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.
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Hospital goes social, puts 'paper last'

Hospital goes social, puts 'paper last' | Social Media and Healthcare |

In opening its new, flagship hospital in the state capital last month, MaineGeneral Medical Center took a bit of a gamble promoting the a $312 million Alfond Center for Health on Facebook.

"Healthcare tends to lag a little bit in terms of social media," Nicole McSweeney, director of marketing and communications for MaineGeneral, said. "It really lagged here in Maine."

MaineGeneral counted down the final 100 days before the Nov. 9 opening of the Alfond Center via Facebook and through a temporary website, Posts included photo galleries, history of MaineGeneral and event listings.

Twitter, however, was not really a consideration given local trends, said McSweeney. "Twitter in Central Maine is not that widely used," she said.

The Facebook page for the new hospital has about 2,100 followers. While that's barely a blip compared to the 723,000 "likes" the Cleveland Clinichas, it still is more than twice as many than before the countdown started, according to McSweeney.

The campaign seems to have worked. An open house promoted on Facebook drew 12,000 visitors in one weekend in Augusta, a town with a population of fewer than 20,000.

When the hospital opened, MaineHealth had to transport 120 patients in a single day from the two old inpatient facilities in Augusta and Waterville, which were being consolidated into a single campus.

"A lot of people wanted to watch," McSweeney recalled. But management was concerned about violating the privacy rights of the patients being moved, so McSweeney relied on Facebook to try to keep the public away.

"We made a commitment to post hourly updates" of the move on Facebook, McSweeney said. She reported getting 11,000 page views that day, and the transfer was successful. "There were very few hiccups. Things went very smoothly," McSweeney said.

Since the opening, the Facebook page has had a profile of an executive each Sunday. McSweeney also posts updates on new services and observances of health-related events, such as World AIDS Day on Dec. 1.

The old hospital in Waterville is being remodeled into an outpatient center with a 24/7 emergency department, to be called Thayer Center for Health when it opens next fall. Expect to see updates on Facebook.

The Alfond Center for Health is modern in terms of information technology, though the IT shop is more functional than groundbreaking.

Allscripts inpatient and ambulatory EHRs were in place at the old facilities, and those transferred over, said CIO Danny Burgess. "We coupled our existing technologies with some new technologies," Burgess said.

Burgess said his top priorities for 2014 are complying with ICD-10 by the federally mandated Oct. 1 deadline and meeting Stage 2 requirements for the meaningful use EHR incentive program.

The hospital is not fully paperless, though most data capture and retrieval is electronic, according to Burgess. "It's a paper-last environment," he said.

Mark St. John, administrative director for technology services, said that MaineGeneral is consolidating much of its IT infrastructure into a 1,400-square-foot data center in the new facility, and also has built a distributed antenna system into the facility to help ensure reliable wireless coverage.

Patient-facing technology includes a real-time location system from Traverse City, Mich.-based Versus Technology, with integration of devices from a variety of other vendors.

A Responder 5 nurse call system, provided by Rauland-Borg, Mount Prospect, Ill., is integrated with the RTLS, as is Vocera wireless communications hardware, St. John said. With the help of Philips Intellispace Event Manager software, nurse calls and in-room patient monitors are tied to the Vocera "badge" that each nurse wears. When an alarm sounds, the nurse can go to the patient's room or simply make a call from the wireless communications badge, St. John said.

This setup allowed MaineGeneral to replace its pagers within the hospital, though the organization still does use the antiquated technology because its service area across mostly rural Kennebec County is sparsely populated, and wireless broadband coverage is spotty, according to St. John.

Each inpatient room has a 44-inch HDTV, and TeleHealth Services, of Raleigh, N.C., is supplying patient education services over the in-house cable system, St. John said. Clinicians can turn the screen on their in-room computers to show videos as well.

For staff, about 30 meeting rooms, including a large education center, have been outfitted with videoconferencing equipment to communicate with other MaineGeneral facilities. So far, the links have mostly been used for meetings, though St. John expects to see the organization employ the technology for medical and nursing education.

"I think it's not as widely used as it's going to be in a year," St. John said.

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7 Secrets to Share-ability Versus Invisibility on Facebook

7 Secrets to Share-ability Versus Invisibility on Facebook | Social Media and Healthcare |

The numbers are simply painful. On the face of it, you’ve got to wonder if social media—and Facebook in particular—is worth the time and effort. “Only about 1 percent of fans ever return to your actual Facebook page after they’ve liked it,” according to Contagious Content, an eBook by author Brian Carter and the software firm Marketo.

The rude fact is that most Facebook (FB) users focus mainly on their personal homepage, but even so, “no one sees every post from every friend or page they’ve liked.” By Facebook’s own data, that shakes out to an average page reaching a dismal 12 percent of its fans. (By other estimates, a FB business page is seen by only three percent of fans.)

The bottom line is that most social media marketing is invisible unless—and this is a big “unless”—your content is good enough to break through the clutter and demand attention. And simply posting to Facebook is not enough. To be effective, your message needs to engage the FB friends, and to motivate them to like, comment, and (perhaps most importantly) to share your material with others.

How to inspire share-ability…

To move from “invisibility” to “share-ability” the test is not what interests you, or for that matter, what might casually interest a Facebook fan. The test is a higher standard, and “what the post does to people.” Does this content sufficiently affect readers (emotionally touch them) in a way that they want to do even more (motivates action) and pass it on to others?

It’s not an easy task. But there are seven attributes of highly shared posts, according to some extensive research, of what works in Contagious Content. We like the way the eBook distilled thousands of posts to these essential concepts. Not every idea is suitable for every situation. But, based on this excerpt, consider how each tip could be adapted to your situation.

“Highly shareable posts do at least one of the following:

  • GIVE: Offers, discounts, deals or contests that everyone can benefit from, not just one sub-group of your friends;
  • ADVISE: Tips, especially about problems that everyone encounters; for example, how to get a job or how to beat the flu;
  • WARN: Warnings about dangers that could affect anyone;
  • AMUSE: Funny pictures and quotes, as long as they’re not offensive to any group- sometimes the humor isn’t quite as strong or edgy- it has to appeal to a general audience;
  • INSPIRE: Inspirational quotes;
  • AMAZE: Amazing pictures or facts;
  • UNITE: A post that acts as a flag to carry and a way to brag to others about your membership in a group that’s doing pretty darned good, thank you very much.”
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Who Do You Trust When it Comes to Healthcare Information

Who Do You Trust When it Comes to Healthcare Information | Social Media and Healthcare |
You've probably done a Google search for that weird spot that cropped up out of nowhere or the pain in your leg that won't go away. Self-diagnosing your ailments through website...
Zdravko Mauko's curator insight, December 17, 2013 4:41 AM

Social Medai vs. old cahnel of healthcare comunication

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Maximizing the Use of YouTube in Pharma Communications

Maximizing the Use of YouTube in Pharma Communications | Social Media and Healthcare |

How can a Pharma company utilize YouTube to its advantage, building brands, increasing awareness, and ultimately boosting sales?


The scope of YouTube is staggering. In 2008, YouTube contained over 70 million videos, published by over 200,000 creators. Every minute, 13 hours of video are uploaded to YouTube. In January 2009, 147 million U.S. Internet users watched an average of 101 videos per person on the site.

The population that uses YouTube is highly varied and skews slightly older than other social networking sites, with the average age of a video viewer being nearly 27. The uses of YouTube are also highly varied, and business marketing is prominent among them.

Numerous brands and television networks have established channels, as have most politicians and celebrities with their own unique designs and constantly updated content. Some of the most highly views clips on YouTube are branded content, but they go beyond a simple rehash of commercials on TV (“The Epic Split feat. Van Damme” is one recent example that springs to mind). It’s no secret why brands are fond of YouTube – it has the ability to connect with consumers on an emotional level through the power of story and video.

Then there are the truly unique pieces (ever wondered if you could blend your old iPod into a fine, metallic dust? This video has you covered). The important thing to remember is it doesn’t need to be anything overly complicate, the aforementioned Blendtec series was incredibly low budget (many of their videos created for $50-$100), and yet the company yielded major press and prospects.


Patients on YouTube are finding educational clips and videos from hospitals, organizations and other patients, teaching them about conditions and treatments. In some cases, patients anxious or curious about screening tests or surgeries can find footage online to show them everything they need to know.

Doctors are even offering discounts to patients willing to post this footage, recognizing the immensely powerful educational value inherent. Doctors are also seizing upon YouTube as a means to educate themselves and teach residents, fellows and other staff, as well as alleviate fear of surgery or procedures for their patients.


Several Pharmaceutical companies have also now recognized the potential of YouTube and have organized videos and channels for viewer-focused content. Examples include:

  • JNJhealth is a YouTube channel launched by Johnson & Johnson in 2008. The channel features branded advertisements and also includes informational videos along key themes such as Obesity, Diabetes, diet and nutrition, Crohn’s Disease, and more. The content is extensive and videos include personal stories, commercials and general education about the conditions. The channel has over 700 subscribers and has garnered over 52,000 views.
  • Novartis created a YouTube campaign called FluFlix in which they asked people to submit videos about what it’s like to have the Flu. They publicized the campaign with example videos, reinforcing the contest rules and the Novartis branding. Almost 800,000 people viewed the sample videos; over 12,000 people viewed the FluFlix channel with entries on YouTube. The videos continue to circulate, get comments and spread the Novartis name. Each winning entry (awarded in different categories) is displayed above a congratulatory comment that includes a link to, the Novartis Flu education site.


The examples of Pharma and other companies using YouTube to inform, educate and entertain, all the while building brands, are wonderful models for other marketers just diving in. YouTube is not a place to simply dump current commercials and straight marketing messages, as these initiatives I’ve mentioned show. Instead, it should be used as social media, as a means to start conversations, involve viewers and add value.

The first step for any company looking to create a presence on YouTube is… just as it is for any other type of marketing… planning. What do you want to focus on with YouTube? How will you create something unique, useful and even important? Who do you want to reach and what messages do you want to use? How can YouTube help you reach out in a different way than any other media? How can you inform, entertain or otherwise satisfy your customers while achieving your goals by using it?

Your YouTube strategy should start with creating a channel. Consider the channel your home base on YouTube, a landing page that can include some company info and all your videos. It acts like a Facebook or MySpace profile page, which you can customize with your business image and brand. Through the channel, you can also interact with viewers and prospects. YouTube users can subscribe to your channel, receiving instant notifications when new videos are posted. They can leave comments on your videos and on the page itself. It’s your hub for the YouTube community and your content.

What content should you create? The best branded videos come in three categories:

  • Information. Present to viewers something informational, useful and even helpful to their lives. In as creative and compelling a way as possible, show off your brand and demonstrate why viewers should care. Some companies use existing or ‘director cuts’ of commercials; some produce entirely new marketing messages for YouTube.
  • Education. These types of videos go beyond information, offering viewers education for things that are important to them. How-to videos, interviews and testimonials from patients or physicians can be immensely impressive and effective, reinforcing to prospects that you care about them above all else, and improving their brand experience. 
  • Entertainment. Think about all the content that catches your eye on a daily basis when it comes to video, and the highly entertaining (and highly viewed) examples here. Here’s where you let loose, branding in as distinctive and entertaining way as possible.

The beauty of YouTube is not only the ability for two-way communication but also two-way creation. As Novartis demonstrated with its FluFlix campaign, sometimes the most intriguing content can come from users. Inviting YouTube users to co-create content supporting the brand is a way to really engage users in a way that TV and other media rarely does.

Remember that no matter the content you do produce, it must reflect highly on the brand. The quality of your videos is one area this is apparent. Videos should be short, definitely under 3 minutes, to suit the short attention spans and browsing behavior of viewers. To create your video, the best equipment for the 320x400 pixel videos is highly cost-effective, and can be as simple as a $300 camera from Best Buy.

Movies can be mixed with programs like iMovie and FinalCutPro. Sound, however, is one area you should pay close attention to. Always use an external microphone to avoid the unintelligible mumbles that can result with built-in microphones. Finally, make sure to add audio and/or visual mention of your brand site in the video. All the viewers in the world won’t mean much if they have no direction to find you afterwards, and no call to action to do it. Include your website address and other company contact information in all content.


You have a plan, you have a channel, and you have video – but so does every other company and user on YouTube. How can you stand out among the millions using the service? By remembering that YouTube is a form of social media, and revisiting our principles of effective social media interaction.


YouTube has a community, just like the other social media and networking tools we’ve discussed. Grow your presence on YouTube by exploring and commenting on other videos, joining existing topic-oriented groups, and paying close attention to other entries in your niche area.


YouTube emails and bulletins are built-in tools that allow you to point out your channel to other users with similar tastes and interests. Emails can be used judiciously to share links with others who have expressed interest in your therapeutic area. Bulletins are quick comments you can leave on other users’ pages, piquing their interest enough for them to come and check your channel out.

Optimize your Video

Use a title that clearly describes the content and includes keywords. Include a description that is as complete as possible. You have the option to include keyword tags with the video. Choose words that are relevant and that may be searched on. Don’t be shy about adding more keywords rather than less as they will only help in search results. Finally, YouTube will automatically create three freeze frame pictures from your video as a thumbnail, so choose the image that represents your content most accurately.

Stay Active

Even if you don’t have new videos to post, log in regularly to your channel page. You can even leave comments or bulletins to keep in touch with subscribers and viewers. When you log in, be sure to check out any new viewers, especially those that have commented. Just like on blogs, be sure to reply to comments and also return the favor on commenter’s own pages.

Seek Subscribers and Viewers

You want as many eyes as you possibly can get. Ultimately, the more subscribers you have, the greater network you have access to. Make your channel as sticky as possible, an engaging place with good content that viewers will want to see again.


The informative and educational potential for YouTube and companies is huge. That’s why many companies are using YouTube as a means to train teams and connect without expensive transportation. YouTube videos can work wonderfully as a format for training videos, educating staff on administrative tasks and techniques, sales methods, therapeutic areas, and much more. At the same time, YouTube can serve as a place for executives to speak to their companies, providing regular presentations to department groups, or the entire workforce, to discuss financial performance, share information and talk about other critical news. Finally, YouTube can be a great place to post highlights of annual events, anniversary parties and other gatherings.

For all YouTube videos, you have the option to mark videos as ‘private’. For corporate projects such as these, the private setting is ideal, allowing only the people you specify in a contact list to see it. YouTube then offers multiple ways to share the video with contact lists or once-off emails.

Video on YouTube can provide the spark for a truly unique eMarketing campaign, and can mesh well with blogs, social networks and Twitter.

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Jean Christophe BENEYTOUT's curator insight, December 19, 2013 12:37 PM

the power of you tube for pharma

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Social media scanner App warns when sick people are nearby

Social media scanner App warns when sick people are nearby | Social Media and Healthcare |

Trying to avoid all those hacking, sneezing cold and flu sufferers who are likely to pass on their ailment on to you?

Now you don’t have to wait until you’re within sneezing distance.

There’s an app that alerts you to sick zones before you even head out the door.

A kind of a sickness scanner, Sickweather is an iPhone app that gathers and analyses all mentions of ill health on social media and plots them on a map.

So if a sniffler comes near you, you’ll know it.

I uploaded Sickweather today figuring I’d plot my day to avoid high fever zones. I ticked off colds and flu as the illnesses I wanted to be warned of.

A respiratory map popped up to report that a common cold and the flu were reported near Granville Street and West King Edward Street in Vancouver.

That was all. No either Vancouverites are either enjoying the healthiest December on record or everyone isn’t sharing the geo-located ailments on social media.

For the app to work, social media posts must have geolocation activated on their devices and people have to mention their illness.

Thinking there must be more sick people nearby, I turned on all 23 symptoms and illnesses tracked by Sickweather, starting with allergies, all the way through to man flu and whopping cough.

Look out for the chicken pox near Oak Street and the allergies that were clearly waking someone up nearby at 5 a.m. the other day.

A search on stomach virus and Norovirus gave me another street to steer clear of.

The Vancouver Sun newsroom didn’t show up on the Sickweather map although I could swear I heard a couple of sneezes and sniffles there. Clearly no one complaining about it online though.

The app leverages data from social media, using that in conjunction with the Apple iOS ability to geofence and analyses it to weed out irrelevant mentions, such as ‘my kid has Bieber fever.’

As your travel around your neighbourhood or city, you’ll get alerts on your iPhone if you’re close to an area where there are reports of any of the illnesses in Sickweather’s watch list.

“What users do at that point is up to them,” says Graham Dodge, CEO & co-founder of Sickweather said in a release. “It could prompt you to wash your hands, get a vaccine, buy medication, or take other preventive measures to boost your immune system, but ultimately we believe that the net effect of this new, real-time awareness will help reduce the spread of illness and reduce healthcare costs.”

Sickweather, which first launched its web site in beta just over two years ago, covers more than 600,000 reports of illness every month

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The Power of Social Media is Shaping the Future of Health Care

The Power of Social Media is Shaping the Future of Health Care | Social Media and Healthcare |

An example of the power of digital partnership with patients can be found with those who have suffered from spontaneous coronary artery dissection (SCAD). SCAD (featured in our 2011 Social Media Summit) is a rare disease in which the lining of a heart artery suddenly tears. As the tear spreads, it can impact blood flow, causing a heart attack, which can result in sudden death or the pump becoming weaker, yielding heart failure. Victims are often young women, many of child-bearing age, without any of the typical risk factors for heart disease.

Until recently, the published studies to guide care and to inform patients of this rare disease were limited to brief case descriptions, leaving patients and their physicians with more questions than answers. While geography isolated these women, they persevered and found community and peer support online.

One peer-to-peer support group, hosted on by WomenHeart, had significant online traffic. Very quickly, this collection of empowered, engaged and electronically adept women realized that they had formed a larger group of patients than had been scientifically studied previously. They understood that their social network had the capacity to be a rich resource for understanding their disease.  All they lacked was a physician scientist to study them. At a WomenHeart-sponsored symposium at Mayo Clinic, two group members sought help from a Mayo Clinic cardiologist, inviting her to serve as the scientist for a research project made possible by their social network efforts.

That cardiologist, Sharonne Hayes, M.D, began a 12-patient pilot study to assess whether a medical disease could be studied via a virtual registry. Within one week of starting the pilot (and patient-advocate recruitment through the Womenheart group), study subjects were identified from New Zealand, Canada, the United Kingdom, and the United States, none of whom traveled to Rochester, Minnesota.  After successful pilot completion, Dr. Hayes created a 200-person virtual registry. Thanks to the continued efforts of this stellar peer-to-peer patient group, and their pioneering use of social media (i.e., Twitter, Facebook, etc.) for study growth, the virtual SCAD registry at the Mayo Clinic is now on track to recruit 200 study subject — the majority of whom have not traveled to Rochester, Minnesota — for what will be the largest registry of this rare and devastating disease.

Fortunately, the Mayo Clinic Center for Social Media had established the structure and support from leadership (see Mayo Clinic CEO, Dr. John Noseworthy’s, presentation two years ago at our Social Media Summit) that recognized the potential for social-networking as a tool for patient engagement by employees, and the social media training and guidelines that encouraged physicians to partner with their patients online. So we were prepared to offer support to Dr. Hayes as she ventured into this promising new field of research.

All too often, health care providers view health care social media as a risk more than an opportunity, which can lead to risk-averse avoidance of online engagement. But not participating with our patients online ignores two facts:

  1. Social media has grown explosively, with social network participation accounting for nearly one-fifth of all time spent online.
  2. When online, our patients are increasingly seeking health care information, which is now the third most common online activity.

These facts highlight the reality that health care and social media are already “living together.” In marrying the two we can help legitimize the relationship for the good of our patients and society.

As health care providers, we must walk with our patients as they journey from health to illness, and from illness to recovery. In Medicine, morality and health care social media, published in BMC Medicine, I discuss further how social networks allow us to share content and join conversations that reach beyond the confines of time and space.

We must be present in those conversations. This is the future of health care.

If you would like learn more about social media transforming the patient experience, please follow me onTwitter or view some of my recent presentations, and consider joining with us in the Social Media Health Network.

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What Physicians Say About Patient’s Internet Research

What Physicians Say About Patient’s Internet Research | Social Media and Healthcare |

Last month we published results of a survey about how patients discuss Internet health information with their doctors. Here are the results of a survey of  doctors on LinkedIn and Twitter conducted in October that included 17 doctors.

Despite the small number of Internet-savvy participants, this material is a window into the thoughts of physicians who experience patients sharing health information from the Internet.

A Range of Responses

Prior to creating the survey, I emailed a few physicians to get their take on Internet health information sharing.  Here is a clue to the range of responses patients might receive. For example, one physician stated:

“Folks bring stuff from the Internet but I never look at it. It is primarily folks who are coming in to discuss options for prostate cancer treatment.”

Yet another physician is interested in learning more about where patients find information:

“I get some patients printing off information from certain websites.  Most of the time it’s reliable like National Cancer Institute or Mayo Clinic, but sometimes it’s definitely more likely a Google search result.  I have started including in consultations a health information review… to assess where they may be going online.”


Back in 2009, Trisha Torrey wrote a post for on the Do’s and Don’ts of sharing health information from the Internet with your physician.  The post included criticisms physicians have with patients’ Internet health research.  The complaints included the reliability of Internet information and its timeliness, the lack of time during appointments, and cyberchondria, a phrase created in the 1990s to describe when people with little or no medical training misdiagnose themselves from information they have gathered online.

Survey Results

There are some similarities in the doubts and the recommendations in Torrey’s post and that of the survey physicians.  Yet some change has occurred in the last 4 years. For example, survey physicians are used to patients discussing information from the Internet—all (100%) of physicians have had this happen and their patients are very likely to share by bringing in printouts of their Internet searches (76%).

Positive Feelings Toward Patient Internet Health Information Research

These physicians (82%) disagreed or strongly disagreed with the statement that it was irritating to have patients bringing the results of Internet searches to an office visit.  In fact, the 13 comments were favorable toward patients who are interested in educating themselves, but with some concerns over the sources their patients present.  Seven of the comments were completely favorable to patient research and sharing.

 “I enjoy helping them vet sources together, plus I usually learn something new.”

“I appreciate having informed patients.  It shows that they care about their health and it provides me with a teaching opportunity.”

“Informed patients are good.”

“I expect people to research their symptoms or disease.”

“The majority of patients are using “Dr. Google.”   To be irritated is to be naïve.  It is most helpful to know what my patients are finding out there so that we can address those concerns.  Plus not being infallible or all knowing, their research may be something helpful to them and for me to learn.”

“It’s great to know what patients are worried about.  I see our role as being a bit like a travel guide.  Sometimes we make recommendations about sites to visit.  It’s good to see what information patients are accessing themselves.”

“It is useful to know what concerns patients.”

Worries About Information Sources

There were worries about the health information on the Internet.

 “I appreciate patients being proactive and wanting to educate themselves.  But it depends on what they do with the info.  Occasionally it can be difficult if they are set on a decision based on misinformation, but that’s rare.”

“It is my job to educate the patient and it is the patient’s job to be as well informed as possible.   Most of the time their knowledge helps me educate them, but occasionally folks bring in info about nonstandard options that I will generally have to shoot down.”

“It is not irritating but the articles are inaccurate and sensationalist.”

Only one physician mentioned “time limitations” in his answer.  And two neutral statements were made:

 “They are free to check other sources of information.”

“It can go either way.  It can open areas of discussion that might not have come up otherwise.  On the other hand the Internet is not infallible.”

Helpful to Office Visits?

Doctors are split about the whether “it’s helpful to have patients bring information from the Internet to office visits”: Forty-one percent (41%) of physicians agreed or strongly agreed with the statement while 30% disagreed or strongly disagreed with the statement. The rest (29%) are neutral.

Eighteen percent (18%) of physicians suggested that the patient provide this information ahead of their appointment, especially if it is lengthy.

 “I like it when patients alert me to interesting articles on social media or email articles to my office ahead of their visit so I have time to review ahead of the office visit.”

“Send it in advance of appt so I can review.”

However, a quarter of the physicians preferred the patient to bring the information to the appointment in person.  Here’s what one physician said.

 “To print out the material and bring it with them to the visit; or if it’s lengthy to email it to me first.

Don’t Judge Me

It is important to remember that physicians have gone through significant training and experience.  Choosing to question them based on searches on the Internet, especially judging them without sharing that research, can be insulting.

 “Just tell me up front what they have found out.  I don’t like it when they keep it to themselves and then judge my comments based on their ‘knowledge.’”

The Need For Respect

If both parties are polite and respectful to each other, bringing health information from the Internet to your doctor appointments can is an opportunity for a positive interaction.

A few physicians offered these ideas to patients interested in sharing Internet health information.

 ‘They should begin by determining where on the spectrum their doctor is with Internet searches.  This will at least give the patient a clue about what kind of reception they may receive.  Then they can start diplomatically with “I found this information [name the source] web site.  What do you think about it?”

“Write down your questions.  Decide what extra bits of information you would like to know in order to make an informed decision.  Ask the clinician what sites they can recommend.”

So What’s The Take-Away?

For at least these physicians, Internet health information is being brought to patient appointments and received in a relatively positive way. To increase the respect and cordiality of physician-patient relationships, responses of physicians in this survey agree with Torrey’s recommendations. These include sharing recent information and sharing from “credible” sites.

Three of the surveyed physicians reiterated the importance of “reliable,” “vetted websites,” “forums with confidentiality HIPAA compliant” and sites that provide “well-written non-anecdotal unbiased pieces.”

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Radiologists and Social Media - a "Scan"

New analysis presented at the annual meeting of the California Radiological Society on September 22, 2013 (#CalRad13).
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Physicians discuss their fears associated with the impact of social media

Physicians discuss their fears associated with the impact of social media | Social Media and Healthcare |

In a recent article by David Shaywitz, he describes 4 reasons why physicians are concerned about the increase in popularity of social media and online search. The information used in the article was gathered from a group of physicians attending a breakout session during a medical conference.

After reading these concerns it occurred to me, that there is a significant gap (lack of understanding) on the part of the medical community surrounding the incredible BENEFITS associated with online search and social media. Which is typically the basis for unfounded fear…

The following 4 central themes emerged:

Concern #1 Patients Receiving “Bad” Information
“Many physicians described the challenges of dealing with patients who had retrieved wrong or incomplete information from the internet. This turns out to be a remarkably common problem; doctors reported spending a lot of time undoing bad information.”
Solution: Evaluate. Embrace. Engage.
Become part of the discussion. Create a viable online presence with up to date accurate information. Encourage patients to visit your Virtual Medical Community for important information related to their diagnosis.

Concern #2 Patients Transmitting “Bad” Information
“Many doctors in the audience were also visibly troubled by the ease with which patients could share “misleading” information, whether about medicine or the doctors themselves.”
Solution: Evaluate. Embrace. Engage.
Control your online reputation. Encourage patients to share their positive experiences online. Contact those patients who were frustrated and try to make it right. See if you can get the post removed. Avoid a victim mentality.

Concern #3 Physicians Receiving Information Badly
“While some senior physicians worried that young doctors might start to rely on tweets rather than peer-reviewed articles, it seemed that the most significant concern raised was the impact that the “internet culture” was having on the practice of medicine.”
Solution: Evaluate. Embrace. Engage.

Concern #4 Physicians Transmitting Information Badly
“The ability afforded by social media to share information rapidly and broadly was another source of concern. Many senior physicians worried young doctors might use social media in unprofessional ways – sharing things they shouldn’t, saying things they shouldn’t – potentially placing themselves and their institutions at risk.”

Solution: Get over it. This is not to trivialize the concern but to put it in a more realistic light. Every “industry” is going through this. Small groups of doctors, lawyers, entrepreneurs, stock brokers etc. have been making bad choices since the dawn of humanity. There is no way to stop it. We must all focus on the things we can control.

What we can do is EMBRACE the fact that online search and social media are powerful mediums and they are here to stay. So the real multi-billion dollar question is what do we do about it.?

According to David Shaywitz:

“I reject the view that the internet and social media are somehow degrading the culture of medicine, or causing it to change for the worse. Instead, I see emerging modalities as offering the profession an urgently needed chance to radically update its approach, and interact with patients, data, and each other in important new ways. Care can evolve from episodic to continuous, and physicians, increasingly accountable, will appreciate the opportunity to partner with patients who are informed, empowered, and engaged.
Rather than isolating doctors, the new technology promises to be fundamentally enabling, allowing doctors to redefine and strengthen their relationships — with patients and with colleagues. The result: a new sense of connection and meaning.”

Medicine could be fun again.”

I am not a Doctor. But that sounds like great advice to me. To learn how your practice can capitalize on the shifting behavior of the social patient contact….

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Should Physicians Blog?

Should Physicians Blog? | Social Media and Healthcare |

It used to be that aside from the tiny percentage of celebrity physicians featured in magazines or on TV, the only way to get a doctor’s opinion was to be in his or her office. Today, on the other hand, you can instantly get tens of thousands of doctors’ opinions on just about anything, thanks to the fact that physicians—like everyone else—have increasingly come to embrace social media. Be it blogs, Facebook, Twitter, email or text messaging, doctors are online, eager to provide medical advice and otherwise opine on an endless array of topics.


In many cases, physicians are participating in the social-media presence established by their hospitals or academic institutions, while others are reaching out on their own. Either way, getting out there via social media is a way for physicians to promote recognition and credibility, bring in new patients, and influence the practice of medicine. As one physician put it in a New York Times blog post, “Doctors need to be on social media because ‘that’s where the patients are going to be.’” (She was herself quoting another blogging physician.)


But is this massive physician presence on social media actually good for patients? Needless to say, there are pros and cons:



  • ŸPatients have more opportunities to get qualified medical advice on issues of concern to them. Access to trusted information from a doctor can be especially important these days, given how many unqualified opinions about health issues are presented in unregulated online forums.
  • ŸWhen a pressing health issue comes up, consumers can find out immediately what doctors have to say about it. No matter how obscure a condition, physicians have weighed in on it online—and that can be a real anxiety reliever in a crisis.
  • There are opportunities to seek tailored advice. Many physicians take questions on websites, blogs and on their Facebook pages, or interact via Twitter. Some new cellphone-based services are specifically designed to let physicians dispense advice to individuals via messages or chat.
  • The online world provides physicians with opportunities to inform patients on a wider range of issues than what might normally be discussed in a visit to the office, providing helpful background and perspective to medical issues. As Baylor College’s Bryan Vartabedian, a blogging physician who specializes in exploring the role of social media in medicine, puts it in a post expanding on this point:

The capacity to be public really amplifies the fact that we all have passions, missions and roles in the world. Being front and center with a footprint and identity forces us to think about where we fit in the world. It was easy to be elusive when the world was private and our existence was restricted to an exam room. But now we’re part of a wide-open, networked world. This capacity to share and create exposes us for who we are and what we believe in. Being here is an act of intimacy.



  • ŸThe online world often highlights to an easily misled public the advice of doctors who take controversial stands with which most doctors would disagree. That can lead to unfounded health scares, for example, or the neglect of potential effective treatments in favor of less-proven treatments.
  • The ready availability of online advice might lead people to be less motivated to get the one-on-one time they need with their doctors.
  • As more doctors come to feel that maintaining an online presence is necessary to staying competitive in the field, they may have to take time away from their already overly packed schedules and practices to do it.
  • Most online pronouncements are not fact-checked or filtered in any way, and there is no way for consumers to validate the physician’s credentials or qualifications to provide the advice. Given a new online pulpit, some physicians may not be able to resist expounding on subjects that go beyond their expertise. Most laypeople don’t have any way of knowing the limit of a physician’s expertise, and may be too trusting.

Overall, I’m a big believer that technology, including and perhaps especially the online world, is in a position to do wonders for the cost, quality and accessibility of health care. That’s especially true in regions of the world, and even communities in the U.S., where high-quality health care hasn’t been widely available.


But technology needs to be applied judiciously, and physician online activity is no exception. It’s an ongoing experiment, and while I hope physicians keep at it, I also hope they’re responsible about reminding people of the limitations of online advice. Hopefully in the future there’ll be mechanisms for keeping the quality of the advice high, and for making sure it’s presented with the appropriate qualifications.

In the meantime, keep in mind that even when the online advice comes from a doctor, it’s a good idea to validate it with a second (or third) source.

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Social Media Networks, Social Intelligence and Medicine, Part 1

Social Media Networks, Social Intelligence and Medicine, Part 1 | Social Media and Healthcare |

Social Media Networking is changing the face of medicine.  With patients wanting to take charge of their medical care, social media networking ,and the social intelligence from it, give them the perfect place to learn from each other about conditions, medications and doctors.

Similarly, the medical profession is using social media to learn more about patients and their conditions. Here is a quick review of just a few of the things going on in this space. is a site where patients can share health information. Their hope is they can make discoveries about difficult conditions and medications for treating them that allude normal clinical research. They work with Pharma to do surveys and review the data for insights. curates medical social media resources through crowdsourcing with medical professionals and e-patients in over 140 topics and 20 languages for free. This give the medical community a quick place to find what’s being talked about.

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Social media marketing for Ambulatory Surgical Centers

Social media marketing for Ambulatory Surgical Centers | Social Media and Healthcare |

Many ambulatory surgical centers (ASCs) across the nation have turned to the Internet for their marketing efforts.

Many ambulatory surgical centers (ASCs) across the nation have turned to the Internet for their marketing efforts. Some use social media in an effort to draw in patients, as a high volume of cases is crucial for healthy revenue cycle management. Most ASCs do market on some level, but many may be missing out on the possibilities the Internet affords, especially social media. Social media advertising isn't cost-intensive, and it can reach many viewers. Here are some ways to leverage a Facebook profile or a Twitter feed to draw in patients to an ASC:

Post links patients will find interesting
Many ASCs that maintain a social media presence make a point of finding and posting articles their patients are likely to find interesting. Centers that concentrate on sports medicine should post articles about that particular branch of medicine and about wellness and other sports subjects, for example. Those that work with pain management might want to curate a continuous list of good resources on how to manage pain and where it comes from. It's often quite difficult for patients to find reliable information online about their medical conditions, so ASC social media feeds that can help them do so will be perceived as very useful to them.

Of course, it's also a good idea to post less serious articles as well. Posts about lifestyle news or healthy recipes may be well received, as might the occasional stress-relieving picture of scenic vistas or animals. Anything patients can use or enjoy is likely to be something they'll want to share with friends of theirs on social media, which can lead to more traffic to an ASC's own page.

Post information about your achievements
ASCs that receive accolades, do good work in the community or both should publicize these things on their social media pages. It's the best way to get information out to patients in the digital age, far surpassing press releases or direct mail campaigns. Patients and prospects can't get excited about an ASC's high quality of care or commitment to social good if they don't know about it, after all.

If physicians at an ASC have achievements like awards, publications or their own medical blogs on the side, the social media page of an ASC is a great place to post them, with permission of course. These can help patients get a feel for who they would see at the center if they decided to schedule a procedure, and humanizing doctors can help take some of the fear and trepidation out of scheduling an operation or consultation.

All of these strategies have the potential to increase new-patient volume at an ASC. In turn, this high volume ensures a steady stream of revenue for the ASC. With the help of a revenue cycle management firm, ASC professionals don't have to concern themselves with trying to get the best reimbursement rates or busying themselves with the business of collections. Their partner firm can handle these aspects instead, leaving ASC administrators to focus on attracting more patients and giving them an experience of the best quality possible.

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Optimizing the Design of Online Randomized Controlled Trials (The Sexunzipped Trial)

Optimizing the Design of Online Randomized Controlled Trials (The Sexunzipped Trial) | Social Media and Healthcare |

Sexually transmitted infection (STI), unwanted pregnancy, and abuse within relationships are public health problems that have a high impact on young people . There are high social and economic costs, making it important to identify cost-effective interventions.

Digital media interventions for sexual health have great potential because of the reach and popularity of technology such as the Internet and mobile phones, especially with young people . Such interventions offer advantages over face-to-face interventions since they can be accessed privately and at users’ convenience and programs can be tailored to meet users’ needs.

The “Sexunzipped” website is an interactive, theory-based website that aims to give young people the tools to make informed decisions about their sexual well-being . We conducted a randomized controlled trial to inform the feasibility of a future definitive online randomized controlled trial to evaluate the Sexunzipped website and to contribute to knowledge about the optimal design of online trials including the best ways to measure sexual health outcomes online .

Background: Sexual health problems such as unwanted pregnancy and sexually transmitted infection are important public health concerns and there is huge potential for health promotion using digital interventions. Evaluations of digital interventions are increasingly conducted online. Trial administration and data collection online offers many advantages, but concerns remain over fraudulent registration to obtain compensation, the quality of self-reported data, and high attrition.

Objective: This study addresses the feasibility of several dimensions of online trial design—recruitment, online consent, participant identity verification, randomization and concealment of allocation, online data collection, data quality, and retention at 3-month follow-up.

Methods: Young people aged 16 to 20 years and resident in the United Kingdom were recruited to the “Sexunzipped” online trial between November 2010 and March 2011 (n=2036). Participants filled in baseline demographic and sexual health questionnaires online and were randomized to the Sexunzipped interactive intervention website or to an information-only control website. Participants were also randomly allocated to a postal request (or no request) for a urine sample for genital chlamydia testing and receipt of a lower (£10/US$16) or higher (£20/US$32) value shopping voucher compensation for 3-month outcome data.

Results: The majority of the 2006 valid participants (90.98%, 1825/2006) were aged between 18 and 20 years at enrolment, from all four countries in the United Kingdom. Most were white (89.98%, 1805/2006), most were in school or training (77.48%, 1545/1994), and 62.81% (1260/2006) of the sample were female. In total, 3.88% (79/2036) of registrations appeared to be invalid and another 4.00% (81/2006) of participants gave inconsistent responses within the questionnaire. The higher value compensation (£20/US$32) increased response rates by 6-10%, boosting retention at 3 months to 77.2% (166/215) for submission of online self-reported sexual health outcomes and 47.4% (118/249) for return of chlamydia urine samples by post.

Conclusions: It was quick and efficient to recruit young people to this online trial. Our procedures for obtaining online consent, verifying participant identity, automated randomization, and concealment of allocation worked well. The optimal response rate for the online sexual health outcome measurement was comparable to face-to-face trials. Multiple methods of participant contact, requesting online data only, and higher value compensation increased trial retention at 3-month follow-up.


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Doctors Prefer Digital Media to In-Person Sales Reps

A new joint study from Capgemini Consulting and Quantia indicates that pharmaceutical companies’ shrinking access to physicians through traditional sales representatives is putting their in-office engagement strategy in flux. The study was comprised of nearly 3,000 primary care physicians and specialists from the QuantiaMD U.S. community.

According to the findings, 67 percent of physicians now rate digital media as their preferred source for accessing information, compared to just 20 percent who prefer pharmaceutical representatives. Capgemini Consulting and Quantia executives claim that this shift is motivating pharma companies to place more emphasis on their digital strategies to maintain their role as a trusted information resource. 

Dan Malloy, senior VP, Quantia told Med Ad News Daily, “We conducted the study to understand how physicians want to receive information from the pharma industry and to understand the implications for their current and future business model.”

The study analyzed how physicians currently interact with pharmaceutical companies and what role pharma sales representatives are projected to play in the future. The study’s findings show that many physicians (40 percent) believe digital media offers the more relevant and personalized content they seek. As a result, 52 percent of physicians believe the role of the sales representative needs to evolve into a coordinator or director of multi-channel information sources to stay on their radar.

“We work with the top 10 pharma companies and they are all looking for innovative ways to sustain their relationships with physicians,” Malloy says. “Given physician’s preference for digital content, it is increasingly being used to meet this objective.”

Pharma companies now have more of a chance to increase their impact on physicians’ decision making by bolstering their digital engagement and leveraging their sales force as part of a robust integrated multi-channel strategy than in the past. The study finds that companies can be successful in these efforts if they can incorporate sales representative feedback with cross-channel data analytics to tailor the appropriate mix of channels and content to each individual physician. Physicians are amenable to utilizing the new digital services that pharmaceutical companies can provide to access information. For example, 85 percent said they would consider using a virtual service to access sales representatives, including outside of standard working hours.

In addition, 73percent of physicians said the primary factor for their utilizing a digital channel was due to its ease-of-use and their own limited time and availability. Only 14 percent of physicians are letting more than one pharmaceutical representative come through their office doors every day, making the face-to-face meeting that much more scarce and at the same time, that much more valuable.

We are seeing a growing trend towards utilizing digital methods of communication,” said Hala Qanadilo, Principal, Life Sciences, Capgemini Consulting.  “Increasing usage of a digital communication strategy can help pharmaceutical representatives increase engagement with the physicians they want to reachWhile the more traditional face-to-face, in-office visits might decrease, the role of these representatives is projected to be as important as ever. Moving forward, they will need them to be the directors of multiple information sources, customizing their outreach so it is more personalized and physician-centric.”

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Use of Social Media in Public Health teaching: 5 reasons why and some words of caution.

Use of Social Media in Public Health teaching: 5 reasons why and some words of caution. | Social Media and Healthcare |

The use of social media has increased dramatically over the last decade.  Sites such as Facebook, Twitter, and LinkedIn have allowed the rapid communication of ideas and news around the world at fast speeds.  Recent estimates suggest that over 90% of young adults have some type of online presence, weather it is in the form of a Facebook page, and/or Twitter or LinkedIn account.  Moreover, it is estimated that over 80% of 25-34 year olds browse the World Wide Web regularly, with 50% of these accessing the Web from a mobile device.  This presents a great opportunity for educators, especially in the Public Health arena, to interact and engage students in a field that is rapidly changing and depends on timely information to make decisions, which may have a potential effect in the population as a whole.

The “theory of student involvement” (1) promotes the interaction of students’ with peers and faculty alike, in order to have the most positive academic experience while pursuing a college degree.  Hence, considering our students are changing the way they connect with each other and the “world”, we as Public Health educators, should consider utilizing some of these technologies to further engage our students and allow them to have “some control” about the information they learn and share, of course, without sacrificing the core pillars of any academic program.

Over the last year, I have become involved in the utilization of social media in the classroom, and consider there are five important components why it can be useful in any Public Health classroom:


1.      Breaking news in Public Health

Considering the importance of “time” in the management of any disease, utilizing social media to follow leading institutions such as the National Health Service in the UK, or the Center for Disease Control in the US, will keep students informed of ‘news’, which can later serve as a topic of discussion in classroom, or ‘online’, as a student can pose questions and receive immediate feedback from instructor, peers, or even the leading authorities in those organizations.  Thus, social media can be used as a way to disseminate content and course specific information.


2.      Theme specific live-chats

In an environment where allocation of traveling resources may be scarce, social media presents an opportunity for all students to virtually travel to any part of the world, while seating at their desks.  The biggest “hurdle”, if any, is to follow the right organizations.  Today, search algorithms make it easy to utilize these sites and learn more about any topic.


3.      Develop an community outside the classroom

The utilization of social media can create an “outside the classroom environment”, in which students remain engaged in a topic before, during or even after the class has ended.  Moreover, some students may be more comfortable sharing their opinions in a Social Media platform than in the classroom; hence, encouraging all students to participate in the dialogue.


4.      Interact with world-renown Public Health practitioners

Aside from meeting world-renowned practitioners at international conferences around the world, which could be very expensive for faculty and almost impossible for students, social media presents an opportunity to reach out to professionals around the world and interact with them in a “live” environment, which could enhance participation and involvement by students in any course.


5.      Meet other students/professionals in the field

Although meeting world-renown practitioners is exciting, reaching out to other professionals, or other students in the field enhances the collaborative nature of public health and encourages learning from others in the field.  Additionally, these interactions can create possibilities for internships, additional graduate and post-graduation work, and even potential jobs.


Although Social Media can be a great tool for the classroom, there are a couple of issues that need to be address for a productive implementation:


1.      Equipment needs

Unfortunately, even though students around the world commonly use Social Media often, it may be difficult for some students to actively engage in class discussions, etc., due to a lack of a mobile device.  Some may only have laptops, or even desktops, which limit the utilization of this technology.  Thus, instructors should be aware of this limitation when “requiring” its use in the Public Health classroom.


2.      Privacy

Although Internet privacy is a big issue these days, it should made clear to ALL students that professional and personal accounts should not be combined.  As young professionals, they each need to work on their “online presence” and the last thing they want to do is to meet a world-renowned epidemiologist who knows what they did Saturday night!  I believe here is where instructors need to pay more attention and have strict guidelines for proper utilization.


As social media continues to gain popularity among our society, public health instructors should consider utilizing these technologies to promote student engagement both in and outside the classroom.  These technologies could maximizing those “teachable moments” in public health, which usually occur outside of the classroom when students are going about their day and see/do something that reminds them of what they discussed in class the week before!  Personally, I think we should stop trying to analyze how and why students are currently using social media; instead, we should focus how WE want them to use it in our classrooms, so that they can become better practitioners and public health professionals.

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Is Twitter Serving up Your Target Market?

Is Twitter Serving up Your Target Market? | Social Media and Healthcare |

Social media is quickly becoming the go-to for all types of brands and businesses—including doctors, dentists and whole practices. A recent article written by Belle Beth Cooper for Bufferpoints out a number of statistics that doctors using social media might find useful.

Surprisingly, the fastest growing demographic using Twitter is the 55-64 year old age group, and the fastest growing age demographic using Facebook and Google + are the 45-54 year old age bracket. This demographic is the target audience for a number of physicians and practices.

With Twitter as the top network focused on that demographic here are some useful tidbits of information to keep in mind when tweeting to your followers.

  • Keep it Short and Interesting: Tweets with images attached get more engagement than those without. Interestingly, tweets that are less than 100 characters also have a higher engagement rate than those over 100 characters. This statistic proved true for Facebook as well.
  • Hash it Out: Tweets with hashtags garner a higher percentage of engagement. Sending a Tweet out about #IBS could connect you and your practice to a niche group interested in that particular subject.
  • Think Links: Twitter users are 86% more likely to retweet a post that contains a link in it. A retweet from a current user will certainly help to further your reach. Adding a link to your practice’s site or third party information will position you as an authority as well as help to increase your engagement.
Marianne Lalonde's curator insight, December 16, 2013 8:37 PM

The fastest growing demographic using Twitter is the 55-64 year old age group, and the fastest growing age demographic using Facebook and Google + are the 45-54 year old age bracket.

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A Facebook Experiment: Can You Recommend a Physician?

A Facebook Experiment: Can You Recommend a Physician? | Social Media and Healthcare |

Recently we’ve been talking to a local medical group about its marketing. When my team presented its recommendations, they included digital strategies (pay-per-click was a big component), additional video content for various platforms, and social media marketing, among others. Unfortunately, the powers that be within this group do not believe that social media is an important component of an overall marketing program for a medical practice. “No one uses Facebook to find a physician.” They had similar feedback related to LinkedIn and Twitter.

With that in mind, I decided to conduct a quick test using my Facebook account. I use Facebook primarily to connect with business friends and colleagues around the country. I don’t have many contacts/Facebook Friends who actually live in my community. So, when I posted my request for recommendations for an orthopedic practice in the Raleigh-Durham area of North Carolina, I wasn’t sure what I’d get. You can see my post below.

Below is a csreen shot of the exchange that ensued (it is still going on). As you’ll see, within 2 hours I had recommendations for three different orthopedic practices in the area (Duke, UNC Sports Medicine and Triangle Orthopedics), along with recommendations for Bikram Hot Yoga and Vodka. Two suggested I consider alternative options: one suggested neuromuscular massage while another recommended seeing a physiatrist. (Physiatrists, or rehabilitation physicians, are nerve, muscle, and bone experts who treat injuries or illnesses that affect how you move.) Later I received a second recommendation for Triangle Orthopedics. Remember, the people making these recommendations are old friends – people I trust. For me, there is power in these recommendations. Note: I’ve blacked out names of individuals in consideration of their privacy.

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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.3This 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.4Data 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.12According 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 cholera during 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.16The 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.19 Nevertheless, 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.”29 Similarly, 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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Tools for Managing Your Practice’s Reputation

Tools for Managing Your Practice’s Reputation | Social Media and Healthcare |

Social media is fast becoming a fact of modern life. More and more searches are performed on Facebook, Google maps are used instead of the phone book, and prospective customers look at social media review sites before they decide to patronize a business.

What does this have to do with your medical practice? Whether they like it or not, physicians are getting ‘reviewed’ by their patients and they have little control about what is being said about them. A local eye doctor has only a dozen reviews on Google, but they are all horrible – not a single positive review is to be found. Now, he isn’t so bad, but a potential new patient would think otherwise, and keep looking for another provider.

What could a doctor in this situation do? It’s a widely held maxim that a satisfied customer tells a friend but a dissatisfied one tells 10 friends. There are probably many more websites disparaging LASIK than there are sites extolling its benefits. Clearly, in the case of social media, it’s better to be proactive than reactive.

1. Reputation monitoring services

These include such products as for Business and eMerit from These use proprietary algorithms which increase the popularity of favorable listings about your practice on search engines and review sites and push unfavorable comments down and away from visitor’s eyes. The idea is that most people rarely read  beyond the first page of listings and hopefully only see favorable comments.

2. Provide better customer service

The days of having a terrible bedside manner while relying solely on one’s clinical skills are becoming a distant memory. Patients have become our customers just as they are customers of any other industry. And they can take their business elsewhere. Ask a practice management consultant to observe all aspects of your practice’s interaction with patients, including phone calls. Or hire secret ‘shoppers’ to call your practice, to schedule an appointment, and go through the entire practice experience – and then give you frank feedback.

3. Have a patient advocate

We all have had patients who have insisted that the practice dropped the ball when perhaps there was just a miscommunication. And doctors are often too busy to handle the problem with patience. Sometimes it’s better to have the practice administrator or a clinical coordinator be the patient’s advocate and calmly try to right the wrong. We have had new patients tell us they heard about us on a social forum in their local retirement community, where we made a mistake but corrected it to that person’s satisfaction – this gave us additional credibility.

4. Go on the offensive, instead of playing defense

Put processes in place whereby customers are encouraged to post positive commentary about your practice and your doctors. This can be as easy as giving them written instructions on how to post a glowing review on Yelp. Or helping them to log in to your practice Facebook account on an iPad in your waiting room.

For the past couple of months we have been using a tool called Demand Force, which integrates with our electronic practice management system. In addition to performing appointment confirmations via text and email, it sends automated surveys to patients allowing immediate feedback and potentially troubleshooting an issue before it escalates. Currently, the survey results show up under Demand Force’s search engine listing, but will soon have the capability of ‘syndicating’ to other popular review sites such as Google, Facebook, Yelp or CitySearch. So far, we have seen steady improvement in search rankings.

You may ask, why encourage patients to write a review since it might not be a favorable one? That’s a valid question. But the reality is that customer reviews of businesses are now quite the norm, and the practice of medicine will be no different. You can hope that none of your patients – especially the dissatisfied ones – know how to post a review online. The better option would be to take the lead and get out in front of the trend, and not fall behind it.

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Why are patients addicted to physician reviews?

Why are patients addicted to physician reviews? | Social Media and Healthcare |

Online reviews have been around for over 15 years and have now disrupted the medical community. Today there are over 90 different online doctor review websites (DRW) where anyone can review any doctor.  The public, including both doctors and patients, know that these review sites are full of false, fake, misleading and damaging content. So why do 75% of consumers report that reading positive reviews makes them trust a business more? The answer is bigger than all of us.

The new social proof

Social proof is best defined by Wikipedia as “a psychological phenomenon where people assume the actions of others in an attempt to reflect correct behavior for a given situation.”

Humans have tendencies to be like sheep in the way that we follow each other based on what the person in front is doing. We have an innate desire to follow along with the masses maybe because it’s easier (pathway of least resistance) or because we don’t want the responsibility (decision avoidance). In the context of patient reviews, social proof occurs when a person reads a positive online review about a doctor and believes that that doctor should be trusted.   The more positive reviews, the higher the social proof. 

How did online reviews become so popular?

No one, not even Google, knows where the first online doctor review was written. Some of the earliest online patient reviews were probably on search engines like Yahoo and Google.  It is believed that the origins of online reviews can be credited to as they brought ecommerce and online reviews to the masses.Amazon started in 1995 and astounded people by offering online products with consumer opinions alongside.  Offering consumer products with opinions and ratings seemed to make all other products “unknown” giving Amazon and similar e-retailers an edge.  We became to rely on consumer’s opinions and feedback as a way to measure a products worth and to justify our own online purchasing decisions.

Smaller in scale than Amazon, Angie’s List, should be credited with being the first company to bring online reviews to services.  They started in 1995 with lawn and home care reviews for members interested in knowing what neighbors thought about local service providers.

In 1999, seeing the trend of the internet, they brought their member’s reviews online. Now they boast over 2 million members who pay for the opinions of other people in the hopes of finding the best products and services.    

Then, in 2004, Yelp came onto the scene. Yelp started as an email service to exchange local business recommendations but quickly pivoted into an online review company mostly for restaurants. They took the previous title holder of social proof, Zaget, and forever changed how we choose places to eat.  It turns out the public is more interested in what regular folks believe than so called experts.  

In the same year, Facebook came online with the advent of social networking and before long; people’s opinions mattered more than ever.  Up to this point, online reviews pretty much stayed where you put them.  But Facebook took private opinion and taught us how to share it with our community and beyond. Now with well over a dozen popular social media companies, a patient review could practically end up anywhere in the world being shared many times over.

The online review was created by early adapters to the internet, rose in popularity with large ecommerce companies, and then became sharing content with social media networks. Online reviews have penetrated even the most resistant spaces on the web, including medicine.  Never before has the doctor patient relationship met such duality.  We’ve been told for centuries “the doctor knows best” right?  Unless you’ve been hiding in the x-ray room, we all know online patient reviews are re-writing this axiom.

To stay tuned on everything related to patient reviews, doctor reviews, physician reviews by clicking on this button below  

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Listen and Engage: Pharma and Social Media

Listen and Engage: Pharma and Social Media | Social Media and Healthcare |

Globally, 83% of people online use the Internet to find information on chronic illness. Patients and doctors worldwide participate in online communities, sharing experiences and stories.

In reality, this leaves pharma no choice but to participate. But should you take an active role or be a passive observer? Trish Nettleship, Director for Social Media and Influence at UCB, believes there are key tenants to successfully engaging in this space, and she shares them with eyeforpharma.

“The first thing is to understand patient needs. The second thing is to engage. This is how you build great customer experiences,” said Nettleship. “We’re actively seeking information to better understand what [a patient’s] needs are, and from there we’re looking to engage with our patient community. But the listening never stops.” Done well, this engagement will lead to customers sharing their positive experiences with their peers, effectively advocating on behalf of the company, but soon that won’t be enough.

“How do we take it a step further without butting into the conversation? We need to uncover opportunities to help our customers. For example one of our products is a patch, and we’re having conversations about the difficulties people have using it. We know exactly how to solve this. There is an opportunity to go out there and help our customers in a more proactive way. We need to engage outside of our own four walls.”

UCB’s activities within epilepsy are a good example of a well-executed, successful campaign. Trish had frequently heard from physicians and patients that they were still accepting the presence of seizures. “The doctor would ask if they were okay, and they would say they might be better than last year or last month, but they were not seizure-free,” Nettleship recounted, “we build a whole campaign around ‘okay is not good enough, go beyond okay.’ We launched it across all social platforms, and we saw people talking about seizure freedom, using the terminology ‘go beyond okay.’ At the same time, doctors reported more patients coming in talking about the campaign, asking what can be done differently. That was our goal.”

What are the features of a successful campaign? It has to be human, and non-intrusive. “The last thing people want on social media is someone butting into a conversation with their own agenda. It’s not about promoting, it’s about help. If we try to promote ourselves, it will have a lot of negative backlash,” Nettleship stressed.

“Depending on the problem they’re having, you can point them toward relevant piece of content, but you can’t do that without human interaction.

Another thing is the human touch. Although a lot of companies are trying to automate the way they engage with customers, Nettleship calls it a “huge fail.” Unless the interaction comes across as human, the customers will not have the feeling that they’re being heard, let alone the confidence that the company can help them. “You need to really listen to the conversation. For example someone might say that they can’t pay for their medication in a given month, and then you can refer them to a co-payment program. Depending on the problem they’re having, you can point them toward relevant piece of content, but you can’t do that without human interaction.”

Although promising, social media has met with a lot of resistance from pharma, where you can hear executives expressing their concerns over the regulatory limitations they’re facing. “I can’t comprehend people who use the regulatory environment as an excuse,” Nettleship confessed. “The regulatory environment does make things more challenging, but we really need to look out for the opportunities,” she added. People nowadays assume that brands are going to help them with problems they’re having, regardless of whether this is regulated or non-regulated space. For example, in the airline industry, it is now expected that if you tweet about the problem, the response will come within 30 minutes.

“It crosses all boundaries. People are thinking about the problem they’re having, and they’re looking to the company to help them solve it. We have to find a way to help without crossing the regulatory line, and there’s plenty of ways to do that.”

All that, however, must be exercised with caution to avoid breaking the rules. For example, a conversation about the brand is unacceptable within a disease-stage community. “We can’t have people talking about medication, and that’s a challenge because that’s what people want, but we can build awareness around a disease without talking about any of our brands.”

“I will be the first one to tell you that we haven’t got the ROI figured out completely […] It’s not always about sales, it’s about what we’re trying to accomplish.

Another concern raised by many pharma companies is the requirement to report adverse events. “Many companies are shying away from social because of that,” Nettleship admitted, stressing that at UCB they have taken a different approach, and are seeking adverse events proactively. “I personally believe that it’s our responsibility to report adverse events to the appropriate regulatory bodies, but also to take it one step further, reach out to that person, and help them understand where they can find help.”

It’s all well and good, but how does social translate to ROI? “I will be the first one to tell you that we haven’t got the ROI figured out completely. You need to think about your business objectives, which aren’t specifically tied to the ROI. It’s not always about sales, it’s about what we’re trying to accomplish.”

Nevertheless, trust remains a big obstacle in social media campaigns. “Stepping outside my role, I would say people are very hesitant to trust pharma. There’s a lot of work to do, but I think social media is a great tool for that ‘cause we know people trust their peers in what they say. If they say they have a positive experience with us, and if they start talking about that, this is where we’re going to build trust, but that won’t happen overnight,” Nettleship concluded.

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Piero Zito's curator insight, December 14, 2013 12:23 PM

“The first thing is to understand patient needs. The second thing is to engage. This is how you build great customer experiences”

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14 Ways Social Media May Soon Change Your Doctor's Visit

14 Ways Social Media May Soon Change Your Doctor's Visit | Social Media and Healthcare |

In 2006, Pew Research Forum discovered that 80% of American adults used the Internet to research medical information. By 2011, data (separately) compiled by Frost and Sullivan and QuantiaMD showed between 87% to 90% of physicians used at least one social media site for personal reasons, with a further 67% to 75% opting for more professional postings. LinkedIn, Facebook, YouTube, Twitter, blogging, and the like stand poised to change the face of healthcare in the exact same manner it pretty much did for most other industries. Medical professionals — not just doctors — have discovered some creative (and not-so-creative) ways to apply the technology to many different aspects of their field, meaning savvy, Internet-literate patients should stay on the lookout for what might lay ahead.

1. Better information and support

PatientsLikeMe serves as a social media site for individuals with various conditions to connect and share their experiences and treatment options that work and do not work for them. As the site grows, so too does participants’ knowledge of what’s happening to their bodies, making it easier for them to communicate with their doctors about possible treatments, rare and common symptoms, and more. In addition, banding together with others in their situation offers necessary comfort and understanding patients might not necessarily receive from even the most well-meaning loved one.

2. Greater risk of compromised confidentiality

Don’t panic; the vast majority of doctors probably won’t be Alexandra Thran, a Rhode Island physician fined for posting enough information online for readers to recognize her patient. All the same, though, savvy consumers should pay attention to their new and old doctors’ Internet presence for signs of breaking confidentiality. The threat might be minimal, but that doesn’t mean patients should grow complacent when it comes to their health and safety.

3. More balanced drug information

In order to counterbalance Big Pharma’s massive social media presence, doctors such as immunologist and allergist Ves Dimov utilize their Facebooks and Twitters to perpetuate more scientific studies proving and disproving the information advertised. Doing so, they feel, will better educate their patients about what drugs they may or may not need when seeking treatment. Be forewarned that many healthcare professionals receive kickbacks, so stay wary of those who seem to eagerly push one specific brand over another. Researching and asking around will dredge up the most trusted professionals speaking on the subject.

4. Better patient interaction

Outside the office, doctors have been known to use social media to let patients ask broad(!) questions without having to schedule appointments for every last one. Some use printouts with diagrams, charts, and links to other resources — including Facebook and Twitter sites — where they can learn more. Dimov highly recommends this heightened interactivity because it provides a much clearer picture about the conditions in question and a faster forum for educating the ailing. He also thinks blogging holds more than a few merits for medical professionals looking to connect with one another and those they are meant to heal.

5. Increased trust in the patient-doctor relationship

For doctors and medical centers such as La Jolla Cosmetic Surgery Centre, social media means attracting more people. Patient testimonials make their services seem more attractive to potential patrons, nurturing a greater sense of trust in a wider range of consumers. According to US News & World Report, it also hosts polls on various subjects and throws “virtual birthday parties for its doctors.” Such connectivity makes it easier for those considering their services to know whether or not the overarching climate will prove a satisfying fit.

6. More informed doctors

Not only does social media (when used responsibly, anyway) better educate patients about the medical field, it also results in doctors better versed in the latest news and views within their industry. In a post at the well-regarded blog, Dr. Natasha Burgert reflects upon how one year working with Facebook and Twitter greatly enhanced her pediatrics. She lauds the technology as essential to staying on top of research (many leading medical journals now boast a social media presence) that could better benefit her patients and increase the level of trust between them.

7. Details about what to expect from specific procedures ahead of time

Doctors, hospitals, medical schools, and even the National Library of Medicine have all established YouTube accounts with everything from lectures to step-by-step walkthroughs of surgical procedures available. For patients nervous about an upcoming appointment, whether routine or critical, watching everything unfold might ease the anxiety before setting foot inside the facilities. Or at least familiarize them with what to expect once everything begins. The popular site’s offerings also tie into the overarching educational benefits social media grants to professionals and consumers alike.

8. More opportunities to participate in clinical research

Men, women, and children who want to do their part in medical research — especially inquiries into rare and serious diagnoses — can take part in polls and studies even faster than before. Rather than going through their healthcare providers, they can search social media sites (PatientsLikeMe has linked up with scientists for Nature Biotechnology before) for opportunities to help save some lives. While this access won’t significantly change doctor’s appointments, it does at least alter it somewhat, especially for the brave souls hoping to help others in any way they can.

9. Check certifications faster

The advent of social media also meant a brand new way for scammers and other sketchy opportunists to separate consumers from their money. Cardiologist and blogger Dr. Wes talks about a colleague offered a fake “board certification” in the industry, which he and his readers quickly identified as a complete fraud. Patients hoping to learn more about what their doctors and potential doctors have to offer have a much faster way of educating themselves about certification claims and other qualifications — or made-up qualifications, as it were. This will help them ferret out medical professionals who aren’t everything they claim.

10. Faster aid

Healthcare professionals working in isolated or impoverished regions, particularly those subjected to natural and political turmoil, use social media to let potential donors know what money and resources they need to better serve their patients. Mashable’s writeup about Floating Doctors discusses how their Facebook and Twitter feeds have proved necessary in helping them establish clinics in Central America and the Caribbean. For some patients, this assistance from abroad might very well mean the difference between life and death.

11. Remote diagnoses

Using social media and resources such as Skype can be a bit dicey in some situations, but in others, Floating Doctors have proven how essential they can be when forging an accurate diagnosis. One story they shared with Mashable involved a Haitian man whose arm was fractured and never properly treated, which resulted in a rare and bizarre condition. Posting videos to YouTube and pictures to Facebook and Twitter allowed other medical professionals to discuss what might have happened and possible treatment options. What resulted was a worldwide effort to get him all the care he needed, and as a result his arm eventually received the right attention from an orthopedic specialist!

12. Group visits

Obviously, scheduling group appointments causes quite a divide within the medical community, but some doctors swear by it as a means of building compassion and empathy between patients with similar conditions. Plus, those in resource-strapped areas or with clogged schedules use the setup in order to make what they have available stretch as far as possible. Social media, while not specifically referenced by the American Academy of Family Physicians, provides a private way for participants to coordinate meetings and discuss what they’ve learned when off the clock.

13. Online scheduling

Beyond online support groups, patients in most major American cities can use the Internet to schedule their appointments quickly and (relatively) painlessly under some healthcare plans. Services such as ZocDoc link up physicians and people in need of their care at no cost to the consumer — doctors pay for listings. USA Today quotes its appointments as comprised of 85% new users and 40% of appointments happening within a day of hopping online. There’s even an Android app available for scheduling with specialists, dentists, and more while out and about.

14. Insight into just what doctors do on a daily basis

Lauded physician and social media expert Dr. Kevin Pho of thinks sites such as Facebook, Twitter, and YouTube demystify much of the responsibilities doctors face on a daily basis. Removing the shroud marks another strategy for establishing patient comfort. He touts that their knowing exactly how much paperwork his position entails fosters bonding, as it’s something to which so many of them relate. And this relative transparency helps quell some of the nerves that inevitably pop up.

eMedToday's curator insight, December 14, 2013 12:42 AM

good lists

Zach Owen's curator insight, December 11, 2014 9:53 PM

What do you think will happen to social media and the medical field? Why?

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#Barf – how Twitter can reduce the spread of norovirus

#Barf – how Twitter can reduce the spread of norovirus | Social Media and Healthcare |
Spikes in Twitter keywords such as #barf and vomiting can help the Food Standards Agency preempt an outbreak of norovirus.

In fact, @Traddski, there has never been a better time to broadcast your bowel movements on Twitter.

The Food Standards Agency (FSA) has embarked on a social media listening project that, it hopes, has the potential to predict outbreaks of the winter vomiting bug, norovirus, earlier than ever before.

FSA's social media team sifted through Twitter data from the last norovirus outbreak during the winter of 2012-13, hunting for spikes in certain related key words and phrases being used in tweets. They then compared the frequency of the key words to the number of lab reports of confirmed norovirus cases in the same period.

They found significant correlations between spikes in the number of lab reports and spikes in conversations on Twitter using words and hashtags such as #winterbug, #norovirus, sickness bug, winter virus and vomiting.

What's more, they discovered a set of symptom keywords, such as #barf, #flu, chuck up, puke, retch and upset stomach, which strongly correlated to future lab cases.

"We found that the changes in the number of tweets using symptom keywords predicted the increase in lab reports at the start of the annual peak in human cases," said James Baker, FSA social media manager.

In some cases, spikes in the key words were being shared up to four weeks earlier than Public Health England released confirmed lab reports.

There was a high correlation between tweets using specific keywords and confirmed lab reports. Photograph: Food Standards Agency

The FSA is currently testing how Twitter monitoring can provide early alerts to norovirus. The agency will also be looking into other areas where social media can help public bodies in similar ways.

"There's the potential for us to idenitfy outbreaks of norovirus much earlier than before, giving us the opportunity to proactively share our advice and guidance with those who might be affected, alert other government departments and industry, and perhaps even help to reduce its spread," said Baker.

Tweets describing the colour and consistency of your #barf may be gross, but they helped inform the FSA project which, once it has refined its monitoring model, could prevent tweets like this one:

Of course, there are caveats on how trustworthy the data can be, said Baker. People self-diagnose. Symptom keywords and search terms are broad so "there's always going to be a bit of noise". And early warnings of an outbreak will increase chatter around the subject and might skew the data.

"But what we'd hope is that as this online chatter increases, the subsequent number of cases would plateau or decrease because of an earlier intervention," Baker said.

The FSA also found strong correlation between search terms on Google with lab reports – but during and after an increase in norovirus outbreaks had been reported rather than beforehand.

Google trends were not as good as Twitter as an early alert system, said Baker. Perhaps because people tweet out their feelings, but use search engines to find out more about something already being experienced by friends and family and reported by the media.

So, give thanks to the public-spirited souls who feel the need to spew out details about their spewing on social media – such sharing may serve the greater good.

Andrea Angioloni's curator insight, December 13, 2013 2:31 AM

Of course, it depends on the level of adoption in the country and the cultural behavior, but this demonstrate that through social listening you can monitor understand and act in a timely manner

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Five Best Practices to Guide Your Hospital’s Social Media Policy

Five Best Practices to Guide Your Hospital’s Social Media Policy | Social Media and Healthcare |

If you search the web for top five HIPAA violations, you will find something similar to the following:

  • Lost or stolen Protected Health Information (PHI) on laptops, back-up disks, and portable drives
  • Inappropriate access of PHI by employees (i.e. snooping into records of family members or co-workers)
  • Improper disposal and storage of PHI
  • Computer Hacking
  • Releasing PHI to patients in a timely manner

You will find after some research that Twitter, YouTube, Instagram and other social media tools are not even mentioned in the list but not anymore. Social Media tools are going to top the HIPPA violations within the next few years unless your healthcare organization and staff are bound by simple, easy to follow, and well protected social media policy. If you haven’t heard about the Woman Sues Chicago Doctor, Hospital For Posting Photos Of Her Drunk In ER To Facebook and you are managing a doctor’s office or urgent care or hospital then this is the time for a must review of your policy and procedure book.

During the past three years, I had the chance to manage a healthcare organization’s brand presence, both offline and online. I can say that managing the offline presence is little easier because most communications are internal while taking the patients online is what makes the whole marketing and branding process a lot harder not just because you are dealing with very sensitive medical information but because their information will become permanent record on the web and you will have no power to remove it later.

My role within the medical center is called Chief Experience Officer, it’s not just a title for another CEO. It is a job that handles the most important responsibility in today’s experience economy, the responsibility to: manage your daily patients’ service problems, contribute to build strong corporate culture, and to full-fill your brand’s promise.

I will share five practices to minimize any threats and exposure your healthcare organization could take. If  these practices work on the medical practices level then you can scale them to work on the hospital level.

1 – Keep it educational policy.

  • Encourage employees to be ambassadors for your brand than to waste time trying to stop them from using social media. Social media networks are extension to your online brand presence and a place where you connect your fans emotionally to your brand. The patient could visit you one time but if the patient follows you online, the connection will mostly stay forever
  • The policy awareness should start from the interview and goes along the way during meetings and HR/PR updates. Everyone should be educated about the proper way to use their personal social media accounts and not to mix it with hospital’s use
  • Social media is an opportunity to build relationships with patients, the brand naturally is helped by the culture. To have a culture, you need a team, make sure they have real time mindset. Real-time means reacting in real, or near-real time. It’s about relevant action to solve problem that could hurt your brand offline or online and it’s better to manage it offline before it escalated online. Remember, the longer and higher a patient complaint lives in an organization, the more it grows
  • Organize educational events inside the hospital via tweetup and Facebook to arise awareness of the social media by discussing a a new HIPPA violation case and how to prevent it happening at the hospital
  • To make your policy work, you need to make it friendly, simple and short. Include some tips on agenda books, hallways screens, and optional tips via text messages

2 – Keep a checklist in handy.

  •  You want every member of your organization to know the process of how to ask happy patients for online review, the URLs of your social media networks, and understanding the rules of administering your social media accounts
  • Hospitals have very strict rules regarding patient privacy. Your marketing or patient experience department need to provide a consent specific for patients who don’t mind appearing on YouTube or Facebook for testimonial. The consent must have the patient full name, signature, along with at least one witness. Scan the consent immediately and shred it afterwards
  • Get the patient approval for any picture you take or video you record even if it’s verbal, get the patient to see what will post online and become permanent record on the web
  • Try to keep patients information shared online anonymous, with only first name or just nickname
  • Keep your camera or video camera inside a safe place. Make it accessible to limited employees

3 – Get your IT department involved in crafting your policy. IT personnel understand computer networks, users permission and privileges, and the basic ways to secure your network, prevent hacking and exposing your shared folders to public. Here are some of the best practices I’ve implemented.

  •  Always secure your computer every time you leave your workstation
  •  Use privacy screens on all your hospital computers
  • Do not store PHI on portable devices unless it’s your off-site backup devices
  • Keep your practice management system passwords private
  • Separate your operation network from guest network both wired and Wi-Fi

4 – Engage your patients offline to motivate them to come online. You don’t need consent for the following:

  • Offer free vitamin B12 for patients who write Facebook recommendation or support a hashtage of your cause
  • Make a tablet accessible in the waiting room to show patient’s testimonials and case studies
  • Offer free lipo-light session for exchange of sharing their visit experience on
  • Make a signage at the gates to offer directions and tips to use hospital’s facilities when they checkin
  • Offer patients exclusive access to educational webinars by registering into the hospital’s email newsletter

5 – Do not do the following:

  • Do not post patients pictures in your hospital until you get patient’s approval
  • Do not tweet or comment any medical information that has no trusted source and always make sure to keep your personal opinion away from the hospital, you can RT or mention but use common sense otherwise
  • Do not take any photo or video with your personal mobile, use the hospital’s resources only
  • Do not engage into online conversation with your patients unless you are on HIPAA compliant medium
  • Do not post any before/after pictures of  patient’s procedures without copyright them in way that can’t be replicate

There’s no sense trying to create a social media policy from scratch (Mayo Clinic & Kaiser Permanente‘s social media policy are available online). Many healthcare organizations have already done some of the work already so adapt their work and change as your business and/or culture needs. Remember, the Internet revolution is still ongoing and new media tools are coming to your business whether you like it or not.

A day is coming where patients visiting your practice or hospital will record the whole visit via Google Glass and upload it to YouTube without your knoweldge!

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I’m getting bad reviews on social media. What can I do?

I’m getting bad reviews on social media. What can I do? | Social Media and Healthcare |

Dr. John has a very busy medical and cosmetic practice. The growth of his practice, and its success, is a testament to the quality of services he provides. Recently, while surfing the Web, Dr. John notes that a recent patient said, “Dr. John was arrogant, insensitive and ran late. The diagnosis he gave me was wrong. And for that, I had to dish out $50 co-pay. Stay away — forever.” Dr. John is incensed. What can he do?

The reality is that most dermatologists go into medicine to help patients. Some dermatologists do provide better care than others. But most are conscientious and wake up every day intending to do the best possible job for their patients. The average experienced dermatologist sees thousands of patients every year. It is impossible to make 100 percent of our patients happy. It is inevitable you will, at some point, receive a bad review. It could be for any number of reasons. What can you do? Do you have legal recourse?


The reality is that if you have an isolated bad review amidst a sea of positive reviews, that is very different than scores of awful reviews. The public generally understands no physician can make everyone happy. But, the public also expects you will make most patients happy. So the first piece of advice is do not sweat an isolated negative review. But can Dr. John fix a negative review?


Unfortunately, most reviews are anonymous, and/or are written under a pseudonym, and/or the review may not give specific information that would allow the aggrieved dermatologist to determine who wrote it. If Dr. John can figure out the author of the review, he should consider reaching out to the patient. If he can fix the patient’s problem, he should do so. Sometimes, it’s an escalating misunderstanding over a $20 bill. Other times, it’s the perception that the physician was rude, does not listen or does not care. These are solvable issues.

Merely calling the patient and apologizing for any misunderstanding may be enough. Most doctors do not call patients about such matters — when YOU do so, it sets you apart from others. It’s what top performers in every other industry do. Healthcare should not be an exception.


Take action

More commonly the physician is not sure who the patient is. The complaint is general. If it’s a systemic complaint about your office, and you can fix it — do so. Then, tell the world you heard the message and took action. If it’s an isolated complaint, consider responding online. You will need to pay attention to HIPAA issues in doing so. Even though the patient may not have posted a name, the post may contain enough details in the post to identify the patient. Be careful with how you respond. In the end, consider responding online to the post if you can do so in a HIPAA-compliant form.


The more global problem is that every review site has is its own “ecosystem.” They have their own guiding philosophies and rules. Most have Terms of Use. If you believe the review was unfair and violated the terms of use, diplomatically write the site and ask if it will take a look at the post in the context of its Terms of Use. They may agree with you and remove the post. Remember, each site is run by human beings who are more likely to respond to “please” and “thank you” than to threats. Couch your note as a request and not a demand.  Review sites may remove an unfair post if it violates its Terms of Use.


Finally, a high-performing practice can be distinguished online by proactively asking patients for feedback. If you have a great patient safety record, positive clinical outcomes, and great “customer service”, your online reputation should mirror your actual reputation. But, you have to be diligent in asking your patients for online feedback. When the inevitable negative review does surface, it will be placed in context of the multitude of positives. Although some social media sites, such as Yelp, on the surface seem to highlight negative reviews and discard positive reviews, this is not true for most social media review sites.


Be proactive

Asking your patients proactively for online feedback allows high-performing practices to be fairly represented online. This drives new patient volume and new patient revenue. If a dermatologist has an office, he/she will receive some bad — and even rotten — reviews.

The best way to prepare for that day is for physicians to ask their patients for online feedback each and every day. That way the physician will be defined by hundreds of happy patients instead of two noisy patients with a megaphone. With this, the public will have a representative picture of your practice.


Lastly, Dr. John may wish to sue the website and/or the patient. This attempt is not likely to be successful. The First Amendment right to freedom of speech protects almost all except the most egregious of online complaints. In the end, try to keep most of your patients happy!


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