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Twitter Chats and Physicians (#eRx630)

Today I (as @drmattmurray) and @TexMed moderated our first Twitter Chat that focused on the topic of e-prescribing. To participate in a Twitter Chat a physician must have a Twitter account and must know the date, time and Twitter hashtag for the Twitter Chat.  In our case the hashtag-- #eRx630--refers to e-prescribing and the date, June 30th, by which time physicians must meet the CMS requirements regarding the use e-prescribing. Physicians who fail to use a qualified e-prescribing system or certified EHR to enter at least 10 e-prescriptions during eligible Medicare encounters will incur a 1% penalty on 2012 Medicare claims.    On the other hand, those who meet this requirement are eligible for a 1% bonus. 

Despite the high importance of this subject matter, there were not any other physicians participating on this particular Twitter Chat.   At least none that we heard from.   It was lonely.  

However, we considered this to be an experiment and a chance to experience what it is like to actually moderate a Twitter Chat.    Without a lot of participating "chit-chat", it was difficult to coordinate questions and answers with my friends @TexMed and @TexMedHIT.     We basically asked each other questions or even asked ourselves for our own answers.  I think we did get out some excellent information, but this would have been more valuable with some active back-and-forth dialogue.   Again, though, the purpose of this venture was to dip our toes in the water to see how this type of format could be used in the future. 

Twitter Chat among physicians will certainly have challenges, but I think it will find it's place as a useful mode of communication for specific purposes and in certain situations.  The format will need to be refined, and this means we will have to try it (like today!), experiment with it, refine it and keep doing that PDSA thing to it (Plan-Do-Study-Act).   Eventually it will find a place where it serves as an effective way to communicate some things.     I already have found Twitter useful at large medical conferences that use a hashtag to communicate real-time information.    It is a matter of finding the right niches. 

One of the useful aspects of a Twitter Chat is that a transcript can be created of the entire conversation.  This means that you don't have to be "online" and engaged in the Twitter stream for the entire duration of the chat.   Since most physicians are hard pressed to find an un-interrupted hour, they would find it very helpful to be able to access and peruse the transcript at their leisure.

Here is a transcript of today's Twitter Chat #eRx630:



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Thanks for taking part, Dr. Murray. It WAS lonely. But I heard later from others who were lurking, and feedback was generally positive. I agree we need to learn from this experiment. What would you do differently next time?

Good to know that there were "lurkers"!

An avoidable problem I ran into was failing to remember, at first anyway, to use the hashtag with each tweet. Having to spend time making sure my message appeared in the chat stream and, when it didn't, re-tweeting the same message a second time caused not only a delayed response to a question but also took my focus off of the chat stream. After a few misses I corrected this, but by that time I was behind on the stream and sometimes missed a question. Had there been a large volume, I would have become lost pretty quickly! Wonder if there is a tool that automates the placement of the hashtag during a Tweet Chat...

When we encountered a lack of participation in our chat I worried that perhaps some physicians who were new to Twitter may not have understood how to participate. So next time I would suggest taking time at the beginning to not only welcome everybody, but also briefly outline the topic, explain what we were going to do and, most importantly, explain to the participants how to participate. After all, this will be new to physicians for a while to come...

A few other thoughts:

1. Test the topic idea a few weeks beforehand and gather some pre-submitted questions; we had prepared questions (and answers) but they were not "attached" to participants who would then have some skin in the game which would draw them in.

2. Let the participants know that for the first 10 minutes (or whatever time needed) the pre-submitted Q&A s will be posted, after which the chat will be opened up for further discussion and for other questions to be submitted.

3. Remind everyone to use hashtag

4. Schedule just 45 minutes of formal chat activity; allow 15 minutes afterward for informal conversation and networking before moderator/subject matter experts sign off.

5. Prepare questions / answers with 140 characters that include the hashtag-- @TexMed and @TexMedHIT did this, but I did not remember to include hashtags-- had to spend valuable time rewriting my otherwise perfect answers-- this casued some tyopos to creeep in.

6. Assemble a team to answer questions as we did; and I felt that linking us up by conference call was very helpful, and will be more so when there is a large participation.

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