A talk given to neonatologists in Boston area.

1. Social Media in the
NICU
2011 New England Association of Neonatologists/Griffin Symposium
Marlboro, MA
September 23, 2011
CLARA SONG, MD, FAAP
Assistant Professor of Pediatrics
Neonatal-Perinatal Medicine
The Children’s Hospital at OU Medical Center
The University of Oklahoma Health Sciences Center

2. DISCLOSURE
• SPEAKER: Clara Song, MD
• I have no relevant financial relationships with the
manufacturers of any commercial products and/or
provider of commercial services discussed in this CME
activity.
• I do not intend to discuss an unapproved or
investigative use of commercial products or devices.

3. OBJECTIVES
• Understand the evolution of social media and its impact
on healthcare
• Classify the current available web-based tools in an effort
to facilitate collaboration between health professionals
• Identify and prevent negative consequences associated
with social media use

4. 100,489 fans + 324 fan photos

5. Social media has
taken over…
… porn as the #1 activity on
the web.
Source: Social Media Revolution from Socialnomics.net

6. Years to Reach 50
Million Users…..
RADIO: 38
TELEVISION: 13
INTERNET: 4
IPOD: 3
Source: Social Media Revolution by Socialnomics.net

7. Years to add 50
million Facebook
accounts?
Facebook added 200 million
users in less than 1 year!
Source: Social Media Revolution 2 by Socialnomics.net

8. Everyday…..
… approximately 2 Billion
Google searches occur.
Source: Social Media Revolution by Socialnomics.net

9. Interestingly…..
Facebook TOPS Google for
weekly traffic in the U.S.!
Source: Social Media Revolution 2 from Socialnomics.net

10. In 2010, Generation
Y outnumber baby
boomers
Over 50% of the
world’s population
is under 30 years
old
One in five Americans uses a social media
96% join a social networking service.
network
(Pew Internet & American Life Project)
Source: Social Media Revolution by Socialnomics.net, Beyond.com Poll

11. Saying it simply…
Many people are on the web…
AND on the web to utilize
social media tools.

12. “Social media is NOT a fad…
“…it’s a fundamental shift in the way we communicate.”
Source: solcomhouse.com

13. Web 1.0
Source: www.jeffc.me/web-10-and-web-20-visual-differences

14. Web 2.0
Source: www.jeffc.me/ web-10-and-web20-visual-differences

15. • Social media is a “group of Internet-based
Social applications…that build on the
Media foundations of Web 2.0, and that allow the
creation and exchange user-generated
content.”
• Social media uses Internet and web-based
1. Concept
technologies to transform broadcast media
monologues (one to many) into social
2. Media
media dialogues (many to many). It
supports the democratization of
3. Social
knowledge and information, transforming
interface people from content consumers into
content producers.
Source: http://en.wikipedia.org/wiki/Social_media

16. Blogs
WEB 2.0
Photos
Videos
Audio
Social Networks
Event Networks
Interest
Networks
Wikis
Microblogs
Source: blog.milestoneinternet.com

17. Social Media is about….
Reaching out and having a
conversation.
Source: www.telegraph.co.uk

18. Social Media is Changing Our
Lives
• Shift in communication to focus on honesty and transparency.
• Social media sites, like Facebook and Twitter, are becoming trusted sources of
information and communication.
• New relationships are being created and old ones maintained.
• Average citizens have the opportunity to influence public opinion and policies.
• New possibilities have been opened for those launching and/or promoting a
business.
Source: mashable.com/2009/10/16/social-media-changing-lives/

19. SOCIAL
MEDIA
Unveiling the
truth behind
the mystery
Source: pjvoice.com

20. Health
2.0
Information: resources
and sharing
Medical education
Collaboration and
practice
Disease management
Research & data sharing
Professional
Development &
Networking
Source: http://en.wikipedia.org.wiki/Health_2.0, health20.org/images/ c/c1/Virtuous_Cycle.png

21. Hospitals in the United States 2009
441 use social media
241 have Facebook pages
323 have Twitter accounts
213 have YouTube channels
Source: Found In Cache, Social Media resources for healthcare professionals from Ed Bennett.

22. Hospitals in the United States 2011
906 use social media
719 have Facebook pages
674 have Twitter accounts
448 have YouTube channels
Source: Found In Cache, Social Media resources for healthcare professionals from Ed Bennett.

23. HealthCare.gov
• “Take healthcare into your own hands…. Your healthcare
explained.”
• A federal government website managed by the US Department
of Health & Human Services
• “Stay Connected” email updates, twitter, Facebook, YouTube,
RSS

24. We are e-Patients
• “equipped, electronic, enabled, educated, empowered, engaged,
equals, emancipated…… expert??”
• Seek online guidance for their own conditions or for their loved ones
• 2 effects “better health information and services and different
(but not always better) relationships with their doctors”
Source: http://enwikipedia.org/wiki/E-Patient

25. SmartBlog on Social Media
• November, 12, 2010:
– Patients and their families benefit from the
community support by connecting through
social media before, during and after a
hospital stay
Source: sbne.ws/r/68Vj

26. “If our patients
are Health 2.0
patients, then
we have to be
Health 2.0
docs.”
Dr. Gwenn Schurgrin
O’Keefe, MD, FAAP
Source: Schurgrin O’Keefe. MDNGnetguide 2009, bitstrategist.files.wordpress.com

27. We are e-Doctors
• 99% of U.S. physicians are online
• 85% of offices have broadband
• 83% consider the Internet essential to their practice
• 91% use Google for medical and pharmaceutical queries
• The web and Blackberrys are replacing textbooks, drug references and conferences.
• ….“e-Doctor”… all the “e’s” and then some (empathetic, eloquent,
encouraging,…..expert”
Source: pharma2blog.com/2008/07/03/taking-the-pulse of-the-physician

28. HITECH • $27 billion over 10 years in incentive payments
Act for supporting the adoption and use of EHRs
Security of Health IT
• December 18, 2009: $60 million available to
Patient-Centered support the development of Strategic Health IT
Cognitive Support Advanced Research Projects (SHARP).
Healthcare Application
• Feb 8, 2010: $375.2 million for 32 regional extension
and Network Platform
centers (REC).
Architecture
Secondary Use of • April 6, 2010: $267.6 million for 28 additional RECs
to complete network of 60 centers
Electronic Health
Record (EHR) Data
Source: http://healthit.hhs.gov

29. “Early Innovator” Grants
• February 16, 2011: The U.S. Department of Health & Human Services
announced the awarding of $241 million to help seven states design and
implement the IT infrastructure needed to launch state health insurance
exchanges.
• Kansas: Kansas Insurance Department, $31,537,465
• Maryland: Maryland Department of Health and Mental Hygiene, $6,227,454
• Multi-State Consortia: University of Massachusetts Medical School, $35,591,333
• New York: New York Department of Health, $27,431,432
• Oklahoma: Oklahoma Health Care Authority, $54,582,269
• Oregon: Oregon Health Authority, $48,096,307
• Wisconsin: Wisconsin Department of Health Services, $37,757,266
Source: healthcare.gov

30. Electronic
Health Primary
Physician
Record
(EHR)
Initiated and Specialist
Patient Network
maintained by an EMR
institution System
In an ideal world,
Laboratory/
Pharmacy
an national EHR= Radiology
PHR (Personal
Health Record)

31. PHR Use Motivates Consumers
• 1 in 14 uses a PHR
• 56% learned more about their health
• 32% took specific action to improve their health
• 60% of low income & 40% of chronically ill felt more connected to their
physician
• 40% asked a question they otherwise wouldn’t have
• 58% would use PHR from PMD, 50% from insurer, 25% from private
tech company
• Increased interest in PHR use if their physician uses EHR (50% vs 41%)
• 68% concerned about privacy
Source: www.chcf.org/media

32. myPHR.com
The American Health Personal Health Record:
Information initiated and maintained by
Management Association the patient
Downloadable PHR forms in
What is a PHR? English and Spanish
Why should you keep a
PHR? Authorization Forms
How to create a PHR?
Emergency PHR Forms
Choose a PHR?
Links, Tools, Resources

33. Personal Health
Records (PHR)
Google Health
Microsoft Health
Vault
My Doclopedia PHR
MediCompass
Medic Alert
Medsfile.com
WebMD
Images: microsoftfeed.com, doclopedia.com, medfiles.eu, medicalert.co.za

34. Information: resources
Health 2.0 and sharing
Medical education
Collaboration and
practice
Disease management
Research & data
sharing
Professional
Development &
Networking
Source: health20.org/wiki/ Health_2.0_Definition

35. Bookmark, Share & Save
Source: tootf.com

36. Source: geekestateblog.com

37. There are over 300 ways
to bookmark and share
information!
Source: Social Media Revolution from Socialnomics.net

38. Diigo
2collab
CiteULike
Connotea
Reddit
Technorati
Google Chrome:
AddThis
SlashDot
StumbleUpon Social Bookmarking
Digg and News Aggregates
Source: doublejdesign.co.uk

39. MEDIA & SLIDE SHARING You Tube
rrripple
Flickr
Daily Motion
Vimeo
Google Video
Yahoo Video
Slide Share
Google Docs
Scribd
280 Slides
“Try not. Do or do not. There is no try.”
-Yoda SlideRocket
Slide
Source: sethpickens.files.wordpress.com/2009/02/luke-yoda

40. YouTube: the
world’s 2 nd largest
search engine
As of October 2009, YouTube
reached one billion views per day.
Source: youtube-global.blogspot.com/2009/10/y000000000utube.html

41. EVERY minute on
YouTube….
20 hours of video are
uploaded….
Source: youtube.com/t/fact_sheet

42. RSS is “a family of web feed
formats used to publish
frequently updated works-
such as blog entries, news
headlines, audio, and video-
in a standardized format.”
RSS feeds “benefit readers
who want to subscribe to
timely updates from favored
websites or to aggregate
feeds from many sites
RSS= “Really Simple
into one place.”
Syndication”
Source: http://en.wikipedia.org/wiki/Rss

43. READER
Google
Reader
NewsGator
My Yahoo!
FeedDemon
NetNewsWire Source: rssboard.org

44. Trends, Tags, and Alerts in
Medicine
• Google Alerts (Google Scholar)
• PubMed Save Search function
• PubMed Reader
• PeRSSonalized Medicine from Webicinia.com
• BioWizard
• AllTop
• WatchThatPage
• DailyMe
• TweepBeep
Source:

45. Overheard….
“We no longer search for
news, the news finds us.”

46. Social
Networking Sites
Facebook
MySpace
Friendster
LinkedIn
Ning
Hi5
Bebo
MocoSpace
MyLife
Source: emarketer.com, June 2009

47. Facebook
• More than 550 million active users
• 50% of active users are logged on in any given day
• Fastest growing demographic is age 35 and older; second is 55-65 year olds
(Fastest growing segment is 55-65 year old females)
• Median user age: 33
• Average user has 130 friends, creates 90 pieces of content/month
• Worldwide, more than 8 billion minutes a day spent on Facebook, yielding over 60
million status updates each day
• Most popular site to share photos (comScore 2009)
• More than 100 million photos uploaded each day
• 3rd most popular site to view online video (Nielson VideoCensus, Nov 2009)
Source: www.facebook.com/press/info.php?statistics

48. FACEBOOK
Fun, casual
Meet old friends, make
new friends
Join interest groups,
communities
Learn
Share stories
Make professional
connections
It’s a party!
Source: facebook.com

49. But, not this kind of party…
Source: glamourvanity.com

50. Neonatologists on Facebook
 Public pages/groups
 Neonatology page
 Neonatology group
 Neonatology UK
 Neonatology Review
 AAP Perinatal FB Page
 Private groups
 AAP Perinatal FB Group
 AAP Perinatal Trainees FB Group

51. If Facebook was a
country….
… it would be the 3rd largest in
population.
Source: Social Media Revolution 2 from Socialnomics.net

52. Image Source: flagspot.net, cia.gov, toddpaynefortennessee.com

53. 2010

54. LinkedIn
• Global network with over 85 million experienced professional in 150
industries in over 200 countries
• Average age is 41 years
• Over 50% users have income >$100,000
• Over-representation of those who attended graduate school, compared to all
internet users
• 64% male
• 34% own a Smartphone/PDA
• 95% of companies use LinkedIn as their primary tool to find new employees
(80% of companies use social media for recruitment)
• Searchable by Google
Source: www.linkedstrategies.com/blog/tag/linkedin-statistics

55. LinkedIn: Business Lunch
• Neonatologists on
LinkedIn
– Neonatal-Perinatal
Medicine Group

56. Twitter is a service for friends, family, and co-
“Share and discover what’s happening
workers to communicate and stay connected
through the exchange of quick frequent answers right now, anywhere in the world.”
to one simple question: What are you doing?
Source: twitter.com

57. Twitter
• unique visitors increased by 1,382% in a year
– 475,000 in Feb 2008  7 million in Feb 2009
• As of Feb 2010, largest Twitter group 35-44 year olds, 64% aged 35 or older, & the median
user age: 39
• Twitter.com primarily visited from work
– 62% assess from work only
– 35% assess from home only
• As of January 2011, 175 million registered users
• 55 millions tweets a day
• 600 million search queries a day via Twitter’s search engine
• 37% of active users are mobile
Source: http://blog.nielson.com/nielsonwire/online_mobile/twitters-tweet-smell-of-success/, denverpost.com/business/

58. Tweets are short and sweet…..
Casual conversation,
like at the water cooler or
coffee house
No one stays too long or says
too much
If you don’t stop by, you’ll
miss it
Image Source: nydailynews.com

59. Tweeter Search:
official search page
Twopular
Tweet Scan
Twitterment
TwitScoop
Tweetmeme: Social
bookmarking site
Twemes: hashtags,
keywords
TweetVolume
Tweet Congress
Source: twittertweettweet.com

60. TwtSurvey
TwtPoll
Twtvite
TwtAway
TwtFAQ
TwtBizCard
TwtJobs
TwtTRIP
Image source: igorhelpsyousucceed.com

61. Does your organization/hospital have a
social media policy?
68% (17 votes) Yes, and
active social media
4% users
4%
8% (2 votes) No, and
active social media
16%
users
16% (4 votes) Working
on it, and active social
8% media users
4% (1 vote) Yes, but not
68% made it into the social
world
4% (1 vote) No, but not
make it into the social
world
Source: @reedsmith, Twtpoll Oct 2010

62. • February 2009
• Surgeons at Henry Ford
Hospital, Detroit, Michigan
for
REAL- • “To let people know that a
tumor can be removed
TIME without taking out the entire
kidney,” said Craig Rogers,
Updates MD, lead surgeon, to CNN.

63. • Tissue recruitment
• Epidemiological survey
• Disaster alerting and response
• Supportive care for patients
and family members
• Diabetes management
• Alarming silent codes (security
incidents)
• Augmenting telemedicine
• Amber alerts

64. • Healthcare professionals
• Harvard Med, Harvard
• AAP, Healthy Children,
Health, HarvardNeo
AAP News, PediaLink, AAP
• HealthSocMed
NCE
• HHS gov, AIDS gov, NIH
• AMA
Library
• MDchat
• Red Cross
• RNchat
• CDC, NIH
• NICUchat

65. • Iran Election
• Swine Flu
• Gaza
• Iran
• Tehran
Source: http://mashable.com/2009/12/15/twitter-reveals-most-discussed-topics-of-2009/

66. • Gulf Oil Spill
• Haiti Earthquake
• Pakistan Floods
• Chilean Miners Rescue
• Chavez Tas Ponchao

67. • Lady Gaga
• Justin Bieber
• Britney Spears
• Barack Obama
• Kim Kardashian
Source: www.blog.newwave.net.au/?p=76

68. Friday, April 2,2010:
Columbia University and MixedInk in New York
identified 52,000 Tweets mentioning antibiotics during a
4 ½ month period in 2009.
Approximately 700 of those tweets included incorrect
information.
Source: www.healthday.com/Article.asp?AID=637674

69. • “No one physician is as knowledgeable as physicians working
together.”
• Largest online physician community
• Over 110,000 community members
• 68 specialties, 50 states
• Free to practicing physicians
• Free of advertising
• Facebook, Twitter and monthly Sermo Blog
Source: www.sermo.com/node/11/

70. sermo: a Conference

71. Social: Physician-specific
• Sermo
• NICU-Net
• DoctorsHangout
• MD Link
• StudentDoctor.net
• Medscape Physician
• Healtheva Connect
• DoctorNetworking • eMedicine
• RelaxDoc • MedicSpeak
• SocialMD • iMedExchange:
• ClinicalVillage practicing MD only
• Ozmosis • FacebookGroups
• 99nicu.org

72. AAP in • Website
• Discussion Board
Social – YP Connection
– AAP Perinatal Trainees
Media • Twitter
– AAPperinatal
– AAP news
– NCE
– Pedialink
Section on • Facebook groups
– AAP Perinatal
– AAP Perinatal Trainees
Perinatal • Facebook pages
o AAP Perinatal
o NeoReviews
Pediatrics o AAP Pediatrics
• Blog by AAP President, Judith Palfrey
• 12/15/09 AAP SmartBrief

73. “Be who you are and say
what you feel ….....
because those who matter
don’t mind and who mind
don’t matter.”
Dr. Seuss

74. Potential Risks
• Social networking is online= Public domain, no longer
private
• Posting online is permanent; can be deleted, but may be
archived
• Professional liability risks (violations of medical code of
ethics, HIPAA, employer or medical staff policy)
Source: Armon, Keller. Who is Dr. Wiki and Why You Need to Know. Unique Opportun. 2009.

75. Minimize Risks
• Use common sense.
– “The least common thing in the world is common sense.” –
overheard from Istvan Seri
• Review the terms of service of the online communities.
• Review your professional liability policy.
• Review your employment agreement.
• Be aware that you may not remain anonymous.
• Include a disclaimer.
• Review before you post. (Think, pause, then post.)
Source: Armon, Keller. Who is Dr. Wiki and Why You Need to Know. Unique Opportun. 2009.

76. Social Do’s and Don’t
• DO:
– Identify yourself with yourself employer if appropriate, but
emphasize that you do not represent your employer’s views
– Engage in discussion with your peers and colleagues
– Think, pause, then post.
• DON’T:
– Use for personal reasons during work time)
– Post personal identifiable OR protected health information
– Use or post profane, defamatory, illegal language or material

77. 80% of SUCCESS is
showing up.
WOODY ALLEN

78. AMA Policy: Professionalism in the
Use of Social Media
• Standards of patient privacy and confidentiality
• Privacy settings
• Appropriate boundaries of patient-physician relationship
• Professional boundaries
• Ethical responsibility to report unprofessionalism
• Possibility of negative consequences

79. Ohio State
Medical
Association
Social Networking
and the Medical
Practice: Guidelines
for Physicians,
Office Staff and
Patients
“It is only a right to write.”
Source: osma.org

80. Philosophy:
Individuals have the right and responsibility to advocate for their own health,
and that is our responsibility to help them use social media tools to get the best
information, connect… and inspire….We intend to lead the health care
community… to spread knowledge and encourage collaboration… improving
healthcare everywhere.
Mission of the Center:
Lead the social media revolution in health care, contributing to health and well
being for people everywhere.
Vision for the Center:
Mayo Clinic will be the authentic voice for patients and health care
professional, building relationships through the revolutionary power of social
media.
Source: socialmedia.mayoclinic.org

81. Social Media Policies
Source: socialmediagovernance.com

82. Evolution of the Internet
Source: radarnetworks.com

83. 2011: Web 3.0??
Source: ahi.cl/blog/category/ uncategorized/2009/10/ socialmediacampaign1

84. Use web tools with
confidence to
streamline
Effective
communication
More “expert-
generated” content
alongside user
content
Ethical
considerations? Why bother???

85. “Social media is like
voting…
You may not like the system, but unless
you vote, you don’t have a right to
complain about the outcome.”

86. “If you ask
me anything
I don’t clara-song@ouhsc.edu
know…….
I’m not
going to
answer.”
- Yogi Berra