Should patients who develop complications after surgery return to the same hospital?
It’s a question with profound implications for patients and providers, which is perhaps why it spurred such spirited debate last year during an “#IGSJC Tweet Up,” a journal club held on Twitter by the Association for Academic Surgery. Sam Finlayson, M.D., M.P.H., chair of surgery at the University of Utah and a health services researcher, was already seeking answers to that question when he tuned into the March 2014 discussion. “That is great idea, and we’re doing it already,” Tweeted Finlayson.
But another researcher who partook in the Twitter exchange – Thomas C. Tsai, M.D., M.P.H., who Finlayson mentored when he was a surgical resident at Brigham and Women’s Hospital – also ran with the idea and his findings were published first.
It would be easy to point to this as an example of the perils of social media. Credit for scholarly findings is the bread and butter of career success in academia. But science has always been competitive, a race to discover something new, and to do it first. “I don’t think you can control it. These conversations are happening,” said Finlayson, who harbors no grudge about being scooped. “Good ideas get stimulated and someone runs with it. In this case two people ran with it.”
Where some researchers see social media as dangerous or frivolous, Finlayson and Tsai see opportunity. The professional Twittersphere has moved far beyond “pointless babble” about Justin Bieber or your last yoga class to become the go-to resource for journalists, revolutionaries . . . and increasingly, researchers. Understanding what peer scientists are working on sparks new ideas, opens the door to collaboration and can hasten research. This wasn’t a new area of study for Tsai, but he admits the Twitter chat was “great motivation” to return to the project. “Sometimes you work on projects that you personally think are interesting, but you don’t know if anyone else does until you submit it for publication,” he said. “So for me, it was a nice validation that I should keep working on this.”
For the record (and in the spirit of competition): Both Finlayson’s and Tsai’s papers were submitted to separate journals for review at about the same time, but Tsai’s went through faster. “We were a little worried that our reviewers would see that somebody else had done the project and reject ours,” said Finlayson, who co-authored the paper with University of Utah surgeon Benjamin Brooke, M.D., M.P.H. “They didn’t. Our review took longer because the reviewers wanted us to do a higher, more complex level of analysis.” Such is the nature of the scientific process. As Tsai notes, “There’s room for multiple papers on this topic, which validates the findings. It’s rarely true that one scientific paper becomes the final word.
While some institutions have steered clear of social media, University of Utah Health Sciences has embraced it, even weaving it into leadership training. “We currently have 250 active Twitter users, including some of our top leaders, and that number is increasing every day,” said Social Media Coordinator Libby Mitchell.
Twitter’s popularity among health professionals is organically propelled by growing awareness of its value beyond that of marketing or self-promotion. Were it not for making a connection on Twitter, family practitioner Kyle Bradford Jones, M.D. might not have been named to the Congress of Delegates of the American Academy of Family Physicians. Anesthesiologist Harriet Hopf, M.D. uses Twitter at conferences to connect with colleagues and is often among the top trending accounts at these gatherings. Transplant surgeons Jeff Campsen, M.D., and Robin Kim, M.D., have “live tweeted” living donor kidney surgeries to raise awareness of the need for organ donors.
While patients are using blogs, wikis, and Facebook to seek emotional support, share clinical data and request treatment recommendations, providers can tap into those sites to better anticipate patient concerns and questions and learn from the conversations. Doctors can also crowdsource answers to clinical questions through physician-only platforms, such as Sermo.
Social media is also a way to stay abreast of current affairs and plugged into the national health care conversation. And it’s a “treasure trove” of public health data, says Quynh Nguyen, Ph.D., assistant professor of health promotion and education at the U. Working with a team of biomedical researchers, computer scientists, sociologists and statisticians, Nguyen has created a social data repository, HashtagHealth, to gather mentions of food, exercise and recreation from Facebook, Twitter, Pinterest and Instagram. The data are geo-coded and organized by location, right down to the neighborhood, allowing scientists to explore nuanced links between things like neighborhood crime rates and obesity.
There are ethical considerations. The American Medical Association has come up with loose professional guidelines for clinicians using social media. U of U Assistant Professor of Biomedical Informatics Mike Conway, Ph.D., who mines Twitter in his public health research, is working toward developing a set of best practices for researchers. “Big Data generated through social media can be fruitful for population-level health research,” Conway said. “But – as with many new technologies – great care is required in identifying appropriate ethical boundaries.” Conway wants to better understand users’ attitudes toward the idea that their public Twitter data could be used for population-level health research.
Bottom line: Twitter is another tool to achieve what academic health professionals have always done: Advance health. It’s not for everyone, admits Finlayson, who squeezes in time for Twitter banter over breakfast or while waiting in line at the grocery store. “Maybe my field is a little more amenable because it’s something people can understand, it has policy implications and it’s about patient care. But practically everybody in health services research and surgery uses it,” he said. “It’s a way of having an ongoing conversation with my peer group, of sharing interesting ideas, articles or congratulating a colleague. It sort of reinforces the fellowship of colleagues in my particular specialty.”
Kirsten Stewart is a senior writer for University of Utah Health Sciences