Social media “likes” healthcare
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  • 1. Social media “likes” healthcare From marketing to social businessHealth Research InstituteApril 2012
  • 2. Table of contentsThe heart of the matter 2Liking, following, linking, tagging, stumbling:social media is changing the nature ofhealth-related interactionsAn in-depth discussion 4Savvy adopters are tapping into social mediato foster new relationshipsExecutive summary 5Social media is changing online dialogue from one-to-many tomany-to-many, at a phenomenal speed 7Consumers are broadcasting their wants, needs, and preferencesthrough social media 8• Social animals• Social studies• Social skills• Social speed• Social networks• Social currencyHow health organizations are evolving from social media marketingto social business strategy 18A future look: Data generated from individuals can helpcomplete the patient profile 27What this means for your business 30Social media enables organizations to expandtheir role with customersApril 2012
  • 3. The heart of the matterLiking, following,linking, tagging,stumbling: socialmedia is changingthe nature ofhealth-relatedinteractions
  • 4. When I was in the ER last night, I Savvy businesses know they must go hospitals, and health plans. HRI foundtweeted about the interminable wait. where the customers are. And in 2012, that one-third of consumers are usingIt seemed as though people who weren’t a rapidly growing number are on social social media for health-related matters.that sick got whisked in ahead of me! media, the space that enables instan- Most tellingly, they are choosingGuess what? Someone from the hospital taneous self-expression and a shared “community” sites over industry-heard me! They spotted my tweet and community experience — at any hour of sponsored sites. In a week’s snapshot ofresponded. And even sent someone the day with someone in the house next several health-related companies anddown to talk to me in person. door or halfway across the globe. The consumer sites, HRI found that daily rise of social media has been phenom- activity numbered in the thousands forThat’s what I love about social media. enal. Use of social networking sites has community sites versus in the hundredsI can write what I want when I want, grown from 5% of all adults in 2005, on company sites.and send it to all my friends, groups, to half of all adults (50%) in 2011.1 Forand followers in an instant. And, all of example, Facebook, which began with Early adopters in the health industrythem can send it to all of their friends, 5 million users in 2005, today has 845 tell PwC that despite concerns aboutgroups, and followers. It’s like million participants, more than the integrating social media into datamy personal electronic megaphone. entire population of Europe.2 Pinterest, analytics and measuring its effective- a social image-sharing site using a ness, they are incorporating socialEver since I found out I had diabetes, virtual “pinboard” interface, just hit media into their business strategy.I’ve posted monthly on Facebook 11.7 million unique U.S. users, growing More than 1,200 hospitals participateabout my struggles managing my from 1.2 million only six months in 4,200 social networking sites.5blood sugar and energy level, and earlier.3 Twitter has also shown tremen-lots of people — some I don’t even dous growth, reporting 460,000 new With these new opportunities comeknow — have swapped healthy recipes, accounts created on average per day.4 challenges and the likely threat ofsent me tips on where to buy test strips, agile new entrants into the market.and even recommended doctors. Some While industries such as retail and With transparency, patient expecta-even had links to YouTube videos. hospitality quickly saw the potential, tions rise. And as health organizations the health sector has been slower collect more detailed information onI feel like the healthcare industry is to move. According to a new survey its patients, proper safeguards will befinally getting it. My hospital has a by PwC’s Health Research Institute needed to ensure privacy and security.Facebook page where they post lifestyle (HRI), hospitals, insurers, and phar-advice, the drug company shares newly maceutical manufacturers can benefit Not long ago, terms such as liking,released treatment studies through its from this new form of interactive following, tagging, and stumbling allTwitter account, and my insurer even communication. had very different meanings. But inhas these interactive games that help the era of social media, they providemanage my diet and exercise. Best of With a single key stroke, individuals the clues that could lead to higherall, I’ve joined a few patient commu- can broadcast their attitudes on physi- quality care, more loyal customers,nities where I share how I’m doing cians, drugs, devices, treatments, efficiency, and even revenue growth.on certain treatments and see how Icompare to others. 1 Madde, Mary. Zickuhr, Kathryn. 65% 2 Facebook, December 2011 of online adults use social networking 3 techcrunch.com/2012/02/07/pinterest- sites. Pew Internet and American Life monthly-uniques/ Project, August 26, 2011, pewinternet.org/ Reports/2011/Social-Networking-Sites. 4 blog.twitter.com/2011/03/numbers.html aspx, accessed on March 28, 2012. pg. 2 5 Ed Bennett, Found in Cache, ebennett. org/hsnl/ The heart of the matter 3
  • 5. An in-depth discussionSavvy adopters aretapping into socialmedia to fosternew relationships
  • 6. Executive summary Willingness to share informa­ ‑ tion depends on trust. Sixty-one percent of consumer respondentsAccording to PwC’s consumer survey are likely to trust information postedof 1,060 U.S. adults, about one-third by providers, and 41% are likely toof consumers are using the social share with providers via social media,space as a natural habitat for health compared to 37% trusting informa-discussions. Social media typically tion posted by a drug company, andconsists of four characteristics that 28% likely to share information withhave changed the nature of inter- a drug company.actions among people and organi-zations: user generated content, Age is the most influential factorcommunity, rapid distribution, and in engaging and sharing throughopen, two-way dialogue. This report social media. More than 80% ofdives into the social world of the individuals ages 18–24 would be likelyhealth industry and provides insights to share health information throughinto new and emerging relationships social media, while nearly 90% ofbetween consumers and the biggest individuals would engage in healthhealth companies that serve them. It activities or trust information foundexamines how individuals think about via social media. Less than half (45%)and use the social channel; how some of individuals ages 45–64 would beproviders, insurers, medical device, likely to share via social media, whileand pharmaceutical companies are 56% would be likely to engage inresponding; and discusses specific health activities.implications for organizations to takeadvantage of with this new view into Consumers are willing to have theirthe 21st century patient. conversations monitored if they get something in return. One-third of consumers surveyed said they wouldHow consumers are be comfortable having their socialusing social media media conversations monitored if thatConsumers are finding answers data could help them identify ways toto their wants, needs and prefer‑ improve their health or better coordi-ences. According to HRI’s survey, 42% nate care.of consumers have used social mediato access health-related consumer A new expectation is being set onreviews (e.g. of treatments or physi- response time. More than 75% ofcians). Nearly 30% have supported a consumers surveyed would expecthealth cause, 25% have posted about healthcare companies to respondtheir health experience, and 20% have within a day or less to appointmentjoined a health forum or community. requests via social media, while nearly half would expect a response within a few hours. An in-depth discussion 5
  • 7. Social media information is influ‑ Initiative (eHI), a national association therapeutics they’ve developed. Butencing decisions to seek care. For of health information and health tech- who has a full view of the individual?example, 45% of consumers said infor- nology companies, reported that their Completing the patient profile is themation found via social media would social media efforts were decentral- likely next step in moving towardaffect their decisions to seek a second ized and managed by their marketing higher-quality outcomes-based care,opinion. More than 40% of respon- and communications departments. IT although the prospect raises concernsdents reported that information found departments and digital teams were about privacy protection and whovia social media would affect the way also identified as owning social media. owns and controls the information.they coped with a chronic condition or Organizations that are strategic about Life activities and behaviors that indi-their approach to diet and exercise. their use of social sites have differenti- viduals report in social networks open ated between social media and social up a new view of patient health. business. Social media was defined asHow organizations are the external-facing component thatusing social media gives and receives customer input, What this means forSocial media activity by industry and social business was defined as the health industryorganizations is dwarfed by the place where core operations, Business strategies that include socialconsumer activity. Although eight like customer service, data analytics, media can help health industry compa-in 10 companies evaluated by HRI and product development, could nies to take a more active, engagedhave some presence on various social use social data. role in managing individuals’ health.media sites, the volume of activity for Social marketing can evolve into socialcompanies is in the hundreds versus Healthcare businesses started to business with the right leadership andthe thousands of posts, comments, and listen, but aren’t translating social investment of resources. Organizationsoverall activity observed in commu- media conversations into practice. should coordinate internally to effec-nity sites in a week’s snapshot analysis. One in two eHI members surveyed tively integrate information from theIn fact, community sites had 24 times worry about how to integrate social social media space and connect withmore social media activity on average media data into their businesses and their customers in more meaningfulthan any of the health industry compa- how to connect social media efforts to ways that provide value and increasenies over that one-week timeframe. a return on investment. Some organi- trust. Insights from social media alsoTwo out of three organizations in zations are capturing sentiment and offer instant feedback on productsthe provider and insurer arena allow standard volume numbers on various or services, along with new ideas forindividuals to initiate posts on their sites, while others know that they innovation. Organizations that canFacebook pages, known as “walls.” But need to go beyond capturing “likes” incorporate this information into theirfewer than one in three pharmaceu- and “followers” to collecting qualita- operations will be better positioned totical companies, which operate under tive engagement metrics. meet the needs of today’s consumers.stricter regulations, have walls avail-able for individuals to initiate posts. Data from interactions in social media can complete the patientMarketing/communications leaders profile. Patients know how theytend to manage social media strate‑ feel, providers know how they treat,gies. The majority of HRI interviewees insurers know what they cover, andand members from the eHealth drug manufacturers know what6 PwC Health Research Institute | Social media “likes” healthcare
  • 8. “ f you want to connect with people and be I part of their community, you need to go where the community is.” Ed Bennett, University of Maryland Medical CenterSocial media changes achieve their goals.” For example, last year Aetna partnered with a socialonline dialogue media company to offer membersfrom one-to-many to Life Game, an online social game tomany-to-many, at a help engage people to achieve theirphenomenal speed personal health and wellness goals. In the past, a company would connectThe term “social media” is used with its customers via mail or a website,widely, but remains ill-defined. but today’s dialogue has shifted toThis instantaneous communica- open, public forums that reach manytion channel consists of four unique more individuals. Early adopters ofcharacteristics that have changed the social media in the health sector arenature of interactions among people not waiting for customers to come toand organizations: user generated them. “If you want to connect withcontent, community, rapid distribu- people and be part of their community,tion, and open, two-way dialogue. you need to go where the communityCommon platforms are Facebook, is. You need to be connecting beforeTwitter, and YouTube. In health, you are actually needed,” explainedexamples of community sites include Ed Bennett, who oversees social mediaCaring Bridge, Daily Strength, and efforts at the University of MarylandBabyCenter. Medical Center.The health industry has been slow to And social media is becoming a plat-embrace social media, but is begin- form for internal discussions as well.ning to see the benefits. In extensive “Our employees and physicians haveinterviews with industry leaders, HRI had fruitful and provocative discus-found many social media converts. sions using IdeaBook, our internalAetna, one of the nation’s largest social collaboration tool. The capacityinsurers, is among them. “Engagement for this candid internal collaboration isis so important, but can be hard to crucial for our organization and essen-achieve,” said Meg McCabe, Aetna’s tial to effectively running an organiza-head of consumer solutions. “We’ve tion in the 21st century,” said Vincebeen piloting several new social Golla, digital media and syndicationhealth platforms, and we’re seeing director, Kaiser Permanente.that they can really make a difference.Building connections among peoplewith similar health challenges givesus a much better shot at helping them An in-depth discussion 7
  • 9. Consumers are broadcast- information. “People like to access Social animals: Young invin-ing and finding answers and connect with other people’s cibles are most willing to share,to their wants, needs, stories, even if they’re unwilling to baby boomers are least likelyand preferences through share their own,” said Ellen Beckjord, assistant professor at the University Based on age factor alone, the “youngsocial media of Pittsburgh Medical Center and invincibles” ages 18–24 lead with theSocial media presents new opportu- Hillman Cancer Institute, whose most social media activity, while thenities for how individuals manage research has focused on how making baby boomers ages 45–64 are least likelytheir health, whether researching health information available electron- to post or comment on any channel.a particular illness or joining a ically can affect disease management. More than 80% of individuals agessupport group to share experiences. 18–24 would be likely to share healthThe virtual aspect of social media HRI’s consumer survey found that information through social media, whileenhances communications by creating Facebook and YouTube are the most nearly 90% of individuals would engagea comfortable, often anonymous, envi- commonly used social media channels in health activities or trust informationronment for engaging and exchanging for viewing health-related informa- found via social media. Less than half tion. A 2011 National Research Corp. (45%) of individuals ages 45–64 would6 National Research Corporation Ticker survey of approximately 23,000 be likely to share via social media, while Survey: hcmg.nationalresearch.com/ public/News.aspx?ID=9 respondents produced similar results.6 56% would be likely to engage.Figure 1: Impact of age level and health status on likelihood to engage, trust, and share about health using social media 6 National Research Corporation Ticker Survey: http://hcmg.nationalresearch. com/public/News.aspx?ID=9 Excellent health Most likely Least likely Trust Share Share: How likely are you to share health information through social media with health-related companies/individuals*? 15 18-24 30 35 40 45 50 55 60 65+ Trust: How likely are you to trustAge health information posted online through social media by health- related companies/individuals? Engage: Have you ever viewed health related information or done health- Engage Share Trust Engage related activities using social media? n = 1,060 * ealth-related companies/individuals include H hospitals, doctors, pharmacies, health insurers, drug companies, etc. Poor health Source: PwC HRI Social Media Consumer Survey, 20128 PwC Health Research Institute | Social media “likes” healthcare
  • 10. “Our patient support groups serve as a real-time referral network.” Ryan Paul, Children’s Hospital BostonWhen considering both age and health Figure 2: Percentage of consumers viewing health information through social mediastatus, respondents ages 18-24 in goodhealth were also more likely to sharevia social media and trust information Health-related consumer reviews* Breakdown of consumer review types:posted via social media (See Figure 1.) 42% = + + +Alternatively, those ages 18-24 in poor 12% 11% 10% 9% Friends’/family health experienceshealth were most likely to engage. Medications Doctors Hospitals Health 32%Respondents over age 65 in poor or treatments and other medical insurershealth were the least likely to trust, Other patients’ experiences with their disease facilities 29%share, and engage using social media. Health-related videos/images posted by patientsIn addition, lower-income Medicaid 24%beneficiaries were the most willing n = 1,060to share at 64%, while individualswith employer-based insurance were *Consumer reviews of medications or treatments, hospitals and other medical facilities, doctors, health insurersthe least willing to share via social Source: PwC HRI Social Media Consumer Survey, 2012media at 51%. Those with individualinsurance and no insurance were alsoamong those who are most likely toshare and engage in health-related of quotes regarding our patient care,”social media activities. said Ryan Paul, social media specialist at the hospital. “This serves as the bestSocial studies: Patients are type of validation for new patientsusing social media to better looking for a hospital and for peopleeducate themselves to connect with others like them.”When consumers are faced with a According to the HRI survey, 42%health decision, social media can of consumers have used social mediaprovide a new avenue of information to access health-related consumerand dialogue. Some may share a health reviews. (See Figure 2.) Thirty-twogoal to generate support or engage in percent of respondents have useda patient community to interact with social media to view family/friendother patients. At Children’s Hospital health experiences, and 29% haveBoston — which had nearly 700,000 sought information related toFacebook “likes” as this report was other patients’ experiences withreleased — prospective patients use their disease.disease-specific support groups to learnmore about the hospital’s treatment orclinical divisions from other patients.“Our patient support groups serve asa real-time referral network, which isvery different than giving people a list An in-depth discussion 9
  • 11. Beyond viewing health-related inform- Research Branch. Social media also patient to evaluate and improvetion through social media, nearly 30% helps satisfy a patient’s desire for self- his or her conditions as well as theof respondents said they supported a service and access to information at system’s performance,” said Jamiehealth-related cause or commented multiple touchpoints. Heywood, co-founder and chairmanon others’ health experiences. (See of PatientsLikeMe.Figure 3.) Although some organiza- Social skills: Increased accesstions fear that creating a social media creates new expectations for The popular site tackles informationpresence will open a flood of negative transparency and healing needs with peer care andcomments, individuals are more likely health data tools. “We’re capturing theto share positive health-related experi- Social media has raised consumer relationship of caring for the individualences via social media than negative expectations. “As more people go by building a new kind of partnershipexperiences. (See Figure 4.) HRI inter- online to interact with their banks and between the patient, their data, andviews also found that most consumer make purchases, they want to do this enterprises with the products thatcomments online tend to be positive. with their doctors, health plans, and need to learn from them,” Heywood condition and disease management said. Perhaps most significantly,Although health activity on social as well. Social media has brought an PatientsLikeMe works with pharma-media lags behind non-health related expectation for a different kind of ceutical companies to use patient-activity, it’s expected to catch up in connection that already exists in their reported outcomes to inform thethe future. Twenty-seven percent of daily lives,” said Laura Clapper, MD, research and development processes.consumers reported posting reviews chief medical officer of the onlineof restaurants, hotels or products, community OneRecovery. (See morewhile 17% said they posted reviews on OneRecovery in Case study 1.)of doctors. Several industry intervieweesThe accessibility of social media pointed to social media sites such ascomes at an auspicious time for PatientsLikeMe, an eight-year-oldconsumers who now pay significantly health data-sharing platform, whichhigher portions of their care. With help patients connect with each otherinsurance deductibles at an all-time and access relevant health informa-high, consumers are more prone to tion. PatientsLikeMe connects moreshop around. “The democratization than 140,000 patients with othersof information through social media who have life changing conditions,is shaping the clinical encounters and such as Parkinson’s and Lou Gehrig’sthe patient/provider relationship. disease. “Social networks will peelIt continues to bridge the informa- back every corner of the health systemtion divide,” said Wen-ying Sylvia and drive transparency on cost,Chou, program director for the value, and outcomes. The informationNational Cancer Institute’s Health asymmetry that patients experienceCommunication and Informatics will be levelled, allowing the average10 PwC Health Research Institute | Social media “likes” healthcare
  • 12. Figure 3: Percentage of consumers who use social media for health-related activities Support health- Comment on Post about Join health Track and Post reviews Post reviews Share health- Post reviews related cause others’ health health forum or share health of doctors of medications/ related videos/ of health experiences experiences community symptoms/ treatments images insurers behavior 28% 27% 24% 20% 18% 17% 16% 16% 15%n = 1,060Source: PwC HRI Social Media Consumer Survey, 2012Figure 4: Likelihood of sharing positive and negative health experiences via social media* Care Experience Specific Health Cost of Coverage Cost of care *Consumers responding likely or very likely to share an experience using social media received with doctor, insurer health by health at a hospital/ at hospital/ medication/ nurse, customer insurance insurer healthcare Source: PwC HRI Social Media medical treatment healthcare service provider Consumer Survey, 2012 facility provider 44% 43% 42% 40% 37% 36% 36% positive negative 35% 37% 35% 34% 35% 40% 38%n = 1,060 An in-depth discussion 11
  • 13. Case study 1 Recovering addicts get 24/7 support through social media start-up Behavioral health is an area in which the round-the- How it works clock support of social media fits well. “Substance abuse • Members are invited by health plans, treatment is one of those things that can negatively impact the centers, or other members “in good standing.” course of anything else you need to manage medically The company has partnerships with five health plans (e.g. diabetes can be complicated by an alcohol addic- and numerous employers, treatment centers, and tion),” noted Yan Chow, MD, director of Innovation and other providers. Advanced Technology at Kaiser Permanente. “Recurrent cycles of cure and relapse make the management of other • Members can tap into various specialists and peer conditions more challenging and expensive.” networks through their smartphones or computers. And, they can aspire to help others as well. Members More than 20 online sites such as In the Rooms, active for at least one year who have an established Recovery Realm, and Addiction Tribe provide virtual reputation on the site can become senior peers, tools to supplement treatment programs by connecting offering one-on-one support. individuals to the support they need around the clock. OneRecovery is an example of a company that has • Evidence-based clinical tools combined with interac- created a consumer model that uses the mobile phone tive social and gaming technologies help members to connect individuals with a community of people who manage their recovery. More than 80% of members share their experiences. This type of program can scale use a tool called the “recovery clock”, which allows up self care without necessarily scaling up traditional them to start their timekeeping from the beginning of medical resources. recovery and alerts the network when someone needs to “restart” their clock due to a relapse. Members can Motivated by his own experience with addiction and check in with emoticons to inform others about how recovery, David Metzler combined his expertise around they are feeling. This allows the members’ peers to gaming and technology into OneRecovery, a “social intervene when there’s a “high risk” emoticon selected. solutioning” company aimed at recovering addicts.” OneRecovery is an invitation-only community of more than 40,000 members. Unlike traditional treatment models OneRecovery’s Social Solutioning® Platform, 2012 in which health plans, physicians, or treatment providers may call to “check in” on patients, through OneRecovery, “Effective” “Members really are in control of how they share and Clinical principles reinforce and extend the reach and impact of participate. People can really feel like they own this the professional. process,” said Laura Clapper, MD, chief medical officer. Clinical The model is changing how providers track patients’ Principles progress. “OneRecovery provides a behavioral record Structured about how individuals and populations are doing peer support post treatment,” said chief marketing officer Drew network Paxton. “Organizations focused on quality and patient Social Game Technology Mechanics outcomes now have access to a new level of analytics.” OneRecovery recently launched a platform which allows connected health plans and providers to access patients’ health reports (with the patients’ approval). “Supportive” “Engaging”  Peer communities where  Leverages stickiness of game Although a member may initially get referred for an members help peers manage science to drive behavior change. chronic conditions. addiction-related disorder, they can join additional communities where they can get support for other conditions, such as depression or anxiety. Source: OneRecovery, 201212 PwC Health Research Institute | Social media “likes” healthcare
  • 14. PatientsLikeMe demonstrates that HRI also found that about one-third Figure 5: Consumers’ feelings on doctorsdespite privacy concerns, many of consumers would be comfortable going to online physician communities forconsumers are open to sharing infor- having their social media conversa- advice related to their health situationmation via social media if it holds the tions monitored if it were to helppotential to improve their health. More improve their health, treatment,than half of consumer survey respon- coordination of care, or management 54%dents told HRI they would be comfort- of their chronic illnesses. Comfortable or very comfortableable with their doctor going to an onlinephysician community to seek advice if Social speed: Healthcare is onthe doctor were to gain information to a new response clockwatchtreat them better. (See Figure 5.) 17% As consumers take advantage of social 9%Online physician communities like media to instantly and publicly expressSermo, a community of 130,000 their opinions, experiences, and reac- 14%doctors, have realized the power of tions, they expect faster responsive-sharing information. The site allows ness from healthcare organizations.physicians to join free of charge and “Truly social brands will listen to whatis funded by companies interested in customers are saying and feeling andsurveying physicians for treatment or use that insight to adapt and create 23%business research. “This is more than products and services,” said Kellynetworking — it’s collaboration and Colbert, director of strategic adver- 37%interacting for learning and treatment tising at the insurer WellPoint.purposes. Our physician members n = 1,060share information with the end goalof enabling better patient outcomes,”said Richard Westelman, Sermo’s Very comfortablechief operating officer. “The next Comfortableevolution is how healthcare providers I don’t careand patients start interacting with Uncomforableeach other. When, and in what setting, Very uncomfortablewill they come together?” Source: PwC HRI Social Media Consumer Survey, 2012 An in-depth discussion 13
  • 15. More than 75% of consumers University Hospitals, was monitoring surveyed would expect healthcare the Jefferson brand on Twitter and companies to respond within a day saw that a patient in the Hospitals’ or less to a request for an appoint- Headache Center was complaining on ment via social media, while nearly the social media site of his long wait. half would expect a response within Goldstein, who was off campus, texted a few hours. (See Figure 6.) In addi- the interactive marketing team to tion, 70% of consumers would expect check out the waiting room and found healthcare companies to respond that the patient had not signed in at within a day to a request for informa- the computer kiosk. Within a matter tion via social media, while just over of minutes, they were able to resolve 40% would expect a response within the matter. The incident highlighted a few hours. Josh Goldstein, director the value of monitoring the Jefferson of social media at Thomas Jefferson brand on social media channels. Figure 6: Expectations for how quickly a healthcare company should respond when contacted through social media Request an appointment or Request information Post a complaint about a follow up service, product, or experience 76% 70% 66% 49% 42% 39% 29% 23% 22% 1 3 6 9 12 18 24 1 3 6 9 12 18 24 1 3 6 9 12 18 24 hrs n = 1,060 Within 1 hour Within a few hours Within a day or less Source: PwC HRI Social Media Consumer Survey, 201214 PwC Health Research Institute | Social media “likes” healthcare
  • 16. 45% of consumers said information from social media would affect their decisions to seek a second opinion.Social networks: Information Figure 7: Likelihood of information found viais influencing decisions about social media affecting health decisionshow and when to select treat-ments and providers Seeking second opinion from another doctor 45%Consumers are increasingly usinginformation from social media to Coping with chronic condition or painassist in making healthcare choices. 42%For example, 45% of consumers said Approach to diet, exercise, or stress managementit would affect their decision to seek a 42%second opinion. (See Figure 7.) Morethan 40% of respondents reported that Choosing specific hospital/medical facility 41%information found via social mediawould affect the way they coped with Choosing specific doctora chronic condition, their approach to 41%diet and exercise, and even their selec- Taking certain medicationtion of a specific doctor. 34%Education levels may also play a Undergoing specific procedure or testrole in determining whether a facil- 33%ity’s social media presence affects Choosing health insurance planpurchasing decisions. Individuals 32%with lower education levels tended n = 1,060to be more influenced by a hospital’ssocial media presence when makingtreatment decisions than those with Source: PwC HRI Social Media Consumer Survey, 2012higher education levels. An in-depth discussion 15
  • 17. Across the health industry, consumers Figure 8: Percentage of respondents Figure 9: Percentage of respondents findingseem to value information and services finding value in services offered by value in services offered by health insurersthat will help make their healthcare healthcare providers via social media and drug companies via social media mediaeasier to manage. More than 70% Percentage represents a response of Percentage represents a response ofof consumer survey respondents somewhat or very valuable somewhat or very valuablewould appreciate receiving assistancefrom healthcare providers via social Availability of doctor appointments Discounts or couponsmedia with referrals and appoint- 72% 68%ment scheduling, while 69% would 67%value offers to save money and receive Appointment reminderssupport post-discharge. (See Figure 71% Voice complaints/seek customer service8.) Regarding the services offered by Referral to specialists 65%insurers and drug companies via social 70% 67%media, consumers find similar value, Discounts or coupons for services Appointment reminderswith the most interest being ways to 69% 58%save money and seek customer service. Continued support post-treatment/discharge 67%(See Figure 9.) 69% Information to find cheapest medication Voice complaints/seek customer service 65% 68% 67% Patient reviews of doctors Treatment reminders 68% 60% Treatment reminders 65% 68% Support groups for similar patients Current ER wait times 56% 65% 58% n = 1,060 Share positive experiences with other patients 53% Source: PwC HRI Social Media Consumer Survey, 2012 54% Games/contests encouraging healthy behavior 42% 42% n = 1,060 Drug company Health Insurance Source: PwC HRI Social Media Consumer Survey, 201216 PwC Health Research Institute | Social media “likes” healthcare
  • 18. Social currency: Providers have than an organization,” said Kathryn Mark Brooks, chief technology officerthe highest trust, drug compa- Armstrong, senior producer of web at Health Net, sees social media asnies the lowest communications at Lehigh Valley a bridge: “In this business, we facili- Health Network. While insurance and tate relationships, so we really thinkConsumer survey respondents said drug companies might try to communi- about social media as not just a tech-they would be most likely to trust cate with their customers through the nology and a process, but also as ainformation posted via social media Internet or telephone, very few have capability that can help drive connec-from providers (doctors, hospitals), direct, personal interactions with their tions in the value chain more effec-and would be most likely to share customers. And while medical tech- tively.” As building these relationshipsinformation with providers via social nology companies will disseminate becomes increasingly important tomedia, over health insurance or drug information via their product sites, establishing trust and credibility withcompanies. (See Figure 10.) very few have actually engaged with consumers, healthcare companies will patients due to regulatory concerns.7 need to reconsider their approach toWhy do individuals trust their Healthcare providers have the ability these relationships.doctors the most? Human relation- to form human relationships andships. “You want to trust and connect connections with their patients, which 7 PricewaterhouseCoopers Med Techwith the people providing you the ultimately leads to increased trust. Focus: Social media opens new interactioncare. It’s easier to trust a person channel for medtech companies and their customers, enhancing innovation opportunities, 2011 7 PricewaterhouseCoopers Med TechFigure 10: Likelihood to trust or share informationFocus: Social media opens new via social media interaction channel for medtech companies and their customers, enhancing innovation opportunities, 2011 Doctor Hospital Health insurer Drug company Likely 61% 55% 42% 37% to trust information Likely 41% 39% 34% 28% to share informationn = 1,060Source: PwC HRI Social Media Consumer Survey, 2012 An in-depth discussion 17
  • 19. Figure 11: Benefits of the digital social environment much more than media, it’s a social strategy.” (See Figure 11 for indi- vidual and company benefits of the Individuals Healthcare companies digital social environment.) –– View what others are experiencing in terms –– Demonstrate timely and thoughtful of symptoms, reactions to treatments responses to problems Aetna is approaching social media in –– Feel supported and not alone –– Understand in-between visit conversa- three ways, said McCabe: “Becoming –– Research information to help ask better tions, behaviors, feelings a social business in how we leverage questions to providers, insurers and others –– Reach a new audience for health social technologies to collaborate education and service –– Find real-time information and exchange within the organization, devel- for a network of information –– Delegate spokespeople and lay oping a social brand in the way we referral agents communicate and engage with ourSource: PwC Health Research Institute customers, and encouraging social health within public or private How health organiza- communities to empower others to lead healthier lives.” tions are evolving from social media Another example of converting marketing to social social media into business strategy business strategy is Mercy’s experiment with the customer referral concept. “We’re Marketing typically owns social trying to capture the word-of-mouth media in the beginning, but that referral patients use all the time and soon evolves. In HRI’s survey of eHI make it easy to do via social media,” members, 82% of respondents said said Brad Herrick, director of digital their social media efforts are managed marketing at the 28-hospital system by marketing/communications. in the Midwest. Mercy is creating However, as an organization’s social an application that allows people to media use grows, its purpose quickly “share” their doctors on Facebook, morphs into customer service, inno- and the physician’s Mercy profile will vation, and service/product devel- appear on an individual’s Facebook opment. “As people go through life page. “Once our physicians agree events and their health journey, they to have their Mercy profile shared, have changing interests in health,” they don’t need to do anything said Ann Sherry, senior director of else — this allows them to be some- Kaiser Permanente’s Internet services. what social media savvy even if they “They want and need different tools don’t have their own professional and different interactions. To say Facebook page.” we are going to have a social media strategy would not be enough — it’s18 PwC Health Research Institute | Social media “likes” healthcare
  • 20. Listen, participate knowing — it can involve looking at handle on negative chatter. On a posi-and engage through company or brand sentiment, tracking tive note, companies that “listen” wellexternal forums touchpoints to various social media draw new ideas for services and useMarkets can shift quickly, and social sites, and analyzing comments and patient-reported health information tomedia enables organizations to gauge discussions for qualitative patterns. inform the business.the pulse of the public to diffuse aproblem or tap new opportunities. Here’s an example. Nurses within “No one has fully tapped into the(See Figure 12.) a social network were discussing explosion of socially generated data defects with a specific drug. The drug to understand what it means,” saidListen maker’s executives had no knowl- Kevin Noble, director of interactive edge of the defects — or the nurses’ marketing at Genentech. “My percep-“One of the greatest risks of social discussions — until the chatter was tion is that the next level of intercon-media is ignoring social media,” said discovered by regulatory authorities nectedness will be between pools ofDon Sinko, chief integrity officer of on one of the drug company’s social people who weren’t previously thatCleveland Clinic. “It’s out there, and media sites. After this experience, close. Social media has the ability topeople are using it whether you like the company quickly established a pull together a fragmented industry,it or not. You don’t know what you capability to mine information from with the patients and their informa-don’t know.” “Listening” is the start to the social online community to get a tion in the center.”Figure 12: Social media participation model for businesses Listen Actively monitor and capture conversations to –– Company/brand analyze and understand the meaning of what is sentiment being said, the sentiment of the discussion, and –– New discoveries what influence it has over audiences –– Patient outcomes Participate Proactively post and publish content on social –– Sponsor media-enabled platforms to communicate a education message to an audience, but not necessarily –– Corporate engage them in a conversation messaging Engage Actively interact in one-to-one, one-to-many –– Customer service or many-to-many conversations within social –– Fundraising media in order to freely exchange information –– Champion a and advance a discussion health related event or conditionSource: PwC Health Research Institute An in-depth discussion 19
  • 21. Participate Engage Extend the customer experience beyond aListening is just the first step for Engaging means having a mean- clinical encounterhealthcare businesses. As social media ingful, active presence in the socialuse increases, new opportunities space. “That kind of relationship is In the retail world, good customerfor innovation emerge as consumer different than the old model of coming experience leads to retention and,insights and ideas become more acces- in when the patient is sick. The new better yet, recommendation andsible. Companies need to actively model is about connecting into the loyalty. Historically, the healthmanage the data collected to capture member’s life decisions when they’re industry has not had to compete forpotential opportunities and respond healthy — about what food to buy customers in the same way, but theappropriately. This may require taking or what type of physical activity to rising demand for value is forcingaction to remedy negative activity participate in,” said Chow of Kaiser companies to find different ways toor information shared in the social Permanente. Before engaging, orga- get closer to their customers. (Seespace. If there’s a negative post on nizations need to think about what Case study 2.) “Companies need toany of Cleveland Clinic’s social media they’re looking for and why they want use health-oriented versus product-forums, including Facebook, Twitter, to be there. Social media invites inter- oriented social media. They need toand blogs, there’s a process to respond action, unlike a static webpage, where start communicating with the patientboth privately and publicly within a content can be developed once and need in mind,” said Greg Simon,designated amount of time. revisited and refreshed later. former senior vice president of patient engagement at Pfizer.Even with the potential for negative “Facebook is turning into a behind-publicity, Lee Aase, director of Mayo the-scenes customer service forumClinic’s Center for Social Media, for answering people’s questions,”argues there can still be benefits to explained Paul of Children’s Hospitalengaging. “If you’re concerned about Boston. “When people have troublethe ‘give and take’ aspect, then just finding what they need on our‘give.’ This is half of it — you can use website (or sometimes they don’tthese tools to spread your message even check the website), they willfarther and at least start to create a come to Facebook and ask for help,connection with your organization.” including how to change an appoint- ment, how to find a certain doctor,The response to negative feedback can etc.” Children’s encourages people tocarry equal or more weight than posi- participate in its various social mediative consumer engagement programs. forums including Facebook, YouTube,“Today, your organization’s digital Twitter, and its blogs, but warns themidentity is your identity,” said Mark against posting medical informationLangsfeld, co-founder of the social busi- and considering information posted asness intelligence company ListenLogic. medical advice. (See Figure 13: “Week“The press is following what people do in the life of social health” for otheron the web. Before, the press is what ways organizations are engaging indrove these insights, and now it’s flip- social media.)flopped. Consumers are driving whatthey want as a whole community.”20 PwC Health Research Institute | Social media “likes” healthcare
  • 22. Case study 2 Health system internalizes social media to improve operations What started as a social media experiment for Arlington, • Crowd-sourced problem solving: For example, when Texas-based Texas Health Resources nearly three years there was an unexpected surge in emergency room ago has resulted in a cultural transformation. Despite visits, the chief nursing officer reached out to the staff initial reservations, Texas Health embraced the stra- to determine if additional support was needed. tegic view that “social media reflects the kind of future where healthcare is headed and can offer new ways and • Creating affinity groups: More than 100 “affinity” delivery mechanisms to reach out to the community to groups have been formed, including ones around encourage personal health responsibility,” said Edward weight loss, innovation, and sports. “We have formed Marx, chief information officer for Texas Health and an a sports team where each member is from a different active blogger and Twitter enthusiast. entity in our health system. Four out of the five team members were picked up via the network,” said Marx. But before Texas Health could be effective in engaging customers externally, they wanted to develop an Texas Health Resources social media model internal culture of collaborating from operations issues to customer service related issues. The effort started Cross-functional social media steering committee with an interdisciplinary committee that developed a CIO Sr. VP Legal CMIO Sr. VP Human REsources simple social media policy based on trust of employees President Director of Marketing with access to social media. “Once the gates were open, Sr. VP Marketing & Communications Director of Communications Sr. VP Compliance Director of Public Relations people joined in. There was an untapped desire to do a lot with social media,” said Marx. Internal social media External social media Knowledge sharing Disease education and support Social media has become a way of life for the multi- Innovation Community building Communication and team building Employee recruitment hospital system and is embedded in many aspects of its business. (See Figure.) The system engages with patients and community through Facebook, Twitter, and blogs, connects with employees and physicians through an internal social platform, and recruits Community Satellite Existing Potential and potential physicians sites employees talent through LinkedIn. patients Although internal social networking is voluntary, more than 3,500 employees out of Texas Health’s 21,500 employees are active members. Following are ways it’s Business being used: partners • Education and knowledge sharing: For example, the Source: Texas Health Resources, 2012 chief medical information officer created a presenta- tion on health information exchanges through input given via the network. An in-depth discussion 21
  • 23. Figure 13: A week in the life of social health Over one week in February 2012, PwC’s Health Research there were lower overall membership counts among the Institute tracked the social media activity of healthcare healthcare companies than communities, on average companies (providers, insurers, pharma companies) more than 100 new members engaged with each company and online consumer communities to create a “week in throughout the week. Further, the interactions that did the life of social health” snapshot. The communities had take place were high-quality touchpoints between organi- the largest membership and interaction — by both the zations and consumers, where they shared an educational community moderators and the consumer members. resource or resolved a customer service issue. Despite Community sites had 24 times more social media activity concerns by industry leaders that social media triggers on average than any of the health industry companies —  negative conversation, more than 80% of interactions a single post in a community could generate several were neutral and only 5% were negative. hundred comments. Communities remained active on the weekends and were mostly driven by their consumer members; whereas, provider, pharmaceutical, and insurer groups had minimal activity on the weekends. Although 24x Community sites had 24 times more social media activity on average than any of the health industry companies. 5% Despite concerns that social media will solicit negative conversations, the majority of mentions across all organization types were neutral and only 5% were negative. Average new likes, followers and views per organization Sentiment analysis* Likes Followers Views Positive Neutral Negative Provider 110 267 3,327 72 305 18 Pharma 148 109 17,119 110 681 50 Insurers 103 12 120 67 416 16 Communities 711 158 53,822 *Average sentiment in social media mentions per organizationSource: HRI Week in the Life Of Analysis, 201222 PwC Health Research Institute | Social media “likes” healthcare
  • 24. Consumer interactions with organizations via Facebook and TwitterActivity measured in likes, shares, and comments A community posted a question to members: “When did you deliver your baby?—early, late, or on time?” and received: 61 likes Consumer activity 766 comments high: 6,778 low: Communities 4,987 An insurer gained new members by hosting A provider used quizzes to engage its a contest to reach its 15,000th page Like. members. A quiz about Vitamin D had: The contest post received: 35 likes 321 likes 3 shares 5 shares Consumer 35 comments 16 comments activity high: 633 low: Provider 6 A pharma manufacturer alerted members Pharma about a product recall which resulted in: 12 likes Insurer 47 shares 12 comments Monday Tuesday Wednesday Thursday Friday Saturday SundayConsumer OrganizationEngagement with organizations’ Facebook sites Activity on their own Facebook sitesConsumers use provider sites to connect and share, but they treat Providers, insurers, pharma companies and communities useinsurer, pharma, and communities as a forum to give feedback. their sites to provide health information or answer questions. Providers Pharma Insurers Communities Providers Pharma Insurers Communities3% 5% 1% 1% 52% 35% 55% 88%31% 48% 96% 69% 8% 18% 23% 5%66% 47% 3% 30% 30% 57% 22% 7% Asking questions Providing feedback Sharing and conversing Providing information Promoting Sharing and conversing An in-depth discussion 23
  • 25. Tune up internal collabora- “There is this shift from hoarding Consider the privacy, securitytion processes to meet knowledge to sharing what you and other regulatory risksexternal demands know as a way to both help others and build your personal brand Privacy and security are top consumerHealth companies are responding to as an employee,” said Dee Anna concerns when sharing their healthemployees’ needs to collaborate and McPherson, Yammer’s vice presi- information through social media.connect through internal (enterprise) dent of marketing. “This knowledge Consumers are most concerned withsocial media as well. Several organiza- can be used to enhance things like personal health information beingtions interviewed are using internal product development, customer shared in public (63%) and informa-collaboration tools to connect on service, or on-boarding.” Several tion on social media being hacked orpersonal interests and work-related interviewees said that personal leaked (57%). (See Figure 14.)issues. For example, Mercy is using interest forums have led to work-one such tool called Yammer to related communications such asencourage and study collaboration collaboration drills on handlingfor a medical home pilot. customer service inquiries that require input from several depart-Enterprise social network services are ments within an organization.changing organizational culture and (See Case study 3 for more informa-increasing employee engagement. tion on enterprise social media use.)Figure 14: Consumer concerns of sharing health information through social mediaPersonal health Information Making a Health None of these Otherinformation being hacked decision based insurancebeing shared or leaked on incorrect coverage beingin public information impacted due to information shared 63% 57% 52% 41% 20% 2%n = 1,060Source: PwC HRI Social Media Consumer Survey, 201224 PwC Health Research Institute | Social media “likes” healthcare
  • 26. Case study 3 Insurer extends customer experience capability through social media Understanding that customers prefer to communicate Lessons learned: and connect in different ways, Health Care Service 1. Consider the implications of a real-time communication Corporation (HCSC), a four-state Blue Cross Blue Shield channel. Responding thoughtfully and timely to insurer, has used Facebook and Twitter to expand its negative comments is just as important as offering relationship with members. Its philosophy of offering new services. members their “channel of choice” prompted HCSC to extend its one-to-one phone and web customer service 2. Educate departments so they’re prepared to to a broader public forum. resolve issues. Since HCSC began using social media for customer 3. Start small and ramp up strategically. As companies service in 2008, its approach has evolved into a broader learn more about their audience and demand increases, they need to be prepared to scale up services quickly. strategy that provides information to raise health literacy and improve disease prevention. “Health insur- 4. Build excitement within the organization about the ance is something people don’t think about or don’t strategy, but make sure there’s an appreciation for want to think about until something goes wrong,” said the amount of work that goes into managing a social Lynde O’Brien, director of electronic media strategy. media channel. “Connecting to members via social media before they need care is a way to change that perception. We see 5. Look for opportunities to educate your customer social media as a way to change the conversation and community about health benefits, processes, and programs while being vigilant about protecting establish a relationship with members in a way that’s their privacy. timely, relevant, and maybe even fun.” 6. Finally, O’Brien said the communications must be For example, O’Brien tells of a young adult member who, “responsible and consistent. Members who decide to after paying his first bill, tweeted negatively, saying on reach out via social media should get an experience Jan. 26 at 7:27pm: “Just got my BCBSTX insurance card. consistent with other channels, such as a call center, It’s confusing and I can’t afford it.” HCSC’s social media which offer an immediate response.” community manager immediately contacted the customer service team to coordinate a response. They invited the unhappy customer to call so they could provide additional information and support. The next day, the member re-tweeted the entire exchange and the help HCSC had provided to him. His final tweet a day later at 5:54pm ended with “Great talking to you too! All my questions were answered and my worries relieved.” TWEET FROM: UPSET_MEMBER TWEET FROM: UPSET_MEMBER Posted on: Jan 06, 2011 07:27 PM Posted on: Jan 07, 2011 05:54 PM Just got my BCBSTX insurance card. It’s confusing and I can’t @BCBSTX Great talking to you, too! All my questions were afford it. #mistake #swindled #PPO answered and my worries relieved. Following: 38 | Followers: 66 | Updates: 1776 | Sentiment: Negative Following: 39 | Followers: 66 | Updates: 1798 | Sentiment: Positive Source: Health Care Service Corporation An in-depth discussion 25
  • 27. As healthcare companies and third Strategies should include a remedia- an area of excitement, but there’s littleparties start using social media- tion plan and training needs to be activity given the industry landscape,”related information to inform busi- continual, detailing the consequences said Bob Rhatigan, senior vice presi-ness, it’s important to be transparent of noncompliance on an individual dent of facial aesthetics at Allergan.with consumers. Social media can and company level. Recent HRI “We can have a very controlled andpresent risks such as information research showed that less than 40% regulated one-way dialogue, but tobeing stolen through online fraud, of health industry organizations have a two-way dialogue in socialknown as phishing, abbreviated URLs, surveyed have included social media media channels is very difficult. This isdata mining of information from in company privacy trainings.8 one of those mechanisms that cannotsocial networking sites, employees be optimized to its full potential byvoluntarily disclosing critical busi- In the HRI survey, pharmaceutical/ pharmaceutical companies withoutness information, and data leakage life science companies were more further clarification and guidelinesviolating confidentiality mandates. likely than providers and insurers to from the FDA.”For more information on privacy and report social media as a top privacy/security of health information, see security concern (35% compared 8 Old data learns new tricks: ManagingOld data learns new tricks: Managing to 27% and 21%, respectively). But patient privacy and security onprivacy and security on a new data- approximately 23% of drug makers a new data-sharing playground, PricewaterhouseCoopers Healthsharing playground. said they have not begun to address Research Institute, 2011. the privacy and security implicationsHealth industry organizations should of social media. Intense regulatoryhave policies on business and personal scrutiny of marketing practices anduse of social media. For example, data stringent adverse-event reportingshould be classified so employees requirements have made the industryunderstand what sensitive informa- reluctant to assume an active voicetion is, how it can be used, and who is in the social media conversation.authorized to access and share corpo- Although the industry is keenly awarerate content. Company policies should of its obligations when sharing infor-specify who owns relationships when mation about products, their uses, andemployees engage in social media side effects, industry regulators haveas representatives. For example, an yet to fully define the rules for socialemployee working at a pharmaceutical media engagement. “Social media iscompany develops a diabetes website.The employee becomes “friends” withdoctors who are interested in hearing 8 Old data learns new tricks: Managingabout the latest technology. If the patient privacy and security on a new data-sharing playground,employee leaves the firm, who owns PricewaterhouseCoopers Healththe physician relationships? Research Institute, 2011.26 PwC Health Research Institute | Social media “likes” healthcare
  • 28. A future lookData generated from Recent HRI research showed that healthcare companies are strugglingindividuals can with how to integrate and analyzehelp complete the data from their own clinical systems,patient profile let alone new data sources such as personal health records, remote monitoring devices, and social media.The ultimate goal for healthcare Health sector professionals surveyedcompanies under an outcomes-based by HRI cited big data integrationreimbursement system is to positively and interoperability issues — amongimpact patient behavior in order to providers and health insurers, 71% ofboth improve health and reduce costs. respondents said integrating data fromBut caregivers lack valuable informa- multiple sources was the top technicaltion for effectively doing so. “There goal of their informatics program overis a lot of patient data — clinical and the next two years. For more informa-soon genomics as well. But what is tion, see Needles in a haystack: Seekingreally happening in our patients’ lives knowledge with clinical informatics.is missing to us and their record — what’s happening in their lives is All sectors view patient engagementhappening in the social space,” said as a way to drive better financialFerdinand Velasco, Texas Health’s performance, either through costchief medical information officer. “If reduction or revenue increases. Butwe understand the life factors that few, if any, providers are includingimpact when and who they select for patient self-reported data in anycare and what challenges they face type of analysis — only 12% ofafter receiving care, there is a lot of provider respondents said they arepotential for merging analytics with feeding it into their informatics tothe clinical side and improving care.” drive research or the development of care protocols. Nearly one-thirdSome organizations are starting to of provider professionals said theythink about how to harness social were not doing anything with patient-media data and integrate it with other reported data. Data integrity — trustinformation to complete their view of that the information is from the actualthe patient. “Many chronic diseases patient and reliability that the infor-are very hard to measure just with lab mation is accurate — was cited as thedata. But, what’s most important is primary challenge.how the patient feels and how they’regetting along day to day — that’ssomething we are in a good position tocapture from social media and trendover time,” said Arash Mostaghimi,MD, research fellow in medicine atBeth Israel Deaconess Medical Centerin Boston. An in-depth discussion 27
  • 29. A key issue is the massive amount of As discussed in this report, patient- Define the social elements ofunstructured data. For example, struc- reported data is already being a complete patient profiletured data such as diagnosis codes and captured within online communities,procedure codes is captured, but data where individuals are made aware Even within one health organization,such as how much pain an individual that their data is aggregated and there are multiple, one-dimensionalis feeling is not. They require more shared with interested parties. They views of a patient. Having a singlesophisticated data mining techniques, are also able to see their progress view of the patient creates opportuni-such as natural language processing or compared to other patients who have ties for improved care. Companiesother “listen and interpret” technology. similar conditions. Companies inter- must first understand stakeholderAnd given that organizations have yet ested in taking advantage of patient demands for this information. Forto take full advantage of the structured self-reported data must proceed example, in a provider setting, physi-data available (i.e. databases, flat files), with transparency and the proper cians and other caregivers may finddeveloping ways to understand these individual permissions. This would lifestyle information helpful to createless structured sources may be quite include a review of how to incorporate a care plan. Pharmaceutical compa-difficult, time-consuming and still social data use into the company’s nies may find self-reported datarequire much human intervention. privacy and security policies. helpful on how an individual isSocial media data presents similarchallenges. (See Figure 15.) Figure 15: Top concerns for organizations related to social media in descending order from top concerns to least concernsHow to start integratingsocial dataPatient perceptions, knowledge, and Integrating social media data/analytics into your organizationbehaviors that influence a patient’s Measuring the effectiveness/linking to ROIhealth could be gleaned by properlyintegrating social media data. “Through Educating staff on how to effectively use social mediasocial media, we can learn what peoplewant to do to make their health better– Keeping up with the pace of technology changewhat their obstacles are, what their Responding to information identified via social mediamotivations and interests are, whatthey struggle with, and what informa- Sharing of patient identifiable information/HIPAA violationstion they need,” said Kevin Abramson,director of marketing planning for Identifying qualified staff to work on social mediaOptumHealth, a health management Decreased staff productivitysolutions company that serves both indi-viduals and organizations. “The ques-tion is: how can we use this informationto better understand the outcomes we Source: PwC e-Health Initiative Survey, 2011see in the claims data?”28 PwC Health Research Institute | Social media “likes” healthcare
  • 30. feeling pre and post-treatment. with higher rates of readmission to guide the physician to have the mostWhat gaps are they looking to fill? create specific and targeted patient valuable, informed interaction possibleThe complete patient profile should strategies. “Our leadership is increas- at that time,” said Allison Orenstein,contain several elements that are ingly interested in understanding director of physician connectivity andcurrently not found in the patient’s the impact of patient lifestyles on marketing at CVS Caremark.medical records. (See Figure 16.) outcomes,” said David Weiss, the health system’s senior vice president The key is determining how to inte-Information regarding lifestyle and chief information officer. grate the social intelligence. Forand behavior could provide addi- providers, this could be a moduletional insight to factors that affect a The more information those inter- within an electronic health recordpatient’s health. For example, Centene facing with patients have to work that receives and displays social dataCorporation, a Medicaid managed with, the more they can potentially that is relevant to the patient or allowscare company, envisions a consoli- offer them. “If we can offer physi- the provider to pull the information.dated member profile that would cians critical information about their Vendors might see this as an opportu-integrate three types of information: patients’ care — from adherence alerts nity to provide a solution.risk, quality, and care management, to savings opportunities, we can helpsaid Phil Mainquist, vice president offinance and business intelligence. A Figure 16: Data elements to complete the patient profilemember services representative couldthen easily see overall gaps affectinga diabetes patient due for a wellness Medical information Insurer data Medicationsexam. The member profile wouldshow how the wellness exam would X-rays All claims regardless of Drugs (OTC and prescribed) Test results health insurers Dosagesaffect their risk score and HEDIS Physician notes Financial situation Adherencescores, which compare health planquality measures. All instances of care All medications regardless regardless of location of pharmacy filledDetermine how the completepatient profile integratesinto workflows Clinical trials Lifestyle/Behaviors Connection to clinical Patient self-reported dataCaregivers can use patient-reported research trials Social media postsdata to help modify behavior and Results of clinical trials and Mobile monitors/telehealth changes to treatment plansdetermine which strategies work best Socioeconomic datafor which patients. For example, BJCHealthCare, a St. Louis-based hospitalsystem, is modeling aggregate socio- Source: PwC Health Research Instituteeconomic data to identify populations An in-depth discussion 29
  • 31. What this means for your businessSocial media enablesorganizations toexpand their roleswith customers
  • 32. Whether you’re a provider, insurer, you. Starting a relationship with Innovatemedical device, or pharmaceutical/ consumers when they are healthy • Establish enterprise sociallife science company, you can benefit builds a foundation for when media: Internal collaborationfrom more active online engagement they are ill. forums can help organizations testwith consumers. In the coming years, the social media concept within thethoughtful and deliberate use of social Adapt internal operations walls of the organization beforemedia will be an increasingly impor‑ • Shift from silos to networks: establishing an external presence.tant element of a health industry Social media is not just a market‑organization’s business strategy. • Create a forum to turn listening ing tool. Invest in a social media into innovation: Companies need “hub” to coordinate with legal,Embrace social media as a to make sure there is a process for IT, clinical, customer service,mindset, not just a channel innovation to be heard and adopted. and other functions.• Take a disciplined approach • Collaborate across the industry: • Revamp processes to be relevant to planning your investment9: Take advantage of social tools to at the point of need: Healthcare Consider the following factors when exchange ideas and coordinate care tends to work in linear and often determining the value of social inside and outside the traditional lengthy process, but social media media to your business — What is healthcare system. promotes a non-linear, instanta‑ the financial impact on revenue or neous experience. Market research, costs? Has brand image and engage‑ customer service, and IT staff may ment improved? Is the organization Embrace social media as a need to be retrained and new skills mindset, not just a channel better prepared to manage reputa‑ sets may need to be procured. tional risk with an established social media presence? Have digital assets Turn social conversations been increased or enhanced? Adapt into insights Innovate Expand your internal• Establish goals focused on role operations • Don’t just talk and listen; analyze in care trust and transparency, not and integrate: Listen beyond your just ROI: The immediate return organization’s Facebook page or of social media may not be quan‑ blog, and develop a strategy for Turn social conversations tifiable in profits, visits or sales. ensuring that conversations are to insights However, it can impact a brand by viewed as insights and transformed establishing trust and transpar‑ into action. ency with customers. • Sift through the noise of social• Focus on being accessible data: Companies have an oppor‑ and relevant: Combine social tunity to engage IT and work media plans with an online and with analytics to discover ways to a mobile strategy to ensure you integrate social data with existing are with patients when they need systems, databases, and tools.9 The Power of social media: How CIOs can build business value using social media, PricewaterhouseCoopers Technology Consulting Services, 2011 What this means for your business 31
  • 33. Pharmaceutical and company complaints and respond big leap from what hospitals andlife sciences by inviting consumers to an offline providers have been doing. In StageWith little regulatory guidance on conversation, or create closed 1, eligible hospitals and providershow manufacturers may engage in social communities to engage other needed only to provide patientssocial media for promotional and customers, such as providers or with an electronic copy of theirother customer engagement purposes, insurers, to improve collaboration health information — includinguse of social media for pharmaceu- and innovation. diagnostic test results, medica-tical and life sciences businesses will tion lists, and medication aller- • Listen and improve:continue to be challenging. Although gies — upon request, and just 50% Invest in monitoring targetedthe FDA’s December 2011 draft guid- of the time. However, Stage 2 may conversations and integratingance provides some direction on require eligible hospitals to offer data into product decisions acrosssocial media use, it was limited in 80% of patients the ability to view research and development, drugscope to requests for off-label infor- and download relevant information safety, product complaints, salesmation and usage.10 Pharmaceutical via a web-based portal within 36 and marketing, market research,and life sciences businesses should hours of discharge and have at least and other business operations.move forward in ways that benefit the 20% of their patient populations Treat social media as anothercompany while minimizing regulatory accessing information that way. source of business intelligence thatand legal risk. can provide insights at the aggre- • Define your digital identity:• Set the stage for proper risk gate level (e.g. how is your product A hospital or physician’s first management and new working, is there an untapped encounter with a patient is often opportunities: market, and what improvements through its online presence. Develop an infrastructure that can be made?). Providers should take advantage includes a strategic approach to of the trust consumers have for social media, the proper governance them over other health compa- Providers nies. Determine how you will to manage risks and opportunities, The industry is shifting toward define your identity in the digital and operational processes that can outcomes-based measurement in part space through avenues such as adapt to a new social structure. due to provisions in the Affordable promoting your hospital or practice• Move beyond marketing: Care Act such as Medicare’s Value- by offering discounts, assisting Improve clinical trial recruitment Based Purchasing and accountable with appointment scheduling and by tapping into social communities, care. Social media can offer a unique referrals, and providing forums for mine social media for product or mechanism for collaborating with patient reviews. other organizations/partners to coordinate care. • Create clear usage guidelines:10 Food and Drug Administration, Patients are increasingly reaching Responding to Unsolicited Requests • Support meaningful use efforts: out to physicians in the social media for Off-Label Information About Stage 2 of the federal govern- Prescription Drugs and Medical space, creating increased risks Devices, fda.gov/downloads/ ment’s “meaningful use” regula- around privacy and the sharing of Drugs/GuidanceCompliance tions sets higher standards for patient identifiable information. RegulatoryInformation/Guidances/ UCM285145.pdf communicating health informa- Set clear guidelines on the use tion to patients. This represents a of social channels for patient32 PwC Health Research Institute | Social media “likes” healthcare
  • 34. interactions to help maintain • Determine approach to professionalism and protect patient data aggregation: information. Consider enforcing Evaluate current member data a standard communication policy and determine what informa- outlining which requests and inter- tion will fill the gap to fully actions are appropriate. understanding member needs and experiences. Think outside of current databases to lifestyleHealth insurers data (e.g., what members like toHealth insurers understand that eat, what activities they like tofocusing on the individual popula- do). Consider the aggregation oftion will be key as more partnerships self reported data on health statusin population health are formed and from communities suffering frominsurance exchanges bring in 12 a specific illness and how thatmillion newly-insured individuals in will feed into health management2014 and up to 28 million by 2019.11 programs for employer clients or• Cast your company as a new populations. patient advocate: • Understand direct and indirect The individual health insurance benefits of social media: exchange market will have orga- Increase in membership can be a nizations vying for the attention direct benefit of using social media of new customers. Start now by to engage, educate, and advocate understanding the needs of poten- for individuals looking for the right tial members and then determining coverage. Metrics such as increased which needs can be fulfilled by customer satisfaction, loyalty, incorporating social media into and brand value may not be easily your member strategy. Insurers tied to increases in revenue but have started working with vendors are indirect benefits that should in the gaming industry and compa- be recognized. nies who provide social support in between clinical visits.11 Congressional Budget Office March 2011 baseline health insurance exchange estimates, cbo.gov/ budget/factsheets/2011b/ HealthInsuranceExchanges.pdf What this means for your business 33
  • 35. Health Research Institute PwC’s Health Research Institute provides new intelligence, perspectives, and analysis on trends affecting all health-related industries. The Health Research Institute helps executive decision makers navigate change through primary research and collaborative exchange. Our views are shaped by a network of professionals with executive and day-to-day experi- ence in the health industry. HRI research is independent and not sponsored by businesses, government or other institutions.About this research Advisory team Karla Anderson Contributors Paul Ceverha Principal Director karla.s.anderson@us.pwc.com paul.ceverha@us.pwc.com (703) 674 6020 (214) 616 2432 Jeff Auker Paul D’AlessandroSocial media likes healthcare: From marketing to social Director Principalbusiness represents the most in-depth research to date of jeff.auker@us.pwc.com paul.dalessandro@us.pwc.comsocial media’s impact on the healthcare industry by PwC’s (860) 597 2206 (847) 910 5763Health Research Institute (HRI). HRI conducted more than30 interviews with executives and thought leaders representing Maxim Duprat James Koenigpharmaceutical and biotech companies, insurers, providers, Director Director maxim.m.duprat@us.pwc.com james.h.koenig@us.pwc.compatient advocacy organizations, and community health (917) 405 4816 (610) 246 4426companies. HRI also tracked the social media activity ofhealth organizations and consumer communities to create a Fadi Khuri Jamie Marks“Week in the life of social health” snapshot. HRI conducted Director Former Research Analyst, HRIa consumer survey of 1,060 adults representing the fadi.khuri@us.pwc.comdemographics of the US population, along with surveying (646) 408 3343 Rani Radhakrishnanmembers of the eHealth Initiative (eHI), a national association Directorof health information and technology organizations. Kenneth Madrigal rani.radhakrishnan@us.pwc.com Manager (510) 300 7050 kenneth.l.madrigal@us.pwc.com (757) 343 3227Kelly Barnes Serena Foong Ted SheltonPartner Senior Manager Managing Director Chetan PaydenkarHealth Industries Leader serena.h.foong@us.pwc.com ted.shelton@us.pwc.com Managerkelly.a.barnes@us.pwc.com (617) 530 6209 (415) 763 5820 chetan.paydenkar@us.pwc.com(214) 754 5172 (408) 239 9779 Christopher Khoury Gurpreet SinghDavid Chin, MD Senior Manager Principal Robin SettlePrincipal (retired) christopher.m.khoury@us.pwc.com gurpreet.x.singh@us.pwc.com Directordavid.chin@us.pwc.com (202) 312 7954 (312) 298 2160 robin.m.settle@us.pwc.com(617) 530 4381 (267) 330 4006 Sarah Haflett Christopher WasdenCeci Connolly Manager, Health Information Managing Director Lloyd SmithHRI Managing Director Technology Research christopher.wasden@us.pwc.com Principalceci.connolly@us.pwc.com sarah.e.haflett@us.pwc.com (832) 816 3606 lloyd.smith@us.pwc.com(202) 312 7910 (267) 330 1654 (678) 419 2328 Health Industries marketingSandy Lutz Marcy Rebello Andrew Sofield Todd HallManaging Editor Research Analyst Director Directorsandy.lutz@us.pwc.com marcy.rebello@us.pwc.com andrew.sofield@us.pwc.com todd.w.hall@us.pwc.com(214) 754 5434 (617)530 4827 (702) 691 5493 (617) 530 4185Benjamin Isgur Erin Manalo Attila KaracsonyDirector Research Analyst Directorbenjamin.isgur@us.pwc.com erin.m.manalo@us.pwc.com attila.karacsony@us.pwc.com(214) 754 5091 (213) 356 6118 (973) 236 5640 Nadia Leather Director nadia.m.leather@us.pwc.com (646) 471 753634 PwC Health Research Institute | Social media “likes” healthcare
  • 36. About PwC PwC US helps organizations and individuals create the value they’re looking for. We’re a member of the PwC network of firms with 169,000 people in more than 158 countries. We’re committed to delivering quality in assurance, tax and advisory services. Tell us what matters to you and find out more by visiting us at www.pwc.com/us.Acknowledgements Janice Fang Customer Success Manager Yammer Arnie Friede Independent lawyer Arnold I. Friede and AssociatesLee Aase Wen-ying Sylvia ChouDirector, Center for Social Media Program Director, Health Communication and Josh GoldsteinMayo Clinic Informatics Research Branch Director of Social Mediafacebook.com/MayoClinic National Cancer Institute Thomas Jefferson University Hospitalstwitter.com/#!/mayoclinic facebook.com/cancer.gov facebook.com/JeffersonHospitalyoutube.com/user/mayoclinic twitter.com/#!/@NCICancerCtrl youtube.com/user/JeffersonHospital youtube.com/ncigov JeffersonHospital.org/TheDailyDose.aspxKevin AbramsonDirector of Marketing Planning Yan Chow, MD, MBA Vince GollaOptumHealth Director, Innovation and Advanced Digital Media and Syndication Directorfacebook.com/myoptumhealth Technology group Kaiser Permanentefacebook.com/myoptumhealthstore Kaiser Permanentetwitter.com/myOHstore facebook.com/kpthrive Brad Herrick twitter.com/#!/KPNewscenter Director of Digital MarketingKathryn Armstrong youtube.com/kaiserpermanenteorg MercySenior Producer, Web Communications facebook.com/MercyHealthLehigh Valley Health Network Laura Clapper, MD,MPPA,CPE twitter.com/#%21/FollowMercyfacebook.com/lvhealthnetwork Chief Medical Officer youtube.com/user/theMercyChanneltwitter.com/lvhn OneRecoveryyoutube.com/lvhealthnetwork facebook.com/onerecovery James Heywood twitter.com/#!/OneRecovery Co-Founder, ChairmanEllen Beckjord PatientsLikeMeAssistant Professor Kelly Colbert facebook.com/patientslikemeUniversity of Pittsburgh Medical Center and Director of Strategic Advertising twitter.com/patientslikemeHillman Cancer Institute WellPoint youtube.com/patientslikeme facebook.com/healthjoininEd Bennett twitter.com/healthjoinin Richard HutsellDirector, Web & Communications Technology youtube.com/healthjoinin Vice President & Chief Information OfficerUniversity of Maryland Medical Center Daughters of Charity Health Systemfacebook.com/MedCenter Brad Crotty, MD facebook.com/stfrancismedicalcenterfacebook.com/marylandnursing Instructor of Medicine, facebook.com/oconnorhospitalmedcenterblog.org/ General Medicine division facebook.com/setonmedicalcenter Beth Israel Deaconess Medical CenterMark Brooks facebook.com/BIDMCChief Technology Officer twitter.com/#!/bidmchealthHealth Net youtube.com/tophospitalMelissa Burke Charlie DierkerDirector, Strategic Partnerships Marketing ManagerSermo Texas Health Resourcesfacebook.com/Sermo facebook.com/texashealthtwitter.com/#!/sermo twitter.com/#!/texashealthlinkedin.com/company/33697 youtube.com/texashealthresources Acknowledgements 35
  • 37. Acknowledgements Mike Ronningen, RAC Director Global ComplianceContinued Medical device company Ann Sherry Senior Director, Internet Services Kaiser PermanenteDawn Koffler Joe MiliciaProduct Director - Dry Eye Franchise Senior Public Relations Manager Greg SimonAllergan Cleveland Clinic Former Senior Vice President Patient facebook.com/clevelandclinic EngagementMark Langsfeld twitter.com/clevelandclinic PfizerCo-Founder youtube.com/clevelandclinicListenLogic Don Sinkotwitter.com/#!/ListenLogic Arash Mostaghimi, MD Chief Integrity Officer Research Fellow in Medicine Beth Israel Cleveland ClinicAlex Lemheney Deaconess Medical CenterAdministrator, Division of Education Chris SmithLehigh Valley Health Network James Murray Senior Director for Marketing Operations Vice President, Information Technology Thomas Jefferson University HospitalsLaurie Litt-Robbins MinuteClinicChief Executive Officer CVS Caremark Darren SmithNew Jersey AIDS Service Enterprise Account Executivefacebook.com/pages/ Kevin Noble YammerNew-Jersey-AIDS-Services/391361594358 Director of Interactive Marketinglinkedin.com/company/ Genetech Christine Theistnew-jersey-aids-services Independent Consultant Lynde O’Brien Hospital AdministrationMary Luthy Director, Electronic Media StrategyDirector, Communications Health Care Service Corporation (HCSC) Ferdinand Velasco, MDMedical device company www.facebook.com/ Chief Medical Information Officer bluecrossblueshieldofillinois Texas Health ResourcesPhil Mainquist twitter.com/bcbsilVice President of Finance, Business youtube.com/bcbsil David WeissIntelligence Senior Vice President and ChiefCentene Corporation Allison Orenstein Information Officer Director, Physician Connectivity and Marketing BJC HealthcareEd Marx CVS CaremarkChief Information Officer Richard WestelmanTexas Health Resources Ryan Paul Chief Operating Officer; Senior Vice President Social Media Specialist of Sales & Client ServicesMeg McCabe Children’s Hospital Boston SermoHead of Consumer Solutions facebook.com/ChildrensHospitalBostonAetna twitter.com/ChildrensBoston Kevin Youngtwitter.com/aetna youtube.com/ChildrensHospital Analyst Relationstwitter.com/aetnahelp Yammer Drew PaxtonDee Anna McPherson Chief Marketing OfficerVice President of Marketing OneRecoveryYammer Bob RhatiganLars Merk Senior Vice President, Sales and Marketing forDirector of Digital Platforms Facial AestheticsMcNeil Consumer Healthcare Allergan36 PwC Health Research Institute | Social media “likes” healthcare
  • 38. Thoughtful and deliberateuse of social media willbe an increasingly impor-tant element of a healthindustry organization’sbusiness strategy.
  • 39. pwc.com/us/healthindustriespwc.com/hritwitter.com/PwCHealthTo have a deeper conversationabout how this subject may affectyour business, please contact:Karla AndersonPrincipalPwCkarla.s.anderson@us.pwc.com(703) 674 6020Lloyd SmithPrincipalPwClloyd.smith@us.pwc.com(678) 427 6341Daniel GarrettPrincipal, National LeaderHealth Information TechnologyPwCdaniel.garrett@us.pwc.com(267) 330 8202© 2012 PricewaterhouseCoopers LLP, a Delaware limited liability partnership. All rights reserved. PwC refers to the US member firm, and may sometimes refer to the PwCnetwork. Each member firm is a separate legal entity. Please see www.pwc.com/structure (http://www.pwc.com/structure) for further details.This content is for generalinformation purposes only, and should not be used as a substitute for consultation with professional advisors. BS-12-0277-03/12.lmt