My Three Words for 2014

It’s fashionable for anyone with a blog to post their New Years’ resolutions, but I have never been very original or consistent. (Looks like my last attempt was in 2011 - that's lame.) So instead, I will follow the lead of Chris Brogan and Bryan Vartabedian and choose three words that I hope will be my guideposts for 2014:

Focus. I will try to be less distractible and multi-task less this year. I will try to start every week by creating a short, realistic list of what I want to accomplish. Certain things will always pull me away from tasks, with patient care being the most important. But in my other jobs - EHR design/implementation at Hopkins, Cancer.Net editorship, JOP podcasts, social media research and evangelism - I will focus more on the task at hand, even if it’s only 20 minutes of uninterrupted thinking. And speaking of 20 minutes, I will try to spend 20 minutes every single day in the month of January writing (here's the source of that one). Not sure if that means that my blog will be any more successful, but a 20 minute goal is manageable.

Innovate. I’ve never thought of myself as visionary or creative, since I’m more the slow, steady, and thorough type, but I will try to devote energy and personal resources to creating innovative ideas for the things that are important to me, including patient-centered care, consumer-health informatics and patient-reported outcomes, and the intersection of digital health and cancer care. I would like to look back at the end of 2014 and say these are the 5, 10, 20, whatever truly original ideas I came up with and what I did with them.

Recharge. I will try to spend a fixed amount of time every week unplugging from what I have to do and do what I want to do (notice I didn’t specify the amount of time - I’m still trying to figure that out). I will recharge by exercise, listening to music, and reading for pure pleasure.

Wish me luck…

ASCO & the Conquer Cancer Foundation Enable Free Full Text for ASCO Journals

This is welcome and really exciting news from a clinician and patient empowerment perspective. The American Society of Clinical Oncology (ASCO) and ASCO's Conquer Cancer Foundation have announced the PatientACCESS initiative enabling free full text access to ASCO's two primary journals. You can read the details here on Cancer.Net. Through an agreement between ASCO, the American Association for Cancer Research (AACR), four other publishers, and the Copyright Clearance Center, patients and their caregivers can now get full access to research articles published in ASCO's Journal of Clinical Oncology (JCO) and Journal of Oncology Practice (JOP). Previously, access to abstracts was free for all, but full text access at the time of publication was available only to dues-paying ASCO members and those with institutional subscriptions, such as libraries, hospitals, and medical schools. Non-subscribers wanting access would either have to either pay a per-article fee, which could be pretty hefty, or wait 12 months when open access was available to all. Now, by clicking the "PatientACCESS" link at the bottom of the abstract page, you will be taken to the RightsLink website, and after agreeing to the Terms and Conditions, you will receive a copy of the article as a PDF delivered via email. (Also, it's important to note that some JCO content, such as ASCO Special Articles, Editorials, Comments and Controversies papers, the Art of Oncology series, and Correspondence has always been free; that's not changing.)

The JCO is ASCO's flagship journal where cancer research findings are published, and it's one of the most widely read and cited cancer journals in the world. The JOP is a newer journal, and it focuses on the mechanics of oncology practice, including such topics as health care delivery, quality of care, and business practices. Both journals are indexed in the National Library of Medicine through Medline and can be accessed via PubMed or their individual web sites above.

For the JCO in particular, it's nice for patients to now have full access to the  same articles their doctors are reading. While an abstract can convey the main points, the full detail of the study, including background, methods, results, and discussion, is now available. If you read about a study only by reviewing the abstract, you can miss some of the nuances and clinical implications - true for clinicians and patients alike.

A number of people have rightfully criticized the "paywall" that keeps this research from being freely available to all. The argument is that, since much biomedical research is paid for using taxpayers' dollars, they have every right to see the results as soon as they come out. There was lively discussion about this on the #hcsm Tweetchat last night. That argument makes a lot of sense, although it's not always that simple. JCO and JOP, for example, are self-published by ASCO, and they are a benefit of membership. Membership dues, in addition to advertising, support their publication. Even if the print version was discontinued (and despite this being the digital era, many subscribers do not want to part with their paper issues just yet), there is obviously a cost to produce a scientific journal that has to be borne by someone. This economic reality isn't going away anytime soon, but it is great news that at least for patients, caregivers, and advocates, they can get full, free direct access to these JCO and JOP research articles, which might very well have immediate relevance to their health.

Spread the word!

Genesis

Don't let the perfect be the enemy of the good.

If I sit through another meeting (usually something related to EHR implementation) and hear that quote, I think I'm going to…well I don't know what I am going to do, since everyone seems to be saying it and acting like they thought it up themselves. But that quote, supposedly paraphrased from Voltaire, partially explains why I have finally decided to put aside all of my reservations and actually go ahead and start a blog. A physician blog is hardly unique or interesting any more, but for me, with my increasing involvement with social media (and some level of visibility), the time is right to do this. To be more accurate, I have already been contributing to a blog on ASCO Connection for a few years now, and even prior to that to one of ASCO's first forays into social media, which was an EHR-focused blog on the Ning platform, which ASCO later migrated to ASCO Connection. I have contributed to ASCO Connection a few times a year, although I definitely feel far eclipsed by Don Dizon, Mike Fisch, George Sledge, and others, who are writing great blog pieces that have helped propel the ASCO Connection site to greater prominence, including a recent national award, a 2012 Apex Award for publication excellence. In other words, even though I was one of the first, these guys do such a great job, they should continue to carry the freight, and I'll probably just continue as a part-timer.

And let me say a word for and give a shout out to George Sledge in particular. I got to know George a little bit when we were both on the ASCO Board of Directors, and it's not an exaggeration to say he is the real deal - interesting and articulate guy, extremely well read with a broad range of interests, a brilliant scientist and clinical investigator, and as far as I can tell from the outside, a truly compassionate physician. But not only that, he is a great writer and really elevated the content and quality on the ASCO Connection blog pages. (Hey George, I'm not slurping you for any hidden reason, just to make this point.) I frankly don't know how he has the time to create these long and nuanced blog posts for ASCO and for Oncology Times, but they are always a great read. So…I knew I couldn't keep up, particularly with the length. Which is one of the reasons I realized it would be best for me to write my own blog - so here it is. Don't worry, Amy Fries and ASCO staff, I'll still post to Connection, although I will probably post it to this blog first and share.

So here is what I would like to do with this blog and a little more of my motivation for creating this. One of my main purposes is to allow me more space to share ideas than I get in 140-character Twitter posts. People who know about my social media activity of the past few years know that I am active on Twitter, and much to my surprise but also satisfaction, have 2000+ followers and growing (and some aren't spambots). But Twitter is all about quick bursts of information and instantaneous sharing, and not about thoughtful content creation. This blog will allow me to share articles, news stories, and other items I find online, that I am currently sharing on Twitter, but on a blog, you just have more "room." Sentences, not just phrases - what a luxury! And you can write in English, not in SMS-speak (Gr8 articl 2 read abt lng ca - blah blah blah).

Another reason to blog is to engage more with followers, more than what you can do with Twitter replies. I intend to enable comments on the blog and when I feel up to it, respond and engage in dialogue, although I don't have the time for a lot of argumentative back and forth, which is not my style anyway. Social media is always primarily about community and connection; a blog will help facilitate that. And I think it will also help people who read me to understand more of the life and experiences of an oncologist and informaticist (there's that word), particularly someone who has been doing this for 20+ years. Not that I think anyone is particularly interested in me as an individual, but sharing on social media is also about sharing who you are and what values you hold. In another post I will talk a little bit about my career and what led me from the East coast to the West coast and back again, and from private practice to academics. Again, not because I think it is particularly interesting to many people, but it helps define my current perspectives.

[Addendum 3/27/13: Re blog comments, I've learned after 6 months of having a blog that unfortunately a lot of comments are spam. There is a way to filter out a lot of them which I am doing. However, even if you get by the spam filters, I don't intend to publish comments where the primary purpose is advertising a specific service unless it has general applicability. That is true even if you have a legitimate medical practice or service. My blog is not free advertising for you. Sorry.]

Another reason I want to blog is purely selfish. I need to learn to write more quickly. I was an English major in college in a different century, and for all of my career, even in private practice, I have been doing a lot of writing and editing. And I think I am fairly talented in this area, I will say in all modesty. But I am definitely not fast, and the hardest thing I ever have to do is to start a manuscript. I sit and dawdle and waste time on the Internet and a million other things. A blog won't cure me of my procrastination tendencies, but if I am really going to make this work, I have to post regularly, and I don't have hours of extra time to do that. So another example of not letting the perfect become the enemy of the good.

A few other thoughts about what I want this blog to be. I expect I will blog about what I cover on Twitter right now, mostly my professional interests. These, of course, include medical oncology, particularly breast cancer, biomedical informatics and health IT, patient-centered care especially as enabled by consumer health informatics, and healthcare-related social media. I may share experiences about clinical practice, but will never give specific medical advice (that is why you have your own oncologist or PCP, and it ain't me), and I will never blog about a specific patient, at least not in any way that could lead to the identification of an individual. Patient privacy is a sacred trust, and not just because of HIPAA, but because it's what our patients absolutely expect of us. So if I talk about clinical practice, it won't be about what happened that day, but it might be about something long ago, where details have faded, or it might also be a composite of several patients or situations, so that no links to real patients can reasonably inferred.

I am going to try very hard to post a few times a week. I expect that many of my posts might be fairly short, since one of my main purposes will be to share articles or other items that my readers can explore themselves. I think that shorter, more frequent posts will be more effective for what I hope to achieve here, and that practice will certainly be a better discipline than slaving over a 1500 word blog post that takes 3 weeks to write. Again, I'm not going to let the perfect be the enemy of the good, or at least the adequate.

Finally, this isn't going to be pretty, at least not to start. Don't look for clever polls, beautiful graphics, or lots of widgets. I am just starting to play with the Blogger tools, and one of the reasons I chose Blogger over Wordpress was that Blogger is much simpler to configure. It's the words that matter. Sorry, if you want fancy, you will have to read a professional.

So here goes. I can safely say that no one will read this post the day it goes up, since I decided not to promote the existence of this blog until I can convince myself it will happen. But perhaps over time, just like it happened for me with Twitter, a community will develop and maybe I can accomplish something unexpected.