Social Media and Healthcare
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Social Media and Healthcare
Articles and Discussions on the intersection of Social Media and Healthcare.
Relevant to Healthcare Practitioners, Pharma', Insurance, Clinicians, Labs, Health IT Vendors, Health Marketeers, Health Policy Makers, Hospital Administrators.
Curated by nrip
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Online Patient Reviews: Power, Influence and Muscle to Grow Even Bigger

Online Patient Reviews: Power, Influence and Muscle to Grow Even Bigger | Social Media and Healthcare |

If you thought that online patient review sites were important, you’d be right. But new survey data reveals their muscle has tons of potential to grow.

Unlike a few years ago, the research power of the Internet has transformed many patients into informed and empowered consumers. Looking for online information is often the first step in researching (and ultimately selecting) a doctor—based on quality of care, experience and even wait times.

Marketing savvy physicians and healthcare communicators monitor this newfound “digital sway” and diligently put forward their own Internet marketing to inform the public, attract patients and protect and extend their reputation.

But what’s surprising is that only one in four patients use online reviews to research doctors, according to a recent survey of over 4,500 US patients by Software Advice. And, for as influential as patient reviews have become, this data suggests that they have a frightening amount of room to get even bigger.

The relatively younger age groups that currently use online reviews also suggests potential for growth. In this survey, patients age 25 to 34 (31%) and 35 to 44 (29%) account for the largest patient/user blocks. It seems reasonable to conclude that, as the population ages, younger and Internet reliant patients will continue to take a place in these ranks.

Most Popular is not the same as Most Trusted…

There are dozens of doctor review sites, but HealthGrades (43%) and Yelp (34%) were cited in this survey as being the first to be used. But as a matter of “most trusted” it was—perhaps surprisingly—Yelp (44%) ahead of HealthGrades (31%).

Reviews don’t pull patients away from their insurance network…

Even when doctor reviews are stellar, only one in four of insured patients are persuaded to visit a doctor outside of their insurance network. “That means good reviews may just help you attract patients even if they’re not in a network you’re partnered with,” observes Software Advice. “But in a face-off, insurance networks still beat out online reviews.”

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Medical Students and Social Media

Medical Students and Social Media | Social Media and Healthcare |

At the end of September, I had the opportunity to attend and present a poster at the 2013 Medicine 2.0 Conference. It was definitely a completely different kind of conference – instead of asking attendees to turn off their phones, we were encouraged to use them and discuss sessions through the Twitter hashtag, #med2. Our badges (see above) had QR codes that linked directly to our Med2.0 profiles and encouraged further discussion and collaboration even after the two-day event concluded. Another interesting aspect of the conference was being able to meet individuals in real life that I had interacted with only through social media sites.

All of this leads me to the main topic of this post: medical students and social media. While there isn’t a consensus on the percentage of medical students that use social media sites, I can confidently guess that at least 90% (if not closer to 100%) of medical students use at least one site. I must make a distinction at this point – although most of us use these sites, the number of us that use it for some sort of healthcare purpose definitely isn’t as high. I’d venture to say that all of us that use sites like Facebook and Twitter, originally made our accounts with the intent of using it to share information on our personal lives with friends and family. But the reality stands that someday we will be medical doctors and our patients will turn to Google to find out more about us; eventually, they’ll stumble upon one of our public social media accounts and discover our most recent musings. This, in combination with institutional policies, leads many medical students to change privacy settings, their account names or delete the accounts altogether. But, is that really necessary?

Since starting my personal blog the summer before my M1 year, I have learned a lot about how powerful social networking sites can be for education, discussion and networking. The Internet is a portal for all of us to connect with individuals we wouldn’t otherwise have an opportunity to. But engaging in online social networking can also be risky if one does not use their professional judgment before posting. For example, posting photos of a drunken post-exam party – while this does not violate laws like HIPAA, it may violate your institution’s policy and may also negatively impact your career in the future if a patient stumbles across the photo. When posting online, all of us need to really consider the ramifications of our words and photos since every single update adds to our digital footprint, which cannot be undone.

Our generation grew up with social sharing and most of us do it without a second thought. But sometimes, it isn’t worth sharing every single moment of your life – the most important thing is that you are aware that what you produce on the Internet may end up resurfacing at an inopportune time.

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Telehealth Program Allows Users To Pay With A Tweet

Telehealth Program Allows Users To Pay With A Tweet | Social Media and Healthcare |

A California-based telehealth program has begun waiving the $25 fee for patients who share their experiences on Twitter or Facebook, mHealth News reports.

The service, called Pay-With-A-Tweet, was launched by Telecure, a virtual branch of Action Urgent Care in California, to raise awareness for the telehealth program.
The telehealth program helps connect state residents with an urgent care provider who can offer health advice and write prescriptions within 15 minutes by phone or video.

The program sees about 500 patients monthly and charges patients a fixed $25 fee per consultation.
Telecure CEO Garick Hismatullin said that the telehealth program is intended to help patients in remote locations, as well as underserved patients, access medical treatment, but not to replace a patient's primary care physician.

Through the Pay-With-A-Tweet program, Hismatullin said the company is "trying to stimulate awareness and growth right now" (

Reshelle Johnson's curator insight, January 11, 2014 11:27 PM

Virtual appointments paid for with a Tweet instead of the $25 fee.  The $25 fee alone is newsworthy.  However, I am leery of virtual appointments although I would LOVE to have this available to me.

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City launches health initiative with social media campaign

City launches health initiative with social media campaign | Social Media and Healthcare |

The city’s Live Well Sioux Falls program is starting the new year with a social media campaign aimed at sharing how residents plan to live well in 2014.

The campaign, called Pic and a Pledge, will collect people’s healthy living pledges and photos illustrating the pledge and share them with Live Well Sioux Falls’ Facebook and Twitter followers, said Live Well program coordinator and Department of Health healthy community specialist Mary Michaels.

“We know New Year’s is a time when people make decisions to change their lives,” Michaels said. “We wanted to ask people how they plan to live well.”

The hope also is to increase the Live Well program’s reach, Michaels said. To that end, anyone who participates in Pic and a Pledge will be part of a pool to win a Live Well T-shirt or shopping bag once a week for about a month.

“It could be anything. It could even be a picture of them getting a blood pressure check,” Michaels said. “… The important thing to know is that you don’t have to make a lot changes right away — you want to set attainable goals.”

John Moreno's curator insight, January 10, 2014 5:56 PM

This is a terrific article on a city hopes to increase live well plans throuhgout the community.  

John Moreno's curator insight, January 10, 2014 6:02 PM

Great article on how a city launches a health initiative throughout the community

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20 Social Media Posts for Health Professionals

20 Social Media Posts for Health Professionals | Social Media and Healthcare |

ealthcare institutions can be a little slow when it comes to practicing online marketing; however, social media is a great way for health professionals to engage with their audience. Outlets like Facebook and Twitter are great tools to share meaningful content that matters. Encourage conversation and keep your audience informed by creating engaging content that’s relevant and timely.

Facebook and Twitter are essential, but have you thought about Pinterest? LinkedIn? Pinterest is a great resource for creating visual content. It’s not just for photos of kittens and Ryan Gosling. Here are a few social media ideas to get you started:

  • Write a blog post about staying healthy in the winter
  • Create a Pinterest board about healthy eating habits/simple recipes
  • Share live broadcasts of surgical procedures on Twitter
  • Create a virtual hospital tour and post it to YouTube
  • Remind patients to get a flu shot and post it to Facebook
  • Use LinkedIn to identify potential candidates for an open position
  • Create a Pinterest board featuring items you need to get over a cold (tissues, orange juice, blankets)
  • Tweet “did you know” snippets of health trivia, or quick newsworthy sneak peeks
  • Write a blog post about surprising health habits that promote longevity
  • Create a video on what to expect from a particular medical procedure
  • Write a few tips on how to exercise during the workday and post it on Facebook
  • Use LinkedIn to share research with relevant health care groups
  • Create a Pinterest board featuring new exercise routines
  • Create vivid, colorful cover photos (this includes Facebook, Twitter, LinkedIn, etc.)
  • Use Twitter to promote annual check-ups and eye examinations
  • Use Facebook to spotlight employees and company accomplishments
  • Create a Pinterest board showcasing stress-free activities
  • Use LinkedIn to network with health professionals from around the world
  • Use Facebook to promote national health weeks/months (National Handwashing Week, Breast Cancer Awareness Month)
  • Write a blog post about current health care changes

Have fun with your social media efforts. Don’t over think it. Concise, digestible information is what your audience wants. It’s what your audience needs.


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Protect Your Practice with Social Customer Service

Protect Your Practice with Social Customer Service | Social Media and Healthcare |

The typical Botox treatment will last 3–6 months; Juvederm, 6 months or more depending on where it’s injected.


The effects of a bad customer service experience? A lot longer than that. In fact, as this infographic from Zendesk suggests, a significant proportion (39%) of people will avoid using a company for 2 or more years after having a poor experience with them:

More to the point, perhaps, the people most likely to be soured on a company included women (45%), Gen Xers (54%) and those from high-income households (79%) – groups which represent an outsized proportion of most aesthetic procedures.


Ten years ago, that might not have been such a big deal. After all, what’s the impact of one lost patient and the few people she might tell? These days, though, it’s huge because there’s a good chance that unhappy patient will share her experience with others via social media and/or an online review.

And since 88% of respondents in the Zendesk survey said they were influenced by online reviews, it’s clear that the impact — on your reputation, your surgical calendar and the long-term health of your practice — can be significant.

Bottom line: While good customer service is always a good idea, it’s even more important when things go bad.

Doctor Takeaway

While most online reviews are positive, social media now gives negative ones an almost unlimited shelf life. Hence, it’s more important than ever to respond quickly, professionally and in a way that demonstrates that you’re sincerely trying to resolve the problem. When appropriate, doing so via social media — staying mindful of patient privacy, of course — can not only prompt the original reviewers to revise their opinions but can also provide insights into your practice philosophy and ongoing commitment to your patients’ satisfaction for everyone else listening in.

Jane Neumiller-Bustad's curator insight, January 9, 2014 4:01 PM

So true - the power of social media amplifies potentially any customer service transaction.

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Physician Reading Recommendations for the New Year

Physician Reading Recommendations for the New Year | Social Media and Healthcare |

Any quiet “thinking time” in late December is likely to find a physician reflecting on the year-end…and the year ahead. For many providers, the only constant—past or future—has been, and will likely be, change…and New Year resolutions can often be distilled to a wish for “a better year.”

Reward yourself this holiday season with a few thoughtful minutes about exactly how to make the days and weeks ahead different and better. Here are two books—one new, and one not-so-new—for mental fuel.

E-Myth Physician: Why Most Medical Practices Don’t Work and What to Do About It

The fabric of American healthcare has been changing in the decade since business guru Michael E. Gerber published this quick-read addition to his E-Myth series of business books in 2003. Nevertheless, the core concept—working on the business of being a physician—still provides valuable insight for both independent practitioners and employed doctors.

In his introduction, Gerber writes:

“According to the E-Myth, the key to transforming your practice—and your life—is to grasp the profound difference between going to work on your practice (Systems Thinker) and going to work inyour practice (Tactical Thinker). It’s the difference between going to work on your practice as an entrepreneur and going to work in your practice as a doctor.”

The E-Myth Physician shows its age in a few spots, but Gerber’s practical business advice still supports the stated goal of “freeing physicians from the daily grind of running a business and leading them to a happier and more productive life while doing the job they love—practicing medicine.”

Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices

Fast-forward to the digital age of today’s Internet-empowered and informed patients (and long book titles). Authors Dr. Kevin Pho and Susan Gay provide a comprehensive roadmap for healthcare providers to navigate social media channels such as Twitter, Facebook and others, as well as physician rating sites and blogs.

Dr. Pho has the unique perspective of being a primary care physician (Nashua, NH) as well as a widely read social media author and blogger ( On the first few pages of the Social Media Guide, authors Pho and Gay establish the newly established importance of the Internet in healthcare delivery. It’s a significant force in the care continuum. Speaking to physicians, they write:

“Why is your online reputation important? Because that’s where your patients go not only to get health information but to read more about you.” Further, “Social media has opened the door for two-way communications between physicians and patients. Partnering with patients can have a profound effect on patient satisfaction and ultimately on outcomes. Social media tools help grow those relationships and should either be a source of reputable information themselves or guide patients to reputable health websites.”

The new dynamics of healthcare now include new online gateways to physician and hospital selection, as well as to produce a new class of informed (and empowered) patients. Patients, they write, “have a voice in their own care that they never had before. And more are using social media and physician review sites to choose their doctor or medical practice. Given these stakes, you can’t afford to leave your online reputation to chance.”

These two reference books were written specifically for doctors with helpful guidance about the business side and the social media side of being in practice. Both provide practical advice worth considering as you formulate your New Year resolutions.

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5 Social Media Trends that Will Change How Healthcare Marketers Approach Strategy in 2014

5 Social Media Trends that Will Change How Healthcare Marketers Approach Strategy in 2014 | Social Media and Healthcare |

Ninety-three percent of marketers will be maintaining or increasing how much they are spending on social media advertising in 2014, according to a new report from eMarketer. But where should healthcare marketers be focusing their attentions to get the most bang for their buck, not to mention their valuable time?

Social media strategy in 2014 will shift focus away from increasing the number of likes/followers your brand has to engaging your target audience through organic interactions. Marketers will need to adapt quickly across many social media channels in order to incorporate micro-video, image-centric content and native advertising into the mix. And finally, if you haven’t built out your brand’s Google+ profile yet you are already behind.

Organic Interactions

Healthcare marketers aim to leverage social media to build authentic connections with members of their healthcare organization’s community. For many, that means working on the tangibles such as gaining Facebook Likes or Twitter followers. The focus is growing the audience then posting content on the social media channels to bring traffic to the hospital’s website. But that completely undermines the “social” in social media. It’s a one-way conversation. As a marketer, focusing on obtaining those Likes without any kind of organic interaction strategy is a wasted effort.

Not to mention social media sites like Facebook and Twitter sort posts on their feeds to show the content they think will be the most relevant to their users. The same logic works for them as it does Google search: if users find things relevant to them they are much more likely to engage with the content and return to use that service/network again. Facebook’s algorithm for sorting Top Stories (default setting on everyone’s current Facebook feed) only shows 16% of posts from pages or organizations they have Liked.

Organic interactions are the intangibles of social media (although you can measure reach and influence to a certain degree on some channels, but not all). They come into play when users talk about or interact with content related to your organization on social media. When this happens, marketers have a small window of time to turn that user into a brand advocate by positively interacting with them. More often than marketers realize, this content is actually user-created (an Instagram selfie of them bored in your waiting room, for example) as opposed to marketing-generated (a diabetic-friendly recipe posted for Thanksgiving). That’s why it’s so important for marketers to have a presence on a range of channels. By becoming a multi-channel marketer, you are able to monitor your brand’s reputation and influence the organic conversations taking place on those channels.


Back in February I first introduced healthcare marketers to Twitter-owned Vine on the GeoVoices blog. When Facebook-owned Instagram added video capabilities to their application back in June, micro-video became a full-fledged social media trend to watch. By October 2013, Vine had over 40 million active monthly users while Instagram boasts over 150 million.

It seemed marketers were struggling to justify the value in micro-video platforms. Struggling, that is, until earlier this month when Snapchat turned heads their direction by rejecting Facebook’s $3 billion offer to acquire it. Facebook was likely after Snapchat due to the app’s popularity with the demographic they are currently losing popularity with: teens. Did I mention Snapchat has over 350 million monthly active users as of September 2013? To put that into perspective, Twitter has 232 million monthly active users.

According to Ed Bennett and Mayo Clinic’s Healthcare Social Media List, about 65% of healthcare organizations in the US have Twitter accounts. Micro-video is still new so it’s unknown how many are using Vine, Instagram, Snapchat or lesser-knowns like Keek or Tout. But I’m guessing very few… for now. Some healthcare organizations have found creative ways to leverage micro-video, but overall there is still a lot of room for the clever and bold marketer to make an impact. The key is to tell a compelling story in order to elicit a response from your target audience in 15 seconds or less. As Snapchat brought to everyone’s attention, micro-video consumption is becoming a fast-growing part of consumer’s lives. That’s why it will be critical for healthcare marketers to incorporate these new social media channels into their content strategy in 2014.


The brain processes visual information 60,000 times faster than text and most people (between 65% and 85%) consider themselves visual learners. Which could partially account for the rapid rise of image-centric social media sites such as Pinterest, Instagram, and Tumblr in the past few years. Another influential factor would be the high ownership rate of cell phones (91% according to Pew Internet). About 43% of global Internet users have shared a photo in the past month alone.

Utilizing the right image on social media channels solicits stronger emotional reactions than text-only posts. When users emotionally connect with content they find online it translates into a higher engagement rate and an increased shareability factor. This is when marketing-generated content turns into user-curated content and is spread on and across social media channels.

Content posted on social media should also provide value to the end user and be findable. Properly tagging posts with common hashtags and properly categorizing the content will help influential users on those channels find it. By focusing on relevant, shareable visual content you set yourself up for opportunities to expand your target audience. When healthcare marketers become publishers of engaging content, everyone wins. It is more important than ever for marketers to create a social media strategy that communicates their brand in the most visually impactful way possible.


As we discussed on GeoVoices back in September, now is the time to dust off your Google+ account and do some work. As Google strives to make the Web a personalized experience from social to search, Google+ will continue to rapidly grow in usage and influence. With 300 million active Google+ users and 540 million users engaging with some form of Google product monthly, Google+ has quickly outpaced Twitter to become the second biggest social network behind Facebook.

The main reason for this growth is that Google continues to integrate their services with features that require businesses and individuals to have Google+ accounts in order to use them. Google Authorship and Google Publisher were just the beginning. Recently Google changed YouTube’s commenting policy to require that comments be connected to a Google+ profile or page.

This move reveals Google’s increasing focus on social signals as an influence on search rankings. Google will always be a bit tight-lipped with how its search algorithm really works, but these moves are big indicators for what could be coming. A brand’s Google+ page may not directly impact search ranking right now, but it won’t be long until it could be a major factor in the equation. Healthcare marketers need to stop viewing Google+ as a ghost town and start building out their healthcare organization’s Google+ business profile. Start by updating your organization’s profile, posting original content, then networking through circles as soon as possible.

Native Advertising

Business Insider defines native advertising as, “Ads that are seamlessly integrated into a user’s feed and are nearly indistinguishable from organic content.” They also project that native advertising will be at least 40% or more of over $10 billion in social media ad spend by 2017. It’s no surprise that social media channels and marketers are working together to create a highly visual and non-disruptive ad format like native advertising. It was the next logical step after Internet users became desensitized (and annoyed) by traditional Web banners and pop-up windows.

Best practices for native advertising are quite simple and effective:

  • Be Transparent: Identify that your ad is sponsored so the audience doesn’t feel tricked into seeing your branded content as opposed to organic content they visited the site for originally. This way the consumer doesn’t bounce from the website feeling duped or confused.
  • Be Compelling: Make sure the advertisement is not only highly visual, but is also highly engaging. Native advertisements are so successful because the content is on par with the quality of the organic content.
  • Be Discoverable: Native advertising should also be easily found through proper tagging and placements on social networks your target audience visits. The advertisements and any landing pages they lead visitors to should always be mobile-ready.

At the end of the day, all the social media trends gaining steam heading into 2014 are all about personalization. I’m not talking about the creepy kind of personalization. I’m talking about tailoring your social media efforts to your target audience in order to provide them real value. Take the time to do more than just copying and pasting links from your website over to your social media channels and calling it a strategy. Interact with your consumers to discover what they really want and deliver it to them. No one can do the social media networking for you. It’s about being well rounded in your digital marketing approach and being where your audience is already.

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Privacy, Social Media, and Public Health: A Changing Landscape

Privacy, Social Media, and Public Health: A Changing Landscape | Social Media and Healthcare |

Communications technology use is growing at a near exponential rate on a global scale.1 A recent United Nations study shows that more people have access to cell phones than toilets, as 6 billion of the world’s 7 billion people (85 percent) have access to mobile phones, while only 4.5 billion (64 percent) have access to working toilets.2

Throughout the past 15 years, communications and information technology have become essential components of public health surveillance and research.3 This technology allows for cheaper and more accessible forms of disease surveillance and epidemiological research, particularly through the mining of online social network data. Social media has potential to change the nature, speed, and scope of public health surveillance and research by offering a real-time stream of user-generated updates from millions of people around the world.

Data mining is a field of computer science involving methods such as computational epidemiology, artificial intelligence, statistics, algorithm development, database systems management, and data processing to identify patterns in large sets of data.4 Data mining from informal Internet sources may lead to the discovery of new information about disease patterns, both communicable and chronic, as well as health risk behaviors. Moreover, developing risk prediction models from data aggregated from informal sources, such as social media, has great potential to supplement formal data sources in predicting disease spread.

Earlier intervention and control measures based on this information may mean the difference between containment and epidemic. In recent years, systems using informal data mined from social media sources have been credited with reducing the time it takes to detect an emerging outbreak, preventing governments from suppressing outbreak information, facilitating public health responses, and contributing to the generalizable knowledge about health risk behaviors in a quick and cost-efficient manner.5

Despite the inherent public nature of social media, there are many ethical implications inherent in the systematic acquisition of personal information, especially that pertaining to health. Concerns surrounding social network data analysis include issues of privacy, data quality, public panic, autonomy, access, and informed consent. While online social network data analysis holds great promise in the field of public health, it is essential that this valuable data be systematically harnessed in compliance with the law and ethical principles, keeping in mind salient privacy concerns, to yield population-level health benefits.

Social Media In Tracking Infectious Diseases

Infectious diseases account for more than 13 million deaths each year.6 It is estimated that 45 percent of the people living in developing countries have infectious diseases, making infectious diseases one of the leading causes of mortality for children and young adults.7 The threat of infectious disease is accelerating with the high mobility of populations due to airline travel and increasing resistance to antimicrobial medicines due to mutations.8 Given the severity of the infectious diseases as a public health threat, culling social media information for epidemiological surveillance during outbreaks is generally accepted as ethically permissible.

Data mining social media sources to track the early stages of an infectious disease outbreak has great potential in developing countries. Although developing countries often lack a strong public health infrastructure, they have burgeoning mobile communication infrastructures.9

Aggregating and analyzing social media’s informal data in near real-time allows public health officials to gain early insight into an evolving epidemic in order to help plan a response weeks sooner than formal routes.10 A two-week jump on an infectious disease may mean the difference between life and death; between containment and an epidemic. The quicker a potential disease can be located, the quicker public health authorities can establish control measures ranging from vaccinations and antibiotics to clean water.

Case Study: Twitter and the 2010 Cholera Outbreak In Haiti

Dr. Rumi Chanura and her team of researchers from Harvard University conducted one of the pioneer studies that demonstrated the value of social media data in monitoring an infectious disease outbreak. The study demonstrated the value of monitoring social media during an outbreak. The study analyzed information from social media sources, primarily Twitter, during the first 100 days of the cholera outbreak in Haiti in 2010. In Oct. 2010, 10 months after Haiti experienced a devastating earthquake, hospitals in the Artibonite River basin saw a swell of patients with severe diarrhea, vomiting, and dehydration.11

By Dec. 31, 2010, more than 170,000 people were afflicted with cholera and 3,600 lost their lives to the disease.12 According to the World Health Organization, “the devastating cholera epidemic provides stark reminder of the challenges that arise in the absence of the infrastructure and institutions that most of us take for granted.”13

Dr. Chanura collected 188,819 tweets and 4,697 online reports that contained the word choleraduring the first 100 days of the outbreak.14 The team analyzed the relationship between frequency of mentions and the occurrence of a secondary cholera outbreak, and evaluated them through risk prediction models.15 They found a close correlation between the aggregated social network data and the formal Haitian Ministry of Health data.16 The study demonstrated that informal data has been surprisingly accurate when it comes to disease tracking. The undeniably strong correlations between formal data and informal data collected from social media sources demonstrated that informal sources can produce reliable decision-making data during disease outbreaks in near real-time.

While Haiti lacks water and sanitation infrastructure for the prevention of cholera, the nation does have a strong mobile communication infrastructure. This communication infrastructure allowed for the sick, their families, their communities, and healthcare providers to share information about conditions on the ground, allowing cholera cases to be reported that may have otherwise gone untracked, since many patients never reported to clinics.17 This also allowed for speedier intervention with oral rehydration tablets and antibiotics in the afflicted areas.18

Hypothetical: Role of Social Media In HIV/AIDS Tracking, Contact Tracing, and Partner Notification

Having discussed the role of social media data in contagious disease cases in the developing world, it is time to turn to a potential role of social media data that is much more ethically contentious—the use of social media data in HIV/AIDS tracking.

The principle of confidentiality between physician and patient dates back to before the Hippocratic Oath.19Nevertheless, the scope of confidentially is subject to limitations, especially in cases where public welfare is endangered. Affirmative disclosure obligations have expanded throughout the years, and every state in the U.S. has some type of mandatory reporting of certain communicable diseases in place.

In addition to mandatory reporting, public health officials can exercise police authority to mandate contact tracing. Contact tracing is the process by which individuals who may have come into contact with an infected person are identified and later notified of potential exposure by a public health official without directly naming the infected individual. For the purposes of HIV/AIDS, this is generally limited to sexual partners or individuals involved in sharing intravenous needles. Despite its controversial nature due to privacy concerns, and potential deterrence of testing, it remains standard practice in nearly all states.

These concerns have inspired various legislative efforts. For example, the Mayersohn-Velella Bill, developed in New York during the early 1990s to prevent the mother-child transmission of HIV, mandated a three-step process to contain the spread of HIV through surveillance measures: 1) Doctors must report the names of HIV-infected patients to the state health department; 2) Public health officials are to contact those individuals for the names of partners whom they might have exposed; 3) Public health officials will contact the partners and be informed of exposure, but not specifically by whom.20 Additionally, the Ryan White Care Act, in effect today, provides grants to states to implement partner notification programs for individuals with HIV.21

It is not unprecedented for nontraditional methods to be used as a means of contact tracing as a last resort. Consider the example of Nushawn Williams in 1997. Williams, a 20-year-old male, was allegedly responsible for a “cluster” of HIV infections through sexual activity in Chautauqua County and New York City, despite knowledge of his HIV-positive status. Because of his self-declared intention of noncompliance, New York state and local health officials declared him a “clear and imminent danger to the public health,” and released his identity to the news media, an untraditional outlet to inform the public about an alleged public health threat.

Now consider the following hypothetical involving an adult HIV-positive male who is unwilling to cooperate with public health officials. He refuses to disclose his contacts in 2012. He also refuses to inform future sexual partners of his HIV status, will not use condoms during sexual activity, and continues to use popular social networking websites to seek out sexual partners.

Due to his refusal to assist in the identification of those exposed, and future noncompliance, the Department of Health and Human Services believes that social media could be of considerable use for the purpose of contact tracing to identify and notify individuals who may have been exposed. Taking into consideration the privacy implications of the proposed expansion of surveillance activities, would it be appropriate to incorporate social media into surveillance for the purpose of contact tracing?

There are two key conflicting principles in this hypothetical: 1) The privacy ‘right to be let alone’ by the individual, and 2) the public health interest as a ‘right to know’ of potential exposure. In other words, the state’s fundamental authority to protect the population’s safety and welfare is at odds with the individual’s legally protected rights to autonomy, privacy, liberty, and property. Under the Millian harm principle, which holds that “the only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others,” intervention and regulation on individual behavior is justified so long as it prevents harm and risk to others.22

To intrude on individual liberties, the state must first demonstrate a rational and legitimate interest in intervention.23 Accordingly, one must assess the nature, duration, probability, and severity of risk at hand. In the case of HIV, there is a potentially high duration and magnitude of harm if exposed, so there is a clear rational interest for intervention. It can be argued that there is a duty for public health officials to warn exposed individuals. The population’s reliance on the protection from the state implies an ethical obligation for the government to exercise its authority to ensure health and safety.24

Generally, public health policy strives toward the least restrictive means of intervention to be exercised, to not unduly compromise the rights and liberties of an individual.25 Accordingly, the use of online social network data without consent should be seen as permissible only as a last resort, rather than standard practice.

While it is often argued that individual liberty must be subordinated to protect the common public health good, it is important to weigh the incidental costs of implementing policies, such as decreased levels of public trust and deterrence of HIV testing. Consequently, the proposed policy of using online social network data in contact tracing may translate to reduced rates of public cooperation, which may make a community more vulnerable to public health harms.

Privacy Concerns

Privacy is an inherently complicated topic in the field of public health. Balancing the protection of an individual’s personal health information with the need to protect public health is no easy task. Advancements in information and communication technologies only further distort the boundaries between what is public and what is private.26

Users of online social networks often share identifiable information about themselves, including their full names, birthdates, email addresses, GPS coordinates, job titles, and the names of their employers.27 By providing researchers with rich, ready-made data sets, social media is incentivizing researchers to develop innovative methods to search the Internet for health-related information. The mining and mapping of social networks, including names, dates, and places, has become a common practice, from market research to biomedical studies.28 It is important then to consider what obligations researchers and public health officials have in determining and meeting their online subjects’ expectations of privacy.

An individual’s constitutional right to privacy hinges on “whether that individual had a personal and objectively reasonable expectation of privacy.”29Similarly, the Code of Federal Regulations governing human subject research, 45 C.F.R. § 46.102, defines private information as individually identifiable information about behavior “that occurs in a context in which an individual can reasonably expect that no observation or recording is taking place, and information which has been provided for specific purposes by an individual and which the individual can reasonably expect will not be made public.”30

While mining publicly available data from open sources is within the letter of the law, it raises a number of ethical issues. Some might argue it seems unreasonable that a public posting on a public site can hold an expectation of privacy. However, privacy can conceptually be considered to be an individual’s right to determine what information one would like to share with others and the ability to control when others can access that information. While the practice of data mining is growing, many social media users are unaware of how public their data is.31

Privacy settings on some social media sites, such as Facebook, are complicated. Many individuals post information to be shared with an intended audience of friends, family, and peers, without the intent of being turned into research subjects by having their information collected, analyzed, and published without notification or consent.

The federal definition of human subject research is the “systematic investigation involving living individuals about whom a researcher obtains data through intervention or interaction with the individual or identifiable private information.”32 It follows that such research activities would require institutional review board (IRB) approval. However, it remains unclear whether subjects in Internet research involving data mining of health information qualify as a human subject research under this definition.

Researchers must take into consideration the level of sensitivity of the information detected, such as stigmatized health conditions. Recent studies have shown that the Internet is used more often by patients with “stigmatized conditions,” such as mental disorders or sexually transmitted diseases, to get health information and communicate with healthcare professionals than by patients with “non-stigmatized conditions.”33

The misuse of such data collected from the Internet by researchers can have maleficent consequences, such as stigma, discrimination, and discomfort of the subject.

Accordingly, researchers and bioethicists are left to grapple with the issue of determining when it is permissible to turn unsuspecting individuals into a research subjects without notification or consent.

Autonomy and Informed Consent

Voluntary informed consent of study participants is a cornerstone of modern biomedical research ethics. Many ethical issues arise when it comes to respecting the autonomy of human subjects in Internet-based research. Respecting the autonomy of subjects necessitates that prospective subjects are given adequate information to make an informed decision before agreeing to participate in a study.

This is done properly through a formal informed consent process, which includes: 1) providing subjects with the information to decide whether to take part in a study (i.e., risks and benefits, compensation, duration of study, etc.); and 2) documenting the information was provided and the subject willingly volunteered to take part in the study.34 The principle question here, then, is whether or not it is necessary to provide informed consent to an individual before his or her informal data via social media platforms is mined for public health surveillance and research.

While it is generally accepted that data mining for public health surveillance in emergency circumstances and communicable diseases is permissible, it would be wise to develop an opt-out system on social media platforms for non-emergency research purposes. While this would surely lead to more incomplete data sets, it can be considered a small price to pay for protecting the privacy of patients, especially those with stigmatized conditions. Further, there are statistical methods designed to deal with missing data so that the incomplete data sets would not render the research impossible.35


Historically, advancements in bioethics standards have been reactionary to human subject abuses. It is vital to resist this reactionary approach to the lack of oversight in internet research and take a proactive stance to develop acceptable standard procedures for the use of big data sets culled from online social network websites before foreseeable abuses occur.

One need only consider the recent public outrage surrounding the National Security Agency (NSA) leaks on the federal government’s PRISM surveillance program, which included online social network data, to gauge the high salience of these concerns.

Achieving a just balance between maintaining individual liberties and ensuring the health and safety of the population is an enduring problem for authorities, particularly those in the field of public health. Champions of autonomy may view social media data mining as an unwarranted and potentially maleficent violation of one’s autonomy and personal liberties.

On the other hand, utilitarian thinkers may consider it a beneficent measure to ensure the health and welfare of the community. Accordingly, efforts should be taken to counter ethical concerns while reaping the benefits of being able to analyze the massive amount of online data available through social media for the purposes of public health.

Privacy concerns notwithstanding, the potential societal benefit of digital epidemiology remains clear. The utilization of social media has the capacity to transform disease surveillance and change how healthcare workers respond to public health emergencies. As public health threats become increasingly complex, trade-offs must be made to ensure the collective benefits of population health warrant infringement on individual rights, while balancing competing ethical, health, economic, and legal concerns.

Public health researchers must work together with policy makers, medical professionals, and bioethicists to develop unambiguous ethical guidelines to answer to challenges stemming from today’s technological advances and changing communications structure.

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Eye-popping Social Media Stats for Healthcare Marketing

Eye-popping Social Media Stats for Healthcare Marketing | Social Media and Healthcare |

When it comes to healthcare marketing, getting found online is a key goal, and social media is a powerful force. Why? Simply, that’s where the people are. 

Your patients are probably looking at their social networks right now, and health topics are a key attraction. Just look at the Affordable Care Act. No matter what side of the argument you’re on, opinions abound through Facebook, Twitter and other social networks. People are not just comfortable using social media to think about health, they’ve made it a daily habit.

As PWC noted in 2012, “social media ‘likes’ healthcare” in general; a survey of more the 1,000 consumers showed that 24 percent shared health experiences, 27 percent comment about others’ health experiences, and 16 percent post their impressions of treatments, medications, doctors or health insurers.

Get social, get known

Marketers in general embrace social media for the many benefits it provides in terms of SEO and networking. Healthcare marketing is likewise poised to make the most of this Internet interest. Of course, using social networks to discuss health carries a large amount of responsibility, not the least of which is HIPAA-style regard to patient privacy. In more than one instance, healthcare workers have been disciplined or fired for revealing facts about patients or procedures through social networks.

But if your healthcare marketing is still tied to outbound approaches – that is, relying on declining media like Yellow Pages, broadcast and display ads – you could be missing out on a valuable way to communicate with current and prospective patients who now spend most of their time online looking for information, not ads. Your website is a start, but you must give people a reason to visit it.

“Like us on Facebook”

How often have you encountered that plea from any number of different businesses or organizations? But the question to ask yourself is: “Why should I like you?” Giving your audience value, not a sales pitch, drives social engagement. The tactics you use on Facebook and other networks contribute to how your patients will discover, read, share and comment on your content. Look at the Facebook homepage for Seattle Children’s Hospital, for example. Its banner art is so warm and inviting, you cannot resist staying on this page. When you scroll down, you’ll find advice, local updates, an event calendar and a whopping 82,000+ “likes” that give you confidence in the hospital’s credibility. Detroit-based Henry Ford Hospital used Twitter to give people what they’d never seen before: live tweets of surgical procedures. “The unintended consequence was that the institution's reputation was enhanced,” noted Bloomberg Businessweek. “More patients wanted to have their delicate surgeries performed there, and more doctors suddenly wanted to work there.”

“Listen, listen, listen”

Stacy Poliseo, the social media guru for Johns Hopkins Hospital, has helped her institution gain great new audience attention through a Facebook page dedicated to the construction of two new medical buildings. You could go to the page to take a video tour, take a quiz about the buildings, and find a countdown clock to the opening day. The page, Poliseo told Social Media Today, drove more than 20 percent of new Facebook “likes” as people came to care about the construction of “their” new medical buildings.

For social media in healthcare marketing, Poliseo’s main advice is “listen, listen, listen and then test and retest. …Listen to your audience and then try different things and test them. Number of posts, content format, and so forth. And this is not a static project. It is always changing and you have to change with it.”

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The Digital Crystal Ball: 5 Healthcare Marketing Trends to Watch for in 2014

The Digital Crystal Ball: 5 Healthcare Marketing Trends to Watch for in 2014 | Social Media and Healthcare |

Increasingly, they’re on their computers and smartphones, on the Internet and on social media, researching procedures, reading reviews and narrowing the search for that one special provider who will perform the procedure they’re interested in.

Along the way, they’re encountering trends and technologies that help them become more empowered than ever, the same trends and technologies that you’ll need to monitor to ensure that your digital marketing efforts are in sync with their needs, concerns and online activity. Here are 5 that promise to grow in importance in the year ahead:

Online video

To say that online video is exploding is an understatement of epic proportions. Americans currently watch more than 1.2 billion videos a day and video content accounts for 50% of all mobile traffic. From video advertising to rolling selfies via Vine, Instagram and other platforms, those videos constitute the most actively shared content on the Internet. If you want aesthetic consumers to share your content, now’s the time to start recording.

Natural language search

The new movie, “Her,” about a man who falls in love with his operating system, is fictional but it’s safe to say that consumers are having an increasingly Siri-ous love affair with voice-based search. Rather than typing questions into a search box, they’re speaking into their devices, conducting so-called natural-language searches that promise to redefine the results they receive. Released six months ago, Google’s Hummingbird update is just the beginning.


Speaking of the 800-lb. gorilla of online search, Google+ will likely shed its “ghost town” image in the coming year. It already boasts more than 540 million users — more than Twitter, LinkedIn and Instagram — and it’s bound to grow for one simple reason: As the “social layer” for the rest of Google’s offerings (YouTube, Gmail, video Hangouts, etc.), it’s becoming increasingly embedded in the services millions of people use every day.

Price transparency

The average nose job or butt lift may not be covered by insurance, and therefore outside the realm of Obamacare; nevertheless, price transparency will increasingly become the norm forall medical treatments. Covered or not, patients already have ample access to pricing information, which will put more pressure on doctors to post their prices and/or explain how they focus on providing the best value not the lowest cost.

Wearable technology

Does Google Glass belong in the OR? Can a smart watch encourage healthier activity in your patients before and after surgery? At this point, there’s no clear answer but it’s increasingly clear that the combination of wearable tech and the rise of life-logging offers the potential to gather and share a tsunami of data regarding a patient’s lifestyle and medical history. How that information is used (or misused) will be another trend worth watching in 2014.

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Why Healthcare Social Media Just Plain Works Best

Why Healthcare Social Media Just Plain Works Best | Social Media and Healthcare |
ver 90% of all adults in the United States own a cell phone. Over 50% of the population over 18 years of age also owns a smartphone or other mobile device, such as a tablet. The Millennials who grew up with the Internet use mobile devices more than any other group. As usage increases across other demographics, so does the quality of services, products and apps. This is true across industry. In healthcare, however, social media is just beginning to have its lucrative potential tapped.

Social Media – the Power to Connect

From connecting families to offering limited specials to loyal clients, social media has wide appeal for connecting people instantly to one another, as well as to pertinent products and services.

Healthcare social media offers similar connections with a medical-related twist. Consider the following facts:

90% of Millennials report that they are comfortable with obtaining health-related advice over the Internet.19% of all smartphone owners have at least one health-related app on their phone.

There was a 30% decrease in depressive symptoms observed in one study that tracked older patients becoming active on the Internet.Understanding current trends can help healthcare executives plan strategies to harness the power of social media in order to promote their products and services.

Social Media in Healthcare Works Both Ways

It isn’t just that patients are able to seek out medical information over the Internet, share information on health forums and read reviews before choosing a doctor. Healthcare providers can also communicate with patients in variety of ways:

New mobile devices and apps allow patients with chronic conditions to report health data to primary care practitioners directly.Medical practitioners can use social media to report new products and services, post health-related articles and direct chronic condition support groups.

In isolated areas, healthcare social media is revolutionizing access to better health services. Through video chat consultation and other social media applications, health aid workers can instantly connect with doctors thousands of miles away from a remote clinic.

Social media applications in healthcare are evolving at a rapid pace. At all levels, highly trained professionals are needed to create valuable apps and train healthcare workers and patients how to use more sophisticated technologies. They can also show professionals how to properly market products and services in light of current industry trends.

Johns Hopkins Leading the Way with Healthcare Social Media

In order for social media to be effective it needs to be responsive and relevant. Johns Hopkins is setting industry standards with their social media use, which includes:

Professional blogs from leading doctorsPopular facebook page where Johns Hopkins’ professionals respond to questions and concerns Twitter, Instagram and YouTube connections aimed at reaching a variety of community members from students to residents to patients and surgeonsPresence on other highly-regarded sites such as ShareCareTop-ranked Johns Hopkins offers a diversified model for reaching all levels of community constituents through a variety of social media avenues.

As healthcare social media continues to gain popularity, it is important to understand the multi-faceted levels of potential patient/client engagement. In addition, devising a comprehensive strategy to utilize all tools available can help organizations reach as many people as possible while using marketing dollars wisely and supporting overall organizational goals.
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Smartphone App Uses Selfies to Check Your Cholesterol Level

Smartphone App Uses Selfies to Check Your Cholesterol Level | Social Media and Healthcare |

A team of engineers has designed a smartphone accessory and app that allows users to monitor their own blood cholesterol levels. Think of it as a sort of cholesterol selfie — or maybe a healthie?

As researchers from Cornell University explain in a paper in the journal Lab on a Chip, all you need — aside from their attachment and a smartphone — is a reagent test strip and a willingness to draw your own blood. Cholesterol tests tend to rely on reagent strips that turn different colors, depending on the cholesterol levels of the blood placed on them. The researchers’ achievement was to design an attachment to be placed over the smartphone flash and camera that can illuminate and capture the color of the strip, rendering unnecessary specialized equipment or an in-person health professional. The lab is working on a smartphone app that can determine vitamin D levels, too.

The technology is relatively straightforward, and the research group is one of many developing smartphone tools such as these. Already, apps can turn smartphones into heart-rate monitors,sleep monitors or ultrasound machines, to name just a few. According to the U.S. Food and Drug Administration, half of the more than 3.4 billion smartphone and tablet users worldwide will have downloaded mobile health applications by 2018.

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Social Media as a Megaphone to Pressure the Food Industry

Social Media as a Megaphone to Pressure the Food Industry | Social Media and Healthcare |

Renee Shutters has long worried that food dyes — used in candy like blue M&M’s — were hurting her son, Trenton.

She testified before the Food and Drug Administration, but nothing happened. It wasn’t until she went online, using a petition with the help of the Center for Science in the Public Interest, that her pleas to remove artificial dyes from food seemed to be heard.

Mars, the candy’s maker, is now hinting that it may soon replace at least one of the dyes with an alternative derived from seaweed.

“I’ve really thought about calling them,” Ms. Shutters said about Mars. “I’m not trying to be this horrible person. What I’m really thinking is that this is an opportunity for their company to lead what would be an awesome publicity coup by taking these dyes out of their products.”

While the F.D.A. continues to allow certain dyes to be used in foods, deeming them safe, parents and advocacy groups have been using websites and social media as powerful megaphones to force titans of the food industry to reconsider the ingredients in their foods and the labeling and processing of their products. In several instances in the last year or so, major food companies and fast-food chains have shifted to coloring derived from spices or other plant-based sources, or changed or omitted certain labels from packaging.

Matthew Egol, a partner at Booz & Company, the consulting firm, said that while food companies had benefited from social media to gain rapid insight into trends, data on what products to introduce and which words to use in marketing, they also had been the target of complaints that sometimes become magnified in an online environment.

Mr. Egol said companies were approaching the negative feedback they get with new tools that help them assess the risks posed by consumer criticism. “Instead of relying on a P.R. firm, you have analytical tools to quantify how big an issue it is and how rapidly it’s spreading and how influential the people hollering are,” he said. “Then you can make a decision about how to respond. It happens much more quickly.”

From Cargill’s decision to label packages of its ground beef that contain “pink slime,” or what the industry prefers to call finely textured meat, to PepsiCo’s decision to replace brominated vegetable oil in Gatorade with a natural additive at the behest of a teenager, corporations are increasingly capitulating to consumer demands.

Companies are reluctant to admit a direct connection between the crusades of consumers like Ms. Shutters or Vani Hari, a blogger known as the Food Babe, and their decisions to tweak products, but the link seems clear. More than 140,000 people have signed Ms. Shutters’s petition on petroleum-based food dyes, and dozens have commented on Ms. Hari’s posts about some of the ingredients in items on Chick-fil-A’s menu.

“We’ve always tried to be a customer-focused organization,” said David B. Farmer, vice president for product strategy and development at Chick-fil-A. “What has clearly changed is some of the channels of communications, which wasn’t a factor in the past like it is today. We’ve had to adapt to that.”

Two years ago, Ms. Hari marveled in a blog post about the nearly 100 ingredients in a Chick-fil-A chicken sandwich and took issue with some of them, like MSG, artificial colors and TBHQ, or tertiary butylhydroquinone, which is used as a preservative in many foods.

“TBHQ is a derivative of butane,” she said in a telephone interview. “The F.D.A. says TBHQ cannot exceed 0.02 percent of fats and oils in a product, but consumers who are eating a sandwich that has it plus French fries and other things that also have it in a single meal may be getting more than that.” She followed that post with another, offering a recipe her readers could use to make a chicken sandwich that is a pretty fair imitation of Chick-fil-A’s — but with only 13 ingredients, none of them artificial.

Chick-fil-A eventually responded, inviting Ms. Hari in October 2012 to spend a day at its headquarters in Atlanta, where she discussed her concern about some ingredients as well as larger issues like the use of chicken from animals whose feed contains antibiotics and the potential for labeling products that have genetically engineered components.

“They went out of their way to make sure I got all the info I needed,” Ms. Hari said. “We sat down and put together a road map of my concerns and then laid out how they would start addressing them and what I would prioritize on a white board.”

Most important for her was where Chick-fil-A buys its chicken, and her second priority was removing artificial dyes from the company’s products. “That was one of the easiest things for them to get rid of, I thought,” she said.

This month the company told Ms. Hari that it had eliminated the dye Yellow No. 5 from its chicken soup, and reduced sodium in the soup. It is testing a peanut oil that does not contain TBHQ and will start testing sauces and dressings made without high-fructose corn syrup in the coming year.

The company said its decision to address some of Ms. Hari’s concerns was just a step in a long-term effort to improve and enhance its menu to give consumers what they want. “We’ve been working through the menu, starting with the removal of all trans fat between 2006 and 2008, taking high-fructose corn syrup out of bread, some dressings, some ice cream and milk shakes and reducing sodium across the board,” said Jodie Worrell, Chick-fil-A’s nutritionist.

Last year, the company added oatmeal to its yogurt fruit cups, and it offers fruit cups as an alternative to fries on its menu at no extra charge, “even though it’s more expensive,” Ms. Worrell said.

Kraft withstood Ms. Hari’s criticism for its use of petroleum-based dyes in its popular macaroni and cheese. But the company announced quietly last month that it would no longer use Yellow No. 5 and Yellow No. 6 dyes in its Shapes line of macaroni and cheese beginning in 2014.

Kraft is replacing the dyes with colorings derived from spices like turmeric and paprika. It is also adding more whole grain to the Shapes products, which are shaped like cartoon characters, and reducing the sodium and saturated fats they contain.

“Our Shapes products are popular with families,” Lynne Galia, a spokeswoman for Kraft, wrote in an email. “Parents have told us they would like fun mac and cheese varieties with the same great taste but improved nutrition.”

Asked whether the changes were made in response to Ms. Hari’s crusade, Ms. Galia wrote that they were made as part of the company’s continuing efforts to deliver better nutrition in its products. “We’re always listening to consumers,” she wrote. “In this particular case, we’ve been working on the relaunch for quite some time.”

She said that it took about a year and a half to reformulate the products, and that one of the challenges food companies face when confronted by consumers demanding change is getting them to understand how complicated that change can be.

Food companies must work with suppliers to determine what’s possible, then suppliers have to make the new ingredient in bulk. That ingredient is then tried in the recipe, and the recipe goes through tweaks to try to achieve the same viscosity, texture and other attributes contributed by the old ingredient.

“Then it goes to a validation stage, where we might have a sensory panel made up of folks who have trained capabilities and can apply science to determine if we’re matching the original flavor,” Mr. Farmer of Chick-fil-A said. “And then we test it with customers to get their feedback.”

Some changes come at little cost, others force a higher price. When Chick-fil-A changed its salads, for instance, replacing iceberg lettuce with leaf lettuce and adding options like fresh blueberries, it raised the price it charges for them to cover some of the additional costs. “It’s a more expensive product, but we’re selling significantly more salads because that’s what the customer wants,” Mr. Farmer said.

Similarly, Mars had to receive F.D.A. approval to replace FD&C Blue No.1, the petroleum-based dye it uses for blue M&M’s, with a blue dye derived from spirulina, an algae, that is often used in confectionary and chewing gum. “As a company, we continue to explore the use of naturally sourced colors,” Mars said in a statement. “While we do not currently use spirulina extract, its approval is a step toward providing us the option to produce confectionary products made with this naturally sourced color.”

Ms. Shutters said she was happy to hear about the potential new dye. She omitted all foods containing petroleum-based dyes from her son’s diet a few years ago, hoping it would help improve his focus, ease fidgetiness and make him more cooperative in his hockey practice.

“His schoolteacher just about passed out when he went back after the break,” she said. “I’m not kidding you, it was a miracle that we figured it out. I never realized until then how big an impact what you eat can have.”

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Pharmaceutical Industry Predictions for 2014

Pharmaceutical Industry Predictions for 2014 | Social Media and Healthcare |

FDA Draft Guidance on Social Media: Nope. I know the FDA is due to respond in July 2014, but I believe they will delay, again. And, I’m not sure if they will deliver on the Correction of Misinformation guidance either. But if they do, it will likely be a vague direction. Something to the effect: if the correction is a) relevant to your brand, b) focuses on current indications and adverse events, and c) puts consumer health at risk, you should make a statement IF it’s living on a property that you manage. If not, then the FDA will say we just need to be good citizens and take ownership for correcting misinformation where we see it. And so, we’re back to where we started… 

Pharma and the Affordable Care Act: Yep. Some company out there will figure out how to effectively integrate with Electronic Medical Records/Electronic Health Records (can we choose one acronym in 2014?!?) to provide physicians better patient materials and support formulary choice (improving health outcomes being one of the factors behind it). Will that company be yours? Check out what’s coming down the pike here.

Relationship with Payers Becomes Crucial: The ACA will have an impact once more. Formulary managers will have more control as consumers participate in Health Exchanges and they (FMs) will scrutinize products for the winning combination of lower price and higher efficacy. Where that line becomes very thin is when they can’t make the case on efficacy and focus on price, generating an industry bidding war. But perhaps publicly releasing clinical data will become more important than ever. Could this create more transparency for the public as a byproduct, which could lead to improving trust in the industry? Maybe.

Mobile will Dominate: Wait, didn’t we say this last year? And the year before? So why are so many desktop sites still not mobilized and why is mobile search still a novelty? I hope this does not appear in my predictions for 2015…

Wearable Sensors for Fitness/Health will Continue to Improve: Wearable technology will become more integrated and fashionable. This year we saw the FitBit Flex, Samsung Gear, and Google Glass launch. We expect to see more expansion of choices and features in the coming year as people figure out how best to use this increased technology integration in their lives to manage their health. What role will Pharma and Healthcare have in this? Innovation at your fingertips (literally).

Hope everyone has a safe, healthy, and happy holiday season.  See you in 2014!

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Social Media Can Help Patients Find 'Comfort Level' They Seek in Provider

Social Media Can Help Patients Find 'Comfort Level' They Seek in Provider | Social Media and Healthcare |

We all know any patient wants his or her medical provider to be skilled and qualified. But marketers of health care need to be aware that patients look beyond the diploma on the wall and the initials after the name. Patients want to know enough about their provider to feel that certain “comfort level” made up of rational confidence and emotional reassurance. Marketers in the health care field can help providers achieve that comfort level, especially when they use social media. After looking at the principles of the concept, we’ll check out examples, including a program by SKAR.

This report starts with the basics: Researchers at Vanderbilt found that patients were more satisfied with their hospital stay if they knew who their doctor was and a few facts about their caregiver. In the study 100 patients in the hospital’s orthopedic trauma division were given “biosketch” cards with physician information, while 112 patients did not receive the cards. The patients had similar kinds of injuries, insurance and levels of education, but the satisfaction scores of patients who got cards were 22 percent higher than those of patients who did not get cards. That’s a pretty inexpensive way to boost satisfaction scores, a Vanderbilt professor noted: “As health care reimbursement shifts to reward quality rather than quantity, it is important to identify ways to improve the patient experience.” That’s valuable advice for marketers of health care providers.

Social media offer great opportunities to accelerate a process like the “biosketch cards,” and this thoughtful essaydiscusses how health care marketers should take a long view in their social media strategy, because the ultimate benefit is building relationships. Although addressed to the pharmaceutical industry, the principle applies to hospitals and individual providers. A good social media program can demonstrate the provider’s expertise and offer a forum for many perspectives; it doesn’t have to make a sale with every posting. “Health is personal and emotional – excellent seeds for starting a relationship,” writes author Zoe Dunn of Hale Advisors. Social media like Facebook, Pinterest and Twitter, along with sponsored blogs, can help patients get to know an individual physician or institution and help build that important comfort level.

Another thought-provoking blog suggests that hospitals might harness the power of social media to improve the patient experience through a form of crowdsourcing called Social-Customer Relationship Management. That’s using social media to solve nuts-and-bolts problems. “If you want to innovate and use social media to be transformative, create an app that allows the patient to schedule their appointment on their iPad,” wrote consultant Paul Roemer of Tower Strategies.

Storytelling is one of the most persuasive arts, and the field of health care offers plenty of opportunity for compelling narratives. The pharmaceutical company Eli Lilly and Co. partnered with Disney (a company that knows storytelling) to create, a website that helps parents of children with Type 1 diabetes. It’s filled with personal accounts of family members along with contributions from experts like dietitians, nurses and psychologists, and it’s a model that could be followed by many health care providers. Interestingly, few of’s stories are about treatments. As one expert commented, “Your brand is not the story, your brand is in the story.”

At SKAR we use this concept in our program of introducing physicians and other practitioners to the public for the East Texas Medical Center Regional Healthcare System, our largest health care client. We interview, photograph and craft a professional and personal profile of the provider, including a summary of the provider’s education, experience and achievements – all to help the prospective patient feel comfortable with the person being entrusted with his or her health care. These profiles are served to the audience through several platforms – the ETMC website, newspaper ads, full-color fliers in ETMC offices and links on various social media. In some cases we produce videos of the practitioners explaining a procedure or health condition; these are available through the website and on demand by a Texas cable TV provider. Our client finds the program is appreciated by patients, providers and everyone involved in marketing. Contact SKAR for more information or help on raising the comfort level for your patients.

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Why Unbranded Social Media Campaigns Work for Healthcare

Why Unbranded Social Media Campaigns Work for Healthcare | Social Media and Healthcare |

What is the value in not putting a healthcare brand’s name in front of online consumers?  You make it less about the brand and more about the consumers.  It allows brands to learn more about the target audience, how they feel, what it means to be sick in their situation, what they need, like and don’t like.


With several health conditions, disorders, diseases and over 6,800 rare diseases in existence (re: National Institutes of Health), social media provides a vehicle to educating a brand’s target audience about causes, history, symptoms, and different care options. Often times, social media pages are the first place where health consumers can learn about a health issue or a support community.  As people are being “social” they are naturally helping several brands by sharing content organically.

Unbranded social media campaigns for healthcare brands provide a time to listen, ask questions and provide a community in which the consumers feel they own.  Why does this work particularly for healthcare brands?  It works because the business of healthcare is about people and people only.  Get your target audience cozied up to a place where they feel secure, where they can meet other people with the same health issues and where helpful information is abundant and trustworthy.  Your brand then has the opportunity to influence opinions and behavior.


The most critical part about running an unbranded social media campaign  is the opportunity for conversion.  Unbranded social campaigns are used by some healthcare brands currently to direct consumers toward other digital assets like websites and landing pages with clear calls to action.  Such examples are: patient advocate programs, symptom trackers, awareness campaigns, discounts for prescriptions, questionnaires and  surveys.

So what are the goals of your pharmaceutical drug, medical device, hospital or clinic?  How will you be social in 2014 and build a concrete strategy around acquiring new patients?

- See more at:

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A Tweet a Day Keeps the Doctors Away: Patients and Healthcare Providers Using Social Media

A Tweet a Day Keeps the Doctors Away: Patients and Healthcare Providers Using Social Media | Social Media and Healthcare |

The influence of Facebook, Twitter, YouTube and other social media giants has spread across modern society faster than the Black Death swept across 14th century Europe. Speaking of pandemics, how does healthcare fit into the world of social media? Welcome to social health.

Social health is the mash-up of social media and healthcare, and it’s starting to gain traction. In fact, a third of all consumers use social media for matters regarding their health. Thanks to social networking sites and the increased availability of broadband and mobile technology, people are forming online patient support groups, becoming better educated on medical topics and diagnoses, and sharing doctor and product reviews – wherever and whenever they want.

However, people still tend to trust their doctors over peers and family when it comes to getting accurate medical advice, giving providers a great opportunity to jump into the social-health fray. And many have. In a 2012 study by the, 24 percent of doctors said they used social media at least once a day to look for medical information while almost two-thirds think social media enhances their ability to care for their patients.

There are many benefits for providers who take part in social health as well, such as giving doctors a way to connect with consumers in between visits and allowing healthcare organizations to receive immediate feedback on products and services.

Concerns about privacy and security have surfaced alongside the rising popularity of social health. Consumers are worried that their medical records will go public while health information technology specialists must try to protect patient privacy and act within the bounds of HIPAA and the FDA as they participate in the online social sphere.

This is just a peek into the vast realm of social health. Check out the infographic below for even more valuable insights about this incredible new online movement.

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5 Ways to Nurture Your Medical Practice with Social Media

Running a social media campaign in a medical practice can be an intimidating prospect, but here are five easy ways to nurture and grow your practice with social
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HIV And AIDS Discussion On Social Media Needs Some Decorum

HIV And AIDS Discussion On Social Media Needs Some Decorum | Social Media and Healthcare |

HIV and AIDS is probably the most talked about health topic on social media because of the large number of individuals, especially youths, who are talking about the virus and disease. Armed with an Android [smartphone] device, they believe they can host HIV and AIDS talk shows on Twitter.

Some even fix times for their “weekly shows” although the truth of the matter is that nobody, except Twitter (and Facebook) chat hosts follow their trends. And the reason is quite simple: who wants to read the same form of messages anyway?

As a health-professional-turned-media-practitioner, I see the wide gap that currently exists between what is on social media concerning HIV and AIDS and what is in the various wards of our hospitals. There is so much difference, and the people know that.

It is quite depressing to note that the social media which could have been the best and strongest tool to get the message about HIV and AIDS across to people has been hijacked by fame-seeking individuals who just want to get noticed by international organizations in search of HIV and AIDS advocates in such developing countries.

I believe these noisemakers should step aside and allow youths who know HIV/AIDS inside out to stand up, sign up and speak up. In other words, we need a paradigm shift in HIV/AIDS social media strategy.

The message of abstaining, being faithful and wearing condoms has been well covered on social media and I don’t think anyone with Facebook or Twitter account could say he or she has not come across something like that before.

Another well covered topic is the issue of stigmatization. Those that need this message are not the tech savvies; it is the people at the grassroots.

It would be depressing to see how boring and scanty messages on HIV and AIDS would be if these two issues, including unscientific road-to-zero campaigns are removed from the dialogue. One thing is for sure, there would be decorum, serendipity and tranquility.

We need new trends, tags and topics.

For instance, there are issues that relate to how patients living with HIV and AIDS are helping the society since they are also members of the society; not condoned off like individuals infected with multi-drug resistant tuberculosis.

There are also exciting topics in fashion, entertainment, sports, politics, and several others, apart from sharing self pictures taken at conferences and picnics with captions like “I just finished talking to Melinda Gates on how we can stop HIV and AIDS in Africa”.  No you didn’t.

From the healthcare point of view, despite the fact that many HIV and AIDS advocates are on my timeline, none are talking about the basics of prevention of mother-to-child transmission of HIV; no one is talking about the anti-retroviral therapy plan in my country so that they can help those affected with the virus to stick to their treatment plans.

Furthermore, despite making so much noise about stigmatization, no one in my Nigerian community is giving voice to victims of stigmatization which may suggest that stigmatization is not really here.

We need to localize the messages being shared on social media about HIV and AIDS. Those tweeting need to be sure that they know what they are talking about and not just re-echoing what everyone is already aware of because the danger therein is that when the advocate has something important to say, no one would be ready to listen to him or her since the individual is known for making noise and less impact.

One of the first set of individuals I interviewed as the managing editor of is a popular HIV and AIDS advocate in Nigeria; he even occupied an enviable position in one of the internationally acclaimed youth organizations involved in the fight against HIV and AIDS.

I thought I was talking to the right person.

But when I asked whether he knows anyone living with HIV and AIDS, he said no. I asked whether he has seen the empirical evidences confirming the existence of the virus, he said no. What of the treatment plan for children living with the virus? He said he had no idea.

So I stopped the tape and asked him what he would like to tell my readers – he said he just want everyone to know that HIV is real and AIDS kills.

Ten minutes later, he was on social media telling everyone he just spoke to the managing editor of Nigeria’s leading online health news platform on the subject of HIV and AIDS. The post got 53 likes and 23 comments by people commending him on the amazing work he is doing.

Like his cheerleaders, he belongs to the demography of those who think they know all about the virus but are actually in dire need of the book entitled HIV and AIDS for Dummies.

I see ACT 2015 as both ambitious and delicate. Ambitious in the sense that it seeks to take on some fundamental issues that to a large extent are contributory to the still high HIV/AIDS prevalence among the young demography. It is delicate because it stands the risk of being easily hijacked by self seeking individuals who only want to appear on UNAIDS timeline and probably get some retweets, follow backs and mentions by the corporate bodies supporting ACT 2015.

UNAIDS can ensure decorum by intentionally and aggressively searching for young HIV/AIDS experts, those who are making impacting contributions and those that really have things to far apart from flooding Facebook and Twitter with spam copied-and-pasted messages.

As a health journalist, I also believe UNAIDS can actively engage local content developers who are the ones that help in developing contents that are usable in their communities; contents that would drive meaningful conversations and willful actions.


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Tips for Healthcare Providers to Connect with Patients on Pinterest

Tips for Healthcare Providers to Connect with Patients on Pinterest | Social Media and Healthcare |

With Pinterest users currently in excess of 70 million people, you can rest assured your patients are active on the image-based social media site. Creating an account on the site is a great way to promote your business and connect with your patients in a more fun, relaxed manner.

Six Ways Healthcare Providers Can Use Pinterest

Pinterest isn’t just for flashy marketing companies and well-known brands ─ Healthcare providers can use it too. Interact with your patients using this image-based social network in the following innovative ways:

  • Coaching Tool: If you’re a therapist, use Pinterest to assist in the treatment of patients, by asking them to pin images representing their feelings on a certain subject, describing past events, and depicting goals they’d like to achieve in life.
  • Health Tips: Create specific boards filled with pins of helpful tips for your patients. For example, a pediatrician could create a board filled with baby milestones new parents can expect to see each month. Or a podiatrist might have a board with pins of running shoes that provide good arch support.
  • Client Photos and Testimonials: Nothing speaks stronger to the benefits of your practice than testimonials from current and past patients. With participants’ full permission, create a board filled with patient pictures and video testimonials highlighting the value gained from treatments you provided.
  • Showcase Products: If you’re in charge of the social media for a healthcare manufacturer, use Pinterest to show how patients are using your products and the positive impact they’ve made. Medical giant, Bayer Healthcare, also uses its Pinterest board to help patients improve their overall health, with board such as Interactive Health Quizzes, Health Industry News, and Healthy Christmas.
  • Treatment Ideas: Create Pinterest boards to help patients manage their health conditions. For example, a hematologist-oncologist could create a board with treatment ideas and offers of support for people with leukemia.
  • Facility Tours: Prior to choosing a hospital or healthcare provider, many people want to see what the facilities are like. Use Pinterest to give prospective patients a tour of your offices, so they can see exactly where they would receiving treatment, to decide if it’s a place where they would feel comfortable.

So, if you haven’t already created a Pinterest account for your healthcare business, now is the time to do so. Happy pinning!

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Tweet This #Toxicology2.0

Tweet This #Toxicology2.0 | Social Media and Healthcare |

The pervasiveness of social media is irrefutable. Social media is an umbrella term referring to blogs, podcasts, micro-blogging, wikis, and online videos to name a few. There are over one billion Facebook members and 500 million Twitter users [1]. One hundred hours of YouTube videos are uploaded every minute [2]. The media, law enforcement, and educational institutions have already recognized and begun to harness the potential of social media. Within only 8 mins of the Boston Marathon bombing, the Boston Globe sent out its first tweet announcing the explosions [3]. A missing Saudi Arabian teenager was found in just 3 hrs after a tweet with a mere 300 followers, thanks to the exponential power of re-tweeting [4]. Countless other examples exist from political campaigns driven by twitter to small businesses connecting with unprecedented numbers of customers. The field of medical toxicology possesses many unique qualities that make it ideal to maximize this new and powerful resource.

Before I proceed, we need to address the elephant in the (figurative) room. Most physicians hear the term social media and immediately tune out. Perhaps it is because they see no immediate connection between medicine and the endless parade of baby pictures and celebrity self-promotion that social media has become synonymous with. Social media, however, is no longer exclusively a voyeuristic tool of narcissistic screenagers. It is a powerful platform that is being leveraged to advance higher education, patient care, and the bedside application of scientific research.
The doubling time of medical knowledge in 1950 was estimated to be 50 years and projected in 2020 to be 73 days [5]. A resident who begins my 6-year training program in Emergency Medicine and Toxicology in 2020 will experience 25 doublings of medical knowledge before completing fellowship. Can the current model of passive didactics sustain this colossal growth in knowledge? Prober and Heath suggest in their proposal for revising medical education that it is time for a flipped classroom, a lecture hall without walls [6]. Trailblazer and Life in the Fast Lane blogger, Dr. Mike Cadogan, accepted this challenge and started Free Open Access Meducation (FOAM) (#FOAMed, #FOAMtox). It utilizes social media to facilitate lifelong learning and interactive education [7]. This movement is designed to keep pace with the ever-increasing knowledge pool physicians are expected to maintain. It capitalizes on the key social media characteristics of convenience, ease of use, expansive reach, and customization to make education available to anyone, anywhere, anytime. This application is one that we can learn, develop, and grow from, tailoring it to fit the needs of toxicology. For example, while it is not feasible to attend every toxicology conference, it is possible to have the content delivered to your phone for instant access. Imagine a classroom where the traditional lecture is augmented by a constant stream of twitter comments and questions, allowing a level of interaction that could not otherwise be attained. The ease with which social media allows for the delivery of knowledge to a learner is unparalleled by traditional methods. Our willingness to participate in social media may be the only rate-limiting factor.
Patient Care
The American College of Medical Toxicology (ACMT) has over 500 members that are spread across the nation. Many toxicologists practice in settings where they are the only experts at their institution. Toxicology is arguably one of the most rapidly shifting specialties, its face ever changing with new designer drugs, not yet reported toxicities, and rare exposures. Social media may be the way to most effectively and quickly link our geographically diverse specialty. It can serve as a platform to share our collective patient care experiences. ACMT established a forum in 2006 with this exact goal in mind. As of October 28th, 2013, the ACMT's Management Questions forum had 130 unique posts in just less than 7 years. There was an average of 1.75 comments per post; however, 47 posts had 0 comments [8]. Can we do better? Consider this contrasting example. A well-known leader in emergency medicine recently posted a clinical case for management and discussion via twitter. Within 1 h of posting, there were 67 tweets in response and within 5 h, there were 184 tweets from over 25 users [9]. The utility of social media to enhance accessibility to expert consultation and, subsequently, improve patient care cannot be underestimated.
Knowledge Translation
The slow transition of research findings to bedside practice is a well-known problem in medicine. There are many barriers to physician implementation of novel treatments, such as awareness, acceptance, applicability, agreement, ability, and adherence [10]. Toxicologists know this first hand, as it relates to our recommendations for the use of novel antidote therapies that are not yet accepted by mainstream medicine. Numerous studies have demonstrated that poison center recommendations are often not followed [11, 12]. This may be partially due to unfamiliarity with infrequently used antidotes and limited access to primary toxicology literature. In this respect, social media can further connect us and allow dissemination of information to those outside of the toxicology community. Furthermore, many of the barriers mentioned previously may diminish through the use of social media. Medical research is only as powerful as its reach, and now, we have a tool to maximize its dissemination. Each of the top ten medical journals by impact factor already have established Twitter accounts and use them to provide introductions and links to articles among other things [13]. Social media can also decrease the delay to post publication critique (i.e., letters to the editor), expert expressions of approval and community agreement on value. If we can utilize social media to decrease the time to acceptance of new ideas through open, real-time discussions about scientific findings, we will make great strides towards decreasing the translational gap.
While the potential for social media is vast, its limitations also deserve recognition. User-generated content is one of the greatest strengths of social media, but also an often cited criticism. There is no standardized quality control process prior to posting, and physicians worry that patients will get misinformation or delay medical care based on Internet advice. There is also the concern that novice learners will not be able to discern fact from opinion when perusing blogs, podcasts, or tweets to augment knowledge. Beyond the issues surrounding quality of information, there remain numerous questions on how to regulate physician professionalism, maintain patient privacy, and address the digital divide in access to social media.
The Future
Researchers are already exploring the use social media for epidemiologic surveillance, toxic vigilance, augmentation of research enrollment, and behavior modification in drug abuse [14, 15]. We have only begun to harness the power of social media as it pertains to toxicology. It is a vast, underutilized tool that has the potential to transform, expand, and improve our field. Social media applications are infinite and only limited by our vision and participation.
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Social Media Use in the United States: Implications for Health Communication

Social Media Use in the United States: Implications for Health Communication | Social Media and Healthcare |

Given the rapid changes in the communication landscape brought about by participative Internet use and social media, it is important to develop a better understanding of these technologies and their impact on health communication. The first step in this effort is to identify the characteristics of current social media users. Up-to-date reporting of current social media use will help monitor the growth of social media and inform health promotion/communication efforts aiming to effectively utilize social media.


The purpose of the study is to identify the sociodemographic and health-related factors associated with current adult social media users in the United States.


Data came from the 2007 iteration of the Health Information National Trends Study (HINTS, N = 7674). HINTS is a nationally representative cross-sectional survey on health-related communication trends and practices. Survey respondents who reported having accessed the Internet (N = 5078) were asked whether, over the past year, they had (1) participated in an online support group, (2) written in a blog, (3) visited a social networking site. Bivariate and multivariate logistic regression analyses were conducted to identify predictors of each type of social media use.


Approximately 69% of US adults reported having access to the Internet in 2007. Among Internet users, 5% participated in an online support group, 7% reported blogging, and 23% used a social networking site. Multivariate analysis found that younger age was the only significant predictor of blogging and social networking site participation; a statistically significant linear relationship was observed, with younger categories reporting more frequent use. Younger age, poorer subjective health, and a personal cancer experience predicted support group participation. In general, social media are penetrating the US population independent of education, race/ethnicity, or health care access.


Recent growth of social media is not uniformly distributed across age groups; therefore, health communication programs utilizing social media must first consider the age of the targeted population to help ensure that messages reach the intended audience. While racial/ethnic and health status–related disparities exist in Internet access, among those with Internet access, these characteristics do not affect social media use. This finding suggests that the new technologies, represented by social media, may be changing the communication pattern throughout the United States.

Nevermore Sithole's curator insight, January 8, 2014 1:39 AM
Social Media Use in the United States: Implications for Health Communication
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Healthcare in Google Zeitgeist 2013

Healthcare in Google Zeitgeist 2013 | Social Media and Healthcare |

Never mind twerking, celebrity breakups and famous Internet animals. A fistful of healthcare-centric topics, things that actually matter, reside within Google’s Zeitgeist 2013. 

The annual compilation of most popular searches to cross its engines, Google Zeitgeist, so named for the term’s definition as the spirit of the times, examines what the world wanted to know during the past 12 months across literally dozens of categories.

Among those are two with a razor-sharp focus on health, those being health issues and health symptoms, as well as broader categories with notable connections to healthcare.

Health issues:

  1. Flu
  2. Cold
  3. Labor
  4. Diarrhea
  5. Balance
  6. Diet
  7. Back pain
  8. Allergies
  9. Rash
  10. Lupus

If that last one comes as something of a surprise, then you’re not alone. What’s more, Lupus also showed up on Google’s list of health symptoms, and two spots higher: 

  1. Pregnancy
  2. Influenza
  3. Diabetes
  4. Anxiety
  5. Thyroid
  6. HIV
  7. Mononucleosis
  8. Lupus
  9. Herpes
  10. Pneumonia

Lupus was in the international spotlight when a court in El Salvador ruled against granting a dying patient an abortion — and I’m not touching that one politically.

Also of note are HHS Secretary Kathleen Sebelius who ranked third among most searched upon female politicians, and number 9, Representative Marsha Blackburn (R-TN), whose query popularity soared at October’s end around the introduction of the Sensible Oversight for Technology which Advances Regulatory Efficiency Act , aka the SOFTWARE Act.

Male politicians fell into even sides among Patient Protection and Affordable Care Act proponents and opponents, with Ted Cruz ranking second and Rand Paul at five, while President Barack Obama was third and Vice President Joe Biden grabbed the tenth slot. 

And then there’s Obamacare itself, which was the seventh most popular term to follow the search question What is? Immediately above Obamacare on that list sits What is Sequestration? At the top: What is twerking? And just below Obamacare: What is Lupus?

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We’d all be better off with our health records on Facebook

We’d all be better off with our health records on Facebook | Social Media and Healthcare |
A Facebook user’s timeline provides both a snapshot of who that user is and a historical record of the user’s activity on Facebook. My Facebook timeline is about me, and fittingly, I control it. It’s also one, single profile. Anyone I allow to view my timeline views my timeline—they don’t each create their own copies of it.

Intuitive, right? So why don’t medical records work that way? There is no unified, single patient record—every doctor I’ve ever visited has his or her own separate copy of my records. And in an age where we can conduct banking transactions on my smartphone, many patients still can’t access or contribute to the medical records their doctors keep for them.

My proposal? Medical records should follow Facebook’s lead.

Cross-industry innovation isn’t new. BMW borrowed from the tech world to create its iDrive; Fischer Sports reduced the oscillation of its skis by using a technology created for stringed instruments. So I asked myself: Who has mastered the user-centric storing and sharing platform? The more I thought about it, the more I decided a Facebook timeline approach could be just what medical records need.

To see what I mean, let’s explore some of Facebook timeline’s key features to see how each could map to features of the ideal medical record.

“About” for Complete, Patient-Informed Medical History

On Facebook: The “about” section is the one that most closely resembles the concept of a user profile. It includes a picture selected by the user and lists information such as gender; relationship status; age, political and religious views; interests and hobbies; favorite quotes, books and movies; and free-form biographical information added by the user.

In medical records: The “about” section would be a snapshot of the patient’s health and background. It should include the patient’s age, gender, smoking status, height, weight, address, phone number, and emergency contact information; the patient’s primary care provider; and insurance information. This section would include a summary list of the patient’s current diagnoses and medications, as well as family history. And importantly, both the doctor and the patient would be able to add details.

FACEBK about-patient“Privacy Settings” and “Permissions” for Controlled Sharing

On Facebook: Privacy settings allow users to control who can see the information they post or that is posted about them. For example, in my general privacy settings I can choose to make my photos visible only to the people I’ve accepted as “friends.” However, if I post a photo I want the entire world to see, I can change the default setting for that photo to be visible publicly instead.

Facebook also allows users to grant “permissions” for outside applications to access their profiles. For example, let’s say I use TripAdvisor to read travel reviews. TripAdvisor lets me sign in to its site using my Facebook account, rather than creating a separate TripAdvisor account. But, to do this I must grant TripAdvisor “permission” to access my Facebook account.

In medical records: Patients could use “privacy settings” to control whether all or part of their information can be seen by a family member or caregiver. For example, if my aging mother wanted to give me access to her “events” (upcoming doctor’s appointments), she could do so. If my college-aged son who is still on my health plan wanted to give me access to his knee X-rays, he could.

facebook privacyAdditionally, a patient could grant “permission” for other doctors to access their records. When I visit a new doctor, rather than signing a form granting my previous doctor permission to fax over copies of my records, I could simply grant permission electronically within the record–and presto! The new doctor would have instant online access.

And doctors could use “permissions” in lieu of the paper forms patients typically have to sign during office visits today–to get patient signoff on the sharing of their information with insurance providers or other doctors, in compliance with the latest HIPAA regulations for patient privacy.

“Status Updates” to Document Diagnoses and Treatments

On Facebook: “Status updates” let Facebook users broadcast what’s going on with them at a given moment. (For example, my status update might say: “I just had a great idea for improving medical records.”) A user’s latest status update appears toward the top of the timeline; older statuses can be viewed by scrolling through the timeline.

In medical records: Doctors could post “status updates” to log new diagnoses, medications or treatments. For example, if a doctor prescribes a patient Lipitor, a status update would be posted automatically to note the new prescription. These types of new prescription updates would also generate drug interaction alerts. Think of those drug commercials that warn, “Before using our drug, tell your doctor if you have any of the following conditions.” Similarly, the timeline medical record would prompt a doctor prescribing that drug to ask the patient about those conditions before prescribing.

facebook status“Photos” for the Online Delivery of Test Results

On Facebook: Users can upload pictures they’ve taken. Photos are organized into albums that are visible on the user’s timeline. There’s also a special “photos” section where viewers of the timeline can go to see all of a user’s photo albums.

In medical records: Doctors could upload scans, X-rays, and other test results to a patient’s medical record timeline. When uploading the images, the doctor would be prompted to select the type of image being uploaded, the applicable body part and the date, which would create an album titled with those details–for example, “X-ray-Left foot-11/17/2013.” The timeline record would serve as a single repository for all such “photos,” rather than each doctor or facility having their own copies. The patient or any doctor granted permission to access the record would be able to view past test results.

facebook photos“Tagging” to Involve Other Parties and Track Common Themes

On Facebook: Users can “tag” other users to indicate their involvement with the content being posted. For example, when I post a picture of myself with a friend, I can “tag” the friend in that photo. This ties the photo to both our timelines instead of just mine. It also triggers a “notification” to the friend that she’s been tagged. She can remove the tag if she doesn’t wish for the photo to be tied to her timeline.

In medical records: Providers can use tagging to alert other providers involved in a patient’s care of pertinent updates. For example, let’s say my primary care physician refers me to a specialist for some tests. When the specialists posts the tests results as “photos,” she could “tag” my primary care physician to ensure he’s notified of the test results as well.

facebook tagging“Notifications” for Test Result Alerts, Medication Alerts, or Preventive Care Reminders

On Facebook: Users are alerted by red “notification” messages when another user writes them a message, posts a picture of them or otherwise interacts with their profile. These notifications are a way to make the user aware of interactions or information involving them.

In medical records: Patients would be notified when a provider uploads “photos” of them–i.e., lab results or scans. Notifications should also be triggered when patient vitals are out of normal range at an appointment–for example, when blood pressure is low or temperature high. The medical record timeline should also notify both patients and providers when a patient is due for a preventive care visit or screening.

facebook notification“Check-Ins” to Denote Office Visits

On Facebook: Users can “check in” to places they’re currently visiting. For example, I could “check in” to the concert I’m at on a Saturday night. This would serve as both a status update and a record of my attendance of the concert. Photos can also be marked with places to record where they were taken.

In medical records: Patients literally check in when arriving for doctor appointments. When medical staff check the patient in, this would automatically generate a note on the patient’s timeline recording the date and which provider the patient is visiting. Visits to a specialist would trigger a “notification” to the primary care provider, allowing that physician to better track a patient through the continuum of care.

facebook check-in“Friendships” to Track New Provider Relationships

On Facebook: Users can create “friendships” with other users when one party electronically requests a friendship and the other party electronically accepts. These friendships are marked on the user’s timeline (“Jane Doe is now friends with John Smith”) along with the date the online friendship was created.

In medical records: “Friendships” in medical records would really be relationships with medical professionals and caregivers. For example, when a patient checks in to an appointment with a doctor he’s never visited before, the timeline would automatically note the new relationship with that doctor. All providers could be accessed via a list of providers, similar to Facebook timeline’s “friends” list. This would serve as a record of all touch-points for care.

facebook providers

“Events” to Track and Remind for Upcoming Appointments

On Facebook: Users can create online “events” to manage attendance and other details for in-person events. For example, I might create an event for the New Year’s party I plan to host, and I might invite my Facebook “friends” to that online event, where they could RSVP and receive reminders as the event date approaches.

In medical records: “Events” in a medical record would represent upcoming doctor appointments or scheduled tests or procedures. Events would be created automatically when a patient schedules an appointment, and as the time of the appointment gets closer, patients would receive online reminders about the upcoming event.

facebook eventsIt’s Time(line) for a Patient-Centric Medical Record

Dr. Rob Lamberts–a practicing physician, speaker, blogger, and health IT evangelist–tells me his biggest complaint with today’s digital record: “It’s not a patient-centered [medical record]; it’s payment-centered.” This he credits to the way the US health system has historically paid for healthcare, which is based on the volume of treatments rather than the quality of outcomes, requiring doctors to log complex medical codes into their EHRs.

Lamberts voices support for a timeline-like record, but he points out that the right incentives must be in place: “An improved record system like this would have to go hand-in-hand with a business model of medicine that benefited from it.” In other words, a business model which is patient-centric.

facebook whole timeline-medical-recordLuckily, this looks more like the direction the US health system is starting to take. Healthcare reimbursement models are slowly but surely shifting to reward physicians for better care instead of more care, and as that happens, technology providers will be incentivized to create solutions that align with that goal. Mine is to bring the magic of Facebook to medical records. But I’m open to other ideas that solve the patient-centric needs of tomorrow’s health ecosystem.
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