It is with mixed emotions that I have to say that I am going to be taking a hiatus from blogging. My reasons for doing so are many including the fact that I have become more busy with work-related activities, and because I’d also like to devote more time to photography. As those of you who blog know, writing a single post can take three to six hours and so it is not an inconsequential amount of time. I also recognize that I have a writing style that is probably better suited to the research grants and articles that I normally write, than to blogging. So if I do return, it will likely be with a new style or approach. Many thanks to those of you who read the blog, either regularly or on an occasional basis, and an especially big thank you to those who took the time and effort to comment.  Your participation was well appreciated.

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You have recently been diagnosed with rheumatoid arthritis, an inflammatory condition that causes joint pain and swelling, fatigue, and may involve inflammation of other parts of your body including your eyes, heart, and lungs. Living with a new diagnosis can often be very frightening, as you worry about what this disease is doing to your body, fret about medications that are powerful and are not without some type of side effects, and struggle with difficulties in managing even the simplest day-to-day activities such as dressing, walking, or driving. While dealing with these and other concerns are hard enough in and of themselves, they are compounded by the fact that you feel very alone with what you are going through and are unsure about the services and resources available to you in managing your disease. And while it is one thing to learn which medications and treatments could be beneficial, knowing how and where to access these services in your own community can be daunting. Keeping up on new services as they’re launched is an added problem. Social media in healthcare is one way of addressing at least some of these issues.

Today’s entry summarizes my thinking on this topic and has been influenced by an online University of British Columbia course on social media in healthcare that I have recently started. Underlying this discussion is the fact that healthcare everywhere is under immense pressure. In my field of practice, arthritis care and management, there are increasing numbers of people being diagnosed with arthritis, while at the same time the resources for providing rehabilitative care are stagnant or declining. As a result, there is considerable pressure to consider new models and strategies for providing education and treatment. Social media offers one set of tools to address this challenge.

Social media comprises but is not limited to blogs, wikis, Twitter, Facebook, online video sharing, and online photo sharing. One way that such tools can improve care is by providing a way for patients to easily communicate concerns about care, ask questions of care providers, or seek support. This feedback might be handled informally through an open forum for people to post questions or concerns and then receive timely responses. One of the benefits of making such a conversation public is that it allows others to learn from the posted discussion. More structured polls or questionnaires allow health care providers to obtain information on patient satisfaction with care or to solicit feedback on potential new strategies for addressing such issues as wait times for treatment or new models of service provision. For example, a rehabilitation centre could be considering the possibility of launching a strategy to provide follow-up care by telephone or email for patients that have been discharged from treatment. However, prior to doing so the developers would want to know whether patients would find this new service useful, what benefits and barriers they might foresee in accessing such a service, and what things the developers would want to consider in the creation and launching of this service.

Another potential role played by online social media is the dissemination of news and information. Regular patients could sign up to receive messages related to new services or education classes, changes that are occurring at the provincial or national level related to drug funding or the availability of new medications, or descriptions of research trials or studies that are recruiting participants. In a related vein, social media can also be used for patient education or to share recently announced research findings related to disease management and treatment. This type of online information could supplement what is provided during a one-to-one visit, thus ensuring that education is standardized and comprehensive, while hopefully making care more efficient.

While all of the examples I have provided relate to ways of enhancing communication between care providers and patients, social media tools can also be used to facilitate knowledge transmission between care providers at different sites, to spark discussions about varied treatment approaches, or to foster shared problem-solving on problems of mutual interest. One of the problems in healthcare today is that care providers are often so busy providing care that they have little time to keep up on new treatment approaches. They also typically work in silos and therefore have little contact with what is being done in other locations. One of the big drawbacks of this is that wheels are constantly being reinvented, as each centre spends significant amounts of time developing nearly identical education classes, or varied programs and strategies for addressing similar problems, such as long wait lists or improving access to care. Social media can link communities of like-minded professionals so that innovative programs and interventions developed at one centre can quickly and easily benefit care providers at other sites. Alternately, care providers at many sites can collaborate online in the development of new services that will be of benefit to all.

Social media in healthcare is a new area that offers significant potential benefits and some issues that need watching, particularly in relation to patient privacy. As the result of social media being a fairly new innovation, I am curious to know if anyone has had any experience with using social media in the managing your health or accessing health care services. Not surprisingly, as Canada has been fairly slow to jump on to this particular bandwagon, I myself have not been involved in the use of any social media in the management of my own health. What about you?

I have now submitted our team’s research grant proposal, have had a few nights of mindless activities, and am now ready to do some fun writing. Being the first piece that I’ve written in over three weeks, I decided to write about the topic of the day, the Occupy Wall Street (OWS) movement. And despite the OWS movement being a recent phenomenon, many of the issues of inequality and corporate greed that the movement rails against have been nagging away at me for years. Hence, OWS gives a voice and a visible presence to things that I, and obviously many others, have been concerned about for years.

Even yet, OWS and the other Occupy movement locations have been bereft of clearly articulated concerns and demands. Although criticized as lacking in focus, this may actually be to the movement’s short-term benefit, as it has allowed many different individuals and groups to rally together under the broad rubric of a mass protest against a wide variety of society’s corporate, political, economic, and environmental ills. These include corporate executives salaries and bonuses often vastly disproportionate to the value these individuals provide, executives of corporations and government agencies that embezzle or otherwise act as if they’re above the normal rules of the game, corporations that value profits above social responsibility and environmental stewardship, and governments that act to coddle the wealthy and large corporations at the expense of the common weal.

Unfortunately, all of the ills I’ve outlined have been around for time immortal. The only thing that has changed is the level or degree to which the balance has further tilted to benefit the rich over the poor, individuals over the common good, and corporate interests over workers and the environment. And that’s not to say that there are not many good corporate citizens, wealthy people who are philanthropic (e.g., Bill Gates and Warren Buffet), and government policy that attempts to rectify imbalances while not stifling individual endeavour, but that these efforts are increasingly outweighed by individuals, corporations, and government policies that are more self-serving or act to exacerbate the imbalances.

People generally tend to be roused by injustice. Historical protests in the name of civil, gender, ethnic, sexuality, or other inequalities have all had fairly clear and well demarcated enemies, as have had prior demonstrations against war, corporate wrongdoing, or the nuclear arms race, to name just a few. What has been fascinating about the OWS movement is that these demonstrations are not rising up against one or two individual issues, but rather represent a protest about the general failure of government and corporations to protect the common good. In the same way, the recent death of Yueyue at the Guangzhou Foshan hardware market has caused individuals in China to question the collective public apathy and loss of public compassion, as much as it has drawn anger against the drivers of the two vans who drove over the girl without stopping or those individuals who passed her by without offering aid. In both situations there is a collective concern about the direction in which society has and continues to move.

What I also find fascinating about the OWS movement is that it has even happened at all. As I noted earlier, many of these injustices are the norm and despite the fact that many of these disparities are worsening, it’s easy to be like the frog that is put into the pot of cold water on the stove that doesn’t hop out as the heat increases because the change in temperature happens relatively slowly. It’s interesting that the clarion call to the OWS protest movement was a simple invocation of peaceful rebellion (see here) in the July issue of the Vancouver-based Adbusters publication. That article set out September 17th as a date for people to gather together in Manhattan’s Zuccotti Park to protest against economic inequality and corporate influence on the U.S. federal government. Ask and ye shall receive.

The movement’s first accomplishment has been to spark a conversation about the type of world we want and what we value as a society. I think that it’s impossible for the movement to come up with answers to the societal problems they’ve identified, but what is essential if the movement is to broaden its base of support is to clearly identify a handful of values that the movement supports – e.g., decreasing income inequality. And as the OWS movement is not singular and homogenous, the individual movements in different European, Asian and North American cities may identify values that differ to some degree from one city or country to another. However, once there is consensus and these values are clearly articulated it will be possible for support to occur from a broader range of individuals and groups. What I remember from many of the Arab Spring protests is that these were not just gatherings of unemployed youth, but were gatherings of a broad spectrum of citizens, old and young, male and female, all there for an explicit aim. That’s one of the reasons why some of those movements were able to topple regimes and rulers. And although I am not a protester by nature, I would be much more likely to gather in solidarity if I knew specifically what my presence was supporting. It will also be easier for ruling and opposition parties, and non-governmental organizations to propose solutions, if the movement’s goals were more clearly and succinctly stated.

Photo above has been taken from the Flickr group, “Occupy Everywhere movement”, in which uploaded photos are geotagged on a map of the world.

As did everyone, as a student I had both amazing teachers and professors and others that bordered on being atrocious. I remember one economics professor whose lectures were so boring that  I would nod off to sleep for at least a few minutes every class. That year I also had a first year geography teacher who gave the most captivating lectures, despite my sharing the lecture hall with hundreds of other students. And as a result, over time I learned to choose as many of my courses as possible based on who was teaching, rather than on whether the course topic sounded interesting. Wouldn’t it have been amazing if all of our instructors were as knowledgeable, thought-provoking, and entertaining as my first year geography professor?

I have seen a few examples recently of Internet sites that try to do this, that is, to make learning complex subjects as simple and entertaining as possible. One of these sites is the Khan Academy, a non-profit organization with the goal of “providing a free, world-class education to anyone anywhere.” The genesis of the Khan Academy arose when Sal Khan offered to help his niece with problems she was experiencing in her Grade 7 math class. After seeing her grades improve dramatically as a result of these lessons, other family and friends wanted to participate and so he decided to record the lessons and put them online. Today the Khan Academy has over 2400 online videos of primarily Kindergarten to Grade 12 science and math topics, most of which are 10 minutes or less in length. As you watch a video what you hear is the narrator explaining a concept (e.g., Introduction to heredity), while at the same time an invisible hand sketches animated diagrams and words in coloured chalk on a blackboard. The site has several features to aid learning, such as a knowledge map that suggests future topics based on how concepts build on each other. If you find one of the videos to be confusing there is a tool for taking a step backwards to the earlier concepts that are the building blocks to the topic with which you’re currently having difficulty. The system also uses badges to reward progress. See here for a Fast Company article on the Khan Academy.

Another site that uses animated videos to explain complex subjects is RSA.  Billed as “an enlightenment organisation committed to finding innovative practical solutions to today’s social challenges”, the site currently has 14 videos that address such subject topics as Changing Education Paradigms (Sir Ken Robinson), The Internet in Society – Empowering and Censoring Citizen? (Evgeny Morozov), and Language as a Window into Human Nature (Steven Pinker). Each video is approximately 10 – 15 minutes in length and takes a segment of a lecture by an innovative thinker that fully describes a complex idea. For example, the Robinson lecture is fascinating as it suggests why the educational system is currently failing children by combining information on the historical development of education with data on rates of Ritalin prescription as a proxy for ADHD diagnosis and a discussion of how we might best change the educational system to foster divergent thinking. Accompanying the lecture is a series of entertaining yet illustrative graphic cartoons.

These two sites offer a good example of the potential future of education. The videos on the Khan Academy are not splashy. What they do provide are an ever-expanding syllabus of information nested into short, bite-sized, conceptual building blocks. The RSA videos combine great speakers with fascinating topics that are presented in a highly entertaining fashion. As the writer of the Fast Company article noted however, there will always be a need for a real instructor who can answer questions or help problem solve if a student is stuck in his or her understanding. There will also be a need for schools that help to teach social and communication skills, and how to learn and work collaboratively in groups.

My vision of the future is a blending of the two types of learning with concepts more easily learned online and other types of learning that can best be done in a more structured group environment. I also see sites like these as democratizing quality education and providing the tools to foster lifelong learning, which is the idea that learning shouldn’t stop when we finish formal education.

My posts over the next couple of weeks may be MIA, as I have a research grant deadline coming up on October 18th that will likely be consuming increasing amounts of my free time.