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Social Media and Healthcare

Why add *another* task to a busy day?

A @Miller7 & @RichmondDoc production

(with a shout-out to @NickDawson)

• During this talk:

– Looking down at your smartphones is a compliment.

– The clacking of phone and computer keyboards is the same as applause.

Social Media and Health Care

• Why should we pay attention to social media?

• What is social media?• How can social media enhance patient

engagement?• How could we use social media in

medical education?• What is the ROI from social media?

Outline

• Physicians should be active participants in social media in order to liberate their expertise.

• Patients are more likely to trust physicians they know, they can identify, and who are local.

Why this matters: Physicians

•E-patient: not an abbreviation for “electronic patient”.•Equipped, enabled, empowered, engaged, equals, emancipated and experts.•E-patients use internet resources and social media to educate themselves and others and to enhance health care for patients (and for providers).

Why this matters: e-patients

•Increasingly, patients and the public will look for physicians who are willing and able to interact with them via social media.•The Healthy People 2020 goals reflect this shift, and recognize the value of social media.•Pew Internet project shows some vulnerable communities with higher-than-average use of Twitter.

Why this matters: e-patients

•According to a Research Corp’s Ticker survey reported in Feb 2011:

–1/5 Americans use social network sites to find health information—94% Facebook, 32% YouTube, 18% Twitter.–1/3 reported “high” or “very high” level of trust; only 7.5% reported “very low” level of trust.–1/4 reported this info was “likely” or “very likely” to impact health care decisions.

Why this matters: e-patients

•Health 1.0: Health care providers (HCPs) control medical information, provide information to pts, and direct treatment.•Health 2.0: Pts become increasingly involved in care, asking questions of HCPs, collaborating in treatment.

Why this matters: Health 2.0

•“A concise definition of Health 2.0 is the use of a specific set of Web tools (blogs, Podcasts, tagging, search, wikis, etc) by actors in health care including doctors, patients, and scientists, using principles of open source and generation of content by users, and the power of networks in order to personalize health care, collaborate, and promote health education.”

Why this matters: Health 2.0

•In other words, in health 2.0 communication crosses in all directions between patients, patient advocates, HCPs, etc.•This communication includes user generated content in which individuals produce the material being distributed.•The goal is to enhance individuals’ health and health care via participatory health care.

Why this matters: Health 2.0

Beware of the Blog

Beware of the Blog

•Blogs•The most traditional of social media tools.•Online publications/diaries.•Content varies on the author’s interests.•Can include embedded pictures, videos, etc.•Dialogue/discussion via comments.

Social Media Tools

•Life in Underserved Medicine

•Social Medial Healthcare: Community of Practice

•Collaborative Care blog and Collaborative Care tumblr

•Nick’s blog

Social Media Tools

• More than 500 million active users

• 50% of active users log on to Facebook in any given day

• Average user has 130 friends

• People spend over 700 billion minutes per month on Facebook

•Facebook•Allows for private messages, public comments and discussion, and information sharing among a network of interested people.•For patient interaction, it is likely safest to have a professional Facebook page separate from your private Facebook page.•For professional pages, determine how much interaction you will allow: wall posts, messages, etc.

Social Media Tools

•Facebook•I recommend using tight privacy settings on private Facebook pages. •There is debate about whether to“friend”patients on Facebook. I choose not to.

Social Media Tools

•UCSD Faculty Development group page

•National Physicians Alliance fan page

•VAFP fan page

Social Media Tools

•Twitter•Characterized by very short messages (140 characters).•Posts (tweets) are distributed among your “followers”.•Tweets are public unless you choose to protect them, in which case you must accept followers requests.

Social Media Tools

•Some jargon:

•All Twitter usernames (handles) start with the“@ ”•Retweet (RT): one user re-posts another’s post. This allows sharing of information and can help start conversations.•Replies start with another’s user name (@); this notifies the other user you are speaking to them.•Direct message (DM): only viewed by recipient, not the public.

Social Media Tools

•Jargon (cont)

•Hashtag (#): topics of interest can be tagged with a #. For example, any post focused on health care reform can be tagged “#HCR”. This allows you to search for any recent posts that incorporate that tag.•#s may be defined on websites (such as What the Trend?), by watching common use, and by asking others.•#s allow for Twitter-based conversations (#hcsm, #MDChat) via TweetChat.

Social Media Tools

•Best practices for Twitter:•Find resources worth following.•Interact with people.•Be a resource to the community.•Develop lists to filter out the stream.•Use tools (TweetDeck) to simplify use.

Social Media tools

• Mark’s Twitter profile

• Ben’s Twitter profile

• Nick’s Twitter profile

Social Media Tools

•YouTube and other video services•Users can record videos on any topic and upload them for viewing at any time.•These videos can be collected under a “channel” and could range from patient education information to medical education topics.•Can use to record and publish short video blogs.

Social Media tools

•Blog Talk Radio and other podcast sites

•Users can record radio shows and podcasts for listeners.•Allows for live, interactive discussions.•Material can be available live, or recorded and listened to on-demand.

Social Media tools

•Mayo Clinic YouTube channel

•University of Wisconsin Dept of Family Medicine

•Mike Sevilla’s Family Medicine Rocks podcast

Social Media tools

•The goals of empowering patients, developing collaborative relationships between pts and HCPs align with the concept of the patient-centered medical home (PCMH):•“Enhanced access to care is available through systems such as open scheduling, expanded hours and new options for communication between patients, their personal physician, and practice staff.”

Why this matters: Patient-centeredness and patient engagement

•The expected shortage of physicians, and the corresponding need to manage a larger number of patients, means that new approaches to doctor-patient communication will be necessary.•Adherence to medications—and improving health outcomes as a result—will be important considerations for PCMH and ACO models of care…especially if blended models of payment that incorporate population management $ are developed.

Why this matters: Patient-centeredness and patient engagement

•Privacy (yours and the patient’s). Remember what is visible by the public.•Cannot practice medicine in this setting.•Not reimbursed.•No standards of use or official“best practices”. The AMA guidelines are not much help, and do not encourage use. The MA Medical Society’s guidelines are better, but still not ideal.•Role is still developing: wider use within patient communities, variable interest for provider/patient communication.

Cautions

•Envision how social media could change health care delivery:

•Public health advisories: emergency responses, disease outbreak management and response.•Broadcast important public health information--#RVASickCall •Answer general medical questions and be a resource to the community for general topics.•Advocacy--#OccupyHealthcare

Potential

•Envision how social media could change health care delivery:

•Send disease-specific reminders (Have you checked your blood sugar? Have you taken your medicine?); patients can choose to receive Tweets or Facebook updates as text messages if they follow a social media account.•Use Facebook or Twitter DMs to ask patients to contact the office to schedule appointments, follow-up, etc.•If/when secure portals enter wider use, can refer patients directly into care via E-visits or other portal-based services.•Greatest potential: combining social media, portals and SMS.

Potential

•Help patients find necessary resources, including free clinic services, health fairs, and dental screenings.•Can have a personal Twitter account and a professional/practice Twitter account, and use them for different purposes.•Personal and professional benefits:

–Professional collaborations on talks, projects, blogs–New information and information sources–New acquaintances

Potential

Why This Matters: Medical Student and Resident Education

– We must teach medical students about the potential risks of using social media. In 2009, JAMA reported that “60% of U.S. medical schools surveyed reported incidents of students posting unprofessional content online.”

– Some family medicine residency core competencies could be addressed via social media: medical knowledge, interpersonal and communication skills, professionalism and systems-based practice.

Medical Student and Resident Education: Faculty Roles• Family medicine faculty can facilitate

student and resident learning via social media:– Identify valuable resources: blogs, Twitter

accounts, Facebook, YouTube channels.– Moderate Twitter chats (or journal clubs?).– Use social media tools in productive and

professional ways.– Record videos or podcasts to supplement

teaching.

• New patient referrals (and resultant billing).

• Goodwill and the “share of voice”.• Health outcomes.• “ROI” = “risk of ignoring”.

Return on Investment

• We think that social media communication tools will continue to impact how doctors and patients communicate with each other. We are early in the process of determining the best use, but we think health care providers need to be engaged in the process because social media will become increasingly important.

• Family medicine could become the preeminent medical specialty on social media: #FamMedChat, #FMRevolution, AAFP board members.

Conclusions

• Thank you for your attention.

• mryan2@mcvh-vcu.edu

• Nick_Dawson@bshsi.org

Thank you