Crashing the #hcsm party

I can never attend the designated Healthcare Communication Social Media (abbreviated hcsm, affix a hashtag and you get #hcsm) community chat on Twitter in real time on Sunday nights, but have usually seen several medical librarians actively engaged and I enjoy catching up on the conversation when I can.

Tonight I also noticed mention of a blog entry entitled The Pew Internet/Health FAQ by Susannah Fox on epatients.net about how people search for quality health information that contained a shoutout to the Medical Library Association (MLA), a comment from medical librarian Luke Rosenberger with an explanation about how the 'Google as diagnostician' article isn't necessarily accurate, and offered a comment of my own with more quality health information evaluation resources.

Part of the #hcsm discussion?



Bring it on!

While I'm happy about steps that MLA is taking to advocate for the role of hospital librarians, such as the recent Vital pathways for hospital librarians: present and future article and others from the October 2009 Journal of the Medical Library Association, I'd love to see the profession take a more active role for medical librarian advocacy in non-traditional settings as well. There are plenty of us there already at @medlibs on Twitter and elsewhere.

Health Care Reform & Medical Librarianship

Me in front of my first poster!

I had a great but tiring time at the Pacific Northwest Chapter of the Medical Library Association (PNC/MLA) annual meeting earlier this week in downtown Seattle.

I wrote a few entries for our conference blog about two of the dynamic speakers we had and wanted to share them with you since they are very timely topics about health care reform:

• What Roles Will Medical Librarians Play in Reforming the Nation's Health Care System? by Will Welton
• Health Care Reform and the Patient Centered Medical Home Model by Dr. Lori Heim

One drawback to a conference being local is that in addition to the wonderful networking and learning, you don't get to detach from the family routine... lunches still need to be packed and school buses caught by 7:30 am, and there were no late nights over drinks with colleagues for me. Nonetheless, for as much as I enjoy online social networking I truly love face to face connections at conferences and already can't wait for our meeting next year in Portland, OR!

My soft spot: Healthcare journalism

With all the current discussion regarding Dr. Sanjay Gupta, CNN's chief medical correspondent, as the nominee for Surgeon General under President-elect Barack Obama, I thought I'd offer a glimpse into my own history for the perspective I'm coming from regarding healthcare and journalism.

In the fall of 1995, I was a young and idealistic student at Sonoma State University and part of Project Censored. Each week we received a stack of paper news media reports to review and match against selection criteria, then discussed them the following week to see if further research (mostly on the Nexis database in the library which contained records of news stories for journalists, quite different from what LexisNexis is now) would be justified to forward it to the much smaller batch of articles a national panel of journalism experts would review & vote to be one of the top 25 underreported stories of the year. The exact criteria and methodology of review have since changed, although so has the news media and the accessibility of information in ways I don't think we could even comprehend over 13 years ago. I was the last class with founder Carl Jensen & am no longer too familiar with the direction Project Censored (now under the Sociology department instead of Communication Studies) has gone since then.

The often-cited 2000 To Err Is Human: Building a Safer Health System report about medical errors being the 3rd highest killer in the United States? Old news to me by 5 years at that point. Two articles that ended up being combined into one and voted #12 for the spring 1996 book (1995 news stories) were in my article stacks: 180,000 Patients Die Annually From Treatment in Hospitals, based in part on a July 1995 JAMA adverse drug events (ADE) study. I apologize for the typos/funky wording in that HTML copy which may be from an optical character resolution (OCR) scan that wasn't post-edited well. I guarantee I used proper grammar in all text I wrote above my name. Can you see my writing style there? I still can. I used way too many commas in my youth and now I only use slightly too many... right? I remember balking at the emphasis on the names and careers of individuals in Chicago but being overridden by higher ups who wanted the personal touch in there.

Investigative journalism and librarianship are not all that far removed in the ability to research with ruthless efficiency under tight deadlines. Where there is a drastic difference between the fields is the pressure in journalism to not have your corporate owners, board members and advertisers look bad and lose revenue as a result of your research. For medical librarians (or any specialization), think about the amount of time you have personally invested in learning the medical and health care field, the information needs in it, and the specialized tools of the trade to be an effective researcher there. Journalists, even those with an MD or focused on health issues, do not usually have such background training nor much time or comprehensive access to the information sources we librarians do. Industry deregulation and the rate of media mergers that was a concern in the 1990s is eclipsed by the extent of the corporate media empires today.

This is why I can't offer an opinion about Dr. Gupta; I never watch CNN. It is hurting greatly in this economy but we always have and will continue to subscribe to a daily & Sunday print newspaper, The Seattle Times, from the independent and family-owned Seattle Times Company. They did an excellent job of researching methicillin-resistant Staphylococcus aureus (MRSA) in the state of Washington that led to the Department of Health announcing they would track MRSA rates as I mentioned in November. It's no longer common to see investigative journalism stories in corporate media since it takes a substantial amount of time and money to do the research for them... and you must also watch your back. This is why I hope people will continue to understand the value in and support independent media sources. They are truly better for our health!

Foreshadowing: Women *are* cutting back on healthcare due to cost

In the pre-Thanksgiving blog post where I encouraged you to talk about health with your family (you did, right?) I theorized

I suspect with our current economic climate even more moms will choose health care for their children first and postpone their own due to the expense.

Little did I know that there was a survey in progress by the National Women's Health Resource Center (NWHRC, at healthywomen.org) about this very topic that was released yesterday with some sobering news about women and healthcare.

• 45% of the women have failed to seek medical care in the past year (including doctor's visits, recommended medical procedures & medications) because the cost was too high, with Hispanic women more likely (58%) than white (43%) or African-American (42%) women.
  
  
• More than 40% reported their health had declined over the past 5 years, mostly due to stress and weight gain.
  
  
• Only 42% mentioned feeling prepared to grow older in terms of financial security, with financial (51%), retirement (46%), medical (42%) and health insurance options (41%) given as information needs.

On the positive side, women feel more positive about aging and named Tina Turner as the celebrity over age 50 that they admired most. Rock on!

NWHRC has created an online wellness information resource for women in response to the findings of the survey. At a quick glance I'm finding a few broken links in this consumer health resource, but I definitely encourage checking out De-stress the Holidays. It's a bit too late for all the long range planning tips (10 weeks) but there are gems in there that could still be done such as "If certain rituals trigger sadness, change them or create new traditions to replace them."

In sickness & in health: Engage With Grace

On Monday I shared my family's story about the importance of discussing health information over the Thanksgiving holiday. Unbeknownst to me until today, there is also a healthcare blog effort encouraging discussion of end-of-life decisions with family as well that I wholeheartedly support.

My thirtysomething husband & I are extremely unusual for our age in that we've had health care power of attorney and advance health care directives written for many years, have cards on us & authorized paperwork with the People's Memorial Association, and even chosen and stood upon our own grave overlooking the Cascade Mountains.

Morbid? Perhaps. Leaving a crystal clear path so that our family doesn't have to guess what to do with us in the middle of their own deep shock & grief? Absolutely. If you don't already know how intensely painful it is to guess at these types of decisions for someone you love who is terminally ill or just died, please take my word for it: talk about these issues now. I can think of no greater blessing than doing what you can to establish peace of mind.

Thank you for your time and be safe over the holidays.

The following post was written by Alexandra Drane and the Engage With Grace team.

We make choices throughout our lives - where we want to live, what types of activities will fill our days, with whom we spend our time. These choices are often a balance between our desires and our means, but at the end of the day, they are decisions made with intent. But when it comes to how we want to be treated at the end our lives, often we don’t express our intent or tell our loved ones about it. This has real consequences. 73% of Americans would prefer to die at home, but up to 50% die in hospital. More than 80% of Californians say their loved ones “know exactly” or have a “good idea” of what their wishes would be if they were in a persistent coma, but only 50% say they’ve talked to them about their preferences.

But our end of life experiences are about a lot more than statistics. They’re about all of us. So the first thing we need to do is start talking. http://www.engagewithgrace.org was designed with one simple goal: to help get the conversation about end of life experience started. The idea is simple: Create a tool to help get people talking. One Slide, with just five questions on it. Five questions designed to help get us talking with each other, with our loved ones, about our preferences. And we’re asking people to share this One Slide - wherever and whenever they can - as a presentation, at dinner, at their book club. Just One Slide, just five questions. Let’s start a global discussion that, until now, most of us haven’t had.

Here is what we are asking you to do: go to http://www.engagewithgrace.org/- download The One Slide - and share it at any opportunity - with colleagues, family, friends. Think of the slide as currency and donate just two minutes whenever you can. Commit to being able to answer these five questions about end of life experience for yourself, and for your loved ones. Then commit to helping others do the same. Get this conversation started.

Let’s start a viral movement driven by the change we as individuals can effect…and the incredibly positive impact we could have collectively. Help ensure that all of us - and the people we care for - can end our lives in the same purposeful way we live them.

Just One Slide, just one goal. Think of the enormous difference we can make together. To learn more please go to www.engagewithgrace.org. Thanks.

President-elect Obama & healthcare: Stand and deliver

What worries you the most about the healthcare system in our country?

Want to bend the future administration's ear about this topic?

...and you don't have to be a doctor like my friend Dora here to participate in our online discussion.

Please, go for it!

Reading the Obama-Biden Health Care agenda would probably be a good idea too, especially noting that things may change from what's currently at the bottom of the page:

A Commitment to Fiscal Responsibility: Barack Obama will pay for his $50 - $65 billion health care reform effort by rolling back the Bush tax cuts for Americans earning more than $250,000 per year and retaining the estate tax at its 2009 level.

Here is what the media stated on Nov. 23rd:

In the presidential campaign, Obama focused largely on tax cuts for low-wage and middle-class workers and tax breaks for small businesses. But as part of a stimulus package, his advisers have discussed letting the Bush tax cuts for the wealthiest Americans expire after 2010 as scheduled.

That, in effect, would delay the tax increases that rich taxpayers would have faced had Obama repealed the Bush tax cuts a year or two early, as he had suggested in his campaign.

Another thing that I hope is that whatever video program is embedded on the Change.gov website is accessible to the deaf and hard of hearing so they receive the message that all are welcome to participate. They'd better be more aware of Section 508 than I am!