Social Media Engagement For Health Professionals
Many physicians and healthcare executives are afraid to engage with social media networks through fear of saying something they shouldn’t, or unintentionally damaging the reputation of the establishment they work for. For so many years the healthcare industry has been governed by rules about patient confidentiality so it goes against everything physicians and healthcare professionals know to update a portal, which anybody can access, in a working environment.
The social media concept can trip even the most professional people up if they do not know how to engage with it properly – take the instance in the news recently of Dr Amy Dunbar, an ob-gyn working at St. John’s Mercy Medical Center in St. Louis. Dunbar posted a comment to Facebook about a patient who was continually late for her scheduled appointments. Dunbar wrote:
“So I have a patient who has chosen to either no-show or be late (sometimes hours) for all of her prenatal visits, ultrasounds and NSTs. She is now 3 hours late for her induction. May I show up late to her delivery?”
When asked in the comments why she didn’t cancel the procedure or transfer the woman to another doctor, Dunbar publically announced that the patient in question had endured a stillbirth in the past. The post was visible not only to Dunbar’s 470 friends, but also to the wider Facebook community.
Dunbar’s posting angered and upset one reader, Amanda Johnson, who took a screenshot of the status update and posted it to a Facebook group run by Dunbar’s hospital – Mercy Moms To Be.
“When did it become okay for a doctor to ridicule and demean their patients?” Johnson, who works in the healthcare field, told Mashable in a Facebook message. “Even in my nursing home contract it very plainly states that we may not speak in any way of our clients, even if their names are not used.”
The Mercy Moms To Be Facebook page was frantic with comments for and against the post; many believed her comments were unprofessional and breached patient confidentiality, but some supported Dunbar and suggested that patient was at fault. Some also noted that Dunbar had never used the patient’s name.
After an investigation the hospital found that Dunbar had not in fact broken any patient privacy laws, nor were any of the hospitals management laws breached.
“Mercy values the dignity and privacy of all our patients and we are very sorry that this incident occurred. While our privacy compliance staff has confirmed that this physician’s comments did not represent a breach of privacy laws, they were inappropriate and not in line with our values of respect and dignity. Mercy holds its physicians and other co-workers to high standards in ensuring the protection of patient information. We cannot comment on specific disciplinary actions, but we will use this as an opportunity to reinforce our standards through additional education of our physicians and co-workers, including appropriate use of social media.”
And therein lies the problem. Many physicians and other medical employees are not given strict rules of engagement for social media networks. It is no wonder that mistakes are made if hospitals are providing their staff with guidelines that can be interpreted in more ways than one. Hospital executives need to be giving their employees strict rules and regulations about how to use social media sites to help them avoid any mistakes. It may take time to implement, but it could save an expensive and damaging PR campaign to rectify the damage caused in the long run.
The challenges to vaccine distribution affecting everyone
While it is comforting to know that vaccines against COVID-19 are showing remarkable efficacy, the world still faces intractable challenges with vaccine distribution. Specifically, the sheer number of vaccines required and the complexity of global supply chains are sure to present problems we have neither experienced nor even imagined.
Current projections estimate that we could need 12-15 billion doses of vaccine, but the largest vaccine manufacturers produce less than half this volume in a year. To understand the scale of the problem, imagine stacking one billion pennies – you would have a stack that is 950 miles high. Now, think of that times ten. This is a massive problem that one nation can’t solve alone.
Even if we have a vaccine – can we make enough? Based on current projections, Pfizer expects to produce up to 1.3 billion doses this year. Moderna is working to expand its capacity to one billion units this year. Serum Institute of India, the world’s largest vaccine producer, is likely to produce 60% of the 3 billion doses committed by AstraZeneca, Johnson & Johnson and Sanofi. This leaves us about 7 billion doses short.
Expanding vaccine production for most regions in the world is complicated and time-consuming. Unlike many traditional manufacturing operations that can expand relatively quickly and with limited regulation, pharmaceutical production must meet current good manufacturing practice (CGMP) guidelines. So, not only does it take time to transition from R&D to commercial manufacturing, but it could also take an additional six months to achieve CGMP certification.
The problem becomes even more complex when considering the co-products required. Glass vials and syringes are just two of the most essential co-products needed to produce a vaccine. Last year, before COVID-19, global demand for glass vials was 12 billion. Even if it is safe to dispense ten doses per vial, there is certain to be significant pressure on world supply of the materials needed to package and distribute a vaccine.
It is imperative drug manufacturers and their raw material suppliers have clear visibility of production plans and raw material availability if there is any hope of optimizing scarce resources and maximising production yield.
It is widely known by now that temperature is a critical factor for the COVID-19 vaccine. Even the regions with the most developed logistics infrastructures and resources needed to support a cold-chain network are sure to struggle with distribution.
For the United States alone, State and local health agencies have determined distribution costs will exceed $8.4 billion, including $3 billion for workforce recruitment and training; $1.2 billion for cold-chain, $1 billion vaccination sites and $0.5 billion IT upgrades.
The complexity of the problem increases further when considering countries such as India that do not have cold-chain logistics networks that meet vaccine requirements. Despite India’s network of 28,000 cold-chain units, none are capable of transporting vaccines below -25°Celsius. While India’s Serum Institute has licensed to manufacture AstraZeneca’s vaccine, which can reportedly be stored in standard refrigerated environments, even a regular vaccine cold chain poses major challenges.
Furthermore, security will undoubtedly become a significant concern that global authorities must address with a coordinated solution. According to the Pharmaceutical Security Institute, theft and counterfeiting of pharmaceutical products rose nearly 70% over the past five years. As with any valuable and scarce product, counterfeits will emerge. Suppliers and producers are actively working on innovative approaches to limit black-market interference. Corning, for example, is equipping vials with black-light verification to curb counterfeiting.
Clearly, this is a global problem that will require an unprecedented level of collaboration and coordination.
Disconnected information systems
While it is unreasonable to expect every country around the world will suddenly adopt a standard technology that would provide immediate, accurate and available information for everyone, it is not unreasonable to think that we can align on a standard taxonomy that can serve as a Rosetta Stone for collaboration.
A shared view of the situation (inventory, raw materials, delivery, defects) will provide every nation with the necessary information to make life-saving decisions, such as resource pooling, stock allocations and population coverage.
By allowing one central authority, such as the World Health Organization, to organize and align global leaders to a single collaboration standard, such as GS1, and a standard sharing protocol, such as DSCSA, then every supply chain participant will have the ability to predict, plan and execute in a way that maximises global health.
Political influence and social equality
As if we don’t have enough stress and churn in today’s geopolitical environment, we must now include the challenge of “vaccine nationalism.” While this might not appear to be a supply chain problem, per se, it is a critical challenge that will hinge on supply chain capabilities.
In response to the critical supply issues the world experienced with SARS-CoV-2, the World Health Organization, Gavi, the Vaccine Alliance and the Coalition for Epidemic Preparedness Innovations (CEPI) formed Covax: a coalition dedicated to equitable distribution of 2 billion doses of approved vaccines to its 172 member countries. Covax is currently facilitating a purchasing pool and has made commitments to buy massive quantities of approved vaccines when they become available.
However, several political powerhouse countries, such as the United States and Russia, are not participating. Instead, they are striking bilateral deals with drug manufacturers – essentially, competing with the rest of the world to secure a national supply. Allocating scarce resources is never easy, but when availability could mean the difference between life and death, it becomes almost impossible.
Global production, distribution and social equality present dependent yet conflicting realities that will demand global supply chains provide complete transparency and an immutable chain of custody imperative to vaccine distribution.
The technology is available today – we just need to use it. We have the ability to track every batch, pallet, box, vile and dose along the supply chain. We have the ability to know with absolute certainty that the vaccine is approved, where and when it was manufactured, how it was handled and whether it was compromised at any point in the supply chain. Modern blockchain technologies should be applied so that every nation, institution, regulator, doctor and patient can have confidence in knowing that they are making an impact in eradicating COVID-19.