Today, Andrew Spong, as I may say my good friend, expert in Social Media and Heath conversations, put up a great blog about the growing use of apps and the proper core of health care: the communication and conversation about health issues.

I like it so much that I like to add it here, as well as the conversation we had about it!

Andrew states:

The best digital health app is conversation

Although our attention may be distracted from time to time by a health-related smartphone or tablet app, a health tracking device, a quantified self peripheral, or some another piece of shiny, soon-to-be-outmoded future junk, I hope it is becoming obvious by now that the best digital health app currently available is conversation.

It is the health conversation on the social web that can best interpret, filter and respond to our need for high quality information regarding disease symptoms, diagnosis and treatment options.

It is conversation that conveys the insight of trusted voices to inform our shared healthcare decision-making.

It is conversation that can offer peer support, solidarity, care, and love and that can help deal with the difficulty, isolation, and occasionally the despair of living with or managing disease.

The health conversation on the social web is inverting norms, challenging protocols, and confounding expectations.

As #gbdoc, #bcsm and others demonstrate on a daily basis, a tweet chat about diabetes or breast cancer can be a vector towards outcomes-improving, life-saving, transformative change not only for individuals, nor even entire communities, but perhaps for the future of healthcare design and delivery overall.

So, in order to contribute to the transformation of healthcare practices, for all our sakes: let’s talk.”


I commented the following:

Greatly said Andrew! I saw your statement on Twitter yesterday in your discussion with Kathy @kgapo at #hcsmeu ;-)
You must have written the blog subsequently and instantaneously with the vigor and perseverance that we know so well of you! And right you are: the number of eHealth applications and electronic means threaten to create so much chaos that patients (i.e. “we” !) can’t see function and use nor will be able to oversee what to do and not. And there’s yet no acknowledged authority to guide. Thanks!

Upon which he responded:

“Hi Rob
Thanks for stopping by and taking the time to comment, hope all is well with you.
There is to my mind something counter-intuitive about waiting for a body to approve or otherwise endorse health apps outside of the context within which we download or purchase them, i.e.: app stores.
I’d prefer to see endorsements within the Mac OS iTunes store or Android OS Play by healthcare professionals or trusted voices whose identity I can verify and whose credentials I can validate. I may even want to reach out to them with a question.
In other words, I’d favour identifiable healthcare professionals leaving endorsements of apps and an account of what they believe to be good or useful about them.
However, it’s probably more likely that I’d hear about the app in question via a trusted voice from my community in a health chat or on a social platform.”

which triggered me to discuss this:

Hi Andrew, thanks for your response, in which I can discern that you were set on the wrong track accidentally. ;-) To me the core of your blog is about the consistency and cohesiveness of the conversation itself. The jungle of the ever more growing number of apps and other means of communication seem to blur the participants in health conversation away from the very core you presented: the conversation itself.
For the conversation itself in order to bare meaning to the participants in that conversation, they must know what means/instruments they will use and what not. Otherwise consistency of the conversation and with it, the potential growth of the level of quality of it, and hence the meaning of it to the participants, will be quickly lost.
Conversation, communication in itself is a process, other than exchanging statements or expressions coincidentally as we are doing so much on social media. They have a certain meaning, surely, but we, as for two, do have the experience that it is due to the very continuity and consistency of the communication that might raise the potential of the proper communication process, to understand, to convince, to induce, to learn, to review, to change viewpoints etc, and, most of all to put words to practice, to act upon it; in short: to learn!
That’s what the core meaning of your post is to me, which struck me as such an obvious point – hence its fierceness! Nearly forgotten in the “violence” of promoting eHealth through means of apps and incidental instruments…
So, the issue of authority, probably in the way of certification too (that apps as medical devices have already to meet, legally) is a thing that might come from authorities, but must stem also from consumers using the very things, as you suggest. Right again to my mind!
I guess we are still on the track of exploring and hopefully experimenting to learn how such promising means might be used so as to enhance the quality of health conversations, not drawing away from it.

Join our conversation, because I am convinced that this is a crucial issue that Andrew initated!

Further to this, now at May 7th, 2013, I like also to refer to a post by Howard Luks: “Medicine and the art of listening“. Howard refers to the fact that most of physicians interrupt the patient after 18 seconds…. !

He states: “Incorporating the art of informed decision making into your daily workflow means you need to listen to your patient. You need to dive deep into their own ideologies, values and goals that will shape their decision when presented with the alternatives available.  Your are a coach, you are part of a team that will arrive at the right choice for that patient at this particular time.  You will need to listen for more than 18 seconds … and you will need to learn to treat patients as people and not as a disease state or an MRI finding.

I commented to the post as follows and also refered to the work of the Dutch professor Jozien Bensing:
Actually we, in the sense of all of us who are in the business of innovating health care, are changing step by step by insights such as this. It proves that the interaction and interrelation between care providers and patients not only have influence of what is cognitively appreciated, but also on what is “taken” in as perception and meaning – obviously with a high impact on health outcomes of the process.

Another influence goes through our “processing system” both consciously and unconsciously. I like to refer to the work of the Dutch professor Jozien Bensing who studied the influence of the placebo effect. See here:
She is professor of Health psychology and her theme is “the power of attention”.

So indeed, a change in attitude to listen rather than to speak may help us getting on!