Twitter: filter, suggestion box, idea machine, window

On Friday I dashed off this tweet:

PhD student just asked me which journals I read to stay up to date on health + tech. My answer: Twitter.

It was classic RT bait and indeed it was echoed dozens of times by fellow Twitter geeks — more than any other tweet I’ve written.  But I would like to qualify it with a fuller explanation.  I don’t just read Twitter and ignore journals.  Far from it. For me, Twitter is a filter, a suggestion box, an idea machine, and a window.

Here’s the story:

I received a familiar and welcome request via email last Thursday:

I am a graduate student in communication at [a university]. You seem to be one of the people at the forefront of the field regarding Web 2.0 technology and health. I am very new (consider me a blank slate) when it comes to knowing what is going on in this field, but I would like to know more.

I have downloaded a number of your articles from Pew Internet, as well as a couple of data-sets from Pew as well.

I am wondering if you have any advice (names of researchers; websites; reference lists of peer reviewed articles) that you may be able to share with me…

Thank you for your time and help. You should know that with all the articles you’ve already published online, you’ve already helped me significantly. So thank you.

I love getting emails like this and I try to respond as quickly and as helpfully as I can.  I welcome the new ideas and approaches that come from students. I also believe in the principle of “be nice to everyone, they could be on your hiring committee some day.”

Here’s my response:

Thanks very much for your interest in my research.  There is a lot to catch up on, but don’t worry, it also is changing so fast that nobody is fully up to date!

For a historical perspective, I recommend reading the E-Patients White Paper — downloadable from the blog (right sidebar).

You have probably already found the Pew Internet Health page, but in case you haven’t:

You can select from a dropdown menu on that page to read only Reports, which might be a shortcut.

The best paper I’ve read recently, if you want to just fast-forward to today, is a book chapter on online health information: PDF

And if you’re not yet following me on Twitter:

You’ll find a large and welcoming community there.  Pay attention to hashtags like #hcsm and #health2con — follow the ones that interest you. Honestly, Twitter is better than any peer-reviewed journal for staying up to date on tech & health.

But I realized that a newcomer would benefit from a longer explanation of Twitter’s possibilities. So here goes, a very subjective health+tech guide to Twitter:

Twitter as filter: Because I get more value from what my colleagues recommend than any RSS mix I could put together.

@ahier separates the wheat from the chaff, consistently pointing out the best information related to health and technology.

@KentBottles – Just how much do I love Kent’s picks? I get up on Sunday mornings looking forward to seeing what he recommends from the New York Times.

@pfanderson has probably forgotten more than I’ll ever know about information technology and its intricate connection with health care. Plus she makes me feel like a welcome friend whenever I check in on her feed (although we’ve never met).

Twitter as suggestion box:

@gfry and @markhawker are two of the health/tech field’s toughest critics and when they tell me to refocus my lens, I do it.

@kevinclauson brings two valuable perspectives — as an academic and as a pharmacist. I could never hope to find the journal articles he highlights, but what I really appreciate are the collegial DMs he sends when I post something new.

@mindofandre and @digiphile completely get what I do and cc me on tweets highlighting articles they know I need to read.

Twitter as an idea machine (and those ideas often are inspired by people outside my field):

@timoreilly – Sure he’s an internet industry guy who is interested in health care, but it’s not his focus, so I count him as an outside influence. He’s a desert-island follow for me.

@stoweboyd is a futurist who is responsible for at least a half-dozen a-ha moments for me since I started following him.

@zephoria stuns me weekly with her insights. She’s another desert-island follow.

Twitter as a window: Because I can’t be everywhere I’d like to be.

@epatientdave is one of the most passionate, but on point, live-tweeters I know. Because of his enthusiastic review of a talk by @SeattleMamaDoc I knew I had to watch the video as soon as it was posted. It knocked my socks off.

@healthythinker is the person I’ll nominate to cover any event I can’t attend because her observations are so sharp, especially when she has time for a blog post like this one.

This list is by no means comprehensive.

I currently follow 591 Twitter accounts and a few public lists.  I also created private lists to follow scientists, health reporters, and patient bloggers, among others. Twitter curates the full range of health-related reading suggestions, from the New England Journal of Medicine to Mothers with Cancer to The Immortal Life of Henrietta Lacks. It’s library + field work combined.

How do you use Twitter?  Who are your desert-island follows?


Posted in: trends & principles





21 Responses to “Twitter: filter, suggestion box, idea machine, window”

  1. Alain Ochoa says:

    Great post and great advice. Got some new valuable following from your list, thank you.

    You sum up pretty much anything you can do with Twitter. Filtering is the most important one for me.

    From Spain, I would recommend following eHealth researchers @flupianez and @luisluque. If they recommend reading something, it’s always worth your time.

    And if you read Spanish, good choices to keep up with latest trends: @manyez (health management) vtraver (HIT research), jbasago (medical news and research), @monicamoro (pharma 2.0), @juliomayol (surgery, medical education), @rafabravo (GP). There are many more, but these will RT anything meaningful you need to know in case you hadn’t noticed.

    • Susannah Fox says:

      Thank you, Alain, I too am a fan of @flupianez and @luisluque — you can only imagine how long this post would be if I included everyone who adds value to my work!

      If only I could read Spanish…

  2. Thank you for this great post, Susannah. It is so true that twitter has these amazing capabilities to bring the information you need to you when you most need it.

    I found myself pitching twitter to European neurologists last week (not an easy crowd to convince).

    How did I finally convinced them? I told them to use twitter as the “window” onto their patients needs as well as a filter to get news faster and be prepared for their patients’ questions…that and I was very luck to have extremely social media savvy neurologists facilitate the session with me and chime in with their hands-on experience ;-)

    • Susannah Fox says:

      You probably saw how I over-prepared for a recent presentation to surgeons. Yet they turned out to be just one notch below librarians (the best audiences of all time, anywhere) in terms of openness and curiosity about social media.

      Thanks for sharing that story!

  3. Thanks for the mention.

    I agree with the gist of your post, but …..

    At the risk of sounding negative, I have to add that not all is gr8t, important, must-read and other forms of twitter-pushed superlatives in the kingdom of the 140-characters “HEY, it’s me again!” messages.

    Here are some of the issues I see:
    * Filtering in twitter is very difficult,
    * the flow of incoming tweets add to our already pathologic communal ADD,
    * Groupthink is clearly becoming a big risk, since twitter communication heavily promotes an “I agree” mentality.

    And finally, most of the greatest discoveries I have made through Twitter have been indirect links, like a post written by mentioned in a tweet (not the post appearing in the short URL). This is in direct opposition to what Dave just wrote a short while back here: “I haven’t read the full Atlantic article yet, but today it was the buzz of Twitter.” Important reads have always demanded significant time and attention. Twitter cannot change that!

    I feel like I must act for just one second like Nicolas Carr and ask “Is Twitter Making Us Stupid?

    • Susannah Fox says:

      Ahem, proving my point that Gilles is a tough critic worth paying attention to.

      I took two weeks off from Twitter in June and while I missed the conversation, I had a chance to read more books than I otherwise would have and come up with some new ideas that I needed to just sit & think about, alone.

      Twitter is a tool. Your mileage may vary.

      • I keep on looking at Twitter as a platform, not a tool. The experience we each have with that platform is modulated by the various clients we use to I/O on the platform. I was thinking this morning that TweetDeck gives me a very different experience than reading my stream on the web via Twitter own UI.

        • Giles is correct. The experience of Twitter via something like Tweetdeck is very different than the stream via the website UI. This is one of the hurdles I face with getting newcomers to view Twitter as something useful. Fortunately, the learning curve for something like Tweetdeck is pretty easy *and* developers are coming up with other tools that are even more powerful for sifting through the noise of Twitter unfiltered.

      • Mark Hawker says:

        I’ll try not to disagree with Gilles, since we’re on the same team! However, I find that increasingly I disagree with what’s being said on Twitter. To me, it’s never really been about the status quo. More often than not I’ll say what’s on my mind, as before I was always quite tentative. It’s always in good spirits, as I believe the key to learning is being challenged. No matter how high you are in the food chain.

        (Un)fortunately, I don’t tend to be affected by information overload/filter failure because I make sure my following list is quite short. But, ultimately, it’s about the interaction. The ability to discuss, reply, debate with others who are willing to engage. That’s not everybody by any means! We all use Twitter in different ways, and that’s just fine. I do tend to find that people are less-inclined to respond to questions, and maybe that’s something that will sadly increase over time until we all just end up tweeting ourselves. Though, I find great warmth in the small cohort of people that make my day that little bit rosier. They know who they are.

        Maybe it’s actually a lot harder to define this space we live in in terms of scholarly writers? Maybe it never was that easy in the first place. I toss and turn between thinking academe is essential to the world, and some days thinking it is a lost cause.

        It’s always a pleasure to share, and to be in touch with some of the greatest minds in this space.

        Thanks, Susannah.

  4. Martin Young says:

    Difficult filtering out all the ‘noise’ – the more people you follow, the more noise you get!

    When different time zones are involved – i.e. USA may be 9 – 10 hours behind Europe, then keeping up is difficult.

    • Susannah Fox says:

      I hugely agree about the noise AND the time-zone challenge.

      Cutting through the noise has made me a little bit more conservative about what I tweet & RT, to avoid the “me too” aspect that Gilles points out.

      I love getting up very early in the morning and seeing all my EU friends going about their day on Twitter — material I would miss if I only checked in midday in my own time zone.

      • Martin Young says:

        My twitter routine is first thing in the morning and last thing at night – as well as every break during the day.

        Funny, what did we do before social media?

        You may be interested to know the challenges I face here in South Africa – I submitted a request to present at my South African ENT Congress on “Doctors and the internet” talking about social media and all other – it was DECLINED!

        So we are probably going to be ten years behind the USA and Europe – sigh!!

  5. Susannah,

    Your characterization of Twitter is pretty much spot on for how I use it as well. I would add that it also has the specific role as a social networking tool (which is sort of implied in bits of what you were saying). That has been one of its most valuable aspects for me – I have been exposed to and interacted with people with expertise that I was unaware even existed.

    One of the things that has helped me consider the utility of Twitter the way I do is that I have made using it an assignment for my elective the last several semesters. The students have to create an account, select thought leaders (or people saying interesting things in their specialty of interest), follow them during the semester, write a brief narrative about whether it was a positive or negative experience (justifying with selected tweet examples) and state whether or not they plan to continue its use post-assignment and why. As you can imagine, the narratives have made for pretty good reading.



    P.S. Coincidentally, I wrote a post recently about who I was most looking forward to seeing here at Digital Pharma this week and Gilles was one of the handful I mentioned. What I did not write, was that I am curious to see where he falls on the spectrum ranging from Rage Against the Machine to Endearing Curmudgeon in person…we shall see!

  6. Boy, I go offline for six hours and the world’s exploded with juicy new stuff. (At least this blog has!)

    The closest I have in Tweetdeck to a “desert follow” list is my Jenstream column. It used to be exclusively for @JenSMcCabe, back when she was a profuse tweep – so intensely perceptive I wanted to miss nothing, no matter who else said what. She’s off in heads-down #startuplife so she doesn’t tweet much now, but I added you to that column. (@GFry and @ahier, too.)

    Here’s another dimension – we could discuss what columns we have, in Tweetdeck or other tools. Sample uses:

    • Star-tracking – e.g. the @TimOReilly/mindcasters list. (Whatever he’s watching, healthcare or not, I’ll listen.)
    • “Don’t miss” filtering – e.g. my JenStream.
    • Subcultures by hashtag:
      • Event chatter e.g. #health2con [Health 2.0], #Swedish100 [Swedish Medical Center Seattle’s 100th birthday conference last week]. Interesting to see differences in flavor; especially interesting to see which events spin off a long stream of follow-up tweets, weeks after.
      • Weekly tweetchat groups e.g. #hcsm (the weekly healthcare social media chat, Sunday 8 p.m. Central.)


  7. So the PhD student in your tweet didn’t really ask which journals you read…

    And you didn’t really answer with just “twitter.”

    In an effort to be engaging and/or provocative on Twitter, you unfortunately sort of misrepresented the entirety of the exchange. You got the RTs, but will any or all of those RTs now link to the fuller message and more accurate representation?

    I think it’s fun to be provocative. But this sort of feels like suggesting that all you used to build this 50-bedroom mansion was this little ole hammer over here and a box of nails. (Twitter, as a group, loves it when people tweet about how great Twitter is.)

    It also reminds me of the recent article in The Atlantic just featured here, where researchers today continue to cite results of long-since debunked studies. Everyone will now cite the original tweet, but how many will cite the real explanation of that tweet?

    Twitter’s a great tool — a wonderful communications modality in an ever-changing online world. But for me, anyways, it’s just one tool I use in my daily pursuit of knowledge and insight. I could do without twitter long before I could do without a web browser (which you don’t see people writing a whole lot about and yet the Internet would be virtually useless without it).

    • Susannah Fox says:

      John, you put your finger on it, as usual.

      I was taken aback by the RT flurry and thought, well, now I have to tell the full story.

      I love your analogy with a web browser. Keeping that long view of history in mind reminds of when, in 1995, someone asked internet pioneer Vic Sussman if the invention of the Web was akin to the invention of the wheel. “No,” he shot back. “It’s like the invention of FIRE!”

      Let’s not get ahead of ourselves, but let’s take advantage of what we have. This post is hopefully a way to show what some of the possibilities are, at least right here, right now, for our tribe of people interested in health & tech.

  8. Great list of folks to check out here Susannah and thanks so much for including me. In thinking about how things change for the public health world, I always try to saturate myself in various forms of information.

    True, it is easy to get caught up in the Twitter world to depend on late breaking news — i mean, it is after all a real time conduit for the things you are interested in.

    However just like this more elaborate post which expands on your original idea, the long form of other journals and books also has it’s place. Kudos for bringing this out further and with community feedback.

    • “Twitter makes me like people I’ve never met and Facebook makes me hate people I know in real life” (by @shaylamaddox).

      Recently the ‘origin’ of the above tweet, which speaks to the topic of Susannah’s post IMHO, was detailed: I think it provides another interesting perspective on how Twitter can be used.

      Having just had yet another experience at a conference where I met several people I had previously only known via Twitter and then used Twitter during and after the conference to make new connections, strenghten existing ones, and livetweet…I may need to propose another category of Twitter use specific to that prupose.


      • Susannah Fox says:

        If there was an “Agree” button on your comment I would click it about 15 times. I had the same experience at the Connected Health Symposium last week, finally meeting David Harlow and Paulo Machado for the first time. Twitter is the Friendfinder of conferences.

        And yet I find myself quieting down at high-tweet-volume events like that — if Andy Carvin or E-patient Dave is there, who else needs to tweet? I just chime in with ideas I don’t see getting picked up.

        I just went back and re-read two great posts by Mark Drapeau on the topic of conference tweets:

        “Live-tweeting is dying”

        “A talk is bigger than a tweet”

        I’ll be at TEDMED this week and will be interested to check out the online zeitgeist.

        • > if Andy Carvin or E-patient Dave is there, who else needs to tweet?

          Uh-oh, that’s the best argument I’ve seen for shutting up!

          What you see as tweetworthy is different from what others see.

  9. […] Twitter: filter, suggestion box, idea machine, window by @SusannahFox [Oct 18, 2010]      Four featured functions of Twitter including example […]

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