A case study in the intersection between health, media and policy

May 14, 2011 at 5:58 pm | Posted in Communications strategy, Health Policy, Journalism, Media business, Public Health, Storytelling, Strategic planning, Uncategorized | Leave a comment

My latest blog post for the Center for Health, Media and Policy at Hunter College/CUNY addresses a topic I’ve been thinking about for a while — the challenge of clearly and effectively communicating clinical guidelines in a world that demands evidence-based medicine and effectiveness research but isn’t always so welcoming when the data doesn’t match “conventional wisdom” or there is genuine disagreement about how to best care for and advise patients.

The “case study” I refer to is the 2009 release of new mammography screening guidelines by the US Preventive Services Task Force (USPSTF). I was reminded of the potential lessons in strategic communications to be learned here by a study and accompanying commentary recently published in the American Journal of Preventive Medicine, where I’m pleased to serve as Editor-at-Large. I had nothing to do with these papers, but their review of and perspective on both public perception of the guidelines and media coverage of their release is rather enlightening.

As an AJPM editor, I’m more than happy to hear what you have to think about this topic. Email me at bsilberg@ucsd.edu with any comments.

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What science editors have on their minds these days….

May 5, 2011 at 5:46 pm | Posted in Communications strategy, Digital strategy, Journalism, Mobile internet, Multimedia, Social media, Storytelling | Leave a comment

I’m just back from Baltimore and the annual meeting of the Council of Science Editors (CSE), an organization with which I’ve been pleased to be associated for — OMG — more than 20 years. I was privileged to be a member of this year’s Program Committee (next year’s too) as well as serve as a moderator for three sessions, on the state of the STM marketplace, media relations tips and tricks, and how to develop a killer mobile strategy (a session organized with my colleague Robert Harington of the American Institute of Physics).

Slides from all three sessions should be up on the CSE site at some point. Until then, I’m pleased that one of the speakers at my media relations session, Brian Reid of WCG, has posted an excellent summary of his talk and those of his co-speakers, Reuters Health Executive Editor Ivan Oransky, MD, and Jann Ingmire, Director of Media Relations for JAMA and the Archives Journals (yet another job I used to have that someone now does far better than I did). Check out Brian’s post here. Ivan posted his slides as well;  some very straightforward and practical advice for public information officers and other media relations types who want to know how to get his attention and that of his journalist colleagues.

Will Politics Sink a Health Care Hero?

April 4, 2011 at 9:36 pm | Posted in Communications strategy, Health Policy, Public Health, Uncategorized | Leave a comment

Harvard pediatrics and public health expert Donald Berwick, MD, just may be the most innovative and qualified administrator ever named to run the Centers for Medicare and Medicaid Services (CMS). But as a number of health policy analysts have reported recently, he may well be on shaky ground.

It’s not because he doesn’t have the smarts to do the job. Rather, as a number of reports indicate, it’s because politics appears poised to trump good policy — yet again.

How can this be, you ask? Read my latest post on the Hunter College/CUNY Center for Health, Media and Policy (CHMP) blog to find out. And let me know what you think.

How is Philanthropy Using Technology to Advance its Goals? Listen to “Talking Philanthropy” and Find Out

April 4, 2011 at 9:21 pm | Posted in Communications strategy, Digital strategy, Multimedia, Philanthropy 2.0, Strategic planning | Leave a comment

My colleague Larry Blumenthal and I have just posted the latest installment in the monthly Talking Philanthropy podcast series that we do in collaboration with Philanthropy News Digest. It’s an interview that Larry and I did with Holly Ross, Executive Director of the Nonprofit Technology Network during NTEN’s recent annual conference in Washington, DC.

Larry and I chatted with Holly about a range of issues relating to how the philanthropic sector is using technology to do its work more effectively.  It was pretty obvious from the overflow crowds at the meeting — more than 2,000 people attended, compared with about 50 just 10 years earlier — that the sector is alive with innovation and creativity. We hope you’ll take a listen to Holly’s incisive comments and let us know what you think.

If you missed the inaugural installment in the series, our interview with Doug White, academic director of the George H. Heyman, Jr. Center for Philanthropy and Fundraising at New York University, please take a listen. And do stay tuned for future interviews.

What’s in a byline? If you’re the AP, not the word “writer” anymore

October 16, 2010 at 12:26 pm | Posted in Business Models, Communications strategy, Journalism, Media business, Multimedia, Social media, Storytelling, Uncategorized | Leave a comment

I have to admit, I was a bit troubled by word that the Associated Press was dropping the term “writer” in bylines noting by whom many of its dispatches are “written.” At first, I couldn’t quite figure out what it was. Then, I realized that this seemingly small and, to many I’m sure, totally innocuous change, raised some much bigger issues, at least for me.

The report from mediabistro cited a memo by AP Deputy Managing Editor Tom Kent saying “that the term ‘Associated Press writer’ would be retired in favor of ‘Associated Press” in order to allow for the fact that, increasingly, articles may be written by photographers, videographers and radio reporters in addition to those working primarily in print.” The change, Kent noted, would not affect bylines for AP’s “special” writers — sports, political, business and so on — and that when several AP staffers contribute to a piece, an end note can identify them individually.

No big deal, right? Kent is just acknowledging what we already know — the “old world” journalism lines between writers, reporters, editors, photographers, graphic artists, producers and so on are now very fuzzy. Add in “commentators” (anyone, prophet or fool, with a position and a platform) and the growing numbers of “citizen journalists” (anyone with a cell phone and a nose for “news”), and the boundaries break down entirely.

Not necessarily a bad thing, right? I mean, what’s so special about traditional journalism and its trappings anyway? (Full disclosure: I was a reporter, editor and bureau chief for UPI — remember UPI, the AP’s arch rival? — for seven years and an editorial manager for professional/trade media for 12 more). Isn’t more news, information and perspective better for society than less? Doesn’t more reporting make it easier for citizens to decide?

Here’s the rub, for me at least, in the move to eliminate the word “writer” in favor of mushing together AP dispatch contributors in more generic bylines.

For all of the wonderful new communications tools and technology we have at our disposal, and for all of their truly transformative potential, I can’t help but think that something basic continues to erode in all channels of public discourse. I fear that all media, fueled by fast-moving technological change, are converging to a lowest common denominator,  where anyone is a “journalist” or a “publisher.” I worry that this not only panders to but accelerates the fleeting attention spans we seem to have for talking about anything that really matters. This is not only ironic but tragic given that the critical issues we face are bigger and scarier than ever.

Let me be clear. I’m not taking about evocative narrative, lush  prose or, for that matter, titles for their own sakes. I like to think that I’ve let go of print as a mindset, not just a medium, and practice what I preach in that regard.

I’m talking about the ability to write (and speak) clearly, think critically, analyze appropriately, act accordingly (and, one hopes, intelligently), and be accountable for those actions.

Am I being overly sensitive? Overly analytical? Overly romantic about or nostalgic for my UPI days? An elitist?Just a cranky old fuddy-duddy? I hope not. If so, please tell me.

Perhaps there’s nothing to be done. Maybe I’m just a Luddite when it comes to this stuff. Maybe I overly value what it means to be a good, clear “writer” and to wear that badge proudly.

I guess Joni Mitchell was right — “Something’s lost, but something’s gained, in living every day.” Hopefully the equation balances out eventually.

Will a new generation of med schools catch a “med ed 2.0” wave?

February 25, 2010 at 11:23 am | Posted in Communications strategy, Health 2.0, Medical education, Medicine 2.0, Uncategorized | Leave a comment

Word that we’re on the verge of a dramatic jump in the number of US medical schools – perhaps two-dozen schools are said to have recently opened or might soon, the most in 30 years – raises all sorts of interesting issues.

Reports about this have, rightly, asked why we’re seeing this surge after years of stasis (though there was a bump years back in the ranks of osteopathic schools of medicine). A recent New York Times story said these new schools are seeking to address a long-standing imbalance in American medicine where many bright students, denied admission to US schools, studied abroad or gave up medicine altogether. The irony, the Times noted, was that at the same time, US hospitals had to use foreign-born or trained physicians to fill many residency slots. This was particularly true in inner-city and rural areas.

The Times notes that there are market forces at work here too, given a growing US population, the Baby Boomers’ march toward retirement, the thinning of the ranks of US physicians as they age as well, and so on.

Supporters of the expansion say more doctors will mean better care and expanded access to needed services, plus a more robust supply of primary care physicians to balance out the growing ranks of specialists. Critics wonder whether newly minted docs won’t just fall into the same patterns we’ve seen in the past – more specialists, concentrations of physicians in affluent areas – and whether the increased supply won’t just make the world’s most expensive health care system even more so.

All important questions, none of which I can claim to answer (though I do have opinions). So I’ll ask another one.

Being the first wave of medical schools to open in a truly digital age, might these new institutions be bold enough to provide a disruptive “med ed 2.0” experience, not just in the science they teach and the technology they offer but in culture of practice they provide? After all, established medical schools are already highly wired; incoming students have shown up for years on day one of class with laptops, now handhelds, at the ready. And there’s no lack of opportunities to fold the latest scientific advances into core studies.

But might this new crop of schools take the next step and be the places where curricula are built from the ground up to not only pass on the latest scientific knowledge and clinical techniques but to embrace “e-health” best practices,  fully shared patient-physician decision-making, effective information-sharing, and routine use of electronic records and related systems as tools for enhancing health as opposed to being efficient bulk storage devices.

I’m certainly not the first one to ask how the medical education experience might be different in the Web 2.0 world. Blogger Bertalan Meskó, a newly minted Hungarian physician now pursuing a PhD in personalized genomics, has written about this for a while and even launched a university credit course focusing on web 2.0 and medicine for medical students.

But I’d like to think that with a couple of dozen new homes available to train eager medical students who have come of age in a wired world, the result really will be worthy of a “2.0” label, or beyond. How about you?

A thousand words… at least

December 8, 2009 at 12:08 pm | Posted in Communications strategy, Digital strategy, Multimedia, Storytelling, Strategic planning | Leave a comment

We hear a lot in the communications community about how much better it is to show than to tell. This is one of the underpinnings of effective story-telling (no pun or irony meant) and the dramatically increased use of multimedia features in a range of vehicles developed by foundations, advocacy groups, NGOs and the like.

As some recent blog posts show, in today’s Google-ized world, the concept is especially useful when it comes to deciphering the mounds of data that come our way in ever-greater quantities and at an ever-faster pace. In such cases, “data visualization” can quickly bring very complex collections of information into stark and compelling focus.

Harvard Business Publishing offers a nice overview piece on this, Swimming in Data, by management and technology consultant John Sviokla, former Harvard Business School professor of marketing, MIS and decision sciences.

Reminding us of the quote often attributed to Napoleon, “A good sketch is better than a long speech…,” Sviokla suggests that enhanced data visualization methods is a natural way to cope with information overload. He says such techniques are efficient, can help to illustrate the basic nature of a problem and, if really good, “help create a shared view of a situation and align folks on needed action.” That last point has particular resonance for those of us in strategic communications.

Sviokla cites a few examples of how this theory works in practice, as does a recent post in the Science Roll blog (Bertalan Meskó, founder of Webicina.com). Science Roll points to a spiffy visualization on “The Cost of Getting Sick” on the very cool Flowing Data site. This series of interactive polar pie charts uses data from GE and the Medical Expenditure Panel Survey to show what various conditions cost at different ages. Lead credit for the work goes to data designer Ben Fry, now the director of SEED visualization.

Of course, this latest generation of data visualization builds on years of work by others.  One of my personal heroes in the field is Nigel Holmes of Explanation Graphics (disclosure: Nigel did some work for me and my colleagues when I was at JAMA). Holmes is a former Time Magazine graphics director and was one of the most interesting and entertaining teachers at the now-dormant Stanford Publishing Course. And no discussion of how to effectively present data would be complete without a nod to visual communications guru Edward Tufte, professor emeritus at Yale and author of seven books, including one of the field’s Bibles, The Visual Display of Quantitative Information.

The big picture on “non-profit journalism” (well, some of it anyway)

November 24, 2009 at 3:22 pm | Posted in Business Models, Communications strategy, Journalism, Media business, Philanthropy 2.0, Professional ethics, Social media | Leave a comment

Are you as fascinated as I am by the non-profit journalism trend, how foundations and NGOs (broadly defined) are supporting and even becoming journalism operations, and the implications for strategic communications?

Then take a look at NGOs and the News: Exploring a Changing Communications Landscape, a series of essays that Penn’s Annenberg School and Harvard’s Nieman Journalism Lab have put together exploring some of the big-picture issues that such initiatives raise.

The latest essay in the series, by Natalie Fenton of Goldmiths, University of London, was just published and looks at how the internet has changed how NGOs work with established media (her take: “not enough”).

Previous pieces in the series, which began earlier this month and came to my attention through a Big Think post, include:

This series is a useful complement and offers important context for the seemingly daily reports on the fast-evolving non-profit journalism landscape (see Bruce Trachtenberg’s October 20 post on the Communications Network blog for a very helpful oveview).

And added bonus from the Nieman Journalism Lab site —  Jim Barnett weighs in on a planned Dec. 1-2 Federal Trade Commission workshop on how journalism will survive in the Internet age. The bigger question: is two days enough to figure it out? Stay tuned.

Can social media be hazardous to physicians’ (professional) health?

November 13, 2009 at 11:24 am | Posted in Communications strategy, Professional ethics, Regulation, Social media | Leave a comment

Ok, so the headline is intentionally provocative. But while the FDA decides how or whether to weigh in on the use of social media to promote regulated medical products (Reuters and many others covered the two-day event), a run of recent articles and blog postings posit the pluses and minuses of the use of social media by physicians.

This discussion is the latest and a logical extension of the ongoing debate about the benefits and potential risks of any new communications tools used by health and medical professionals. Clinicians, after all, regularly discuss sensitive patient information and are subject to all manner of legal oversight and professional ethics.

We saw a variation of this debate back when the profession mulled whether doctors should advertise, then over the rise of web, physician-patient e-mail, and now blogs, Facebook, Twitter and whatever the next new thing will be. (By the way, a related discussion on the blog Scholarly Kitchen looks at whether scientists are joining social networks and, to the extent that they haven’t, why that might be the case).

The clinician-focused discussion in a nutshell (Medscape has a nice overview on this) – social media tools can be useful ways for clinicians to seek out professional information and opinion, raise professional visibility and stay in touch with communities of interest. But like any technology, clinicians should be aware of possible risks.

Specific caveats (Medical Law Review hits this most explicitly)  — physicians should be mindful of patient confidentiality and not let the seeming informality of social media lull them into straying over professional boundaries – even on closed or “secure” sites. A couple of posts on the physician blog 33Charts nicely summarize some of the issues around doctor-patient interactions via social media. And you can monitor the Clinical Cases and Images blog for ongoing updates about this issue.

This all seems like common sense, certainly. And in many ways, it hearkens back to debates within professional circles about the early days of online communities, discussion boards and the like.

What may be different now is that both professionals and patients/consumers with access are using digital technology in far greater numbers, with far more sophistication, than a few years ago, and the adoption curve for social media tools is especially steep. We’ve also seen the ongoing rise of the “e-patient,” the term the late Tom Ferguson, MD, coined years ago to describe individuals “equipped, enabled, empowered and engaged” in their  health and health care decisions.  A federally sponsored summit earlier in November discussed this trend and its implications in depth.

My favorite take-away from this discussion? The Medscape review noting that, as far as the potential for clinician missteps on social media platforms is concerned, “physicians behaving badly is not a new concept, but for years, the risqué humor, alcohol-fueled hijinks, and derogatory slang in patient charts — think ‘CLL’ for ‘chronic low-life,’ ‘LOBNH’ for ‘lights on but nobody home’ and ‘grave dodger’ to describe a chronically ill elderly patient — have been hidden from view.”  Digital technology, the piece notes, makes it possible for all the world to see such potential bad behavior.

Will the pluses that social media tools present to transform professional and professional-patient/consumer communications outweigh the minuses, real or perceived? I  hope so. But stay tuned.

The more things change….

November 6, 2009 at 12:29 pm | Posted in Communications strategy, Digital strategy, Multimedia, Regulation, Social media | 4 Comments

Add the Food and Drug Administration to the list of those following how social media is transforming communications. In this case, the subject is the promotion of FDA-regulated medical products — including prescription drugs for humans and animals, prescription biologics, and medical devices – “using the Internet and social media tools.”

To gather comment from parties interested in this topic, the FDA has scheduled a public hearing November 12 and 13. There’s plenty of interest – registration for speakers and attendees is closed. You can follow the hearing via a free webcast . The agenda is here.

For those of us old enough to remember, this is especially interesting since we’ve been here before – on October 16 and 17, 1996, to be exact. That’s when FDA held a public hearing “to discuss issues related to the promotion of FDA-regulated medical products on the Internet.” Topics covered at that time included investigational product information, chatrooms and newsgroups (remember those?), and Web site links. The FDA has fired up its wayback machine and helpfully provided a transcript of that meeting.

There was widespread expectation that that hearing would yield specific guidance on using a then-new communications medium to promote, market or just plain discuss regulated medical products. As it turns out, FDA didn’t issue such formal direction, instead advising marketing/communications types to follow existing guidelines, which were developed with print and broadcast in mind. As I recall, the idea was that the net/web, while a new medium, did not necessitate a whole new set of regulations for proper use.

Thirteen years later — an eternity in Internet time — the digital media landscape has changed dramatically, of course, with an explosion of new technologies — particularly social media. But what about the core issues?

The FDA, in its Federal Register posting on the new hearing, has identified five areas to be explored in this latest hearing:

  • For what what online communications are manufacturers, packers or distributors accountable?
  • How can manufacturers, packers, or distributors fulfill regulatory requirements (e.g., fair balance, disclosure of indication and risk information, postmarketing submission requirements) in their Internet and social media promotion, particularly when using tools that are associated with space limitations and/or real-time communications?
  • What parameters should apply to the posting of corrective information on Web sites controlled by third parties?
  • When is the use of links appropriate?
  • Questions specific to Internet adverse event reporting.

All good questions, but when asked in the formalized setting of a public hearing by a regulatory agency, they underscore how policy can lag market/user demand and behavior when it comes to fast-moving developments in communications.

There are other instances of this, of course. For example, Susannah Fox of the Pew Internet and American Life project, one speaker at a meeting I’m attending on consumer health informatics, spoke today about security issues related to the broad adoption of electronic health records.  She noted that the federal law governing health information privacy dates from 1996, barely two years after the Web was born. Final regulations were issued in 2002, but even that date is years removed from the current explosion in the development and use of online medical and health information.

Will the latest FDA hearing on social media raise substantive new issues that prompt the agency to act in any way different than it did more than a decade ago? Stay tuned.

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