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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Social Media and the Empowering of Opponents of Medical Technologies: The Case of Anti-Vaccinationism

Social Media and the Empowering of Opponents of Medical Technologies: The Case of Anti-Vaccinationism | Social Media and Healthcare |

Social media has been defined as “a group of Internet-based applications that…allow the creation and exchange of user generated content” [1]. These platforms range from social networking sites such as Facebook, to content sharing sites such as YouTube and Picasa, and even to interactive virtual worlds such as Second Life and World of Warcraft. Rapidly increasing in popularity and influence, social media presents a double-edged sword for proponents of medical technologies. On one hand, social media has transformed how companies communicate with potential consumers of medical pharmaceuticals and technologies.


Both consumers and producers have a range of novel communication channels available to them that can rapidly match consumer interests and needs with available products and services. Social media platforms provide companies with new communication channels, relatively inexpensive and targeted advertising opportunities, and a consumer-mediated information stream that could potentially improve consumers’ trust in information and brand loyalty to companies through information shared online. Social media has also given consumers communications tools that enable them to rapidly seek health information, share medical advice, directly manage health conditions, and benefit from, and contribute to, a community discourse by rating, ranking, and describing experiences with medical products. These applications have been developed partly in response to a shift in how consumers see their role in managing their health in an increasingly complex and patient-oriented medical system [2-4].


However, along with these opportunities for empowering both health consumers and producers alike comes potential peril [5]. Social media activities have raised alarms in the medical research community over companies having more effective tools to directly market health products to consumers—an activity regulated in most jurisdictions outside the United States [6,7]. The direct marketing of pharmaceuticals, procedures, devices, and medical tests to consumers is thought to lead to overconsumption or inappropriate consumption of medical technologies [8,9]. Conversely, social media also presents new opportunities for opposition to medical technologies, most notably for those that raise the ire or concern of some citizens, such as religious opposition to stem cell or novel fertility technologies. Social media provides a new platform for these individuals to organize, communicate, and undermine industry messages. It allows these individuals to circumvent traditional communication mechanisms and therefore does not require their messages to be either acceptable or relevant to mainstream broadcasters. It thus permits a minority of motivated individuals to potentially control the discourse and, at times, contribute to the spread of misinformation, damaging an otherwise useful interaction between proponents and consumers. An example of where this disruptive new media has been particularly problematic, and which offers cautionary messages to advocates of other technologies, is in the field of immunization. We have been studying this phenomenon and provide a summary of our experiences and lessons for advocates of new and existing technologies.

Social Media and the Anti-Vaccination Movement

Anti-vaccinationism has existed since the introduction of the first vaccine. Individuals who have alternate belief systems have mobilized, typically geographically, to communicate their concerns. This has led to sporadic vaccine rejection movements. More recently, the claim that the MMR (measles-mumps-rubella) vaccine or thimerosal containing vaccines are associated with autism continues to persist despite numerous studies refuting the link [10]. This rumor, largely initiated by a since-withdrawn paper in the Lancet, has resulted in vaccine rejection and contributed to over 26,000 cases of measles in Europe in 2011 [11,12].


What is social media’s role in all of this? Traditionally, geographic proximity was necessary for mobilizing anti-vaccination forces. However, social media has circumvented this potential barrier, allowing individuals from disparate regions who likely would not have otherwise communicated to come into contact. In this process, individuals who had otherwise had their viewpoints rejected and been marginalized can be emboldened and can feel empowered. Social media also provides these individuals with new dynamic mechanisms to communicate their viewpoints. We observed this in several ways while studying vaccine concerns. We first observed the congregation of anti-vaccination viewpoints on YouTube [13]. Individuals utilized YouTube to upload videos that highlighted vaccine concerns and commented on each other’s videos in a quasi social-network manner. Our observation was reinforced by the fact that anti-vaccination videos had more views and higher ratings than pro-vaccine videos. We observed similar vaccine concerns on the social media site MySpace when studying postings related to the HPV vaccine [14]. Examining these blogs revealed geographical clustering of anxiety—with Texas’ attempt to make the HPV vaccine mandatory leading to a plethora of anti-HPV vaccine blogs in that state. Our assessment of the blogging sentiments also revealed potential future challenges in having boys accept the vaccine given that boys’ blogs were determined to be more negative. We even observed organized anti-vaccine behavior when we surveyed health communications in the virtual world Second Life [15] (see Figure 1 for a screen capture showing the Vaccine 911 auditorium; Vaccine 911 is a vaccine critical organization that presents weekly lectures on immunization in Second Life).


As can be surmised, these pernicious activities can pose a real threat to mainstream messaging. If vaccination, one of the most important mechanisms for reducing mortality and morbidity where all established sources of information support the practice, can be undermined by social media activities, more novel technologies are at real risk of being similarly undermined [16]. Other examples of where traditional health messages have been undermined using social media include the promotion of anorexia and the spread of misinformation pertaining to rheumatoid arthritis [17,18].


[view this figure]Figure 1. Screen capture from the Second Life Site of the Vaccine 911 auditorium: The Iowa Wellness and Spinal Tuning Center (SLurl 163,122,28; Image taken Dec 15, 2008).



What strategies should advocates of medical technologies employ to combat the social mobilization of opposition to their products derived from marginalized opinions, hearsay, and inaccurate representation of the science involved? Here are a few recommendations stemming from our observations.

Social Media Monitoring

This is now an established part of marketing strategies. Numerous services are available to track online comments and social media activity about a new product and also to analyze sentiment, providing businesses with an opportunity to interact with customers, and to potentially intervene and prevent viral marketing campaigns by responding rapidly to customer concerns [19]. This is a necessary first step for any pre-emption efforts. Moving beyond social media monitoring, advocates of medical technologies may also want to consider monitoring search behavior related to their products. In health, search term surveillance has shown promise in identifying behavior patterns and anticipating disease outbreaks [20].

Be Where the Conversation Is

The US Centers for Disease Control and Prevention has made it part of their outreach mandate to master the various social media platforms so that, as much as possible, they can deliver scientifically accurate and appropriate content at the point when a consumer is seeking information, either via a Google keyword search, blogging on Facebook, watching videos on YouTube, or scanning related news items [21].

Interacting Through Social Media

This is a delicate task that needs to be approached with caution. When exploring social media contact, proponents of medical products may encounter a lot of negative sentiment. However, responding to the sentiments may simply provide a platform and greater audience for the more extreme viewpoints. Proponents of medical products need to recognize that opposition to their products will lie along a spectrum. There will be those who are ideologically opposed, and no effort to persuade them will be successful and will likely only intensify their opposition. We observed this when studying anti-vaccination attitudes and found that individuals often frequent social media sites to hear like-minded viewpoints and are not interested in hearing alternate viewpoints [13]. While vaccination may be a somewhat extreme example given the intensity of rhetoric that characterizes the discussions, nanotechnology, stem cells, and reproductive technologies could also create similar opposition. Proponents of medical technologies need to recognize that their target is the ambivalent individual. An individual who has no strongly held opinion and is susceptible to influence by a persuasive argument or an argument that resonates with a strong pre-existing belief system they hold (for example religious/political views). This leads to our fourth recommendation.

Recognizing the Power of Social Media

While some of the more radical viewpoints on social media may seem bizarre, dismissing the overall sentiments on social media would be a mistake. Public figures may champion these viewpoints (Jenny McCarthy on vaccines and Prince Charles on nanotechnology) giving the viewpoints’ credibility among more moderate participants. Further, heavy-handed tactics by proponents of new technology may backfire because of the ability to create opposition through social media. Finally, and perhaps most importantly, there may be a basis of truth to the concerns voiced on social media sites. Proponents of medical products would be well served to listen to this discourse, ignore the extreme contributors, and prepare to address the concerns of the more moderate contributors. Companies that respectfully acknowledge these concerns and respond with clear actions, demonstrating that these concerns are being listened to, will build trust in their products. In contrast, companies ignoring the media and its messages will do so at their own peril.

Social media has been described as a game changer and proponents of medical products will have to develop mechanisms to understand and manage its influence. In many ways, social media has been beneficial, serving to improve the interaction between proponents of products and the public, in addition to providing members of the public an opportunity to provide valid criticism. However, the risk of discourse being hijacked by an extreme minority can be destructive to the relationship between producer and consumer. Ours are but a few of the suggestions to guide proponents of medical technologies as they navigate this new media and its impact.

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How is Digital & Social Media changing Medical Journal Publishing?

How is Digital & Social Media changing Medical Journal Publishing? | Social Media and Healthcare |

Last night, when I was searching online for an article published in the Journal of American Medical Association (JAMA), a message popped up on my screen, asking if I would like to install an app called “The JAMA Network Reader“ in my Google Chrome browser. Out of curiosity, I downloaded the app and set up an online account. I was immediately impressed by the app: it has incorporated content from 10 JAMA journals, highlighting “Online First” articles and including links to all articles in current issues.  The intuitive web-based digital platform is easy to navigate with a clean and modern design. Other helpful features include “Offline Library” and “Bookmarks.” Like Amazon’s Kindle, the app even allows you to adjust font size instantly.  I was surprised the well-designed app was developed by a medical journal publisher.

The design of JAMA Reader is sleek and intuitive

The content of medical journals (data and science-heavy) and their primary readers (physicians) did not traditionally fit into the digital media world–we would never expect articles in the New England Journal of Medicine to be written in the same way as Buzzfeed viral stories. However, in the last couple of years, there have been some gradual but major changes driven by digital technologies and social media in the medical journal publishing industry.

Besides JAMA, several other medical journal publishers have taken the advantage of digital technologies and social media to leverage user experience and content sharing. For example, NEJM has established a comprehensive online presence, from Facebook pageFacebook appTwitter handleemail alerts tomobile apps. And the uptake has been high. The NEJM Photo Challenge Facebook app has more than 8,900 active monthly users. NEJM’s Facebook page has more than 430,000 subscribers and its Twitter handle has more than 129,000 followers.

In addition to efforts in digital and social media, the open access movement has gained momentum in medical journal publishing as well. PLOS, a peer-reviewed, open access medical journal online publishing platform challenges the traditional process of science data publishing, attracting much attention from the research community. Now the non-profit organization has seven journals and five blogs, accumulating more than 53 million page views, 12 million article downloads and 145,000 cross citations.  Other organizations have also announced plans to join the movement–the Infectious Diseases Society of America announced this year that it will launch Open Forum Infectious Diseases, another open access online journal in the first quarter of 2014.

Open access movement is changing the landscape of medical journal publishing.

As the health care landscape continues to evolve, these changes are inevitable for the medical journal publishing industry.

Physicians, the biggest clientele of medical journals are rapidly adopting digital, social media and mobile. According to a Google/Manhattan Research published last year, when making clinical decisions, U.S. physicians spend twice as much time using online resources compared to print. 87 percent surveyed physicians use a smartphone or a tablet in their practice. The increasing demand for digital and mobile-friendly content requires medical journal publishers to build robust online platforms and create more engaging content.

The culture of medical research is also shifting as big data, open access movement and social media lowered the threshold to enter the medical research conversations. Collaboration among different industries and business functions are reshaping medical research and drug development, which forces publishers to adapt to the new reality by embracing emerging communication channels, facilitating a quicker and streamlined publishing process and expanding data/content access to a larger audience.

Together, these efforts are changing how medical research information are being distributed and received: data will be more accessible and sharable; jargon-filled journal articles will be easier to understand and more fun to read; more people from outside of medicine will participate in and contribute to conversations around medical research. The bottom line is that these changes can lead to higher efficiency in knowledge sharing and innovation, something the medical research community has been searching for a long time.

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More Hospitals' focusing on the Wrong Agenda for Social Media

More Hospitals' focusing on the Wrong Agenda for Social Media | Social Media and Healthcare |

Picture this: Mary has been sitting in a hospital bed all morning struggling to cope with her recent medical diagnosis. Looking for a way to interact with other residents in her situation, she clicks on the hospital’s Facebook page. All she sees on the group’s newsfeed, however, is a history of interactions between employees and hospital achievements.

There is no mention of the group yoga session set to occur at noon. There are no subgroups where patients can connect with one another. Instead, the only thing that the patient sees is a string of comments on the recent employee of the month, and a group vote asking what to order for lunch on Friday.

According to a recent study, customer interaction in the healthcare sector is suffering on social media. Hospitals are increasingly focusing on promoting internal dialogue through social media at the expense of patients’ interests. In fact, the report indicated that only one quarter of all posts observed in the study were patient-focused. This is extremely detrimental to the growth of organic user generated content. 

“We find that if a hospital devotes its postings towards client-specific communications, then active social media management can still lead to incremental user-generated content, which is a function of the number of clients,” the study says. “However, most hospitals do not do this. Instead, more of their postings are devoted to either generic observations or to employee-related issues and achievements. Such content appears to inspire primarily the employees at the organization to respond, rather than clients.”

In the healthcare industry, patient outreach is a crucial method of preventing those who are sick from feeling like customers in line.  Right now, however, only 18 percent of hospitals actively manage their Facebook accounts.

In a setting such as a hospital, customer interests have to come first. As it was proven in a 2012 Global Consumers Survey, one in five customers switched providers in 2012 based on a negative customer service experience. Focusing on employee interests or organizational gains via social media does nothing to help those who are actually in need.

 Likewise, prospective patients will look at social media pages as a means of gauging the level of care they are to receive. In fact, 90 percent of adults between the ages of 18-24 claim that they would trust medical information from peers across a social media network. Further, 41 percent of people claim that social media would play a role in choosing a healthcare provider.

Failing to cater to this demographic could be detrimental to a hospital’s marketing strategy. By keeping the conversation focused on patients, however, this could be avoided. At the end of the day, nobody likes to hear an organization talk about itself excessively.

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Can A Hashtag Change Healthcare? The Impact of Healthcare Tweet Chats

Can A Hashtag Change Healthcare? The Impact of Healthcare Tweet Chats | Social Media and Healthcare |

The first time I read this quote from Dana Lewis, moderator of #hcsm the premier tweet chat on healthcare, I was gripped by the notion of how Twitter and in particular tweet chats could influence the way we practise healthcare.

Social media is a radical shift in the way we communicate. The healthcare conversation is no longer a one-way narrative but is evolving into a global, participatory discussion. One of the most powerful ways I see this happening is in the modality of the tweet chat. The role Twitter plays in breaking down patient/provider barriers, disseminating and expanding the reach of healthcare information, widening social networks and co-creating a collaborative model of shared health information is one of the most exciting developments in social media.

What Is A Tweet Chat?

For those who may be unfamiliar with the phenomenon of a tweet chat – it is a pre-arranged chat that happens on Twitter through the use of updates called tweets. It includes a predefined #hashtag which links the tweets together in a virtual conversation. Most tweet chats follow a common format of a moderator who introduces pre-arranged topics relevant to the chat and keeps the conversation on track. The chats usually last one hour and a transcript of tweets is available after the chat has ended.

Symplur is doing an impressive job of compiling all of the healthcare hashtags and providing chat transcripts in The Healthcare Hashtag Project. The goal of the project is to make the use of healthcare social media and Twitter more accessible for the healthcare community as a whole (a full list and a tweet chat calendar of meeting times can be found on the Symplur website).

What Is The Impact Of Tweet Chats On Healthcare?

As a relatively new technological innovation, the use of Twitter as a modality for health communication is only now beginning to be explored with particular emphasis on the role Twitter may play in contributing to health based conversations directed at individual, community, and societal levels.

Many times, people’s choices in terms of Personal Health Practices (PHP) are context dependent and socially constructed. Healthcare tweet chats have tremendous potential to motivate participants and encourage change. Much of this change comes from peer-to-peer support which has been shown to be highly effective in motivating change. Many participants share conversational and informational knowledge that they believe is valuable both to themselves and others.

Tweet from participant in the #BCCEU (Breast Cancer Social Media Europe) tweet chat

Studies show that individuals enrolled in meaningful social networks have protective properties in terms of overall health and wellbeing. Healthcare tweet chats provide participants with a sense of community and valuable opportunities for meaningful exchange and positive interactions.

The impact of digital technology in healthcare is leading to changing expectations by health consumers who, along with a desire to share information and connect with others, increasingly want to interact and engage with their healthcare providers. Twitter has also facilitated the emergence of  the “patient opinion leader” an individual who is seen as an expert in chronic conditions such as cancer.  Gunther Eysenbach refers to this group as “Apomediaries” – individuals that assist in the process of information searching but do not act as a gatekeeper.

So, what’s in it for healthcare practitioners?

Dr Bryan Vartabedian (@Doctor_V) of Baylor College notes of social media ”the greatest value of this medium is the breakdown of barriers that have traditionally come between doctor and patient.” It is encouraging to see the increasing participation by doctors in many healthcare tweet chats, reaching out and sharing information, but also listening too.

Twitter offers opportunities for healthcare to reach out to patients in new and valuable ways.

These [social media] tools help us reach so many more people; we can bring shared interactions into our practice and that is powerful … This isn’t an addition to your job. This is part of your job.  This is a conversation, and that is what we are trained to do … This is where our patients are these days and this is where we need to reach them. We can engage learners, patients and peers, and we are not limited by geography or time – Farris Timimi, M.D., medical director for the Mayo Clinic Center for Social  Media.

Another striking feature is Twitter’s crowd-sourcing capacity which allows health consumers, researchers and practitioners tap into a global source of advice, support and information. Twitter also provides a unique opportunity to learn from patients’ direct experience shared during these chats.

If healthcare innovators and providers wish to remain relevant and connected to digitally enabled patients, they need to go where the conversations are – more and more those conversations are happening on Twitter and the evolving dynamic of the tweet chat is the best place to find them.


Eysenbach, G. (2008). Medicine 2.0: Social networking, collaboration, participation, apomediation, and openness. Journal of Medical Internet Research10(3), e22. doi:10.2196/jmir.1030

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Digital Profile Management tips for the Modern Doctor

Digital Profile Management tips for the Modern Doctor | Social Media and Healthcare |

A patient complained about a doctor on Facebook and generated a lot of online traffic. The story was reported in the newspapers. The Medical Board started an investigation. Pending the outcome the doctor relocated to another city. This left the local community without a doctor as no replacement could be found.

Reputation management should be part of a professional risk management strategy.

A year later the doctor’s name was cleared by the board. But the damage was done. And for many years the article kept showing up in Google search results in relation to the doctor as well as her old practice.

The good news is that I made this scenario up. The bad news: reputation damage can happen to all of us. Pro-active online reputation management should be part of a healthy risk mitigation strategy.

Here are some simple (ethical) tricks I have used to manage my online reputation and improve my Google rankings. You can do it too, it’s easy. It is applicable to your personal brand (your name) as well as your organisation.

1. Always respond to customer needs and expectations

Prevention is better than cure. Our managers act on complaints immediately, as negative comments have the potential to spiral rapidly out of control, especially online. Here is an example of how not to handle a social media crisis.

Our quality assurance committee starts its meetings with a ‘good, bad and ugly’ review of the past month. The group looks at any problems or feedback received, including e.g. Facebook comments. We’re not perfect by any means, but this approach allows our organisation to improve patient services on an ongoing basis.

2. Create, promote, and update your own online content

Develop a professional website but don’t stop there! Start a Blog. Create social media profiles on LinkedIn, Twitter and Google+, and update your profiles regularly. This will improve search engine rankings so your own content will show up first. Use to find out which social networks are available.

3. Interconnect your online profiles

This will further improve rankings. Splash pages like help to connect your profiles in one place.

4. Encourage constructive criticism and respond timely to feedback

Engage when people post comments. Respond preferably on the same day. Look at feedback as free business advice. Thank the reviewer and explain your point of view. We have learned from the comments on our website and practice Facebook page.

5. Don’t argue online (and offline)

Set an example. Be a leader. I know this is not always easy, but an angry response is as bad as no response. Be aware that many clients are watching. Avoid deleting comments as this will usually not help your case.

6. Monitor the web

Google yourself and your organisation at least weekly. Set up Google alerts for your own name and other brands or topics you would like to follow. Free services like,, and can be helpful. There are lots of other tools to watch your web presence.

7. Correct and improve information on external sites

Most sites will update your details at no cost. Some sites like HealthEngine or HealthOptions Australia may have added your name and address but will only allow you to update details or improve your listing after paying a subscription fee.

If you feel a review about you or your organisation is incorrect or unfair ask the owner of the website to make amendments. If that’s not an option request to write a comment on the feedback. Google will only remove reviews if they contain unlawful content, are spam, off-topic or if there is a conflict of interest.

Google offers useful tips about how to respond to reviews.

8. Improve positive content, push down negative content

There are many reputation management services on the web. They improve rankings and make it harder for negative content to show up high in search results. is an excellent free reputation management tool to improve your personal search results. You need to have a social media profile and a website before you start.

9. Be ready to engage with traditional media

Have an official spokes person. Consider media training. I like to give journalists a written summary of the main message our organisation wants to bring across.

10. Know the rules

The Guidelines for advertising of regulated health services explain the advertising limitations under the ‘Health Practitioner Regulation National Law Act 2009’. The Good Medical Practice Code of Conduct of the Australian Medical Board includes principles about how to respond to complaints. If in doubt, ask your medical defence organisation.

Most social media networks, including Facebook have rules. This article is a great illustration: Kicked off Facebook? Here’s what happened. If you want to know how not to use social media – and stay out of trouble – have a look at the AMA social media guidelines.

Reputation management will take time and ongoing commitment. We’re improving our strategies all the time – learning from our mistakes. Let us know how you go! Tips are always welcome!

The information contained on this site is intended to support, not replace, discussion with your doctor or healthcare professionals. The contents of this post are the opinions of the author(s) and do not necessarily represent the views of the Panaceum Group. Blog content is copyrighted. Please read our disclaimer. Thanks for your visit!

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10 tips for Medical Device Companies using Social Media

10 tips for Medical Device Companies using Social Media | Social Media and Healthcare |

Doctors and patients are using social media, so it makes sense that medical device companies have a presence too. But jumping into social media should be done with eyes wide open. It requires commitment and diligence…and, doing it without understanding social media’s platform could hurt your brand.

Building relationships with your audiences requires taking a very different approach compared to traditional marketing. Traditional marketing is an outbound marketing initiative—your direct mail, print advertisements, TV ads, cold calls, etc. Social media marketing is an inbound marketing initiative—your website SEO, blogging, social media, etc. Relationship building means engaging with others.

With this in mind, here are 10 steps to better social media for medical device company owners and marketers.

  1. Listen. Before you even choose a name for your Facebook page, listen to the existing conversations of your audiences. Joining social media conversations is similar to approaching a group at a party. Etiquette keeps you from overtaking a conversation—stepping in to bark your opinion—without listening to what’s being said. So, don’t push messages at your audiences on social media platforms. The conversations are already happening. Listen to them.
  2. Create a Social Media Policy. Medical device companies live in a regulatory environment. To avoid a warning letter from the FDA, work with your legal counselor to create a Social Media Policy. According to DuVal & Associates Attorney Mark Gardner, social media is a useful but potentially dangerous medium. Understand the legal issues related to it and put an SOP in place for social media use that covers training for employees, monitoring of social media pages, when to turn comments on or off, and who actually posts and edits your social media messages.
  3. Be Strategic. Your social media strategy should meet a business goal and be integrated with existing marketing strategies. Define clear objectives for social media marketing. Create key messages and plan your content. Web 2.0 is broader than social media platforms. It includes your website, your mobile website, online public relations, online advertising, webinars, etc. Integrate your marketing across platforms.
  4. Optimize. Optimize. Optimize. Many medical device companies have not optimized their websites for being found on search engines. Optimizing your website is an important step in effective social media marketing. But you will also want to optimize your blog and Facebook posts, Tweets, YouTube and LinkedIn content.
  5. Engage with Visitors. According to Facebook, the top reasons people “like” a brand on Facebook is “to get the latest information,” followed closely by “to fully engage as a fan.” Social media is a two-way medium.
  6. Lead and Follow. Whatever social media platform on which you choose to participate, post information of value and pay attention to others on that platform. An example would be Twitter. Follow others—especially Twitter influencers—to hear conversations and lead with your own Tweets. Re-Tweet. Join the conversation.
  7. Be Easily Found. Make it easy for customers, patients, and doctors to engage with your company via social media platforms. If you have a Facebook page, use a Facebook widget on your website. Better yet, have a live stream of your latest Facebook posts with it.
  8. Don’t Wait for FDA. The FDA is not likely to come out with guidelines specific to social media any time soon. According to Gardner, the rules don’t change just because the medium is different. The same rules apply to social media as to all other labeling and advertising.
  9. Be Balanced and Transparent. Don’t make claims that are false or misleading or lack fair balance and remember that failure to present risk information may violate federal regulations. Choose your content wisely. Watch how you use Twitter, which limits your message to 140 characters. Be transparent. Avoid using links to risk information.
  10. Monitor Conversations. From a marketing perspective, you want to continue listening to conversations on social media platforms. But you’ll also want to pay attention to how information you post is re-used as you are responsible for what you post.

**BTW…Both articles are worth a read if you’re with a medical device company and interested in using social media: Thinking of Dipping Your Toes in Social Media? Medtronic is the Example to Follow andExpert Gives Medtronic’s Social Media Effort a Big A+, Patients are More Critical.

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How to cite a Tweet and other social media in a medical journal

How to cite a Tweet and other social media in a medical journal | Social Media and Healthcare |
Social media has blossomed recently as a repository for professionals to share ideas and thoughts. Many healthcare professionals follow journals, key individuals in their fields, and general users for the information they put out.

Often, these sources of information may take precedent over searching for information in the general news. In a way, this curated version of information is becoming very popular. With this in mind, now academics and others are considering how to use this information for research and writing purposes.

How does one cite a tweet, blog, or Youtube?

There has been a fair share of attention given to this. For instance, The Atlantic ran an article on it, and the education technology blog Edudemic has recently released an article as well. TeachBytes also created a great table (as seen below) to help users cite social media in APA and MLA style.

Social Media Citation Table attached

The one thing that this still does not answer and I have not found an answer for is how to cite Chain-Posts. This includes when a post (e.g. Tweet) runs over the word limit and has two or more parts. Do you cite both of then? The other issue, is how to cite a conversation, such as a TweetChat.
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Medicine & Social Media: Worktools for a Relationship in Progress

Medicine & Social Media: Worktools for a Relationship in Progress | Social Media and Healthcare |

As social media usage continues to expand beyond the personal realm, it’s not surprising that doctors are exploring its potential for enhancing their communication with patients. The business world’s increasing reliance on social media has naturally led physicians to consider whether it offers any advantages in improving care or strengthening their financial base. The American College of Physicians (ACP), the second-largest physicians’ group in the U.S., has given thought to the potential risks and benefits attached to doctors’ use of social media, and they have recently released a position paper detailing their recommendations.

Proceed with Caution

The press release summarizing this position paper strikes a cautionary note, and raises interesting new issues that many physicians and patients probably never previously contemplated: The ACP urges physicians to keep personal and professional profiles separate, and to avoid “liking” or friending patients. Communication with patients by text message regarding medical topics is likewise discouraged, except in cases in which the physician knows the patient well and has previously secured permission for this means of contact. Even email, while perhaps more secure than text message, must be used with great caution when communicating with patients.

The concerns voiced by ACP center on confidentiality and the risk of substituting online contact for in-person consultation. While the association recognizes the clear benefit of increasing physicians’ accessibility, it suggests that digital communication between doctor and patient be restricted to situations in which the online conversation is going to be followed up by an in-person office visit.

Not Yet the Norm

It’s worth noting that, while clearly expressing reservations, the ACP did not broadcast a blanket rejection of the idea of doctors and patients connecting via social media. The shape of internet conversation continues to evolve, and it’s obvious that in the near future, some form of social media contact between doctors and patients will become the norm. Given that fact, it’s important to have a look at the types of tools that are currently available to physicians.


Hootsuite has become one of the staple social media tools in one’s arsenal for B2B and B2C organizations alike — and healthcare is no different. More healthcare institutions, hospitals, group practices, and solo practitioners are utilizing Hootsuite for brand and patient engagement. One hospital utilized Hootsuite to “live tweet” during a surgical procedure to help educate their patients. A medical school in the Caribbean is using Hootsuite to aid in their recruitment efforts. Group practices are using the tool to manage their content, streamline their profiles and monitor social communications. And solo practitioners have found that Hootsuite makes it easy to monitor their brand and engage with potential patients on any of the major social media networks.


One of the more general tools for contact management is Nimble, a web-based relationship management solution that unifies the four C’s (“contacts, calendar, communications and collaborations”) in one simple platform. Nimble merges activity from Twitter, LinkedIn, and Facebook with an office’s business contacts, so that it’s possible to keep track of all the conversations currently being generated by the people important to your business or practice. In this way, customer relationships are easy to nurture and advance, and there is no need to jump back and forth between social media websites. The utility of this customer relationship management (CRM) tool is obvious, and PC Magazine had good reason for awarding it “Editors Choice” status. It is not specifically tailored for the medical provider, however, and would not be helpful in communicating personal information to a patient. For direct patient engagement, PostwireHealth may be a more appropriate tool.

Postwire Health

A more specialized — and more private — channel through which doctors and patients can communicate online is Postwire Health. Post Wire Health characterizes itself as a HIPAA-compliant “Patient Engagement Tool,” and it works in conjunction with office visits. The medical practitioner videotapes the office interaction with the patient, and then shares the video (together with other supplementary information) with the patient through the patient’s personal online portal. This enables the patient to revisit and review the interaction as many times as they wish, so that there is no danger of forgetting any part of the provider’s advice. When this type of communication is used by a practitioner who gives specific exercises or discharge instructions, it empowers the patient by giving them the chance to listen over and over again. This functionality is extended into the area of clinical counseling, so that patients can listen at home to their therapy consultation and have the chance to remember everything the therapist said.

Medical Marketing or Patient Engagement?

When evaluating which type of social media channel to reach out through, it’s important not to lose track of your reasons for using social media in the first place. If you’re involved in medical marketing, your social media use will center on branding and accessibility. For example, a physician could use Nimble to manage various posts and public conversations on medically valid health tips, and to present ways that their medical practice provides outstanding service.

This kind of content can be shared from one patient to the next, through their personal networks, and can be a friendly (but still professional) way for a medical practitioner to engage in marketing. Individual patient treatment discussions are a very different kind of social media engagement, since confidentiality laws require these conversations to be private, restricted to one doctor and one patient. A doctor can be in touch with a patient via email, or can make use of a secure, encrypted platform such as Postwire Health. This type of online conversation will not give rise to a flurry of sharing, but will enhance the individual patient’s experience and may attract new patients via word of mouth. Healthcare providers’ professional use of social media is still in its early days, and patients’ expectations of their doctors’ online accessibility will continue to evolve in coming seasons.

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Study: Twitter useful for food tracking

Study: Twitter useful for food tracking | Social Media and Healthcare |

A study published earlier this summer in the Journal of Medical Internet Research found that Twitter can help people capture dietary intake and behavior.

The data from the study was integrated into Eat It Tweet It, an app in the Apple App store created to integrate with Twitter and offer users a portal to tweet exclusively about their diet. The app, created at New Mexico State University, includes preset hashtags categorized as behavior or food and a camera feature to take a picture of the meal.

The study acknowledges many software applications exist for tracking food data, but lack the “empirical evidence supporting their efficacy as health promotion tools”. Researcher Melanie Hingle’s objective was to test the feasibility of Twitter to capture young adults’ dietary behavior and visualize this data using Twitter’s analytic tool. Upon finishing the study, the participants completed a survey to determine if they found this method viable for regularly recording food data.

After the study, users made various comments about the feasibility of the program. Overall, 38 of the 50 participants found Twitter easy to use while five thought the character limit presented a challenge to accurately reporting data. Participants also suggested creating their own hashtags to better describe food choice and reasons for eating. Eighteen participants wanted feedback on their diet habits and suggestions for how to improve their diet.

The study’s other objective was to create data visualizations of the tweets, which Hingle’s team was able to do with the information from hashtags and time of day of tweets. The study authors believe that future iterations of data visualizations could include heat maps that integrate phenotype of sociodemographic  data.

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Why Health Care Needs a Dose of Social Media?

Why Health Care Needs a Dose of Social Media? | Social Media and Healthcare |

Health care isn't inherently social. It doesn't typically evoke positive emotions—you're calling the doctor because you're sick, not because it's #ThrowbackThursday. Other experiences, such as shopping, dining and travel, are inherently social. As a result, these industries have leveraged social media to improve the consumer experience. 

According to the Journal of Internet Medical Research, 60 percent of adults surveyed used the Internet to find health information. Meanwhile, less than 15 percent actually engaged in social media to discuss health with their peers. This is largely because the health-care industry has failed to enable social opportunities for consumers, because it has not had an incentive to truly focus on the consumer. However, this will soon change with the Affordable Care Act's mandates on patient outcomes.

Currently, a staggering 75 percent of health-care costs are related to preventable illnesses such as obesity, diabetes, hypertension, high cholesterol and asthma. Financial incentives for providers to improve patient outcomes will create a greater focus on prevention and a shift toward patient responsibility. This means the industry should start to view the patients as "consumers" and find ways to improve their overall satisfaction and increase engagement. One clear way is going the same route that retail, dining, travel and other consumer industries have gone: social. 

It's important to recognize that some of the recent patient engagement advancements in health care are steps in the right direction. Take employee wellness programs, for example. It's a great approach—creating a healthier working environment, offering incentives and using colleagues as inspiration. But adding a social layer to this—one that combines your coworker's voice with your spouse's, children's, best friend's and even a stranger who is experiencing the same challenges—can lead to long-term systemic changes. 

Some health issues are a result of individual behaviors, but using the people around us can help change those. As Nielson reported, 92 percent of the major influences in our lives come from those we know, and because so much of our interaction now occurs online, it's time to use social media in health in a bigger way.

At Audax Health, we believe that going social leads to better health and a better health system, and the industry is poised to be reinvented by social media. As this change gets underway, here are three lessons learned on what's proved successful in social media to increase engagement and improve consumer outcomes:

1. Consumption

People need to be able to visualize their health.

This trend is evident with the popularity of platforms like Instagram and Pinterest: We like seeing information through graphics. These social sites have given us a more effective way of browsing through content with a constant stream of free-flowing material at the tips of our fingers. We find ourselves scrolling through endless pages of "stackable" content, being drawn to the visuals. There is infinite data in health care to draw from to develop these engaging graphics for users— presenting it in a way that's not only easy to consume but to understand. Technical health jargon makes it difficult for consumers to connect with their health. There's great information on medical charts, but consumers can't read them, so why not create a visual health report? A 20-page whitepaper about hypertension is useless, but a personalized infographic that's intuitive and simple can help them visualize a story about their individual health.

2. Connection

People need to be able to freely share their health status with those who most influence their environment.

Social media is about making it easy for large populations to connect with one another. People enjoy talking to and hearing from their online networks. A peer's review of a product or service can be the deciding factor of whether or not we choose to use it. A recent study of social media trends found that 78 percent of shoppers first refer to their Facebook friends' opinions before making a decision to visit stores. The health-care industry should leverage this behavior of peer-sharing and observed behavior. We can influence people to take the first step to better health by changing the conversation from "guidelines suggest …" to "people like you. ..."

3. Integration

Social media is at its best when everything works together

Any good social platform plays nice in the sandbox. But social media in health care right now is a series of walled gardens. There are several great digital health tools available, but they have notoriously low adoption rates because they lack immediate value for the end user. None of them are working together, and they are sending users in too many different directions. By integrating core services such as provider directories and health savings accounts, and using social media to reimagine them, we can improve the user experience and give them functions they actually want and need in one connected place. Think health-care provider directory meets Yelp, and health savings account meets Groupon.

Managing our health has always been fundamentally important, but with skyrocketing costs and the high prevalence of preventable diseases, we need to take more proactive steps to encouraging people to better handle their health and wellness. Technology and social media have come to play an incredibly meaningful role in our society, and using the existing mediums and creating social tools specifically for the industry, we can begin to arm consumers to be more involved in their managing their health. Sectors including retail, fashion, dining and entertainment are already using social well, and at Audax, we're helping the health-care industry take a page from their book to improve health and lower costs.

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How the Internet and social media are changing healthcare

How the Internet and social media are changing healthcare | Social Media and Healthcare |

You wake up feeling a slight tickle in your throat. You try and shake it off and drink lots of water. After a few hours, it’s still there. Instead of calling your mom or making a doctor appointment, you head to the Internet.  Today, anyone with a computer and a connection can get online and find a variety of results, ranging from simple sore throat to the more serious, like bronchitis and asthma.

But just because we can doesn’t mean we should. In a world where almost everyone is online and can easily find and provide medical solace, is it really, truly a good idea to consider social media and the Web a reliable source of healthcare?

Doctors and hospitals are on the social media bandwagon

Today, more and more members of the medical profession are embracing social media for sharing helpful medical information and providing patient care. A Pricewaterhouse Cooper conducted survey asked over a thousand patients and over a hundred healthcare executives what they thought of the way many healthcare companies are utilizing social media and the Web, and results show the most trusted resources online are those posted by doctors (60 percent), followed by nurses (56 percent), and hospitals (55 percent).

Social media is becoming more and more utilized by hospitals and medical professionals as a means to convey general health information, sometimes even personalized help. Amanda Mauck, Interactive Marketing Specialist for Le Bonheur Children’s Hospital, thinks engaging with patients via social media is a great way to empathize with those who need comfort, not just provide relevant health news. Aside from the latest news about the hospital, Le Bonheur’s Facebook page mostly contains relatable family stories and parenting advice. “Our users love photos and [success] stories, [especially those] that showcase our team’s compassion and ability to go above and beyond for a family,” says Mauck. The hospital does receive private messages inquiring about specific medical conditions, but they never address them publicly on their Facebook page, usually recommending patients to direct their questions to the hospital’s general contact form or contact them by phone. “When a family posts a comment about a medical issue, we like to encourage the family to email our general account. We do this for a couple of reasons: One, to protect that patient’s privacy, and two, it is easier to put the family in touch with the right person on our team for help,” Mauck explains.

Kevin Pho, M.D., an internal medicine physician and founder of, however, notes the potential for misinformation on the Internet is high. “The problem is, you can’t trust everything you read online,” Pho says. “For instance, consider that fewer than half of websites offered accurate facts on sleep safety for infants, or that pro-anorexia websites were shared more frequently on YouTube.”  According to Pho, health professionals need a strong social media presence to establish themselves as reputable sources as well as to properly point patients toward legitimate sites to be used as secondary sources.

While Pho uses Facebook more for personal reasons, he uses Twitter professionally on a daily basis to retweet provocative healthcare opinions and news stories, as well as curate information that’s relevant to his profession. “Health reform tends to drive many of the health opinions on the web.  To truly fix healthcare, I believe that we need solutions from both ends of the political spectrum, so I avoid sharing opinion pieces that are overly partisan or dogmatic,” Pho says. His “essential list” includes a variety of healthcare stakeholders, including physicians, social media experts, and policy analysts. 

The likes of Facebook and Twitter not only give medical professionals a platform to connect with patients, but with fellow doctors as well. Doximity is like Facebook for physicians, where general M.D.s can easily consult specialists for cases they need assistance with. 

The challenges to Internet healthcare

Of course there’s a downside to doctors becoming too available online. The Internet is almost always the opposite of private – sensitive subjects like physical and mental ailments can easily be revealed by the person suffering from them or the doctor treating them through a tweet or a comment. Social relationships between doctor and patient can also be easily muddled; many health institutions discourage staff from “friending” patients on Facebook and other social media platforms at the risk of jeopardizing treatment as well as reputations.

The Wall Street Journal mentions a survey published in the Journal of General Internal Medicine back in 2011 that revealed 35 percent of respondents who are practicing physicians have received friend requests from patients on their personal social network accounts, and 58 percent of them always reject them.

“I see Twitter as a higher-risk environment, as it’s basically an open forum.”

Thomas Lee, M.D. of the Orthopedic Foot & Ankle Center in Westerville, Ohio raises a valid point: Social media is a difficult media for a physician because of HIPAA, the Health Insurance Portability and Accountability Act. “It is very difficult to talk about medical care without personalizing the content, and you can’t personalize content without violating HIPAA,” Lee explains. “In addition, the practice of medicine requires a thorough history of the patient’s current condition and a thorough physical exam before we can render a diagnosis and treatment plan. A person with a severe headache for several months can range from a simple headache to migraines to an allergic reaction to a life threatening brain tumor. How would a doctor – or a computer program – differentiate between these diagnoses without physically talking and touching the patient? Without the opportunity to directly talk to a patient and examine them, our ability to be accurate is significantly mitigated.”

Lee avoids dishing out professional and medical advice on his Twitter and Facebook accounts, but admits that both help in making himself appear more accessible to his patients and staff. Although he posts frequently, it is unusual for him to engage in a dynamic conversation online.

“I see Twitter as a higher-risk environment, as it’s basically an open forum,” Dr. Rob Lamberts says of his minimal use of the micro-blogging site for his own practice; he only utilizes it occasionally to float a medical question to his colleagues. He has used Facebook in the past to advise people regarding a study on Zithromax, but other than that, Lamberts believes social networking sites are more for marketing and general communication than for medical application.

Scott Linabarger, Senior Director of Multichannel Content Marketing for the Cleveland Clinic, believes that nothing should take the place of having a conversation with your physician. “We cannot provide specific advice, nor can we diagnose users via social media. Our information is general and is intended to provide guidance. Our posts are about the users, not about Cleveland Clinic,” Linabarger explains. According to Cleveland Clinic’s over 450 thousand Facebook followers, they want health and wellness tips, information about diseases and conditions, and news about the latest in medical innovation from the hospital’s Facebook page. The general information is usually presented by Cleveland Clinic through images, a manner they have proven to garner a higher response rate compared to purely text content.

What about online therapy and similar practices that conduct virtual sessions? A study conducted by University of Sydney researchers on the effectiveness of Internet-delivered Cognitive Behaviour Therapy (iCBT) examined e-couch, a free online program that offers various modules that provide anxiety and depression assistance. The results reveal the program to be more effective in alleviating mild to moderate depression and cardiovascular ailments as well as physical health issues than other methods of searching for health advice online.

“Essentially, online therapy will help serve the nearly 3 out of 4 people who have mental health problems but do not currently get any kind of help,” says Lawrence Shapiro, Ph.D., President of Talk to An Expert, Inc., a HIPAA-compliant e-therapy company that launched quite recently. “It is particularly important for people who cannot get to an office for conventional help because they are housebound, in remote areas, physically disabled, and so on.  Online therapy lowers the bar for people who need help.”

“There are a few studies that have been done suggesting that online therapy is just as effective as in-office therapy,” Shapiro continues. “According to the American Psychological Association, almost 25 percent of people with mental health problems don’t get the help they need with the current mental health delivery system. Online therapy extends the reach and reduces the cost of therapeutic services.” With the emergence and acceptance of e-therapy as a legitimate form of healthcare, any patient who cannot afford to schedule appointments during office hours or is undergoing a problem in a public place (think of someone with an intense fear of flying freaking out at the airport, or someone injured and traumatized at a disaster site) can receive instant psychological services.

Dr. Internet, at your service

According to a report compiled by the Pew Research Center’s Internet & American Life Project, one in three American adults have used the Web to figure out a medical issue. Of all those users hoping to find solutions online, 46 percent thought they needed to seek professional medical assistance to be certain, 38 percent believed they could handle their ailments in the privacy and comfort of their own homes, and 11 percent ended up doing both or something in between. The accuracy of accessed information online is a different matter all together – 41 percent of those who sought medical advice got diagnostic confirmation from actual physicians and an extra two percent only got partial confirmation. 18 percent were met with disagreement or a different diagnosis, while one percent got an uncertain reaction.

As an Internet savvy patient, it’s always good to be prepared – or to first look for alternative, quick, and easy (and risk-free) methods to address a less serious medical issue before committing money and time to a medical consultation and medication. Facebook is a rich source for fitness-focused pages that inspire users to adopt healthier lifestyles. In one click you can become a member of a community that will help you with any fitness-or-health-related questions through their personal experiences.

“I do my best to not complain a lot at home. Instead, I use social media sites like Twitter and Tumblr to express how I’m feeling without having to burden my loved ones.

A lot of patients suffering from serious ailments also turn to Facebook for support. Dana Baker – a thyroid cancer survivor – has been a long-time sufferer of a long list of ailments, including chronic fatigue syndrome, fibromyalgia, anxiety, and depression. She is a member of various support groups on Facebook and uses them to sympathize with other people suffering from similar conditions. “When you are chronically ill, it is emotionally draining not on just yourself but also on your friends and family. It becomes very difficult for your loved ones, because they have to see you suffer, and the majority of the time there is nothing they can do to help you,” Baker says. “I do my best to not complain a lot at home. Instead, I use social media sites like Twitter and Tumblr to express how I’m feeling without having to burden my loved ones. I use support groups on Facebook to talk with other people, share our experiences with doctors, medications, and alternative treatments. We also share coping strategies.”

Aside from using social networking sites to keep in touch with fellow patients, Baker also uses Google to look up prospective doctors, sites like WebMD to look up any prescription medication, as well as condition-specific sites like and (for thyroid cancer). She also uses an iPhone app that allows her to keep in touch with her doctors via direct message and they usually respond within the day.

The Internet can also bring the world’s home remedies to your desktop. Trusting the Web to prescribe a homemade concoction might sound sketchy, but by using the right keywords and employing responsible Internet navigation, you can find legitimate “all natural” solutions for common mild ailments. Sites like Home Remedies Web encourage healthcare at home – their list of natural cures address a wide range of common problems, from acid reflux to yeast infections. It also features comments from people who’ve tried the remedies so you have an idea what you’re getting yourself into.

Based on Pew Research Center’s findings, a large percentage of people online prefer taking matters into their own hands, thinking it’s enough to be armed with enough Web search prowess to beat any disease. The trouble is, the wealth of information leaves too much room for guessing – patients can easily underestimate a medical condition, and too often they lean toward inaccurate and scary data. This isconfirmed by research conducted by the Hong Kong University of Science and Technology, which reveals that the less familiar you are with the patient and the condition (meaning being diagnosed by someone besides a search engine and your own queries), the better the chance you have at finding out what’s really wrong.

“I encourage patients to go online and inform themselves about their medical conditions.  Patients deserve to be well-informed, and the transparency of the Internet allows them access to information that used to be gated by a provider,” according to Pho. “The problem, as previously mentioned, is the quality of the information on the Web. There’s too much information available. Physicians need to act as curators of that information, and help patients sort out what’s helpful and what’s not.”  

The middle ground and the bottom line: social media and healthcare can go hand in hand

“Social media isn’t always a secure forum; there’s no way to confirm whether the person on the other end is a legitimate patient or physician,” Pho says. Most hospitals and medical institutions provide healthcare social media policies for their physicians and staff, and as long as these guidelines are respected, social media is a great tool to bring patients and doctors together. 

The problem arises when patients tend to believe that they have the worst diagnosis out of the many possibilities and create unnecessary anxiety within themselves.”

Patients should use this same compromising policy as well. “I don’t mind informed and well educated patients at all,” says Dr. Amit Malhotra, M.D. of Smart Health Technology. “The problem arises [when] patients tend to believe that they have the worst diagnosis out of the many possibilities and create unnecessary anxiety within themselves. It is important to educate yourself and then have a good conversation regarding your problem with your doctor [so he can] guide you through your problem and address your concerns.” Instead of looking up diagnoses, patients can use the Internet as a positive resource for ways to stay healthy and to research sites that provide credible health content. “Patients should ask, ‘who funds it?  Who’s writing that information?  Are there any commercial relationships?  Is there an agenda?’ As a rule of thumb, I recommend health information from ‘.gov’ websites, such as Medline Plus, or ‘.org’ websites that belong to hospitals or medical centers, like the Mayo Clinic,” Pho suggests.

According to Lee Aase, Mayo Clinic’s Director for Social Media, aside from posting general health information, it is also important to offer content that invites patient involvement. “We do a ‘Myth or Matter of Fact’ feature each week in connection with our Saturday radio program in which we post a frequently heard saying about a disease or condition, and then invite users to say whether they think the statement is true or whether it is a myth. We reveal the answer on the page after radio program airs,” Aase mentions.

The world today is technologically driven, and it’s in our best interest – whether you’re a physician catering to your patients’ queries or an individual seeking proper medical treatment – to keep up with these advancements, especially when it comes to accessing healthcare. But even the Internet needs to be taken with a grain of salt, and in the case of healthcare, it’s in everyone’s interest to proceed with caution and skepticism. 

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Introduction To Social Media For Healthcare Professionals

Social MediaFor HealthcareProfessionals

Social Media Is Not A Passing Fad. The specific platforms may come and go but the act of connecting in the digital world will only grow, become more pervasive in our lives.You cannot afford to take a “wait-and-see approach.”The sooner your organization develops an activepresence, the less distance you will have to make uplater.

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Patients’ and health professionals’ use of social media in healthcare: Motives, barriers and expectations.

Patients’ and health professionals’ use of social media in healthcare: Motives, barriers and expectations. | Social Media and Healthcare |

To investigate patients' and health professionals' (a) motives and use of social media for health-related reasons, and (b) barriers and expectations for health-related social media use.

METHODS: We conducted a descriptive online survey among 139 patients and 153 health care professionals in obstetrics and gynecology. In this survey, we asked the respondents about their motives and use of social network sites (SNS: Facebook and Hyves), Twitter, LinkedIn, and YouTube.RESULTS: Results showed that patients primarily used Twitter (59.9%), especially for increasing knowledge and exchanging advice and Facebook (52.3%), particularly for social support and exchanging advice. Professionals primarily used LinkedIn (70.7%) and Twitter (51.2%), for communication with their colleagues and marketing reasons. Patients' main barriers for social media use were privacy concerns and unreliability of the information. Professionals' main barriers were inefficiency and lack of skills. Both patients and professionals expected future social media use, provided that they can choose their time of social media usage.CONCLUSION: The results indicate disconcordance in patients' and professionals' motives and use of social media in health care.PRACTICE IMPLICATIONS: Future studies on social media use in health care should not disregard participants' underlying motives, barriers and expectations regarding the (non)use of social media.
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Social Media: One Size Doesn't Fit All

Social Media: One Size Doesn't Fit All | Social Media and Healthcare |

By Bryan Vartabedian, MD

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

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

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

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

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

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

–Bryan Vartabedian, MD, writes monthly for Wing of Zock about the intersection of health care, medical education, and social media. He is a pediatrician at Baylor College of Medicine in Houston, Texas, and blogs at 33 charts.

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The Facebook Effect - Boosts Organ Donor Registration in a Single Day

The Facebook Effect - Boosts Organ Donor Registration in a Single Day | Social Media and Healthcare |
Johns Hopkins researchers see 21-fold increase in a single day

A social media push boosted the number of people who registered themselves as organ donors 21-fold in a single day, Johns Hopkins researchers found, suggesting social media might be an effective tool to address the stubborn organ shortage in the United States.

The gains were made in May 2012 when the social-networking giant Facebook created a way for users to share their organ donor status with friends and provided easy links to make their status official on state department of motor vehicle websites. The findings are being published in theAmerican Journal of Transplantation.

“The short-term response was incredibly dramatic, unlike anything we had ever seen before in campaigns to increase the organ donation rate. And at the end of two weeks, the number of new organ donors was still climbing at twice the normal rate,” says study leader Andrew M. Cameron, M.D., Ph.D., an associate professor of surgery at the Johns Hopkins University School of Medicine. “If we can harness that excitement in the long term, then we can really start to move the needle on the big picture. The need for donor organs vastly outpaces the available supply and this could be a way to change that equation.”

Over the last 20 years, despite many efforts, the number of donors has remained relatively static, while the number of people waiting for transplants has increased 10-fold. There are more than 118,000 people currently on waiting lists in the United States for kidneys, livers and other organs and thousands of these patients will die before they receive transplants. It’s estimated that between 5,000 and 10,000 people die every year whose organs would be suitable for transplant, but because they had not consented to be donors, their organs go unused. In the United States, organs may not be removed from a deceased donor without permission from either the individual prior to death or the family at the time of a relative’s death. It is believed that over time, roughly 100 million Americans have registered to donate.

By looking at data from Facebook and online motor vehicle registration websites, the researchers found that on May 1, 2012, the day the initiative began, 57,451 Facebook users updated their profiles to share their organ donor status. There were 13,012 new online donor registrations on the first day, representing a 21.2-fold increase over the average daily registration rate of 616 nationwide. Registrations varied by state, with the first-day effect in Michigan rising nearly seven-fold and with nearly 109 times as many online registrations in Georgia as on a typical day. Cameron says it was heartening to see that the states of New York and Texas, where organ donation rates are among the lowest, had some of the biggest bumps on that first day.

While the number of online registrations dropped over the following 12 days, Cameron says it was still twice the normal rate at the end of that study period. “The half-life of a movement online is often just hours,” he says. “This had a very powerful, lasting effect. But we need to find a way to keep the conversation going.”

While the number of declared organ donors increased, it could be decades before researchers determine whether those people ultimately donate their organs.

The Facebook organ donor project came about after Cameron, a transplant surgeon, and his Harvard University classmate — and current Facebook chief operating officer — Sheryl Sandberg began talking about the organ shortage at their 20th college reunion in 2011. Through many conversations, the idea of having a place in the Facebook timeline for users to share organ donor status was born.

Going forward, Cameron says the key to continuing the push for more organ donors is figuring out a way to bring back some of the lost attention of those early days of the campaign and to find a way to get it to again go viral. Cameron says he has spoken to Facebook officials who are discussing relaunching it on its mobile platform, changing its prominence on the Web version or even offering incentives, such as coupons, for people who declare they are organ donors.

Cameron says that in recent years social media has shown it is not only a place for sharing what you ate for lunch or posting cute pictures of your kids. It can be an agent of social change, such as its use during the Arab Spring, after natural disasters such as the recent Oklahoma tornado, and in get-out-the-vote efforts before the recent election, he says.

“This was the first effort like this designed to mobilize people for a public health cause,” he says. “Now we want to build on that. Studying the response to the organ donor effort is the next step in the process of using social media for social good.”

Other Johns Hopkins researchers who contributed to this research include Allan B. Massie, Ph.D.; Robert A. Montgomery, M.D., D.Phil.; and Dorry L. Segev, M.D., Ph.D.

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How hospitals are hustling as health content creators

How hospitals are hustling as health content creators | Social Media and Healthcare |

Today’s health care consumers – baby boomers in particular – are hungry for reliable health content, and more than ever they are using the web to educate themselves. The Pew Research Center reports that nearly 80 percent of internet users go online for answers to health questions.

Perhaps more surprising is the rising role social media plays in consumer health education. According toPwC’sHealth Research Institute (HRI), 42 percent of consumers have used social media to access health-related consumer reviews (e.g., specific treatment therapies or physician reviews), and 20 percent have joined a health forum or community. Younger consumers in particular tend to trust social media as a credible source of information – 90 percent of individuals age 18 to 24 would engage in health activities or trust health information found via social media.

Consumers also are demanding tools to help them take charge of their own health care decisions. Currently, more than 40,000 health-related apps are marketed to consumers – covering everything from diet counters to smartphone-enabled blood-pressure monitors and glucometers.

This change in consumer behavior represents a huge opportunity for fast-moving hospitals to become content creators and provide an alternative to Google search, Everyday Health, and any of the thousands of health-centered sites and apps available today. Let’s take a look at which hospitals are moving fast, launching marketing news portals, community sites, videos and mobile apps to satisfy their customers’ appetite for health content.

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Social Media & Technology Access Could Lower Barriers to Clinical Trial Acceptance

Social Media & Technology Access Could Lower Barriers to Clinical Trial Acceptance | Social Media and Healthcare |

“Research is to see what everybody else has seen, and to think what nobody else has thought.”Nobel Laureate Albert Szent-Gyorgyi no doubt would be impressed with the modern pace of medical research, but possibly concerned that we need to think about clinical trials in ways nobody else has.

Only 3% of people with cancer enroll in a Phase I trial, but 72% of all Americans say they would gladly volunteer on the advice of their doctor. Social media and internet tools have tremendous potential for increasing volunteer enrollment in clinical trials, but many barriers still exist. The factors keeping potential trial volunteers away have been consistent over the years: unease with trial settings, randomization and placebos; lack of understanding or discomfort with the research process; fear of drug side effects and trial protocol rules/requirements; as well as lack of awareness, a perception that trials aren’t appropriate for serious disease, and hesitation among physicians to make recommendations.

While internet access to clinical trials, online patient groups, and social media tools can’t do much about side effects, randomized protocols and research processes, they can raise awareness, change perceptions by patients and doctors, and maybe even make favorable changes to trial settings and protocols.

A number of new online tools introduced this year make it easier for patients to enroll in clinical trials, and may help boost awareness of these studies. The National Institutes of Health website,, lists about 145,000 trials—albeit it’s not the easiest list to use to find your disease. So, to sift through all this data, patient advocate sites have developed ways to match patients with trials, and physicians with clinical researchers. These sites include the Michael J. Fox Foundation-sponsored Fox Trial Finder, a Parkinson’s disease site for patients, and Virginia Commonwealth University’s MD Alert Notification System, which pings physicians at the university’s cancer center about patients who might be eligible for trials.

But how well do these tools work? For most, it’s too early to tell. But one site,, created by UC San Francisco surgeon Laura Esserman, tested the acceptanceof the site and found that more than half of the patients surveyed at cancer clinics were eligible for a trial, and 42% reported enrolling in a trial. Another study suggested that as more of these tools expand beyond pilot stage, and patients themselves start directing their doctor’s attention to these clinical trial tools, we may see a shrinkage in the critical gap between patients needed and people volunteering.

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Doctors who skip social media risk alienating patients

Doctors who skip social media risk alienating patients | Social Media and Healthcare |

Physicians who forgo social media in their practices run the risk of falling behind patients’ growing demands for digital communication and allowing negative reviews to define their reputations, says a new research paper by HP Social Media Solutions, a digital consulting firm.

The report, released June 27, details why hospitals, health systems and physicians should have social media presences as more patients use technology to discuss and manage their health care. It says doctors who don’t use social media are more likely to be unaware of negative reviews posted by dissatisfied patients. Having no social presence online makes it difficult for doctors to respond to such reviews.

Doctors can use social media to counteract wrong medical information posted online by providing correct information for patients or guiding them to other websites, the report said.

Social media experts said physicians don’t need to spend a lot of time online to meet patients’ increasing digital demands. But they do need at least a minimal presence to enhance their practices and protect themselves from unfair criticism. Building positive reputations online can offset negative comments, and having a social media presence allows physicians to respond to patients’ comments in a timely manner.

“They should have a social media plan,” said Frances Dare, managing director of connected health services for the consulting firm Accenture. “If they don’t do social media, social media will do them.”

At the minimum, physicians should monitor their digital footprints to see what patients are saying about them, Dare said. Some patients post negative reviews on various doctor rating sites.

Beyond that watchful eye, physicians should consider having a practice website with a blog. Opening a Twitter account to post updates about their practices and general health reminders is a good idea, too, Dare said.

In addition to a practice website, doctors might consider creating a LinkedIn profile, said Leslie Hobbs, director of public relations at, an online reputation management company. Doctors should create Twitter and Facebook accounts in their own names to prevent anyone else from claiming to be them. They also should get on health care industry profile sites such as, Hobbs said.

“Purchase website domain names for yourself and your practice,” Hobbs said in an email. “There are many low-cost or no-cost templates for creating a nice website, but you can also hire a designer. Populate your site with what you’d want to know as a prospective patient. Where did you go to medical school? What awards have you won? What do you specialize in? What’s your philosophy of care? Where are you located? What insurance do you take?”

Increased access wanted

Nearly a quarter of patients reported in a 2012 survey by consulting firm PwC that they are using social media to manage their health care, said John Edwards, PwC’s director of health care strategy and health care business intelligence. PwC surveyed more than 1,000 consumers and 124 health care executives.

Edwards said many patients are interested in making appointments online, receiving appointment reminders through texts and interacting with physician practices through secure emailing options.

"DID YOU KNOW: 25% of Americans use social media to manage their health care."

Patients in the survey said they used social media to talk about their health care with others. Twenty-four percent said they posted about their medical experiences, and 27% said they posted reviews about medications, treatments, doctors or health insurers.

Edwards said physicians should ask their patients what kind of social media communications would be most helpful.

“Ask them what they want,” he said. “Asking patients about this is a step toward demonstrating how you want to be relevant to patients.”

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Are Your Patients Engaging with Your Brand? (why you needed to be on this yesterday)

Facebook, much like Google, is constantly evolving, staying ahead of the spammers, the scammers, the cheaters, and the haters. The relentless evolution has purpose – to better the brand experience for Fans, and to make money. These are essentially the same philosophies that drive every business, including healthcare and medical business. With that said, some new News Feed changes should be accounted for, and a fresh look at your healthcare marketing on Facebook needs to be addressed. Let Quaintise walk you though it.


The two new concepts that Facebook has released to update it’s News Feed include Story Bumping and Last Actor. shares with us what these exactly mean:


  • Story Bumping – This shows older stories that the user might have missed the last time they perused their News Feed.  In other words, the stories are new to the user, although possibly older than the current time they’re viewed. Facebook saw:
    • a 5 percent increase on interaction with stories from Friends
    • an 8 percent increase in interaction on stories from Pages
    • an overall increase in stories read from 57 percent to 70 percent
  • Last Actor – This involves real time “signaling,” where Facebook tracks the last 50 interactions a user has done within the social network on a rolling basis, and uses that to rank which stories to show in a feed.


What I want you to notice is the “overall increase in stories read from 57 percent to 70 percent.” This is a big jump, and could mean big things for your social media healthcare marketing campaign.


Do Your Patients See Your Posts?

According to Facebook itself, 16 percent of your Fans will actually see your Page posts. That is a remarkably low number, and yet in 2011 that number was as low as three to 7.5 percent.


Thankfully, Facebook seems to be taking steps to improving that 16 percent, but you, the healthcare marketer, physician or specialist must give Facebook a reason to increase that 16 percent for you specifically. How do you make that happen? Let Quaintise show you:


1. Post Photos –

Don’t just post a photo, post a photo with an engaging description and call to action. Photo posts get 39% more interaction on Facebook then any other form of post. More importantly, photo posts get 84% more click-throughsthan traditional link posts. As a physician on Facebook, look to The Cleveland Clinic or Family Practice Specialists for examples on what these photo posts look like, and how they can improve engagement with your Fans. Ultimately, improved engagement means that 16 percent will increase dramatically.


Of course, this is subject to each specific physician Facebook Page. For example, Quaintise client Family Practice Specialist’s Facebook Page receives the greatest amount of engagement through links to the website, while Arizona OBGYN Affiliates receives the greatest amount of engagement from photo posts.


2. Short and Sweet –

There is a practical reason why Twitter initially took off like it did, and why it’s continuing to grow in leaps and bounds – short posts. On Twitter, you’re limited to 140 characters, which is not necessarily a bad thing according to new stats showing that shorter posts actually generate more engagement – 23 percent more to be exact.


3. Perfect Timing –

Every social media marketing agency in the healthcare industry is going to tell you the perfect day of the week and time of the day to post on Facebook when, in fact, it all depends on your target audience. Overall, statistics from Buddy Media show that posts on Thursday and Friday receive higher engagement numbers, but as the social media expert at Quaintise I’ve also seen statistics showing Saturday afternoons and Wednesdays to be the most engaging days and times.


In order to know when the perfect time to post your to reach your patients, you’ll need to analyze your page’s Insights. For example, if we look at Quaintise client Arizona OBGYN Affiliates Facebook Insights, we see that Thursday and Fridays right after lunch is the best time to post. But if we look at Quaintise client Family Practice Specialists, we see that Saturdays right before lunch is the best time to post.


5. Should, Would, Which –

According to Hubspot, there are key words that elicit greater responses than others; should, would and which. By asking a question, you can engage your patients on a different level, literally asking them to engage. Statistics show that question posts get 100% more comments than standard text-based posts. If you’re looking to increase engagement, ultimately increasing that 16 percent number of Fans that see your posts, asking the right question is a great way to accomplish that goal.


The social media experts at Quaintise determine the most effective strategies to increase your physician page engagement and ultimately drive traffic to your website for conversions.

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Hashtag your health: Building a health record with likes, shares and check-ins

Hashtag your health: Building a health record with likes, shares and check-ins | Social Media and Healthcare |

Set your status. Check in with your symptoms. Share photos. Tag parts of the body. Hashtag to join conversations. Personiform‘s Project Medyear combines Twitter and Google Plus with a political campaign-style health record-sharing patient movement. It aspires to be NoMoreClipboard on a Friday night — less official, more social. And Personiform’s kicked off a campaign on Indiegogo to raise $80,000 by Sept. 19 to mobilize field operations and volunteers for the movement its website supports.

The site — the “first-ever consumer health information exchange” — would launch Feb. 14, 2014.(The technology itself is already fully funded.)

The idea for the site stemmed from the growing trend of patients taking to social media for healthcare advice, in part due to physicians’ time crunches. But because the social networks don’t really connect physicians and patients, they miss out on the opportunity to learn about and help their patients. (Not to mention the questionable advice they could be getting.) CareRings (a la Google Plus’ Circles) allow users to choose who they share what information with. And that information can be as wide as general statuses to full-fledged clinical records. If your physician joins, you can even share medical history, data and so on with him there. In theory, clinicians, caregivers, patients and physicians could unite using this tool to develop more holistic (if unofficial) records. (According to the company website, the data is secure.)

According to the site, here are Project Medyear’s everyday uses:

  • Compare health records with a stranger that has the same disease
  • Let your doctor know that symptoms have been flaring up a lot recently
  • Remind your brother to take a parent to the doctor today
  • Invite a new doctor into the family health conversation
  • Gain insight about an upcoming procedure from those who’ve had it before
  • Show your support to a good friend going through a hard time
  • Get your latest medical records and test results all in one place
  • Share the kind of images you don’t want all over Facebook

In theory, this would allow patients to connect with other patients, patients to update doctors and doctors to give quick advice and share test results. Unlike NoMoreClipboard, however, this is pretty unofficial. One shortcoming: In the push for sharing and reclaiming data, the convenience of sending that data to your provider or payer — if they aren’t on the social network — seems to have been forgotten. And unlike state health information exchanges, your health info would have a name and a face, if you choose to share it.

But founder and CEO Panha Chheng claims it’s not convenience at the heart of the movement; it’s empathy. When Chheng was in grade school, he came home from school crying to his father (a smoker) about how smoking cigarettes can kill people. His dad quit cold turkey. He claims that sharing health information compassionately leads to change.

Rather than letting states use healthcare information of individuals anonymously, Project Medyear hopes users will add their name, take ownership of their records and propel the empathy movement forward. Though some healthcare providers, like Cleveland Clinic, have made a push for empathy through their marketing, this remains a unique strategy.

According to the website:

Project Medyear is a people’s movement to share health records, however we want. We believe in the power of sharing to uplift lives, and that our collective empathy can become a powerful force for social change.

“We are focused on what it takes to accomplish real progress in healthcare, and it takes more than the best technology can offer,” Chheng said. “It takes people, empathy, and courage.”

Other Personiform leadership includes Dr. Tamer Fakhouri, a physician at OneMedical, and health and social technology strategist Mark Scrimshire, the head of cloud computing at 3M. Chheng has worked at Deloitte, and was a strategist for iSoftStone when it was brought to IPO.

If those connections don’t convince you, maybe the sweet Regina Holliday (patient advocate and artist) jacket will.

Yet, I can’t help but think doctors won’t be too keen on the idea of spending more time on the computer and interacting with potentially hypochondriacal updates. (No more “if it gets worse I’m going to the doctor.”) Or that, if very few doctors join, Project Medyear will dissolve to a realm of everyone crowdsourcing their medical problems, complete with pictures and status updates–a dump of all of those skitterish people looking up what their coughing might mean on WebMD in the wee hours of the morning. (Help me, I’ve been one of them.) No thank you. Sorry if that doesn’t sound empathetic.

Where is the fine line between sharing and oversharing?

Aren’t there better ways to spread empathy in the healthcare community than a social network? What do you think? Let me know in the comments below.

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Experts say current social media guidelines are misframing issue of physician professionalism

Experts say current social media guidelines are misframing issue of physician professionalism | Social Media and Healthcare |

From the small-town doctor to the Freud—Ferenczi debate over sharing personal anecdotes, controversy over physicians' professional identity is nothing new. The question of physician conduct on social media is simply a new context for an old debate, but ethics and psychiatry experts at Johns Hopkins say current guidelines are misframing the issue of physician professionalism online, missing the opportunity to shed new light on the evergreen issue of physicians' role in society.

In a JAMA Viewpoint opinion published August 14, the experts say that current guidelines, including the recently released by American College of Physicians and Federation of State Medical Boards, are asking the wrong question about medical professionalism online; it's not a question of whether content is professional or personal, but whether it is appropriate of a physician in public.

"Resolving the online identity crisis requires recognizing that social media exist in primarily public or potentially public spaces, not exclusively professional or exclusively personal ones," write authors Matthew DeCamp, MD, PhD, Thomas Koenig, MD, and Margaret Chisolm, MD.

The authors assert that it is "operationally impossible" and therefore "nonsensical" to separate personal and professional identities, as many guidelines suggest. They will underscore their point by participating in a live Twitter chat scheduled for 2:00 PM on Friday, August 16, with the hashtag #IDcrisis, hosted by the Johns Hopkins Berman Institute of Bioethics (@bermaninstitute).

"Professional identity is a component of personal identity, much as a person can identify both as a colleague and parent in different contexts," says Chisolm, a professor in the department of Psychiatry and Behavioral Sciences.

"The internet is a reimagined small-town square for the digital age, where a comment made casually to a friend can suddenly spread like wildfire," says DeCamp, a practicing general internist at Hopkins and faculty member at the Berman Institute. "Social media presents an opportunity for physicians to connect with their community, and they can maintain an appropriate professional identity while doing so by keeping in mind they are speaking in a public forum. So rather than something completely novel, social media is simply a new forum for professional conduct in public, which physicians negotiate all the time," DeCamp says.

The authors warn that attempts to adhere to existing guidelines and "depersonalize" their identity online may backfire, reducing trust of physicians who are attempting to hide something, and increasing patient stress in response to a physician perceived to be impersonal and unsympathetic.

Source: Johns Hopkins

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How Social Media Improves Chronic Disease Care

How Social Media Improves Chronic Disease Care | Social Media and Healthcare |

A new approach to using social media in healthcare is being pioneered in the Netherlands, according to a study in the Journal of Medical Internet Research. Focused on chronic disease care, this strategy breaks down the boundaries between online communities for doctors and patients to promote better care and empower patients to take better care of themselves.

The Dutch study examines three different types of online health communities (OHCs) in which patients with Parkinson's disease (PD) participate. All are used in association with ParkinsonNet, a professional network that includes physicians and allied health professionals who treat these patients.

In general, the authors define an OHC as "an Internet-based platform that unites groups of individuals with a shared goal or similar interest regardless of their whereabouts." That could include patients with a particular condition, a group of healthcare professionals with a shared medical interest, or both. Through an OHC, these people can interact via blogs, chats, forums and/or wikis.

The best-known example of such a community in the U.S. is PatientsLikeMe, which encompasses multiple forums for patients with various conditions. Physicians here have their own online communities, such as Sermo and KevinMD.

In Holland, "closed" OHCs -- which include groups for PD, dermatology, stroke, MS, rheumatoid arthritis, fertility, and cancer care -- are accessible either to healthcare professionals only, or to professionals and patients if they're connected to a particular clinic. All participants may contribute to forums, but care teams don't answer individual patient questions because of privacy concerns.

"Open" OHCs, also known as community forums, may include patients, their caregivers, and healthcare professionals. In the open OHC for Parkinson's disease, patients use the community forum for online peer support and discussions with health professionals, according to the study. Often, it points out, fellow patients provide useful answers, which may alleviate the pressure on health professionals.

Another type of online community, known as the personal health community (PHC), is governed by an individual patient who can invite providers and caregivers to participate. In a PHC, the patient can communicate online with his or her care team about particular health problems. The PHC includes a personal health record that can be accessed by the patient's care team.

The chief advantages of OHCs, according to the report's authors, include facilitation for the exchange of medical experience and knowledge; enhancing interdisciplinary collaboration across institutions and traditional echelons; providing a platform to support self- management; and the ability to improve patient-centered care.

"OHCs offer a platform for supporting medical decision-making and interdisciplinary collaboration across professionals caring for complex patients," the authors said. "OHCs enable communication between community members who are not able to have face-to-face interaction at any point in time. Moreover, OHCs bridge geographical distances and enable interaction across institutions and traditional echelons."

While this sounds like the kind of professional collaboration that an accountable care organization -- rather than a social network -- is designed to promote, the authors also point out that OHCs are structured to engage patients. "Chronic patients using online communication tools become more knowledgeable, feel better socially supported and empowered, and have improved behavioral and clinical outcomes compared to nonusers," they explained.

People who join these communities seem to be highly motivated. Over a 12-month period, the study said, 54% of the Parkinson and ParkinsonNet community members generated new content or posted a comment.

But the authors acknowledged that in Holland, as in this country, financial incentives and cultural norms will need to change in order for this social networking approach to have widespread success. "The implementation of OHCs into clinical practice demands a paradigm shift in control and power, out of the hands of those who deliver care, into the hands of those who receive it," they wrote.

In the U.S., patients are more likely to share information about their own or others' health experiences on a social media site such as Facebook or Twitter than participate in online health communities. But about a fifth of respondents in a PWC survey said they'd joined a health forum or community. About 140,000 of them belong to PatientsLikeMe.

The PWC researchers said, "PatientsLikeMe demonstrates that despite privacy concerns, many consumers are open to sharing information via social media."

U.S. physicians, however, are less interested in sharing with their patients online. Most physicians who have been invited to "friend" a patient on Facebook, for example, have declined. Doctors' top social media sites include physician online communities and LinkedIn.

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Social Media Policies for Physicians: Good or Bad!

Social Media Policies for Physicians: Good or Bad! | Social Media and Healthcare |

Social media guidelines for physicians frequently focus on the need for doctors to separate their personal from their professional identities, but those types of policies get social media all wrong, according to a viewpoint recently published in JAMA.

Instead, the viewpoint's authors suggest a simpler, more straightforward means for physicians to assess potential social media activity: Is what you're about to say appropriate for a doctor to talk about in public?

"When a physician asks, 'Should I post this on social media?' the answer does not depend on whether the content is professional or personal but instead depends on whether it is appropriate for a physician in a public space," write the authors - Matthew DeCamp, MD, PhD; Thomas Koenig, MD; and Margaret Chisolm, MD - from Johns Hopkins University.

But for those who remain unconvinced, the authors offer these four reasons why, for physicians, it simply isn't feasible to separate personal and professional identities:It's operationally impossible: With minimal effort and information, anyone can do a web search that quickly connects a physician's personal content to her professional content - assuming both types of content exist. And if both types of content do exist, there's no way to keep them separated, when a connection between the two is just a Google search away.

Lack of user consensus: Despite recommendations from groups such as the American College of Physicians and the Federation of State Medical Boards, some physicians remain unconvinced of the need to maintain separation between personal and professional content. For some, blurring the lines between the two is part of the reason to use social media in the first place, as doing so can level hierarchies and increase transparency, the authors say.

They're often the same thing: Separating personal and professional identities is inconsistent with the concept of professional identity. In other words, professional identify is determined to at least some extent by personal identity. For example, medical students undergo identity changes from student to professional and from consumer of medical services to provider.

Those personal identity transitions help shape who they are as professionals. "When recommendations fail to acknowledge the complex, mutable nature of professional identity and its connection to personal identity, the recommendations fail to offer the unambiguous, practical guidance that is needed," the authors write.It could be harmful: Doctors aren't required to avoid personal contact with patients offline, so why should they be required to do so when they're using social media?

In small or rural communities in particular, such encounters can be unavoidable, and they can even be beneficial to both doctor and patient. The unrealistic expectation that physicians need to maintain two separate identities can carry with it a "psychological or physical burden," the authors write.The authors stress that they aren't proposing that doctors should "eliminate boundaries," or that "anything goes" on social media.

Rather, the key to resolving physicians' "online identity crisis" lies in recognizing that social media exist in primarily public spaces, not in exclusively professional or exclusively personal ones

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Sharing Experiences Online Makes It Easier To Deal With Cancer

Sharing Experiences Online Makes It Easier To Deal With Cancer | Social Media and Healthcare |

Personal cancer blogs abound online. They can be heart-wrenching. They can be inspiring. Many offer comfort and hope to others with a diagnosis. Just look at Healthline’s list of the 24 Best Breast Cancer Health Blogs of 2013: Nancy Stordahl explores the theme of loss on Nancy’s Point, ChemoBabe is “edgy and ever-ready for battle,” and Shari Linders shares her problem-solving outlook on “The Best Breast Cancer Ever.”

The instinct to be public about coping with a serious illness will become more common as the generation that grew up with blogging and social media ages, but for most cancer patients, starting a blog is still the exception, not the rule.

Is it generally a good idea for a cancer patient to chronicle their experiences online? Thefirst study to examine this question in a controlled experiment suggests that yes, it is, and that maybe doctors should actually suggest it.

Annette Stanton, a researcher at UCLA’s Jonsson Comprehensive Cancer Center, got the idea for the study when she heard the story of a tech-savvy woman who helped her two sisters--both diagnosed with breast cancer a few years apart--learn to set up a website so they could share their experiences.

Stanton essentially did the same with a group of 44 breast cancer patients. She ran a short workshop teaching them how to use Project Connect Online, a web platform she set up for the purposes of the study, that allowed the women to customize similar sites and control privacy setting to make their updates only as public as they chose (for example, their sites wouldn’t show up in Google search).

After six months, she compared their mental health to a control group of patients who hadn't created websites. Statistically, the women who wrote had fewer depressive symptoms, better moods, and a higher appreciation for life than those who didn’t, she found--a result that was especially pronounced for women who were undergoing active treatment at the time, she reported in the Journal of Clinical Oncology this month.

Though more nuanced studies are needed, especially on men and for other chronic diseases, Statton imagines that doctors might at least suggest the idea of setting up an online diary, whether on Facebook, Wordpress, or any number of existing blogging platforms dedicated to the cancer community.

“It’s really easy to offer it as option,” says Stanton. “Some women, we knew, really didn’t want to share all that on Facebook.” In fact, other research Stanton has done shows that simply writing in a diary also helps cancer patients.

Social media is the elephant in the room when it comes to sharing thoughts on any personal tragedy. On Facebook, many people restrict sharing to happy life events--marriage, birth--so that when a person posts about their depression or illness, it can be awkward for observers. Especially loosely connected ones. Personally, I felt a little voyeuristic reading the detailed Facebook updates from an acquaintance of mine, neither a stranger nor a good friend, who was diagnosed with cancer in her early 30s. There could be other downsides of being totally or even partially public, like being penalized at work for your illness.

But aside from potential catharsis, the experience of the women in Stanton’s study also suggests that a patient experiences other benefits from going public. Maybe she saves the emotional effort of having to explain the details of a latest setback or triumph over and over again, or maybe she gets unexpected help from a neighbor.

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