subtitled: foreseeing a day when we will shop for and buy medical services without leaving the house.

Google  - (n.) first stop on the information superhighway.
“I went to google to find the answer”

Google – (v.) to look for anything online
“He wanted to know more about diphtheria, so he googled it”

Google – (n.) medical instrument used to aid in diagnosis and treatment
“Sally wondered about the bump on her arm, so she went to google and googled the symptoms of spider bites”

Sometimes a topic is like a cloud full of metaphors waiting to rain down. The trains coming and you better get onboard. That ship has sailed. Know thy enemy. A few weeks ago I had the privilege to speak (along with a group of infinitely more qualified other folks) at a healthcare conference in Chicago. During one of the panel discussions, someone made a comment which I’ve been chewing on for a week. ”The competition, for attention online, is sites like RatedMd and WebMD.”The only thing I could think of was those Loony Tunes where the Abominable Snowman always got confused and said: “Which way did he go George, Which way did he go?”. He was cutely befuddled by misdirection as abominable snowman are apparently wont to be. (The catch phrase, by the way, comes from Of Mice and Men.)

The context of that comment was in regards to reputation control and public perception. The concern is healthcare providers are being valued and rated online and without some presence of their own, their “brand” has potential to be devalued. While that point deserves some consideration, it wasn’t what got me thinking.

What set the hamster on my mental wheel gasping for breath was the idea of online sites competing for patient attention in general.  This isn’t a new idea and likely won’t strike you as terribly profound. People go online, they google, and now they talk to each other via social media sites. Now think about this: how does that play out when those searches, sites and conversations reduce the overall need for your system’s healthcare services? What happens when a patient goes online and gets a diagnosis and even a treatment rather than coming through your doors?

Think it won’t happen?

I’ve been looking for pickle crocks. I like to pickle things. You probably know that about me. Here’s the thing about pickling, when you let natural bacteria do the work, its a delicate process. Two things will kill the bacteria and render salty but unpicked veggies every time: sunlight and chlorine in municipal water. The later is easy, you buy spring water from the store. The best solution against sunlight is an earthenware ceramic pickle crock. You’ve seen them in your grandmother’s kitchen, probably holding the wooden spoons and whisk in the corner near the stove. Once upon a time, they served a real purpose. The problem is that they are increasingly more rare. It seems no one else shares my interest in pickling – shame. So try this: go to google, type in “pickle crock”.

If your results are similar to mine (and remember, a google search is in the fingers of the beholder), then the top 5 or 6 results for pickle crock are online stores or sales sites. You may even get some Google Shopping results at the top. Think I even checked a local store first? (I know, I know, its good to shop locally).

Now, google “allergies”. This time the top several sites are informational sites: WebMD, MedicineNet, eMedicineHealth, and even a few nationally known hospitals.

I know what you are thinking. Yeah, you can buy a pickle crock online but its not like you can buy an allergy diagnosis on WebMD. …. yet.

Last week CMS, the Center for Medicare Services, announced it is loosening the regulations around telemedince certifications. That is a big step. The process for credentialing practitioners to treat people via Skype just got a lot easier.

Lets talk fee-for-service

This one is simple. The average net reimbursement for a family physician visit is about $60. The average patient co-pay is $25. If a patient can stay in their own home, avoid the hour wait in the waiting room, not to mention the germs and two year old copy of Highlights magazine, and see a doctor or nurse via Skype for $15, which path do you think they’ll pick? You’re out $60 and the patient saved $10. There is, of course, the huge downstream impact on referrals and patient loyalty as well.

Enter the ACO

With the hullabaloo around Accountable Care Organizations, there is an increased interest in technologies like telemedcine. They can save money. Here’s the rundown incase you missed it. In an ACO model, a provider is given a pool of patients, lets say 5,000. They are then allotted a fixed amount of money to keep those patients well for a year. Lets say $1,000,000. If no patients come in the door at all and all of those patients are perfectly healthy you effectively pocket the cool million. However, when they do come in, you need to use your resources wisely. The healthier they are, the more you keep. So you have a mixed bag – don’t order expensive tests, thats money out of your pocket. But you do need to ensure they get better. Now what happens when those patients start going online and getting treated by eVisits from other providers? The current CMS regulations do not prevent patients from seeing other doctors. However, you are still on the hook for the outcomes. If that eVisit doesn’t work out, or worse, has an adverse outcome, guess who’s pocket is being reached into?

Now, I’m the last one to spread FUD and start fear mongering. I’m also a big fan of the interwebz and the potential these technologies hold for patients (after all, we are all patients). What I would suggest is that health systems and providers need to be ahead of this curve, not behind it (that one counts double for buzz word bingo). We need to offer these services to our communities and patients ourselves and not let large, profit driven websites own this space. eVisits, telemedicine, social media, text messages, email, EMR … these are all doable today. There are already patient populations where this makes sense and there are revenue models which work. In a fee for service environment, what does the pro forma look like? Can you staff a nurse in a role to interact with patients and charge them just a little less than an office visit co-pay? What about doctor to doctor telemedince as a start? Lets not be the Abominable Snowman with our arms crossed and fingers pointed in opposite directions asking: “which way did he go George, which way did he go?”

Update: From the “great minds think alike department”, Jen Riggle wrote a great post on the same day talking about, of all things, skyping doctors. Her research and links suggest reality is closer than we may think. In particular, take a look at Dr. Brian Goldman’s advice. He suggests starting with established patients. If you already know, because you have meaningfully implemented an EMR, that someone has seasonal allergies every spring, that is one more check box in feeling secure about making that diagnosis next April via Skype.

By the way, Leeners sells great stoneware pickling crocks at a good price.

I had the privilege recently of being asked to write a short reflection on the use of social media in healthcare. I suggested many of us are moving from our freshman year – getting familiar with campus, determining which is the cooler spot to hang out at, facebook or twitter… you get the idea – towards our sophomore and junior years. For many providers, this year is about figuring out what to do next. What will actually bring value and make using social media in healthcare, well, meaningful. What are the meaningful use guidelines for #HCSM?

In late 2010, the federal government released a much anticipated set of guidelines around how healthcare providers should use electronic medical records. The guidelines, know as Meaningful Use, specifically spell out what features an EMR must contain and how doctors must use those features in order to qualify for federal stimulus dollars. For instance, the guidelines suggest providers council every smoker on smoking cessation. The software must be able to prompt doctors when someone has identified as a smoker and it must be able to capture that the physician has spoken to them about quitting.

Meaningful Use says it is not enough to simply have an electronic record. Meaningful Use says the EMR’s feature set and how it is put into practice determine the impact it has on care. Today, we can say the same thing about social media in healthcare. With heartfelt thanks to the pioneers who fought the HIPAA and ROI battles, it is no longer enough to simply have a facebook page or twitter account. There are expectations around engagement, user experience, quality and value which users have come to expect through interactions with other individuals and organizations.

The good news is that there is no single correct way to use social media and digital communications as a provider. There are, however, a few basic ideas which I boldly offer as guidelines for using social media as a healthcare provider:

• Be available – Phil Baumann said it well. You do not need to be famous online, you just need to be available. In fact, the rest breaks down if when this guideline is not followed. It has been said many times by many people, social media is less about pushing and more about pulling. If you are not open to conversations with the public, patients, other providers, etc then social media may not be for you.  As guidelines go, this one may be the most significant for meaningfully using social media. Being available is more than just replying to tweets. Availability means knowing who within the organization can answer the question authoritatively; It means having a team of on call experts. I know at least one healthcare thought leader who envisions call centers giving way to tweeting centers. Have the capacity and expertese to follow up with your tweets, comments and facebook wall.
• Bring Value – There is an easy litmus test for this one. Think: “why would I follow or fan a company?” Most people get enough spam email and junk mail. Can you honestly say you would want to get the message you are pushing out if you didn’t work for the provider pushing it out? If not, then it is probably spam. So what kinds of things bring value? Think about curation, sharing expertise, answering questions, helping someone find what they are looking for. Here is a simple way to bring value: go to search.twitter.com and select advanced search. For the search string, enter something like “doctor” and then put your zip code in the location field. Chances are someone in your area is looking for a good doctor. Reply and offer to set them up with a same day appointment. Now that’s value! Another example includes hosting diagnosis specific communities and wikis with clinician participation. Imagine an online community of folks who have been and are about to go through an orthopedic joint replacement. What kind of value would they get from connecting with each other and sharing experiences in a forum moderated by a clinical expert?
• Liberate your expertise – Most physicians go through at least 4 years of medical school and post graduate education. Many pursue fellowships and residencies. There is a significant amount of intellect and scholarship trapped in those brains of theirs. Here is the problem, until there is something wrong with me, I have no way of tapping into that knowledge. We often mistake holding onto our ideas and knowledge as power. The reality is the opposite. Those who are willing to share their expertise often find the rewards to be considerable. If you are a physician, you are a trusted expert in your field (the same can be said of provider organizations). Your use of social media must consist of sharing that expertise. Provide your opinion on the health news of the day. People would much rather get that expertise from someone local and trusted than an etherial disembodied name on the byline of a major news paper. Here are two great examples: Dr. Howard Luks and Piedmont’s HealthWatchMD site.
• Be collaborative – engage publicly with other physicians and experts (and can’t patients be experts in their own conditions?). If you are an expert individually, and there is indeed benefit to liberating that expertise, imagine what happens when you team up with other experts? In medicine there is the concept of grand rounds – opportunities for physicians to present complex cases as learning experiences to other providers. Today’s social tools are perfect platforms for grand rounds. The more providers are willing to interact and share, the more we all benefit. This collective knowledge becomes searchable, accessible by anyone – patient or provider – who wants to learn more about a condition or treatment. Dr. Gayle Smith does a fantastic job of collaborating with patients and colleagues.
• Be Innovative - Innovations come in many forms; not everyone has to be the next iPod. Think about how social and digital tools are being used outside of healthcare. What applications might they have in improving health and patient experience? Over 500 million people are using facebook. According to their statistics, 250 million access the site from a mobile platform and mobile users access the site at least two times a day. What does that tell us about the role mobile platforms play in what has become the most significant communication tool of our age? Do you have a way to interact with patients via a mobile device? What about text messaging? There is an innovation which is easy to adopt. Solve problems, don’t get hung up on them.

There you have it. How is that for a start? As we start to go beyond simply being online it is time to think about how to have an impact in what we are doing. What other guidelines would you propose? What about from a patient’s perspective, what makes social media meaningful?

The third in my elsewhere series of important content from other sources, this post highlights the entire December 2010 issue of the Harvard Business Review. Because HBR is a business and has to pay the bills, not every article is available online. I’d implore anyone reading this to find a print copy and read it, cover to cover.

I’m obsessed. If we’ve chatted about social media recently then you know about my obsession with the December 2010 issue of Harvard Business Review. The majority of the issue focuses on social media and branding. I’ll sum up my reaction simply by saying the entire issue is a profound validation of the new model for community engagement. Along similarly profound lines, Dana Lewis recently posited, “social media is more art than science.” If that is the case, then the HBR outlines the form of the art, its importance and place in the world.

That later point is not to be understated. As barriers to communication disappear, the expectations on meaningful interactions rise. Today, social has to touch nearly every business line and strategy before it goes out the door.

According to the authors:

Many consumer touch points are owned-media channels, such as the company’s website, product packaging, and customer service and sales functions. Usually they are run by parts of the organization other than marketing. Recognizing the need to coordinate these channels, one of our clients, a consumer durables company, has moved its owned-media functions into the sphere of the chief marketing officer, giving him responsibility for orchestrating them. Along with traditional and digital marketing communications, he now manages customer service and market research, product literature design, and the product registration and warranty program.

Here is the take away: its not a silo. I don’t agree with the quoted case study saying it has to be under marketing, in fact I’d suggest that there is a new breed of communications department, or as we call it, Community Engagement. But the salient point is regardless of what you call it, it has to be empowered and positioned to include responsibilities for customer service, market research, business development, communications, branding, outreach, sales and more.

I hear a lot of heathcare organizations asking the hows and whys of using social media. This week, Ed Bennet released the latest round of hospital social media stats – 890 hospitals are now engaged in some form of two-way, modern communication. And while that figure is impressive, validating and promising, there are still some 4,200 odd hospitals and countless physician practices, vendors, professional groups, patient groups, etc which are still struggling to understand the value of how people are communicating today. That’s ok. They are asking themselves important questions which those organizations need to sort out for themselves. I will offer one cautionary bit of advice:

heathcare is not like retail

Sure, there’s lots of talk about consumer driven healthcare. And maybe I’ve gone on on and on about what healthcare can learn from consumer companies. I’m not trying to contradict those points. What I am suggesting is that looking at retail as a model for using social platforms is flawed for a few reasons.

Retail can get away with…

Selling, for starters. When you interact with a retail brand online, you expect their goal is to sell you stuff. Indeed, the savvy ones understand the importance of experience and customer service in making the sale, but it’s still about the sale.

So when a company asks you to fan them on facebook for deals or retweet for a chance to win, you enter into a pact which both the consumer and the retailer understand.

In the infographic above, the idea of giving away kidneys may be a crass example. It is however not any different from a retail approach.

What healthcare organizations can do…

Is what retail has a hard time with; actually caring about (and for) individuals. Healthcare organizations have an inherent trust based on the services they provide. When a healthcare provider ventures into modern communications, there is a pulpit awaiting them with the words “first do no harm” emblazoned on the front. That credo is also a pact which patients and providers understand. Providers can further build trust by using social platforms to extend the reach of their care.

Again, in the example above, actively listening for and responding to patient needs is something retail simply can’t do with any cache. Here are some other things providers can do which retail cannot:

• Give away trusted, curated medical news and tips
• Help people find care
• Participate in the medical decision making process
• Be genuinely compassionate
• Support community efforts without bias

Rather than taking the retail approach to interacting with the digitally connected, try taking the nursing approach. Let’s ask ourselves what a nurse can do that a shopkeeper cannot (are there still shopkeepers? well, you get the idea).

So, let me get this out in the open. I’m not a social media advocate. I’m not a social media guru, expert, thought leader, or zealot. I am not pro-twitter. I’m not really that into Facebook (please don’t unfriend me!). You might be surprised to read that I’m not always looking down at my phone. Maybe I am. But still.

I am an advocate for care. I am an aspiring healthcare guru, a wanna be expert, a hopeful thought leader and unabashed zealot for improving the patient experience. I am a pro human. I am really into making someone’s care experience a holistic one. You might be surprised to read that I like to spend part of my day greeting people at the door of our ER.

When did social media become about, well, social media? When we we decide that talking about what we are talking on was more important than what we should really be talking about? I’m not an angry blogger, I promise. And I’m not singling out anyone or any post either. In fact, there have been some important online discussions recently about the validity of social media in healthcare.

But, isn’t it really about healthcare, about care. I mean, if its not, why are we interested? I’m guilty of getting wrapped up in frenzy; and suspect we all are. This is my call to action, my reminder to myself and my sincere wish – lets keep it about advancing how we care for others. We do that in many unique ways. Doctors do it differently from nurses, who do it differently from patient advocates, who do it differently from mental health professionals who do it differently from us admin types, who …. well, you get it. Still, we are all focused on improving the experiences and outcomes of those we care for. When we start talking about the 1s and 0s that our bully pulpit is made of, we’ve lost some of our effectiveness.

Be health champions first. Let’s be champions of care first. Let’s focus on using early adopter, expert, and guru status to champion what it is we are really doing – elevating the art of healthcare.

epilogue: Now, I know what you are thinking. Wasn’t my last post on this blog a hubristic, aggrandizing, self-promotional link to an article where I was quoted as being some kind form of thought leader? I see where you are going with that though and I agree. I’m talking to myself in this post. In fact, when I forget about this altruistic nonsense, I expect you (my two readers, hi mom!) to call me out. I’ll also add that those kinds of articles and posts are important. They are ammo in our arsenal to promote the use of social media – we just need to remember why we are so keen to promote it in the first place.

Ever go shopping and see something and think “I have no idea what I’d do with that, but I have to have it?” It happens to me all the time, and almost always in one of two areas: food and tech. Take for instance this Star Trek USS Enterprise pizza cutter- I have to have it! I’m nothing if not predictable. This week, I was blown away when I learned about what the folks at Expert Labs have come up with. They are calling it ThinkUp. In their words:

ThinkUp is a free installable web application that captures the insights and expertise of your social network by collecting and organizing replies to your conversations on Twitter, Facebook and (soon!) other networks.

I grabbed a copy of the code and installed ThinkUp on my hosted webserver – in fact, you can see it here. Like a left handed garlic peeler that doubles as a beer opener you pick up in the check out line, ThinkUp is one of those things that is both immediately full of possibility and confusion at the same time. ThinkUp connects to your twitter account(s), and Facebook account and begins backing up your conversations. Via a sleek web interface, it presents all kinds of data and analtics back to you. ThinkUp shows:

• Your most replied-to posts
• a breakdown of clients
• your most re-tweeted posts
• Threaded conversations that you have had
• Links the people you are following have tweeted
• photos from the people you are following

And much more. Like I said, I’ve just begun to scratch the surface.

What makes this Healthcare and HCSM related? Nothing special other than it is a great tool to have in your arsenal. Providers should consider installing ThinkUp for two reasons: Firstly it backs up your twitter stream. There are plenty of other great ways to do that, including Backupify, although TweetUp lets you own that data on your own server. Secondly, it helps you produce some dynamite metrics easily – replies, retweets, popular tweets, etc. It makes showing the effectiveness of your posts quite easy.

There are some not so obvious examples as well. For instance, ThinkUp shows your percentage of “conversationalist” vs “broadcaster”. Maybe it is time to stop telling and start listening…and responding.

ThinkUp helps you track your conversations and replies. When you ask a question, particularly if you have an engaged set of followers, you often get answers in an asynchronous timeline. That is to say, replies may trickle in over time. ThinkUp remembers your query and presents all the replies in an easy to digest view.

Your experience with the setup process will depend on your comfort level of installing web applications. If you have ever set up a WordPress site on a hosting account, you’ll have no problem. If the idea of installing software on a web server sounds daunting, then you may want to wait for hosted ThinkUp providers to pop-up – and that is sure to happen.

If you want to see the user’s public dashboard, feel free to check out my install. Or, grab the code and get your HCSM nerd on!

Remember when rock bands would storm the radio station, taking over the morning zoo? They had totally free run of the place. “Dogs and cats, living together, mass hysteria.” Well, at least that’s how it seemed to me circa 1993. In the end, it was just one of many marketing and promotional tools used by bands to tout new records. However, there is a kernel of validity in handing over the controls from time to time. When the same idea is applied to healthcare social media programs, the result are fresh voices and perspectives, deeper explorations of topics and a group of employees who are more capable of representing the organization online.

Lately, I have been inspired by the Ritz Carlton’s use of “guest tweeters;” ladies and gentleman outside of their core communications team who take over the reigns on behalf of the organization. Having different members of the organization represent the company gives a chance to highlight regions and specific properties. Hospitals, even single facility systems, are not much different. Using guest tweeters, or “social media ambassadors” is a great way to add some dynamic range to what you are sharing online. Recently we tried something similar in our Richmond market. If success can be measured in sentiment, we felt energized by the pilot.

There are many reasons to consider cultivating social media ambassadors. For starters, no [person] is an island. Even with best efforts, it is difficult for any one person to represent an entire healthcare organization. The most seasoned healthcare communicators may still be clinically novice; having a nurse tweet for a day could be a detailed look at a clinical topic. Interviews and quotes from various departments or experts give a sense of a topic. Allowing those same groups to run the show for a few hours or days lets them to take a much deeper dive. Showcasing someone else’s voice in the mix also keeps things fresh and interesting. The way someone talks passionately about their own work is always more stimulating that listening to someone else try and represent it for them. Finally, cultivating a group of ambassadors helps organizations develop a base of pitch hitters and trusted spokes people. (I’ve written before about empowering employees to speak for the organization.)

The logistics and mechanics of a social media ambassador program is fairly straight forward. Just like any successful project, coaching and a partnership will go a long way. Start with a simple, one page document. It should include an overview of the tools (twitter, Facebook, etc) and terms (retweets, direct messages, likes, etc). It should also spell out, in lay terms, the organizations communications guidelines. For example, thank everyone, even those with negative feedback, or don’t engage in political banter. Finally, it should define expectations of what is on and what is off limits. For instance, you may want your ambassadors responding to general comments and you may ask them to avoid replying to anything negative. Perhaps you stay “on call” and formulate any replies together, ensuring that the organization is well represented along with the guest’s voice. Regardless of the plan, spell out out.

In addition to coaching the experience for online ambassadors, it is important to make sure they understand the tools they are using. Many will already be familiar with Facebook, making it easy to turn “Wellness Wednesday” over to your wellness team. They may not have administrated a page, something that is easy to walk through in a 30 minute coaching session. The same goes for Twitter. Tools like Hootsuite can help and give some control. They can also be tedious for new users to pick up quickly.

A good policy and agreement of expectations will help the governance process. That said, turning over the controls should not mean abdicating responsibility. It is important for those responsible for social media to watch the flow of the posts and conversation. Maintain close contact with your guest posters and make yourself available to answer any questions they have along the way.

Take a page from the Ritz Carlton’s play book and find some social media ambassadors. Hold their hands through the process and you’ll be well rewarded. Your social media stream will get a fresh voice, some deeper perspectives and you’ll be training a whole team of spokespeople in the process.

There is a great deal of attention these days to the concept of electronic medical records (EMR). Sometimes we refer to them as electronic health records (EHR) or even personal health records (PHR). While there are semantic differences between each, the idea is the same: a complete, portable electronic snapshot of your health. At least that is the idea. In practice today we are really talking about an electronic record of your medical history. (notice I left out portable, complete and health).

Enter the idea of accountable care. Many industry experts are already envisioning a near future when providers will move from reaction to proaction. Rather than being paid to treat the symptoms that walk in the door, doctors may get paid for keeping you out of the office. A practical example is obesity. Instead of being reimbursed to treat the side effects of obesity (asthma, diabetes, joint pain, etc), a doctor may get paid for helping a patient achieve a healthy lifestyle and losing weight.

There is still something missing from this equation. And that is where your social graph comes in. A lot of us do healthy things all the time. According to Foursquare, the geolocation based social network, I have “checked in” to my gym 57 times since early March. I have gone to the farmer’s market 15 times this year. I have attended four medical education seminars (ok, those were work-related, but I still learned something). Here’s the rub, my doctor doesn’t know any of that. If he is going to be responsible for my complete health, shouldn’t those things factor in?

So, continuing my “someone please build this” series of blog posts, here is my latest plea: someone please build a conduit between my social graph and my health record. Let me opt in and chose which things I share online which should also go into my EMR to become available for anyone treating me. Tools like Foursquare come to mind as an obvious choice. Since it is based on location, it takes some of the effort out of participating; it just knows where you are. So when I check in to the gym, wouldn’t it be great if my health record was updated too?

My good friend and HCSM guru, Dana Lewis pointed out the power of twitter hashtags. What if we were able to define a specific, personal tag, say #NicksHealth. Every time I want to include a twitter update in my health record, I tag it with #NicksHealth. Last week, I had surgery on my knee to repair an ACL injury. Every day for the first week, I took a picture and loaded it into Flickr, the social photo sharing site and posted a link to the picture to Twitter. If I were able to tag it with #NicksHealth then my doctor would have a series of images showing the progression of my range of motion, wound healing, etc. When I update my Facebook page with details from physical therapy, that information could populate my medical record, along with my Foursquare checkins – my doctor would see just how compliant I have been with his rehab orders.

It doesn’t all have to be healthy. Providers need a complete snapshot of our lifestyles if they are going to suggest a course of care. Perhaps through incentives, competition or other means, patients may be encouraged to also share things that are less healthy. “I ate a burger tonight, with fries…and bacon…lots of it. #NicksHealth” – My doctor should probably know how often that happens in relation to my trips to the gym.

There are, of course, some challenges to this idea; including the burden of combing through all the data. Physicians may already feel like they have information overload. Without an accountable care model in place today, there is not much to entice them to pour over patients’ social graphs. In time, we will also need software that can automatically sift through the updates and present them in a meaningful way to physicians. However, the first step remains building the connection.

Every major social network has an API, or Application Programer’s Interface. APIs are a way to move data into and out of systems. If you use a twitter client like Tweetdeck or Twitter on your iPhone, you are using the Twitter API. Health providers, when considering their online offerings, would be wise to build in API functionality to online health portals.

Let people chose which data they want to share with their medical record. Providers can incentivize participation through reduced co-pays, social competition, etc. In return they get a rich flow of lifestyle information. When accountable care, meaningful use, EMRs and social graphs come together it will be a win for us all.

The genesis of this idea came out of the Healthcare track of the C2C US/Russia Civil Summit that I participated in in June 2010. During a discussion around the use of social games, Dr. O Marion Burton had a lightbulb moment. He piped up with, “oh wow! how cool would it be to show off that I used a cheaper med and had better results!” I have been taken with the idea since that conversation. Since I am not a coder, here is my plea: someone help build this.

Imagine a social site, a game of sorts, that rewards doctors and clinicians for improving outcomes, reducing costs and improving a patient’s experience. Docs are a competitive lot, they worked hard to get where they are and that kind of drive doesn’t end at graduation from medical school. “Dr. Smith just prescribed a less expensive alternative.” Oh yeah? “Well, my patient just got out of the hospital a day under the national average length of stay.” Can you see the peer pressure building?

Unfortunately this site doesn’t exist…yet. Imitation is the sincerest form of flattery right?

Have you checked out the Foursquare social network? It is a social game, you (or rather your GPS equipped mobile phone) tells Foursquare where you are and Foursquare tells your friends. If you are out on the town and want everyone to get together at your favorite watering hole, you log into Foursquare, update your location and blast a note to your friends.

The game part comes into play in two ways. First, if you check into a place multiple times you may become its “Mayor”. Savvy restaurants and businesses are rewarding mayors. In early 2010, Starbucks began offering Mayors a $1 discount off Frappuchinos. The second part of the game are the badges. You get badges for anything from checking in after 3:00AM (School Night) to checking in near the water (On a Boat). Think of them like Girl or Boy Scout merit badges, only, well, internetier.

Back to our medical example

Patient care is not a game and to create a social site that does not trivialize it takes tact. However, there is nothing wrong with a little healthy competition. The Federal Government’s CMS website offers good data on how one hospital stacks up against another; and it is fairly easy to read….if you work in healthcare and spend your time digesting these kinds of things. I am not convinced that the average consumer wants to suss out the percentage difference between two providers (although the site does a nice job of using plain language).

What I am suggesting – no – begging someone to build is a site that is relevant to both clinicians and the public. Think: Foursquare for doctors. Write a script for a generic med three times, get a badge. Have a better than average outcome, get a badge. Become the mayor of wherever you attend CME courses. Doctors could follow each other and would see what their peers are up to. When Dr. Jones writes a generic script three times, Dr. Smith might ask him which med it was, what the differences are, why Dr. Jones prefers it, etc. The professional interaction does not have to happen on the site. The site is simply a way for docs to encourage each other to improve care. Patients can follow along too. You could visit your doctor’s page and see what badges they have. Looking for the best surgeon? Find the one with the “10 complication free surgeries” badge.

I’m not much of a coder and don’t have an ability to produce great design (although I did the fancy syringe badge for this post, pretty good huh?). So please… someone build this!