Category Archives: Enterprise

Social Media For Exclusion

First posted (with a few small editorial changes) at the Mayo Clinic Center for Social Media Blog:

Pic of the day - Sweetness

We praise the power of social media to bring people together, to engage people around topics and events of shared interest, to include. Too often we don’t stop to think that every new tool with new ways to include people is probably excluding someone else in a new way.

The accessibility of social media is rarely discussed outside of communities of persons with disabilities. When it is discussed, the people who most need to hear it (us?) may not be in the audience. When we aren’t, the work we do to try to include and engage may actually serve to accomplish the opposite.


The obvious example, one you probably already know about, is when you share video or use streaming tools, but lack captions. It isn’t always possible to pay for live captioning, as much as we might want to, but there are tips and tricks to get around that with low-cost options. In Second Life, the Virtual Ability community has, as a standard of practice, a roster of volunteers who offer to type into live chat a synopsis of what the speaker is saying, and who describe images on the slides for the blind. Because some conversations there are held in typed chat, they also have someone sighted volunteer to read aloud the typed chat, identifying the speakers. Why couldn’t we working in healthcare media implement something like this for streamed events?


Did you know about Easy Chirp? It’s a Twitter browser designed for people who are blind or visually impaired, but it can be useful for others as well. Just as with curb cuts, tools to make social media more accessible for marginalized and excluded audiences can make life easier for people who are nominally able-bodied. Accessible browsers can require less bandwidth and be more robust when you are in that crowded meeting room with a hundred people sharing wireless, just as an example.

Do you tweet using one of those marvelous fancy tools for the pros that allow you to track multiple channels at the same time? Often those will place the relevant hashtag for the channel at the beginning of each tweet. I wager you weren’t aware that this makes life harder for those with visual or cognitive challenges, because it makes it harder for them to sort out the important part of the message. Recommended practice is to place hashtags at the END of your tweets.

Also, for those hashtags which smoosh together parts of different words? Screenreaders struggle to figure out how to read those when they are all lower case or all upper case. I have a bad habit of not mixing the capitalization because it is faster when I am typing, but for screenreader, there is a world of difference between #mayoclinic and #MayoClinic. Now that I know, I am trying to be better about it, because I was excluding people when I meant to include them.


These are just a few examples, low-hanging fruit. There is a lot more to know. Luckily, there is an upcoming free webinar on social media accessibility from the ADA National Network, if you are interested in learning more. If you are here on campus, we are meeting in the Hatcher Gallery Lab to watch this together.

October 20, 2015
2:00-3:30 p.m.
Social Media and Accessibility

#WHDemoDay and #ADAinitiative — Oh, the Irony

Welcome to Demo Day at the White House! (Megan Smith, the First US Chief Technology Officer)

“It’s a tradition in the tech community to show off amazing things that people have built. … All Americans do this. All American are capable of this. And it’s a big part of our future, and it’s always been a big part of our past.”

Yesterday was a landmark day in diversity and inclusion.

Yesterday saw the first ever White House Demo Day (#WHDemoDay), for women and minority entrepreneurs and innovators to ‘pitch’ their ideas to President Obama.

Yesterday saw the end of the ADA Initiative, “a feminist organization. We strive to serve the interests and needs of women in open technology and culture who are at the intersection of multiple forms of oppression, including disabled women, women of color, LBTQ women, and women from around the world.” (Ada Initiative, About Us)

How enormously ironic to see the closing of the one with the opening of the other, and both with such closely related missions. I can only hope that this first White House Demo Day proves to be one of many, and that the effort continues to embrace and support diversity as essential to American creativity and innovation.

White House Demo Day

The White House Demo Day had demonstrations to illustrate the diversity of people contributing to the innovation that helps strengthen the American economy. Most of the companies presenting had at least one woman founder or co-founder. Almost as many of the companies presenting had a founder that is a person of color or who shows ethnic or cultural diversity. The two companies represented by white men were (1) military, and (2) a winner of the XPRIZE. There were a few wonderful presenters from Michigan, including Ann-Marie Sastry of the University of Michigan Ann Arbor talking about her innovations in batteries and power storage. Products presented included new search engines based on cognitive models, medical innovations in cancer / HIV / aging / asthma, parenting tools, strategies for empowering patients, creative ways to repay student loans, several on converting ‘waste’ to profit, and much more. There was even Zoobean, who partner with libraries to recommend books and apps based on children’s preferences.

White House Demo Day

Part of what made this so wonderful (and why I wish I’d heard about it sooner) was the move to encourage parallel events across the country. I wish we’d done this here! Here are some tweets about the high points.

Read about the presenters here. Listen to the pitches here.

President Obama Hosts the First-Ever White House Demo Day

White House Demo Day:

Ada Initiative

“When the Ada Initiative was founded in 2011, the environment for women in open technology and culture was extremely hostile. Conference anti-harassment policies were rare outside of certain areas in fandom, and viewed as extremist attempts to muzzle free speech. Pornography in slides was a regular feature at many conferences in these areas, as were physical and sexual assault. Most open tech/culture communities didn’t have an understanding of basic feminist concepts like consent, tone policing, and intersectional oppression.”

The Ada Initiative began by trying to change the world for women in STEM and tech. They stopped, but not without having made change, and not without leaving a permanent legacy. You’ll see tributes and comments below to testify to this, but you’ll also see links to some of the content they made open source and Creative Commons in order to help perpetuate their work, as well as work from some of their partners who carry on the good message and work. By the way, their open source toolkits are absolutely incredible and well worth downloading.

HOWTO design a code of conduct for your community
Code of conduct evaluations

Announcing the ADA Camp Toolkit:

ADACamp Toolkit:
– Inclusive event catering:
– Providing conference childcare:
– Quiet room:
– Supporting d/Deaf and hard of hearing people at an unconference:

Eszter Hargittai on Essential Tech Skills (#mlanet15)

Part 5 of a series of blogposts I wrote for the recent Annual Meeting of the Medical Library Association.

Eszter Hargittai #MLAnet15

Is the Internet good or bad? Safe or dangerous? The answer from Eszter Hargittai at the MLAnet15 Closing Plenary was, “It depends.” Even if I was tracking tech events at the conference, even if this topic wasn’t my own bread-&-butter, even though Natalie has already done an completely excellent blogpost about this session, I would (and do!) still want to blog on this.

“It depends,” is the correct answer to most debates about anything to do with the Internet. Eszter Hargittai has hard data, and strong methodologies behind it, to show that most of our stereotypes about Internet use, audiences, abilities, etc. are considerably more subtle, nuanced, granular, and shaded than commonly believed.

Eszter Hargittai #MLAnet15

In her research, there were a surprising or worrying number of students who were unable to distinguish phishing URLs from real URLs, to define fundamental Internet jargon terms, to determine accurate versus biased news, to leverage social sharing appropriately for employment, to find accurate and useful health information for common search topics, and more. She described impacts of lower socioeconomic status, gender differences that carry over to online environment, and importantly reframed the “digital divide” as “digital inequalities.” The example which most impressed me related to emergency contraception use. I suspect I’m not the only medical librarian who’s been approached by friends or neighbors with questions related to this topic. In Dr. Hargittai’s sample, a full third were unable to discover that it was possible to buy this over the counter at your neighborhood drug store. And that doesn’t even touch on the question of the other two thirds who do know how to find and purchase it, but do they know how to use it appropriately and safely in the context of their own health history?

Eszter Hargittai #MLAnet15

The Internet can empower as much as it can endanger. What makes the difference? Hargittai says skills.

Eszter Hargittai #MLAnet15

And the skills that are needed are ones that can largely be taught and learned. Librarians are people who generally (“It depends”, remember?) have both the needed skills and know how to teach them. This was a talk that the librarians who attended are still talking about, and I suspect that will continue in months to come.

You can explore the Storify, and its over 300 tweets to see what else people had to say about the talk.


GPII Introductory Video

We all use technology every day. Well, people reading this blog, anyway. We use it, and everywhere we go, we either carry our own devices or spend time fiddling and fussing to make it work right. Or both. So, … have you heard about GPII?

Global Public Inclusive Infrastructure (GPII):

It gives me goosebumps, it really does. I’ve been hearing about this via Jane Vincent, author of “Making the Library Accessible to All” and a colleague here at the University of Michigan. Jane has been working on this project for a long time, before she came here. We are so very lucky to have her here and be informed literally at the ground level as this evolves. So what is it? What does “Global Public Inclusive Infrastructure” actually MEAN? It is the ultimate (for now) in portable technology personalization. Basically, how do you prefer to set up your computer? Now, code that into a little snippet, kind of like a credit card, and you take that with you wherever you go. Want to use a computer? Wave your magic card, and voilà! It’s set up just the way you like it.

I am, of course, oversimplifying, so here is a video introduction, and a video demo. Watch them both, and see if they don’t give you goosebumps, too!

Global Public Inclusive Infrastructure (GPII) w/captions and description:

Human Rights Museum Demo Instructions:

A big part of what I like about it is the community behind the idea and the process. Here’s a grateful nod to the following engaged and supporting organizations.

Cloud 4 All
FLOE Project
FLUID Project (which is worth an entire blogpost on their own!)
Prosperity 4 All
Raising the Floor
TRACE Center, University of Wisconsin

Personalized Medicine, Biosensors, Mobile Medical Apps, and More

At the Quantified Self Meetup, someone was praising the Rock Health slides. Of course, I had to go explore and see what was so great. These are my favorites.

About FDA’s Guidance for Mobile Medical Apps

FDA 101: A guide to the FDA for digital health entrepreneurs by @Rock_Health:

I especially took note of slide 10, where they describe things I would think of as an app, but which do not qualify as such for FDA regulation. This is an important distinction I hadn’t previously considered. Slide 12 takes it further by describing the categories of regulation as based on risk to patients, with good clear examples. Slie 21 on “pro tips” would have really benefitted companies like 23andMe (even though that isn’t actually a mobile medical app, the pro tips still apply, and in spades).

Biosensing Wearable Tech

The Future of Biosensing Wearables by @Rock_Health

This one definitely gets into topics relevant to the quantified self movement and self-tracking. Slide six emphasizes the shift from the low hanging fruit (fitness, pulse, sleep) to the long tail — more targeted solutions for specific challenges (hydration, glucose, salinity, skin conductance, posture, oxygenation, heart rhythm, respiration, eyetracking, brain activity, etc.). That’s really quite interesting, and it gives examples of companies working in each space.

Slides 19-24 get into several of the areas our own local meetup defined as challenges to success for companies working in this space and for the future success of the entire area — it has to work, easily, and dependably. Slides 27-30 extrapolate these challenges into the transition into healthcare environments.

Personalized Medicine

The Future of Personalized Health Care: Predictive Analytics by @Rock_Health Video



It’s probably safe to say that most individuals working in the quantified self / self-tracking space eventually end up struggling with the issue of how to use their data to anticipate avoidable problems. This idea can be translated into the jargon phrase of “predictive analytics.” Slide 11 does a nice job of lining this up with how traditional healthcare is practiced, which is very useful. Slide 12 places this in the context of big data resources, databases, and tools, listing several of the main players. This context is essential for making personal data relevant beyond the drawn out process of n=1 studies. Slide 14 identifies the BIG problem of how companies working in this space largely focus on hospitals and health care providers, and seem to have entirely missed the idea that patients are deeply and actively engaged in this space. And, frankly, there are more of us than them (even if our pockets aren’t as deep). I love the phrase on slide 18, “Symptom calculators are the “recommendation engines” of health care.” Most of the rest of the deck identifies challenges and opportunities, which I hope any entrepreneurial types would examine closely. Do notice that there is a video with this one. You can hear the entire webinar as well as reviewing the slides.

Big Beautiful Questions (A HOTW post from #hcldr)

Guy with questions 8

The other blog for which I was writing the “Hashtag of the Week (HOTW)” posts has changed focus, so I am no longer doing them weekly, but I am still doing them when available time and something amazing both intersect. The something amazing part happens ALL THE TIME, and if that was the only factor, I could do these daily! But this time, the conversation was so relevant and useful that I would feel like I wasn’t doing my job if I didn’t share it.

Yesterday evening, the Healthcare Leadership group had a conversation about the role of questions and questioning in healthcare. The conversation was lead by Bernadette Keefe, MD, and was triggered by Warren Berger’s work in the area of “beautiful questions.” He wrote a book, but you can find a short intro to the core ideas in his New Year’s article, “Forget Resolutions.” To help people ask better questions, more answerable questions, questions that have a higher potential for leading to positive change in their life, Bernadette pointed out the tips from the “Right Question Institute“, and I pointed out the “Question Prompts List” strategy.

Right Question Institute Question Prompt Lists

The real value of the #hcldr conversation, however, came from the questions. The questions posed for the group, and the questions posted as answers. My favorite of the questions posed was, “What are we not asking?” Keep that in mind as you read the following selections from the questions given as answers to the prompts.

T1 In our sizable efforts to make healthcare more efficient, accurate and safe,as well as less costly, what are the questions weʼre not asking?

T2 As you experience healthcare delivery today – is questioning valued?

T3 What are questions you, personally, would like to ask of your healthcare provider, medical insurance company, or hospital?

T4 How could the value of questioning be incorporated into healthcare delivery in an efficient and effective way? Programs etc?

Closing Thoughts

Fair Use & Figures: When Is It OK? (Part Two: Fair Use)

Fair Use?

Point 2: Is it fair use?

In part one of this post on using research tables and figures in social media, the focus was on, “Let’s find something that isn’t copyrighted, and just use that, because we know that will be safe” (sort of). But sometimes what you want is new, not old, and from a copyrighted publication, not something open access. When that happens, what do you do? Can you still use it?

It started with Andrew’s question, but he sure isn’t the only person asking!

The answer is (again) it depends. And, to be honest about it, the “it depends” is a whole lot messier. The idea of “fair use” makes the idea of “copyright” look like child’s play. As usual, I am not a lawyer (IANAL), so take the information here at your own peril, and don’t go quoting me to your own lawyers. That said, I’ll be giving references to a lot of information that IS from lawyers, so refer people to the original sources whenever possible!

This is a question that comes up a lot. Even more often, I suspect, it doesn’t come up at all when it ought to, because someone assumed it was alright and didn’t think about it more deeply. I may have even done that myself (and I’m afraid to go back and look too closely at my blogposts).


The shortest version I’ve found explaining why “fair use” for research figures from articles are DIFFERENT from other images is this snippet from Scholarly Publishing @ MIT Libraries:

“Note: an image or figure would commonly be considered a work in and of itself, weighing against fair use; or could summarize the key point of an article, also weighing against fair use.” Reuse of figures, images, and other content in theses

That’s the gist of it. Applying “fair use” to reusing content from a larger work depends on four factors:

1. The purpose and character of the use, including whether such use is of commercial nature or is for nonprofit educational purposes
2. The nature of the copyrighted work
3. The amount and substantiality of the portion used in relation to the copyrighted work as a whole
4. The effect of the use upon the potential market for, or value of, the copyrighted work
US Copyright Office: Copyright: Fair Use:

The point from MIT regards the 3rd factor, “amount and substantiality.” If the image is considered a work independent of the article, then copying it is copying a complete work instead of a percentage, and that is not OK. If the figure is considered a fair distillation of the complete article, then that could be considered equivalent to copying the whole article. To be allowed to use something under “Fair Use” claims, it is recommended to meet all FOUR of the four factors: no money, factual or data-focused content, a tiny bit of it (insignificant amount), and little to no impact on sales of the original. If any of those are iffy, you’ve got a problem.

In a recently published article in the research journal CIRCULATION, the editors of the journal attempted a randomized controlled trial to test the success or failure of social media in promoting readership of articles. How did they do this? Well, they posted randomly selected articles to Facebook and Twitter, but a bit part of how they posted included (you guessed it!) FIGURES. For exactly the same reasons we are NOT supposed to use them, technically speaking.

“However, our social media postings were comprehensive in that they focused on the main message of the article and included a key figure from the article. Thus, it is possible that social media users did not find it necessary to access the full article and therefore experienced increased awareness of the article but not online access of the primary source. This raises the possible concern that social media could reduce the potential reach of original published research as demonstrated by altmetrics.” Fox CS, Bonaca MA, Ryan JJ, Massaro JM, Barry K, Loscalzo J. A Randomized Trial of Social Media From Circulation. Circulation 2015; 131: 28-33.

In that test, it was the editors of the journal posting the figures, and even then, they questioned the utility and benefit. A big part of the question, which they highlight in that snippet, was whether it is better to have awareness of the article and its findings, or actual readers. This assumes that people who click through to the article actually read it, which is itself questionable.

So, that’s the short view. Just to round it out, here are a few more pieces relating to this topic.


A common recommendation is to redraw the figure. Annoying, time-consuming, but supposedly legal, most of the time, as long as the content is primarily data (since data can’t be copyrighted). Indeed, this is recommended by many experts as THE solution to this problem.

Q: I want to use a figure from another thesis or dissertation from my group. Do I need to ask permission?
A: “Usually. The student who wrote the thesis or dissertation owns the copyright and must be asked for permission. Figures are generally considered works in and of themselves and do not usually constitute a small portion of the work. See “How to Use Copyrighted Materials” for more information. If, however, the figure is a simple representation of data, you may not need permission. Data cannot be copyrighted, so non-creative ways of representing the data are generally considered fair use.” Copyright Frequently Asked Questions | Michigan Tech Graduate School

It depends on who you ask, though. I don’t know the court law on this, but I’ve found recommendations on both sides. Overwhelmingly, what I’ve found it people recommending to redraw the figure. And then I found this, from the Association for Computing Machinery (ACM).

“Redrawing a figure does not change the Fair Use analysis; the figure cannot be used without permission just because it is redrawn.” ACM Guidance for Authors on Fair Use


Another common approach (probably the one I am most guilty of myself) is to assume that you aren’t important enough to bother with, or that no one will notice you did it, or that if they do notice all that will happen is they ask you to take it out. I haven’t even attempted to figure out how often this happens. The gist of the idea is that, while it may not be strictly legal, it IS fairly common practice, and can be a win-win for each side (as long as you are saying nice things, anyway).

The “Win-Win” Argument:

“Most authors will probably be happy that their results are disseminated, and reuse is likely to lead to more people reading the full paper and citing the work.”
Martin Fenner. Why can’t I reuse these tables and figures? Gobbledygook (PLoS Blogs) 2010.

The “Standard Practice” Argument:

“Posting figures from papers “was something we all did, all the science blogs, and I had been doing it since I started the blog. I always thought I was doing a public service, I wasn’t plagiarizing or claiming it was my own data.”” Andrea Gawrylewski. For blogger: A threat, then an apology. The Scientist May 2, 2007.–A-threat–then-an-apology/

So, it’s fine, right? Uh, not so much. If you are doing this on a work related blog or for your organization, it is awfully risky, since they can be held liable, which is a real can of worms. If you are only doing this on your personal blog, and it is made clear that these are your words and actions and not to reflect on your employer, … it’s your decision.


There are publishers who have (or will) pull out the big guns. Yes, usually, even if they notice, they’ll just ask you to take it down, to “cease and desist,” but there is no guarantee. The best known case in science blogging of use of a figure gone wrong actually centered around a PhD student here at the University of Michigan, Shelley Batts, back in 2007.

“When Shelley Batts wrote up a report on an article about antioxidants in fruits, she never expected to get contacted by the copyright police, but that’s exactly what happened.” Munger, Dave. Is reprinting a figure fair use?

In Shelley’s words:

“In short, I was threatened with legal action if I didn’t take it down immediately. I used a panel a figure, and a chart, from over 10+ figures in the paper. I cited and reported everything straight forwardly. I would think they’d be happy to get the press. But alas, no.” Batts, Shelley. When Fair Use Isn’t Fair.

The blogosphere went WILD. Some of the issues brought up included that this was government funded research paid for by taxes; the “amount used” argument (since it was such a small fraction, not even a complete image); the stifling impact on science discourse; the chilling of public awareness and policy discussions; and heavily, the critical distinction between “fair use” and being granted permission.

“First, the blogger Batts did not go through the usual process to request permissions to use published material in advance. It is not clear that had this been done that she would have been refused and indeed permission may eventually be extended. … Of course, once the appropriately senior person at Wiley was involved, the situation was resolved. This is not a “win”. This is a “loss” …” DrugMonkey. “This figure is reproduced with permission of the publisher.”

It is easy to find posts about this, but the one that seems to have really tipped the balance was when BoingBoing stepped in.

“This is, of course, bullshit. Reproducing part of a figure in a critical, scholarly essay is so obviously fair use that it hardly bears discussion. Wiley’s lawyers know this. You and I know it too.” Doctorow, Cory. Wiley threatens scientists with copyright law – UPDATED.

Eventually, it all calmed down, when Shelley was “granted permission” to use the image by the publisher. Many expressed concern that this ended up muddying the waters, that this was and should have been respected as fair use, that the publisher should have acknowledged this was fair use, and that granting permission implies that permission was theirs to grant (permission that is irrelevant in the case of fair use). Shelley was happy – she wasn’t getting sued, and her original blogpost was able to stay (although I can’t find it now, and I don’t know why).

“I was so surprised that anyone would think I was doing science a disservice. Science blogs bring pedantic ‘ivory tower’ knowledge to a completely new audience that would probably never hear about it otherwise. But in the end, I’m glad it happened — and that the entire blogosphere howled.”
Moments in Medicine at Michigan, Summer 2007.

But the University of Michigan lawyers stated that she had done nothing wrong to begin with. So. Clear as mud, eh?

“Maybe if we weren’t so worried about copyright, we’d be able to report on more research.” Dave Munger, op cit.