ADEU Update Pre-Conference WorkshopNovember 4, 2009

Presented by Nancy Lombardo, MLS;Todd Vandenbark, MLS/TM;

Ginny Burns, CDE, RN, MEd;Grant Sunada, MPH

Weighing in on Social MediaHands-On Social Media Workshop

ObjectivesBe able to define “Web 2.0” technologies and

describe their characteristicsLearn how to apply relevant Web 2.0

technologies Practice using some of the technologies Discuss ways to incorporate Web 2.0 into your

professional lifeHave fun!

OverviewWeb 2.0 definitionsWhat is Social Software?

What is it good for?Web 2.0 and Diabetes

Our conundrumHow to start?

Social Networking: Listening, Connecting, CreatingListening: RSS – Hands OnConnecting

“Micro-blogging” (Twitter) – Hands On Facebook – Hands On

Creating: Blogs – Hands OnQuestionsConclusions

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Diabetes in Utah

1. Utah Health Status Survey (2007-2008). Office of Public Health Data. Utah Department of Health, Salt Lake City, UT

2. Utah BRFSS 2005-2008

More than 120,000 Utah adults (6%) have been diagnosed with diabetes1

13.3% of Utah adults with diabetes are uninsured2

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Why in UtahMinorities have risen from 1.9% (1960) to 17.7%

(2007)1

Disparities exist in age-adjusted percentages of Utahns with diabetes by race & ethnicity2

1. Pamela S. Perlich, http://health.utah.gov/cmh/data/UtahDemographicTransformation.pdf2. Diabetes in Utah (2008), http://health.utah.gov/diabetes/pdf/fctsandfig/diabetesinutah_book_May08.pdf

American Indian

Pacific Islander

African American

Non-Hispanic

White

Asian American

Hispanic/Latino

Our society is changing

… so is the World Wide Web

Web 2.0 Definitions

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Web 2.0StaticLectureExpert-Model

InteractiveConversationConsumer [Patient]-ModelPublic wants to have all the

information From multiple sources In ways they can

understand From experts AND peers When they want it

Web 1.0

• http://www.brochure2blog.org/

What Is Web 2.0?

Originally coined by Tim O’Reilly of O’Reilly Publishing in 2003

Classic article:http://www.oreillynet.com/pub/a/oreilly/tim/

news/2005/09/30/what-is-web-20.html User participationHarnessing the collective intelligenceDesign for "hackability" and remixability

Wikipedia Definition

“2nd generation Internet services that let people collaborate and share information online in previously unavailable ways” (wikipedia)Blogs, wikis, photo / video sharing sites,

social networking sitesOnline web services that share data

(“mashups”)

Two Sides of Web 2.0

Two-Way Communication(“Social Software”)Creates

conversations between people

Examples Blogs Wikis Photo/video sharing Social networks

Web ServicesSoftware online

Google Tools Protopage.com/websoft

Mashups Photos overlaid on

Google EarthEmbed services

Google custom search engine, Google calendar, etc.

Two Sides of Web 2.0

With social media, people communicate with each other.

With web services, machines communicate by sharing data.

What is Social Software?

Whoa, but what is it good for?

Sharing with othersCreating knowledge basesMaking connectionsBuilding communitiesEngaging colleaguesEmpowering patientsAll of these things and more!

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The “Digital Divide”

A Possible Bridge:Mobile Access

~32% of all adults having ever gone online with a handheld (2009): 48% of African Americans 47% of English-speaking Hispanics 53% of those between the ages of 18 and 29 39% of college graduates 28% of white Americans

http://www.pewinternet.org/Reports/2009/12-Wireless-Internet-Use.aspx

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Generation GapOlder generations use the Internet for

information searches, emailing, and buying products (2009).

More likely than younger generations to look online for health information.

Health questions drive those age 73 and older to the internet just as frequently as they drive Generation Y users, outpacing teens by a significant margin

““Get health info”Get health info”

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Web 2.0 and Diabetes8 in 10 internet users (regardless of health status) look

online for health info1

AKA e-Patients

86% of internet users living with a disability or chronic illness have looked online for health information2

compared with 79% of internet users with no chronic conditions

Just half of adults with chronic conditions use the internet2

But once online, they are avid consumers of health information

1. http://www.pewinternet.org/trends/User_Demo_Jan_2009.htm2. S. Fox, http://www.pewinternet.org/Reports/2007/Epatients-With-a-Disability-or-Chronic-Disease.aspx• S. Fox, http://www.pewinternet.org/Reports/2008/The-Engaged-Epatient-Population.aspx

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Web 2.0 and Diabetes (cont.)E-patients living with a chronic condition are more

likely than others to say that online info:Affects decisions about how to treat an illnessPrompts new questions of a doctorChanges the way they cope with a chronic condition or

manage pain1

However, they feel frustrated by a lack of info or an inability to find what they are looking for

1. S. Fox, http://www.pewinternet.org/Reports/2007/Epatients-With-a-Disability-or-Chronic-Disease.aspx• S. Fox, http://e-patients.net/archives/2009/01/doing-our-best-to-blow-your-minds-emerging-trends-in-chronic-disease-care.html

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Our ConundrumMost people under age 40 are fully engaged with

“social media” but not yet dealing with chronic illness

Most people over 60 are starting to face chronic conditionsbut are not participating in social media

This is changing, but what do we do???

1. S. Fox, E-patients With a Disability or Chronic Disease, http://www.pewinternet.org/trends.asp

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Provide the Best Information Using the Best Communication Methods

• http://www.brochure2blog.org/

Don’t just tell people what to doTry to empower them to be better consumers of health

informationMake it easier to distinguish good information from bad

Rise above junk-infoUser-generated content is here to stayReal risk is for diabetes professionals to be quiet

Tailor content and delivery to the audienceEncourage their participationPromote dialogueEnable people to tell their personal stories

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How to proceed or even start?People generally don’t believe that the

Internet is a panacea1

But it is empowering patients like never before2

What do you do now?ListenConnectCreate

1. S. Fox, http://www.pewinternet.org/Reports/2008/The-Engaged-Epatient-Population.aspx2. e-Patients: How they can help us heal healthcare, http://www.acor.org/epatientswiki/index.php/

Listening

Creating

Connecting

BLOG

Fooducate: 3 steps to embrace social media for RDs #FNCE2009 http://yfrog.com/0r42459875j 12:44 PM Oct 19th from Twitterrifichttp://twitter.com/fooducate/statuses/4998762906

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Developing a strategy: Identify Target Audiences, Goals and Mediums

Starting point – Utah Diabetes Prevention and Control ProgramKnew that online resources provided general information

about diabetesReceived a lot of requests for more specific, local

information

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Forward to Local Expert*Local Diabetes

Questions

LocalAnswers

????

* “Local Expert” not necessarily a diabetes expert

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Identify Target Audiences, Goals & MediumsGoal – Help connect the members of our community

who have diabetesSupport each otherGain a better understanding of our diseaseConnect with local resources

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Forward to Local Diabetes

Expert

Record for Public

ReferenceLocal Answers

Local DiabetesQuestions

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Addressing a Community NeedGestational patient

High glucose levelsDifficulty getting into a free clinic and sliding-

scale fee clinic

Calls were made in her behalfLed to a discussion with medical directors

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Improving local resourcesPatient had Primary Care Network insurance

Had questions about diabetes pump suppliesCalled state office but information was

confusing for patient and PCN staff

Notified State officeArranged for more training for PCN staff

members about diabetes products

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Sharing Information & ExperiencesHypoglycemia question

Individual had a chance to describe her unique symptoms

Sends note back saying it was helpful to understand she was not alone

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Entrance KeywordsWhat did a person type into their search engine to find Ask

Ginny?

cost of insulin pump utah carbohydrates lip tingle colds and flu medication for diabetics carbohydrate grams for pre diabetes

vegetarian my ears are buzzing help i'm a

diebetic minimed supplies utah diabetes ideal glucose number blue cross blue shields of utah

diabetic pump coverage where to purchase a minimed insulin

pump in utah i am a type 1 diabetic..should i

exercise when i have a cold diabetes type 2 grams of carbs for

dinner

how many grams of sugar is o.k. on a daily basis for someone with type 2 diabetes

how many grams of carbohydrates are in 1 piece of pumpkin pie

is there a place where i can get a free high blood check in salt lake city, utah

diabetes help utah program for uncontrolled diabetes questions to ask on diabetes i had a glucose level of 104 but my

a1c was normal blocked nose and low glucose levels gestational diabetes vegetarian

menu

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Intermountain Healthcare IntranetImproved interactions between

Provider-PatientProvider-Provider

Patient-Patient?We know that it is powerful

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Think globally, but …what can you do locally?Create a public or private

Twitter accountExample from Frankie951

Option to connect via Internet and/or text messages

Connect with other CDEsConnect patients togetherLimited to 140 characters

Provide links to in-depth information

1. http://www.rikomatic.com/blog/2009/06/twitter-as-an-event-organization-tool-our-experience-with-the-frankie-95-birthday-festival.html

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Think globally, but …what can you do locally?Create a local diabetes Q&A blog

Try Blogspot, Wordpress or othersSet up to receive questions and comments via e-mailPatients can also respond to questions

Moves beyond Q&ALink to Twitter account with TwitterFeedUse keywords (“meta-tags”) to increase people’s ability

to find your blog Remember to track your web traffic with Google Analytics,

Wordpress or others

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Think globally, but …what can you do locally?

Join or create a diabetes social network on Facebook.com or Ning.com Join an existing national or

international network AADE on Facebook TuDiabetes.com

Connect local support groups Create a local identity Local diabetes educators and

experienced e-patients become “moderators”

Next steps for Ask GinnyConverted Ask Ginny to a

Blogspot blogLinked blog to TwitterLinked both to a Facebook PageCreation of “Ask Ginny &

Friends”Improved sustainability

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Next steps for diabetes in UtahCreate a tool for diabetes educators and professionals under

the working title Online Family & Community Health Center

Use empowerment education model1 to help those affected by diabetes:1. Reflect on self-management experiments2. Discuss the emotional experience of living with diabetes3. Engage in systematic patient-centered goal setting and problem

solving4. Answer clinical questions and provide culturally tailored

education materials

1. Martha M. Funnell, Robin Nwankwo, Mary Lou Gillard, Robert M. Anderson, and Tricia S. Tang. Implementing an Empowerment-Based Diabetes Self-management Education Program. The Diabetes Educator, 2005, 31: 53-61.

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Next steps for diabetes in UtahTarget audience

Uninsured people affected by, or at risk for, diabetes Those who care for and care about them

Reach Partner with universities to conduct market research Explore public kiosks, public libraries, ATMs and elementary

schools Utilize text messages, existing media channels and support

groupsLaunch – First Phase – World Diabetes Day (14 November

2009) The Faces of Diabetes in Utah Inspired by local girl scout Current site – http://inspiredbydiabetes.blogspot.com Future site – http://health.utah.gov/facesofdiabetes

Social Networking

Listening

Creating

Connecting

BLOG

Fooducate: 3 steps to embrace social media for RDs #FNCE2009 http://yfrog.com/0r42459875j 12:44 PM Oct 19th from Twitterrifichttp://twitter.com/fooducate/statuses/4998762906

Listen, Connect, Create

RSS - Listen and ConnectReally Simple Syndication

Subscribe to information “feed”Receive updates automatically

“Current Awareness Service”Automatically receive PubMed searches,

journal table of contents or newsNew information tailored to your

interestsNo email overload!

The “Old Way” – Web sites

The “New Way” – RSS feeds

How do you find an RSS feed?

Search for RSS feeds: http://technorati.comhttp://newsisfree.comhttp://medworm.comOR ask a colleague or friend

As you are surfing, watch for the bright orange icon…

Using and reading RSS feedsPlay around with various servicesSee which one works best for you (and

that is easy to use!)

PubMed and RSS

PubMed: http://pubmed.gov/

PubMed and RSSKeep up with the current literatureReceive literature updates from PubMed

searches

Professional Journal and Current Awareness RSS FeedsDiabetes Educator

http://tde.sagepub.com/rss/American Diabetes Association journals

(4 Titles)http://diabetes.diabetesjournals.org/rss/

Medscape Headlines in RSShttp://www.medscape.com/pages/public/rss

RSS Demo and Exercise

Connect:Micro-blogging

A means of publishing brief text updates140 or fewer charactersPossible uses

Communications: keeping up with colleagues and leaders in your field

Communications: control over your messageMarketing 1: publicizing services, trends,

events and resourcesMarketing 2: identify your community and

build those relationships

Twitterhttp://twitter.comThe short micro-

blog messages are called “Tweets”(< 140 characters)

You can “follow”your colleagues

They can “follow”you

Search topics or people

Ways to Send a Tweet

Directly on Twitter’s websiteThrough an IM client (GoogleTalk,

Jabber)From your mobile phoneTwitter Demohttp://twitter.com

Who uses Twitter?

Utah Diabeteshttp://twitter.com/UtahDiabetes

Ask Ginnyhttp://twitter.com/askginny

American Diabetes Association http://www.diabetes.org/

Amer Assoc of Clinical Endocrinologists(AACE) - http://www.aace.com/

Utah Diabetes - http://twitter.com/UtahDiabetes

Ask Ginny - http://twitter.com/askginny

American Diabetes Association - http://www.diabetes.org/

Twitter Problems

Down timeSustainabilityPrivacyAdds to distraction level

Productive Uses for Twitter

“Push” out information to the publicHealth AlertsServicesNewsletterEventsWellness Coaching

IndividualWeight managementSmoking cessationSocial Support System

Twitter Discussion

What do you think? Useful or waste of time?Let’s try it!

Connect - Facebookhttp://facebook.comFind friendsPost statusChatEmailJoin groupsPlay gamesShare PhotosBe a “fan”

Facebook

Facebook PagesA public figure, business, or organization can

create a Facebook Page to share information, interact with their “fans”

Optimized to represent a business, or organization

Separate from user profilesPages can only be created to represent a

real organization, and may only be created by an official representative of that entity

Use your personal account to manage a Facebook Page for your organization

Facebook GroupsAn informal networkUsed for discussions and special eventsCan help organizations connect with their

stakeholdersEmployeesCustomers/services usersShareholdersGeneral public

Anyone can create a group

Exercises

Exercises

Exercises

Exercises

Create - Blogs

In theory, blogs take the complexity out of creating content, or publishing, on the web

Most blogs have a comments area to facilitate feedback and conversation

Blogs are (usually) organized in reverse chronological order

Blogging started out as first-person, informal communication

Blogging has evolved to include professional, political, and editorial communication/publication

How a blog can benefit a healthcare organization?Destination for information and

community newsResponsive to feedbackMore staff can be involved with the

websiteIncluding the public in the

“discussion” is easierEmergency notifications

Blogs for Diabetes Information

Who is the author?Is she or he affiliated with a reputable

organization?What is the author's educational background or

experience?What is their area of expertise?

Is the information provided based on proven facts? Is there information provided to support

statements of fact?

Evaluate blogs as a source

Search Engines for Blogs

• Google blog search: http://blogsearch.google.com/

BlogCatalog with directory for browsing:http://www.blogcatalog.com/directory/

May be better off searching Google with “blog” in the search.

Medworm:http://www.medworm.com/

Blog Software

Online ( free, hosted) servicesBlogger.com - http://blogger.com/TypePad - http://www.typepad.com/

Software installed on your serverWordPress (open source)MoveableType (commercial)

Blog Features

Features to look for when choosing blog software:Authors and permissionsCommentsNotification servicesCategoriesCustomization options

Templates vs. programmingPublishing options

Publish from e-mail or mobile deviceRSS feeds

Blog Exercise

Questions?

Will you use Social Networking tools in your future work?

What opportunities for communications and collaboration in your work might be possible with these tools?

Conclusions

These tools are easy and fun! New software and services change rapidlyLiving in the “ever beta” worldTaking advantage of user-generated

contentFind the combinations that work for youKeep an open mind!

We shall see!

Thank you!

Contact usGrant Sunada:

E-mail: gsunada@utah.gov Office: 801-538-6141 Twitter: @UtahDiabetes

Ginny Burns: E-mail: ginny.burns@imail.org Twitter: @AskGinny Blog: http://askginnyaboutdiabetes.blogspot.com… or askginny@utah.gov

Nancy Lombardo: E-mail: nancy.lombardo@utah.edu Office: 801-581-5241 Twitter: @nancylombardo

Todd Vandenbark E-mail: todd.vandenbark@utah.edu Office: 801-581-5263 Twitter: @tvandenbark

Website for workshop: http://library.med.utah.edu/ed/web20/ , OR http://tinyurl.com/w20ADEU

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THANK YOU!