Health Care Managers and Social Media Literature Synthesis, 2011 (Read, Giustini)A Social Media Workshop for Health Care Managers (HMCs)

Key Canadian content (CC) Challenges in IT (IT) – e.g., firewalls, time factors, skill Driver or trend (D&T) – e.g., mobile devices Influencer – person(s) or organization(s) (IPO) – person or organizational ‘mover’ Privacy issues (PI) – HIPAA in the US; FIPPA in Canada (FIPA in BC) Seminal article (SA) – important article in discourse New ideas or trends (NTs)

Categories 1 1. Health Organizations & Their Use of Social Media2. Health Communication and Collaboration 3. Patient-Centred Use of Social Media4. Social Media Policy Development5. Social Media and Site/Tool-Specific Studies6. Teaching and Social Media

Web 2.0 & social media research written by or specifically referring to “ health care managers” (HCMs) Abraham (2011) Bottles (2009) Cummins (2010) Currie (2009) Eytan (2011) Hackworth (2010) Holt (2011) Malvey (2009) Orsini (2010) Randeree (2009) Zeng (2008)

1 For related information about social media usage by physicians & med students, see Emerging evidence in web 2.0 medical literature on HLWIKI Canada.

Read & Giustini, Health care managers & social media literature review - 1

Canadian health organizations & their use of social media

Canadian hospitals on Twitter - http://t.co/nkLPg0e - a free list compiled by Innovation Cell of Toronto.

Deloitte. Social Networks in Health Care: the Canadian Experience

This blogpost at Genomics Alberta discusses some unique aspects of social media use in healthcare in Canada.

Innovation Cell (Seeman) - http://innovationcell.com/wiki/Main_Page

The Innovation Cell was formed January 29, 2009 by Neil Seeman CEO of the Health Strategy Innovation Cell. It has been fortunate to receive some at-tention from global industry, social entrepreneurs, global media and patient advocates around the world

SMiCH — Social Media in Canadian Health Care

A blog started by Ann Fuller as a vehicle for hospitals in Canada to share resources on social media and exchange ideas and best practices. “In my own research, I had discovered that there were many great resources available on the use of social media for U.S. hospitals, but not a lot for Canadians. Our Americans counterparts share resources through such blogs as Found in Cache and the Mayo Clinic Center for Social Media

. Using social media to improve the quality of patient experience - see part 1, part 2 and e-Toolkit

Social media in health care. "What are the basics on Social Media in healthcare?"

This site has been designed by The Health Strategy Innovation Cell and The Change Foundation to help healthcare organizations understand the possibil-ities of using Social Media for Quality Improvement (QI).

Top Health & Medical Bloggers 2011

This wiki entry is hosted at HLWIKI Canada.

White Coat, Black Art. Social Medicine. Dr. Brian Goldman

This is an excellent CBC podcast about social media in medicine produced by Dr. Goldman.

Read & Giustini, Health care managers & social media literature review - 2

I) Health Organizations & Their Use of Social Media

Article SM Tools Mentioned

SM Strategies & quotes SM Benefits & Drawbacks SM use for Health Care Managers

Burrus D. Social networks in the workplace: the risk & opportunity of Business 2.0. Strategy & Leadership. 2010; 38(4):50-53.

Twitter, Facebook, Wikipedia (includes LinkedIn, delicious, cloud computing)

Article (non-health specific) written in 2010

Retailers & suppliers can create versions of Wikipedia to foster education, training and enhanced info-sharing

Twitter is a fast way to solve problems

Social networking is inexpensive alternative and businesses / managers should embrace it

Facebook helps organizations increase internal networking & collaborative practices

New web-based social networking tools foster innovative teamwork, customer co-creation of value, collaboration with external partners & interactive communication between leaders and employees efficiently

Resist losing control of information flows; some leaders are reluctant to embark on communications program that may raise the expectations of employees

Currie, D. (2009). Public health leaders using social media to convey emergencies: new tools a boon. The Nation's Health 39(6): 1-10

Twitter, Facebook

Article (health specific) written in 2009

'''Twitter & Facebook allow public health officials to reach out to consumers

CDC and FDA are examples of doing this (IPO); use online community to distribute important health information & learn what issues are imp. across country at any time

Includes tips to mitigate risk combined traditional

outreach methods with social media outreach

Upside of democratic nature of social media is that scores of people (network) can help broadcast important public health messages, according to users.

downside includes security concerns; making sure credible information is not lost in the conversation

Cites: APHA’s Social Media Primer & Expert Round Table on Social Media and Risk

Management needs to get focused before launching into social media “know your audience & where you’re going”.

“In the evidence-based world of public health, coming up with true measurements of social media effectiveness poses a challenge, but as the tools are used more frequently, data is emerging. For example, Wilson said the Twitter account CDC uses to communicate about emergencies, at twitter.com/ cdcemergency, had 2,500 followers before the H1N1 influenza outbreak. In late June, the account had 370,000 followers, a huge network of potential communicators to heed and help spread public health emergency messages.”

Domingo, M. C. Article (health specific) challenges such as privacy and

Read & Giustini, Health care managers & social media literature review - 3

(2010). Managing Healthcare through Social Networks. Computer 43(7): 20-25.

written in 2011 Surveys show an increased

reliance on physician and patient social networks, which promise to transform healthcare management

data accuracy remain

Eytan T, Benabio J, Golla V, Parikh R, Stein S. (2011). Social media and the health system. Perm J. Winter;15(1):71-4.

Twitter, YouTube Article (health specific) written in 2011

“Influencer” Ted Eytan also defined “Health 2.0”

In patient-centered models, absence from SM networks that are important to patients may lead to gaps in care between patients and clinicians

SM has potential risks; both participation and abstention are covered

efforts to embrace SM seen at Mayo Clinic Center for Social Media

doctors cite SM as enabler of purpose in professional work to “realign families with science” & tap into why they went into medical school

Tweetreach for dermdoc on Twitter http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048641/figure/i1552-5775-15-1-71-f02/

More SM innovation is inevitable in the future

Health organizations and physicians use SM to build trust, promote health and wellness, and disseminate knowledge

Article is meant to continue the conversation about the pros & cons of SM

Cites this article: Coffield RL, Joiner JE. Risky business: Treating tweeting the symptoms of social media. AHLA Connections. 2010 Mar;14(3):10–4.

Holt C. Emerging technologies: Web 2.0. Health Information Management Journal 2011 04;40(1):33-35.

Twitter, Hello Health

Article (health specific) written in 2011

Arguably, educational benefit justifies Twitter updates as the surgical procedure progresses (PI - unsure ‘live’ tweeting would be acceptable in most hospital ORs)

Henry Ford Hospital (IPO) tweets about live surgery & publishes case information

immediacy of information released from organizations helps health practitioners and organizational providers comply with bioethical principles of veracity

HIMs (Health info managers) need to ensure electronic & manual systems adapt to receiving information from online collaboration & communication tools

HIMs are integral in optimizing benefit to patients’ health to be gained by effectively managing technology challenges, posed by emergent communication

Read & Giustini, Health care managers & social media literature review - 4

prior to tweeting event requires patient consent /

disclosure as per HIPAA regulations

‘tweets’ form part of patient’s Unit Record, as stated in HPP 3 (Data Quality) of Health Records Act 2001

Hello Health uses secure portal to manage & maintain patient contact fee of $US35, patients

email, instant message & video chat with practitioners; alleviates need for appointments for minor complaints

NT new idea ? Or security risk?

modes, to ethical and legal practices

Kietzmann, J. H., Hermkens, K., McCarthy, I. P. and Silvestre, B. S. 2011. Social media? Get serious! Understanding the functional building blocks of social media. Business Horizons, 54 (3), 241-251.

Twitter, Facebook, LinkedIn

Article (non-health specific) written in 2011 by SFU professor

4C's of social media implementation plan

Cognize understand social media

landscape & who main influencers are

collect competitive intelligence to determine if rivals are active & what response levels are for their SM strategy

Congruity develop SM strategies

congruent with or suited to

See Social Media functionality & implications

Provides information on how to structure a social media plan

“Once a firm has identified appropriate metrics for the reputation of its community's social media engagement, the appropriate evaluation tool must be chosen. This could either be based on objective data (e.g., number of views or followers) or collective intelligence of the crowd (e.g., rating system). For example, social media service sites such as Social Mention search and compile user-generated content from over 80 social media sites. It enables firms

Read & Giustini, Health care managers & social media literature review - 5

different social media functionalities and goals

integrate social media strategy tightly with other marketing strategies where one points to the other

Curate act as curator of social

interactions and content develop understanding of

how often & when firms should join conversations & who will represent firm

identify employees who can listen and follow chatter online; those who can create emotionally appropriate content

Chase scan environment to

understand speed of conversations & other information flows that affect current or future position in the market revisit assumptions about

community's engagement needs, observe how other platforms are evolving, & gauge competitors’ response

and individuals to monitor how many times they and others are mentioned, using a number of metrics including: strength (the number of times you are mentioned); sentiment (the ratio of mentions that are positive to those that are negative); passion (how often certain users talk about you); and reach (the number of different users talking about you divided by the total number of times you are mentioned).”

Lombardi G, Baum N. Health 2.0: how interactive Web sites are

A website is not a luxury or perk for your practice and patients – it is a basic necessity that patients expect from physicians

“Common features and functions of an interactive website include:

Information customized to pa-tient’s diagnosis, medications or

The creation of an interactive site is critical including why it is necessary for doctors to enhance their digital information so that patients

Read & Giustini, Health care managers & social media literature review - 6

changing the healthcare industry . J Med Pract Manage. 2011;26(4):242-4.

Patients expect an interactive site, and to communicate with the practice and physicians

other health care needs

Access to lab and x-ray reports

Contact with doctor, nurses and staff with questions or concerns that are answered in a timely fashion

Request appointments

Download registration forms for expediting first appoint-ments

Browse educational re-sources

Request prescription re-newals

Access to automated ap-pointment reminders

Provides the latest education material on your area(s) of medical interest and exper-tise

can interact with their doctors

Lupianez-Villanueva F, Mayer MA, Torrent J. Opportunities and challenges of Web 2.0 within the health care systems: An empirical

(www.sermo.com), nurses (www.nurseconnect.com) or patients (www.patientopinion.org.uk); other initiatives based on mix of profiles (www.medhelp.

Article (health specific) written in 2009

How will initiatives be used by patients in everyday life? what are consequences in terms of health outcomes?

how will companies manage privacy, security and terms of use of available information (PI)

How will companies manage privacy, security and terms of use of information? (PI)

How will health care providers and health care professionals be part of this practice?

“Focus on Web 2.0 and Health within the health care system at large allowed to clearly identify the gap between the potential of this phenomenon and the current features of interactive communication technologies. Health care systems could be characterised by: a lack of

Read & Giustini, Health care managers & social media literature review - 7

exploration. Informatics for Health & Social Care 2009 09;34(3):117-126.

org) rate their doctors (www.ratemds.com), or share experiences about their own illnesses www.patientslikeme.com

interactive communication technologies available on the Internet; a lack of health care professional production of the information on the Internet and a lack of interaction between these professionals and patients on the Internet. Faced with that situation, there are enormous possibilities in Web 2.0 applications to overcome the different weaknesses detected as long as these kinds of applications are characterised by the interaction process which supported it. But, it is important to bear in mind that those processes are embedded and embodied [3] in the relationship between the social structure of health care systems and the new technological paradigm.”

Malvey D, Alderman B, Todd AD. Blogging and the health care manager. Health Care Manag (Frederick). 2009;28(2):159-64.

Fiercehealthcare Article (health specific) written in 2009

Blogs offer audience that extends beyond workplace. Managers have access to range of opinions outside workplace channels & extended peer groups

Healthcare blogs are niche blogs, focusing on specific streams of information.

As managers identify blogs of interest, check them periodically to keep up to new

Blogs offer unprecedented access to expert information via authors & other subject experts, and enable staying on top of new developments.

On blogging “Blogging is a 2-way street for health care managers. Managers can use blogs to find information quickly for use in compiling reports or making decisions. But managers can also use blogs as a means of disseminating information, sharing opinions, or soliciting

Managers need to help employees develop skills of value in workplace

Imperative to embrace use of tools such as blogs

Ability to communicate in transitional environments must be gained by health managers if organizations are to be competitive

Blogs offer managers way to communicate in non-face-to-face environments

premier communications &

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information & developments FierceHealthcare IT and

Hospital Impact blogs are funded by ads for meetings, products, webinars, and services relevant to managers in health care industry

feedback. For example, when the government proposes large spending cuts in Medicare reimbursement, managers can turn to blogs to find out how other managers are responding. Moreover, the blog format is perfectly suited for health care managers, most of whom are straight talking and quick to get to the bottom line.”

marketing tool with both customers & employees

Managers can use blogs to find information quickly for reports or making decisions

disseminate information, share opinions & solicit feedback

Orsini M . Social Media: How Home Health Care Agencies Can Join the Chorus of Empowered Voices. Home Health Care Management & Practice 2010 04;22(3):213-217.

Hello Health, PatientslikeMe, Kaiser Permanentehttp://merrilyorsini.com/merrily-orsini-homecare-marketing/

Article (health specific) written in 2010

Hello Health (2009) is not the only health care practice to charge into social media Kaiser Permanente - each

physician at KP given home page where patients get to know physicians better NT new idea

similar to profiles on Facebook, includes image, contact info & personal data

Patients – LikeMe claims to help those diagnosed with life-changing diseases “take control” of health by creating community where they can connect with others

Reservations: privacy issues – creation of

policy to cover issue (PI) who has control? - no

shortcut to personal integrity & transparency

Companies want to win respect of consumers have to do it the old fashioned way: through fair dealing

How to get set up? Interactive provider profiles

include features that interest families and patients; allow them to get acquainted with philosophy of care

care blogs opportunity to

demonstrate knowledge and experience

provide way to attract visitors - people are looking for information, not promotion

SM releases links, sections, tagging to

attract user attention to other forms of material

Video gallery “video gallery” draws in

visitors; members can comment on videos

Randeree E. Exploring technology

RevolutionHealth (also Facebook, Friendster, Flickr, YouTube, Blogger,

Article (health specific) written in 2009

Paper reviews challenges and

Benefits include patient empowerment, improved patient-provider

Article reflects on the challenges and benefits of implementing an online virtual community

Read & Giustini, Health care managers & social media literature review - 9

impacts of Healthcare 2.0 initiatives. Telemed J E Health. 2009 Apr;15(3):255-60.

and MySpace) impact of “Healthcare 2.0” RevolutionHealth

(www.revolutionhealth.com) wants to create largest health virtual community

Challenges: INFORMATION

ACCURACY/QUALITY

With promise of more information, dangers of incorrect or misleading information arise

INFORMATION PRESENTATION

how information is displayed presents challenges; access to information without structure, education or guidance is not in best interests of patients or physicians

INFORMATION STEWARDSHIP

Each user of patient data is a "steward" for security and privacy and must protect it; privacy continues to surface as new technologies affect users & providers (PI)

Patients using portals must be aware of misuse, unauthorized secondary use and other dangers of

relationships, increased patient safety, improved quality of care, more efficient care delivery, better safeguards on health information privacy, and cost savings. benefits accrue to

consumer/patients when analytical tools and decision support are embedded in PHR software

“Healthcare 2.0 …has evolved to users finding ad-hoc ways to connect …creating Web-connected diaries and blogs … sharing journals to address various medical conditions outside of the healthcare providers' offices. Support groups have found a new platform for organizing while concerned family members use the Web to blog about their experiences, seek online consoling, and connect with other families. Bloggers are using their sites to share their findings and educate others with similar conditions, creating sites to report new treatment options and places to go for new resources. Web-based services are aggregating data from multiple sources and delivering customized content (in various forms) to users. Consumer empowerment has been increasing, facilitated by more access to resources and the ability to locate information with ease. This access has changed the patient-physician relationship; medical decision making is affected by the increase in knowledge prior to the clinical encounter.”

Read & Giustini, Health care managers & social media literature review - 10

Web-based data

INFORMATION PORTABILITY

Web 2.0 systems should be Internet accessible, interoperable & secure

INFORMATION LITERACY

reflect concerns related to educational issues (patient literacy level, Web site literacy level, technology access skills)

Web 2.0 requires individuals to navigate sites, enter medical jargon, and participate in health exchange medium

Rooney K. Consumer-driven health care marketing: using the web to get up close and personal. J Health Care Manage. 2009;54(4):241-251.

Facebook, LinkedIn, eHarmony

Article (health specific) written in 2009

“…examines the emergence of consumer-driven healthcare marketing NT new idea, including its operational definition, how it has been used in the past, and how it has evolved...

Consumers need dynamic, interactive web presence to perceive organization legitimacy; along lines of eHarmony, patients could be

Presence on online social networks (e.g., Facebook, Linkedln) serves to extend the healthcare organization's agenda – OFTEN OVERLOOKED The technology-

enhanced word-of-mouth advertising creates the impression of peer-determined credibility and achieves an economy of scale that is elusive

A divide exists in how healthcare providers and patients define "relationship." For providers, healthcare

relationships place emphasis on collecting and applying data effectively through new database techniques that aim to improve health outcomes as well as marketers' overall return on investment

Read & Giustini, Health care managers & social media literature review - 11

matched with physicians NT new idea

Patients state physician preferences, while physicians supply info pertaining to practices such as fees, specialties & preferred Rx approaches

websites home to active blogs that are frequently updated and generate viewer traffic

Viewed favourably by search engines; blogging by healthcare team softens antiseptic feel of hospitals, corporations, healthcare industry in general

to traditional marketing

Setbacks: organization must portray professional image yet appear warm and personable, maintain control but allow input as normal part of a relationship; be current enough to stimulate interest without consuming time

HIPAA represents tangible barrier in implementation of healthcare marketing plans Challenges in IT (IT)

Skiba, D.J. (2009). Nursing Practice 2.0: The Wisdom of Crowds. Nursing Education Perspectives, 30(3), 191-192.

Are we preparing nurses to partner with patients and their families in their health care? Sure, we pride ourselves in preparing nurses who serve as patient advocates and we emphasize patient-centered care, but are we truly preparing them to actively engage with patients and their families to support the use of Health 2.0 tools?

What research needs to be conducted on the impact of social media on nursing practice?

Perhaps the bigger questions are: Are nurse educators aware of these tools? Are they preparing the next generation of nurses to use Health 2.0 tools with their patients?

Sarasohn-Kahn's report, The Wisdom of Patients: Health Care Meets Online Social Media, describes how regular people use a host of tools (wikis, blogs, user-generated podcasts/videos, and social networking) to inform their health care decision-making (2008). Building on Surowiecki's (2005) ideas, she concurs that "when patients managing the same chronic conditions share observations with each other, their collective wisdom can yield clinical insights well beyond the understanding of any single patient or physician." Sarasohn-Kahn reports that the top five reasons for consumers to use social media are: "to see what other consumers say about their

Read & Giustini, Health care managers & social media literature review - 12

medication or treatment, to research other consumers' knowledge and experiences, to learn skills or get education that helps me manage my condition, to get emotional support and to build awareness around a disease or cause" (p. 8).

Sarringhaus, M. M. (2011). The great divide: Social media's role in bridging healthcare's generational shift. Journal of Healthcare Management, 56(4), 235-235-244

Article (health manager specific) written in 2011

Social media can be an invaluable tool with which a healthcare organization can engage workers in a company culture, recruit and retain millennials and provide consumers with personalized experiences

baby boomers' social media use is a significant step closer to tech-centric lifestyles of millennials

an appropriate strategy for any HCO to adopt; good for the modern workforce, and dynamic transformation as baby boomers retire and millennials become fully integrated into healthcare labor force

“…Among all the benefits previously discussed, the most significant one is that the cost of a social media recruitment strategy is budget neutral. In this dismal economy of lowering reimbursement rates and the uncertain implications of healthcare reform, every organization needs to reduce costs. With most social media options free to users, such as Facebook, Twitter, Linkedln, blog hosting sites, and YouTube, the costs associated are mainly those of labor in the marketing and human resources departments.”

“…Social media, a resource largely untapped in the healthcare field, presents opportunities and advantages and, if used properly, can innovate healthcare and create a competitive advantage for adopters. Many organizations have considered social media but dismissed its advantages as fleeting products of the new generation entering the workforce: the millennials.”

Squazzo, J. D. (2010). Best practices for applying social media in healthcare.

YouTube, Facebook, Twitter

Article (health manager specific) written in 2010

Health blogger Ed Bennett (http://ebennetr.org/hsnl/) identified 557 U.S. hospitals using social networking tools,

“…Hospitals already using social media report benefits in areas such as recruitment, community relationship building and patient satisfaction. To examine these and other benefits, including best practices from industries outside

Read & Giustini, Health care managers & social media literature review - 13

Healthcare Executive, 25(3), 34-34-6, 38-9.

including 254 YouTube channels, 336 Facebook pages, 430 Twitter accounts and 70 blogs as of February 2010. Bennett follows social media trends which involves searching for U.S. hospitals' presence on social networking sites (excluding unofficial sites such as those established by patients or hospital staff members' personal accounts). The 557 hospitals identified by Bennett make up just 9.58 percent of U.S. hospitals.

healthcare, ACHE presented the program "Best Practices for Applying Social Media in Healthcare." Funded in part by the Fund for Innovation in Healthcare Leadership, it was held in San Antonio last November in conjunction with the San Antonio Cluster…”

Zeng X, Bell PD. Web 2.0: what a health care manager needs to know. Health Care Manag (Frederick). 2008 Jan-Mar;27(1):58-70.

Clinical Cases Blog

Article (HCM specific) written in 2008

policies such as copyright disclaimers or information classification should be discussed with employees before they start any web 2.0 publishing activities

discusses “the benefits of Web 2.0 in general and the reasons why a health care manager should know these trends…”

HCM & web 2.0 – why bother? some Web 2.0 tools are

cost-effective for HCMs to adopt in daily work

workforce & health consumers are natural users of Web 2.0

social tools, esp. blogs bring transparency into management practces; Web 2.0 permeates health care and current operations seem more transparent and dynamic

Setbacks: patient privacy (PI)

(HIPAA) privacy and security rules may be violated if employees publish materials online about their

health care managers can blog to distribute management highlights to employees or patients

use multiple tools to create content called "mash-up" which offer ways to create new services without reinventing wheel EX: HCM can combine

publicly available hospital evaluation data with Google API to compare performance of organization with others in region

Read & Giustini, Health care managers & social media literature review - 14

experiences with patients

Information accountability: bloggers who consider

themselves as proxy "oversight" agencies combined with consumers who can’t make distinctions between official vs imagined accreditors may lead to confusion or litigation about published information

Intellectual property: HCMs should be familiar with terms in different IP licenses before engaging to avoid conflict; For example, a wiki entry could be misused by others as chapter of book

Read & Giustini, Health care managers & social media literature review - 15

II) Health Communication and Collaboration

Article SM Tools Mentioned

SM Strategies & quotes SM Benefits & Drawbacks SM use for Health Care Managers

Abbott R. Delivering quality-evaluated healthcare information in the era of Web 2.0: design implications for Intute. Health Informatics Journal 2010 03;16(1):5-14.

RSS & other web 2.0 tools

Article written in 2010 by UK health librarian

Article is about the Intute website and integrating web 2.0 tools

existing users and attracting new ones are concomitant aims; maintaining strength of existing product while adding new benefits – but not drawbacks – of social media

RSS feeds exacerbate overload – additional source required

proceed cautiously; be aware of dangers of following transient technological or social fashions

distinctions between readers and writers, and between amateurs and experts, become more blurred in SM

Addresses some strong concerns with using social media -especially relating to the dissemination of information

Bacigalupe G. Is there a role for social technologies in collaborative healthcare? Families systems & health. 2011 Mar;29(1):1-14.

Twitter, Blogs, Facebook, Collaborative Family Health Association

“Social technologies are the ICTs tools that augment the ability of people to communicate and collaborate despite obstacles of geography and time. There is still little empirical research on the impact of social technologies in the case of collaborative health. Defining social tools with the potential for developing, sustaining, and strengthening the collaborative health agenda should prove useful for practitioners

Article written in 2011 Start a SM presence for health

organization: set up virtual office to

archive documents--to build institutional memory and make available to members – free software or wiki use

second goal to strengthen communication between and among board and general membership – add blog, Twitter, Facebook etc

SM policy needed for each tool organization adopts Privacy (PI), membership,

control of information, accountability, accuracy and

new tools, which are not only technological but also suggest new culturally different interactions, can strengthen participation, collaboration, openness, and reduce the barriers to the inclusion of patients/consumers

Besides the ability of capturing wider audiences, at minimum cost, and faster, tools like Twitter may foster innovative ways for personal and professional interactions

Examples: HCSM #hcsm - discussion focuses

on specific and emergent topics in health care and social media; questions submitted by participants in previous days;

A collaborative method is needed to approach the challenge of learning, integrating, and participating from the transformation of our way of working.

informed patients with larger social networks as a result are more empowered.

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and researchers.” transparency need to be incorporated into these policies

power to set up virtual meeting spaces, tools to implement them, and their control are not linked to the prestige of convener

Collaborative Family Health Association members have employed hashtag #CFHA to promote collaborative ideas on official CFHA blog

Eysenbach G. Medicine 2.0: social networking, collaboration, participation, apomediation, and openness. J Med Internet Res 2008;10(3):e22.

Digg, Wikis Article written in 2008 by Eysenbach (IPO)

Seminal article (SA) three main users of

Health/Medicine 2.0: consumers/patients, health professionals & researchers

ideal Medicine 2.0 application would connect user groups and foster collaboration between different groups (, engage public in biomedical research process)

need to move away from hospital-based medicine, focus on promoting health, provide healthcare in people's own homes, and empower consumers to take responsibility for their own health

second generation of personal health records, which allow patients to access their EHR, share parts of it with others, build communities around certain health topics

Wikis relevant for participation among health professionals and scientists – and scholarly communication function as well

apomediation - health care field from perspective of patients users and friends in case of

Digg; users navigate onslaught of information afforded by networked digital media; provide credibility cues & supply metainformation!

better health systems emphasize collaboration, participation, apomediation, and openness, as opposed to traditional, hierarchical, closed structures in health and medicine

Giustini D. How web 2.0 is changing medicine: is a medical wikipedia the next step? BMJ

Wikis Article written in 2006 1st article on topic in major

medical journal use, share, and exchange

information on web in a continual loop of analysis and refinement

New: highly connected digital network of practitioners (medical or otherwise), knowledge exchange is not

limited or controlled by private interests

An expert moderated repository of the knowledge base, in the form of a medical wiki, may be the

Read & Giustini, Health care managers & social media literature review - 17

333(7582): 1283-84.

the more open and creative platform becomes - the more useful it is for work

Web 2.0 openness results in expectations of transparency & openness when publishing

answer Must have the

initiative to create one

Hughes B, Joshi I, Wareham J. (2009). Health 2.0 and medicine 2.0: tensions and controversies in the field. J Med Internet Research. 10(3): e23.

N/A Article written in 2009 Highly-cited article in JMIR “…The terms Medicine 2.0 and Health

2.0 were found to be very similar and subsume five major salient themes: (1) the participants involved (doctors, patients, etc); (2) its impact on both traditional and collaborative practices in medicine; (3) its ability to provide personalized health care; (4) its ability to promote ongoing medical education; and (5) its associated method- and tool-related issues, such as potential inaccuracy in enduser-generated content. In comparing definitions of Medicine 2.0 to eHealth, key distinctions are made by the collaborative nature of Medicine 2.0 and its emphasis on personalized health care. However, other elements such as health or medical education remain common for both categories…”

Positives of Health 2.0 to consider: (1) the participants involved

(doctors, patients, etc); (2) its impact on both traditional

and collaborative practices in medicine;

(3) its ability to provide personalized health care;

(4) its ability to promote ongoing medical education; and

(5) its associated method- and tool-related issues, such as potential inaccuracy in enduser-generated content.

Tensions involved with Health 2.0 (1) lack of clear Medicine 2.0 definitions, (2) tension due to loss of control of information as perceived by doctors, (3) safety issues of inaccurate information, (4) ownership and privacy issues with growing body of information created by Medicine 2.0

Demonstrates the positive and negative attributes of using social media in medicine

Scanfeld D, Scanfeld V, Lar-son EL. Dissem-ination of health informa-tion through

Twitter Article written in 2010 Measures the frequency of the

words antibiotics on Twitter

Social media sites provide means to share health information

More study is warranted to explore how networks provide venues to identify misuse or misunderstanding of antibiotics

Potential applications in patient care; telehealth

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social networks: twitter and anti-biotics. Am J In-fect Control. 2010Apr;38(3):182-8 .

Promote positive behaviours, disseminate information, and explore how tools can be used to gather real-time data

Yates D, Wagner C. Factors affecting shapers of organizational wikis. J Amer Soc Inform Sci Technol. 2010;61:543–554.

Wikis Article written in 2010 Wikis are important if shaping

behaviour provides a mechanism for community agility Allows (encourages)

participants to adopt shaping role; may increase community’s ability to absorb knowledge, facilitate crossing of thought worlds & interpretive barriers & faster transformation cycles

wikis for open sharing; what are the potential consequences of poor quality of information?

basic seeding structure is needed; technology brings out norms of collaborative editing

benefits at multiple levels in organization, promoting community to increase times a wiki is accessed

Read & Giustini, Health care managers & social media literature review - 19

III) Patient-centred use of Social Media

Article SM Tools Mentioned

SM Strategies & quotes SM BenefitsSM Drawbacks

SM use for Health Care Managers

Abraham J et al. Selecting a Provider: What Factors Influence Patients' Decision Making? J Healthcare Manage. 2011;56(2):99-114.

N/A Article written in 2011 by US health care manager

Giving consumers a role in decision making is advocated as strategy to improve efficiency in US healthcare system

Background & demographic information of health providers is important

Whether the HC provider is in patient’s health plan?

Provider and reputation of organization and physician are all important Providing information in

easily accessible ways is an effective strategy for reducing search costs and attracting patients to medical practice

Reputation of physicians & orgs appears to be highly influential

consumers seek ways to narrow down selection, especially sources that are easy to understand & that they trust

Patients rely less on ads & formal information in choosing providers; publicly available information may be difficult to access, interpret and apply

patients rely on informal sources of information such as family and friends and physician referral, when making decisions about where to get health care

explore the capabilities of new media and social networking sites for building reputation

“… physicians and healthcare organizations more generally may want to explore the capabilities of new media and social networking sites for building reputation. Whereas these technological innovations have relatively short histories, their potential for becoming major factors affecting provider choice is recognized. They blend the current information-delivery capacity of the Internet with the more traditionally interpersonal processes for recommending providers. More research is needed to understand the effectiveness of such communication tools

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for influencing consumers' provider selection…”

Adams SA. Blog-based applications and health information: Two case studies that illustrate important questions for Consumer Health Informatics (CHI) research. Int J Med Inf 2010 06;79(6):e89-e96.

Valtaf Article written in 2010 patients need tools to

address information gathering & sharing, enabling them to get involved in their care create tools that are

easy to use and allow for integration of different information/communication interfaces

Implicit - refer to weblogs that consist of links to types of web material on general topics but refer to health-related issues or practices as part.

Explicit - refer to blogs that are set-up with a particular health situation in mind

explicit blogging practices among patients increase our understanding of how alternative avenues for managing health information foster healthy practices and contribute to patient identities and understanding

quality of information being produced (primarily by lay web end-users) using different web 2.0 applications is an issue of concern

ability of the collective to correct mistakes has been called into question both generally and specifically for health-related information

“…What can we learn from the fact that patients are taking it upon themselves to utilize these and other publicly available applications for health purposes? Research into health-explicit blogging practices among patients will increase our understanding of how alternative avenues for managing health information foster healthy practices and contribute to patient identities and understandings of health. Understanding what tools patients want and how they use them will also enable health care providers to capitalize on these easy-to-use applications for patient education, disease prevention and health promotion, or for changing policy and improving services….”

what aspects of blogging tools are most important and why are they effective or not?

include identifying and categorizing health-specific blogs and typifying who uses blogs; why and how they use them

organizations can identify target populations that benefit from such applications; explore new avenues for reaching user groups for promotion and prevention purposes

Bleicher P. Health 2.0: do it yourself

OrganizedWisdom, PatientsLikeMe,

Article written in 2008 “…Medicine in the United States is

one of the few industries in which

OrganizedWisdom delivers high-quality information about patient illnesses and treatments

Understanding of how various patient-centered social

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doctoring. Applied Clinical Trials. 2008;(17)10:38-42.

MyMedLab, MyFamilyHealth, WholsSick

the consumer of the products and services has little to no say in the setting of prices and delivery of services. The painfully cumbersome economic infrastructure of health care has thus far prevented a serious overhaul in consumer choice to bring it up to the same level as in almost any other industry. However, the transformative nature of Health 2.0 may very well bring choice and the free market to the consumer long before the government can or will….”

PatientsLikeMe allows patients to understand how symptoms and treatments compare

MyMedLab and order from hundreds of lab tests, go to local lab for blood drawing, receive results without physician intervention

MyFamilyHealth allows members of family to create shared family tree to be annotated with medical histories, valuable knowledge for patient and important tool for physicians

WholsSick - anyone who believes they have infectious illness such as influenza or a gastrointestinal virus can enter symptoms and geographic area on Google map search for geographic clusters of

patients with similar symptoms in specified time theoretically giving clues to developing outbreaks of viral illness

media sites function

Bos L, Marsh A, Carroll D, Gupta S, Rees M. Patient 2.0 Empowerment. Proceedings of the 2008 International Conference on Semantic Web & Web Services SWWS08

N/A Article written in 2008 Written by health execs &

physicians Health 2.0 is the transition

to personal, participatory health care. Everyone is invited to see what is happening in their own care and in the health care system in general, to add their ideas, and to make it better every day

Everyone in health care is interested in the value of

social networking & collaboration make "long tail" of medicine a "value"able venture

patient is personally responsible for own health pathway & personal care

bi-directional contact between patient and clinician is necessary

networks have an empowering aspect on different level - medical research

Importance of networks and the exchange between patient and clinician

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the patient PHR, CHR, EHR and NHR

must be based on standards and interoperable

Bottles K. Patients, doctors and health 2.0 tools export. Physician Executive Journal (10 July 2009)

Twitter, Mobile phones

Article written in 2009 by HCM and social media expert; Bottles is (IPO)

Seminal article (SA) Positive notion of using

Twitter /cell phones to organize, interact and share patient information

Twitter as an alert sign between physicians

Patients assuming leadership over their own care

Using mobile phones to stay connected with outpatients and to provide care

Patients in social network sites talk to other patients who have the same disease, compare notes on treatment options, aggregate the disease community’s experience, and provide emotional support

Those who use Health 2.0 to bridge the gap between patient and provider will end up providing better care

The learning is very different from the common single patient interaction – must figure out how to do it

Boulos MNK, Wheeler S. The emerging web 2.0 social software: an enabling suite of sociable technologies in health and health care education. Health Info Libr J. 2007;24(1):2-23.

N/A Article written in 2007 by two names in 2.0 area

Seminal article (SA) ; cited the most in area

laypersons and patient communities can develop their own information portals under guidance of clinical expert(s) to ensure quality of portals] by adopting social bookmarking for discovering, tagging, sharing, rating and recommending resources of interest in those

Patients and clinicians can securely and simultaneously access these records across multiple institutions and places, facilitating speedy information exchange, communication and

collaboration among clinicians, and between them and their patients, to potentially improve clinical outcomes and cost reduction

these technologies for clinicians is also great in supporting their continuing professional development, and in helping them establish and benefit from virtual

health care providers should aim to become social enablers, providing situations that become positively‘addictive’ and indispensable, so patients can gather,learn from, and support each other, improving health outcomes

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communities Web 2.0 technologies as

enablers in health and health education should not be underestimated, particularly for disadvantaged groups such as the disabled and elderly

communities of practice where advice and expertise

multi-media clinical elements, can be easily shared among them, and where they can all learn from each other and keep up to date with the latest advances in their specialities

Friedman L, Gyr H. The changing patient in the digital era: a typology for guiding innovation in healthcare. Int J Innovat Sci. 2010;2(1):39-46.

N/A Article written in 2010; well-written for health execsFour digital customers:

Passive and Open to Guidance traditional patient

Interactive and Engaged search for medical

information for conditions, treatments, medications, side effects, prognosis, expected outcomes, or even information on providers.

Do research on health providers, groups & organizations; can add his own experiences; rate and comment on aspects of care; office visits, treatments, wait times, courtesy and communication, negative side effects or positive outcomes.

health apps can analyze data and give easy

Patients’ "digital life" can become a useful adjunct to their in-person visits with medical staff in a healthcare facility

most important to understand the evolving mindset of the customer, to understand how customers’ use of media and other technologies is changing their expectations for healthcare.

Patient as partner: must meet the needs of above 4 customers = up to health innovators

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access to second opinions, relevant news, and suggested steps for reducing health risk and increasing wellness.

Empowered to Act easy access to expert

information so he can be take charge of his own decisions and new health providers are scrambling to help

sign up for personalized information services such as Daily Apple and others to deliver latest research and recommendations for any condition, treatment or medication listed in medical record

Connected to Community find in-person

community or online social network in almost any area; members post links to latest research and articles, often as soon as they are published

post their own evaluation of Rx, medications, providers; message boards and chat rooms for topics of interest, relaying

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personal stories, giving and receiving support, encouraging each others

Hackworth BA. Health care and social media building relationships via social networks. Academy of Health Care Management Journal. 2010;6(1):

Facebook, Twitter, PatientslikeMe

Article written for HCMs in 2010 (most recent??)

Marketing oriented Patientslikeme: network

provides a communication channel for doctors, patients, and organizations to discuss health issues important to them.

Inspire: provides a platform for patients, families, friends, caregivers, and health professionals to connect and provide support for one another. major priorities is that

this network maintains the individual community’s and its members’ privacy and security, unlike the general social networks such as Facebook and Twitter.

HIPPA restrictions as well as the security of patient information must always be considered in the interactions of health care providers on social media networking sites.

“…Online collaboration between groups of patients and medical care providers has replaced the concept of one-to-one patient to doctor in the exam room conversations. Consumers in particular are the one leading this movement, especially those with chronic conditions. These individuals are looking for clinical knowledge in addition to emotional support. As more people take control of their health and health care, they are embracing social media (Solomon, 2009)…”

Social media networks can assist health care providers promote deep relationships, allow fast organization, improve the creation and synthesis of knowledge, and permit better filtering of information way to read the

comments and improve shortcomings of the provider

use to develop personal, yet professional relationships with their customers.

using Twitter, health care providers must develop catchy and clever ways to express the most recent company information

Health care providers can take advantage of the benefits YouTube offers by

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posting videos related to the current events and recent news of the company

providers should look further into the employment of social networks which can be less expensive than traditional marketing media.

Lagu T, Hannon NS, Rothberg MB, Lindenauer PK. Patients' evaluations of health care providers in the era of social networking: an analysis of physician-rating websites. J Gen Intern Med. 2010 Sep;25(9):942-6.

Thirty-three (33) physician-rating websites

Article written in 2010 most sites were neither

user-friendly nor patient-centered. Patients searching for specific physicians find that search mechanisms are cumbersome, advertising is prevalent, and information about physicians is incomplete.

these websites have potential to empower patients looking for a physician and to offer a new route for providing physicians with constructive feedback, use by patients has been limited to date and reviews are mostly positive

Physician-rating websites offer patients a novel way to provide feedback and obtain information about physician performance.

“…The British National Health Service (NHS) has encouraged patients to review their physicians and hospitals, suggesting that this new form of public reporting is growing in popularity and gaining respect.9,10 In the US, however, physician organizations [including the American Medical Association (AMA)] have opposed the development of physician-rating websites, arguing that the identity of patients cannot be confirmed, physicians’ responses will be hampered by confidentiality issues, and reviews will be excessively negative. Despite the controversy, little is known about physician-rating websites. The aim of this study was to describe the structure and content of these websites and to assess the extent to which a patient might find them valuable….”

A look into empowering patients in health care – viable option

Pulman A. A Blogs Article written in 2010 Social networking tools offer the Social media use for

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patient centred framework for improving LTC quality of life through Web 2.0 technology. Health Informatics Journal 2010 03;16(1):15-23.

need to design a framework encompassing the use of Web 2.0 technology for the benefit of patients with LTCs a framework devised

from the patient’s perspective, which encapsulates the use of Web 2.0 technology for the benefit of patients who might want to support, mitigate or improve their own quality of life.

potential of supported learning, for example networking with peers, families and friends or sharing problems, processes and outcomes with the worldwide community

capacity for a social identity approach to enrich academic understanding in these areas and how it could help to play a key role in shaping health-related policy and practice.

Social learning theory focuses on the learning that occurs within a social context

Disadvantages: lack of face-to-face contact

between health professional and patient, leading to confusion, unnecessary worry, and even misdiagnosis

can be a high ratio of false or irrelevant data compared to useful information in online self-help groups, as there is an absence of group rules and guidelines and few controls to prevent people from posting erroneous or off-topic information

patients who require long term care

Cites: http://eprints.bournemouth.ac.uk/5731/1/CEMP-PAPERS-Blogging.pdf

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Sarasohn-Kahn, J. (2008). The Wisdom of Patients: Health Care Meets Online Social Media, California Healthcare Foundation.

Article written in 2008 by health manager consultant

Seminal article The Internet has evolved to

“Web 2.0” to allow people not tech savvy to generate and share content; collective wisdom harnessed by social media yields insights beyond knowledge of single patients or physicians

“Health 2.0” is new movement that challenges notion health care happens between single patients and a doctor in an exam room

A demand for transparency will drive evolution of social media in health; an array of tools are increasingly mobile; personal health data storage is coming in commercial products like Microsoft Health Vault, Google Health, and others

http://www.chcf.org/~/media/ MEDIA%20LIBRARY%20Files/PDF/H/PDF%20HealthCareSocialMedia.pdf

Cites Health 2.0 feature in Economist 2007 http://www.economist.com/node/9719054?story_id=9719054

A consumer-driven health marketplace inspires innovation in applications that integrate clinical, financial, and ratings information

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IV) Social Media Policy Development

Article SM Tools Mentioned

SM Strategies & quotes SM Benefits & Drawbacks SM & Health Care Managers

Burke TR, Goldstein G. A legal primer for social media. Mark Health Serv. 2010 Summer;30(3):30-1.

N/A Article written by a health lawyer in 2010

Social media policies educate staff about practices/ content

Consequences for violations Guidelines about appropriate use

of social media by staff and employees; set procedure for enforcement of violations

Social networking controls are likely to change and vary between social media platforms in the future

‘…health care providers can take a simple step to alleviate these ambiguities by adopting a social media policy”

providers have an affirmative legal obligation to safeguard protected patient information from disclosure to third parties without authorization

prudent for providers to remind public of their social media pages that any content posted will be seen by public - simple disclosure may suffice

Cain J. Social media in health care: The case for organizational policy and employee education. American Journal of Health-System Pharmacy 2011 6;68(11):1036-1040.

Twitter, Facebook, Youtube, blogs

Article written in 2011 by pharmacy educator and “big name” in pharmacy 2.0

Advocates for policies Global study of ~34,000 employers

from October 2009 revealed ~25% had formal policy on social media & the workplace

Privacy issues (HIPAA) - communication re:

personally identifiable patient information must be secure and transmitted to permissible parties only

organizations now require disclaimers on employee e-mail

In social media, harassment may extend beyond posting derogatory comments about race, religion, national origin, etc.

Reputation issues Controversial or

negative dialogue on Twitter, YouTube, Facebook, or blogs has potential to reflect poorly on organizations if viewers associate individual with organization

Productivity issues many organizations

restrict access to SM sites on

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messages stating information is private; do not share OR forward

Training and education issues Corporate policy should not be

sole means of addressing issues of social media use

Providing employees with knowledge of the issues and risks associated with social media use places the burden of responsible use on them

company networks to prevent interference; however, network blockades do not prevent employees from using mobiles to access SM

Kane GC, Fichman RG, et al. Community relations 2.0. Harvard Bus Rev. 2009;87:45-50.

PatientslikemeInspire; Sermo; CareSeek (nursing)

Article written in 2009 online communities vary widely in

purpose and membership – can be supportive or hostile depending on forum

importance of collaboration with communities is part of shared passion for knowledge

social media promotes: deep relationships, faster organization, creation and synthesis of knowledge, and better filtering of info

Mandate for SM Team before implementation

Develop formal SM policy; monitor external & internal online communities

engage online communities & act as first responders

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V) Social Media and Site/Tool-Specific Studies

Article SM Tools Mentioned

SM Strategies & quotes SM Benefits & Drawbacks SM use for Health Care Managers

Barras C. Innovation: Is the future of healthcare online? New Scientist July 2009.

Vena-platform wireless inhaler

Article written in 2009 Testing whether patients and

medics can interact via this platform

concept websites that go with our inhaler to show how you could use the data to benefit the patient," he says.

The sites receive signals from medical devices and award points for every compliant dose of medicine. Friends with similar conditions could then informally compete against each other to improve compliance.

Less concerned about privacy (PI) in terms of having their health records online

"There's been a sociological shift from not sharing any information to sharing everything – your location and what you're doing every hour of the day,"

interacting with health professionals online outweighs the privacy risks (PI)

Study indicating patients' willingness to participate and risk privacy – this article is to be read with caution as privacy should be considered as a legal precaution regardless

Chou WY, Hunt YM, Beckjord EB, Moser RP, Hesse BW. Social media use in the United States: implications for health communication. J Med Internet Res. 2009 Nov 27;11(4):e48.

N/A Article written in 2009 examined utilization of chronic

fatigue syndrome (CFS) website at Centers for Disease Control and Prevention (CDC).

evaluated CFS website utilization, outcomes of a CDC CFS public awareness campaign, and user behavior related to public awareness campaign materials and CFS continuing medical education courses.

user interest shifts from information targeting consumer knowledge to information for health care professionals

utilization of the CFS website reflects a high level of interest in the illness by visitors to the site

"Information for Healthcare Professionals" segment showed the greatest percentage increase in page views

website was an effective means to provide health information about CFS and serves as an important public health tool for community outreach.

Study of SM focusing on a specific condition - CFS

Cummins J. Few Twitter, Youtube, Article written in 2010 Twitter, YouTube, and Facebook are Organizations

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Hospitals Use Social Media Effectively, Says Study. Health Leaders Media. 2010.

Facebook 70% report they have three or fewer people monitoring SM.

only small numbers reporting that they have been successful improving community relations (16.7%), customer service (8.7%), employee engagement (8.7%), and crisis management (4.5%).

most popular social media for hospitals, and most effective in driving traffic to web sites

that have a formal plan to manage their social media interactions are more likely to be successful

Pearson Social Media Survey. Online Marketing & Research. 2010

Facebook, Youtube, LinkedIn, Skype

Non health-article written in 2010

80% of educators have at least one social media platform

used primarily in the humanities and the social sciences

academic communication focused on a few sm's – facebook, youtube, linkedin, skype primarily

videos/podcasts most popular with social networking sites and blogs following

value seen in using SM to teach◦ extend classroom, talk to

students in their language (SM)

Study of important of blogs for teaching – at time not used as much in medicine

Senadheera V, Warren M, Leitch S. A study into how Australian Banks use Social Media. Pacific Asia Conference on Information Systems. May 31, 2011.

Twitter, Facebook, MySpace, Youtube

Non-health article written in 2011Honeycomb SM Block Explained:

The identity functional block represents how users describe themselves and the extent to which they agree to reveal their identities

conversations consider the extent to which they communicate with others when using the given social media service.

Sharing functional block represents the extent to which users distribute, accept and recieve content.

Twitter◦ two banks have found tool to

engage users who need immediate answers to day-to-day concerns

Facebook◦ unsanctioned pages give no

opportunity to Facebook followers or engage in discussion; community pages do not add to banks’ social media presence or strategy

Myspace◦ With 80% of its users based in

United States, Australian banks have not seen any utility in using

Provides info on how another institution is using social media in a different professional environment

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The extent of visibility of a user to others using the same service is represented by the presence functional block and the

relationships block represents the extent to which users can relate to other users.

In the context of social media, reputation represents the extent to which a particular user can be trusted to engage in online ‟social interactions‟ and is represented by the reputation functional block

groups block represents the extent to which users can form communities.

MySpace as part of social media strategy

YouTube◦ most widely used social media

tool among Australian banks in this study ; video clips posted on Facebook pages or links to video clips using Tweets; multiple channels & viewers from many sources

honeycomb framework has its limitations◦ Indicating strength of

functionalities is subjective; considers technological value of individual; functionality possessed by each social media service

Tan H, Ng JHK. Googling for a diagnosis—use of Google as a diagnostic aid: internet based study. BMJ 2006;333:1143-5.

Google Article written in 2006 Controversial article Internet based study using

Google to search for diagnoses; researchers were blind to the correct diagnoses.

Percentage of correct diagnoses from Google searches (compared with the diagnoses as published in the New England Journal of Medicine).

Google searches revealed the correct diagnosis in 15 (58%, 95% confidence interval 38% to 77%) cases.

N/A As internet access becomes more readily available in outpatient clinics and hospital wards, the web is rapidly becoming an important clinical tool for doctors. The use of web based searching may help doctors

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to diagnose difficult cases.

Thaker SI, Nowacki AS, Mehta NB, Edwards AR. How U.S. Hospitals Use Social Media. Ann Intern Med 2011 05/17;154(10):707-708.

Facebook, Twitter, Youtube

Article written in 2011 February and March 2010 -

conducted structured review of sites of 1800 hospitals randomly sampled from 6436 hospitals in American Hospital Association annual 08 survey ◦ Stratified hospitals by key

characteristics and oversampled for children’s hospitals

Considered hospital is using SM when site indicates an institutionally maintained account with Facebook, Twitter, or YouTube

Twenty-one percent of hospitals use social media.

Hospitals that were statistically significantly more likely to use social media were large, urban, or part of a health system; were run by nonprofit, nongovernment organizations; were involved in graduate medical education; or primarily treated children

Hospitals used social media to target a general audience (97%), provide content about the entire organization (93%), announce news and events (91%), further public relations (89%), and promote health (90%).

Study of hospital social media use

“…to identify how many U.S. hospitals use social media, what types of hospitals they are, and what content hospitals disseminate through this medium.

Methods: In February and March 2010, we conducted a structured review of Web sites of 1800 hospitals randomly sampled from the 6436 hospitals in the Ameri-can Hospital Association 2008 Annual Survey. We stratified these hospitals by key organizational characteristics and over-sampled for children's hospitals. “

Usher W. Types of Social Media (Web 2.0) Used by Australian Allied Health Professionals to Deliver Early Twenty-First-

Email, Skype, , iPhone, Facebook

Article written in 2011 Health enabling qualities of SM;

1) Multimodality, 2) Networkability, 3) Temporal Flexibility, and 4) Message Tailoring Capabilities

935 respondents - 9.5% indicated that they used social media for

These “overlapping qualities bring about number of Health Outcome commonalities such as 1) increases in self-efficacy, 2) ability to communicate & control information either synchronously or asynchronously, 3) ability to manipulate text, and 4) ability to

Study indicates types of SM used by health professionals

Lists health professionals views (pros/ cons of SM); positive qualities of the

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Century Practice Promotion and Health Care. Soc Work Health Care 2011 04;50(4):305-329.

their work, 19.1% of them did not use it for work but used it for their personal needs, and 71.3% of them did not use social media at all

Among the 15 listed social media applications, e-mail (62.9%), Skype (22.5%), iPhone (20.8%), and Facebook (15%) were rated as the most frequently used social media applications for delivering health care to patients during the last 12 months (2009)

willingness to undertake web 2.0 education: 55.8% of the 670 respondents indicated YES while 15.8% of them indicated NO

narrow/segment information for an audience, group or individual

many avoid SM due to a lack of practice models; perception of vulnerability and issues of privacy;

lack of SM usage in health care due to quality associated with unreliable nature of info

tools“Future e-health initiatives should include development of Web 2.0… development and implementation of courses, designed to familiarize and up-skill AHPs re: usage and implementation of Web 2.0 for health care delivery would be one avenue (as displayed in Tables 1 and 2). As this is the first Australian study that has examined AHPs' Web 2.0 technologies, further research and cross-cultural studies should be undertaken to investigate collaborative avenues between researchers and health societies for the design and implementation of the identified Web 2.0 educational modules and practical application platforms.

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VI) Teaching and Social Media

Article SM Tools Mentioned

SM Strategies & quotes SM Benefits & Drawbacks SM use for Health Care Managers

Boulos MNK, Maramba I, Wheeler S. Wikis, blogs and podcasts: a new generation of Web-based tools for virtual collaborative clinical practice and education. BMC Med Educ. 2006 Aug 15;6:41.

Blogs, wikis, podcasts

Article written in 2006!~ Seminal article (SA) What are the best ways to

integrate this material into e-learning for all mentioned?

Importance of privacy, and closely monitored moderation of these tools

Blogs/wikis/podcasts are relatively easy to implement within health professions’ educational environment

Enhances student, clinician and patient learning and deepens learner engagement and collaboration within digital learning environments

Observations of teaching using SM

Kane GC, Fichman RG. The shoemaker's children: Using wikis for information systems teaching. MIS Quarterly. 2009;33(1) 1{17.

Wikis Article written in 2009 wikis, have begun to influence

business and knowledge sharing practices in many organizations

Challenges facing wiki-based content for teaching: wikis harness better

knowledge for use but introduce variances in consistency of content

without incentives to contribute, difficult to continue generating content as initial enthusiasm wears off

content from wikis and Web 2.0 sources target audiences other than that of an academic class

Observations of teaching using SM

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