The Listening Tour: Teaching, learning, and social media at academic hospitals

Hillary Clinton came through my little Upstate NY town in 1999 to kick off a “listening tour” on her senate campaign in which she handily defeated challenger Rick Lazio. She demonstrated the power of starting by listening.

Academic hospitals can channel the same power to broaden their reach, and teach.

The first step in launching a social media strategy, according to Hive Strategies, is to listen:

Listen to how patients are talking in the waiting rooms. Listen to the questions new moms in your birthing center are asking nurses. Go to the FAQ web pages created by your Centers to read what they feel are the issues of key concern to patients. Go sit next to the person who answers the hospital’s main phone line. What questions is he or she answering for patients? Listen to the voicemail introductions of each of your centers to give you insight into what the managers think their patients need to know? Listen to the conversations in Emergency Rooms. Listen to what your patients are saying on patient surveys, and listen to how the media talks about your hospital.

What if medical students were used to do this listening as an elective? They would gain exposure to the real needs of various stakeholders in healthcare. Reporting on their discoveries, they could research supporting evidence and share it using a social media tool like Yammer. All the students working on such a project could upload their findings and discuss them in a common, secure web document that could serve as an informative portfolio for the social media strategy.

Such a listening tour would offer students valuable insight into the realities of healthcare barriers and quality issues, as well as some exposure to the applications of social media both to share information and tackle these barriers to deliver better care. The hospital would get free “boots on the ground” for the fact-finding step as they reach to claim the mantle of "healthcare innovator." The college of medicine gets their students talking about issues and passing them along to the whole class, as well as incorporating social media into the curriculum. And, some day, patients get better care.

How to get started with Twitter (QUICKLY)

I've outlined 10 quick steps to getting started, in video and text. Play the video while looking at the text?

1. Sign in at twitter.com.
    *Your username will become your identifying "handle." I recommend going professional. I'm @astupple.

2. Click the drop-down at the upper right, choose "settings," and attend to "tweet privacy."
    *Before you share content, decide if you want it public.

3. Click "profile" and upload a picture.
    *Better to use a photo of your cat than nothing- otherwise people will think you're a spammer.

4. From the homepage, click "who to follow" and enter "@astupple," "@westr," and "@kentbottles."
    *You can sample our "feeds" by clicking on the links.

5. "Twitter clients" are programs, apps, and extensions that interface with twitter better than the website.
    *I recommend the web browser extension "chromed bird" for google chrome. Fast. So fast and easy.
    *Others love "tweetdeck" and "hootsuite" as desktop programs to use instead of the twitter website.
    *For your phone, I like the "echofon" app, but tweetdeck and hootsuite apps are great too.
 
6. Know this: Only those who follow you will see your tweets EXCEPT...
    *If you include a handle, @JohnDoe, in the tweet, then John Doe will see it even if he doesn't follow you.
    *If you include a hashtag, #thebeatles, then anyone following or searching #thebeatles can see it.
    *If someone searches your for terms that you used in your tweet, they MIGHT see it.

7. Q few quick terms:
    *Tweet- Any time you send a message via twitter.
    *Retweet- You resend a message that someone else tweeted, the originator notices (and appreciates it)
    *Reply- A tweet that starts with someone's handle, it's viewable by your followers who follow that person.
    *Direct Message (DM's)- Private message someone by entering "d astupple Blah blah blah..."

8. When including links, shorten them with services like tinyurl.com or bitly.com.
    *The twitter clients usually do this automatically, you'll get a sense of how to condense links quickly.

9. If you want to see crazy, sign in to tweetchat.com Sundays at 9PM and enter "HCSM."
    *I dare you. (It's the H.ealth C.are S.ocial M.edia weekly tweetchat and it's FUN.)

10. Finally, I'd follow @tweetsmarter to get LOTS of great tips on Twitter use and everything else.
    *The Twitter Guidebook answers questions like "What is a hashtag?" and others far better than me.

Happy tweeting!

Twitter is a vastly rich medium that's worth your time.

It's 10 minutes, and it's all been said before, but I hope this video is worth your time.

Summarized below are three reasons (among many more) to give Twitter a shot.

1. Taking
You don't have to give in order to receive. By following people without ever delivering a keystroke, you can quickly consume information that is relevant to your interests. Like surgery? Follow Atul Gawnde (@Atul_Gawande). Curious about the latest in neurology? Check out @NeurologyNow. Interested in healthcare policy? Follow @GarySchwitzer. Thirst for everything? @KevinMD and @KentBottles.

2. Giving
If you want to create content, there are gradations of involvement. You can innocuously resend what you thought was interesting (called retweeting), or post websites that interest you, along with short descriptors. More boldly, you can share experiences, make statements and judgements, or use Twitter to broadcast your own creations (warning- you might find yourself creating a blog and posting videos about how awesome you think it all is). See how medical student Allison Greco unifies blog and Twitter at md2bGrecoa3.com and on Twitter as @GrecoA3, or gastroenterologist Bryan Vartabedian at 33charts.com, @Doctor_V.

3. Networking
While conventional circumstances narrow who we get to know in this world, Twitter offers a great way to connect with people we don't know but who otherwise share our interests, our quirky insights, idiosyncratic hangups, or outrageous perspective. If nothing else, consider establishing a Twitter account before attending your next conference, whereby you'll more easily meet attendees with your motivation. And, it's not just for connecting with those across the country, but also for meeting local people and maintaining relationships you've already started. I know @Peds_ID_doc pretty well, and gain much clinical insight, considering I'm rarely physically in his presence on the floors.

Caution: Don't say anything that would would bother you were it printed in the newspaper. Envision each tweet on a billboard outside your hospital. In the digital world, it's hard to know where the walls are that enclose your statements, and depending on your personality, it's easy to lose yourself, or to outright forget yourself, and say something boneheaded (or worse).

Aphorisms and The Black Swan and Twitter

The most compelling aspect of Nicholas Nassim Taleb's book The Black Swan was his dissection of the narrative fallacy. We continually concoct explanatory stories to comfort ourselves in the face of an irreducibly complex world. Crucially, stories compel not only by their truth, but by their very nature as stories. (Taleb cites those fantastic split-brain experiments where intelligent patients, faced with their own obviously contradictory behavior, will fabricate wild explanations without hesitation or doubt.)

However, stories often fail (even the best inevitably fail at the hands of unpredictable, rare, black swan events), and we rewrite our stories and hang on until they fail again.

But these stories do have kernels of insight and nuggets of experiential wisdom. How do we pluck out the insight?

Enter the aphorism, short statements that focus on the insight and dispense with the time-consuming and misleading narrative. Nietzsche authored many of my favorites:

"A casual stroll through the lunatic asylum shows that faith does not prove anything."


"Admiration for a quality or an art can be so strong that it deters us from striving to possess it."


Are Twitter, status updates, and the sound bites of social media digital aphorisms, dispensing with the narrative and going straight for the insight?