Episode 14: Open Minds and Online Communities

It’s amazing how a respectful exchange of ideas can create positive change. Colin Hung shares what he has learned from chatting with thousands of healthcare executives in his 7 years as one of the co-founders of the #HCLDR online community. What started as a weekly tweet chat has turned into a global online community of open-minded leaders trying to solve issues from different corners. Hear how sharing perspectives can build trust and influence the nationwide dialogue.

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Full Transcript

Announcer: It’s time to think differently about healthcare, but how do we keep up? The days of yesterday’s medicine are long gone and we’re left trying to figure out where to go from here. With all the talk about politics and technology, it can be easy to forget that healthcare is still all about humans. And many of those humans have unbelievable stories to tell. Here, we leave the policy debates to the other guys and focus instead on the people and ideas that are changing the way we address our health. It’s time to navigate the new landscape of healthcare together and hear some amazing stories along the way. Ready for our breath of fresh air? It’s time for your paradigm shift.

Michael: Welcome to the paradigm shift of healthcare, and thank you for listening. I’m Michael Roberts here today with cohost Jared Johnson and Scott Zeitzer. On today’s episode, we’re talking with Colin Hung, the CMO and Editor healthcarescene.com and cofounder of the HCLDR TweetChat and Global Online Community. Hi, Colin and thank you so much for coming on the show.

Colin: Hey, thanks for having me. It’s gonna be fun today.

Michael: Absolutely. Absolutely. Well, we’re gonna go ahead and jump in. I know that you already know, Jared, that you guys already have some background and Scott and I have jumped on the TweetChats at different points in the past. So, we’ll go ahead and just jump right in. I’d love to know a little bit more about just the HCLDR community, the whole TweetChat in general, but how do you feel that this TweetChat and, again, the fact that it’s really has built into a complete community, how does that represent a paradigm shift and where healthcare’s at?

Colin: Yeah, that’s a good question. You know, it’s funny when we started HCLDR, which is, you know, it started its life as just a tweet or Twitter chat, or TweetChat that we wanted to host and discuss healthcare topics that weren’t being discussed at that time. So, you know, back in 2012 when we started this, there was some chats that really focused on how can healthcare leverage social media, how can healthcare leverage IT, but there really wasn’t anything specific to just general healthcare issues as a whole.

And so, that’s what we created the chat for. You know, it really was just an opportunity to gather people together who had different perspectives and who had different roles in healthcare into one public space, that being Twitter, to share ideas, thoughts, and comments. When we started, I never really thought that this would morph into a community of people that, you know, whenever we get together now and see each other at conferences, you know, hugs exchanged, there are smiles, there’s, you know, it’s like greeting old friends that you’ve never met before. You know, that is all this stuff that’s now kind of become possible because HCLDR has been around so long.

So, I would be lying if I said that at the beginning we created and started the conference or, sorry, the TweetChat to create a paradigm shift. It sort of just ended up that way. I’m sorry, to answer your question directly, “Is it representing a paradigm shift?” The answer is, I think it does in the sense of it’s democratized comments and ideas and sharing. It’s through a medium that you know is still relatively untapped and unused in healthcare, which is Twitter.

Michael: Yeah, absolutely. It’s interesting. I know that I’ve been on the TweetChat now, I think, joining at different times, you know, maybe for the past three years you and Joe have obviously worked with it for a lot longer, but to come in from my personal experience and interacting with the group, it was very much this opportunity to just jump in and actually talk with people that are, you know, making decisions in healthcare, and it was, it was a little intimidating at first, honestly, jumping into something where, you know, I know nothing about it, especially when I first started joining the Twitter chats.

We, you know, had a history that was very much just like in hospitality and marketing, but it was nothing to do with medical and I was really just kind of getting my feet wet with all of that. It was fascinating to me that my voice could be heard and that I could actually be a part of this conversation. And I see that experience happen so many times with new people as they join the community and just how welcoming people are to invite them in to welcome their experiences, to hear what they have to say about all of that. And so, is that something that, that you and Joe, and I know that you’ve had different co-hosts over the years, but how intentional was that going into the process and how has that sort of evolved on its own?

Colin: So, I think it’s partly intentional and partly it’s just who we are as people. You know, when we first started this, again, back in 2012, there wasn’t … there wasn’t a lot of Twitter chats. On the flip side, there were a lot of them being started at that time too. And so, you had to be welcoming because otherwise, you wouldn’t attract many listeners or many participants. So, by necessity, you wanted to welcome more people in. But I think also the cohosts that I’ve had, the people that have been involved in the community, we are all by nature, very welcoming.

And being on this sort of social platform, it kind of makes people a little bit more accepting, I think, of others. And so, you know, Twitter to me is one of the greatest title … of democratized leaders out there, if that’s such a word. But basically, it doesn’t matter whether you’re a physician, or if you’re a nurse, or if you’re administrator, or if you’re a patient, or if you’re a student, it doesn’t matter on Twitter, it’s impossible to tell unless you click on their link and read their profile, which you can’t do during a Twitter conference, or a Twitter chat. So, I find that partly was intentional because at the beginning we had to attract new listeners and so we had to be welcoming.

But over the years, it’s just, I guess, it’s the nature of the individuals that have gotten involved in the community. We’re all very welcoming. We appreciate the different perspectives, even though they might not agree with our own. And because of that, you’re right, we’ve built a reputation as being one of the friendliest and most welcoming communities online, especially on Twitter where it doesn’t matter if your opinion is new or it’s already been said, go ahead and say it. No one’s gonna make fun of you or no one’s gonna make you feel bad that you’ve mentioned something that may have already been said before. We want people to get involved.

Scott: Yeah, I think it’s really well structured to being new to the whole Twitter cast kind of a thing. How you ahead of the evening, you’ll send out the topics so you can think a little bit about it. You’ll let everybody know how to be involved about it. So, there is some structure to why it is so inviting as well. That’s one of the things that I really like about it. You can think ahead of time. You’ve talked to, I don’t know, I’m gonna guess thousands of healthcare leaders over the years. Just, you know, it’s been seven years or so, what’s changed over time with a lot of the healthcare executives, like, what used to be on their mind, what’s still on their mind, what are you noticing, and more recently that that’s happening?

Colin: Yeah. You know, you’re probably right. I mean, I’ve been in the health IT business for 20 years and as a marketer on the vendor’s side, I’d go to a lot of conferences too. So, you know, on top of the work I do online, I’d probably go to about 30 or 40 conferences a year. And now that I’m part of the media, I still go to that many. So, it’s fun. It’s also great for the airline that I frequent. But, yeah, I do have the opportunity and privilege to speak to a lot of healthcare leaders and get a sense of what’s going on out there. You know, I think over the years what’s changed is just our natural evolution of going from paper to digital.

It’s hard to imagine, but 10 years ago, the majority of hospitals were still on paper systems, right? Or we didn’t have EHRs that spanned the entire hospital or span the entire practice. And along came Meaningful Use and that the big initiative to fund it and the billions of dollars that were poured into the industry and all of a sudden now, you know, it’s rare to find someone who’s paper-based anymore. And so, I think, you know, over the years, because of that digitization, the comments and the concerns of organizations have evolved. So, you know, for example, interoperability is probably one of the hottest topics right now or the lack of it. But that’s a hot topic right now. But, you know, 12 years ago that wasn’t even a possibility because everyone was just on paper.

So, you know, interoperability meant literally photocopying something or faxing something. I mean, faxing still happens, of course, but we’re having the conversation now about standardized data. We’re having the conversation now about how to connect multiple systems across multiple states together into a health information exchange and all these other mechanisms. So, we’ve evolved as our infrastructure has evolved, and that’s a great thing. So, we’re talking about things today, you know, what’s on the mind of been executives today is, of course, data privacy, data security, and breaches, interoperability, leveraging data for analytics and AI and getting more precision, precise in terms of the treatments that are effective for some patients and not others. And so, everything is becoming much more digital and data-based that was not possible even five years ago.

Scott: Yeah. It’s really fascinating because I was listening to a conversation, I think it was on NPR, about the recent vaping crisis with a lot of young adults and teens, and they were just trying to collect data to try and get a better idea about what was happening and connect the dots a bit. And that led into a whole conversation about data compatibility, security, trying to connect the dots with some sort of AI. And you just brought up all those things and that’s what they talked about it.

It was fascinating how it started out as a conversation about, “What do you think is happening to these kids?” All the way across to, “Wow. What are we doing with all this data and how can we really use it?” You know, which is another, I think a fascinating thing that a lot of other companies are looking at as well, like, say Apple computer and Microsoft at a personal level, how do you get that into your hands so that if you walked into an ER that would very easily be transferred? Like, “Yes. I’m…” I don’t know, I’ll make something up, “I’m diabetic and I’ve got a heart issue,” or something along those lines. So, it is fascinating.

Colin: Yeah. I just recently it was at a conference where there was an executive up on stage, a CEO, and it was basically, you know, she made the comment 10 years ago, they were truly just providers of health. That’s what they did. And now fast forward today, they are providers of health that collect a lot of data, right? And you know through their electronic systems, their imaging systems, through all these different platforms, they’re collecting a lot of data. Ten years from now, what she said was, “We’re gonna be data companies that happen to provide health as the output.” And I thought that was really intriguing for her to say that and she went on to explain it, you know, down the road it’s gonna be all about, “How much data do I have on you as a patient?

How do I crunch all that data most effectively, most efficiently to come up with a treatment and an outcome that is the most ideal for you? We’re all hearing little bits and pieces about that today around, you know, customized or personalized pharmaceuticals, customized and personalized treatment plans. Maybe my diet needs to be different than your diet because of your genetic makeup versus mine. All of this will become the norm 10 years from now and we’ll look back at this time in medical history and go, “Why do we mass-produce health? Like, this mass production kind of health method where everyone was treated the same way. No, it should all have been personalized in the first place.” But that only is possible if we’re collecting enough data.

Jared: Yeah. Colin, I think what’s interesting about all this, you’re talking about this evolution of technology essentially in healthcare. And it’s not just in healthcare, it’s because of a lot of things that have been enabled in other industries. And, you know, your background’s in IT and tech innovation and I know just being able to look back at, you have a very wide-ranging view of what’s happened, how things have evolved and possibly what’s coming next. I’m curious what you think, kinda what’s coming next. You know, say the next five to 10 years, what do you see coming next for health IT?

Colin: Okay. That’s an interesting one. So, let me start with a negative one. I think unfortunately data security is gonna get worse before it gets better. I just think, unfortunately, you know, we have not made the investments that we need to in data security. It’s not to say that they don’t care about it, I’m just saying that I think the folks out there who are nefarious have gotten wise to the fact that health data is worth a lot or can be worth a lot and also, you know, it can be worth a lot in terms of being able to access drugs and so forth.

So, I think unfortunately for the healthcare industry over the next five years, we’re just gonna hear more and more about data breaches and data integrity issues and all that. So, I think it’s gonna get worse before it gets better. That’s one prediction. But the other thing I think is sort of much like what’s going on in the IoT world, where we’re suddenly gonna have all these devices, and all this information, and all these things connected together. I see that happening in terms of health data. Things that we don’t consider health data today, like what we’re eating, where you’re shopping, how far it is between your office and the local fast food joint.

All of this kind of information will now be crunched or crunchable, if you will, analyzable and that will help determine lifestyle choices and help determine your diet habits and things like that. And I think that’s gonna be something that’s gonna happen in five years where all of us are gonna have those apps that today are novelty, but tomorrow will just be part of life to say, “Okay. You know what? I’m looking for lunch today.” And instead of going to Yelp and picking something, it’s gonna be, “Well based on your profile and your data that I’m getting from your watch today, you should probably go to this restaurant and I’ve already booked it for you and here you go.” Right?

Scott: It’s interesting you bring that up because I agree with you that data security is gonna get worse until all companies, which to your point, it’s not like data companies are avoiding it, hospitals, etc. It’s just that there’s so much that everybody wants to do. It’s almost painful to have to go back to square one and make it secure. It’s like, “I thought it was, can’t we just work on this cool thing?” And it’s like as soon as we clean this up better we’ll be able to do all the cool things. Because like you’re saying, if we knew that we had true anonymity and we knew that we had true security, I really do think a lot more patients would be happy to share data.

Colin: Now, we’re getting sort of metaphysical, but I think what you’re talking about as well, hints on where we’re going as a culture. It used to be, “Oh. So and so was on a kale diet. Look at them.” They’re all like, “What TV show have they been watching?” But nowadays you look at it and go, you know, and people are much more aware,” Hey, you probably shouldn’t be eating as much red meat. You probably shouldn’t be eating everything fried. You know, whole grains are better than the processed stuff.” Like, there’s an awareness of food as one example, but also air quality exercise, looking for where to live, where I can actually walk to work or bike to work rather than drive to work or even take transit.

There’s an awareness now in our culture which is now more ingrained I think than in prior generations. And because of that, I think and because of the amount of data that we now have available to us, it’s really gonna change how we define health care. I think it’s gonna go beyond the walls of the hospital. And that to me is the most exciting part where things are going…and you can see some of it now with the retail clinics, with Amazon, with Apple, and everyone getting involved in health. How long before healthcare now spans all the way to your fridge, right? Whereas today we don’t think of your fridge as part of healthcare.

Scott: Yeah. And you’re right. It truly is. And how we, again, connect the dots with safe, secure data will really be fascinating to see what happens.

Michael: It made me think of when an example Colin, that you just mentioned, this whole thought of being data companies that have to do healthcare. There’s an organization that just earlier this year I was getting to know them pretty well and they have a really good thing they do. They match people who are on an employer’s health plan, they match those who are predisposed to have a propensity for diabetes and they help match them to programs that can help kind of address those either symptoms or lifestyle choices and whatnot.

So, it’s not necessarily the things that people are going out there shopping for. It’s helping match you with an exact type of program for you, your age, and your demographic, and so forth and it’s really cool on the front end of it. That’s where I first got to know them was kinda how they presented themselves and portrayed themselves outwardly, digitally, and so forth in social media and on their website and it’s a great story to tell. Then once I got behind the scenes, I saw it really was a data company.

It really was everything to do with the business had to do with sorting lists, structuring data, matching data, re-running lists, and analytics. And that was everything behind the scenes. And it wasn’t… Because they weren’t the ones offering the care, they were just the ones matching people to the care that was most likely to benefit them. And so, I see exactly what you’re talking about. I can see how there could be more of that type of model where what they actually do is totally based on their ability to clean and structure data and find people that are matching a certain way. It was just fascinating to me to kinda see that dichotomy happening in real life.

Colin: Yeah. And I think that’s why it’s so important to just kind of bring it back to what we were talking about originally. I think that’s why it’s so important to get many or as many voices involved in the healthcare discussion as possible so that we don’t end up with biased data or biased treatments that only, you know, the drug clinical trial was like 80% white male, right? Like, “Okay, that’s great, but, you know, that doesn’t represent the population.”

You know, I see that same thing happening with AI. These AI algorithms that we’re training today, there’s some questions as to, well, what data sets are they being trained on? I mean, are they diverse enough, are they inclusive enough? And the answer today is, “It might be, but we just don’t know.” My hope is that over time, as we standardize the data and make it available in a universal format, that that that becomes a non-issue. Like, you know, everyone can share the data, everyone’s sharing it in the same format there, now we have a billion data points rather than a million data points that we’re basing these AI algorithms on.

So, you know, but that only starts when we start to realize that there are other voices and other perspectives. And they’re all valuable and, you know, that we have things to contribute. For the longest time, for example, patients weren’t included in anything, right? They were literally the consumers or forced consumers of the healthcare industry. And now, thankfully, you know, people are recognizing that, “No. No. Patients and caregivers, they have a voice, should have a voice in how their care is administered.” And now we’re seeing this, you know, the consumerization of health as the new movement. And we’re starting to see that only because people are recognizing, “Oh. You know what? Patients now have a choice.” You know, and it’s not the doctor down the street, I’m now competing with Amazon to deliver this person’s healthcare.

So, I better get ready for that. I better do some things that Amazon is doing, highly personalized, knowing who the customer is, all those kinds of things that, you know, I think in years past healthcare didn’t have to worry as much about now that we’re being forced to. So, that means to me that we’re heading for a world where the voices of all of the stakeholders in healthcare, are we going to be more equal, which I think is wonderful.

Scott: I couldn’t agree more. It’s one of the things I really love about the Twitter chat every Tuesday is that so many different perspectives and opinions and if you only look at it from one perspective, it really does get skewed very quickly. And so, having everybody kinda having a polite, good genial conversation about what they think and why really it’s been very eye-opening. And you can be as involved in it as you want or just watch, you know, so to speak, and then jump in when you want to. It’s a good Tuesday evening.

Colin: Yeah. That’s what a lot of people tell me when they meet me in person. I’m always tickled to hear that, of course. And, you know, I just to know that the community is out there and appreciates what we do and enjoys the interaction and you really do learn a lot. I mean, I learned so much just from listening to the people who contribute to the community and to the TweetChat. You know, I’ll just give you a quick example. I used to, when I first started in healthcare, I used to say, “Oh we’re all patients, right? Because one day we’ll all be making use of healthcare.” And I learned over time that that statement, I really was not a patient. Like, I learned through HCLDR what a patient really is. And these are people with chronic conditions. These are people with rare diseases who have no diagnosis. And I stopped saying that term or using that phrase because I am sort of an atypical patient where I go to see my doctors every six months, every year. And I’m good. Like, that’s it. Like, I don’t.

But I would not have known that perspective. I would not have been taught that perspective had I not been as involved as I am in the HCLDR community because I was basically told politely, thankfully, by these rare-disease patients, by people who have multiple chronic conditions who have just a much tougher time and just not access to healthcare like I do and I was basically schooled. And, again, I’m so appreciative for that perspective because it’s changed my view of what health care really was.

Michael: It’s interesting as we’ve, we’ve been going through all this discussion, I’ve been thinking about different people in my life that I know that are very concerned with their health, whether it’s a chronic patient that’s in my life that as a family member I think about family members that are just thinking through living healthy, you know, and at the age that they are and all the different family members that are dealing with different challenges at those age levels and thinking about trying to go through this big healthcare shift or those big technology shift really and how their data’s gonna…they’re gonna interact with that and all of that kind of stuff.

And the fact that there are more discussions like the Twitter chat, that there are more opportunities for people to get in contact with healthcare providers, it’s interesting because right now, you know, as we’re recording this here in the U.S., everybody’s looking at whether they’re gonna legislate Facebook more, whether they’re gonna go after Google more, whether they’re gonna go after all these big technology companies because we are all untrusting of them and we don’t trust where they’re going with our data.

We’re not happy with how they’ve handled it so far and for good reason, and it’s gonna be this interesting shift of, “Hey, there are these very, very positive trends happening in healthcare. There are opportunities where people are coming together and actually talking about it, where our family gets to go and be a part of conversations with nonprofit organizations, with the hospital that we interact with quite a bit, all of that kind of stuff.” And so, it’s exciting, but it’s gonna be this weird mix between the trusted and the untrusted, I think over the next several years.

Colin: Yeah. Now, you know, that’s a topic we could spend whole hours on talking about. But you know, trust is the new currency. Data might be the oil, but trust is what we’re all gonna be trading in in terms of, “Do I trust you enough with my data, with my health, with me,” and what are companies going to have to do in the future to earn that trust? You know, the interesting comparison I have to just what you said was, you know, you look at some companies that are essentially collecting data for data’s sake. A company like Google, a company, like to certain degrees, a company more like Microsoft.

And that’s it’s not evil. I don’t think either. I think those are both wonderful companies are doing great things, but both those companies, they collect data for the sake of collecting data and then they are trying to do something with it. You know, Google tries to refine their search criteria, they’ve built self-driving cars and all these wonderful things. But you’re looking at a company like Amazon who doesn’t normally get included in these kinds of discussions around, “Well, what are they doing with the data?” Right?

And to me, the difference is Amazon’s collecting probably just as much information as Google is collecting on you, maybe even more. And yet what they’re doing with the data is offering you something valuable in return. So, you don’t mind, right? Like, no one minds when, well, they know exactly what kind of brand of toilet paper you use and no one seems to mind that the next day Amazon is like, “Hey, do you want me to preorder it for you because you’re kind of due for another, you know, set?” Right? Like people go, “Well, isn’t that creepy?” I mean everyone’s like, “No. It’s okay. It’s super convenient.” Right? Like, “I don’t have to remember to order this thing, and thank you.” Right? And you go, “Well, wait a minute.”

If you think about it, what’s different between collecting that intimate information versus collecting what I’m searching for on Google? The answer is, “There’s no difference.” But yeah, “I’m getting something valuable return. So, I don’t mind.” And to me, that’s the difference between what healthcare needs to do and what some of them maybe are doing. If you’re just collecting data on me to build a profile of me, so then you can build an AI, a routine on top of it. That to me is like, “Okay. Now, I don’t want to share my data with you because what am I getting out of it?”

Selfishly, we’re not getting much. But if I’m sharing my data with you and all my health history with you and what I eat and where I shop and how far I…and how I get to work, and you’re able to customize a health plan for me, that’s gonna keep me healthier longer, that’s gonna allow me to mountain bike for more years than I would’ve if you didn’t get involved. Well, that to me is a trade that now I can consciously make. I’m probably will go, “You know what? For that, I’ll share my data.” I’ll take the risk of a breach because I’m getting something amazing in return.

Scott: You’re right, you’re absolutely right.

Colin: It’s just not clear today that that’s what’s happening. And so, I think that’s where that trust, there’s an opportunities there. And I think that’s where the industry is going is that there will come a time where someone will be able to say that. And that entity is gonna win that trust battle.

Michael: That’s awesome. Guys, thank you so much. This is a conversation I could keep having for quite some time, but we’re gonna go ahead and wrap for today. But I think that there’s some real, like, you’re saying, there’s a real opportunities here for companies. I think also for providers at the individual level. There are these chances to build trust. Yes, with data but also just with that, the ongoing conversations. We’ve been talking about that a lot to the show. Just how much more of a conversation health care is and it’s exciting to see it going that way. So, Colin, thank you again. Guys, thank you all for joining and thank you for listening.

Announcer: Thanks again for tuning in to the Paradigm Shift of Healthcare. This program is brought to you by P3 Inbound marketing for ortho, spine, and neuro practices. Subscribe on iTunes, Google Play, or anywhere you listen to podcasts.