Social Media In Health Care: FDA Limits Liquid Morphine

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    Social Media In Health Care: FDA Limits Liquid Morphine - Presentation Transcript

    1. Social Media in Health Care Case Study: FDA Removing Morphine Christian Sinclair, MD April 12, 2009
    2. Background
      • Morphine liquid at a concentration of 20mg/ml is an essential medication in hospice care
      • It is currently ‘unapproved’ but allowed to be manufactured and distributed by the FDA
    3. March 31st
      • The FDA issues a memo notifying pharmaceutical manufacturers to stop making and dispensing a variety of opioid products that are unapproved within 90 days.
      • Morphine 20mg/ml is included in the list.
      • The memo is posted to the website, RSS feeds and fax. (?email?)
      On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    4.  
    5. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    6. Late March 31st
      • A nurse who I used to work with and is a Facebook friend posted a status update.
      • Notice the times: I did not see this until late on April 1.
      On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    7.  
    8. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    9. April 1st
      • FDA memo mentioned by two people I follow (and trust) on Twitter
        • @doclake
        • @johnmulder
      • Also hits newspapers
        • Never saw the story in local paper
        • Or online news feeds
      On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    10. First mention on Twitter
    11. Re-tweeted in one hour
    12. Re-tweeted again in few minutes
    13. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    14. April 1 st – Late PM
      • Sporadic emails to AAHPM/NHPCO likely throughout the day
      • Multiple discussions on local levels
      • FDA memo and unintended consequences posted to Pallimed around 11pm CST
      • Hits RSS and Twitter immediately (800+ subscribers)
      • Email subscriptions go out around 2am CST 4/2 (800+ add’l subscribers)
      On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    15. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    16. April 2 nd
      • Comments on Pallimed post begin early in the AM and continue thru day
      • Commenters encouraged to contact NHPCO and AAHPM leadership
      • AAHPM source says emails between orgs did not start really going until April 2 nd
      On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    17. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    18. April 2 nd late PM & 3rd
      • NHPCO on 4/2
        • Announces on Website, ?Email
      • AAHPM on 4/3
        • Issues email alert
      • Neither post to Twitter or Facebook at that time
      • Announces plan to write joint letter to FDA
      On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    19. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    20. April 4th-8th
      • Multiple emails between major organizations detailing strategy
      • Official letter from orgs to FDA on 4/6
      • Individual Letters/Emails to the FDA
      • Individual Letters/Emails to Congress
      On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    21. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    22. Thursday, April 9th
      • A Facebook group protesting the memo is formed the morning before the FDA teleconference
      • FDA arranges teleconference
      • AAHPM gets the word out by email, Twitter and Facebook only minutes before teleconference (due to late arrangement)
      • Multiple listeners on conference call
        • ?numbers?
      On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    23. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    24. Thursday, April 9 th - PM
      • FDA issues reversal of memo
      • Morphine 20mg/ml will not be removed from the market at this time
      • Although regional shortages are still present
      • Announced by:
        • Email, Facebook, Twitter, and Websites
        • By multiple individuals and organizations
      On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    25. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    26. Reversal Announced
      • On many different platforms
        • Individual emails
        • Broadcast emails
        • Twitter (and re-tweeted a lot)
        • Facebook (in many different groups)
        • On websites (AAHPM, NHPCO, FDA)
        • On blogs (HFA, About.com, Pallimed)
      On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    27. Lessons
      • Develop your social networks across platforms for maximum effect
        • You must contribute to the social network or else you will not have the connections or social capital to move messages
        • Pallimed has built readership over 4 years but has never been part of an event like this
        • Our readers felt empowered by a shared narrative. What is your networks shared narrative?
    28. Lessons
      • Redundancy is good
        • If you find something important to you, pass it on, even if you think your friends & followers may have already heard it
        • I missed the FDA memo on Facebook and the News, before I saw it on Twitter
        • It is sometimes OK to repeat your message
        • It is better if other people do it for you
    29. Lessons
      • Be humble
        • I cannot pretend to think posting about the FDA memo on Pallimed changed the world
        • But it could have accelerated the change
        • If the Twitter/Facebook and other social networks you need are strong, you can move mountains
        • Or get the FDA to reverse a ruling in 9 days.
    30. Lessons
      • Stickiness Matters
        • No one will forward what you had for dinner
        • But if you put your concern in context for your reader/friend/follower, they will listen, and possibly interact, and possibly pass on your message
    31. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
    32. Thanks to:
      • Drew Rosielle, MD
        • For creating Pallimed and letting me join
      • My Twitter and Facebook networks
        • For passing on the message because it meant something to you
      • Email any questions/corrections to:
      • [email_address]

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