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The Year In Review: Social Media Medical Stories

2011 was a very intense and exciting year regarding the developments and new insights of the relationship between medicine/healthcare and social media. Here are my favourite stories from 2011 selected and featured month by month.

January

I had the honour to be included in the Advisory Board of the Mayo Clinic Center for Social Media; I wrote about how a Samsung Galaxy Tab changed totally my online activities, how Google Translate can be used in medicine and featured HealCam, a medical alternative of ChatRoulette.

February

Facebook diagnosis by surgeon saved a friend; there was a lively discussion whether pharma companies can edit Wikipedia entries about their own products, it turned out Wikipedia can be a key tool for global public health promotion; and Scienceroll won the Best Medical Technology/Informatics Blog category for the third time in a row in the Medgadget’s Weblog Awards.

March

The new semester of the Internet in Medicine social media university course was launched, pregnant women could text their due date for free weekly advice during pregnancy on Push, Baby Push;  Webicina was featured by the Kairos Society on Wall Street,  UCSF Medical Center installed a robotic pharmacy in order to remove medication errors from the system; and here is my video message for Stanford about the importance of digital literacy in medical education.

April

Jay Parkinson summarized his story of being the first online doc, the Webicina iPhone app won the 2011 Medical App Awards; Al Jazeera called me Dr. Twitter after I described how Twitter can be used for medical crowdsourcing, and in the fight against AIDS a time lapse video of a woman with HIV/AIDS was published.

May

Blogger announced own death after battle with cancer which shocked people, then a woman managed to find a kidney donor through Twitter, The Social Life of Health Information Pew Internet report was released, and top doctors described how a medical professional should start using social media.

June

I co-authored a medical textbook about medical communication in social media; Google Health was announced to be closed, a cancer patient who blogged about his hospital treatment was threatened with legal action by an NHS trust; Doctors 2.0 and You was the event of the year; and here are some disasters in social media and what we should learn from them.

July

ePatient Dave rocked TED; Mayo Clinic launched an online community in a perfect way, Pfizer’s Facebook page got hacked and they reacted badly, I listed the reasons why I like Google+ even in medicine; mobile apps got regulated by the FDA; and it turned out iPhones can be used for obtaining ECG.

August

I published a story about how Twitter can be used to predict epidemics; even waiting rooms can be redesigned to improve healthcare; I described why I’m happy that patients use the web; started managing the social media presence of a huge medical portal; I stated what you write only is forever; and pharma had hard days because of comments on Facebook.

September

Using hashtags is crucial in medical communication on Twitter;  I talked about the future of health 2.0 in Europe; organized a virtual medical consultation in the virtual world on World Heart Day; this is how creativity can be used in healthcare; and I presented the best apps of a physician at the Doctors 2.0 and You conference.

October

Nobel winner died days before award announced; I shared a social media love story about a bone marrow donor; an app let us run figures on maps; Google+ was used for case presentations; and Mayo Clinic launched the Know Your Numbers campaign.

November

I published the 7 Features of the New Generation of Physicians; my open access success story; a summary about the Games for Health conference; hardcore campaigns about men’s health; and revealed why the most viewed medical video on Youtube got millions of hits.

December

Winners of the Webicina social media story contest were announced; WHO featured Webicina; the launch of a global medial social media course was announced; I described my time management tools and tips in medicine; the open access set of social media guidelines for and about pharma was published; and finally found the cutest story of 2011, parents got insulin-pump tattoos to support diabetic child.

I’m going to post my predictions for 2012 tomorrow and I hope you will stay with Scienceroll.com next year as well!

*This blog post was originally published at ScienceRoll*


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Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

“The urinalysis is not a very exciting medical test,” stated Dr. Fishbinder. “It doesn’t matter that it’s cheap, fast, and most likely to provide an explanation for strange behavior in hospitalized patients. It’s really not as elegant as the testing involved in a chronic anemia or metabolic encephalopathy work up. I keep it in my back pocket in case all other tests are negative, including brain MRIs and PET scans.”

Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.

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