“Still having trouble wrapping my head around all the tweets. They say so little…but I’ll keep trying.”

This simple statement by a colleague via email is completely understandable. I can appreciate that the value of reading or sending tweets can be obscure. And often there is little or no value—it varies. It depends on the person tweeting, the relevance of the content to you, and the quality of the information being shared. And like anything else, the whole deal might not resonate with some people. It is perfectly fine to ignore it altogether (just like some people don’t ride bikes, or go swimming, or listen to country music).

Let me explain the anatomy of three example tweets (below): tweets A, B, and C.

Tweet A
@fischmd December 3, 2012. 12:40 PM via HootSuite

• Patient experience design: @ClevelandClinic strategy, culture shift push for better care dlvr.iYVTS4 via @n8pennell #health #hpm
  
  Tweet A tells you that the Cleveland Clinic is working on a culture shift related to patient experience design. That alone may have no value to you if you are not interested. If you are interested, the tiny URL link takes you to a newspaper article from the Cleveland Plain Dealer explaining this in more detail and telling you about Dr. James Merlino, the colorectal surgeon who is now the Chief Experience Officer at the Cleveland Clinic and what that unusual job title entails. The article was noticed by a thoracic oncologist at the Cleveland Clinic (Dr. Pennell). Because he found it of value and tweeted it—I noticed it and found it of value and retweeted it. Through retweets, it was shared with others like you (who might not notice it at all, or who might skim over it if it is not of value to you…). The #hpm hashtag indexes this content to those from the world of hospice and palliative care who might be interested.

Tweet B
@fischmd Dec 2, 2012. 10:05 PM via HootSuite

• Reverse translational science: how #cardiotoxicity from HER2-directed tx of #breastcancer led to rNRG1 therapy for CHF ow.ly/fLfgf
  
  Tweet B is a straightforward "heads up" about a recent NEJM essay illustrating how cardiotoxicity with trastuzumab has led to some basic cardiovascular science insights about how the heart repairs itself and triggered new drug development with recombinant neuregulin-1 to treat congestive heart failure. The tweet entails a short headline to describe the topic and then a tiny URL that takes you to the PubMed citation for the NEJM essay. Within PubMed, you can click on the link to get the full text if you have NEJM access. If you are interested in this topic, this tweet can be a useful alert. It is all too easy to overlook stuff even when you subscribe to the NEJM or JCO etc. What if you are not interested in the topic? It is skimmed over painlessly. You can screen a lot of “headlines” on twitter rapidly…and you can access Twitter (or useful dashboard applications like Hootsuite or Tweetdeck) using your smartphone. This should not take up your valuable attention when you are in clinic or doing something else at your computer or paying attention to your family. It can be used when you are waiting at the airport or when you have some other small fragment of time available for this kind of exploring for information and connection.

Tweet C
@fischmd Nov 30, 2012. 11:32 AM via HootSuite

• Hard for oncologists! Newcomer at #ASCOQLTY: It is more important that you do it the same than that you do it "right" (Brent James quote)
  
  Tweet C is an example of using twitter as a shared note-taking method. The Brent James quote that struck me as so insightful was tweeted by me during the ASCO Quality Care Symposium. I took some notes on my laptop and also sent some tweets to help me recall and review the key points (because I can gather the tweets and review them afterwards). Tweeting some key points also shares my "notes" with others at the meeting as well as those who aren’t there but may have interest. At this ASCO meeting, by following the hashtag #ASCOQLTY, I could see who else was there and which of the speakers' statements resonated with them. It was a good conversation starter during the breaks. It also helped me catch some good points from others that I missed (due to distraction or fatigue). Moreover, I felt more engaged with the patient viewpoint about various issues being discussed, because I saw the various tweets from a variety of patient advocates and survivors. As an aside, remember that you can gobble the great information from this inaugural ASCO Quality Symposium by going to quality2012.asco.org

While I am not attending the San Antonio Breast Conference currently, I have already seen a few key points from this morning’s AACR talk on minority issues by Dr. Sexton. I can do this because highlights are being tweeted by generous note takers that I can find by searching #SABCS [Example: RT @regrounding: Can’t lump Hispanic women together—area of origin changes risk factors for #breastcancer. #SABCS @AACR].

Although Twitter will not appeal to every oncologist, or even most oncologists, I hope that this explanation helps my colleague who expressed trouble “wrapping my head around all the tweets.” The more oncologists who tweet, the more we will learn from each other, understand the perspectives of patients and caregivers, and ultimately influence cancer care and science for the better.