David Kerr: Twitterology

David KerrThe NHS is in love with the airline industry. The idea of checklists before operations has really caught on, and increasingly ex-airline people are being placed in advisory roles for a variety of NHS organizations. Hospitals are especially envious of the ability of the airlines to develop and use technology that allows hundreds of random individuals to be safely transferred over thousands of miles with the minimum of fuss and at relatively specific times. The dream is that if this could be applied to hospitals it will dramatically improve efficiency and reduce costs. However, experiences with airlines are not always universally positive, and there are now websites devoted solely to reporting negative experiences of travellers with specific, usually budget, airlines. A common complaint relates to the challenge of trying to speak to a human being rather than a machine in the customer service department. However, one way to circumvent the barriers of telephone trees and paucity of email addresses is to send a tweet. For example, airlines have been asked recently about their attitudes to travellers with diabetes using Twitter, and the responses are being posted as they come through.

In the US, estimates show that around 8% of Americans have a Twitter account and that the numbers are growing rapidly with 155 million tweets each day from 175 million registered users. However, there is some debate about how many people actually “tweet” on a regular basis and how many “follow” anyone else? Nevertheless the US Department of Homeland Security plans to use Twitter (and Facebook) to warn citizens about potential threats with its new National Terrorism Advisory System. The new programme will in part replace the old color-coded system, put in place after the 9/11 terrorist attacks.

The question is, will Twitter ever be a used for healthcare? Until recently this particular micro-blogging system has been described as “a tornado of noise and chaos.” The media use Twitter to promote their headlines and news and celebrities like it for its PR potential. Businesses use it to hype their products, but beyond these the value of much of the rest of the content of Twitter is difficult to determine. For healthcare, as with all social media, there are concerns around confidentiality and security, and Twitter is no exception. However the concept of a secure micro-blogging system for a hospital and surrounding primary care network could have value. It could be used for sending patients reminders, recording the effects of introducing new medicines, following up after discharge from hospital, providing patient to patient support and so on. Micro-blogging could allow complaints to be dealt with at an earlier stage and provide an opportunity for dissemination of plaudits. At a public health level, rapid communication with large numbers of people would be straightforward for health promotion and during major incidents. Increasingly many patients are happy to “bare all,” but there would have to be an option for private “tweeting.” The key would be to keep to the limit of 140 characters to avoid excess verbosity.

Micro-blogging for health is worth a try and perhaps could be a topic for the “NHS Concepts Incubator” suggested in my previous blog. One high profile technology researcher reported to me that part of the reason his company is so successful is that all employees are expected to spend 20% of their time at work on “self-innovation.” Basically to have time to reflect and think about new ideas for the company, then shared using a micro-blogging system so that others who could help taking the idea forward are alerted at an early stage. The ability to communicate using social media has been a key component of recent major change in many parts of the world – why not the NHS?

David Kerr is the managing editor of the Journal of Diabetes Science and Technology.