 berci example

Fig 3 Example of Smartphone App for consumers

Some tools are explained in more detail, i.e. the anatomy of a tweet or a stepwise description how to launch a WordPress blog.
Most chapters end with a self test (questions),  next steps (encouraging to put the theory into practice) and key points.

Thus in many ways a very useful book for clinical practice (also see the positive reviews on Amazon and the review of Dean Giustini at his blog).

Are there any shortcomings, apart from the minimal language-shortcomings, mentioned by Dean?

Personally I find that discussions of the quality of websites concentrate a bit too much on the formal quality (contact info, title, subtitle etc)). True, it is of utmost importance, but quality is also determined by  content and clinical usefulness. Not all websites that are formally ok deliver good content and vice versa.

As a medical  librarian I pay particular attention to the search part, discussed in chapter 3 and 4.
Emphasis is put on how to create alerts in PubMed and Google Scholar, thus on the social media aspects. However searches are shown, that wouldn’t make physicians very happy, even if used as an alert: who wants a PubMed-alert for cardiovascular disease retrieving 1870195 hits? This is even more true for a the PubMed search “genetics” (rather meaningless yet non-comprehensive term).
More importantly, it is not explained when to use which search engine.  I understand that a search course is beyond the scope of this book, but a subtitle like “How to Get Better at Searching Online?” suggests otherwise. At least there should be hints that searching might be more complicated in practice, preferably with link to sources and online courses.  Getting too much hits or the wrong ones will only frustrate physicians (also to use the socia media tools, that are otherwise helpful).

But overall I find it a useful, clearly written and well structured practical handbook. “Social Media in Clinical Practice” is unique in his kind – I know of no other book that is alike-. Therefore I recommend it to all medical students and health care experts who are interested in digital medicine and social media.

This book will also be very useful to clinicians who are not very fond of social media. Their reluctance may change and their understanding of social medicine developed or enhanced.

Lets face it: a good clinician can’t do without digital knowledge. At the very least his patients use the internet and he must be able to act as a gatekeeper identifying and filtering thrustworty, credible and understandable information. Indeed, as Berci writes in his conclusion:

“it obviously is not a goal to transform all physicians into bloggers and Twitter users, but (..) each physician should find the platforms, tools and solutions that can assist them in their workflow.”

If not convinced I would recommend clinicians to read the blog post written at the the Fauquier ENT-blog (refererred to by Bertalan in chapter 6, #story 5) entiteld: As A Busy Physician, Why Do I Even Bother Blogging?

SM in Practice (AMAZON)

Book information: (also see Amazon):

  • Title: Social Media in Clinical Practice
  • Author: Bertalan Meskó
  • Publisher: Springer London Heidelberg New York Dordrecht
  • 155 pages
  • ISBN 978-1-4471-4305-5
  • ISBN 978-1-4471-4306-2 (eBook)
  • ISBN-10: 1447143051
  • DOI 10.1007/978-1-4471-4306-2
  • $37.99 (Sept 2013) (pocket at Amazon)




Medpedia, the Medical Wikipedia, is Dead. And we Missed its Funeral…

12 07 2013

In a post about Wikipedia in 2009 I suggested that initiatives like Ganfyd or Medpedia, might be a solution to Wikipedia’s accuracy and credibility problems, because only health experts are allowed to edit or contribute to the content of these knowledge bases.

MedPedia is a more sophisticated platform than Ganfyd, which looks more like a simple medical encyclopedia. A similar online encyclopedia project with many medical topics, Google Knol, was discontinued by Google as of May 1, 2012.

But now it appears Medpedia may have followed Google KNOL into the same blind alley.

Medpedia was founded in 2007 [2a] by James Currier, an entrepreneur and investor [2b], and an early proponent of social media. He founded the successful Tickle in 1999, when the term Web 2.0 was coined, but not yet mainstream. And his list of  investments is impressive: Flickr, Branchout and Goodreads for instance.

On its homepage Medpedia was described as a “long term, worldwide project to evolve a new model for sharing and advancing knowledge about health, medicine and the body.”
It was developed in association with top medical schools and organizations such as Harvard, Stanford, American College of Physicians, and the NHS. Medpedia was running on the same software and under the same license as Wikipedia and aimed both at the public and  the experts. Contrary to Wikipedia only experts were qualified to contribute to the main content (although others could suggest changes and new topics). [3, 4 , 5, 6] In contrast to many other medical wikis, Medpedia featured a directory of medical editor profiles with general and Medpedia-specific information. This is far more transparent than wikis without individual author recognition [5].

Although promising, Medpedia never became a real success. Von Muhlen wrote in 1999 [4] that there were no articles reporting success metrics for Medpedia or similar projects. In contrast, Wikipedia remains immensely popular among patients and doctors.

Health 2.0 pioneers like E-Patient Dave (@ePatientDave) and Bertalan Meskó (@berci) saw Medpedia’s Achilles heel right from the start:

Bertalan Meskó at his blog Science Roll [7]:

We need Medpedia to provide reliable medical content? That’s what we are working on in Wikipedia.

I believe elitism kills content. Only the power of masses controlled by well-designed editing guidelines can lead to a comprehensive encyclopaedia.

E-patient Dave (who is a fierce proponent of participatory medicine where everyone, medical expert or not, works in partnership to produce accurate information), addresses his concern in his post

“Medpedia: Who gets to say what info is reliable?” [8]

The title says it all. In Dave’s opinion it is “an error to presume that doctors inherently have the best answer” or as Dave summarizes his concern: “who will vet the vetters?”

In addition, Clay Shirky noted that some Wikipedia entries like the biopsy-entry were far more robust than the Medpedia entries [9,10 ].

Ben Toth on the other hand found the Atrial Fibrillation-Medpedia item better than the corresponding Wikipedia page in some respects, but less up-to-date [11].

In her Medpedia review in the JMLA medical librarian Melissa Rethlefsen [5] concludes that “the content of Medpedia is varied and not clearly developed, lacks topical breadth and depth and that it is more a set of ideals than a workable reference source. Another issue is that Medpedia pages never ranked high, which means its content was hardly findable in today’s Google-centric world.

She concludes that for now (2009) “it means that Wikipedia will continue to be the medical wiki of choice”.

I fear that this will be forever, for Medpedia ceased to exist.

I noticed it yesterday totally by coincidence: both my Medpedia blog badge  and Mesko’s Webicina-“Medical Librarianship in Social Medicine”-wiki page were redirected to a faulty page.

I checked the Internet, but all I could find was a message at Wikipedia:

‘It appears that Medpedia is now closed but there is no information about it closing. Their Facebook and Twitter feeds are still open but they have not been updated in a few years. Their webpage now goes to a spam site.

I checked the Waybackmachine and found the “last sparks of life” at January 2013:

11-7-2013 23-57-49 waybackmachine medpedia

This morning I contacted Medpedia’s founder James Currier, who kindly and almost instantly replied to all my questions.

These are shown (with permission) in entirety below.

=============================================================================

[me: ] I hope that you don’t mind that I use LinkedIn to ask you some questions about Medpedia.

{James:] I don’t mind at all!

Is Medpedia dead? And if so, why was it discontinued?

For now it is. We worked on it for 6 years, had a fantastic team of developers, had fantastic partners who supported us, had a fantastic core group of contributors like yourself, and I personally spent millions of dollars on it. In other words, we gave it a really good effort. But it never got the sort of scale it needed to become something important. So for the last two years, we kept looking for a new vision of what it could become, a new mission. We never found one, and it was expensive to keep running.
In the meantime, we had found a new mission that Medpedia could not be converted into, so we started a new company, Jiff, to pursue it. “Health Care in a Jiff” is the motto. Jiff continues the idea of digitizing healthcare, and making it simple and transparent for the individual, but goes after it in a very different way. More info about Jiff here: https://www.jiff.com and here https://www.jiff.com/static/newsJiff has taken our time and attention, and hopefully will produce the kinds of benefits we were hoping to see from Medpedia.

Why weren’t people informed and  was Medpedia quietly shut down?

We definitely could have done a better job with that! I apologize. We were under a tight time frame due to several things, such as people leaving the effort, technical issues around where the site was being hosted, and corporate and tax issues after 6 years of operating. So it was rushed, and we should have figured out a way to do a better job of communicating.

Couldn’t the redirection to the spam-site be prevented? And can you do something about it?

I didn’t know about that! I’ll look into it and find out what’s going on.*

Your LinkedIn profile says you’re still working for MedPedia. Why is that? Are there plans to make a new start, perhaps? And how?

Yes, I haven’t updated my LinkedIn profile in a while. I just made that change. We have no current plans to restart Medpedia. But we’re always looking for a new mission that can be self sustaining! Let me know if you have one.

And/or do you have (plans for) other health 2.0 initiatives?

Jiff is our main effort now, and there’s a wonderful CEO, Derek Newell running it.

I know you are a busy man, but I think it is important to inform all people who thought that Medpedia was a good initiative.

Thank you for saying you thought it was a good initiative. I did too! I just wish it had gotten bigger. I really appreciate your questions, and your involvement. Not all projects flourish, but we’ll all keep trying new ideas, and hopefully one will break out and make the big difference we hope for.

*somewhat later James gave an update about the redirection:

By the way, I asked about the redirect, and found out that that that page is produced by our registrar that holds the URL medpedia.com.

We wanted to put up the following message and I thought it was up:

“Medpedia was a great experiment begun in 2007.
Unfortunately, it never reached the size to be self sustaining, and it ceased operations in early 2013.
Thank you to all who contributed!”

I’m going to work again on getting that up!

============================================================================

I have one question left : what happened with all the materials the experts produced? Google Knol gave people time to export their contributions. Perhaps James Currier can answer that question too.

I also wonder why nobody noticed that Medpedia was shut down. Apparently it isn’t missed.

Finally I would like to thank all wo have contributed to this “experiment”. As a medical librarian, who is committed to providing reliable medical information, I still find it a shame that Medpedia didn’t work.

I wish James Currier all the best with his new initiatives.

References

  1. The Trouble with Wikipedia as a Source for Medical Information
    (https://laikaspoetnik.wordpress.com) (2009/09/14)
  2. [a] Medpedia and [b] James Currier , last edited at 6/30/13*  and 7/12/13 respectively (crunchbase.com)
  3. Laurent M.R. & Vickers T.J. (2009). Seeking Health Information Online: Does Wikipedia Matter?, Journal of the American Medical Informatics Association, 16 (4) 471-479. DOI:
  4. von Muhlen M. & Ohno-Machado L. (2012). Reviewing social media use by clinicians, Journal of the American Medical Informatics Association, 19 (5) 777-781. DOI:
  5. Rethlefsen M.L. (2009). Medpedia, Journal of the Medical Library Association : JMLA, 97 (4) 325-326. DOI:
  6. Medpedia: Reliable Crowdsourcing of Health and Medical Information (highlighthealth.com) (2009/7/24)
  7. Launching MedPedia: From the perspective of a Wikipedia administrator (scienceroll.com) (2009/2/20)
  8. Medpedia: Who gets to say what info is reliable? (e-patients.net/) (2009/2/20)
  9. Clay Shirky at MLA ’11 – On the Need for Health Sciences Librarians to Rock the Boat (mbanks.typepad.com) (2011
  10. Wikipedia vs Medpedia: The Crowd beats the Experts (http://blog.lib.uiowa.edu/hardinmd/2011/05/31
  11. Medpedia and Wikipedia (nelh.blogspot.nl) (2009/10/08)
  12. Jiff wants to do for employer wellness programs what WordPress did for blogs (medcitynews.com)
  13. Jiff Unveils Health App Development Platform, Wellness Marketplace (eweek.com)




Silly Sunday #43 Know Your Numbers

20 11 2011

As I touched upon in Grand Rounds 8.5 the Mayo Clinic Center held the 3rd Social Media’s Health Care Social Media Summit a few weeks ago. Lots of good information and resources were shared, including the video below. The video has already gone viral (it has been viewed appr. 24,000 times), but most important is that its message gets viral.

The song is a parody of 867-5309/Jenny, produced by the Mayo Clinic Center* to promote healthy heart awareness, especially among women:

Heart disease is the number one killer of men and women, but most women aren’t aware of this.

You need to know your numbers, don’t let them get too highblood pressure, lipids and BMI

I love it & remember, know your numbers!

Go to http://knowyournumbers.me/ to calculate your heart risk (BMI and LDL-cholesterol) and see how you can lower it.

You can become a fan of Mayo Clinic at Facebook:
http://www.facebook.com/MayoClinic

* For this purpose, the band of Ron Menaker, the administrator for the Mayo Clinic Division of Cardiovascular Diseases, was renamed to “Tommy and the Heartbeats” (see The  Making of  Know Your Numbers) .

Hattip: Scott Hensley (Facebook)





E-Patients & I-Patients?

24 05 2010

I read an interesting post -or perhaps rather a kick-off for a discussion- at Lucien Engelen’s posterous blog:

“To be or not to be : E-patient or I-Patient.

Lucien feels that e- and i-patients are not the same:

  • An e-patient is a (ex-) patient able to advocate patients rights, needs, experiences and able to advice healthcare institutions in a neutral way on steps to be made in REshaping healthcare, so more an ambassador-role.
  • An i-patient is a patient who uses the internet for information, sharing moods, questions experiences etc.

People who comment on his post do not see the need for a division between e- and i-patients.

Freek Bodemeijer for instance found that the division would make no sense as nowadays almost all Western patients use the Internet to look up information. In his view the ambassador role goes beyond the usage of e-tools.

E-patient “par excellence” E-Patient Dave deBronkart has more or less the same opinion: two overlapping memes are harmful from a marketing perspective,  but in the academic / analyst world a taxonomy of E-patient subtypes would be helpful.

While I agree that creating more terms (and certainly abbreviations) is not always clarifying and while I’m also skeptic that one can force new definitions, Lucien touches upon an important aspect: “when is an e-patient an e-patient?”

The definition of E-patients is not unequivocal.

Wikipedia, the e-medium also for e-medicine (although not always as accurate as we would like it to be [1]) defines e-patients as follows:

e-Patients (also known as Internet Patient, or Internet-savvy Patient) are health consumers who use the Internet to gather information about a medical condition of particular interest to them. The term encompasses both those who seek online guidance for their own ailments and the friends and family members (e-Caregivers) who go online on their behalf. (…)”

According to another definition (also mentioned Wikipedia):

They [e-patients] are equipped, enabled, empowered, engaged, equals, emancipated and experts:

  • Equipped with the skills to manage their own condition.
  • Enabled to make choices about self-care and those choices are respected.
  • Empowered
  • Engaged patients are engaged in their own care
  • Equals in their partnerships with the various physicians involved in their care
  • Emancipated
  • Expert patients can improve their self-rated health status, cope better with fatigue and other generic features of chronic disease such as role limitation, and reduce disability and their dependence on hospital care.
These two definitions of e-patients are overlapping but certainly not identical.
Use of Internet is necessary but not sufficient to become an E-patient in the latter sense (from now on written with a capital E to indicate the difference)

So in a way the former e-patient is what Lucien calls an “an i-patient”, a health consumer who uses the Internet to gather information about his/her/a friends or a relative’s disease.

This i-patient definition is in line with the definition and the current use of the word e-health:
eHealth (also written e-health) is a relatively recent term for healthcare practice which is supported by electronic processes and communication. (…) some would argue it is interchangeable with health care informatics (…), while others use it in the narrower sense of healthcare practice using the Internet. The term can encompass a range of services that are at the edge of medicine/healthcare and information technology, i.e.

But this definition does no right to the true meaning of e-health. I agree with the one-liner of Prof Bas Bloem, who initiated Parkinson Net in the Netherlands [2]

“Health 2.0 is not “the world of gadgets”, but a new way of thinking in healthcare”

Similarly, an E-patient compares to an i-patient (or e-patient) as a real web 2.0 attitude compares to being on Facebook or using whatever Web 2.0 tool.

Web 2.0 is “sharing”, in contrast to Web 1.0 which is “finding”.

So Lucien’s i/e-patient is only finding information and a true E-patient is sharing his/her own experience or knowledge to learn more about a disease him-/herself or to inform and help others. Some of these empowered patients grow into an ambassador role.

To be really empowered, patients should (generally)* not act on their own, they need other patients, doctors (and/or other healthcare worker) too. For real engagement all have to share knowledge, experience, thoughts and information.

And as an information specialist I have to add, that finding information doesn’t mean a lot, if the information isn’t reliable. Many patients (and alas also doctors) adopt Internet information, without checking the source.
How did the anti-vaccine sentiment become so powerful? Why do so many people turn to ineffective alternative medicine? Dr Google also feeds hypochondria.
Admittedly there are many success stories of patients finding crucial new information via the Internet, that wasn’t provided by their doctor. But good care doesn’t stop there.

So, although we do not need to invent new names, the awareness should grow, that the E-patient doesn’t not stop where dr Google ends, it is not passive, needs the involvement of doctors too and requires the (free) availability of good information on the Internet.

For this we need a ReShape, I agee with Lucien. But the reshape has already begun with patient-advocates like E-patient Dave, Gilles Frydman (@gfry on Twitter) and Sussanah Fox of e-patients.net of  and with the initiatives of doctors like Bas Bloem and Jan Kremer in the Netherlands, who created the award winning initiative MijnZorgNet (MyCareNet).

Active, well-informed, E-patients are central to this Health 2.0 movement, but not the only players.

*dependent on the nature of the disease; in case of prevention or less serious conditions, the patient/person might not need to see a doctor.

Related Posts on this Blog:

  1. The Trouble with Wikipedia as a Source for Medical Information
  2. Web 2.0 and Health Care Reform: Two Dutch Examples (1)
  3. The Web 2.0-EBM Medicine split. [1] Introduction into a short series
  4. The Doctors & the Patient




Practicing Medicine in the Web 2.0 Era

29 01 2010

Many people don’t get Web 2.0 – and certainly not Medicine 2.0.

Just the other day a journalist asked me if the redesigned PubMed could be called PubMed 2.0.
I said: “well no….no… not at all” ….Web 2.0 is not merely tools or fancy looks, it is another way of producing and sharing information and new web tools facilitate that. It is not only simplicity, it is participation. PubMed has changed it looks, but it is not an interactive platform, where you can add or exchange information.

Well anyway, I probably didn’t succeed to explain in just a few sentences what Web 2.0 is and what it isn’t. For those that are unfamiliar with Web 2.0 and/or how it changes Medicine, I highly recommend the following presentation by Bertalan Mesko (of ScienceRoll and Webicina), who explains in a clear and nontechnical way what it is all about.

By the way Bertalan is a finalist with ScienceRoll in the 2009 Medical Weblog Awards (category Best Medical Technologies/Informatics Weblog). He could surely use your vote. (here you can vote in this category). You can see all Finalist here.

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BlogWorld Expo [SOTB]: Two Additional Videos

25 10 2009

s739843689_121258_9975 dr valToday I learned there were two more videos realted to the BlogWorld Expo, that I shouldn’t withhold you.

First, the ABC News Covered the Medblogger Track At Blog World Expo. Here is an interview with Dr. Val Jones with Dave Lucas of ABC.

The video “Medical Bloggers On ABC News: Empowering Patients With Accurate Information” is summarized as follows at her blog Get Better Health:

….”Dave Lucas is tired of all the false health information that fills his email inbox each day. He’s very relieved that there are physicians, nurses, and patient advocates “swimming against the tide” of pseudoscience and misleading health information online. Today Dave and I discussed how people can find accurate and potentially life-saving health information through peer-reviewed medical blogs, thanks to the health blogger code of ethics (administered by MedPage Today)”.

Another interview was with Paul Levy, President and CEO of Beth Israel Deaconess Medical Center in Boston, and author of Running a Hospital. Paul participated in a panel discussion as part of the Medblogger Track (co-sponsored by Johnson & Johnson and MedPage Today). Because the video is barely audible, I just mention his main statements (highlighted in red in the video shown here at the JNJ Health Channel):

  • Paul writes his blogposts without any prior permission or approval process
  • It is quicker to fix a mistake on a blog, than it is in traditional media
  • Biggest regret is responding to sarcastic or hostile comments in kind instead of staying above the fray

Medical Bloggers On ABC News: Empowering Patients With Accurate Information

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