I took care of a young lady the other day whom I admitted for diabetic ketoacidosis. She asked me what her bicarbonate level was. I was a bit surprised since most of the time my DKA patients don't care what their bicarb levels are. I told her it was eight. For the non medical types out there, that's low. That's critically low. I asked her why she wanted to know. And before she could even get the words out, she had posted a tweet onto her Twitter acount to update all her friends and family of her impending hospital admission. I found that fascinating.
I've been a hospitalist for seven years now. When I started, my phone couldn't do anything but call people. Now I have an iPhone that functions like a portable mini computer filled with wireless internet, high speed data transfer, instant weather, text messaging, camera, GPS maps and 100,000 applications at my finger tips. When I was a medical student and resident, my hospital wouldn't even allow cell phone usage near patient floors for fear of interference with wireless hospital telemetry boxes and ventilator equipment. How silly that sounds now.
I can't even imagine what I'll be carrying around seven years from now. For my patient, she chose to use her phone to access her Twitter account to let the world know about the state of her health. I'm sure she also updated her Facebook status before I was done writing my hospital admission orders.
While many people worry about the privacy of their health problems, many more are turning to social networking sites to liberate themselves from the secrecy of their health problems. I think social networking sites will revolutionize a public's perception of depression and disease and help patients focus on recovery rather than secrecy. There is a large amount of liberation and relief that comes with discussing your medical problems with others around you.
Perhaps someday, hospitalized patients will have 24 hour immediate access to social network portals at their bedside, with live streaming updates and real time recording of their discussions with doctors and nurses to keep friends and families in tune with what's going on. Perhaps this process will also reduce physician risk and malpractice by better documenting discussions with patients and families who feel they were not given appropriate care.
Perhaps someday Twitter will create a secure Tweeting network for doctors and nurses to communicate with patients and each other. Hospital systems may someday link directly with a patient's portable health site on Facebook so they can take their hospital records with them without doing a thing. As technology expands exponentially and the abilities of today's computers are dwarfed by the next generation processors, hospitalist medicine and social networking sites such as Twitter and Facebook may someday find themselves partners in a unique opportunity to provide patients and the families of patients with better quality of care, improved efficiency, and better real time communication of real time medical care.
Perhaps someday I could Tweet a negative CT result to the patient as soon as I get the result, instead of having them wait until the next day wondering for hours whether they have cancer or not. Perhaps someday, I could Facebook the daily chest xray picture to an anxious man wondering if his lungs are getting better or worse, so he's prepared for my daily rounds and discussion. The possibilities are endless. Social networking for hospitalized patients offers a unique opportunity to reduce costs, decrease anxiety and improve communication between doctors, nurses, patients and families for people who have nothing better to do than Tweet and update their Facebook status between biopsies, x-rays and lab draws.