The Twitter Trap: Are we outsourcing our brains to the cloud?

The Twitter Trap by Bill Keller (@NYTKeller), Executive Editor of The New York Times captures many of the thoughts I have been having lately about the impact social media and technology is having on our society. Where does it end? What will be the future? How will it change us as humans? As a society? Like Mr. Keller, I have had similar feelings as I watch the impact on my 7 and 10 year old children.

Recently I have been preparing a presentation for the AHLA Annual Meeting at the end of June on the practical ways health lawyers can and should use social media. As a result I have tried to step back from the social media explosion to examine some of these issues, including the parallels between Mark Zuckerberg and Johannes Gutenberg referenced in Mr. Keller's piece.

I love this quote from Mr. Keller's article that helps visualize the innovation/disruption/impact cycle:

"My father, who was trained in engineering at M.I.T. in the slide-rule era, often lamented the way the pocket calculator, for all its convenience, diminished my generation’s math skills. Many of us have discovered that navigating by G.P.S. has undermined our mastery of city streets and perhaps even impaired our innate sense of direction. Typing pretty much killed penmanship. Twitter and YouTube are nibbling away at our attention spans. And what little memory we had not already surrendered to Gutenberg we have relinquished to Google. Why remember what you can look up in seconds?"

I also like his explanation of Twitter as a tool, "So let me be clear that Twitter is a brilliant device — a megaphone for promotion, a seine for information, a helpful organizing tool for everything from dog-lover meet-ups to revolutions."

His question around whether these new social media instruments are genuinely social is a good one. It is hard to see the answer to this when you are sitting in the midst of the social media cloud. One question that he doesn't address is how the collection of all this "collective social media data" about you and me will be used in the future. Is Facebook just one big social experiment. It now knows more about my family and friends than I can probably remember.

Take time away from your Twitter and Facebook posts, go read the article, and then sit back and take some quiet time to reflect on his message. I will leave you with this quote from Mr. Keller's article:

"The things we may be unlearning, tweet by tweet — complexity, acuity, patience, wisdom, intimacy — are things that matter."

Thanks to Jason Keeling (@JasonKeeling) for pointing out this insightful piece that was published back in print on May 22, 2011.

NY Times Health: Articles On Changing World of Online Health Information

The New York Times Health section in the article, "Logging On for a Second (or Third) Opinion," examines the changing world of online health information search.

As the article points out we are moving from a "search and read" web to a "search, share and interact" web. As Dr. Ted Eytan indicates, we are seeing the "democratization of health care." Patients as consumers are becoming more engaged and knowledgeable through the use of online search and collaboration before and after they visit with a health care professional. Likewise, physicians and other providers are utilizing technology and the evolving social networked web in the same fashion. I agree with the comments of Clay Shirky who indicates patients (aka health consumers) are becoming empowered actors in the health system. The article gives a good overview with links to some of the health care business models evolving in this sector.

Matthew Holt, co-founder of the Health 2.0 Conference, ends the article by stating "the marketplace in information can correct itself over time." He indicates that "the more people you have in the conversation, the better information drives out the worse information." I think there are risks with a socially networked and driven health system but I hope the rewards of improved information, treatment, outcomes and reduced costs outweigh such risks. Time will tell.

A companion article, "You're Sick. Now What? Knowledge is Power," also examines the rise of the empowered health consumer and offers some sage advice on how much information is good, how much is bad and some best practices on using web based health information. The article hits on these key points:

• The goal is to find an M.D., to become one.
• Keep statistics in perspective.
• Don't limit yourself to the web.
• Tell your doctor about your research.

Much of what is discussed in these two articles will the topic de jour at the Health 2.0 Conference next month in San Francisco. I look forward to attending and participating in the ongoing conversation about how technology is changing the health care industry.

Thoughts on HIPAA and Privacy: NYT Article on PatientsLikeMe

First, an apology to my regular blog visitors for the lack of posts over the last month. Busy, busy, busy at work and home. No time to blog. The last couple of days I have been experimenting a bit with micro blogging via Twitter as a result of a conversation with my firm's IT director and blogger.

Quick post to this interesting NYT article, Practicing Patients, about PatientsLikeMe. The article covers some ground on some of the questions that periodically swirl in my brain regarding HIPAA, privacy rights, who is (should be) the steward of medical information, pro/cons of patients (consumers) self treatment, etc.

I particularly found interesting Alan Westin's taxonomy of Americans' attitudes toward privacy. The article states:

In 1990, Alan Westin, a political scientist at Columbia University and an expert in privacy issues, offered a useful taxonomy of Americans’ attitudes toward privacy. On one end of the spectrum were what he called privacy fundamentalists — the 25 percent of Americans who feel that their privacy is paramount and that no one, not the government or corporations or their family, should have access to their personal information without explicit permission. At the other end of the spectrum were the privacy-unconcerned — about 15 percent of Americans — who paid no mind to privacy issues and didn’t figure they had anything to hide. In the middle were the vast majority, the 60 percent whom Westin called privacy pragmatists: those who felt that they could give a company they trusted some information — birth date, ZIP code, telephone number — for particular benefits.

NYT Looks At Dr. Google and Dr. Microsoft

Today's NYT article, Dr. Google and Dr. Microsoft, takes a look at how Google and Microsoft are focusing efforts on the health care industry and how to improve the traditional health care system by utilizing technology to allow patients greater access and control over their personal health information. Both companies are still in the planning phase and trying to determine what will work and what patients might want, use and need.

The entry of these two tech giants along with a slew of other health-technology companies are likely to cause disruption in the health marketplace traditionally controlled by historic models (physicians, hospitals, insurers, etc.) Whether there will be enough momentum to bring change and whether patients are willing to trust these new models is the question that has yet to be answered.

Interestingly, the article mentions a little more about what Google Health might look like. The Google Health prototype focuses on the health consumer:

The welcome page reads, “At Google, we feel patients should be in charge of their health information, and they should be able to grant their health care providers, family members, or whomever they choose, access to this information. Google Health was developed to meet this need.”

A presentation of screen images from the prototype — which two people who received it showed to a reporter — then has 17 other Web pages including a “health profile” for medications, conditions and allergies; a personalized “health guide” for suggested treatments, drug interactions and diet and exercise regimens; pages for receiving reminder messages to get prescription refills or visit a doctor; and directories of nearby doctors.

The article also mentions West Virginia native, David Brailer, former Bush administration National Coordinator for Healthcare Information Technology, who now heads up Health Evolution Partners. Note: Yesterday Matthew Holt posted at The Health Care Blog that Dr. Brailer will be joining the list of speakers at the Health 2.0 Conference to be held next month. Mr. Bosworth of Google will also be on the consumer aggregator panel being moderated by another top health care thinker, Jane Sarasohn-Kahn.

UPDATE: Interested in learning more about Google Health? Check out this post by Jeff O'Conner at the Health Care Information System Blog with links to the Clinical Cases and Images Blog with links to screen shots of the prototype.

Also check out what Doc Searls perspective at ProjectVRM Blog.

UPDATE2: Good insightful follow up post, Here comes Google and Microsoft, from Tony over at Hospital Impact. I especially agree with the last two paragraphs:

Of course, all the same old data issues have to be worked out - privacy, malpractice, storage, interoperability, and security . . . Plus, there's a little problem with funding and business model (hopefully we will never see a Google banner ad within our medical record!) . . . Make no mistake about it- this is not a continuation of the Google vs. Microsoft War that's been going on for years. This is Google or [insert brave company name here] against the most powerful force of them all: the healthcare industry status quo.