Still trying to get my head around social media and testamonials for midwives in Australia

A couple of months ago, the regulatory body for midwives (and health professionals) in Australia, AHPRA, brought out guidance about the use of social media and testimonials which caused a kerfuffle to say the least. Now that guidance has been clarified and the dust has settled, I have gone back to finalizing the Australian College of Midwives' guidelines for social media so that we can get on and publish them. But having re-read the latest AHPRA advertising and social media guidelines I find myself still in a bit of a dither about exactly what the ACM should be advising its members.

I understand that a testimonial is a "statement that says something positive about, or recommends a midwife’s qualification, care/service/business, character or conduct". This may be solicited or unsolicited. What I cannot get my head around is what AHPRA sees as the difference between a testimonial and a favorable comment posted on a midwife's social media site. I am also struggling to see how birth stories that midwives publish fit into the picture - are they commentary, or could they be perceived as testimonials?

Here is the draft of what I have written so far.

1      Advertising and testimonials

The National Law states that midwives must not use testimonials to advertise their services. A testimonial is a statement that says something positive about, or recommends a midwife’s qualification, care/service/business, character or conduct.  Midwives are not allowed to use testimonials to advertise their services because the testimonial may unduly influence the public,

mis-represent the service, business or midwife, or prevent consumers from making informed choices about their care. In the ‘Guidelines for Advertising Regulated Health Services’ (2014), AHPRA states that midwives “cannot use or quote testimonials on a site or in social media that is advertising a regulated health service, including patients posting comments about a practitioner on the practitioner’s business website.”

Best practice points:

• If social media is used to advertise midwifery practice/business, the midwife should always publish full name and contact details, as well as professional qualifications.
• Do not publish solicited or unsolicited endorsements, testimonials or materials that could be perceived as recommendations in any online space.
• If a woman would like to provide a favourable comment or review of a midwifery service, request that she do this in her own online space. 
• Do not publish a woman’s birth story if it describes or comments on quality of the midwifery care provided.

• For further direction visit ‘Health of the Net (HON) Code of Conduct’ (http://www.hon.ch/home1.html); an internationally recognised standard for health professionals on how to provide online health information to women and families.

Best practice example A new mother wrote a long comment on her midwife’s blog thanking her for the excellent care she received from the midwife. The midwife thanked the mother very much for her lovely compliment, but explained that she had to remove the comment because it could be perceived as an testimonial. Before the midwife deleted the comment, she took a screen shot and saved it as evidence of her practice for the next time she had her Midwifery Practice Review.

 
What do you think? Too conservative, or about right? What would you change and why?

Image: 'Free Social Media Networking Icons - 154 Orange Grunge Stickers'
http://www.flickr.com/photos/44071822@N08/4440931283

Chance to talk to AHPRA's CEO about the advertising guidelines

The latest news from the AHPRA advertising guidelines saga is that Martin Fletcher, AHPRA CEO, is taking to Twitter to explain the guidelines and answer any questions. 

The Twitter chat is using hashtag #ahpraqanda and is taking place on Friday 28 March at 12pm AEST.

Even if you're not very interested in the topic, it will be worth following to see how a real-time hashtag chat works, and how an organization uses Twitter for engagement and PR.

Totally hooked on Hootsuite

Up until the last six months or so, I was a frequent user of Twitter. I used it to send around information and make real time connections with all sorts of people. But over the months, I have stopped feeling the Twitter love, and become a Facebook recluse.

This has partly been because the tool I was using to manage my Twitter accounts was closed down. And the other main reason was that with three Twitter accounts - my own personal account, the Australian College of Midwives, and the Virtual International Day of the Midwife - I started to feel completely over-whelmed.

For a number of years I have heard about Hootsuite, which is a tool that allows you to manage all your social media accounts in one place. I had played with it about two years ago, but never really got it. But this weekend I decided I would give it another go.

Hootsuite is web-based, which means I can access my account anywhere as long as I have Internet access. It allows me to manage and monitor multiple social media accounts such as Twitter, Facebook, LinkedIn and so.  For the time being, I have chosen to use Hootsuite for managing my three Twitter accounts.


I have to say that after only a couple of hours I am totally hooked. I have set up all three accounts so I can see who I am following, who is talking about me and who is talking to me. This will make it so much easier to monitor conversations and to answer messages in a timely manner. This is turn will improve engagement, especially for the two professional accounts I manage.

The other thing I have done is set up several hashtags I follow on Twitter, including #VIDoM14 and #phdchat. It is so much easier to have them all in one space, and will make it especially easier to manage at times of intensive use, such as the weekly chats such as  #hcsmanz - a chat every Sunday evening about health care and social media.

A further feature that I may find very useful is the ability to schedule messages, or tweets. This will make it so much easier to plan what and when I am going to post.

Do you use Hootsuite? How do you use it? What other social media management tools would you recommend?

AHPRA provides guidance for the guidance on advertising, but still leave health professionals with concerns

Over the last week or so, there are been a lot of discussion, concern and complaints about the advertising guidelines released by the Australian Health Practitioner Agency (AHPRA) -  full story can be read here. So much so that an online campaign has got going, and health professionals' associations have been lobbying to have the guidelines revised.

On Tuesday,  AHPRA released FAQ that has gone some way to clarify the advertising guidelines. AHPRA states:

• There is a difference between advertising and unsolicited online comments;
• The advertising guidelines do not apply to unsolicited comments over which practitioners have no control; 
• Practitioners are not responsible for removing (or trying to remove) unsolicited testimonials on sites over which they have NO control.

Still unsure about positive comments
However, there is still no clear guidance in the FAQ about unsolicited comments in the health practitioners’ own space. The FAQ initially say “There is a clear difference between advertising – which requires an advertiser’s intent to promote a health service – and unsolicited online comment, which does not involve an advertiser’s intent to promote a health service.” The FAQ then go on to say “Practitioners are not responsible for removing (or trying to have removed) unsolicited testimonials published on a website or in social media over which they do NOT have control.” There is no mention of how practitioners should deal with unsolicited comments in websites or social media which they DO control.

Should we need guidance to read the Guidance?
At the beginning of the FAQ, AHPRA states “We will keep updating these FAQs to answer questions about emerging issues and guide practitioners about their regulatory responsibilities in relation to advertising.” Whilst it's great that AHPRA is willing to respond to practitioners’ questions as they emerge, I feel that the Guidelines should be easy to understand, consistent, and lacking contradictions in the first place. Then there would not be such a need to provide guidance on how to read the Guidance. I am also very concerned about the fluid nature of the FAQ. I feel it makes practitioners vulnerable and begs the question about how much reliance we can put on the changing information in the FAQ.

What is the legal impact of inconsistencies between Guidance and FAQ?
Finally, in view of the confusion and inconsistency between the Guidelines and FAQ I am left asking what would be held up in a court of law – the Guidelines, or the FAQ which contradict the Guidelines?

 Need for robust guidance
The #AHPRAaction campaign are asking for the complete removal of the section of the guidelines that talks about social media and testimonials. I am not sure I agree with the complete removal because I feel there needs to be guidance on the difference between testimonials and unsolicited comments. However, I would call upon AHPRA to incorporate the FAQ into the Guidelines. This will significantly strengthen the Guidelines and decrease risk to practitioners, especially in the face of vexatious reporting that I have already heard is happening in relation to practitioners’ use of social media.

I would also recommend that the Guidelines are reviewed again in one to two year’s time, instead of three years. The social media landscape changes very quickly and a shorter time frame for review is appropriate in this instance, especially as this is a relatively new area for regulatory consideration.

What do you think? Are the FAQ clear? How will the Guidelines impact on your practice?

Two sides to every gardening story

As far as I am concerned, one of the great mysteries of life is how everyone and anyone can grow the most wonderful vegetables in the most unusual pots and challenging locations but I can't!!! 

I know all about vertical gardening....

                                                                                                                   growing vegetables in pots...

making the most of a balcony...

But do you think I can manage anything similar?!  The answer is NO!

I lost track how much I spent this spring on pots, plants and compost, with the view of feeding Africa from the produce I would grow on the balcony of my flat in Canberra. 

This is all I managed....3 tomatoes...and 4 capsicum the size of gob stoppers!

Honestly...I give up!

Confusion for Australian health professionals about AHPRA advertising guidelines and social media

In the last couple of weeks the Australian Health Practitioner Regulation Agency (the body that regulates health professionals in Australia) has released its social media policy and advertising guidelines. They are generic documents and apply to all the health professions that AHPRA regulates, including midwives, nurses and doctors. The social media policy is broad and uncontroversial. But the advertising guidelines, in particular the advice regarding social media, has caused a good deal of confusion and consternation amongst health professionals.

What is the difference between a testimonial and unsolicited online comment?
The problem with the guidelines is the lack of clarity around the difference between a testimonial used for advertising the services of a health service or health professional, and an unsolicited online comment that is posted by a consumer in an online space, such as Facebook or review website.

It is illegal for health professionals in Australia to use solicited testimonials to advertise their services because of the potential to interfere with health consumers' ability to make informed choices about their care.

What the guidelines advise is that unsolicited appreciative comments or stories posted by health consumers in online spaces belonging to health professionals, such as Facebook, could be deemed as testimonials, and must be removed. Additionally, if these comments are posted in the consumers' own online spaces, health professionals must do all they 'reasonably' can to get the comments removed.

Does AHPRA understand how social media works?
Since the guidelines were published, there has been a lot of discussion about this apparent lack of understanding of how social media works. Social media gives health consumers a voice that they often do not have in the face-to-face setting. Online comments that are both appreciative and critical increase transparency in health care practice, and provide health professionals feedback that supports reflection. These comments and stories are the everyday way that people network and hold online conversations using social media, and generally are not used for advertising.

Is it right to censor health consumers?
One of the main concerns is that the guidelines appear to be an attempt to gag health consumers. The guidelines say that stories told by health consumers and patients could be construed as testimonials. This has huge implications for health professionals. For example, if a woman tells her birth story on her blog and talks about the excellent midwifery care that I provided, I would have to ask her to remove any reference to my clinical care. At best, it feels rude to do that, and could potentially impact on my relationship with that woman  - at worse, it feels like censorship.

This advice has implications that reach beyond the online environment.  For example, could health professionals be disciplined because of what consumers say about them in birth or death announcements? Would the nurse who was praised for her care of a terminally ill patient in a death announcement be taken to court?

How 'reasonable' is AHPRA being?
A further concern that health professionals have is the advice that they must make "reasonable" efforts to have comments and stories removed from online spaces that are not under their control. There is no discussion about what it deemed to be reasonable. Keeping in mind how far comments are shared, 'liked' and re-tweeted, the guidelines do not make it clear what is considered to be 'reasonable'  and how far health professionals have to go to get online content removed, or how they should track online content.

All for one, and one for all?
Criticism has ensued since the publication of these guidelines, especially from doctors. This led to what appeared to be back-tracking from the Medical Board last Friday, when Dr Joanna Flynn announced in a media statement that "there is a clear difference between advertising - which requires an intent to promote the health services - and unsolicited online comment over which practitioners do not usually have control", and that health professionals are not expected to monitor or control what is written about them in online spaces.

This statement was well received by doctors, but the rest of us continue to be unclear if the statement from the Medical Board applies across all the other national Boards ie was the Medical Board speaking on behalf of AHPRA? 

Another question is, what credibility does this media statement have compared to the guidelines?  In other words, if I am charged with breaching National Law, am I judged against the media statement, or the guidelines?  If this response to one doctor is anything to go by, the Medical Board spoke out of turn, and AHPRA does not intend to change the stance that it has taken in the guidelines.

Where does this leave us?
Until if or when the guidelines are amended, health professionals must use them as their basis for practice, and not base their actions on unsubstantiated media statements.

In the meantime, I would advise all health professionals to write to AHPRA asking that they amend the guidlines to clarify that:

• testimonials are solicited comments and stories used for the purpose of advertising;
• unsolicited comments and feedback from consumers in either health professionals' online space, or that of the consumer, are not considered to be testimonials;
• heath professionals are not expected to monitor online spaces, or ask consumers to remove content from consumers’ own space.

Disclaimer:  This blog post contain my own views and are not necessarily that of the Australian College of Midwives

Image: 'Does flickr need an eyetest (freedom test)?'
http://www.flickr.com/photos/60364452@N00/546901054

ACM workshop (January 15 2014): Use social media tools for collaboration and engagement

Plan and resources for the ACM workshop on Wednesday, 15th January 2014.

Welcome

Welcome video using Animoto: http://animoto.com/play/vVeIDpLJv50z3EOu5VaRhw

Animoto is a web-based tool that you can use to make videos, which can then be shared on Facebook, YouTube etc. It's really easy to use, and free to make a 30 sec video - there is a charge to make longer videos. Need to think about copyright of the images you use.

What do you know about social media and how do you currently use it?

Brain storm/discussion using Google Docs: https://docs.google.com/document/d/1m038bNvYN_Sn-MoO5t02kxC2X_LosBF5-6RwsVf4DtQ/edit?usp=sharing

Google Docs is a web-based collaborative tool that allows collaborators to edit in real time. May be restricted to invited only, or completely open access. Ideal for work that requires collaboration on one document- saves multiple versions and monitoring track changes. Some people have problems accessing without a Google account.

Social Media Revolution 2013

Introductory video explaining the impact of social media using YouTube:

http://www.youtube.com/watch?v=QUCfFcchw1w

YouTube is third most commonly used social networking site. Not only excellent for finding out information, but also for publishing your own messages. 

Characteristics of social media 

PowerPoint presentation delivered via Slideshare: http://www.slideshare.net/sarahs/using-social-media-for-collaboration-and-engagement-in-associations-and-organisations

Slideshare continues to be one of social media's best kept secrets. A place to find information and get ideas about how to make great presentations (or not, as the case can sometimes be).  You can add audio to make a screencast. Need to watch copyright.

Example of a profession conversation:

https://www.facebook.com/sarahmstewart/posts/10152124937136306?stream_ref=10

Different types of social-media tools and applications

Blogs - http://midwifethinking.com 

Wiki - Virtual International Day of the Midwife 

Web-based applications - eg Screenr, MindMeister

Video-sharing websites -  Vimeo 

Hosted services - eg Skype, Google Drive and Google +

Bookmarking - Delicious  

Social networking - Facebook, Twitter, Pinterest, Snapchat

One example of how social networking can be used for gathering information and promoting discussion

Issues to consider when using social media - curated using Storify:
http://storify.com/SarahStewart/issues-associated-with-the-use-of-social-media-too

Most popular social networking tools and applications

Facebook - Eligible Midwives Group (closed)
                - Example of professional discussion using Facebook

Flickr - http://www.flickr.com/search/?q=midwife

LinkedIn - http://www.linkedin.com/in/sarahmargaretstewart

Pinterest - http://www.pinterest.com/pin/479633429036800280/

Twitter

Closer look at Twitter

Common Craft - What is Twitter : http://www.youtube.com/watch?v=ddO9idmax0o

Activity

In this activity, I would like to ask you to go back to your computers and explore Twitter.

• Set up a Twitter account: https://twitter.com
• Post your Twitter name on the Google Doc
• Develop your profile 
• Decide on your avatar 
• Post a message/tweet
• Find the other workshop participants on Twitter  and follow - see names on Google Doc
• Send a message to the other participants 
• Reply to message 
• Include the hashtag in one message - #midwives 
• Follow hashtag conversation and respond
• Follow someone other than a participant to follow

Evaluation activity

While you are interacting with Twitter, have a think about these questions - we will discuss them later as a group.

1. How easy is it to use?
2. How reliable is it?
3. How can the ACM use it?
4. Is it fit for ACM purpose?
5. What are the potential constraints/problems?
6. How would the use of Twitter by the ACM compare with other social media tools and resources that you know about?

 Workshop evaluation

Thank you for attending this workshop. I would greatly appreciate your feedback on this evaluation: https://www.surveymonkey.com/s/B7B2CRM

Additional resources

Mashable.com is the first place to go to for all things "social media", including its Facebook and Twitter guides. 

I have written a lot about social media on this blog - some key posts are:

• Non-profits using social media - taking things to the next level
• Facebook and critical thinking   
• Facebook for midwives: how to enjoy Facebook and stay out of trouble 
• Why I don't follow you on Twitter 
• How to get a conversation going on Twitter?

If you want to know "how to"...with any social media tools, go straight to Google or YouTube.

Heaps about social media and non-profits by Beth Kanter: http://www.bethkanter.org 

Image: 'Growing Social Media'

http://www.flickr.com/photos/93212162@N08/8539048913

Midwifery: Isn’t there an App for that?

 

I am facilitating a workshop around midwives' use of social media, on Monday 30th September, at the Australian College of Midwives 2013 conference. My usual program is to talk about the reasons why midwives should engage with social media, and then focus on some of the most popular tools. But this time, I am going to take a slightly different tack.

Over the last year I have observed a shift in Australian midwives' requirements for knowledge, from what tools are best to use, to how we use the tools. I feel there has been a greater engagement with Facebook, and a growing interest in Twitter. But along with the greater use of social media has been an increase in stories of the misuse, both by midwives, and the people they engage with.

So, along with my usual talk about tools, I am going to use the draft Australian College of Midwives' social media guidelines as a framework to explore how to use social media professionally. In particular, I am going to devise some scenarios for the participants to discuss and explore solutions.

What situations have you found yourself in, or observed that would make a good scenario for discussion at a workshop about social media? 

Image: 'What’s on my iPhone'
http://www.flickr.com/photos/15261067@N00/3969329831
Found on flickrcc.net

Why I don't blog much any more - and is there a cure?!

I have been blogging since 2007, and up until this time last year, wrote fairly regular posts, at least three times a week. But looking back at the last year, you can see that there has been a rapid drop off, to the point where I wrote just one post in July and again in August.

You could be forgiven for asking why it matters; after all, it may indicate that I have found a life away from the computer, which has got to be a good thing...hasn't it?!

In a way, that has been true. Since moving to Canberra, especially in the summer months, I have been spending more time outside and enjoying the beautiful warm weather, especially on a Sunday, which is when I typically write my blog posts for the week.

But it does matter that I am not blogging much these days because of the benefits I found when I was doing it regularly, which include:

• a space for reflection;
• a permanent record of my work, processes, thinking and development;
• collaboration with people in the online space
• development of international networks
• a reputation as a midwifery/educational blogger
• opportunities for research and work as a result of my blogging.

Because I am not blogging at the moment, I feel as if my networks and the conversations I have been involved with are slowly drying up. And this is not good for my professional growth in the long term.

So why aren't I blogging at the moment?

Much has to do with my new job.  Because it is a national role, I am extremely wary of what I talk about on social media. So I feel I must only blog about "neutral" topics that aren't going to get me into any kind of trouble, which is a tad tricky at times if I cannot come up with any ideas.

I spend a lot of time working on the Australian College of Midwives' Facebook page and use a lot of emotional energy figuring out what is appropriate to post on that page, and responding to comments there. So by the time I get to my social media platforms, I'm too tired to start again with the process. You have only got to look at my personal Facebook page to see how it has changed from a professional page, to almost completely personal comments and links.

On a personal level, I don't have much time where I am completely alone to spend thinking, or I am too tired, and just want to blob and watch reality TV.  And the studying I am doing isn't inspiring any creative thought.

So how do I get my blogging mojo back? Any suggestions?

I would especially love to hear from people who manage professional social media sites - how do you juggle that work with your own social media needs?


Image: 'The Art of Social Media'
http://www.flickr.com/photos/93212162@N08/8468788107
Found on flickrcc.net

Saying goodbye to our darling Angel

It's been a sad couple of months.

Six weeks ago I had our darling cat, Blackie put down. She had been with us for nearly 21 years and was a vital part of the family.

If that wasn't enough, I have now just had our dog, Angel, put down today. She was 16 and a half years old, and like Blackie, was an integral part of the family. But also like Blackie, she was very old and her quality of life was suffering.

We got Angel from the SPCA in Gisborne when she was about three months old. She was an absolute terror when she was a puppy, and had quite a few adventures. I lost her once in the bush, about an hour's drive outside Gisborne, when I was visiting a midwifery client. Mark and I went looking for her twice a day for a whole week, and eventually gave up, and broke the sad news to the kids. On the morning of the eighth day we had a call to say that the driver of a logging truck had picked her up. She wasn't half as quick to go wandering off after that.

Angel was a bit of a rascal when it came to chocolate. She loved nothing better than to steal chocolate out of the grocery bags, if I made the mistake of leaving my shopping on the floor.

She loved going down to the beach, which I think was a result of the many hours we spent at the sea side at Gisborne when she was a puppy. We spent many hours trying to teach her to catch sticks or balls, but all she loved to do was run through the waves.

One day I took a friend down to Broad Beach, which is just outside Dunedin,. We took our shoes off and went for a long walk. Suddenly I realized that Angel wasn't with us. And knowing her history for running off, I knew I wouldn't have a chance of finding her in the fields that surround the beach. We spent ages calling and calling her, and eventually I gave up. But when we got back to the pile of shoes, we found her there guarding them, and waiting patiently for us to return.

The other thing that used to make me laugh was the love-hate relationship that Angel and Blackie had. Blackie knew that we would regularly let Angel out into the garden so that she could do her thing. So as soon as Blackie saw us head for the front door, she used to dart into the door entrance and wait for Angel to pass by. As Angel passed by, she would whack Angel with her paw. Then, she would wait for Angel to come back indoors and give her another whack. Poor Angel never worked out a way to get past her without being clobbered.

Angel was so much a part of our lives, and for so long that we took her for granted. But now she is gone, the house is going to feel very empty.