Eye on FDA

Today Mashable carried a posting that quoted Dick Costolo, CEO of Twitter, as postulating that the election of 2012 would be the “Twitter Election“.  Even people who do not participate in Twitter will likely have seen articles regarding trends in Twitter topics on the elections as potential predictors for primary outcomes.  Recently the TweetReach blog looked at the reach of candidate mentions during a debate and suggested that it could be a predictor of outcomes.

In fact, it is often that in mainstream media Twitter trends have become news – Twitter is not just a news medium, it is also news.

Don Costolo is correct, this will be the Twitter election – but Twitter has been significantly re-shaping journalism and the news market place since 2009 and the impact of those changes reach far beyond elections.

For example, most journalists are now on Twitter.  The primary benefits for a journalist is obvious.  It increases their exposure and therefore their influence considerably.  Instead of being names behind a headline or talking heads on a screen or behind a microphone, they are now in a venue where they can interact and develop relationships.  And instead of writing just one big story that gets printed or aired daily, they can report all day long on much more granular subjects or report in a continuous stream from a live event – such as an FDA Advisory Committee meeting.

What else has changed in journalism as a result of Twitter?

Last week I noted a high profile journalist who regularly reports the pharma beat issue a #PRFail via Twitter for the lag time between an FDA approval of a new compound and the issuance of a press release.  Press releases are by no means over, but in the Twitterverse, things happen in real time.  The minute something happens, the release needs to be there and tweeted.

And consider the media list.  Today’s media list needs to include a reporter’s twitter feed, following and some way to measure influence such as a KLOUT score.  Without that information, a media list is only partial.

Other ways Twitter may change our view of the media?  Tweetreach itself is an interesting example.  One can use it to measure the reach of a hashtag during a medical conference or to assess the baseline reach of a subject before and after a campaign.  It is in these terms we need to be thinking about media today.

Think not that many reporters are on Twitter?  Think again.  In the media lists I’ve assembled lately where I’ve had this information included, I’ve also noted the date that reporters began their twitter feeds and what quickly became apparent was that in 2009, mainstream journalists, with few exceptions, migrated heavily into Twitter and began acquiring their followers.

Sometimes as change occurs, the strategic aspects of it slip by us.  Make no mistake, however, in today’s market, particularly in healthcare, a Twitter strategy is an essential component of any media strategy.

Every so often when I have giving a talk on social media I ask the audience how many of them are on Facebook.   Usually nearly everyone in the audience raises a hand.  Then I ask how many of them are using a “cloud” based platform regularly.  Nearly all hands come down.  In fact, applications and platforms like Facebook have become so ubiquitous in our lives, we don’t even realize that when we use them, we are using cloud based technologies. And if we don’t realize we are using them, we are also probably not so attuned to the ways that new and emerging technologies and communications are changing our lives.  In a similar vein, I think many physicians see the way technology changes the way their patients are accessing medical information, but perhaps not realizing the change it demands on the practice of medicine.

Each day I step on my Withings scale in my bathroom, equipped with WiFi which then sends my weight into a cloud where I can retrieve it in a chart (lately not an attractive chart) on my i-Pad.  I can attach a cuff to my i-Pad which will then also take my blood pressure on my i-Pad and plot it out along with my weight in either chart or graph form by date and available for my physician.

The problem is that my physician then hand enters the readings into my chart with a pen and paper.

Change has happened.  The number of medically related apps is prolific.  Some, the FDA has deemed as medical apps, such as my blood pressure cuff, and have provided guidance for their development, use and approval.  Others may have a medically related purpose but are not medical apps – such as a calorie counter.  I have an app that will track my bicycle ride and estimate the calories burned and even post it on the Internet.

Patients are changing.  They are accessing medical information differently, they are storing it differently and they are consuming it more voraciously.  This access to medical information and tools means that many patients are more medically conversant and knowledgeable than the patient of just five years ago.  Medical literacy is likely on the rise.

It also changes the way physician and patient communicate.  Five years ago, I never would have considered the need for email between my physician and myself, thinking it impractical.  Today, I think a physician needs to have some portal of access for the exchange of data and information.  Here are my readings – blood pressure, blood sugar, whatever… – for the week.  The medical record will reflect information not just gathered at an exam in the office, but that gathered by my apps when I am not in the office.  And when I’m diagnosed with a new condition, I fully expect either the physician or someone in his or her office to not only prescribe some medication, but to pull out an i-Pad to steer me to some good resources, including apps.  If the condition is one where there are few treatment options and I’m expected to consider a clinical trial, the i-Pad should have a clinical trials app that lets us look at what’s available together.

The use of e-tools has become so ubiquitous, many physicians may not be aware the extent to which the patient experience is being changed.

Past milestones have had an impact on the medical literacy of patients.  Direct-to-Consumer advertising is one – where patients got greater exposure and understanding of treatments.  Search engines were another – where patients could seek out information from that great data base in the ether.  But the advent of social media with access to medical app support takes the patient to a whole new level, compelling physicians to change with them – from keeping electronic records to changing the means by which they communicate.