The Disease Management Care Blog Annual Report: Three Insights on Social Media in Health Care

It's that time for the Disease Management Care Blog to reflect on the state of social media, both in general and for this blog. 

First off: an annual report for this blog.

Stats: While overall readership in 2013 was down compared to prior years (37,000 vs. 49,000 unique visits) the number of  "regular readers" (at least once a month) has increased from approximately 5000 to 5200.  And these DMCB regulars are a brainy bunch, with ISPs that include health systems, government agencies, policy shops, regional and national health insurers, population health service providers, hospitals, consultants, news organizations, organized medical societies, universities, pharma companies, health care trade associations, foundations, state as well as city governments and other bloggers.  The DMCB doubts many CEOs or SVPs are reading its bloggery; more likely it's front line managers, supervisors and other leaders who are looking for that extra insight.

It's also been a good year for the DMCB Twitter, with over 700 followers. They likewise reflect the spread of health care stakeholders described above.

What has the DMCB's learned in the last year?

A New Wrinkle on An Old Digital Divide: Health writers have pointed out that the socioeconomically disadvantaged and the hospitals that serve them have been unable afford the power of health information technology. Yet, many well-off health care organizations with knowledge and cultural disadvantages are likewise failing to leverage social media to build visibility and enrich their brand.  Some with established accounts are using them to achieve a competitive advantage, but far fewer have actually done anything useful with them.  The DMCB has listened and their silence is embarrassingly deafening.

Cloud Beats Complicated: While the dominant mainsteam media continues to get complicated medical and health policy news stories half right, the good news is that a collective "cloud" of critically thinking bloggers and twitterers are getting things completely right with an on-line wisdom of crowds. As news sources consolidate and their market power grows more concentrated, social media will come to the rescue.

Print and Social Media beat Print Alone: While the prestigious New England Journal has 200,000 subscribers, the DMCB doubts every published article has the same number of readers.  In contrast, Kevin MD has 100,000 readers and a million monthly page views.  To make a real splash, policy authors would be well advised to have their insights appear in both outlets; that's doubly true because the Digital Divide is likewise present in the medical community.  What's more, social media will place an increasing role in increasing awareness - and the implementation - of discoveries from research extending from the bench to the organization of care.

Image from Wikipedia

Open the Medicare Claims Data Base to the Wisdom of Crowds.

If you believe that CMS has what it takes to make sure that Medicare claims are paid the right way for the right patients most of the time, you may need to think again. According to this article in the Wall Street Journal, it's too easy for the government to misspend millions of dollars for dubious care involving questionable doctors.

But Medicare's fiduciary ineptness is not why this article is worth reading.

If you believe the Journal, the Medicare claims data base, otherwise known as the "Carrier Standard Analytic File" is a gold mine of information that, but for archaic privacy laws, could be used to spot those questionable doctors. Organized physician groups have generally opposed the public release of those doctors' names, even if it involves public money.

But physicians' right to privacy vs. the public interest is not why this article is worth reading.

Rather, this article is important because it portrays the power of allowing open access to the government's health insurance claims databases. The Journal simply sorted Medicare claims costs by provider and came up with some potentially important insights. Imagine, says the DMCB, what would happen if everyone could access the data from the world's largest insurer and mine it for correlations, regressions and other statistical whattnot. There are a host of amateur statisticians who could not only uncover important practice patterns, but mine other unknown associations involving demographic information, the incidence of disease and likelihood of successful cure. It's called the wisdom of crowds.

While privacy for patients and physicians is important, reasonable protections are possible. As for Medicare itself, the program would not only benefit from the clinical insights that would be uncovered, but other investigations similar to the Journal's might make it more responsive to acting on potential fraud.

Last but not least, those data belong to the American public.

The data are too useful to lock away from its owners. This is an idea whose time has come.