E-health in a tangle

Excerpted from Australian Doctor, 20 March 2009:

With so much reform in the offing, does the Rudd Government have the political will to finally make e-health a reality? Ray Welling investigates.

Ordinary Australians can use their bank cards all over the world or seamlessly connect their laptop to a wireless net work from Broome to Berlin, yet their critical health data can’t be shared with their local hospital or even the pharma cist down the road.

This is despite extensive international and Australian research pointing to significant savings in lives as well as public health expense when health IT innovation is applied.

This year researchers in Texas reported in the Archives of Internal Medicine that increasing the automation of hospital notes and records led to a substantial decline in mor tality rates for all conditions studied. An author of the study said that by computeris ing health records, more than 100,000 lives a year could be saved in the US alone.

Closer to home, a 2002 Australian Institute of Health and Welfare study found that up to 18% of medical errors — many of them fatal — were due to inadequate availability of patient information.

According to the study, these adverse events account for as much as 3% of the gov ernment’s total cost of care — $3 billion a year in avoidable cost.

A business case for a national electronic health record program was published last year by the National E- Health Transition Authority (NEHTA), which suggested a net benefit to the Australian economy of between $7.5 billion and $8.7 billion over the first 10 years.

Australia is not the only late adopter of e-health. In the US, just 1.7% of hospitals sur veyed in 2008 had fully imple mented a comprehensive patient e-health records system across all units of their hospi tals and only 7.9% had imple mented a basic system.

However, the US is much closer to fully sharing health data. Electronic health initia tives were specifically men tioned in former US President Mr George W Bush’s last four State of the Union addresses, and USPresident Mr Barack Obama announced shortly before his inauguration that he was dedicated to making 100% of personal health records available electroni cally within five years. He backed that up by allocating $US20 billion in his initial economic stimulus bill to the task. Electronic health records were specifically mentioned in his maiden speech to the US Congress in February.

SO what’s happening in Australia? It’s not that we’ve been ignoring e- health. It is estimated that more than $5 billion has been spent by state and territory governments, GP divisions, and others on e-health devel opment activities in the past 10 years.

Those initiatives include a program by General Practice Network NT to have the entire NT population regis tered for shared electronic health records by 2010, bed side electronic records and clinical decision support tools being trialled in SA hospitals, a $250 million Enterprise Information Repository in Queensland, and a hospital- based electronic health record system deployed in the South Eastern Sydney and Illawarra Area Health Service in NSW, which is soon to be rolled out across the state.

But for e-health to make a real difference, national co- ordination is needed. On a national level, NEHTA was set up with Commonwealth funding in 2005 to develop core technical foundations for e-health in Australia, such as clinical terminologies, infor mation messaging standards and designing unique con sumer and care provider iden tifiers.

Other than this, however, none of the local or state groups developing e-health systems are talking to each other or working to create sys tems that can be integrated across borders. Some can’t even be integrated across hos pitals or surgeries in the same state. It’s a situation that brings to mind the 19th cen tury, when each colony built its railway systems using incompatible rail gauges.

Read the full story here (password required – let me know if you’d like a full copy).


Electronic health records, brought to you by Wal-Mart

The Australian government doesn’t appear keen on consumer-led e-health solutions such as Google Health or Microsoft Health Vault. Well, it could be worse: here’s an excerpt from The New York Times this week:

Wal-Mart Stores is striding into the market for electronic health records, seeking to bring the technology into the mainstream for physicians in small offices, where most of America’s doctors practice medicine.

“Wal-Mart’s move comes as the Obama administration is trying to jump-start the adoption of digital medical records with $19 billion of incentives in the economic stimulus package.

“The company plans to team its Sam’s Club division with Dell for computers and eClinicalWorks, a fast-growing private company, for software. Wal-Mart says its package deal of hardware, software, installation, maintenance and training will make the technology more accessible and affordable, undercutting rival health information technology suppliers by as much as half.

“’We’re a high-volume, low-cost company,’ said Marcus Osborne, senior director for health care business development at Wal-Mart. ‘And I would argue that mentality is sorely lacking in the health care industry.’

“The Sam’s Club offering, to be made available this spring, will be under $25,000 for the first physician in a practice, and about $10,000 for each additional doctor. After the installation and training, continuing annual costs for maintenance and support will be $4,000 to $6,500 a year, the company estimates.”

Read the whole story here

A Twitter epiphany

From the Zazoo blog:

They say a year on the Internet is like seven years in the offline world – think of it as dog years (oh no, now I can’t get this image of my Dalmatian chasing his tail out of my head!). In that case, a year in social media is at least twice as fast.

So 10 weeks is a long time in the life of Twitter – by my complicated reckonings, it’s about a year ago. Now that I’ve completely confused the issue, I’ll get to my point: 10 weeks ago I wrote a post questioning the business value of Twitter (two posts, actually). Since then, Twitter has really entered the zeitgeist, with global users supposedly jumping from 6 million to 8 million just in the past couple of weeks, up from practically nothing 12 months ago.

There have been articles in just about every major newspaper in the Western world trying to explain the appeal and the utility of the service. It’s been used by Australian and American politicians, Rove, my resident breakfast radio announcer Adam Spencer and schoolkids. Most of the coverage has been favourable if somewhat bewildered, though some people are looking at it harshly, such as IT philosopher Jeremy Pettit, who wrote, “Didn’t Nietzsche say, ‘Soon everyone will learn to read and write, and that will be the death of language’? Brilliantly offensive. I’m sure he had Twitter in mind. The morbidly self-obsessed screeching to the morbidly self-obsessed in bite-sized chunks.”

Anyway, after writing those earlier posts I decided to become more pro-active and try to test the business utility of following scores of people and having them follow my 140-character musings (BTW, I’m @raywelling if you would like to follow). I tried to seek out social media experts to follow and sought the advice of more experienced Twitterers about how to monitor what’s going on in the Twittersphere.

I’ve watched people of all ages and backgrounds join up, particularly social media geeks, such as the hundreds of people attending ad:tech this week who drove the conference search term up to the #2 trending term on Twitter on Tuesday.

After attempting to manage the growing flood of postings through Tweetdeck (a specialised Twitter browser) and setting up regular searches on terms I’m interested in (contact me via the comments box if you want to know how to do this), I noticed a few trends settling in, such as the fact that an increasing number of posts tend to be links to interesting/useful blog posts, stories, videos, photos etc. (if you’re wondering about the problem of long web addresses in a 140-character environment, there is a widget you can use to shorten addresses to a manageable length).

Anyway, I had my Twitter epiphany this week. After viewing a tweet from a social media PR expert in the US who happened to be in Sydney speaking at a conference, I decided to follow him. Within minutes, I had a direct message from him noting that I was based in Sydney and since he was in town, did I want to catch up for a drink? We did catch up, and even if it doesn’t turn out to result in extra business, I can now clearly see how these connections can prove to be extremely useful. If nothing else, I met an interesting person who I would never have connected with through conventional means.

They don’t call it ’social media’ for nothing!

Skittles aftermath: Nothing to see here, mosey along now

Following on from yesterday’s post on the Skittles.com saga, the interest in this story in social media circles has been phenomenal, but now that Skittles has yanked the #skittles Twitter Search page from its home page (you can still find it if you go looking deeper on the site) like a spam Twitter account, the post-mortem has begun in earnest. It’s a bit like a digital version of the finger-pointing that goes on after disasters such as the recent Victorian bushfires.

Catherine Taylor writes today in Social Media Insider: “Now, it’s time to drown in social media clichés, like the following: The mere fact I’m writing about this means the campaign achieved some success. Awareness of Skittles on the Web probably hasn’t been this high, ever. The underpinning for the strategy for this campaign is in itself a social media cliché: The consumers own the brand.

“But I’d also like to offer that, in obsessing about this campaign, social media watchers are becoming their own cliché. What stood out to me in looking at the tweets about Skittles this morning wasn’t the naughty stuff, which seems to have run its course, but the whole meta phenomenon where people aren’t talking about Skittles per se, but what the Skittles campaign means for social media. Then there’s all the hand-wringing about the fact that some people said naughty things about Skittles and how that somehow mars the campaign (no pun intended, though Skittles is made by Mars). C’mon. Do you really think the agency and client were so naïve as to not know that would be part of it?

“It’s time to move on to something truly important. Kudos to Skittles and Agency.com for embracing the idea that it’s not the brand home page that defines the brand. That’s a good thing. But we knew that already.”

To quote from a couple of the comments on Catherine’s blog post:


“We have to be very careful about what strong thinkers we are and make sure not to over-intellectualize these new age approaches as marketing professionals. This wasn’t about us. This campaign or experiment thereof was about where we’re going. It wasn’t rocket science, but I’m sure it worked. Skittles displayed a direct interest in finding their consumers where they are likely to be found and used their consumers to communicate the brand however the consumer chose to in their very own language…and the consumers did just that!”

“I’m not sure what you need to know to wake up and be MORE IN TOUCH with your audience. They got trashed on Twitter because Twitters are about REAL, organic, testimonials and truth in real time. Spending the time, and $$$ with an agency that didn’t understand nor grasp that from the get go, shows that someone at the top of this, should have done more homework, or solicited better advice about using Twitter. Every agency in the world wants to jump on the bandwagon and utilize Social Media. If you don’t understand how to properly “engage” consumers using Web 2.0 technology, you need to be careful, for it’ll blow up it you face.”

“The only important question is will this cause people to buy more Skittles? I look forward to learning the answer.”

“I think the real value is less about the execution and more about the philosophy that drove it. If it means anything at all, it’s that this campaign is a recognition of the importance of the role social media plays in brand-building. The game has changed. It’s not 1999 anymore.”

It will be interesting to see how the campaign is viewed in the fullness of time. Brilliant tactic or big mistake? What do you think?

Skittles, Twitter Search and Facebook: a recipe for good publicity

From the Zazoo blog:

Skittles has conjured up a storm of controversy over its new un-website. The lolly-maker turned its home page into a glorified Twitter Search page on the weekend, and the company has been praised and pilloried ever since.

David Berkowitz wrote in Mediapost: “Today, when contacting a company, the first place I’d likely turn is its Web site. I’m saying that tentatively, as Skittles makes me wonder if corporate Web sites will be around much longer. The company’s new site seems to herald the fact that the corporate site is nearing its expiration date.

“…. Here’s the message Skittles is sending: What consumers say about the brand is more important than what the brand has to say to consumers.”

He asks: “Why would anyone care about what Skittles has to say? What, pray tell, could Skittles ever say that was so important, unless we woke up one day to find out that eating Skittles is the world’s tastiest cancer cure, or alternatively that Skittles lower men’s sperm count. Then, perhaps, the world will listen.”

On the positive side, Marketing Daily spoke to a range of marketers who thought the move was a great idea, quoting the head of eConsultancy as saying that: “Skittles has essentially turned its site into ‘a massive social media experiment. It is possibly the bravest move I have yet seen, in terms of a global brand getting into bed with social media and social networks … it appears to be an extension of the old adage about there being no such thing as bad PR. Everybody is talking about it.’

Marketing Daily also reported that: “‘Some will question whether it’s wise to give up control on the Web – whether this is a good use of social media,’ says Charlene Li, author of business best-seller Groundswell: Winning in a World Transformed by Social Technologies, consultant, speaker and blogger (altimeter.com). ‘But they are controlling content in the most important sense, which is that they’re getting people to talk about and engage with the brand. It’s hard to get people to engage with a candy, but this is generating incredible buzz and PR. This is a big brand pushing the envelope toward what a brand will be in the future.'”

MG Siegler on Venturebeat was bit more sanguine: “In what is either a sign of Twitter’s ongoing transition to the mainstream or of a candy company’s epic laziness, Skittles.com is now simply a Twitter Search result page for the candy.

“I’m a firm believer in the power of Twitter Search as perhaps the most compelling thing about the service, but the candy’s use of the feature just feels gimmicky. It would have been better as a part of the site, not as the homepage. My advice: I know times are tough, but hire a web designer.”

He presciently wrote: “Naturally, people are already spamming the hell out of this. One tweet being repeated over and over again unfortunately uses a racial slur. As such, I suspect this little experiment will end rather soon for Skittles.”

Meanwhile, Berkowitz suggested that Skittles should highlight its Facebook presence rather than Twitter Search, since its Facebook group has an astonishing 587,000 friends. And as of Tuesday US time, after a puerile Twitter campaign, that’s exactly what they did. The Twitter experiment ended, and the Twitter Search page was replaced by the Facebook page. But the debate goes on. Of course the big question is: what effect will it have on the brand and on sales? We’ll let you know.

Follow the story as it developed:

Skittles Converts its Home Page to Twitter Search

Marketers Praise Skittles Gutsy Site Move

Why Skittles Killed its Website

Skittles: tweet the rainbow (or racial slurs)

Skittles switches homepage from twitter to Facebook (what’s next?)

Bad Jokes Force Skittles to Retreat from Twitter Search to Facebook

Travelling down the health information highway

RJ Eskow has written a great article in the Huffington Post this week that explains in simple terms why electronic health records are a good thing. To wit:

“The digitizing of medical records could have a far more profound effect on health – and on our economy – than most people realize. The president said the recovery plan will ‘invest in electronic health records and new technology that will reduce errors, bring down costs, ensure privacy, and save lives.’ All that and much more is possible. With a new HHS Secretary and health czar, and a White House health care summit scheduled this week, this is the right time to act.

“‘Electronic health records’ don’t sound like a particularly exciting or innovative idea. But neither did ‘a network that could quickly reroute digital traffic around failed nodes’ in case of military attack, or ‘dynamic routing protocols to constantly adjust the flow of traffic’ between computers. Yet those were the modest original goals of ARPANET – which evolved into the Internet as we know it today.

“Paradoxically, computerizing the health system in this country could make it much more humane than it is today. But that calls for a broad vision of health IT as an ‘information highway’ that stores information, looks for problems, and eases the many routine interactions that make up the health system.”

The article concludes: “A comprehensive strategy should lay the foundation for a boom in private initiatives. If the Internet’s any example, people will meet these needs… and hundreds of others nobody’s thought of yet. That won’t just help us save money and improve healthcare. It could also create a new mini-boom in the technology and service sectors of our $2 trillion health economy.

“And that sounds a lot like a stimulus to me.”

Well said.

Big Pond content coup for West Australian portal

The Virtual Medical Centre has struck a deal with BigPond to provide health content for Australia’s biggest ISP.

The West Australian-based health site, which has been in operation for more than five years, operates websites for consumers and healthcare professionals across more than 20 therapy areas.

BigPond visitors can link through to the Virtual Medical Centre site, which provides information on diseases, pharmaceuticals and practical remedies, as well as healthy living and diet tips.

It also gives users access to a GP directory, educational videos and a medical dictionary, as well as interactive tools including a BMI calculator, a pregnancy calculator and a blood count evaluation tool.

Medical specialists who join the site are given access to “professional members only” tools which allow them to evaluate a patients’ health, including tools to calculate how many migraines a patient may suffer a month, a durogesic dose calculator and a body surface access calculator.

There are also separate sections for women, men and children, which group together relevant medical topics such as pregnancy, immunisations and prostate health.

More than 1000 medical specialists have contributed to the site.