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Social Media & Medicine 2012A Primer for Docs

MARGARET POLANECZKY, MDAssociate Professor

Obstetrics & Gynecology

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Social Media & Medicine 2012

• Social Media Primer• Patients & Social Media• Doctors & Social Media• Rules for Engagement• How to get started (or not)

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Social media is user generated content that is shared over the internet via technologies that promote engagement, sharing and collaboration.*

* Definition from The Social Media Guide.com

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The Internet

Revolution

Percent of population

55

65

46

21.9

24.9

9.6

http://www.itu.int/ITU-D/ict/statistics/at_glance/keytelecom.html

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Social media is the second Internet revolution.

http://en.wikiversity.org/wiki/File:Web_2.0_elements.png http://en.wikiversity.org/wiki/File:Web_1.0_elements.png

Used w/ permissions GNU License

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Healthcare 1.0

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Health Care 2.0

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The Long Tail

Healthcare 1.0 Healthcare 2.0

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Social networking – 50% of all US adults

% of internet users

Pew Internet Project

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PATIENTS are using social media

The search for health information online its usually triggered by health concerns of the patient or their family member.

*Survey, Rich Meyer, Pharmaforum.com

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YOUR PATIENTS Are Using Social Media

•Source - Pew Internet project

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60% of patients say Information found online

affected a decision about how to treat an

illness or condition

Source - Pew Internet Project

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E-PATIENTS engage in communities online to share their stories, disease & treatment information, referrals and support

Social media sites have 24 TIMES the activity of healthcare sites

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E-PATIENTS crowd source

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HOSPITALS are using Social Media

http://ebennett.org/hsnl/

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Hospital-Sponsored Patient Communities

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Mayo Clinic E-Visits – 2 year pilot study

• 4,282 patients registered

– 2,531 online visits

– Billings ($35) were made for 1,159 patients.

• E-visits used primarily by women during working hours

• E visits nvolved 294 different conditions.

– 2% included uploaded photographs

– 16% replaced telephone protocols with billable encounters.

• Office visits unnecessary in 1012 cases (40%)

• In 324 cases (13%), the patient was asked to schedule an appointment for a face-to-face encounter.

Mayo Clin Proc. 2010 August; 85(8): 704–7.

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Video Visits, Instant message visits

Mobile patient platform

• Online communication - patients can upload

BP, blood sugars, weight data for review online

• Online appointment scheduling, refills

• Patients pay an annual fee + low costs per visit

• No insurance

E-Medicine Practices

Jay Parkinson, MD

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Online, your patients TRUST YOU the most

Likely to trust online information from…

Likely to share online information from…..

Source: PwC Health Research Institute: Social Media “Likes” healthcare Chart pack

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Physicians & Social Media Use

Blogs

Percent

Source - http://www.quantiamd.com/q-qcp/DoctorsPatientSocialMedia.pdf

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Why Don’t Docs Engage in Social Media?

Source - http://www.quantiamd.com/q-qcp/DoctorsPatientSocialMedia.pdf

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Don’t believe me?

Whether you know it or not -

Information in the public domain Insurer’s databases Physician review sites Pharmacy databases Patient websites Social networking sites

Whether you like it or not - You are Online

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YES

• Authority • Influence• Reputation• Marketing of practice• Patient education• Share medical knowledge• Crowd-sourcing• Expressing yourself

NO

• Lack of personal privacy• Liability concerns• Patient privacy risks• No way to get paid for it• Takes time• Employment Insecurity• Being marketed to• Being asked for advice online

Will YOU engage in Social Media?

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SOCIAL MEDIA - GETTING STARTED

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Physician Online Communities

•Provide Doctors with a protected community for sharing clinical information and advice•Provide Pharma an opportunity to observe and engage with physicians

You don’t get something for nothing

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SOCIAL MEDIA – GETTING STARTED• PRACTICE WEBSITE

– Professional, clean design with simple interface, Dynamic updates, RSS Feed– ? Patient portal (appointment, refill requests),? Online EMR, ? Patient community

• TWITTER – Each doc has their own twitter page (? + practice twitter for larger practices)– Broadcast health news, commentary & messages– Engagement with colleagues ,Crowd sourcing medical dilemmas– Avoid direct patient interactions

• LINKED IN – Professional network, useful for job networking

• FACEBOOK – Keep practice page and personal pages separate

• YOUTUBE – Patient education videos , medical education

• BLOG– Can be part of practice website or separate

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Your patients are not your friends

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ANONYMITY

Privacy

Freedom

Employment security

?Increases risky online behavior

IDENTITY

Authority

Reputation Control

Enhanced practice

Employment security

Engagement

vs.

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ANONYMITY IS NOT INVISIBILTY

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WHAT ABOUT PATIENT PRIVACY?

• If the information that is shared is generic enough that nobody can identify a patient in the course of reading, (Berkman, Mass Med law report, Social net- working 101 for Physicians, 2009) the post is permitted and is a valuable tool for physicians to share information and skills with other physicians

faster than ever before.

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weill.cornell.eduCopyright © 2012 American Medical Association. All rights reserved.

98% of US state medical boards report online violations by physicians

JAMA. 2012;307(11):1141-1142. doi:10.1001/jama.2012.330

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• Posts limited to 140 characters

• Can have private account or public account

• Users follow other users

– Can block followers or be private and only permit certain followers.

– You don’t have to follow everyone who follows you

• Post tweets, comment on other’s tweets, send private messages

• Hashtags (#) allow for grouping of related posts

– Conferences, breaking news, topics of interest, Twitter chats

• WHO TO FOLLOW?

– Experts in your field

– Reporters who report in your areas of interest

– Medical journalists

– Colleagues

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Doctors on Twitter Nature of tweets

49% Health or medical related21% Personal12% Self-promotional1% Medical education1 % Recommended medical product

148 Tweets (3%) were Unprofessional33 (0.6%) Contained profanity

38 (0.7%) Potential patient privacy violations

14(0.3%) Contained sexually explicit material

4 (0.1%) Discriminatory statements

2158 tweets from 260 twitter users with >500 followers

JAMA, February 9, 2011—Vol 305, No. 6 567

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Twitter Smarts(@DrWes )

1. Follow smart people doing work that is relevant to yours. Trash most others.

2. Post relevant, valuable content of interest to your followers.

3. Watch your time on Twitter. At most, I spend 20 minutes a day on Twitter, and I think it would take me far more time offline to gain and share the same information.

4. Do not EVER post patient information – Tweets are public and searchable on Google.

Twitter Not-so-Smarts@mommy_doctor )

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The Eleven Commandments of Social Media Engagement1. Observe, Listen & Think Before Engaging What are your goals with this tweet/post/comment? Is this

the best platform?

2. Add Value. Be relevant. Be Accurate. Research & attribute your sources.

3. Maintain patient privacy – Don’t post anything about a patient that he/she would recognize themselves. Go beyond HIPAA. Stay away from patient-specific dialogue.

4. Be Respectful. Keep it Civil. Keep it Clean. Don't post material that is profane, libelous, obscene, threatening, abusive, harassing, hateful, defamatory or embarrassing to anyone.

5. Abide by the law. Don't post content that violates any state or federal laws. Get permission to use or reproduce copyrighted content.

6. Be Transparent. Disclose affiliations and conflicts. Clearly identify any advertising as such.

7. Remember - What happens on the Web stays on the Web. Forever. Even if you delete it.

8. Engage with others. Social media is not a place for you to talk without listening, commenting and responding to the conversations around you.

9. Don’t give individual medical advice online

10. Patients are not your friends. Keep your individual Facebook page private.

11. Be yourself. That’s what social media is all about. Show your personality.

Modified from Vanderbuilt University Med Center Social Media Toolkit

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1. Authoritative. Indicate the qualifications of the authors. Any medical or health advice provided will only be given by medically trained & qualified professionals unless a clear statement is made that it is from a non-medically qualified individual or organization.

2. Complimentarity. Information should support, not replace, the doctor-patient relationship.

3. Privacy. Respect the privacy and confidentiality of personal data submitted to the site by the visitor. The Web site owners undertake to honour or exceed the legal requirements of medical/health information privacy that apply in the country and state where the Web site and mirror sites are located.

4. Attribution. Cite source(s) of published information, with specific HTML links page. Clearly display date when a medical page was last updated.

5. Justifiability. Any claims relating to the benefits/performance of a specific treatment, commercial product or service will be supported by appropriate, balanced evidence in the manner outlined above in Principle 4.

6. Transparency. Accessible presentation, accurate email contact.

7. Financial disclosure. Clearly identify funding sources, including the identities of commercial and non-commercial organizations that have contributed funding, services or material for the site.

8. Advertising Policy. Clearly distinguish advertising from editorial content. If advertising is a source of funding it will be clearly stated.

HON Code of Conduct for Medical and Health Web Sites

http://www.hon.ch/HONcode/Pro/Conduct.html

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Sample Website Disclaimer

The opinions expressed in this blog are strictly my own, and should not be construed as the opinion or policy of my employer, XXX Medical Center.

Material on this blog is provided for informational purposes only. It is general information that may not apply to you as an individual, and is not a substitute for your own doctor’s medical care or advice.

Reading this blog should be construed to mean that you and I have a patient-physician relationship. Therefore, I ask that you not ask me for medical advice, either in the comments or by email. I may delete such comments and accept no responsibility to respond to unsolicited email.

The inclusion of any link does not imply my endorsement of the linked site or its affiliates, or any information, content, products, services, advertising or other materials presented on or through such web sites. I am not responsible for the availability, accuracy, or any information, content, products or services accessible from such sites.

NEVER DISREGARD MEDICAL ADVICE OR DELAY SEEKING MEDICAL CARE BECAUSE OF SOMETHING YOU HAVE READ ON OR ACCESSED THROUGH THIS WEB SITE.

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SOCIAL MEDIA RESOURCES• Ten Best Practices for Social Media

http://asne.org/portals/0/publications/public/10_best_practices_for_social_media.pdf• Social Networking 101 for Physicians -

http://www.massmed.org/Content/NavigationMenu2/ContinuingEducationEvents/NewCourses/SocialNetworking101forPhysicians/Social_Networking_.htm

• Healthcare Blogger Code of Ethics - http://medbloggercode.com • The Social MEDia Course - http://med20course.wordpress.com• Mayo Clinic Center for Social Media - http://socialmedia.mayoclinic.org• A twitter primer for physicians : http://www.kevinmd.com/blog/2012/06/started-twitter-

primer-doctors.html • Community Sites for Scientists & Physicians -

http://scienceroll.com/2008/05/24/community-sites-for-scientists-and-physicians-the-list/

• Doctors on Twiitter - http://www.TwitterDoctors.net• European Docs on Twitter https://docs.google.com/spreadsheet/ccc?key=0Av-

UbEbXL7m7dDhQQkdKUHJkcW5aLVFyWjRTUXNLRFE#gid=0• Dr Polaneczky’s Blogroll - http://www.tbtam.com/blogroll• 5 Best Blogging Platforms - http://lifehacker.com/5568092/five-best-blogging-platform• iMedical Apps – http://www.imedicalapps.com/s• Medgadget – http://medgadget.com

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