In the U.S., there is SERMO, a private social network exclusively for doctors, and Doximity, an online social networking service for physicians in the country. Up until recently, however, there was no such social networking service for doctors in Canada. But a few years ago, The Rounds, a professional networking site exclusive to Canadian physicians based in Halifax, was launched by Blair Ryan, who, despite not being a physician, realized that Canadian healthcare professionals needed a secure forum where they could easily collaborate and share ideas.
As of 2014, about 1,500 physicians from every Canadian province were using The Rounds, and its members were connecting more than 20,000 times each month, according to the company. The free service is in compliance with the federal Personal Information Protection and Electronic Documents Act and the U.S. Health Insurance Portability and Accountability Act (HIPAA), according to company officials. What’s more, just recently, The Rounds announced that it is upgrading, offering a service that lets doctors on the network set up their own collaborative communities; create specific case files for patients, send messages, and boost their user profiles with more information.
Right off the bat, Ryan compiled team members to help him launch the service, including Michael Clory, M.D., an emergency physician at the Nova Scotia-based Capital Health, and chief of medical staff at Cobequid Community Health Centre in Nova Scotia. Clory is an advisor to The Rounds, and recently spoke with HCI Associate Editor Rajiv Leventhal about the impact that the social networking service has had on Canadian providers and healthcare in general.
What was it about The Rounds that first interested you?
Wouldn’t it be great if physicians had a way to collaborate in real time across Canada? What if a physician had a problem that he or she didn’t always see or wanted to get other expertise opinions on? Imagine a network across multiple physicians that they wouldn’t otherwise have access to. I thought that was a great starting premise. At the time, there were all sorts of things out there that I wasn’t really involved with, like Twitter, Facebook, and LinkedIn. I’m an ER physician, and we might have had group email, where we could reply all to a topic or something. That was obviously not very secure, and by a stroke of a key, that could get to everyone. There really wasn’t a good way to collaborate outside of one department.
We then got into thinking about it as how physicians would collaborate in the olden days. There used to be physicians lounges—that’s how old I am, everyone would congregate in the lounge, whether you were a surgeon or family physician or whoever. It was nothing formal, just “I saw this” or “What do you think of that?” type discussions. That used to be pretty prevalent in areas where I worked, and that has disappeared today.
I started with The Rounds in the beginning as a founder in helping direct how we went along. In Canada, we have the Canadian Medical Association, and the Canadian Medical Association Journal, so everyone who is a member gets that. It used to be mailed only, nothing was electronic, and there was a little section where people would write in something and then other people write a few comments back. But that’s very limiting to a hard copy once a month, and it hasn’t evolved into multiple people commenting electronically like you see on blogs and articles online. As we were moving along, I did register for LinkedIn, but it’s not physician-only. The services that we were seeing in the U.S. that would bring value to physicians weren’t available here, since only U.S. physician could join those.
Is the network moderated at all?
There is no moderator per se, as any physician is free to post a topic, and anyone could comment. We do look at it to see if something is inappropriate, but we haven’t had issues to that regard yet.
How is compliance maintained?
The Rounds adheres to strict guidelines ensuring only Canadian physicians in good-standing are able to access the network's information and resources. This means each member is contacted and personally vetted before being given a login and password.
I don’t understand all the nuts and bolts of the coding, but when we wrote the platform, all of the messages are coded to the same standard as bank and financial information. So for someone on the outside who could try to mine in, it’s meaningless gibberish. Whatever they’re doing, they’re 100 percent HIPAA compliant, and there’s a high level of confidence in that. The information won’t leak out, unless you had a physician member sign in and let someone go in and copy it on that computer.
What are the conversations normally like? How often do you participate in discussions?
We recently had an issue locally in Halifax where they suspended dental students because the males in the class were posting inappropriate stuff about female classmates on a Facebook group, and that got out. There was a huge uproar at the dental school, and controversy about how would they be handled. Some of the stuff was very disturbing. Someone here posted about that, and discussion ensued. Additionally, it’s now legal to have doctor-assisted suicide in Canada, so that will be out there now, and our government is looking at a framework for that to work. That’s a thing where physicians will form to discuss and give opinions on.
Depending on my work schedule, I read the site daily or at least try to, but I don’t always get to it. I will read most of the posts, and I probably comment weekly. You can share stuff, can take pictures, and you can eliminate identifiers. Posts will also ask opinions on medications, side effects, what to use, etc. That’s what our envision was from the beginning—get advice from others in the industry. I have received suggestions that I really wasn’t familiar with, so I have incorporated that into my practice in the ER. So I would say that it has improved patient care in my practice.
Generally speaking, what are the advantages of making healthcare more social?
There are huge advantages. It comes from the very nature of humans, as we are social creatures. People congregated to villages, then cities, and they look to communicate. I missed the old doctor’s lounge in the hospital, because after that, everyone became siloed. I work in an ER department where four or five doctors are on, so the very nature of it is that people are working in silos. With single physician coverage in ERs, you’re only really collaborating when you’re leaving shifts, and then people want to get home. It’s a huge benefit from the physician perspective, and from the patient perspective too. Recommendations help, and the interconnectivity on social networks to find out about better healthcare helps too. It’s better to have informed consumers rather than non-informed ones.