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Engaging in Health Care Discussions

One of the recurring themes in my recent blog posts has been my participation in the Connecticut Health Foundations Health Leadership Fellows Program. It has been a very engaging program which has given me lots to think about. For those interested in participating next year, applications are due April 1st. Please check out the program and see if it might be for you. If you have questions, feel free to contact me directly.

If you have an idea about how to help achieve health justice in Connecticut, you may want to check out the Health Justice CT Challenge. Submissions should include a simple two minute or less video describing the project. I hope to share some of these videos in the coming weeks. Just remember, what matters is the idea, so if you have a great idea, but can't make a great video, make a simple video and let people see the idea. The deadline is February 22nd. Last year, there were some great ideas proposed, and hopefully we'll see some really good ideas proposed this year as well.

If you've got smaller ideas, consider texting them. The Community Health Center Association of Connecticut has a program called Txt 2B Heard. Just text the keyword txt2bheard together with you ideas about how to make health care better to 24587.

If you're looking for more of a discussion, consider joining the Health Care in Social Media CT Group We have monthly meetups and weekly tweetchats. The Meetups are the first Wednesday of every month and the Tweetchats are every other Wednesday at 3 PM, using the #hcsmct hashtag.

Finally, if you're looking for a panel discussion, consider attending the Connecticut Social Media Breakfast on February 22nd at Quinnipiac. February's breakfast will be on Social Media and Healthcare and I will be one of the panelists.

There's a lot of interesting discussions about health care going on here in Connecticut, and I hope you'll find ways to join in.

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Creating Better Health

Today I listened into the first session of Learning Creative Learning. This is an online learning event run by the folks at MIT's Media Lab rooted firmly in constructivist theories of education. I alluded to it in my blog post yesterday about a learning event taking place around the language of Hollywood, and I hope to tie these events together with some other events soon.

But first, I want to explore my initial reactions to the first lecture. I had read the paper ahead of time, and I've read a lot of related material, so nothing new jumped out at me, with one exception.

This time, I was approaching this whole creative learning thing from a different context. I'm part of the patient education committee at the Community Health Center, trying to help underserved patients learn how to better care for themselves. I'm in the Health Leadership Fellows Program of the Connecticut Health Foundation, trying to find ways to address disparities in our health care system. I've been spending a lot of time thinking about the whole e-Patient movement, and I've been trying to bring some of this together in terms of the Mayo Clinic's Center for Social Media.

The Center for Social Media draws in a lot of e-Patient types. e-Patients are "empowered, engaged, equipped and enabled". Some of them even went to MIT. They gather in groups like the 'Society for Participatory Medicine' and I have to wonder if the Society for Participatory Medicine was influenced by Henry Jenkin's idea of Participatory Culture.

It all fits nicely together for those who are already empowered and have a love of learning, but I have to wonder how it can fit with patient education where I work; the fifty year old man from Puerto Rico with a heart condition and no family doctor, the young muslim women struggling to get by in a society which doesn't embrace them as they deal with domestic violence at home, the newly diagnosed diabetic patient with complicated cultural relationship to food who lives in a food desert. Where does creative learning fit in for these people? How do we help people who have been downtrodden for years to become empowered? How does this relate to the frustration of providers to get the patients comply, take their medicine, get exercise, quit smoking or whatever?

How can we help underserved patients create better health? That's my question for tonight. Care to join with me in this?

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Uplift: What's your SuperBetter Online Score?

As I sit down to write this, I find that my Klout score is current 73, my score on PeerIndex is 65, and my stock is at 229 on Empire Avenue. Klout shows my top topics to be social media and social justice. PeerIndex has news, lifestyle and the arts as my top benchmark topics and on LinkedIn, the skills I've received the most endorsements in are Blogging, Social Media and Social Networking.

Yet I have to wonder, how much does this really mean? Are these the scores that matter? I remember one person describing HITS on a website as How Idiots Track Success. How influential am I really, what sort of impact am I really having? These are thoughts I think about as I struggle with setting my goals for 2013, especially as part of the CT Health Foundation's Health Leaders Fellowship Program.

I've been writing a bit about Jane McGonigal's TED talk, The game that can give you 10 extra years of life which she calls SuperBetter.

In SuperBetter, you work on building up physical, mental, emotional and social resilience. It is a great concept and it made me wonder, what my SuperBetter Online Score would be. How often do I read a post that stops and makes me think (+1 mental resilience)? How often do I stumble across something mind numbing or brain dead (-1 mental resilience)? How often do I see something that warms my heart and causes me to want to do something good for the people around me (+1 emotional resilience)? How often do I see something that makes me want to just quit (-1 emotional resilience)? How often do I see something that makes me feel more connected to friends on line (+1 social resilience)? How often do I see something that makes me want to hide in a cave and not talk to anyone (-1 social resilience)? I have skipped over physical resilience; I'm not sure I get much for pluses or minus physically from my online activities.

Wouldn't it be great if someone came a long with a game, perhaps as a mashup of Klout, StumbleUpon and SuperBetter, where a post could be rated, and optionally shared using these scores? Instead of simply 'liking' a post on Facebook, I could say it gave me a +1 mental resilience. I could chose which posts to share based on this, and make an effort to only share those posts that are increasing resilience in whichever areas I'm most interested in at the time.

At times, I could go back and see which friends have posted things that have been most uplifting. I could thank them for it, tell others about how uplifting I find them. For people posting material generating negative resilience, I could decide if I really wanted to keep following them. Perhaps even a back propagating neural network could be added, but that's probably pushing the envelope beyond the scope of this blog post.

As Facebook, Amazon, Google and other sites continue to refine their searches and recommendations, perhaps I would start getting more uplifting content. Perhaps brands and news organizations could start promoting their material in a more uplifting manner.

I'm probably too busy to write something like this myself, but perhaps I'll find some open source tools I could tweak to get close to this. So, if someone wants to steal this idea and implement it great.

So, what sort of SuperBetter Online Score is this blog post worth?

Further Thoughts about First Person Shooter Games

Recently, Matthew Katz, a social media savvy doctor I've become friends with put up a blog post, Defending Our Youth: No First Person Shooter Video Games. I've shared his blog post and there has been a very interesting discussion on the topic which I will try and summarize and add my own comments.

Dr. Katz wrote this as part of a larger opus dealing with gun violence from a public health framework. This is an important framework that we should be working within as we try to address issues of gun related violence in the United States.

Much of the discussion around gun control seems to be black and white thinking. Some are suggesting all guns should be illegalized and the second Amendment should be repealed. Others are suggesting that no new gun controls should be put in place, and instead, that more people should carry guns. It seems like the more reasonable viewpoint is somewhere in the middle, where access to certain types of guns should be made much more difficult.

Similarly, there is the discussion about video games. Some people call for banning video games. Others say absolutely not. Dr. Katz seems to come closer to a more reasonable middle ground by looking at access to a specific set of video games, first person shooter games.

I am a big proponent of gaming. I believe we should be using ramification to change many aspects of our society and I hope to write more about some of these ideas later. Games, like guns, are tools. They can be used a lot of different ways.

So, with that, let me get to some of the comments I received on my Facebook wall about Dr. Katz's blog post. Much of the discussion has been around different types of games, some not even video games. I played a lot of Dungeons and Dragons back in the 1970s. At that point, it was paper, pencils, dice and a lot of imagination. Yes, there was violence in the game, but it was a small part of the game. What mattered was creativity, problem solving, and collaboration; some of the twenty-first century skills I've been writing about.

My brother posted a link to a video about a Veterinary Medical Class that took place in Second Life. It is a fascinating video and a great illustration of the positive aspect of video game like activity. One person posted a link to the article, Ten-country comparison suggests there’s little or no link between video games and gun murders. Dr. Katz properly points out that this is a study of video games in general, and not violent video games, or even more specifically first person shooter games.

Yet I'll even go so far as to suggest that there can be some benefit to first person shooter games. Re-enactment of a traumatic event can be an important part of processing the horror, whether it be young kids playing with toy guns after Newtown, or veterans spending time in virtual worlds to learn to cope with PTSD. Perhaps the real question is, what are you getting out of the games you are playing.

This ties back to some of the discussions I've been having at the CT Health Foundation Health Leadership Fellows Program about intent and impact. What are you intending to get out of your games and what impact is it really having?

One intent may be simply to relax and unwind. That is an important thing to seek. The question becomes, is this the most effective way to relax and unwind? Are their other, unintended side effects that are detrimental? Might these detrimental side effects indicate there are other ways to relax and unwind that might be more beneficial?

I also like to come back to Jane McGonigal's TED talks about gaming. What sort of societal change is the gaming having? How is it affecting your resilience; mental, emotional, and social?

For the seventh grade boys playing first person shooter games, what sort of effect is that having? The research Dr. Katz talks about suggests it may not be all that beneficial. So, how do we address this? Do we ban first person shooter games? Do we make it harder for kids to access them? Do we put warning labels on them? Do we train parents, teachers and even doctors about them?

For example, my eleven year old daughter was asked at her latest physical about if she always wore her seat belt, if there were people around her that smoked, and if there were guns in any houses she went to. She was also asked about playing video games.

Now there are some people who have tried to prohibit doctors from asking their patients about gun safety, and I imagine if more doctors start asking about video game safety, that might get a similar response, but that is something that primary care providers interested in dealing with gun violence from a public health perspective could start asking patients about. It would be a simple start, without requiring new legislation. Twelve years ago, the American Academy of Pediatrics came out a Joint Statement on the Impact of Entertainment Violence on Children. As part of releasing that statement they stated they hoped to "encourage greater public and parental awareness of the harms of violent entertainment, and encourage a more honest dialogue about what can be done to enhance the health and well-being of America's children". It sure seems like such a dialog is long overdue.

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Addressing Underserved E-Patients

There is a quote, I'm trying to find, something about all the undiscovered Einstein's, people with the intellectual capabilities of Einstein, living lives as sharecroppers; their mental prowess undiscovered. It came to me over the past couple days at the Health Care Social Media Summit.

I have met some incredible people at the summit, both this year and last. I think of e-Patient Dave and Liver Lindsey, people who have been able to use their skills to live empowered lives in the face of cancer. The e-Patient movement is bringing important changes to health care, as patients take a more engaged role in their own health. They speak well to the folks from the hospitals and health systems that send staff to conferences like this.

I come from a different sort of health care system. I work for a Federally Qualified Health Center. Most of our patients are uninsured or are on Medicaid. They live their lives below 200% of the Federal Poverty level. Their struggles are not overcoming some rare disease, but simply living day to day, being able to get healthy food, exercise, and the health care they need. They don't have computers at home or the skills and reading ability to be the sort of e-Patients we hear about at conferences like this.

Our health center talks a lot about health care being a right, not a privilege, but it seems like the e-Patient movement is for those with decent educations and good access to the Internet. What about our patient population? Will they be left behind? Will the e-Patient movement increase the health disparities in our country? What can we do to prevent a widening health care rift and bring the e-Patient movement to all Americans?

On Tuesday, I met a doctor giving voice to this concern at this conference. Dr. Ivor Horn spoke about how many underserved patients are on social media. They have different usage patterns. They're on Twitter using smartphones and we need to find ways to serve them. There are probably other usage patterns we need to understand as well.

I suspect that e-Patient Dave or Liver Lindsey would be just as compelling and compassionate to the underprivileged as they have shown themselves to be to attendees of this conference, so I have my fantasy panel: e-Patient Dave, Liver Lindsey, Dr. Ivor Horn, and Junaid's Mom talking about helping underserved e-patients. For those who aren't regular readers of my blog, Junaid died this summer of Neuroblastoma. His mother, brought up in poverty, a former drug addict who has been clean for several years now, and the victim of domestic violence, is a powerful woman, an e-Patient amongst the underserved.

How do we address the needs of underserved potential e-patients? It's a discussion that it is time to have.

Postscript: After writing this, I noticed that it is Alejandra Ospina's birthday. Alejandra is the Community Liaison at GimpGirl Community and a powerful spokesperson for people with disabilities. She would be another great member of my fantasy panel.

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