Applying the four tests to NHS reform…really?

Happy New Year (almost). Here’s an interesting one to be filed in the ‘NHS reform challenges’ folder…

In a recent article from GP online, we see more issue arising in the GP-led NHS conversations. First it was that there was – and is – concern as to whether GPs would have the expertise and desire to commission services. Next came the privitisation concerns. Then the centralisation/decentralisation of services concerns.  Meh, perhaps they all came about at the same time.

Anywho, it seems that Health Secretary Andrew Lansley ‘this week backed plans to centralise specialist maternity services across hospitals in Kent, with Maidstone Hospital set to lose its consultant-led service’ – even though 90% of local GPs were against it (according to a BMA poll).

There are four tests that must be applied prior to any significant reform. Any reform must:

  • Have the support of GP commissioners
  • Fully involve the public (consultation and engagement)
  • Be underpinned by clear clinical evidence
  • Consider and support patient choice. That is, ‘no decision about me, without me’ (the new mantra since the release of the White Paper).

Wow. The four tests open the floodgates for interpretation. Whilst clinical evidence is rather definitively hard-and-fast, the others are so…squishy.

Significant change

What is the definition of ‘significant change’? Isn’t that a bit subjective? Some changes greatly affect certain populations whilst others may not give a lick. I mean, I may not be concerned right now with cancer services and how they’re delivered. However, should I ever find myself a service user (knock wood), you can bet your bippie I’d have an opinion.

What’s the threshold for involving the public? Is it to include a percentage of service users in a particular area? Receive a discrete number of responses? A guesstimate of sentiment? Is engagement achieved online? Through in-person events and meetings? All of the above? Maybe that’s a toolkit that should be created.

GP support

Similarly, I find ‘support’ such a nebulous term. If we take the above 90% of GPs that are against the specialist maternity centralisation as an example, we could (incorrectly, of course) assume that the remaining 10% favour the change. Does 10% constitute support?

Health minister Anne Milton has already advised that if the changes don’t meet needs, GP commissioners can seek to redesign and commission services. Sigh. Instead of constantly changing services through centralisation/decentralisation and back again, perhaps we should first design the most efficient service for an area and keep it intact for enough time to improve and truly measure the outcomes. Take the London stroke model which is already providing real results. It took a step-by-step approach to create an integrated system that would achieve maximum ROI. Patients, the public and clinicians were all involved in the design. Implementation was phased in to ensure all sites were ready with specialised staff and facilities.  Bing, bang, boom.

Patient choice

I’ve not had personal experience with the NHS and patient choice. In the very few times I’ve visited a doctor here, I’ve simply gone to my neighbourhood GP. However, if you’re a soon-to-be mom, you may well have a strong preference in specialised maternity services.

In an ideal world, we’d all be free to use any service we wished, without geographic boundaries, and would be assured of the same high-quality, cost-efficient care.

Oh, if only. Perhaps that’s my wish for the New Year…


Communications plans: Where to start when starting from scratch?

I’ve landed my first job here in the UK (hooray!) and in a few short days have come to learn quite a bit about the organisation, how it functions, and the extremely impressive range of skills and talents of its employees. Two of the main purposes of this contract is to devise a communications strategy and a new Web site for the organisation, which is a newly-merged result of two similar, yet geographically separated firms.

My first few days were spent pawing through the materials and content already in existence, believing that it would be more of an organise-refresh-relaunch task. Upon further inspection, however, I learned that it’s much, much more than that. In fact, neither organisation seemed ever to have any semblance of full-time communications staff and resources at all. Yikes. I found information on the two Web sites dating back half a decade and more, with typos peppered throughout, and a general lack of focus in messages and materials.

Hmm…It was time to drop back and punt.

I interviewed staff members to find out their thoughts and what they viewed as the purpose and mission of the organisation. Responses were somewhat varied, though (thankfully, at least!) not absolute polar opposites. It seems to me that this is where we’d need to start. After all, whilst I can develop a strategy and plan for the next year, three years, five years, whatever, I need to base any writing done now on such foundational information of the goals and future vision of the organisation–even if it is to evolve in the near future, as I’m sure it will.

It’s an exciting time, as I feel I can truly make a difference in molding the future of this organisation. However, it’s a bit daunting to think that the starting point is so…well…nebulous and unfocused. When any task is this open with so many moving parts, one begins to wonder where one ought to start. Nonetheless, from goals and objectives to tools and resources to the timeline required to complete it all, I’m absolutely up for the challenge. Heck, maybe I’ll be able to prove myself as one with good ideas on this side of the pond and show them some of the newer channels and methods that are currently developing! (winks)

Using Web 2.0 tools for instant information: Murderers, earthquakes, and snow — oh, my!

An article on Mashable notes four innovative uses for Google Wave. One such interesting use was a manhunt for a Washington state man who was suspected of shooting four police officers. When The Seattle Times opened up a public wave to exchange information about the state-wide search:

“The Wave received photos of the suspect, sightings, a description of what was believed to be his vehicle, evidence, and updates from the police radio. The Times also set up a Google Map with place markers for important events and locations in the manhunt.”

Now that’s a pretty cool way of using these new Interwebby tools for the greater good, eh? One wave participant, Brianwpost, commented that the instant exchange of information “makes Twitter look slow.”

While I’m not sure I’d agree that Google Wave should overtake Twitter, as they both have their well-intended uses, I do think it was a creative way to use Wave in a beneficial new way…Talk about collaboration.

Twitter has also been used for such instant information exchange, as we’ve already seen countless times. Take this morning, for example, when I looked out my window and saw my first London snow. I, of course, tweeted it out and then searched for other mentions of my post code, whereby I then saw that the #uksnow hashtag was in use — apparently resurrected from last year. Within moments, there was a flurry (pun intended) of snow notes coming in from across the country. One tweeter, Chris_Titley, observed, “Iwent to the toilet and came back to 1547 tweets on #uksnow .. I wonder if it is snowing,” as the hashtag instantly zoomed up to the top of the trending topic list.

The immediacy of sharing is the coolest part of these new tools, in my opinion, and can be used not only in manhunts or in weather reports, but in the event of disasters such as earthquakes. According to a BBC article this morning, the US Geological Society (USGS) is searching and filtering tweets “to get instant public reaction to earthquakes.” Using tweets of those in a particular region (as such tweets spike following a quake), they are able to quickly gauge the severity of the event.

Dig this:

“It is a speed versus accuracy issue,” explained Dr Paul Earle. “Twitter messages start coming out in the seconds after an earthquake whereas, depending of the region, scientifically derived information can take 2-20 minutes,” he told BBC News.

Seriously cool. I’ve seen this in action myself. Last May, my boss’s daughter was on a volunteer trip to Costa Rica when an earthquake hit the very area in which she was situated. By culling Twitter tweets and using sites like CNN’s iReport (and using my Spanish language skills to translate the “terremoto” tweets), we were able to not only get a handle on the severity of the quake, but to also obtain emergency phone numbers long before they were published on traditional Web sites. (As a p.s. to the story, I’m pleased to report that the daughter was fine and had been outside of the badly-hit village.)

Folks always note how much information is constantly and continuously being pushed at us in this new age. That may be true, but we have the ability to sift and filter and even tune off, should we wish. However, we can rest assured that when we need the information instantly, there are sure to be tweets and waves out there to satiate our instant information appetites.

…and heck…Just imagine if London could have created a public wave during the time of Jack the Ripper, eh?

One [bad? entertaining? whatever…] lip-synching vid from ad agency Publicis and everyone tweaks out…

The ad agency Publicis London uploaded a video yesterday of its staff lip-synching to the Black Eyed Peas “I’ve Got a Feeling” song and all H-E-double-hockey-sticks breaks out today…Criminy.

Supposedly, the video was just for internal purposes, a shtick-y, silly deal in preparation for Publicis’s upcoming Christmas party. Ah, we all should know by now, however — once something is on the Interwebby, it’s public and up for much criticism.

The comments, both on the YouTube video and on Twitter, were rather harsh, IMHO. I think this was just a bit of random silliness rather than an attempt at trying to make something go viral…at least, I hope and pray it is. Yikes. Else, it’s a good example of what not to do.

This was exactly as we discussed at last night’s #SMUK meetup…Shannon Boudjema presented a fab deck with great examples and resources. One point in particular that she noted, if you want to gauge the sentiment of your company, simply do a quick Web search — through Twitter,, or any of the myriad other tools that exist. After all, nowadays, in the Land of Social Media, your brand is not what you say about you, but what others say about you…

Meanwhile, I have to agree with qwghlm who said, “Wow. Judging by the Twitter feedback, it’s as if Publicis butchered a live kitten in their Christmas video, not did a sh**ty lipdub.” Indeed.

Is marketing the last to get social media (correctly, that is)? Or do they play nice in the sandbox with Corp Comm?

This morning during my daily perusal of blogs and tweets, I came across an interesting post from Amy Mengel, “Five reasons corporations are failing at social media.” Within the comments of her post was another blog entry from Gary Hayes, “Corporations in social virtual worlds – psychopaths or welcoming friends?” Both posts make an awful lot of sense, and both make points that I’ve seen in my own experience.

One year ago, I moved into an eCommunications Manager position with my organisation. It was, as one member of staff claimed, “the best job in the company” — and she was absolutely right. I got to work super-closely with some fab guys in the IT department and thus was able to pair my mar/comm skills with my affinity for technology. The role included ghostwriting a blog, and developing a virtual presence through Twitter, directories, and other channels, to drive traffic to the postings, get some traction on the blog, (which had, up until then, been rather neglected due to a lack of resources), and build out a true community of engagement.

In moving to this position, I left the Marketing team to join the Corp Comm team. The blog was viewed as a positioning effort, and truth be told, because of its very nature, was rather tangential to the core business. I loved it…Everything I was doing — tweeting, blogging, scoping the virtual world for mentions, building friendships with other healthcare folks — was just up my alley. The fact that I could hone my skills on the technical side with what I knew about communications and writing? Even better.

The funny thing about this was that, particularly in the early days, the Marketing team seemed hardly impressed and, in fact, quite uninterested with what I was doing online. Months later, social media became mainstream and other organisations — including competitors — started dipping their toes into the virtual stream. It was then that some curiosity was piqued. While the head of the marketing team seemed somewhat interested, the rest of staff (including one specific VP) seemed content with developing Web pages for new programs and initiatives instead. However, as Amy notes in her blog whilst quoting Jason Falls, “corporate Web sites [are] little more than online brochures.” Indeed…and agreed.

The very few who were interested wanted only to use social media to tout new products, reiterating again their “talk at them” rather than “talk with them” mentality. No, no, I tried to reason. It’s to listen and to collaborate, rather than to shout and to promote. My keen Creative Director summed it up well: “These are intelligent people. They know the B.S. already and block it out effortlessly. They’re not going to stand for another commercial about how fabulous we are.”

I preferred to make virtual healthcare friends. After seeing a tweet asking for examples of healthcare in social media, I DMd the author with a list of two dozen examples. I became engaged in the Sunday evening #hcsm chats regularly. I exchanged ideas on quality with folks I valued. This is what it was about — connecting and engaging with forward thinkers in healthcare. Those are the ones I wanted to read the blog…and to be involved in my own network.

An interesting point that Gary brings up in his post is a simple, yet necessary, idea: understand the culture by spending time there. Although a few of the marketing staff wanted to get involved in social media, they didn’t know anything about it. They’d neither skulked nor lurked in any forums, nor on Twitter, nor investigated relevant blogs. Without knowing what audiences already exist, how can one truly understand where one ought to be? As they say, there’s no need to necessarily create the conversation; rather, try to go where one already exists.

The conversations do exist, of course. The quality people are out there. I realize most marketing teams do understand and engage in social media more so than perhaps those I’ve known. I wonder if most of them get the idea of talking about something broader than their own products, as Amy notes, or if they just want to shout “Look at me! Look at me! I’m awesome!”

If Corp Comm departments are typically tasked with positioning an organisation and marketing departments tend to be tasked with branding and promotions, how can they work together to develop a clear-cut, strategic plan with which everyone agrees? While it really shouldn’t be this difficult, my past experiences sometimes makes me wonder why we can’t all just get along..?

My US iPhone moves to the UK…and seems homesick

Last week, the most infamous of hackers, George Hotz (aka geohot), who had successfully hacked the iPhone for unlocking onto any carrier back in 2007, released blacksn0w, “a free unlock for the latest iPhone 3G and 3GS.” The countdown to its release , kept us all on the edge of our seats – and he’d even released it a day earlier than planned, as testing went so smoothly. I was one of his more than 31,000 Twitter followers anxiously awaiting with bated breath, as it would mean freedom from AT&T and the ability to get Twitterific back into my life again whilst here in the UK.

Since moving to London, my iPhone has served just one purpose: as an iPod to listen to podcasts (like Today in Social Media) and music during long tube rides. (O.k., admittedly, two purposes: I still can use some of my offline game apps like air hockey.) However, the pay-as-you-go mobile phone that I’d picked up on my second day has been rather expensive (40 pence per minute on calls – yikes!) and incredibly non-user-friendly (the buttons are ridiculously small and the T9 predictive text doesn’t remember new words, even though I save them myriad times). So I, for one, was really excited for the unlock.

Thus, after unlocking with blacksn0w, I swapped out my SIM card and giggled uncontrollably at the thought that I might again have my beloved iPhone in use. No dice. I brought it to my local tech guy, who suggested that although I may be able to get the phone part to work – and may then save some quid on calls – I’d likely not be able to access the Web. He said he believed that the Web access used in the US would not be compatible with that in the UK. Argh. I was dismayed.

One never ought to give up hope, however.

In writing this post even now, I explored the settings to identify the version and stats for my iPhone to post herein. Incredibly, when checking for wi-fi networks (which I did at a friend’s house just two evenings ago with no luck), it recognized my home network, Starlow. Wait just a tick! How exciting; my iPhone may just be back. Next up: re-swap out the SIM and see if I have any luck.

Seems Web access works with wi-fi, but using the T-Mobile UK SIM I have, I still cannot make calls. It shows a few tiny, tiny bars, akin to when roaming in rural West Virginia with no coverage, rather than the No service it typically shows. After seeing that a Twitter connection, EmilyFralick, was using a US iPhone in the UK, I asked her what service she was using. Her response? “02 pay and go with 3G. Trust me it works!!! I’d pay for the web bolt-on though.” May be worth a shot.

If anyone has ideas, feel free to comment and let me know what route to try next.

Social media examples in healthcare

Since moving to London and trying to get my life back again upright, I’ve fallen rather far behind in my blog postings. One such example of my delayed work is this list of social media use in healthcare, which I’ve been meaning to post for about a month. Sigh.

In gathering articles for a daily newsletter that I created, Media Monitoring, sent to 3,600+ subscribers, I came across many links and examples of Premier member and non-member hospitals and other health organizations implementing social media in interesting ways.

We’re now all familiar with tweeted surgeries, as pioneered by Henry Ford Health System. This new use of Twitter provided information to medical students, clinicians, and even the general public as we were, for the first time, allowed into the [virtual] OR to witness the first incision. There are plenty of other examples of how this new method of communication is connecting us and removing hurdles within the disparate world of healthcare. One needs to look no further than a quick scan of say, The New York Times’ health section or a healthcare media expert’s blog for new stories; there are plenty of ’em.

The list I’ve quickly put together is not intended to be comprehensive by any stretch of the means. Rather, its purpose is to highlight a few different concepts of use and mentions in trade publications. Another piece worthy of consideration in the list, I believe, is to  note the development and frequency of social media use. As it is in chronological order from November 2008 through mid-September, it’s easy to see the increasing mentions and interest in Twitter, Facebook, and YouTube as they relate to healthcare.

I believe social media in healthcare is not a fleeting trend; it’s here to stay. Obviously, we may alter today’s tools used in lieu of the next shiny object, but the fact remains that engagement, interaction and connection are all necessary to improving the health of our communities.

What do you think? What are some of your favorite uses of social media in healthcare?

As a p.s. to this post…Upon looking for Henry Ford’s Twitter link, I found another cool and October-appropriate example that they’ve created. It’s Pinky Swear, a Facebook app that lets users send “mammography reminders to friends, along with information about how to set up an appointment.” Cool-o.