Creating a Networked Imagination in Healthcare One Patient at a Time

Web 2.0, social media, and the movement from interpretation to participation can best be witnessed in how blogger/Twitter/G+ is not simply transferring knowledge or information but creating a community with reader’s and their shared experiences. I want to continue my look at the work by Thomas and Brown ‘Learning for a World of Constant Change’ Homo Sapiens, Homo Faber & Homo Ludens’ specifically moving from passive participation to active participation and what it means for healthcare.
 
Today all of us can participate (let’s call this learning) with writers, thinkings, film makers, and more by leaving comments on a blog, posts on our personal digital media (e.g. Twitter links, Gooogle + posts, etc) linked back to the authors posts, Twitter chats, podcasts and more. This is different from traditional media and learning (broadcasts, lectures, reading). Thomas and Brown state ‘learning was a function of absorbing (or interpreting) a transmitted message’. In this new media we find the learner engaging with information, using it more broadly in a social context. Thomas and Brown call this ‘productive inquiry’.
 
Productive inquiry is associated with John Dewey  He associated productive inquiry with the ability to engage the imagination. This new media “has enabled the fusion of network technology, communities of interest, and a shared sense of co-presence…’ Thomas and Brown call this ‘networked imagination’ which is a type of social and collective participation, think #hcsm. Learning is taking place in a social context. It is more effective than passive participation because it speaks to the learners needs. 
 
What does this mean for healthcare? I think we need to look at what it is happening to the average American and how they are using the web. And how this behavior is shaping current healthcare so we may capitalize on it. 

You’ve seen the data on how Americans use the internet for healthcare related data here  Americans are using the internet to find answers to healthcare problems they are seeking solutions to here. Americans are sharing healthcare knowledge with each other. Americans are using mobile devices to search for health information. In short and unsurprisingly Americans are going online, joining social networks, and sharing knowledge to manage their healthcare. These learners are engaging in their healthcare through the creation of networks of healthcare knowledge and information. They are doing it patient to patient, HCP to HCP, and in some cases HCP to patient. Web sites and publishers are focusing on getting health related information to consumers in an easily digestible fashion quickly. 
 
Historically HCP have been trained in traditional learning, absorbing a transmitted message. This works well as witnessed by the skill and expertise of our medical professionals. They leave medical school and residency as well trained as any in the world. And as HCPs continue their training in pretty much the same vain with CME lectures, online, grand rounds, etc. And further, HCP do access networks of other HCP and colleagues to learn. They to are part of this online healthcare revolution ‘networked imagination’.

So we have patients engaging in ‘networked imagination’ in healthcare. We have HCP trained in a traditional fashion, message sent message received and moving toward active participation in social media as they enter into practice. What we don’t see here is the overlap of physician and patients in a way where the HCP is taking the lead in becoming that trusted resource for the patient. Leading this productive inquiry. Becoming a valued network for the patient not just a parental figure. 

HCP need to move away from the idea that patients uniformly want a simple transfer of information or knowledge. ‘You have HTN and you need to take this.’ Because you know a majority of your patients will go do a http://duckduckgo.com/search HTN and the medication and find 20 other patients taking the medication with opinions and ideas. And if they feel welcomed they will call or come into to discuss it with you. Are HCP ready to create participation in order to manage interpretation? 

Let’s look at ‘You have HTN and you need to take this’, as part of a productive inquiry. This is not shocking to the patient, you’ve told your patient they are moving toward HTN. Both of you are prepared. What’s to keep you from handing that patient a single 8″x11″ sheet of paper with some URLs to links and PDFs on the topic of HTN and the medication that you have selected based on good evidence? Nothing. What is to keep you from adding a short paragraph about each URL or PDF as your abstract? Nothing. And you can do it with the following direction: a) Fill the Rx, begin your regimen, and read the information. b) Read the information, fill the Rx, and begin your regimen or c) Read the information don’t fill the Rx. I will see you in two weeks to follow-up with you on the medication, side effects, what you’ve read, and answer your questions. 

You have engaged this patient in a social context on a clinical topic. You are now occupying the learning receptors of patient and managing their expectations. This is not you waiting to react. It is you leading a networked imagination in healthcare one patient at a time. 

 

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