Update (Feb. 22nd, 2010): Thanks to Kevin, MD for featuring this post on “Twitter and Facebook Can Help Conduct Group Patient Visits”! I’m very honored!

Twitter + Group Medical Visits = ?

The concept is simple. Group Medical Visits already exist. So:

1. Take 10 minutes at the midpoint of the visit and have everyone tweet their feelings, keywords, anything! (with designated hashtag)
2. Visualize in real-time with Twitterfall
3. Discuss, discuss, discuss!

The rest of this post is about the argument in favor of the above.

Twitterfall makes Twitter parties sparkle.

I was thinking about how some “Twitter parties” revolve around a real-time Twitterfall projected on a wall.

Participants go about their party business, but constantly add tweets—appending each with the party’s hashtag (e.g., #med2) which can be fed into Twitterfall search.

The result is fascinating live information about what’s popular in the conversation.

And yeah, people are using it! Last February, the UK newspaper The Daily Telegraph made big news when they revealed that their integrated newroom featured Twitterfall projected right up “traditional” video feeds from heavyweights like BBC and CNN:

However, maybe you’re thinking: so why not just talk to people? Isn’t that the point of a party?

Sure. But I think that good topics easily get lost in a mishmash of party conversations.

I’ve sat in a meeting room with 10 people where 5 different conversations were going on and 1 word caught the attention of 8 people who suddenly perked up and wanted to be caught up on that 1 topic. Or maybe those 5 conversations were actually trending the same topic, but no one knew, so they didn’t engage with each other afterwards?

We are drowning in information yet thirsting for knowledge. How do you “see” a trend?

You can discuss, and listen, and overhear, but you’re only one person. How do you know what is being discussed? How do you know HOW it’s being discussed?

And what does this have to do with medicine?

The New Health Care needs to address some very 21st-century problems.

Support groups have been around forever. Some successful ones are electronic, like the wonderful breast cancer listserv of my home province, Newfoundland. Some are quite informal, just common folks getting together.

Now, as our life expectancies continue to grow, and we’re faced with the very 21st-century challenges of prevention of disease and management of chronic conditions, these group settings become very important.

Patients are recognizing the need to supplement the doctor-patient relationship. Patients want to talk to each other. Especially if they’re going to be in the tough spot for the long haul. This is why a community like PatientsLikeMe — targeted especially to incurable conditions — has absolutely thrived.

But they can’t do it alone.

Physicians should give it a lurk, sort of.

DrV coined the term pre-emptive online health literacy a while ago – i.e., knowing what your patients find when they consult Dr. Google and Dr. Wikipedia.

I wonder, shouldn’t this include some awareness of what your patients are saying about a condition/disease on the internet?

On occasion, wouldn’t patients benefit from a physician’s ability to confirm, explain, or debunk a trend that’s been propagating among a group?

But you’re probably not going to start skulking around corners or lurking in forums.

It has to be efficient. And non-intrusive.

The case for Twitter-supplemented group medical visits.

First, Group Medical Visits 101 (adapted from champsonline):

• You receive an appointment to see your doctor together with 10 – 20 other patients who also have the same condition as you (e.g., high blood pressure or diabetes)
• You get to spend about one hour with your Doctor discussing your condition and any other pertinent health problems that you may have.
• You also get to speak to a Nutritionist or Health Educator and to learn from other patients who are also in your group

The Group Medical Visit is like the party.

We might get lots of great discussion, but wouldn’t it be nice if a portion of the visit could focus on addressing “trending topics”? So, once again:

1. Take 10 minutes at the midpoint of the visit and have everyone tweet their feelings, keywords, anything.
2. Visualize in real-time with Twitterfall.
3. Discuss, discuss, discuss!

*Alternatively, Twitterfall could be used for traditional non-face-to-face Twitter parties of a set duration. People from different locations, including remote ones, get terrific real-time information, but it’s easier to analyze than a text or video chat. And you don’t necessarily have to be sitting at the computer the entire time.

The Tweet Stream is organic.

Advantages:

• ideas arrive in parallel, yet are still discrete and understandable
• less intimidating than yelling out an opinion
• both individual words and longer ideas can be trended
• trending topics and phrases auto-generated (the big concerns rise to the top)
  Update (Feb. 6th, 2010): Ok, I just checked and Twitterfall actually doesn’t have this functionality yet. But Tweetdeck does! There’s a button at the bottom of each column “Show what’s popular in this column” which comes up with a tag cloud of terms, ids, and hashtags.
• you get way more ideas than a traditional whiteboard brainstorm

Another way to look at it: the Google-fu argument!

Tweets are great. 140 characters is just enough to accommodate concepts…but also phrasing, context, and emotions.

For example, don’t you ever wonder how people’s Google search styles vary?

Your Google-fu ~= my Google-fu!

Dr. Schwimmer (@JoshuaSchwimmer) posted this great screenshot on Google’s search suggestions for the phrase “doctor’s are”. Just look at the diversity (and perversity?)! And that’s only given the first 2 words of the query!

Now imagine a Group Medical Visit. What are the concerns of the 20 people in the room? And with what terminology would they express themselves if left to their own devices?

It’s just too hard to identify these subtleties in a crowded room. And the New Health Care is supposed to be about finding your voice.

So that’s the idea!

For a fascinating example of simple Twitter meta-analysis, have a look at:

• Chew and Eysenbach’s abstract
  Pandemics in the Age of Twitter: Content Analysis of “Tweets” During the H1N1 Outbreak