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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Click: The Doctor Will See You Now - Spreading Health Information Online

Click: The Doctor Will See You Now - Spreading Health Information Online | Social Media and Healthcare |

For more than 80 years, Blue Cross and Blue Shield companies have worked alongside local physicians and hospitals across America to help improve access to healthcare.  And today the traditional avenues of access to healthcare are expanding as quickly as the online networking capabilities of both doctors and healthcare consumers. 

A recent survey by Parks Associates revealed that “1 in 5 broadband households want live chats with health experts.” This is the new access. In an on-demand and online world where consumers expect to get what they want how they want it, healthcare consumers are no different. Healthcare consumers now expect to get access to doctors and medical information online because they know the technology and communication techniques exist. It’s just a matter of expanding and re-defining the setting of the doctor-patient relationship.


Dr. Peter Salgo, host of PBS television’s Second Opinion, agrees. In its 10th season, this award-winning television program, dedicated to health literacy and improving communication between doctors and patients, has expanded its format to include live Twitter chats during production.


“I think this [social media] is the answer that medicine has been searching for since the dawn of time,” said Dr. Salgo. “How do you stay in touch with people? You know the answers to the questions they’re asking, you know how to help them but you can’t reach out to them. They’re not in your office, you can’t call everybody every day, but you can reach out to them with social media.”

Salgo believes that social media can indeed improve health literacy. “There’s nothing more powerful in medicine than information. And access to that information is where the key is. This is the future of the human race: sharing information.”


The Blue Cross and Blue Shield Association saw this communications trend emerging in healthcare over a year ago. As the sponsor of Second Opinion since its inception in 2003, we collaborated with the show producers to include live Twitter chats with the show’s doctors about concussions, food allergies and diabetes in season 10, which premieres in October 2013 on PBS stations across America. We’re also developing interactive online video features hosted by physicians from the show, and a new web site that provides healthcare consumers with a searchable video database to access information about health and wellness and medical information from trusted physicians.


Doctors and consumers are on social media. Access to information is on social media too and Blue Cross and Blue Shield companies see this as a new, dynamic opportunity to help improve access to healthcare in America.

Nicoline Maes's curator insight, September 17, 2013 9:25 AM

De patient is online! Nou de doktoren en ziekenhuizen nog...#Health #Gezondheidszorg

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Social media is improving health literacy in Australia's indigenous population

Social media is improving health literacy in Australia's indigenous population | Social Media and Healthcare |

Around the world, social media is a disrupting and transforming force, bringing new opportunities for innovation and participation.1 In the United States, the Centers for Disease Control and Prevention have developed resources to provide guidance on using social media in health communication.2 In the United Kingdom, the NHS Institute for Innovation and Improvement encouraged its staff to explore the potential of using social media to transform care and staff engagement.


In Australia, the Indigenous health sector has been at the forefront of innovative use of social media for advocacy, public health promotion and community development. Two striking examples are the Lowitja Institute’s nuanced explanation of knowledge exchange from Indigenous perspectives4and the Healing Foundation’s engaging explanation of the impact of colonisation on Indigenous health.


The National Aboriginal Community Controlled Health Organisation (NACCHO) was an early adopter of social media, and finds it a valuable advocacy tool, according to its Chair, Justin Mohamed. It distributes daily Aboriginal health news alerts via social media. Mohamed says downloads of NACCHO’s policy submissions have increased since they have been promoted on Twitter and other online channels.


The popularity of user-generated content — a hallmark of social media — is being harnessed in new tobacco control programs. These include the No Smokes campaign from the Menzies School of Health Research and the Rewrite Your Story initiative by Nunkuwarrin Yunti (a community-controlled service). In New South Wales, the Aboriginal Health and Medical Research Council uses Facebook to promote sexual health and smoking cessation.

While the digital divide is thought to be an issue relevant to remote and hard-to-reach communities, social media has been successfully used in the Torres Strait Islands to connect young people with a public health initiative in sexual health — the Kasa Por Yarn (“just for a chat”) campaign, funded by Queensland Health. Unpublished data show that Facebook, YouTube and text messaging were effective in reaching the target audience of 15–24-year-olds (Heather Robertson, Senior Network Project Officer, Cairns Public Health Unit, Queensland Health, personal communication). Patricia Fagan, a public health physician who oversaw the campaign, says that social media helped increase its reach. The campaign was using tools with appeal to young people, and, importantly, “it didn’t feel like health, it felt like socialising”. Heather Robertson, the project leader, says engaging local writers, musicians and actors in developing campaign messages and social media content was also important.


Social media has also been used to increase engagement with the Heuristic Interactive Technology network (HITnet), which provides touch-screen kiosks in Indigenous communities and in prisons. The kiosks embed health messages in culturally based digital storytelling. Helen Travers, Director of Creative Production and Marketing for HITnet, says this has brought wider health benefits, by developing the content-creation skills of communities. “The exciting thing for health promotion is that this kind of work is increasing digital literacy and digital inclusion”, she says.


Social media’s facilitation of citizen-generated movements is exemplified by the @IndigenousX Twitter account, where a different Indigenous person tweets every week, enabling many health-related discussions.


Innovation in service development is also being informed by the anti-hierarchical, decentralised nature of social media. The Young and Well Cooperative Research Centre is developing virtual mental health resources for Indigenous youth in remote communities. The centre’s Chief Executive Officer, Jane Burns, envisages that these will resemble a social network more than a health care intervention, and will link young people and their health care providers with online collection of data about sleep, weight, physical activity and related measures. Burns says, “It really is . . . creating a new mental health service, a new way of doing things that empowers the individual, rather than being that top-down service delivery approach”.


However, barriers to wider use of social media exist. Burns says that upskilling health professionals is critical. Kishan Kariippanon, a former paediatric physician studying social media and mobile phone use among youth in the Yirrkala community in Arnhem Land, says health professionals need support and encouragement to engage more creatively with technological innovations. He would like to see regular “hackathons” to bring together programmers, health professionals, innovators and community members to encourage “out of the box” thinking

KaitlynandSydney's curator insight, October 3, 2013 1:19 PM

This article fits into the social category because it talks about how social media is helping promote health issues

Kiann and Kenneth's curator insight, October 3, 2013 1:27 PM

This article relates to the socal interaction in Australia.


Social Media in Australia is popular. Social websites like twitter, Facebook, YouTube and more. Social media is changing our health in the way you sleep, your weight, and physical activity.

Geography Jordan & Danielle's curator insight, October 4, 2013 1:22 PM

Social media ia disrupting a big in AustraliaAustralia

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Study suggests that social media can be used to successfully improve medical practice

Study suggests that social media can be used to successfully improve medical practice | Social Media and Healthcare |

A doctor from the UK has shown how an innovative music video can help increase awareness of how to treat asthma.

Dr Tapas Mukherjee, from Glenfield Hospital in the UK, produced and starred in a music video to draw attention to new guidelines showing a better way of managing asthma.

A study presented at the European Respiratory Society (ERS) Annual Congress in Barcelona today (10 September 2013), has demonstrated the success of this video and suggests that social media can be used to successfully improve medical practice.

In April 2012, an audit at Dr Mukherjee's hospital highlighted a lack of knowledge in acute severe asthma management. Only 45% of healthcare professionals had used hospital guidelines on the management of asthma and only 62% were aware of them.

The guidelines were translated into memorable lyrics, with Dr Mukherjee singing the advice on how to treat acute asthma. The video was posted on the social media sites, Facebook, Twitter and YouTube.

A repeat audit was carried out in June 2012. When comparing the results to the previous audit in April, the study found that 100% of healthcare professionals were aware of the guidelines. All aspects of asthma management and knowledge had improved, with the most significant improvements seen for chest radiograph indication and target oxygen saturation.

Dr Mukherjee said: "Our study has shown that social media can help to change clinical practice, with 100% awareness of the new guidelines in the post-analysis. As doctors are often working in busy environments, we have to think of creative ways of reaching them with important clinical information. Our study has shown that social media is a free and effective way of doing this. The method could be adapted to different scenarios and the possibilities are not limited by resources of money, but only by imagination."

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Social media monitoring in the health care field

Social media monitoring in the health care field | Social Media and Healthcare |

In an effort to build relationships with consumers of medical services and ensure they are well-educated about their care, many hospitals and other health services organizations have taken to social media. Through Facebook pages, YouTube channels and more, health care professionals attempt to disseminate important information and solicit feedback. This can drive brand loyalty and create informed consumers. The use of social media in health care has many possibilities in addition to public relations and marketing, as well.

Tracking progress in brand awareness and information reach
Social media monitoring solutions can be of great use to health care professionals. Those hospitals and other organizations undertaking a social media campaign to build brand awareness and loyalty can use such tools to determine how well their efforts are performing. Social media analysis can show how many users are discussing the hospital and its posts and give administrators a better idea of how much engagement a particular campaign generates.

Those social media activities that aim to educate consumers about health care and treatment options can also use social media listening tools in a variety of ways. A preliminary scan of relevant posts to see what users say when they discuss a certain condition or procedure can help establish a baseline of general knowledge. For example, if misconceptions or questions consistently appear in social media posts on the subject, it will be easy to construct a campaign to counter or answer them.


Once an informational campaign on social media has been in effect for some time, it's possible to use social media monitoring to see how well it has performed, just as with public relations campaigns. A notable increase in posts from the intended area that display a correct understanding of the facts can demonstrate the success of an informational campaign, perhaps driving investment in further efforts of the same kind.


Research opportunities
Many social media users are free with what they will post. There is some amount of health information to be gleaned from such activity. The most basic aspects of a healthy lifestyle, including diet and exercise, are often things people will make social media posts about. Photographing meals and checking into gyms are not uncommon activities on social media. Others living with chronic conditions may post updates or questions. Social media analytics can allow researchers to tap into this wealth of data. Demographic research on a variety of topics can be accomplished through social media or supplemented by it. Of course, this can be part of a reciprocal process within organizations, where research both precedes and follows education efforts.

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Exploring the use of a facebook page in anatomy education

Exploring the use of a facebook page in anatomy education | Social Media and Healthcare |

Facebook is the most popular social media site visited by university students on a daily basis. Consequently, Facebook is the logical place to start with for integrating social media technologies into education. This study explores how a faculty-administered Facebook Page can be used to supplement anatomy education beyond the traditional classroom. Observations were made on students perceptions and effectiveness of using the Page, potential benefits and challenges of such use, and which Insights metrics best reflect users engagement.


The Human Anatomy Education Page was launched on Facebook and incorporated into anatomy resources for 157 medical students during two academic years. Students use of Facebook and their perceptions of the Page were surveyed. Facebooks “Insights” tool was also used to evaluate Page performance during a period of 600 days. The majority of in-class students had a Facebook account which they adopted in education. Most students perceived Human Anatomy Education Page as effective in contributing to learning and favored “self-assessment” posts. The majority of students agreed that Facebook could be a suitable learning environment.


The “Insights” tool revealed globally distributed fans with considerable Page interactions. The use of a faculty-administered Facebook Page provided a venue to enhance classroom teaching without intruding into students social life. A wider educational use of Facebook should be adopted not only because students are embracing its use, but for its inherent potentials in boosting learning. The “Insights” metrics analyzed in this study might be helpful when establishing and evaluating the performance of education-oriented Facebook Pages.

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Healthcare companies using Facebook to promote health products and their branding

Healthcare companies using Facebook to promote health products and their branding | Social Media and Healthcare |

When Parth Patel started his online pharmacy store in Ahmedabad, the venture threatened to be a non-starter. Though there was a fairly large product mix, the young entrepreneur was unable to reach his target audience who would buy medicines and health supplements on the internet.

Patel would often see social media posts by Indianhealthcare companies like Zydus Cadila, SunPharmaceuticals, Lupin, and Ranbaxy, and one day decided to try with Facebook. The strategy worked and online orders started coming in from all over the world.

Facebook has over 1 billion users worldwide with more than 50% active users. India has the second highest number of users on Facebook at 61 million.

Among big pharma companies, Ranbaxy has an active fan base of more than 1,00,000 users across the brand pages of Revital and Volini that can reach to over 27 million users on Facebook through status updates. Revital was the first page on Facebook launched in 2011 and has a reach of 16 million. Last year, Ranbaxy launched the Facebook page for Volini with a weekly reach of over 830,956 consumers.

Brijesh Kapil, vice-president, Ranbaxy Global Consumer Healthcare said "Ranbaxy has recognised the importance of being where the consumer is looking for information i.e. facebook and has created brand pages to provide information and encourage active engagement. We make regular updates on fitness tips and recommendations to avoid pain."

Ranbaxy also uses other social networks to build holistic connectivity between products, brand ambassadors and users via viral videos. "Last week, we uploaded a Revital video on YouTube and has been viewed by 50,000 users," says Mr Kapil.

Last year Revital launched the 15-year campaign where brand ambassador Salman Khan testified that he has been using Revital for the last 15 years. Ranbaxy came up with a Facebook application developing a contest around the theme and was able to reach out to 8,00,000 users.

"Apart from general public, one of the main target audiences is doctors and they are definitely viewing this," says Vivek Hattangadi, CEO, The Enablers, a pharma brand consultation firm. According to him, this works best in metro and semi-metro cities as doctors have less time and it's not possible to meet each and every medical representative from the 25,000 registered healthcare companies. "Brand activity for non-prescription medicine and dissemination of scientific knowledge of prescription drugs help in long term corporate brand identity creation" he adds.

Lupin has created and built a small social media presence over the last two years and a Sun Pharmaceuticals spokesperson said it was building its presence in the social media.

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Online CME Participation Increasing

Online CME Participation Increasing | Social Media and Healthcare |

The number of physicians and non-physicians participating in continuing medical education (CME)has increased, especially in online activities, according to a report published by the Accreditation Council for Continuing Medical Education (ACCME).


Researchers from the ACCME reviewed state and national data to provide information about the CME accreditation system, including trends in CME revenue and expenses, the number of educational activities, and participation in activities from 2005 through 2012.


Almost 2,000 accredited CME providers offered more than 130,000 educational activities, comprising nearly one million hours of instruction in 2012. More than 24 million physicians and other health care professionals were educated. Although there has been a decrease in the number of CME providers, a steady increase has been seen in the number of physician and non-physician participants in overall CME activities. Participation in online CME has increased, as well as activity types such as Internet searching and learning. In 2012, 58 percent of the total income for CME providers came from income from sources other than commercial support, advertising, and exhibits. Eighty-two percent of CME activities produced by ACCME-accredited providers did not receive commercial support. These activities accounted for 81 and 78 percent of physician and non-physician participants, respectively. Commercial support was received by 18 percent of CME activities.


"Although the number of CME providers has declined, this has not necessarily represented a reduction in physicians' and other health care professionals' access to accredited CME within the ACCME system," according to the report.

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Social Media: Enhancing Medical Outreach and Quality of Healthcare

Social Media: Enhancing Medical Outreach and Quality of Healthcare | Social Media and Healthcare |

In this era of digital science and globalization, medical profession seems to be a charm for many people. Throughout the world, each year, many students appear for this noble profession with the dream to explore something new with their keen interest in humanity or to flourish in education. The world is moving so fast with new discoveries, inventions and growth in technologies which connect each and every individual in a manner without which life seems to be impossible. In the same way, the top most preferred profession of this world, the Medical Profession is indulging more in connecting with the digital world through different communication media.


Social Media is a Platform that involves internet based activities through which individuals get and share knowledge, communicate and collaborate. It is totally different from other broadcast media because social media is online way through which people discuss, communicate research, earn and discover new things individually or in collaboration. In this age of rapidly growing technologies, different professions use blogging, personal websites like twitter, Facebook, wiki, slides share and videos share sites, collaborative projects, research tools and contents, online communities, photo sharing sites and educational information sharing and news sites. According to “Facebook statistics, 9th September 2011”, Published in white paper 2012; Facebook emerged as largest social media network in use worldwide and represents the enormous growth of social media usage among the general public, Facebook allows internet users to interact with community pages, events and personal post.


Social Media presents several opportunities in positive or negative way to medical community, so that physicians, medical students, patients, nurses, health organizations and their representatives seize those opportunities and improve health literacy, issues and quality of life. Social media is a dynamic way through which people can raise health awareness about issues, can communicate, discuss to improve health related activities and behavior. This is also a powerful way to provide better quality of life. According to one survey, over sixty five percent physicians in the world are using social media, and in U.S. more than thousand hospitals are using social media and several organizations are taking part in it for different purposes. Different Health organization in public and private sector using social media like, ‘Mayo Clinic social media’ was created in January to educate health care professionals, and public health agencies like World Health Organization (WHO) are reshaping medical world with great advancement.


Throughout the world Physicians, Surgeons, Medical students and Nurses all are using different blogging sites and social networking communities to enhance and seize opportunities and to tackle all the challenges which come on their way of professionalism. Dr.Lissa Rankin, a gynecologist in San Diego said in her interview that: “I was trained that doctors are supposed to be up on this pedestal and we’re supposed to put on our white coats and play this role. That’s not necessary who we are. We’re humans. I personally use social media as a way to communicate to people my humanity, that I have flaws, that I make mistakes, that I have doubts, insecurities and fears”.


Social Media is playing its role for medical community through different categories like students, doctors, nurses and different industries are using several blogging sites, social networking communities, Facebook, flickers, twitter, slides share, videos share, YouTube, online journals, e-books, online researches and last but not the least different video courses and lectures provided by health care teachers in several ways. But matter of concern is that, social media can have negative impact and can harm medical profession, personal dignity, identity, employment, patient’s integrity, self respect, can demoralize individuals life and can disturb relationships, future admission, careers and opportunities, if people have inappropriate online activities and social behaviors. It can affect patient’s morale, self respect, privacy and their beliefs.


One survey shows that social networking sites are affecting medical school acceptance, in U.S. Social network activities and profiles are negatively affecting doctor’s reputation, personal integrity, public trust and their careers and can destroy their fame and employment. In twitter accounts, doctors using and sharing medical information and patient’s problems can be fruitful but they are against ethics and destroy personal dignity and morale by crossing boundaries. In a nutshell, in spite of negative influence of Social Media individually or collectively, it is playing a powerful role in medical community by reshaping the ways of thinking, ways of living, ways to receive and share, and the ways to explore and generate better health. By providing routes to overcome challenges and grab new opportunities it can create better relations that enable persons individually and professionally to grow and live in a ‘healthy literate world’. 

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Professional use of social media in medical education

Lecture to first year uOttawa medical students by Pat Rich and Ann Fuller
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Social Media Education Should be Tailored to the User

Social Media Education Should be Tailored to the User | Social Media and Healthcare |

When we think about the boundaries of communication technology and social media, we tend to put students, residents, and faculty into the same bucket. Policies for one are the policies for the others. But these are all very different people with respect to their ability to understand and handle their public presence.


The latitude given a publicly seasoned attending should be different than that of third-year medical student. For example, I encourage students to avoid online discussion about the hospitals they are rotating in. This is because:


  • They don’t yet know what represents the normal workings of a hospital. There are things that seem strange or unjust to a trained eye but happen for a good reason. Perhaps more important, the viewing public doesn’t understand what students don’t know.
  • Students are sorting out what represents the thoughts and ideas for their close personal network versus those for global publication. They’re learning which conversations belong where.
  • They’re figuring out their public presence

Students come to medicine with a relatively self-focused view of their networked world, and don’t yet understand how they fit into the broader networked world. As they mature professionally, they recognize that they are part of a broader community, which brings accountability. This progression has real importance when we expose ourselves to the great wide open.


The way we handle ourselves must be driven by the context of where we are. Discussions, guidelines, and educational programs need to be designed around the specific differences that exist at various levels of experience and clinical maturity. Not all policies fit these different levels.


While the principles of privacy and professionalism in the public space shouldn’t differ at any level, the way we approach and discuss those principles necessarily must.

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10 tips for hospital bloggers

10 tips for hospital bloggers | Social Media and Healthcare |

Statistics show 80 percent of people look for health care information online. Blogs can help them find it.

10 tips for hospital bloggers 

1. Make it personal: The blog shouldn’t be a cut-and-paste job from your hospital’s marketing/media relations press release site. This is your chance to show off your human side and emotionally connect with patients. Urge doctors to explore topics, such as why they love their work and what they learn from patients. 

2. Monitor the buzz: Pay attention to current events and hot topics. When flu season arrives, a family practice may blog about prevention tips and vaccination schedules. What’s the latest research on disease causes and links, and do you have an expert who can weigh in? Is a new treatment that your center offers getting wider media attention? Find a way to talk about it. You can always set up aGoogle alert for subjects you know your audience cares about. 

3. Check your jargon: Be cautious about so-called “doctor speak.” You’re writing to connect with patients, not medical colleagues, so keep it casual and easy to understand. Remember that patients don’t refer to their chests as “thoracic cavities.” See this study that showed that most people find thelanguage on hospital websites way too elevated. 

4. Keep it brief: The best part about blogging is that shorter is better. Aim for 200 to 500 words. 

5. Don’t ignore it: Post regularly. Make a plan – one entry a day, two a week – and adhere to it. Consistency is key for readers to see it as a serious effort.

6. Know your audience: Keep in mind who’s reading to guide its content and tone. If you’re a children’s hospital or pediatric practice, your readers are parents, mostly moms. But a cancer center can expect a much wider, varied audience, as both patients of all ages, as well as their family members, may tune in. 

7. Be social: Blogging is, after all, a form of social media marketing, so create plenty of opportunities for readers to join the discussion. Allow them to leave comments on the blog, and enable widgets so they can share your post on sites like Facebook and Twitter. Interact with the commenters. 

8. Use multimedia: Think outside the text box. Post photos, videos, photo slideshows and hyperlink generously. 

9. Branding: Your blog, though more casual, is still an extension of your hospital and represents your brand. Seize the opportunity to brand the blog and fully integrate it into your overall digital marketing plan. 

10. Share the work: The content doesn’t have to be fruit of one person’s labor. Allowing several members from your medical team to contribute adds a good variety of ideas and perspectives, and makes the blog easier to maintain.

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"Social Media Residency": Essential for Tomorrow's Physicians

"Social Media Residency": Essential for Tomorrow's Physicians | Social Media and Healthcare |

Should doctors undergo a formal social media training program? The answer from Mayo Clinic is “yes.”

The healthcare system’s social media training program, “Social Media Residency," will for the first time will be offered at another hospital. The program will be held at Lenox Hill Hospital in New York City this June.

Although there have been many doctor advocates for social media, there are still limited social media training resources for doctors, especially for young doctors.


One can argue that doctors should use their common sense to guide their online presence. But as social media and digital technologies progress, the implications of these emerging channels are beyond their functions as communication platforms–innovators in healthcare have been exploring social media for other functions such as clinical recruitment, mobile medicine, hospital re-admission reduction and patient adherence. Some of these explorations have shown promising results and physicians may be able to utilize these new tools in a clinical setting soon.


Thus, training physicians on the use of social media is more than about telling them how to maintain a professional online profile when patients search their names; more important, the training should be about the future trends of the online world, and how physicians can bridge the knowledge in medicine and digital techniques to ultimately advance medicine and enhance healthcare delivery.


There are three reasons why a social media training program like “Social Media Residency” is essential for tomorrow’s physicians.


Physicians will be a driving force in medical innovation  

Physicians are the stakeholders in healthcare who directly engage patients and touch different segments of the healthcare system—from ordering tests, prescribing medications, checking medical record, coordinating with other specialists and even handling billing. Therefore, insights from physicians are unique and valuable for healthcare innovation.


As the healthcare system is shifting to a patient-centered model, non-medication intervention will play a more important role in patient management. Prevention, early diagnosis, better integration and improved patient communication can all contribute to driving outcomes. Many of these improvements can be driven by social media and digital technologies. As physicians work together to deliver cost-effective healthcare for patients, they not only need to understand how these emerging tools work but also use insights to identify opportunities to improve them.


Social media has redefined the relationship between physicians and patients


With free and easy access to medical information, patients are much more educated today. According to a study published on the Journal of Health Communication, 70 percent of surveyed patients planned to ask their doctor questions about the information they found, and 40 percent had printed the information to take to the appointment.  Meanwhile, patients are also using online channels and mobile tools to counsel peers, share experience, track progression of their condition and log side effects of treatments. In some disease state with extremely active patient advocates (e.g., diabetes, cancer, rare diseases), patients are powerful enough to influence policy making and business decisions made by pharmaceutical companies.


Physicians who play a leading role in healthcare delivery cannot react to the trend by ignoring it. To manage the new physician-patient relationship properly requires knowledge in social media and digital—where patients are discussing the condition, what websites contain the most reputable medical content, what mobile apps might add value to disease management for patients and what a proper way would be to convince patients about diagnosis or treatment when it is different from what they found online.


The bottom line is about adding value in healthcare delivery

The essence of patient-centered healthcare is about adding value. As Michael Porter discussed in his famous paper What Is Value in Health Care back in 2010, achieving high value for patients must become the overarching goal of healthcare delivery and value should define the framework for performance improvement in healthcare. Thus, the reason why we need to train physicians on social media should also be about adding value.


Although researchers and the industry are still figuring out ways to measure the value of social media in a clinical setting, some indirect or qualitative findings illustrate social media can enhance value in healthcare.


For example, many studies have shown social connections can be beneficial for mental health. Peer counseling and support groups—things patients do in social media each day—foster such connections and help patients to better cope with their conditions. When I was doing research for a client in ALS drug development, I encountered this comment: “I desperately needed to adjust my ‘new life’ to this ‘new reality.’ Social media has helped with that adjustment by empowering me and other patients.”  This is just one of many revealing patient comments that I have seen in the last couple of years.

Efforts to drive the value of social media in healthcare have also been made by businesses. Forbes reported a company called Healtheo360 has recently launched a patient study designed to measure the advantages of Virtual Social Therapy, a social media-based service developed by the company, in patients with diabetes.


Mayo Clinic’s “Social Media Residency” program indicates leading healthcare organizations have realized the necessity to incorporate social media into the formal training channel and started to experiment emerging tools in a clinical setting. It is a great starting point, but more still need to be explored from multiple perspectives before physicians can ultimately utilize social media to deliver measurable, meaningful and consistent outcomes.

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A conversation about digital literacy in medical education

A conversation about digital literacy in medical education | Social Media and Healthcare |

A strong advocate for including digital literacy in medical education, self-described “geek medical futurist” Bertalan Meskó, MD, PhD, believes that online communication tools, such as social media, can improve the way medicine is practiced and health care is delivered. His interest in technology and health care led him to create a university course focusing on bringing the web into medical practice and to launch Webicina, which offers curated social media resources in 140 topics and 20 languages for patients and medical professionals for free.


In September, Meskó will lead a Master Class on how to teach social media in the context of health sciences as part of the Stanford Medicine X conference. Interested to know more about the class, I contacted him to discuss his approach for incorporating digital literacy into medical school curriculum. Below he discusses, among other things, top trends in social media and health care and why medical professionals should take an evidence-based approach to social media.


Why do you believe that medical students and professionals should engage in social media?

Being a medical professional means we constantly have to communicate with patients, our peers and even with information. Since social media is now an integrated part of communication, medical professionals must deal with this as well. [It's] the responsibility of doctors to deal with e-patients properly and use the Internet in a meaningful and efficient way.

It is getting more complicated to keep ourselves up-to-date and get medical answers when we have really hard questions, but social media can be useful if used with strategy and design. This is why we have to teach how to properly use these tools.


During a 2011 keynote speech at Doctors 2.0 & You, you advocated for health-care providers to take an evidence-based approach to social media. Can you explain why this strategy is important and how you use it in your own practice?

Including social media solutions in any industry can be a fast and efficient process, but medicine works in a different way. I was trained to embrace evidence-based medicine and I use that approach when teaching social media. There are platforms and solutions that might be fantastic and useful in health care, although sometimes when these are tested in practice, they fail compared to traditional methods.

By using the evidence-based approach, I mean that we should not include something immediately in medicine just because it is about social media… We have to test everything to make sure it’s truly useful.


What are some of the top trends you’re seeing in social media and health care?

Platforms come and go. I’m glad to see that trends are now more about meaningful use. There are fewer medical mobile apps downloaded, and people spending their precious time online seem to use the web in a more efficient way. If I have to mention certain trends, I would say Twitter seems to be the top platform for communication; gamification seems to be the best way to motivate students (the Septris app is a good example); people tend to realize they need to know their communities if they want to crowdsource medical questions; and curation of social media is key; while wearable technologies such as Google Glass will definitely add new practices to using social media.

But the practice of medicine must still take place in real life, and these digital technologies can only be useful after an established relationship between the patient and the doctor.

In 2008, you introduced the Social Media in Medicine course at the University of Debrecen, Medical and Health Science Center in Hungary. In creating the course, what was your process for selecting which topics and platforms to cover?

I was lucky from two perspectives. First, I tried and evaluated all the social-media platforms myself – from Wikipedia to medical blogging to crowdsourcing a diagnosis on Twitter. Second, the university committee gave me a chance [for this pilot class] to make decisions about the content. Since every student filled in online surveys before and after each semester, I’ve got a lot of data based on which changes I made to the curriculum. Due to the basic nature of social media, I must constantly change some parts of the content to meet today’s expectations.

I wanted to show the medical use of a range of social platforms and also wanted to transmit concepts to the students. This is why I launched the course with a series of 13 lectures [on topics ranging] from using e-mails to the future of web.

How has the Social Media in Medicine curriculum evolved over the past five years?

Last year, I moved the course to Semmelweis University, a medical school with over 240 years of history. Now it runs with full house every semester in English and Hungarian. The curriculum represents today’s social media trends (in 2008, I mentioned Twitter in a lecture, now a whole week is dedicated to microblogging) and I also implemented some new approaches.

As all the students in the course are on Facebook, this semester they worked for bonus points on the Facebook page of the course by answering questions about digital literacy every single day. The winner did not have to take the exam last week.

The course has a website where all the lectures, hand-outs and notes are available and students can take tests.

Moreover, using my large social network I try to get a prototype of every important development in medical technology, such as AliveCor ECG and other devices. Students can use these in practice; I really try to train them for the world of technological advances by the time they graduate from medical school.

How would you advise medical schools to encourage students and educators to proactively use social media?

The only way to fill health care with technology-savvy medical professionals is to train them like that. Therefore I don’t think that encouragement is the best solution - but first digital literacy should be included in the medical curriculum as well as in post-graduate education.

Maintaining an exemplary social-media presence is certainly a good start for medical schools. But to persuade students and educators to proactively use social media, good practical examples have to be demonstrated to them. In my experience, this is the best strategy.

What specific tips can you share for medical educators who want to leverage the power of social media by incorporating interactive content into existing curriculum?

For this, educators should first check the digital landscape of the topics they teach by searching for relevant content, resources and even mobile apps. They should listen to other educators who are already active online.

The most important thing here is a quote I’ve been using for years: “If you want to teach me, you first have to reach me.” Therefore I love going to the platforms that my students are already using. This semester it was Facebook, and I managed to teach them and test their knowledge on that platform. It was a real win-win situation.

All medical educators should design a new approach in transmitting the knowledge to students by analyzing what they do online. We do the same thing in the offline world by coming up with new textbooks and creating engaging presentations - why would we not do that online as well?

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Social Media Implementation Checklist

Social Media Implementation Checklist | Social Media and Healthcare |

Set goals first. If traffic, leads and sales are part of the goal, then gotta have the next focus be on content creation. Then, using social to share. Can't get much value out of social unless you're actively creating, publishing and sharing content. 

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What the Khan Academy Teaches Us About What Medical Education Will Look Like Ten Years

What the Khan Academy Teaches Us About What Medical Education Will Look Like Ten Years | Social Media and Healthcare |

From SFO, I carefully followed my Droid Navigator’s directions off Highway 101 into a warren of non-descript low-slung office buildings—non-descript except for the telltale proliferation of Google signs and young adults riding colorful Google bikes.  I drove around to the back of several of those complexes and finally found the correct numbered grouping.  It really could have been any office or doctors’ office complex in the U.S.  The Khan suite is on the second floor. 


There’s a simple brass plate saying “Khan Academy” on what looked like oak double doors. I let myself in and immediately encountered a large, central open space—with long dining tables, food, an ample sitting area with couches conducive for group discussions—and a friendly greeting by programmers and staff.  Oh, and computers—there were lots of computers.  As far as I could tell, nobody had their own office—though maybe Sal does.  Everyone was also open, friendly and passionate about the great work happening there.


After some trial and error, Rishi and I found an unused office and huddled around his Mac for a Google Hangout interview with a Bay Area reporter about the Khan/RWJF health care education project.  Later, I met with Shantanu, the Khan COO and former “math jock” high school friend of Sal, as well as Charlotte, external relations, and Matt, software engineer. They’re all long termers at Khan—that means they’ve been there for about two years.  Overall, the energy was pretty electric.  One other small thing—do not be fooled—these incredible people are, how should I put it—ferociously—intense and focused.


Pioneers in flipping the med school classroom

The next morning, Rishi and I met at Stanford Medical School—in the Li Ka Shing Center for Learning and Knowledge—an enormous and beautiful building off Campus Drive near the hospital that did not exist back in my days as an earnest Stanford law student.   We were there to observe some pioneers in medical education attempt to use Khan-like videos to flip the medical school classroom.  This work at Stanford is part of the currentKhan Academy and RWJF collaboration. We’re trying to understand what happens when a medical school attempts to use the Khan-style videos to change the classroom interaction.


The class we observed was an ECG Cardiology course.  The professor, Dr. Paul Wang, was everything you’d want from a teacher—smart, informed, compassionate, patient—and popular with his students.  The students were great—also smart—and empowered.  Several noted that they liked viewing the video before class.  In fact, at one point, a number of female students grouped around Rishi—once they discovered he was the man behind the Khan medical school curriculum videos—and gushed.  I momentarily flashed to black and white footage of Beatle-mania.


This Stanford class-flipping experience is new—in fact, it’s just a week old—so I got to see it at its beginning.  In the first hour, Dr. Wang essentially gave the video lecture again.  In the subsequent two- hour small group sessions, the students worked with teachers on ECG problem-solving and games.  They engaged well with the teachers and each other—and seemed to be using new vocabulary and identifying ECG patterns pretty adeptly by the end.


The dean, Dr. Charles Prober—a Stanford Medical School champion of moving medical education content into YouTube format and onto the Khan platform— was there.  Another local champion of this work, Dr. Drew Patterson, associate professor of anesthesiology, was there as well.  These leaders, Drs. Prober, Patterson and Wang, are creative and brave people.  They are trying to bring the first ripples of widening care transformation to fortress academia, and no doubt the status quo will not adjust quietly.  Both Drs. Prober and Patterson spoke passionately about the enormous potential of this technology along with changing attitudes about medical education.  They are trying hard to get their medical school to embrace that change and help lead it.


Facing massive changes and challenges

This new work is not without problems, of course.  In fact, it’s pretty challenging.  Rishi and I witnessed early baby steps.  Drs. Prober and Patterson readily admit that they would like to rely more on videos, better empower students to teach themselves based on those videos and more quickly change the role of teachers to be more like coaches.   Rishi and I also, though, wondered about waves of transformation hitting health care now—around, for example, patient empowerment and professional accountability for results and decreased cost.  Those massive changes include efforts to alter the dynamic both between the professional and the patients and among various health care professionals.  Those challenges are enormous and could swamp fledgling incremental efforts to help a few medical students learn well and efficiently.  Right now—in this interesting experiment—these teachers are not yet training for that new day.  I say, though, give them time.


Rishi and I also talked about an even more worrisome point.  What if in the near future much of this learning becomes anachronistically analog?  Imagine the coming proliferation of Watson-like artificial intelligence in health care.  On our visit we observed bright minds learning how to “read ECGs.”  That’s what medical students have done since ECGs came to medicine—that’s part of what medical students must learn.  What about when things change, though?  It’s not too much of a leap to imagine that a device will simply inform teams—including the patient, by the way—of the definitive ECG reading.  All this learning about how to read ECGs would then be superfluous—an “FYI.”  What then?  My guess is that we’ll need professionals who are very adept at taking that knowledge and working together with patients do the actual healing—you know like Bones on Star Trek.


We have a lot of work to do.

Michael W. Painter, JD, MD is the senior program officer at the Robert Wood Johnson Foundation. This post originally appeared on the RWJF Pioneer Blog.

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How Hospitals are Using Social Media For Patient Education

How Hospitals are Using Social Media For Patient Education | Social Media and Healthcare |
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Social Media Made Easy: Guiding Patients to Credible Online Health Information and Engagement Resources

Social Media Made Easy: Guiding Patients to Credible Online Health Information and Engagement Resources | Social Media and Healthcare |

Within the changing dynamic of health care, health care professionals (HCPs) are no longer the sole sources of health information. Recent estimates suggest that 83% of Internet users with chronic conditions such as diabetes go online to look for health information.1 People with diabetes seek online information about the condition, treatment options, practical strategies and tools for managing diabetes in their daily lives, scientific breakthroughs, and advocacy efforts.2 


Yet, a Google search for “diabetes” returns 290 million results. A search for “diabetes online support” yields close to 36 million results. This can be overwhelming for anyone.

Some HCPs assist with this information overload by filtering and narrowing down online resources and search results for their patients. SurroundHealth, an online learning community for nonphysician HCPs, recently surveyed its members about the use of educational technology in health care. Many respondents reported that they used time during patient interactions to refer patients to online resources. Eighty-two percent of HCPs in private practice reported having referred patients to specific online resources, compared to 60% of HCPs in outpatient clinics and 52% of HCPs in hospital settings.


The HCPs who made referrals intended to help patients overcome common online obstacles such as difficulty distinguishing between high-quality information and material that is out of date, inaccurate, or overly promotional.3 Connecting patients to credible online health information during office visits can facilitate more appropriate use of health care resources, shorter clinical encounters, more patient-centered decision-making, and, in some cases, reduced barriers to treatment adherence.4,5


This article explains how online health information and engagement resources are integrated into patients' overall health care experiences. In addition, it addresses common HCP concerns about patients accessing online resources and will outline steps that busy professionals can take to help connect patients to appropriate online resources.

Online Health Information Resources Versus Online Health Engagement Resources

Online health information resources push information out to the patient, whereas online health engagement resources promote the sharing of information, as well as support and interaction among patients.

Within an online health information resource, the information flows in one direction—from the content author to people with diabetes. The content reflects the perspectives and priorities of the author or author's organization. The author determines what information to share and when and how to share it. Typically conveyed in an objective manner, the information is usually vetted for factual accuracy before publication.


Examples of online health information resources for people with diabetes include Web sites of the American Diabetes Association (ADA;, the National Diabetes Education Program (, and the Centers for Disease Control and Prevention's Diabetes Public Health Resource ( In addition, people with diabetes can find credible health information resources via online learning centers affiliated with medical centers such as the Joslin Diabetes Center (


In contrast, online health engagement resources are social-networking tools and platforms (e.g., blogs, Twitter, Facebook, YouTube, and other online community sites) that allow active, two-way sharing of information (Table 1). Created by participants or community members, content often focuses on the real-life challenges of living with a particular disease or condition and offers emotional support, encouragement, coping, and problem-solving. People with diabetes often determine for themselves which specific health engagement resources are most useful and credible based on their life situation and learning needs. The information in health engagement resources is not guaranteed to be vetted for factual accuracy and may reflect an individual's opinion or experiences.

View this table:
Table 1.

Comparison of Social Networking Tools and Platforms

Examples of online health engagement resources for people with diabetes (, Diabetes Social Media Advocacy (DSMA) (, Children With Diabetes (, and You Can Do This Project ( In general, the goal of health engagement resources is not to undermine the professional-patient therapeutic alliance or replace medical recommendations, but rather to serve as a source of inspiration, offer motivation and encouragement, and provide a sense of community.

Table 2.

Comparison of Health Information and Health Engagement Resources

Limited formal evidence exists of the effect of patients' involvement in social media on their overall health. However, research is underway to determine whether participation in a controlled social network of HCPs, patients, friends, and family members has a positive effect on knowledge, attitudes, and diabetes self-care management.6 Although providers seek evidence to support the use of social media in improving diabetes care, people with diabetes view social media as tools to facilitate connecting with others, not as an intervention or a treatment approach.


Well-known blogger Kerri Sparling, who has type 1 diabetes, commented in a recent column titled “Proof Is in the People,”7 on HCPs' interest in evidence: “Through connecting online, and in person, people living with diabetes have concrete proof that they are not alone, and that there is health worth fighting for, even after a diabetes diagnosis. Social media … shows people that there isn't such a thing as a ‘perfect diabetic,’ but there can be an educated and determined one. It lets people know they aren't alone in the ebb and flow of their diabetes management. It doesn't encourage people to wallow in their troubles, but serves to inspire them to do the best they can, and to seek out the best healthcare they can find, both at home and in their doctor's offices.”


Although the characteristics of health information resources differ from those of health engagement resources (Table 2), many people with diabetes consider both to be part of their overall online experience (Figure 1). In combination, online health information and health engagement resources represent informal learning and support that can complement the more formal information and education that people with diabetes receive from their HCPs.


Online health information and health engagement resources represent informal education and support that can complement the more formal education people with diabetes receive from their health care team during office visits.

These resources are also there for HCPs' use. By going online and becoming acquainted with the different resources, HCPs may gain a better perspective on how their patients experience and learn from such sites. However, even with a deeper understanding of the value of online resources for patients, HCPs may struggle with concerns about protection of patient privacy, their professional responsibility, and the time constraints involved in staying up to date on available resources.

Overcoming Concerns About Privacy and Time

HCPs may hesitate to learn about or participate in social media because of concerns related to the Health Insurance Portability and Accountability Act (HIPAA) and uncertainty about how much to engage with people (possibly patients) online. HIPAA protects patients' privacy by limiting the ways in which their information is shared with others. Patients can choose to share or engage online and provide personal health information, whether about their care and treatment, health care decisions, or details of their patient-professional interactions. HCPs' reading of content that patients chose to share online does not violate HIPAA. However, commenting in a public setting to an individual patient without the patient's signed consent may be considered a HIPAA violation or cause concern that the patient's privacy is not being protected or respected.8 

Even if an HCP has a signed patient consent form, when commenting within a public viewable health engagement resource, the professional should provide only general health information and avoid specific, individualized medical advice. Privacy-protected e-mail is the best tool for direct online communication about medical care with individual patients.

Lack of time is another deterrent to embracing social media for busy HCPs. In addition to more traditional avenues of continuing education (e.g., medical meetings, symposia, and peer-reviewed journals), HCPs may benefit from supplementing their education with social learning and curation. Curation is the process of evaluating a range of available resources and identifying specific ones that are most appropriate for patients' needs. Like a museum curator selecting pieces of art to include in a display, HPCs can identify and select online resources to share with their patients. Ultimately, the curated resources that professionals share with their patients can be an effective strategy to both enhance direct-to-patient education and save time during in-office education. In addition, posted patient experiences within the resources can help HCPs themselves learn about patients' challenges and insights related to new treatments and technologies.

Patients' Perceptions of HCPs' Involvement in Social Media

Because of the availability of social media tools, people with diabetes can now congregate and interact with each other online without restrictions of geographical location. Thus, online networking and engagement by people with diabetes is collectively referred to as “the diabetes online community.” This online community also includes friends, family, and HCPs who work with people with diabetes.


DSMA holds weekly Twitter chats, known as #DSMA, for people with diabetes. During the 20 June 2012 chat, participants were asked to comment about whether having HCPs using social media was valuable. Responses included, “Yes, it will help them learn more about the 24/7 aspects to living with diabetes,” “Yes, but I worry about ‘big brother medical care’,” and “Yes, to connect on a more human level, but no lecturing/knowing what's best.” Overall, the #DSMA community consensus appeared to be that participation by HCPs in social media would be valuable and could help HCPs further their understanding of the complex issues that people with diabetes must deal with daily.9


Building the Bridge From Office Visit to Online Interaction: Time-Saving Approaches

Helping patients access online health engagement resources does not have to be a time-consuming endeavor, and professionals do not have to actively use all social media platforms and tools. Professionals can use the steps to curate credible resource suggestions for their patients.

1. Solicit and review recommendations.

Ask staff members and patients to share their favorite online health information and engagement resources for diabetes. A listing of many health engagement resources can also be found at the Diabetes Advocates Web site (; click on the tab for Members and Resources). Diabetes Advocates identifies a number of health engagement resources specifically for people with type 1 or type 2 diabetes, for parents of children with diabetes, and for Spanish-speaking people with diabetes.

Seeking input from patients regarding health engagement resources is crucial because HCPs may not have the necessary objectivity to identify the most useful engagement resources. People with diabetes of varying ages and life situations are sharing their experiences through health engagement resources. Relying on patients to help identify the most useful health engagement resources ensures a synergy between patients' needs and the recommended resources. Remember that self-policing among individuals within online diabetes communities also helps to ensure that the most credible and useful resources gain validation and trust.

HCPs should ask their staff members and patients the reasons the resources they recommend are highly preferred and use that rationale to inform their own recommendations. Seeking input positions HCPs as curators and navigators on behalf of patients and decreases the appearance of bias or of “endorsement” by professionals.

2. Create a list of credible online resources to proactively share with patients during office visits.

Before sharing the list, HCPs should first access and review the recommended online resources to become familiar with what they offer patients. HCPs or health care organizations that have their own Web sites can also share resource links via their sites.

HCPs should use the opportunity to emphasize to patients that a diabetes care plan is based on individual needs. If patients want to make changes to their plan based on online information or conversations, they should first discuss the proposed changes with their HCP.

HCPs should emphasize characteristics that indicate that a resource may not be credible. These include sites that:

Sell a specific product or service

  • Display numerous advertisements, which may indicate potential for editorial bias

  • Tout a quick fix or cure

  • Use sensationalized stories and testimonials to persuade patients to take a specific action

Likewise, HCPs should teach patients how to recognize credible resources. These include sites that:

  • Clearly identify the backgrounds and experience of the content author and the reason for sharing the information

  • Offer a balanced perspective or information that is vetted and backed by a trusted organization such as the ADA

  • Provide current and frequently updated content

  • Seek input from credentialed medical advisors for any clinical content about diagnosis and treatment

3. Assess patients' use of online resources and level of health literacy.

Identify the health information and engagement resources patients are using, and gauge their level of understanding of such health information. Ask patients how the resources are helping them, and offer to address specific questions related to the information. Ask patients what tips and advice they would give other patients who want to reach out to online communities. Integrate this advice into ongoing discussions with other patients.

The number of patients who look online for diabetes-related information and resources is expanding. HCPs who proactively encourage patients to investigate reputable online health information and engagement resources may help improve their patients' problem-solving skills in managing diabetes day to day while also potentially strengthening the HCP-patient relationship.

Nevermore Sithole's curator insight, November 4, 2013 5:53 AM

Health Information Literacy

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The use of social-networking sites in medical education - research paper

The use of social-networking sites in medical education - research paper | Social Media and Healthcare |
Background: A social-network site is a dedicated website or application which enables users to communicate with each other and share information, comments, messages, videos and images.

Aims: This review aimed to ascertain if “social-networking sites have been used successfully in medical education to deliver educational material”, and whether “healthcare professionals, and students, are engaging with social-networking sites for educational purposes”.


Method: A systematic-review was undertaken using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Eight databases were searched with pre-defined search terms, limits and inclusion criteria. Data was extracted into a piloted data-table prior to the narrative-synthesis of the Quality, Utility, Extent, Strength, Target and Setting of the evidence.


Results: 1047 articles were identified. Nine articles were reviewed with the majority assessing learner satisfaction. Higher outcome measures were rarely investigated. Educators used Facebook, Twitter, and a custom-made website, MedicineAfrica to achieve their objectives.


Conclusions: Social-networking sites have been employed without problems of professionalism, and received positive feedback from learners. However, there is no solid evidence base within the literature that social-networking is equally or more effective than other media available for educational purposes.

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Social Media Spots a Strep Outbreak

Social Media Spots a Strep Outbreak | Social Media and Healthcare |

An alert parent who noticed postings about multiple cases of severe sore throat on Facebook helped the Minnesota public health authorities identify a foodborne outbreak of group A Streptococcuspharyngitis, according to a new report.


Within days of a banquet given for an all-female high school dance team attended by 63 people, a parent notified the public health department of a cluster of cases of strep throat described on the team's Facebook page, Sarah K. Kemble, MD, of the Minnesota Department of Health, and colleagues reported.


A total of 18 primary cases ultimately were confirmed, for an attack rate of 29%, the researchers reported online in Clinical Infectious Diseases.

Foodborne illness associated with group AStreptococcus today isn't widely reported, but may be more common than usually recognized because patients and contacts may assume the infection is spread by the respiratory route.

The Minnesota outbreak occurred in March 2012, when teenage girls and their family members who had attended the banquet began posting comments about having sore throats and fever.


The public health authorities suspected a possible foodborne cause because, when cases have been identified in the past, the usual source was infected food service workers.


They therefore conducted telephone interviews with 100 people who had attended the banquet and their classmates and household contacts, obtaining detailed information about food and beverage preparation and consumption.

The banquet menu included pasta, various sauces, breadsticks, salad, and cake, and drinks included water, soda, lemonade, and coffee.

Cases were confirmed by rapid strep tests and/or cultures, individual isolates were analyzed using pulsed-field gel electrophoresis, and the CDC provided sequencing of the emm gene that encodes an M protein on the pathogen's cell surface.


In addition to the 18 primary cases, there were three secondary cases and two cases of colonization.


Among the primary cases, median age was 16.5 years, and 89% were female.

Seven parents or coaches also were among the primary cases.

The incubation period was about 1.5 days, and disease duration was 2.5 days.

Aside from the sore throat, the majority of patients also had swollen lymph nodes and fever. All had received medical care at an emergency department, urgent care center, or physician's office.


None of the patients developed sequelae.


A definite food source for the infection wasn't found, but pasta appeared to be the most likely culprit, with a relative risk of 3.56 (95% CI 0.25 to 50.6, P=0.29).

The pasta had been prepared by a team member's parent, who had been ill with pharyngitis 3 weeks earlier. The parent cooked the pasta 2 days in advance of the event, wearing gloves, and stored it in plastic bags in the refrigerator.

Four hours before the event, the pasta was reheated in roasting pans to 160 degrees.


The infectious inoculation most likely occurred during the reheating process, according to the investigators.


"Reheating a substantial volume of pasta could have provided an excellent growth environment for [group A Streptococcus], because heating likely occurred unevenly and [group A Streptococcus] is known to grow rapidly in this type of medium at temperatures of ... 68 to 98 degrees F," they explained.

The streptococcal strain identified in this outbreak was emm type 1, which is common in North America and Europe and has been linked with disease recurrences.


"Potential causes of recurrence include antibiotic resistance (to macrolide antibiotics), deficient adherence to the prescribed antibiotic regimen, copathogenicity with beta-lactamase-producing bacteria, eradication of protective normal pharyngeal flora, or host-dependent factors," the researchers observed.


They noted that social media "played a critical role" in identifying the outbreak.

"More formalized use of social media for disease surveillance and outbreak investigation has the potential to benefit public health in appropriately selected circumstances," they noted.


In addition, clinicians need to remain on the alert for clusters of symptoms, according to study co-author Edward Kaplan, MD, of the University of Minnesota in Minneapolis.


"When one sees this happening as a physician in the community, then there is an opportunity -- in fact perhaps an obligation -- to follow up and see if there's a common source," Kaplan told MedPage Today.


Limitations of the study included the possibility of recall bias and the lack of a definitive link to the index household because the initial cases were tested only by rapid antigen detection.

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Social Media for Residency Programs – #ABIM, #FOAMed, #MedEd

Social Media for Residency Programs – #ABIM, #FOAMed, #MedEd | Social Media and Healthcare |

There has been a lot of discussion lately around the use of social media in medical education. The topic has been researched, discussed and analyzed. Our favorite social media tool for ABIM exam review / medical education is twitter. The platform provides a convenient way to teach, learn from, and connect with others interested in medical education. Our belief is that it can be a powerful tool for residency programs to enhance medical education for their residents. Below is our list of the top internal medicine residency programs using twitter as an education tool:

East Carolina University (@ecuimchiefs) – Internal medicine pearls, trivia, and ABIM exam style clinical vignette questions

University of Chicago (@MedChiefs) – Great internal medicine pearls and information to stay current on what’s happening

University of Texas Health and Science Center in San Antonio (@UTHSCSAIMres) – Great use of twitter for internal medicine board exam prep

New Hanover Regional Medical Center (@NHRMC_IM) – Sharing pearls useful for ABIM board exam review

Thomas Jefferson University Hospital (@JeffIMchiefs) – Sharing pearls and valuable medical education articles

University of Nebraska Medical Center (@UNMCIMResidency) – Use of twitter to update residents on conferences and seminars

University of Florida (@UFGenIM) – Sharing important medical education articles

West Virginia University (@WVUim) - Occassional board pearls and RTs of important NEJM articles

There are a few other residency programs on twitter but the posts are few and far in-between. Here’s hoping other IM residency programs follow the lead of the programs above and begin using twitter to provide medical education to their residents! Fortunately, there are some top notch educators have joined twitter to provide #FOAMed (Free Open Access Medical Education). Below is our attempt to list some of the best educators for medical education and internal medicine (ABIM) exam prep.

This is by no means a complete list – In fact, there are a lot more educators and #FOAMed enthusiasts that are on twitter. This is simply a small list of people to follow for Internal Medicine Board exam prep. Even then – we are certain we have missed some really great handles! We’ll keep updating it.

We are also counting on our twitter followers to help make this the best list possible:

Knowmedge (@knowmedge) Salim Rezaie (@srrezaie)UTHSCSA Pearls (@UTHSCSAPearls)Internal Medicine (@IMMemorandum)Medicinemia (@Medicinemia)Joel Topf (@kidney_boy)Edgar V. Lerma (@edgarvlermamd)Haney Mallemat (@Criticalcarenow)Nikita Joshi (@njoshi8)Matt Astin (@mastinmd)Conrad Fischer (@SeeFisch)David Marcus (@EMIMDoc)FOAM Highlights (@FOAM_Highlights)Javier Benetiz (@jvrbntz)Natalie May (@_NMay)

While this post is focused on use of twitter for internal medicine education / ABIM, we would be remiss if we didn’t point out a couple of great #FOAMed lists – GoogleFOAM and Dave Townsend’s “Internet Resources for Medical Students”. Twitter is a fantastic tool for education – there is already a strong and growing #FOAMed and #MedEd community that exists.

If you or your medical residency program are not already on twitter, we highly recommend joining in the conversation! Happy tweeting! #ABIM #MedEd #FOAMed

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Medical Schools Using Social Media for Faculty Development

Medical Schools Using Social Media for Faculty Development | Social Media and Healthcare |

Physicians and scientists at academic medical centers face many competing demands for their time. Efforts to help them improve their teaching or scholarship traditionally have taken place in face-to-face lunchtime workshops. As clinical volume and the difficulty of obtaining external funding increases, faculty members have less opportunities to devote to their own professional development.

Researchers from BUSM and BUSPH surveyed the websites of all 154 accredited medical schools in the U.S. and Canada to locate examples where medical schools have used social media to engage with faculty in a virtual environment. Their findings were recently reported in Medical Education Online.

The researchers found 22 medical schools (14.3 percent) employed at least one social media technology tool in support of faculty development. In total, 40 instances of social media tools were identified — the most popular platforms being Facebook (nine institutions), Twitter (eight institutions) and blogs (eight institutions). Four medical schools have developed integrated strategies to engage faculty in online communities. “Our results show that only a few medical schools, including BUSM, are experimenting with online tools to boost faculty productivity and effectiveness,” said senior author Christopher Shanahan, MD, assistant professor of medicine at BUSM.

According to the researchers, although relatively few medical schools have embraced social media to promote faculty development, the present range of such uses demonstrates the flexibility and affordability of the tools. “The most popular tools incorporate well into faculty members’ existing use of technology and require minimal additional effort,” added Shanahan. The researchers believe more research into the benefits of engaging faculty through social media may help overcome hesitation to invest in new technologies.

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3 ways to get docs to use hospital social media

3 ways to get docs to use hospital social media | Social Media and Healthcare |
Doctors are crucial to hospitals' marketing and social media strategies but organizations across the country struggle to get their physicians to use social media.

To help get physicians on board with your social media plans, look at the following 3 suggestions

1. Create educational content: Doctors spend a huge chunk of their day educating patients so developing useful, informative content that patients can access online has the potential to save physicians time,  Ask your physicians for the instructions they repeat throughout the day to patients and suggest they work on an instructional video or article on the subject that the hospital can post online.

2. Do the legwork: Make it easier on doctors by assigning marketing department staff to create accounts and upload physician bios and photos. By making this a marketing function, physicians can make better use of their time developing content for your site.

3. Share results with physicians: Reward doctors who share their expertise by showing them how their photos, videos or articles led to an increase in traffic to your hospital website or rise in clinic registrations, the article states.

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Social Media in Medical Education: The Debate

This debate took place between Dr Damian Roland and Dr Rakesh Patel at the University of Leicester Medical School on 26 June 2013.
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