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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Programs for Physicians Should include Online Options

Programs for Physicians Should include Online Options | Social Media and Healthcare |

A recent survey from Medical Marketing Service Inc. (MMS) stated that "the key to successful medical direct marketing is listening to physicians, not only by analyzing results of client direct mail and email campaigns, but also by conducting annual surveys." Early in 2013, MMS conducted surveys to physicians regarding three aspects of medical marketing:

  1. CME,
  2. pharmaceutical marketing, and
  3. physician recruitment.

The surveys were emailed to random samples from the AMA Physicians List, generating 516 responses. The results are as follows:


  • Physicians want and read email and direct mail, and are reading email on mobile devices. Therefore, email and direct mail should be part of every medical marketer's multichannel mix.
  • Physicians read email during evenings and weekends/days off.
  • Physicians check multiple email addresses.
  • A majority of physicians prefer email at their professional/office address.
  • They are almost unanimously interested in honoraria, which should be offered to qualified professionals whenever legal, ethical, and practical.
  • Online CME is on the ascendant, so CME providers should offer and promote online options.
  • Physicians prefer to receive pharmaceutical information via email instead of from sales reps.
  • Pharmaceutical marketers should offer samples in their email marketing.
  • Recruiters should emphasize location and compensation in direct marketing, and make it easy to respond by email and phone.

In addition to this survey, researchers recently looked at the use of social media in medical education to answer two questions: (1) How have interventions using social media tools affected outcomes of satisfaction, knowledge, attitudes, and skills for physicians and physicians-in-training? and (2) What challenges and opportunities specific to social media have educators encountered in implementing these interventions?

The authors searched the MEDLINE, CINAHL, ERIC, Embase, PsycINFO, ProQuest, Cochrane Library, Web of Science, and Scopus databases (from the start of each through September 12, 2011) using keywords related to social media and medical education. Two authors independently reviewed the search results to select peer-reviewed, English-language articles discussing social media use in educational interventions at any level of physician training. They assessed study quality using the Medical Education Research Study Quality Instrument.

Fourteen studies met inclusion criteria. Interventions using social media tools were associated with improve

  • knowledge (e.g., exam scores),
  • attitudes (e.g., empathy), and
  • skills (e.g., reflective writing).

The most commonly reported opportunities related to incorporating social media tools were

  • promoting learner engagement (71% of studies),
  • feedback (57%), and
  • collaboration and professional development (both 36%).

The most commonly cited challenges were

  • technical issues (43%),
  • variable learner participation (43%), and
  • privacy/security concerns (29%).

Based on these findings, the authors concluded that social media use in medical education is an emerging field of scholarship that merits further investigation. The authors also noted that "educators face challenges in adapting new technologies, but they also have opportunities for innovation."

New CME Tool

In other CME news, a toolkit has been developed based on a recently-completed performance improvement CME activity to help clinicians manage neuropathic pain of residents in long-term care facilities. The PI CME activity was co-sponsored by The Academy for Continued Healthcare Learning (ACHL) and the University of Michigan Medical School, and supported by an educational grant from Pfizer, Inc.


This toolkit provides resources, templates, and strategies to help long-term care facilities and clinicians develop their own quality improvement project. The goal of this project is to help clinicians accurately and appropriately manage residents with neuropathic or persistent pain.

This toolkit is available on the Agency for Healthcare Research and Quality (AHRQ) Innovations Exchange siteThe toolkit is designed based on the following model of performance or quality improvement:

Stage A: Learning from current practice performance assessment

Stage B: Learning from the application of performance improvement to patient care

Stage C: Learning from the evaluation of the performance improvement effort

- See more at:

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Social Media Connections: The Rise of Virtual Courses for CMEs

Social Media Connections: The Rise of Virtual Courses for CMEs | Social Media and Healthcare |

In this column, I’d like to explore what our world might look like in the near future and answer the question, “What impact will new social learning technologies have on the future of medical meetings and medical education?”  


So here are my predictions for the next three to five years:

1. The number of medical meetings will decrease by up to 50 percent.

2. The amount of online medical education will increase by up to 300 percent.

3. The vast majority of emerging online medical education will be received through “virtual course” models.


Here is why I think these things will happen:

For the past few years I have been looking for trends in how learners access medical education, and one is that live meetings are falling out of favor with learners due to the high costs and inconveniences they entail. This trend has been confirmed in data we have recently gathered across hundreds of clinicians—the future will include fewer live meetings and more online learning.


Online learning has evolved, and now the integration of new social learning technologies is accelerating this evolution. There is an clear opportunity to use online channels to offer more convenient, more interactive, and less expensive education.


Clinicians are increasingly comfortable engaging in online learning communities. And, perhaps even more critical, we are learning (through published research) how to structure these learning communities to increase their “perceived usefulness” for clinicians. We can apply this research in practice by designing competency-based curricula delivered within smaller, safer, closed virtual classrooms. When you leverage social learning technologies in the design of virtual courses, you enable learners to sustainably engage with faculty, interact with “classmates,” and absorb content efficiently.


As for the timeframe—three to five years—the reality is that this evolution is unlikely to be linear. The evidence we have already gathered, coupled with trends we can see in other disciplines, suggest that changes will more likely be exponential. As more learners experience these new models, and as they see the benefits of learning and sharing together, then we may very well see changes happening even more quickly. The question is whether the expectations of learners will soon outpace the capacity of the medical education community. So my question for you is: Will you be ready to lead this change?


Brian S. McGowan, PhD, has dedicated the past 12 years to medical education as a faculty member, mentor, accredited provider, and commercial supporter. The opinions expressed are McGowan’s and do not represent the views of past, current, or future employers. Contact him via Twitter: @BrianSMcGowan.

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Can Social Media Expand the Audience For Medical Research Articles

Can Social Media Expand the Audience For Medical Research Articles | Social Media and Healthcare |
The use of social media tools, for the purpose of releasing an article in the clinical pain sciences, increases the number of views and downloads

The use of social media tools – Facebook, Twitter, LinkedIn, and – for the purpose of releasing an article in the clinical pain sciences increases the number of people who view the article and download it. Social media tools also have implications for the dissemination of medical research articles in other fields.


Generally, anyone interested in accessing research articles either utilizes a research database such as Pubmed or simply follows a few specific journals. As a result, many articles go unnoticed because end users who could benefit from them lack the time to find them. In addition, those who have time to search these databases may be overwhelmed with lots of articles that are not relevant to their needs.

Approach to Address Problem

The researchers selected 16 PLOS ONE articles using four inclusion criteria relevant to the clinical pain sciences, first published online between 2006 and 2011, of interest to readers of a research group blog (, and not previously mentioned in a blog post on The articles were assigned randomly to four researchers who wrote blog posts on them, comprised of approximately 500 words and a link to the online version of the article. These blog posts were randomly assigned two dates: one date for a social media release and one date as a control. The control is not well explained by the researchers and appears to represent a period where nothing is being done to promote the article.


The key innovation in this research project was the use of social media to push research information to end users instead of waiting on the end users to “pull” the information from a database.

Key Results

The key result was a statistically significant increase in HTML views and PDF downloads one week after the blog posts when comparing the control date and the social media release date  (p < .05). However, none of the measures of social media reach, engagement, or virality related to the outcome variable. Hence, some other unknown factors are affecting HTML views and PDF downloads.

Implications for clinicians/health care system

Better dissemination of research can save clinicians time by improving the efficiency of information uptake by them. This is useful for health care systems because this is one of the many ways that a health system can improve its quality. One of the challenges is making sure that the information coming from social media is well catered to the needs of clinicians.

Implications for public health

Improved dissemination of research could also provide benefits to the public. In the case of patients or lay individuals, social media can be used to send not only research articles, but lay translations of the information in order to increase the probability of more people understanding the information. This can contribute to increasing health literacy of individuals.
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The changing face(book) of medical research

The changing face(book) of medical research | Social Media and Healthcare |

Is it time for the medical research community to friend Facebook? One research group’s experience with the social media tool suggested yes, but an accompanying editorial urged caution. 


Shannon W. Stephens, EMT-P, of the emergency medicine department at the University of Alabama School of Medicine in Birmingham, and colleagues described their experience using Facebook to facilitate two Resuscitation Outcomes Consortium (ROC) trials in the July 16 issue of Circulation. Trauma and emergency research such as theirs falls under an Exception From Informed Consent federal regulation, which includes a community consultation and public disclosure (CC/PD) process.


Traditionally, researchers turn to community town hall meetings and random-digit telephone dialing in an effort to address CC/PD, but these are costly and inefficient, Stephens et al pointed out. They instead chose Facebook as a way to reach the public for two trials, one on cardiac arrest and the other on major trauma. For each, they posted Facebook ads targeted by age and location.


The cardiac study ad, posted between Dec. 14, 2011 and Jan. 12, 2012, had 27 displays per target population, with 437 people being redirected to the study website for a cost of $2.29 per visitor. The trauma study ad was posted between Feb. 1 and April 30, 2012. It had 28 displays per target population, with 743 people being redirected to the study website for a cost of $1.35 per visitor.  By contrast, a previous study using traditional CC/PD methods cost $17.24 per person.


The majority of visitors for both the cardiac and trauma trials were women between the ages of 40 to 54 years old. Only 16 percent of the cardiac study viewers and 12 percent of the trauma trial viewers spent a minute or more on the site.


Stephens et al wrote that social media offers an efficient mechanism to reach a large audience, but acknowledged Facebook use was demographically spotty and needed to be augmented with strategies to fill those gaps.


In an editorial, Katherine C. Chretien, MD, of the Veterans Affairs Medical Center in Washington, D.C., noted that the emerging role of social media in research raised concerns and challenges. About 20 percent of the population in the U.S. does not have access to the Internet and of those who do, only half access social media sites.


“Full CC/PD simply cannot occur when certain subpopulations, vulnerable populations who are more likely to require emergency medical services, are not invited to the discussion,” she wrote.


Chretien viewed social media as complementary to traditional CC/PD methods but emphasized ethical and logistical challenges such as privacy, data ownership, informed consent and access. Regulatory agencies have failed to keep pace and provide adequate guidance, she argued.


“[W]e also have a duty as investigators, as IRBs [Institutional Review Boards], as members of the medical profession, to fully inform, even if consent is not the goal. The methods by which we do this need to stand up not only to published regulations, but also to an even higher standard of what is right.”

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Positive Vibes Going Viral for Physicians on Facebook

Positive Vibes Going Viral for Physicians on Facebook | Social Media and Healthcare |

I’m sure you’ve seen them – those Facebook posts from happy customers explaining a recent amazing experience at a local restaurant or grocery store. I came across one today that was posted by a restaurant-goer on the Facebook Wall of a Chili’s. It was adorable, emotional and inspiring, and it garnered nearly 130,000 Likes, 30,000 Shares, and hundreds of Comments. Stories like this touch people, and do far more for your healthcare marketing campaign than any paid advertisement ever could.


So, how do you make this happen for your practice? Follow these easy steps:

1. Provide The Best Service At All Times – You need to be the best family physician! But, here in lies the rub. It’s not about being the most knowledgeable, quickest or most efficient doctor, it’s about truly connecting with your patients. It’s about doing those little things that make a difference. When a Facebook Fan writes a touching story about a lunch at Chili’s, or a shopping trip to Target, it’s not because they received typical service; it’s because they were surprised by the little things that were done to make them feel special. Which brings us to tip number two in healthcare marketing on Facebook…


2. Make Them Feel Special —  Your patients need to feel special. In fact, they need to feel that every one of them is special to you and your staff.


3. When it Rains – These positive comment stories are Facebook are like a waterfall. Once you get one or two, you’ll notice that all of a sudden you’re seeing more and more roll in. People like the positive vibes, they like the inspirational stories. If you do end up getting one of these positive comments on your Wall, share it!


4. Make it Public – One of the big mistakes that many physicians make on Facebook is to ignore comments and Wall posts. If a Fan posts something on your Wall, read it, even if it’s invisible to everyone else. If you get one of these positive comments, make absolutely sure to highlight it on your Wall and Share it with your Fans. They will comment and share it with their friends and family, and you will have a viral post. This will do wonders for your Facebook page.


Example of one of these positive Facebook Posts attached as image

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7 ideas for physician content marketing on facebook

7 ideas for physician content marketing on facebook | Social Media and Healthcare |

Not many physicians have heard of content marketing. But it’s a new way to keep current patients engaged and to attract new patients.


Content marketing involves the creation and sharing of content for the purpose of acquiring customers. It is the art of communicating with customers and prospects without selling.

“Instead of pitching your products or services, you are delivering information that makes your buyer more intelligent. The essence of this content strategy is the belief that if we, as businesses, deliver consistent, ongoing valuable information to buyers, they ultimately reward us with their business and loyalty.”

According to the Content Marketing Institute, content marketing works. Companies like Proctor and Gamble, Microsoft, Cisco Systems, and John Deere have embraced this new way to attract customers. Small businesses and independent entrepreneurs are also using it.


“Consumers have simply shut off the traditional world of marketing. They own a DVR to skip television advertising, often ignore magazine advertising, and now have become so adept at online “surfing” that they can take in online information without a care for banners or buttons (making them irrelevant).”

So, how can physicians use content marketing? It starts with creating content that is valuable and relevant to your patients and adding that to your web site, blog, or patient newsletters. Here are seven ideas for content to help get you started.


Practice changes: keep your patients updated on any practice changes, such as adding a new physician, change in office hours, new practice services added, etc.


What you do: if you are a family physician and you offer sport physicals for students, explain what you look for during a sports physical. If you offer travel medicine exams and immunizations, explain why these are important.


FAQs: keep track of the questions your patients ask and answer those in-depth.


Video: people read less and watch more. YouTube is now the number two search engine, after Google. And patients are searching for videos to answer specific questions, such as “What can I expect after my colonoscopy” or “Should I have a PSA screening?” 
Adding video to you site is not complicated. Use a flip camera to create a video introduction of yourself and your practice. Is there a health topic you feel strongly about? Create a video explaining why the topic is important and what steps you want your patients to take. 
Health in the news: Let’s say a new study has been published on colon cancer screening, and the study has been misconstrued by the media. Set the record straight for your patients by posting the correct information about the study on your web site and encouraging your patients to see you if they have any concerns about colon cancer.


Health topics relevant to your patient base: Think about your patients and what most concerns them. What top 10 patient conditions do you treat? Write a short blog post about each of them and encourage patients to seek treatment for these conditions from you.


Importance of immunizations: there is a lot misinformation out there about vaccinations. Explain to your patients why vaccines are important and how they should discuss their concerns with you. Provide links to reputable web sites and credible information about immunizations.


A version of this article appeared on Affynity Web Solution s blog. 

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3 ways to deal with a patient’s online rampage on Facebook

3 ways to deal with a patient’s online rampage on Facebook | Social Media and Healthcare |

Each time you log on to your hospital’s Facebook page, you’re never quite sure what you might see.

Facebook is a great way for you to express what your hospital is doing, but it’s also a great way for patients to express how they are doing. And sometimes, it gets weird.

Below, she shares a few thoughts:

What do people want when they’re upset and post negative things on Facebook?

Generally speaking, people want to be heard. They need acknowledgement (although you shouldn’t openly admit to any wrongdoing, for legal reasons). In most cases I’ve encountered, people are reasonable and willing to work toward a solution. For a small minority, nothing short of a miracle is going to shift them from angry to even mildly understanding. We’ll review actual instances where I’ve dealt with both varieties of negative feedback, pulling directly from my hospital’s Twitter and Facebook accounts.


Give us a quick example of something weird that’s happened on your Facebook wall.

I had a woman post on my hospital’s Facebook page as if she was writing to a former classmate. I thought she had just posted it to the wrong wall, so I reached out and let her know she had posted it to the hospital’s wall. Well, that’s what she meant to do. She was trying to reconnect with her classmate, and all she knew was that her classmate (an employee) drew blood at the hospital.


With a little detective work, I was able to find the employee and give her the message. I’m not sure whether she attended the reunion.


What are three things a hospital communicator should do when someone is upset on social media?


Respond as quickly as possible. 

In many cases, you’ll be getting a tiny bit of information about the problem and a lot of anger. Let the person know you’re listening and interested in finding out what’s going on.

Fix it (if you can).  

Some issues will be easy to fix. I’ve sent a patient with Celiac disease a gluten free meal after the wrong tray was delivered to her room. I’m sorry she got the wrong meal to begin with, but glad she reached out so we could make it right. Other issues will be much more complex, like a patient’s family who posted complaints we were killing their father (true story, made even more difficult because the father was here under confidential status). Fix what you can as fast as you can.

Take it offline. 

Be sure you show the social media world you’re responding to the person who’s expressed a problem, but particularly in health care, it’s best to move the discussion offline (or at least to a private message) at some point. I have a great relationship with our service excellence department, and they’re happy to follow up on any complaints that reach us through social media. If I can’t solve the problem myself, I know I can get the person in touch with our service excellence team, and they’ll do their best to make things right. My strength may be in social media management, but they’re the experts in customer service; it’s a great collaborative effort.

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10 essentials of Facebook etiquette for Medical Practices

10 essentials of Facebook etiquette for Medical Practices | Social Media and Healthcare |

Some brands have mastered the art of Facebook marketing; others, not so much. As with any social media platform, there are rules by which we should abide. 

Over the last few weeks, we’ve offered etiquette advice for LinkedInTwitter, and Pinterest. It’s Facebook’s turn. 

On this platform, there’s one protocol for brands and another for individuals. The tips below land somewhere in between and apply to both groups: 

1. Stop asking people to “like” your updates. A few years ago, it was common to see posts that started with “Like this post if…” Sadly, it’s still common. Create remarkable content. and people will like it—and “like” it. 

If you think about it, a “like” is an empty action—the simplest form of engagement. Asking for people to like your status is cheap and adds no value to your fans’ news feeds. 

2. Don’t overpost. Quite simply, if you clog up news feeds, people are going to hide, unsubscribe, and even “unlike” your brand’s page. 

The same goes for your personal page. Obviously, we’re all free to give our friends as many updates about our lives as we want, but you should beware of the consequences. 

3. Keep those hashtags to a minimum. We’re not exactly sure how hashtags are affecting brand engagement on Facebook, given that they were introduced just this summer. But the same advice we gave for Twitter holds true for Facebook: Make sure your hashtags are relevant and not excessive. 

4. When tragedy strikes, just shut up. We’ve dedicated entire posts to this, but there’s no reason brands should post when national/global tragedy strikes. Sending “thoughts and prayers” to the people in the affected area also feels a little thin—garnering engagement that way smacks of desperation. A better technique would be to offer your audience a way to help in the form of donations, etc. 

5. Don’t be patronizing. Condescending Corporate Brand Page has become my favorite destination on Facebook. It offers so many examples of what not to do. It’s also clear by looking at all the posts they call out that we seem to be running out of new ideas on how to engage on Facebook. 

6. There’s a fine line between real-time marketing and “brandjacking.” For brand pages, Oreo’s foray into real-time marketing during the Super Bowl power outage was great—but it was also a bit destructive overall. It inspired a ton of imitators, and their attempts at real-time marketing aren’t always relevant; they can be downright spammy. Not sure what we’re talking about? Check out this story about real-time marketing during the Oscars. 

7. Keep it positive. This one goes for the personal and the brand side. As much as you want to rant on your page, consider your audience and whether they’re really interested in hearing you. 

Ask yourself: Are we sharing this content because it serves us or our audience? 

8. No one wants to visit your brand’s mobile unfriendly Facebook tab. No one. 

9. When there’s a PR issue on your page, the worst thing to do is stay silent. So often, brands will shut down all Facebook communication when they’re facing any kind of backlash. You’re only going to exacerbate the problem by staying silent. Respond, even if it’s just along these lines: “We hear you. We’re working on it.” 

10. Personalize your reply to people who take the time to contact you. Whether it’s a direct message or a comment, the response should never be rote. Seldom does a “Thanks!” suffice. Every person who comments on your page represents an opportunity for a personal connection. Make that connection special, and you’ve got a fan for life. 

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Facebook Isn’t Dead Yet—It’s a Tool for HIV Prevention

Facebook Isn’t Dead Yet—It’s a Tool for HIV Prevention | Social Media and Healthcare |

Facebook takes a lot of cuss these days for having too many moms, babies, and ads. But for all the gripes and rumblings of the social network’s perceived decline, Old Blue still has a few tricks up her sleeve—like preventing the spread of HIV in at-risk populations of men.


That’s right, a new study published in the Annals of Internal Medicine shows that targeted interventions launched via Facebook group are an effective way to communicate health information, particularly in relation to HIV testing and safe sex practices. 


Researchers at the David Geffen School at UCLA started by recruiting African-American and Latino men 18 years or older who had a Facebook account, lived in Los Angeles, and reported having sex with a man in the last 12 months. (According to the study, these populations have increased risk of HIV transmission in L.A. and higher than normal levels of social media use when compared with other adults.)


After some base-line screening, the men were randomly separated into four closed Facebook groups, some that would receive “intervention” communications from their peer leaders and some that would receive only information about general health from their peer leaders. In other words, some peer leaders would be looking to start conversations about HIV prevention and testing, while others would focus on exercise, diet, and how to reduce stress. In all groups, communication occurred through Facebook wall posts, messaging, and chat—though participants were not required to respond to the messages or engage with their peer leaders.

This sounds awful to me. I already have a plenty of people in my Facebook feed telling me how to eat, think, and vote, so the idea of receiving personalized messages discussing my sexual habits and/or exercise routine is positively off-putting.


And yet … the messages worked. When presented with the option to get an at-home HIV test, 44 percent of the intervention group opted-in, as opposed to just 20 percent of the control group. Furthermore, a higher percentage of the intervention group actually followed up to obtain the test results.


“There is a lot of excitement about the possibility of using technologies, big data, and mHealth to improve health outcomes and change behavior,” lead author Sean Young told me in an email. However, he says surprisingly little research has gone into actually testing such ideas. (Though, one remembers the enormously successful Facebook campaign to boost organ donor registration.) “We validated that our approach combining behavioral science and social media can create sustainable health behavior change.”


All in all, the study shows serious potential for Facebook and other social networks as venues for targeted public health information—the added bonus being that participants can always leave the group the minute things get too annoying. But the rest of the world is considerably less curmudgeon-y than I am: The study had 12-week retention rates of more than 93 percent. (Think about the last time you participated in anything for 12 straight weeks that wasn’t court-ordered.)


Or maybe I’m looking at this all wrong. Perhaps this study shows that the public has accepted Facebook as a place to be poked and prodded, and now that we’re transitioning away from phone calls and paper mail, Facebook inboxes are open game for solicitation. At least, until the next medium comes along to provide us with refuge.

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CQC to search for patient feedback on GPs using Facebook and Other Sites in UK

CQC to search for patient feedback on GPs using Facebook and Other Sites in UK | Social Media and Healthcare |

The CQC will search for positive and negative comments about GP services on social networking sites such as Facebook and Twitter, in order to discover the ‘reality’ of the care that patients are receiving, said the regulator today.

Launching a document which lays out their strategy and purpose for the next three years in response to the report into the failings identified in the Francis Inquiry in Mid Staffordshire Foundation NHS Trust, the regulator said it wanted to ensure they were responding to patient concerns more effectively.

The report also said it would introduce a ‘more robust’ test for new primary care providers applying for registration, although a CQC spokesperson confirmed that GP practices that have already registered would not be affected by the new process.


It also said that a proposed chief inspector of primary and integrated care will look at patients’ experiences as they move between different services. Jeremy Hunt announced in February that he was considering plans for a chief inspector to provide an ‘expert view’ of primary care to mirror the appointment of chief inspectors for hospitals, to uphold standards and make the final call when a practice is failing.


As Pulse revealed last week, the report also said when inspecting providers, practices will be judged on five domains, with inspectors asking whether practices are safe, effective, caring, well-led and responsive to people’s needs.

The CQC said it will develop new fundamental standards focusing on these five areas, although a ‘judgement’ element will be introduced to avoid ticking the box, but missing other factors.


They confirmed that the frequency of inspections will increase as the perceived risk of harm to patients increases. The regulator said it will also develop a series of ‘triggers’ which will allow it to predict future problems with services, and allow it make better decision about when, where and what to inspect.


The report also re-iterated a commitment to a better use of information, meaning information sources such as the ‘Friends and Family Test’  and reviews carried out by others will be used to inform their regulatory work.

The CQC strategy said: ‘We will make it easier for people to tell us about the reality of the care they receive and we will improve how we respond to and report on how their views and experiences have informed our work. We will focus on gathering the views of people in the most vulnerable circumstances.

‘We will search for both positive and negative comments on what is being said about services, including social media (for example, Facebook and Twitter) and other digital media such as or website. We will make sure that the full potential of the results of the ‘Friends and Family Test’ and other similar information is used in our work.’


It added that they will consider working with other agencies to carry out inspections, and will work with NICE to make sure they are clear about the measures used in assessments.


David Behan, CQC chief executive, said: ‘People have a right to expect safe, effective, compassionate, high quality care. CQC plays a vital role in making sure that care services meet those expectations.


‘We recognise that quality care cannot be achieved by inspection and regulation alone – that lies with care professionals, clinical staff, providers and those who arrange and fund local services – but we will set a bar below which no provider must fall and a rating which will encourage and drive improvement.


In developing our plans for the next three years we have looked closely at what we do and listened to what others have told us, to make sure we focus on what matters to them. The plans also take account of Robert Francis’s report into the failings at Mid Staffordshire NHS Foundation Trust and the response by the Secretary of State for Health.’

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When Doctors and Patients Are Facebook Friends

When Doctors and Patients Are Facebook Friends | Social Media and Healthcare |

When Kenda Ross's husband, Robert, has an excruciating arthritis flare-up or other urgent health issue, she typically calls the office of his doctor, Jen Brull. If she can't get Dr. Brull by phone, she sometimes tries another way—Facebook

Dr. Brull gets the messages on her smartphone and usually calls back quickly with advice. Once, when Mr. Ross's knee was red and swollen after a shot and Dr. Brull was traveling, she urged a visit to an urgent-care clinic to check for infection. "I know she's available, no matter where she is," says Ms. Ross, a 64-year-old retiree in Plainville, Kan.

As social-media tools become ubiquitous, doctors are finding a role for them in their medical practices. But Facebook, Twitter and other social media bring challenges and worries, as well as opportunities. Among the concerns: protecting patient privacy and maintaining appropriate boundaries between professional and social relationships.

Gerry Tolbert, a family physician in Florence, Ky., uses Twitter to communicate health messages, and occasionally some personal interests—like "Star Wars"—will surface. He likes relaying useful information broadly to patients and others, he says. But he never tweets about individual patients, not even anonymously, he says. "It's not my place to decide who gets to hear their personal story."

According to a survey published in 2011 in the Journal of General Internal Medicine, 94% of medical students, 79% of residents and 42% of practicing physicians reported some use of online social networks, nearly all for personal reasons. Among the practicing physicians, 35% said they had received a "friend" request from a patient or family member—and 58% of those who had received those "friend" requests said they always rejected them.

A survey of physicians last May by Epocrates inc., which develops medical reference apps for physicians, found that 82% were using social networks to engage with other physicians, while just 8% were doing so with patients.

Saroj Misra, a Warren, Mich., family physician, saw a patient with a fracture last year and used Doximity, an online professional physician network, to send a question to a medical-school classmate who is an orthopedic surgeon. His friend suggested a certain type of splint and urged that the patient follow up with a local orthopedic surgeon. It took just "a few minutes" to get the advice via his smartphone, Dr. Misra says. "That is awesome."

Jake Varghese, a Cumming, Ga., family physician, communicates with patients digitally, using a portal and other tools provided by his employer, the Kaiser Permanente system. But he said he wouldn't feel comfortable "friending" a patient through his personal Facebook page. "It crosses a line" from a professional to a personal relationship, he says. "If I'm talking to them about their blood pressure, and they say, 'You went out to eat at so-and-so last week, should you be doing that, Doc?'—it takes a bit from that objectivity.

Dr. Brull, the Kansas family physician, says in her small-town practice she inevitably has social contact with many patients, and she's comfortable with having those who are her friends offline also becoming Facebook friends and seeing updates about her family and professional life. Plus, it's an easy way for certain patients to reach her, she says. "It fits the way I like to practice," she says. Like other doctors, though, she says she won't send answers to health questions via social media for privacy reasons.

Mark Ryan, a Richmond, Va., family physician, doesn't mind if patients follow his Twitter feed, which sometimes reflects his views on political issues related to health care. He wouldn't spontaneously bring up his policy opinions in the exam room, he says, but if patients choose to seek him out on Twitter, it is their choice. "They may or may not agree with it, but at the end of the day, I don't think they could point to anything and say it was unprofessional," he says. "Physicians need to be actively involved in our communities."

Patients can reach Jen Brull, a Plainville, Kan., physician, by Facebook message.

The American Medical Association's Council on Ethical and Judicial Affairs published guidelines in 2011 suggesting doctors need to "maintain appropriate boundaries of the patient-physician relationship" online and to consider separating professional and personal content online.

Some doctors say they connect with patients in ways that are completely separate from their own personal lives, and they sometimes see benefits. Pamila Brar, who practices in La Jolla, Calif., focuses on health advice and information in her tweets and on her Facebook page. Sometimes she learns something useful about her patients. One patient mentioned in a Facebook post that he was waking up a lot at night to use the bathroom, which he hadn't shared with Dr. Brar at his physical exam. Dr. Brar followed up by phone and eventually prescribed treatment.

Wanda Filer, a York, Pa., family doctor, connects with some patients via LinkedIn, and she tweets to followers who include many fellow doctors. Her Facebook page is dedicated to health topics, and she doesn't post personal information. Still, she once learned via a LinkedIn update that a patient had been in the hospital. "I gave her a call and said, 'Maybe we should make an appointment,' " Dr. Filer says. "It was fortuitous."

Social-media issues are getting more attention from medical schools, which are starting to teach about social-media standards and regulators. A survey of state medical board officials published last month in the Annals of Internal Medicine highlighted several hypothetical situations they might target. Of most concern were physicians who posted misleading information about clinical outcomes, misrepresented credentials, used patient images without consent or contacted patients inappropriately—the same kinds of behavior that typically draw scrutiny offline, said S. Ryan Greysen, lead author of the study and assistant professor at the University of California, San Francisco. The article said several scenarios were based at least partly on actual incidents.

The Rhode Island Board of Medical Licensure and Discipline in 2011 reprimanded an emergency-room physician who posted about her clinical experiences on Facebook. Though she didn't identify patients by name, readers were able to identify one of them because of the nature of the injury. "There's no business for protected patient information on Facebook, period, the end," said James McDonald, chief administrative officer for the Rhode Island board. "Social media isn't meant to be the exam room." The physician didn't return a call seeking comment.

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Pharma Interest in Pinterest

Pharma Interest in Pinterest | Social Media and Healthcare |

There is a good deal of activity in social media by pharma, at least on the face of it, which many people still think is not the case.  I am tracking over 230 Twitter feeds, 121 Facebook pages, 172 YouTube channels, and over 80 Google+ pages (more on that in an upcoming posting).  

As always, it is important to note that this is the activity of which I am aware and there is likely activity beyond what I know – so this is only a partial look at pharma social media activity, though I believe we have captured a very large chunk of it.

In addition to the above platforms, also included in the tracking efforts is pharma activity related to Pinterest – the social media platform that allows you to take images and pin them to various categories of boards for others to see and share.  Here are a few highlights of the Pharma Pintrest Profile:

  • Number of Pharma Pinterest Pages. While there are 39 Pharma Pinterest pages, not all of them are active.  In fact over one-third (16) are dormant pages where there has been no activity for at least the past year;
  • Geography. Of the remaining active 23 or so that are active, slightly less than half of them are from the U.S. while the balance are out of Europe;
  • Purpose. The overwhelming majority of pages are corporate or general pages with only about 4 being product-specific and 2 aimed at recruitment;
  • Regularity of Activity. Only 3 provide daily updates, but 9 (25%) provide either weekly or daily updates;
  • Volume. The highest number of pins was over 4000 and the highest number of followers is 460.

While it does not represent a great deal of activity, for many Pinterest is a platform that many may be surprised as any pharma activity at all, much less two job recruitment efforts.  And while the volume of activity may not be significant, what is perhaps significant is how far pharma has been willing to explore emerging social media platforms even without the long-awaited guidance from FDA.  (BTW, I did not find an FDA presence on Pintrest.)

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Should You Friend Your Patient On Facebook?

Should You Friend Your Patient On Facebook? | Social Media and Healthcare |

In the age of Social Media, the relationships between physicians and patients are changing. While there are no guidelines or laws on how to communicate with your patients online, the American College of Physicians (ACP) and Federation of State Medical Boards (FSMB) have recently come up with a framework. Their policy paper “Online Medical Professionalism: Patient and Public Relationships.” was released this week and delivers recommendations on when to observe social media profiles and when it’s better to pause before posting.

The guidelines point out that “it is paramount to maintain the privacy and confidentiality of patient information, demonstrate respect for patients, ensure trust in physicians and in the medical profession, and establish appropriate boundaries.” Online communications may come with risks, but there are also a lot of good use cases for using those new outlets. Here are some detailed recommendations the ACP and FSMB give in their new publication:

  • Physicians should keep their professional and personal personas separate. Physicians should not “friend” or contact patients through personal social media.
  • Physicians should not use text messaging for medical interactions even with an established patient except with extreme caution and consent by the patient.
  • E-mail or other electronic communications should only be used by physicians within an established patient-physician relationship and with patient consent.
  • Situations in which a physician is approached through electronic means for clinical advice in the absence of a patient-physician relationship should be handled with judgment and usually should be addressed with encouragement that the individual schedule an office visit or, in the case of an urgent matter, go to the nearest emergency department.
  • Establishing a professional profile so that it “appears” first during a search, instead of a physician ranking site, can provide some measure of control that the information read by patients prior to the initial encounter or thereafter is accurate.
  • Many trainees may inadvertently harm their future careers by not responsibly posting material or actively policing their online content. Educational programs stressing a pro-active approach to digital image (online reputation) are good forums to introduce these potential repercussions.

While digital communication is encouraged, the study suggests to always do face-to-face follow-ups after you have checked in with your patient via email. Studies have shown that online conversations are often initiated by the patients sending friend requests to their doctors. The FSMB advises to refrain from adding patients on Facebook or other private networks. In terms of Googling patients, the report emphasizes that online research might bring up helpful insight about an individual, but the physician should always keep the intent of their Google search in mind.

With the rise of blogs and forums, doctors further have the opportunity on contributing to public health. Regarding physician-produced blogs, the framework suggests to avoid ranting and venting about the industry. Authors are advised to “pause before posting” controversial or negative content.

The full position paper has been published online by Annals of Internal Medicine. 

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Infectious Disease Research Gets a Boost from Websites, Blogs, and Social Media

Infectious Disease Research Gets a Boost from Websites, Blogs, and Social Media | Social Media and Healthcare |

While public health officials around the world are on alert about the pandemic potential of new disease threats, a team that includes Penn State University biologist Marcel Salathé is developing innovative new systems and techniques to track the spread of infectious diseases, with the help of news websites, blogs, and social media. An article by Salathé and colleagues from the Harvard Medical School, published in the early online issue of the New England Journal of Medicine on 3 July 2013, describes the advantages and challenges of "digital epidemiology" -- a new field of increasing importance for tracking infectious disease outbreaks and epidemics by leveraging the widespread use of the Internet and mobile phones.


"In the past year, the world has seen an emerging outbreak of two viruses with considerable pandemic potential: Middle East Respiratory Syndrome Coronavirus and Avian Influenza A H7N9," Salathé said. He explained that the former is similar to the virus responsible for the SARS outbreak in 2002 and 2003 and has, since 2012, infected 64 people, 38 of them fatally. Influenza A H7N9 is a virus that normally circulates in birds but has, since the beginning of 2013, infected 137 people, 32 of them fatally.


"Digital epidemiology played a crucial role in the surveillance of both Middle East Respiratory Syndrome Coronavirus and Avian Influenza A H7N9 by enhancing transparency and helping public health officials to understand outbreaks more fully. It is clear that the importance of digital epidemiology will only increase in the future as more people get mobile access to broadband around the globe," said Salathé, who uses data from social media in his research to study how sentiments about vaccination spread in populations. "With 6.8 billion mobile-phones and 2.9 billion people online, it's getting increasingly hard for any micro-organism to spread undetected for long."


Salathé also said he predicts that digital epidemiology will not be limited to just infectious diseases for long. "Mining these novel, big-data streams is of enormous interest to practically anyone interested in health and disease," he said. "For example, researchers and public health officials could use data-mining techniques to detect adverse drug reactions, assess mental disorders, or track health behaviors much faster than they do with traditional methods."


Salathé added that he is honored to have the opportunity to reach such a wide audience through the New England Journal of Medicine. "We're hoping to put digital epidemiology on the agenda of every public health agency to complement their traditional efforts to track diseases and assess and mitigate the spread of infectious diseases," he said.

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Doctors Have a ‘Heart’ for Social Media

Doctors Have a ‘Heart’ for Social Media | Social Media and Healthcare |
Earlier this month at the Doctors 2.0 & You conference in Paris, Creation Healthcare publicly released findings of a long-term study exploring how doctors

Via Aditya Patkar
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Making a Case for Social Media

Making a Case for Social Media | Social Media and Healthcare |

Twitter can help scientists build networks, develop ideas, and spread their work

Twitter’s not just for the birds, argues a group of marine scientists in an Ideas in Ecology and Evolution report. The paper presents a case for more scientists to engage with one another and the public through social media like Twitter—a micro-blogging platform that allows users to send short messages and engage in two-way information flows—using examples drawn from the researchers’ own online networks.

“Many scientists may think they don't have time for Twitter,” lead author Emily Darling, a Smith Conservation Research Fellow at the University of North Carolina at Chapel Hill, told the University of Miami. “But a little effort can provide enormous value for communication and outreach. The solution is to just give it a try.”

The researchers highlighted Twitter’s ability to help scientists build scholarly connections, refine ideas through pre-review, and amplify discussions of science to a broad audience. Twitter, they pointed out, provides an informal and low-investment way to reach a large virtual following, which can increase exponentially through retweets. Scientists can benefit from using Twitter to share their work at various stages of completion with potential collaborators and students, government officials, science journalists, and the public, the authors noted.

“We hope our experiences with social media, and Twitter in particular, will encourage hesitant scientists to give it a spin—we believe there can be great and unexpected value to including social media into the life cycle of a scientific paper,” the authors wrote.

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Should Physicians be Utilizing Facebook?

Should Physicians be Utilizing Facebook? | Social Media and Healthcare |

Social Media tools (Facebook, Twitter, Pinterest, etc) are synonymous with big brands such Coca Cola, Starbucks, Ford, Red Bull and even Disney, but are also making waves for medical organizations such as Cleveland Clinic and WebMD. And as social media tools have become a pivotal piece of the entire healthcare marketing puzzle, it’s our job at Quaintise to quell any fears that our physicians and specialists might have.


Personal vs Professional Page

An aspect of social media that many physicians and specialists often overlook is the line between professional and personal. While Facebook does have guidelines for setting up multiple accounts under the same name, it does allow you to set up a professional presence as well as a personal one. Our healthcare marketing experts do not touch your personal profile and highly suggest that you do not respond to personal friend requests from patients or personal messages. All questions, concerns and friend requests need to be dealt with on a professional level, directly from your professional page.


This is where things can get dicey, and the line between patient and friend can easily get crossed. It’s in this grey area that HIPAA guidelines can easily be forfeited, penalties accrued, and patient privacy put at risk.


If you have a personal Facebook page, all Privacy settings should be set to Friends Only. IN reality, there should be no way for anyone on Facebook to run a search for you as a physician and find you. Many physicians under Quaintise use a nickname or shortened spelling of their names to avoid this issue and confusion with their professional Facebook accounts.


Physician vs Office Page

A decision that every physician needs to make is whether to create social media accounts for each physician on staff at a professional level, or whether to create one office page where everyone has access. At Quaintise, it is our suggestion that physicians create one office page to be maintained and managed by healthcare marketing experts who can engage patients and Fans, as well as relay any questions, concerns and advice between office staff, physicians and Facebook Fans.


One of the pertinent reasons we advise this strategy is so that all HIPAA guidelines are followed at all times, no patient privacy is put at risk, and Fans receive the highest engagement levels possible while adhering to all privacy rules and guidelines.


Facebook Increases Patient Engagement

There is no question that Facebook increases patient engagement, making them more aware of lifestyle choices and healthy options. For example, during flu season Quaintise ran many posts, blogs, and informational discussions regarding flu symptoms and flu vaccines. Within one month of increased Facebook engagement on a subject that was relevant to every patient and non-patient of Family Practice Physicians (client), we were able to increase web traffic via Facebook referrals by 146%, and overall web traffic by 48.39%.

Allison Emma Schizkoske's curator insight, November 26, 2013 7:45 PM

As the article says, there is a grey area when it comes to professional facebook and personal. You have to be careful when posting and who to add. Yes you can gain alot of audience engagment but you must remember to keep your facebook page professional and not to add your paitents to your own personal facebook account. Know where to draw the line to keep things working the best for you practice. 

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Is Social Media Effective for Pharma Marketing?

Is Social Media Effective for Pharma Marketing? | Social Media and Healthcare |

In the U.S., a major KPI of any digital program is to drive traffic to the website. Since about 40% of pharma's digital budget goes to search marketing, I presume that is effective in driving traffic to sites. But is social media effective in doing this and should traffic referrals be a KPI of social media campaigns?

We may never see real data from any pharma company that tells us how effective social media is in driving traffic to pharma websites, but we do have survey data indicating that ads placed on social media sites are not very effective.

A national consumer survey conducted by Makovsky Health and Kelton (see here), for example, asked consumers about what motivated them to visit a pharma company’s disease-state or drug website for information. According to this survey, the key influencers were a physician recommendation (42%) and news articles (33%). Other drivers of pharma-sponsored website traffic included:

  • Recommendation from a family member, friend or colleague (30%)
  • TV ad (25%) • Drug discount (14%)
  • Magazine ad (13%)
  • Web, digital, radio or newspaper ad (11%, 11%, 9% and 9%, respectively) 
  • Social media ad (6%)

Find more data from this survey in this infographic.

I assume a "social media ad" is an ad placed on Facebook or maybe Twitter. I'll have to get more details about this survey to find out for sure.

But the survey raises a question that it probably did not explore: Aside from ads, is engagement with consumers via social media effective in driving consumers to pharma websites? I think the jury is still out on that. Social media may help drive awareness of news articles, for example, which then drive traffic to websites. So there's an indirect KPI associated with social media.

nrip's insight:

Social Media(SocMed) is by far the most effective digital lead generation technique after Email marketing today. The issue is that too many marketeers take short cuts when it comes to SocMed. Profiling at both ends of the funnel and identifying the best prospect touch points socially are difficult on SocMed. But if these are done right, the results are terrific.

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Facebook, a legitimate source of data for medical research?

Facebook, a legitimate source of data for medical research? | Social Media and Healthcare |

A recent study highlights the opportunities which online social networks may provide to analyze the impact of social behavior on health outcomes such as the prevalence of obesity.


For several years researchers have been trying to find the causes of obesity, aside from any genetic predisposition. Our social environment is regarded as one of the decisive factors overall. For example, families living in deprived circumstances are often prone to obesity because, it is argued, cheaper food is often more fatty and sugary –although this supposed causal link still remains controversial. Such studies have their limitations, since there is relatively little reliable information available on people’s physical activities and dietary habits. However, there is today one source, though rather unconventional as regards public health studies, which can provide a wealth of data: Facebook. Recently four researchers from Harvard Medical School, working together with the Center for Disease Control and Prevention Behavioral Risk Factor Surveillance– an ongoing telephone health survey system – and NYC EpiQuery systems, a web-based system designed to provide health data from a variety of sources, set out to examine the relationship between Facebook users’ ‘likes’ and their weight*.


Studying populations through the lens of social networks

This is one of the first attempts to study the health of a population by extracting data from online social networks. Recently, another online study, carried out via social networks among 61 million people, which looked at the influence of messages on voting patterns, has already demonstrated the potential of social networks for this type of study. Such networks provide a new source of usable data and Facebook is one of the most useful tools since users tend to volunteer information on their surroundings, origins, background and personal interests.  Moreover, the sheer size of the network in terms of its user base is an argument in itself for using this data source. In the United States, half the population is active on Facebook, as is one person in eight worldwide. The study on obesity analyzed Facebook users’ ‘likes’, broadly categorizing them under "health and fitness" and "outdoor physical activities" as an indication of being physically active, and "television" as a marker for a sedentary lifestyle. The study reveals that in the US as a whole there is one clear link between Facebook users’ ‘likes’ and obesity: in any given area of the country, a greater proportion of people with activity-related Facebook interests and a smaller proportion who like television appears to be correlated with a lower prevalence of obesity.


Gathering data on public health

The major increase in obesity on a global scale suggests that a person’s social environment says a lot about his/her health. Many studies have already examined the relationship between people being overweight and their immediate environment. For example, in places where there is less opportunity for people to walk, we find higher rates of obesity. Beyond the physical environment, this study now shows that people’s social environment may also be linked to obesity. There are many variables – among them common interests, whether active or sedentary – which make it easier to pinpoint populations at risk. Up to now, obtaining data relating to the social environment of these populations has been costly and slow, and the process difficult to carry out across a large population. The availability of online social network data for this type of study therefore seems to have come at the right moment.  Further research is now needed to better understand how the online social environment actually relates to health outcomes and how it can be used to identify when action is needed or target specific interventions.


*‘Assessing the Online Social Environment for Surveillance of Obesity Prevalence’ by Rumi Chunara, Lindsay Bouton, John W. Ayers and John S. Brownstein

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Facebook and Your Medical Practice: Making ‘Friends’ with Social Media

Facebook and Your Medical Practice: Making ‘Friends’ with Social Media | Social Media and Healthcare |

Though the medical community has been slow to adopt social media as part of its business model—and possibly for good reason—social media is here to stay as the new medium of communication. While there are certainly pitfalls associated with healthcare providers’ use of social media, the fact remains that Facebook, Twitter, and other outlets can be effective tools to promote your practice, disseminate information, and share ideas.


Social media should not, however, be used by healthcare providers to communicate directly with patients, provide medical advice, promote products, or warrant outcomes. Further, physicians and other healthcare providers need to be cognizant of the potential permanency of a social media post. While social media account managers can delete or remove posts and other information shared online, subscribers and “friends” can take screen shots or print errant posts before they are deleted. These potentially damaging posts can live forever.


Social Media and Patient Privacy

Patient privacy is probably the most significant consideration when mixing medicine with social media. The lines of the physician-patient relationship often can become blurred in the social media context if appropriate precautions are not taken. Further, because of the potential for anonymity among bloggers and other social media commenters, there is no guarantee that “patients” actually are who they say they are, and vice versa. That’s why healthcare providers need to follow a few simple rules when establishing a social media presence in order to ensure they maintain appropriate boundaries, respect patient confidentiality, and best promote their practice:


(1) NEVER post about patients. When using social media, it’s not enough to simply eliminate patient-specific data such as name, date of birth, or social security numbers. Physicians have been disciplined for blogging or commenting about patients or the care provided, even when the post seemed completely devoid of personal information. If there is any way for a third party to identify the patient through the information contained within your post, it should not be posted. When in doubt, don’t post.


(2) Keep personal accounts separate from business accounts. Business pages can be set up to provide practice information only, such as business hours, holiday closings, new additions to the practice, upcoming events, etc. These business pages do not include “friends” or allow “comments” by non-approved administrators.


(3) If you maintain a personal Facebook, Twitter, or other social media account, always decline friend requests from patients. A professional boundary must always be present between patients and physicians. This boundary can be blurred or even dissolved when social media communication is allowed.


(4) Maintain the highest levels of security for your personal account(s) and business page. Routinely check your account settings to ensure that the privacy and security settings are constantly updated since many social media sites, particularly Facebook, change their security settings on a fairly regular basis. If you have a business Facebook page or Google+ page, then disable outsiders’ ability to comment, post or tag photos in order to make sure that the communication is one-way (from you) only.


(5) Do not provide medical advice, whether solicited or not, on blogs or social media posts. Even innocent comments on others’ pages can be deemed “advice” and should be avoided. For example, a friend of a friend might post a comment about post-appendectomy incisional pain, to which you respond “Don’t worry, that’s normal.” Such a post is technically a comment on the patient’s medical status and could potentially impact that individual’s treatment decisions. It also raises the question of whether a physician-patient relationship exists as a result of the communication.


(6) Implement a social media policy for your practice, and ensure your office staff is familiar with the policy. In fact, it’s a good idea to have your employees sign a social media agreement and maintain that in their personnel file. Your policy should be clear that staff members are never to post about patients, period. Staff also should be prohibited from “friending” patients or communicating with patients through social media sites. Likewise, instruct your staff to maintain proper privacy/security measures, and make sure only allow responsible, trained staff members are allowed to administer your practice’s social media page(s) or blogs.


(7) If a patient somehow contacts you or a staff member about her care using social media, then immediately respond that you will call to discuss the issue. During your phone conversation, let your patient know that social media is not a suitable method of communication, and suggest that the patient call the office for future needs.


(8)  Do not blog anonymously (see rule 5).


Final ‘Comments’

The number of social media outlets is growing every day, so it can be time consuming to monitor and ensure patient confidentiality, adequate security and proper boundaries. However, if properly managed, these sites can be a fun social outlet for communication with family and friends, and an effective tool to help promote your practice. Though social media has enormous potential, it is important for healthcare providers to ensure their online involvement is ethical, with a clear divide between personal and business uses.


The Texas Medical Association provides a social media guide on its website, which can also be a helpful tool when navigating the wide world of social media.

One final word of advice, whether it’s a professional blog, your practice’s Facebook page, or your personal Twitter account: Take a moment to reflect before posting. (Note: public Tweets are archived by the Library of Congress!)

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Facebook 'Likes' a good indicator of quality hospital care

Facebook 'Likes' a good indicator of quality hospital care | Social Media and Healthcare |

While those active on social media aren't shy about expressing opinions on their Facebook pages, how much do their "Likes" really reflect the quality of an organization? American Journal of Medical Quality (a SAGE journal) recently published a study that found that Facebook "Likes" were indeed an indicator of hospital quality and patient satisfaction.

"Findings suggest that Facebook offers an additional resource, beyond surveys, to gauge the attitudes of patient populations," wrote study authors Alex Timian

Researchers compared the 30-day mortality rates and hospital patron recommendations to the number of "Likes" on the hospitals' Facebook pages from 40 hospitals near New York, NY. They found that Facebook "Likes" were positively associated with patient recommendations and that a one percentage point decrease in the 30-day mortality rate corresponded with almost 93 more Facebook "Likes."

In addition to these findings, the researchers also found that teaching hospitals had a lower number of Facebook "Likes" than traditional hospitals, despite the fact that the staff at teaching hospitals is younger and predicted to be more active on Facebook. The researchers noted that this negative association of "Likes" and teaching hospitals may be a reflection of quality issues at those hospitals.

"Any hospital can start a Facebook page, but those with higher levels of quality and patient satisfaction are more likely to attract "Likes" to their page" wrote the authors. "Public health researchers and hospitals can use facebook "Likes" as a proxy for hospital quality and patient satisfaction

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Facebook Page Apps Every Medical Practice Should Use

Facebook Page Apps Every Medical Practice Should Use | Social Media and Healthcare |

Ever doctor who is “in” is now using facebook pages to improve communication with patients. Though the number of facebook apps available to do this is in the well over 100,000, too many for physician to look through.

Start here to build out the tools for your medical practice. The goal of every doctor using facebook pages is to give information to new and existing patients, also get patients to engage with the physician in a social supportive way.

Below are five essential Facebook apps.

1. Twitter Tab — Display Your Twitter Feed

Twitter Tab, which has 1+ million monthly active users, will create a tab on your Facebook Page that displays a timeline of your medical practices most recent tweets. This is a great feature for providing additional, real-time information to Facebook patients and medical staff who don’t have a Twitter account and for avoiding the annoyance your fans would feel if you were to constantly stream your tweets to Facebook as wall updates. The app is very easy to set up.

2. Static HTML: iframe Tabs — Create a Custom Landing Page

Static HTML: iframe tabs, which has 61+ million monthly users, will simplify the process of making a custom landing page by automating many of the steps. Forget about creating a developer account and your own application — this app provides copy and paste textboxes for your custom HTML, CSS and JavaScript. It also offers checkboxes to remove the scrollbars. If you want to incentivize Likes on your Page, the application enables you to “like-gate,” and show different content to those who have and haven’t “liked” your page.

It’s worth noting that you will still need to host your own files, and designs over 520 pixels wide and 800 pixels tall will have the scrollbars.

3. EHR online facebook scheduling — Place you free appointment schedule on Facebook

Let patients schedule appointments in a HIPAA compliant way!  Use the Static HTML iframe Tabs to get this done.

Step by step instructions on how to do this can be found here:

4. ContactMe — Add a Contact Form

ContactMe, with 180,000 monthly active users, adds a tab on your organization’s Facebook Page with a contact form. This allows anyone visiting your Facebook page to easily get in touch with you at the very moment when they’re most interested.

The biggest advantage of this app is its customization options. You can choose whether you’d prefer to show your company’s contact information or social media icons for Facebook, Twitter, LinkedIn or Skype. This is very customizable.

5. RSS Graffiti – Automatically Post Updates

RSS Graffiti, with 1.5 million monthly users, allows you to automatically post wall updates any time there’s a new item in one of your specified feeds. For example, if you publish to a medical blog every day, RSS Graffiti can automatically post an excerpt of the article with a direct link onto your Facebook page’s wall. That saves you the time and effort of creating a new wall update every day to distribute your company’s content.

It has customization options making it stand out. You can automatically post more than one RSS feed, adjust how the post looks when published, schedule how often the feed is checked, and specify how many posts should be published per check. And most importantly, with all these options and more, the configuration interface is still easy to use and intuitive.

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Facebook as a Platform for Health Information and Communication: A Case Study of a Diabetes Group

Facebook as a Platform for Health Information and Communication: A Case Study of a Diabetes Group | Social Media and Healthcare |



As one of the largest social networking sites in the world, Facebook holds a great potential for promoting health.In this exploratory study, we analyzed 1352 messages posted to an active Facebook diabetes group to identify the characteristics of the group. The results revealed that the group was international in nature. Users overcame language barriers to communicate with people with similar conditions. Users interactions were structured around information, emotion, andcommunity building.
They exchanged medical and lifestyleinformation, and highly valued their peers personal experi-ences, opinions, and advice. They also demonstrated a posi-tive attitude toward the reality of living with diabetes andgenerously provided encouragements and affirmations to one another. Great efforts were made to maintain the proper operation of the community by the administrator and a group of cormembers. As a result, the group was shaped as a social network where peer users share social support, cultivate com- panionship, and exert social influence. Based on the results,we discussed future directions for research of health communities in a highly connected world.
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Facebook is Not Evil Proves People with Diabetes

Facebook is Not Evil Proves People with Diabetes | Social Media and Healthcare |

Facebook has been demonized tremendously throughout media, with claims that it causes depression, impairs social skills, creates isolation, feeds addictive behaviors, lowers self-esteem, and last but not least, one report claims it can cause eating disorders. The list goes on and on, further supporting the variety of accusations and reports that say Facebook does far more harm than good. People living with diabetes, Facebook is anything but evil, as those living with the two most common forms of the disease will argue that Facebook has become an immense source of support and much-needed connection in their daily lives.


But more, first, on the evils of Facebook: studies have actually documented that seeing posts about the lives of your friends can actually cause a person to feel worse about their own lives. Those most prone to this type of depression are teens, reports the American Academy of Pediatrics: “Researchers have proposed a new phenomenon called ‘Facebook depression’ that develops when preteens and teens spend a great deal of time on social media sites, such as Facebook, and then begin to exhibit classic symptoms of depression.”


While it can’t be denied that having friendships which revolve primarily through the internet could absolutely be detrimental to a person’s social skills for real-life interactions, and the reality that people are far more likely to be criticized and harassed for what they post and say on Facebook when abusers can hide behind a computer screen, Facebook is not all evil.


For people with diabetes, Facebook can be the source of immense comfort, support, kindness, generosity, and empowerment.


Due to the privacy laws of HIPAA, people with diabetes cannot rely on healthcare professionals to inform them of others in their community living with the disease. In the diabetes online community, Facebook has become a source of connection for thousands of people across the globe. Thousands. Some of these connections start through adults or teens living with type 1 or type 2 diabetes, others start through the parents of children with type 1 diabetes connecting with other parents. In general, however, the groups appear to have mixed themselves together, with a larger group of thousands that consists of type 1s, type 2s, teenagers and adults, and parents of children with type 1 diabetes.


Literally, thousands of people with diabetes are connected to each other personally, have met in real life thanks to their relationship on Facebook, and work together to increase the amount of support and advocacy available to those living with diabetes across the globe with events such as#DSMA Twitter Chat (which stands for Diabetes Social Media Advocacy) every Wednesday night at 9 p.m. EST, or DiabetesAdvocates–both of which were born largely due to relationships that evolved through Facebook.


Why is this online social community such a profoundly positive resource for a disease like diabetes? While each type of diabetes has its differences, the varieties of the disease have enough similarities and challenges to bring them together, but the community doesn’t exist just in specified diabetes “groups” or “pages,” they exist through straightforward friendships on Facebook.

Understanding the basics of diabetes is also important:


Type 1 diabetes, for instance, is an autoimmune disease in which the immune system will, at any age between birth and as high as age 50, attack the cells of the pancreas responsible for producing insulin. Insulin is a hormone essential to life in all mammals, as it is the only way glucose from the food we eat can be taken into the cells throughout the body that need that glucose for energy. Without insulin, any human being would eventually die.


Type 2 diabetes, albeit distorted greatly throughout greater mainstream media as pertaining primarily to obesity and eating “too much sugar,” is characterized most commonly in science by a dysfunction in the body’s ability to either produce or utilize insulin; however, it can also be the result of the liver’s overproduction of glycogen, too. In other words, while there is absolutely a correlation with excess body fat and insulin resistance which can lead to higher blood sugars and diabetes, the cause of type 2 diabetes is not simply about sugar and obesity. (If it were that simple, everyone who is overweight or obese would have diabetes and this is not the case.) Some forms of type 2 diabetes can be managed through changes in diet and exercise, while others require oral medications or insulin injections.


Today, there is no cure for either type of diabetes–and no, losing weight will not “cure” diabetes, it simply causes the symptoms of that person’s diabetes to subside, therefore making weight-loss one form of successful treatment for diabetes for some, not all.


One of the largest benefits of Facebook for those with diabetes are the lifestyle lessons and simple support that is shared around actual management of the disease. Gene Bertram, living with diabetes explains, “It’s put me in communication with other diabetics to find out how they are controlling their disease and improving their health.”


Richard Vaughn, who was diagnosed with diabetes in 1945 and continues to thrive today, says, “I did not know about diabetes online until 2006, so that was 61 years before my online experience. After consulting with other type 1 diabetics in the diabetes website support groups, I realized that I had much more to learn. At least 75% of my current knowledge about type 1 diabetes has been learned in the diabetes online community.”


As for the accusations that Facebook actually induces depression, those in the diabetes community have a different perspective:

Lauren Walsh, living with diabetes, explains, “I was diagnosed just over 2 years ago, I was 43 years with 3 kids and a granddaughter. This came out of nowhere, totally unexpected. I have truly found a wonderful community of others with diabetes that I can actually connect with and have even learned from! I love the diabetes online community!”


Michael Kenney, living with diabetes, explains that through Facebook he has been, “encouraged by others and been able to help others get answers to the same questions I had early on in my diagnosis.”

Donna Shuford, married to a man living with diabetes, explains, “It has made me realize I’m not alone. It has allowed me to reach out to other parents with diabetes with multiple children. I would be more depressed about my life without Facebook.”


According to clinical psychologist Dr. Jen Nash of PositiveDiabetes who specializes in treating people with diabetes, depression has proven to be two to three times more prevalent in people with diabetes. If having access to a free, simple resource like Facebook can alleviate some or a great deal of that depression, that’s a very good thing.


Sue Lebarron, living with diabetes, adds, “It helps me keep in touch with people that truly understand the frustrations of diabetes because they have those frustrations, too!.”


Shana Hammer, a mom of children with diabetes, says, “I was able to connect and contact other moms of multiple kids with type 1 diabetes–there are none in my area.”


Todd Williamson, living with diabetes, explains, “Through Facebook, I’ve been able to connect with other people with type 1 diabetes, which is a good thing. As many people as there are with diabetes, I’ve literally yet to meet another person with type 1 in my city. Nobody.”


Jess Buchanan, living with diabetes, adds, “It gives me a place to vent about diabetes and this is dually beneficial: First, friends who also have diabetes comment with things that make me feel better. Secondly, my friends without diabetes often follow up with questions. So basically it’s a chance to both empathize and educate. A win-win!”


In the end, though, both type 1 and type 2 forms of diabetes are constantly ostracized, mocked, and lectured by the general community. Accused of eating too much, being too lazy, being too fat, having given it to themselves or to their children for “eating too much sugar.” And of course, the constant lectures and inaccurate statements about diabetes in the media only adds to the lectures and scolding people with diabetes receive from the world around them.

While people with diabetes find themselves constantly being told by strangers and overly policing friends and family that they need to “eat less sugar, lose weight, and take better care of themselves,” through Facebook these people with diabetes can surround themselves with a community who understands the lesser known aspects of life that make this disease so challenging.


Common phrases and questions those in the Facebook community of diabetes hear include: “Why did you feed your child so much candy? You gave them diabetes!” or “My grandmother had diabetes…she lost both legs, and then she died” or “You have diabetes? You don’t look that fat!” or “Why don’t you just cure it by exercising more?” or Oh, you have diabetes? That sucks!” or “Well, it’s your fault for eating too much candy.”

None of the above statements are actually scientifically accurate observations about life with diabetes or how to treat it. Instead, they are merely misconceptions about diabetes perpetuated by mainstream media.

In reality, there is no one-size-fits all treatment for diabetes. Everyone’s insulin needs and oral medication needs vary and can change easily throughout their entire lives. The constant order to “exercise more often” comes with the overwhelming challenge of actually balancing one’s blood sugar levels during exercise, because exercise can easily cause dangerous drops in blood sugar if not carefully monitored, making exercise one of the hardest things to do more of safely.

Through Facebook, the people in this community have found allies in the daily challenge of balancing their blood sugars around insulin injections, exercise, nutrition, and the daily stressors of life. In life with diabetes, even an adrenaline-rushing ride on a roller coaster or white-water rafting can cause a significant spike in blood sugar.

Even Charlie Kimball, diagnosed with type 1 diabetes in 2007 and recently won the IZOD IndyCar series in Ohio in early August, said about the growing diabetes community online, “I was blown away by the amount of support and outreach. I know there are many people out there with diabetes, and I have met so many, but it still caught me by surprise how impressive and how significant the response was. It meant so much to me to hear from them.”

Kimball continues, “The coolest thing about the diabetes community is that you are now part of this tight-knit community that inspires, shares, and helps one another. If you can help someone with their diabetes, then you help them with their whole life.”


The best part about this online community? Facebook doesn’t require appointments or any 8 to 5 limitations–it’s always there. Thanks to Facebook, says Jennifer Davis, who lives with diabetes, “I know that I am not alone in my struggles with diabetes. I can go online at any time of day and get support.”

Lisa Stoler may have encompassed every benefit of Facebook for people with diabetes in her story, explaining that, “Before I found the diabetes online community in Facebook, I had been completely alone in my diabetes. I never knew anyone else that was like me and felt misunderstood all the time. Now I know there is always someone just a tap away that know what I’m going through.”


Stoler adds, “In the middle of the darkest nights when I’m dragging myself to the kitchen with a low blood sugar, using all my strength to get food, sit in a chair, and stay alive while waiting for my blood sugar to come up, I know I am not alone because of the community on Facebook. There are always at least 10 type 1 diabetes right at my fingertips. And after 42 years as a type 1 diabetic, I thought I know everything but realized I didn’t–I have learned so much from my online friends in the diabetes community, enabling me to take better care of myself and live a healthier, fuller life.”


While emotional “support” gained through chatting back and forth on Facebook may not seem like a vital ingredient to one’s health for most people, for those living with diabetes who know that every day comes with a variety of challenges impacting every aspect of life from breakfast to work to school to relationships to Christmas parties, it is beyond valuable. For this community, Facebook serves as an endless source of support, education, and empowerment in their lives that are impacted 24/7 by life with diabetes.

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How one CCG is using Facebook to improve communication

How one CCG is using Facebook to improve communication | Social Media and Healthcare |

GPs traditionally have a habit of working very separately from one another, each locked away in their own consultation room. But as we prepare to take on a host of new management responsibilities under the health reforms, we have suddenly found the need to do a lot more talking.

As well as modernising services, a number of forward-thinking clinical commissioning groups (CCGs) are also bringing their methods of communication up to date. As part of this, I have been tasked by Esydoc, my East Surrey CCG, to develop its use of social media.

These online platforms are already transforming the way we operate by allowing an instantaneous flow of information and suggestions on how best to manage local healthcare services.

At the heart of our social media activity is a Facebook group that board members can use to speak to one another.

Thanks to social media, we no longer need to rely on face-to-face meetings or long chains of emails to share ideas and hold discussions. It is like an online meeting with real-time minutes that can be easily accessed and updated at any time.

The group also allows the CCG to communicate with the 'rank and file' GPs in the area. Take a recent example of one of our GPs who posted about a joint clinic and uploaded the referral form. Within seconds, members could download and print the form, refer patients and provide valuable feedback about the new service.

The Facebook page is a huge, multifunctional electronic noticeboard for members. Commissioners can publicise the latest services and guidelines and doctors then use the group to provide feedback and make suggestions about what improvements can be made.

As well as the obvious benefit of being able to discuss CCG matters from the comfort of our homes or surgeries, these conversations provide a cost-effective substitute for lengthy consultations or one-way feedback.

Creating, publicising and (to some extent) running educational events is another key way in which we use social media. Events fliers are uploaded to the Esydoc group and members can discuss the topics and share resources in advance. Facebook's calendar and event functions can also be used to create online invitation and booking systems.

The ease with which local information like this can be accessed is proving beneficial for all kinds of doctors. While there are still a number of GPs who do not use social media, newly qualified doctors have found our group particularly useful when familiarising themselves with services in the area.

Of course, as one of the first CCGs to create an active social media strategy, there are some potential pitfalls to consider.

Concerns will always exist around internet security and privacy for instance, though we have mitigated these with meticulous moderation and full use of Facebook's multitude of security settings. All of the group's conversations are "closed" and only visible to group members. Instead, we use our Twitter feed to keep the public up-to-date on our work.

Doctors' online conduct is also a concern. Most health professionals are sensible in their social media etiquette. But there is always the risk that GPs will share inappropriate material or identifiable information about patients.

The recommendations provided by the Royal College of GPs (RCGP), the General Medical Council (GMC) and the Nursing and Midwifery Council (NMC) are helping to clarify how we go about communicating online.

The development of these guidelines demonstrates that the medical profession accepts and largely welcomes the growth of social media use among healthcare professionals.

I am fortunate to work within an innovative CCG that is keen to embrace change and new ways of communicating. Hopefully, it will not be long until others follow our example.

Dr Hamed Khan is a principal GP in Oxted, a member of Esydoc CCG's communications subgroup and GP advisor for Network Locum

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