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)
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Clinical Reader, a Fancy New Aggregator – But All is not Gold that Glitters

3 08 2009

Before I went on vacation (July 14th) I started a blogpost about Clinical Reader, a new aggregator. However, a Twitter riot -started July 13th- drastically changed my view of Clinical reader and I decided to await further developments till my return. Alas, things have only worsened.

The adapted blogpost consists of two parts: a neutral look from the outside (original draft) and a look behind the scenes: how social media and web 2.0 tools should not be used.

I submit this post to the Grand Rounds, not only to inform you about a potential fancy aggregator, but also to warn potential users to “look before you leap”.

Please note that the figures shown in the first part are all screendumps taken at July 13th or earlier and might no longer exist in this form (note added after publication, as all sentences in this color)

——————————————————————————————————

Earlier this year (see post) I compared PeRSSonalized Medicine, a new aggregator, created by Bertalan Meskó to various other aggregators: Amedeo, MedWorm and Libworm, Netvibes, I-Google and RSS-Readers, (i.e.) Google Reader.

Most of these readers (can) track medical journals or news, some (can) also track blog posts and web 2.0 tools (like PeRSSonalized Medicine and MedWorm).  PeRSSonalized Medicine excels by the input from the readers (doctors, health 2.0 people and patients), Amadeo and especially Medworm have large lists of journals to choose from. All these aggregators can be personalized. Of course Netvibes, I-Google and RSS-Readers give the utmost freedom in compiling list feeds, but one first has to learn how to use them. And although it is not difficult, it means a hurdle to many.

June 29th, a new aggregator was launched, Clinical Reader, specifically designed for busy clinicians to reduce the information overload.

1. From the Mission Statement:

We are building a user-friendly platform that will enable medical professionals around the world the ability to easily interact with the latest developments in their respective specialties. Our aim is to bring academic content together and create a semantic digital medical library.

10-7-2009 9-16-36 Clinical Reader node——————

2. What it is and what it isn’t.

Clinical Reader is website that syndicates content via RSS/Atom (aggregator), enabling busy clinicians to easily browse top medical journals, health news sources and multimedia without having a clue what RSS is about (and for free). The same is true for other aggregators discussed previously: PeRSSonalized Medicine, Amedeo and MedWorm. In fact the presentation of the feeds looks pretty similar (see Fig. for comparison of Clinical Reader and Perssonalized Medicine). Disadvantage of these kind of aggregators is that only the first items are shown, and as these often are editorials, comments, correspondence and news, the physician still has to follow the link to the journal to see most of the (true) articles.

3-8-2009 0-51-08 clinical reader vs pss medicine

In contrast to the aforementioned  services, the “RSS-feeds” of Clinical Reader cannot be personalized (a personal selection of journals). There is however the possibility to select an entire clinical section, each with its own selection of specialist journals. And according to Rashada Henry, associate editor of ClinicalReader.com (commenting on Bertalan Mesko’s post), open or closed personal pages may become an option in due course.

10-7-2009 10-13-21 Clinical reader sections

3. What’s new?

As said, the idea isn’t new, Clinical Reader is an old concept in a new guise. But what a guise. It is a glimmering site with prints of the main journals on the home page. It has the appearance of an i-pod touch: you can scroll the sources with your mouse and click the ones you would like to read. Wow, I was immediately taken by it.

10-7-2009 9-21-33 Clinical Reader

4. Coverage

The emphasis is on medical journals and news. But there is also a page for with a selection of 14 Medical Blogs. There are also plans to include top Twitter doctors worth following (spreadsheet prepared by Ves Dimov, MD), for nurses, open access … and top medical librarians blogs (worth following for doctors). Following Ves’ example I made a spreadsheet of useful medical librarian blogs, open to editing here

The original spreadsheet looked like this:

10-7-2009 0-30-55 excel top medlib

The preview of the medical librarian page (how it would look when incorporated) looked like this.

10-7-2009 9-05-43

The address was: http://medical-librarians.clinicalreader.com/phase3.php – but when I came back the link was dead?!….

The other side of the coin

Apart from the fact that the site was not as revolutionary as suggested, there were some basic things about the site that were of some concern. The “About us” section contains no names, picture, verifiable info, etc. It only says: “Clinical Reader was brought to life in 2009 by a junior doctor and a small group of forward thinking young tech programmers spread across London and Toronto.” Furthermore I wondered whether NLM would ever give stars to commercial tools like this. I wondered, but no more than that….

1. Starry ethics fail
Nikki Dettmar, a medical librarian at the National Network of Libraries of Medicine (NNLM) did take a closer look. In a blogpost Starry ethics fail she says that:

it is with concern that I’ve heard about some of my colleagues promoting and collaborating with the newly launched company, Clinical Reader.

Why? (red scrawl emphasis mine)

This above-the-page-fold graphic is intentional (not accidental, this is clear marketing intent to lend quick visual credibility to the organization) and currently displayed everywhere (homepage, sections pages, multimedia page, the newsletter, etc.) throughout the resource.

It is bogus as far as the National Library of Medicine (NLM) is concerned since the U.S. Government doesn’t endorse or grant 5 stars to anything. The NLM Copyright Information page offers more elaboration, ….

Later Ben Goldacre (MD, columnist for the Guardian) concludes in a Twitter discussion regarding the endorsement by the Guardian (source http://eagledawg.blogspot.com/2009/07/gratitude.html).

bengoldacre @ClinicalReader so youre supported by the guardian in the sense that you went to an event they organised and some people gave you sm advice? 2 weeks, 5 days ago from TweetDeck in reply to ClinicalReader

2. Infringement of copyright

Nikki was also the first to notice the use of two copyrighted, unattributed images:

Clinical Reader also currently uses two copyrighted images on their Partners (specific original source, copyright notice at bottom) and Advertising pages (from somewhere on Signalnoise). A ‘credit’ link to a source doesn’t honor an image copyright. (….) Commercial organizations can well afford to purchase or design their own graphics.

In a later post, Nikki also showed that the multimedia wrongfully used SpringerImages, that must not be (…) used for commercial purpose  including the placement or upload of the Licensed Content on a commercial entity’s internet website.

Peter Murray twittered to @allan marks, co-founder of Clinical Reader:

@allan_marks It seems your Clinical Reader radiology image (http://bit.ly/3YbLa) was swiped from a Flickr user http://bit.ly/3XXKGm

In addition, the logo that was used by Clinical Reader to indicate the untangling of a maze of information (that I copied in my original draft above), was taken without permission from the website of FeedStitch where it was created by their designer Owen Shifflett. (see discussion).

You kind of wonder what wasn’t copied.

3-8-2009 5-06-36 feed stitch

3. Threat to Nikki (Eagledawg) via Twitter

For me the most astonishing event was the immature “response” of Clinical Reader to Nikki after publishing her first post with appropriate critique. It was in the from of a real threat.

Twitter response

From several sources I now  understand Clinical Reader also reacted kind of offensive to other librarians, including @DataG and lukelibrarian. One was warned “I will contact Twitter and have your accounts shut down. Stick with the real deal – EBSCO, Ovid .. etc” or something to that effect. @DataG (Murray) also found a version of a Clinical Reader newsletter, still catched by the Google search engine entitled: “wave goodbye to the library journal shelf”, which was later withdrawn. (source: Murray on Twitter as @DataGhis blog dltj.org (6)) and

17269831

I immediately responded (while packing) to the initial threat and so did dozens of other medical librarians. Mostly on Twitter and Friendfeed, but also via their blogs (see below and Nikki’s blog). Some also retracted their initial support (i.e. see this mail of  Connie Schardt, who like many of us -including me- was “temporarily dazzled by the flashy display and ease of use of the product.”)

4. Change of Twitter-accounts, deleting tweets

Quite confusingly Twitter-accounts have been changed and deleted. First initials appeared after tweets to designate the person who tweeted for @clinicalreader, which I thought was a good thing. I followed @clinicalreader, but now the account was discontinued. The archive was kept at @clinical_tweets, which vanished as well. Now there is @clinical_reader, that states that tweeting has not really begun?? The only Clinical Reader account I know of is that of allan_marks. ALL previous tweets have been deleted. What remains are dm’s (direct messages) and tweets that are preserved by services like QuoteURL.
(for a detailed account of the switching of the original Twitter account’s name ‘at the speed of light’ see this blogpost of pegasuslibrarian)

It is all very confusing. Why would one do that other to conceal what has been said?

One salient detail. At their website Clinicalreader still refers to @clinicalreader, which is taken over by someone taking the opportunity to register the account when it moved to @clinical_tweets

3-8-2009 5-50-41 @clinicalreader

5. More lying

There are several examples of making up retweets (quoting someone), see here (@ClinicalReader “I didn’t RT anything from y’all. Y’all aren’t very good at the whole social media thing, huh?”-David Rothman) and here (@ClinicalReader – “Would you mind not attributing fabricated quotes to me please? I never said this: http://tr.im/sCFb #ClinicalCheater“) (source: 6)

6. Denial

The behaviors of the ones in charge are so immature. It’s really unbelievable. You always have to take critique seriously, and if you choose to use social media and make a mistake, than apologize openly (see the blogpost of Peter Murray below, 7).

Look at this discussion with Ben Goldacre (thanks Nikki). It is really ridiculous, QuoteURL: one, two, three, and four. Clinical Reader is playing dumb.

I might not have been exhaustive, but I know enough for the moment. Also in my eyes, Clinical Reader has lost all its credibility.

In contrast to the massive protest of Medical Librarians only one doctor (Ben Goldacre) took a stand against Clinical Reader (see here).

Clinical Reader = zero stars: non-existent endorsements, threaten blogger, nasty and silly, avoid! http://tr.im/sdJA

The others remained erily silent. Why?

——————————

More extensive reading:

  1. http://eagledawg.blogspot.com/2009/07/clinical-reader-starry-ethics-fail.html
  2. http://eagledawg.blogspot.com/2009/07/gratitude.html
  3. http://stevelawson.name/seealso/archives/2009/07/clinical_reader_from_zero_to_negative_sixty_with_one_bogus_threat.html
  4. http://healthinformaticist.wordpress.com/2009/07/14/clinical-reader-malicious-or-just-stupid/
  5. http://davidrothman.net/2009/07/14/watch-nikki-pound-clinical-reader/
  6. http://dltj.org/article/clinical-reader-background/ (in depth coverage by @dataG or Peter Murray)
  7. http://dltj.org/article/learning-from-clinical-reader/ (excellent advice)
  8. http://pegasuslibrarian.blogspot.com/2009/07/best-bad-marketing-ever.html
  9. http://pegasuslibrarian.blogspot.com/2009/07/clinical-reader-train-wreck-just-keeps.html (detailed coverage of deleting and changing accounts) (8-9 added after comment Steve Lawson)
  10. Friendfeed discussions: http://friendfeed.com/search?q=%22clinical+reader%22

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