Social media & medicine 2012

Social Media & Medicine 2012 A Primer for Docs MARGARET POLANECZKY, MD Associate Professor Obstetrics & Gynecology weill.cornell.edu

Social Media & Medicine 2012• Social Media Primer• Patients & Social Media• Doctors & Social Media• Rules for Engagement• How to get started (or not) weill.cornell.edu

Social media is user generated content that is sharedover the internet via technologies that promoteengagement, sharing and collaboration.* * Definition from The Social Media Guide.com weill.cornell.edu

Percent of population 55 The 65 Internet 46 Revolution 21.9 24.9 9.6http://www.itu.int/ITU-D/ict/statistics/at_glance/keytelecom.html weill.cornell.edu

Social media is the second Internet revolution. Used w/ permissions GNU Licensehttp://en.wikiversity.org/wiki/File:Web_2.0_elements.png http://en.wikiversity.org/wiki/File:Web_1.0_elements.png weill.cornell.edu

Healthcare 1.0 weill.cornell.edu

Health Care 2.0 weill.cornell.edu

The Long Tail Healthcare 1.0 Healthcare 2.0 weill.cornell.edu

Social networking – 50% of all US adults % of internet usersPew Internet Project weill.cornell.edu

PATIENTS are using social media The search for health information online its usually triggered by health concerns of the patient or their family member.*Survey, Rich Meyer, Pharmaforum.com weill.cornell.edu

YOUR PATIENTS Are Using Social Media•Source - Pew Internet project weill.cornell.edu

60% of patients say Information found online affected a decision about how to treat an illness or conditionSource - Pew Internet Project weill.cornell.edu

E-PATIENTS engage in communities online to share their stories,disease & treatment information, referrals and supportSocial media sites have 24 TIMES the activity of healthcare sites weill.cornell.edu

E-PATIENTS crowd source weill.cornell.edu

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HOSPITALS are using Social Mediahttp://ebennett.org/hsnl/ weill.cornell.edu

Hospital-Sponsored Patient Communities weill.cornell.edu

Mayo Clinic E-Visits – 2 year pilot study• 4,282 patients registered – 2,531 online visits – Billings ($35) were made for 1,159 patients.• E-visits used primarily by women during working hours• E visits nvolved 294 different conditions. – 2% included uploaded photographs – 16% replaced telephone protocols with billable encounters.• Office visits unnecessary in 1012 cases (40%)• In 324 cases (13%), the patient was asked to schedule an appointment for a face-to-face encounter. Mayo Clin Proc. 2010 August; 85(8): 704–7. weill.cornell.edu

E-Medicine Practices Mobile patient platform Jay Parkinson, MD Video Visits, Instant message visits• Online communication - patients can upload BP, blood sugars, weight data for review online• Online appointment scheduling, refills• Patients pay an annual fee + low costs per visit• No insurance weill.cornell.edu

Online, your patients TRUST YOU the most Likely to trust online information from… Likely to share online information from…..Source: PwC Health Research Institute: Social Media “Likes” healthcare Chart pack weill.cornell.edu

Physicians & Social Media Use Blogs Source - http://www.quantiamd.comPercent weill.cornell.edu

Why Don’t Docs Engage in Social Media?Source - http://www.quantiamd.com/q-qcp/DoctorsPatientSocialMedia.pdf weill.cornell.edu

Whether you know it or not -Whether you like it or not - You are Online  Information in the public domain  Insurer’s databases  Physician review sites  Pharmacy databases  Patient websites  Social networking sites Don’t believe me? weill.cornell.edu

Will YOU engage in Social Media? YES NO• Authority • Lack of personal privacy• Influence • Liability concerns• Reputation • Patient privacy risks• Marketing of practice • No way to get paid for it• Patient education • Takes time• Share medical knowledge • Employment Insecurity• Crowd-sourcing • Being marketed to• Expressing yourself • Being asked for advice online weill.cornell.edu

SOCIAL MEDIA - GETTING STARTED weill.cornell.edu

Physician Online CommunitiesYou don’t get something for nothing •Provide Doctors with a protected community for sharing clinical information and advice •Provide Pharma an opportunity to observe and engage with physicians weill.cornell.edu

SOCIAL MEDIA – GETTING STARTED• PRACTICE WEBSITE – Professional, clean design with simple interface, Dynamic updates, RSS Feed – ? Patient portal (appointment, refill requests),? Online EMR, ? Patient community• TWITTER – Each doc has their own twitter page (? + practice twitter for larger practices) – Broadcast health news, commentary & messages – Engagement with colleagues ,Crowd sourcing medical dilemmas – Avoid direct patient interactions• LINKED IN – Professional network, useful for job networking• FACEBOOK – Keep practice page and personal pages separate• YOUTUBE – Patient education videos , medical education• BLOG – Can be part of practice website or separate weill.cornell.edu

Your patients are not your friends weill.cornell.edu

vs. IDENTITY ANONYMITY Authority  Privacy Reputation Control  Freedom Enhanced practice  Employment security Employment security  ?Increases risky online behavior Engagement weill.cornell.edu

ANONYMITY IS NOT INVISIBILTY weill.cornell.edu

WHAT ABOUT PATIENT PRIVACY? • If the information that is shared is generic enough that nobody can identify a patient in the course of reading, (Berkman, Mass Med law report, Social networking 101 for Physicians, 2009) the post is permitted and is a valuable tool for physicians to share information and skills with other physicians faster than ever before. weill.cornell.edu

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98% of US state medical boards report online violations by physiciansJAMA. 2012;307(11):1141-1142. doi:10.1001/jama.2012.330 Copyright © 2012 American Medical weill.cornell.edu Association. All rights reserved.

• Posts limited to 140 characters• Can have private account or public account• Users follow other users – Can block followers or be private and only permit certain followers. – You don’t have to follow everyone who follows you• Post tweets, comment on other’s tweets, send private messages• Hashtags (#) allow for grouping of related posts – Conferences, breaking news, topics of interest, Twitter chats• WHO TO FOLLOW? – Experts in your field – Reporters who report in your areas of interest – Medical journalists – Colleagues weill.cornell.edu

Doctors on Twitter Nature of tweets 49% Health or medical related 21% Personal 12% Self-promotional 1% Medical education 1 % Recommended medical product 2158 tweets from 260 twitter 148 Tweets (3%) were Unprofessional users with >500 33 (0.6%) Contained profanity followers 38 (0.7%) Potential patient privacy violations 14(0.3%) Contained sexually explicit material 4 (0.1%) Discriminatory statementsJAMA, February 9, 2011—Vol 305, No. 6 567 weill.cornell.edu

Twitter Smarts Twitter Not-so-Smarts (@DrWes ) @mommy_doctor )1. Follow smart people doing work that isrelevant to yours. Trash most others.2. Post relevant, valuable content ofinterest to your followers.3. Watch your time on Twitter. At most, Ispend 20 minutes a day on Twitter, and Ithink it would take me far more timeoffline to gain and share the sameinformation.4. Do not EVER post patient information– Tweets are public and searchable onGoogle. weill.cornell.edu

The Eleven Commandments of Social Media Engagement 1. Observe, Listen & Think Before Engaging What are your goals with this tweet/post/comment? Is this the best platform? 2. Add Value. Be relevant. Be Accurate. Research & attribute your sources. 3. Maintain patient privacy – Don’t post anything about a patient that he/she would recognize themselves. Go beyond HIPAA. Stay away from patient-specific dialogue. 4. Be Respectful. Keep it Civil. Keep it Clean. Dont post material that is profane, libelous, obscene, threatening, abusive, harassing, hateful, defamatory or embarrassing to anyone. 5. Abide by the law. Dont post content that violates any state or federal laws. Get permission to use or reproduce copyrighted content. 6. Be Transparent. Disclose affiliations and conflicts. Clearly identify any advertising as such. 7. Remember - What happens on the Web stays on the Web. Forever. Even if you delete it. 8. Engage with others. Social media is not a place for you to talk without listening, commenting and responding to the conversations around you. 9. Don’t give individual medical advice online 10. Patients are not your friends. Keep your individual Facebook page private. 11. Be yourself. That’s what social media is all about. Show your personality.Modified from Vanderbuilt University Med Center Social Media Toolkit weill.cornell.edu

HON Code of Conduct for Medical and Health Web Sites1. Authoritative. Indicate the qualifications of the authors. Any medical or health advice provided willonly be given by medically trained & qualified professionals unless a clear statement is made that it isfrom a non-medically qualified individual or organization.2. Complimentarity. Information should support, not replace, the doctor-patient relationship.3. Privacy. Respect the privacy and confidentiality of personal data submitted to the site by the visitor.The Web site owners undertake to honour or exceed the legal requirements of medical/healthinformation privacy that apply in the country and state where the Web site and mirror sites arelocated.4. Attribution. Cite source(s) of published information, with specific HTML links page. Clearly displaydate when a medical page was last updated.5. Justifiability. Any claims relating to the benefits/performance of a specific treatment, commercialproduct or service will be supported by appropriate, balanced evidence in the manner outlined abovein Principle 4.6. Transparency. Accessible presentation, accurate email contact.7. Financial disclosure. Clearly identify funding sources, including the identities of commercial andnon-commercial organizations that have contributed funding, services or material for the site.8. Advertising Policy. Clearly distinguish advertising from editorial content. If advertising is a source offunding it will be clearly stated. http://www.hon.ch/HONcode/Pro/Conduct.html weill.cornell.edu

Sample Website Disclaimer The opinions expressed in this blog are strictly my own, and should not be construed as the opinion or policy of my employer, XXX Medical Center. Material on this blog is provided for informational purposes only. It is general information that may not apply to you as an individual, and is not a substitute for your own doctor’s medical care or advice. Reading this blog should be construed to mean that you and I have a patient-physician relationship. Therefore, I ask that you not ask me for medical advice, either in the comments or by email. I may delete such comments and accept no responsibility to respond to unsolicited email. The inclusion of any link does not imply my endorsement of the linked site or its affiliates, or any information, content, products, services, advertising or other materials presented on or through such web sites. I am not responsible for the availability, accuracy, or any information, content, products or services accessible from such sites. NEVER DISREGARD MEDICAL ADVICE OR DELAY SEEKING MEDICAL CARE BECAUSE OF SOMETHING YOU HAVE READ ON OR ACCESSED THROUGH THIS WEB SITE. weill.cornell.edu

SOCIAL MEDIA RESOURCES• Ten Best Practices for Social Media http://asne.org/portals/0/publications/public/10_best_practices_for_social_media.pdf• Social Networking 101 for Physicians - http://www.massmed.org/Content/NavigationMenu2/ContinuingEducationEvents/New Courses/SocialNetworking101forPhysicians/Social_Networking_.htm• Healthcare Blogger Code of Ethics - http://medbloggercode.com• The Social MEDia Course - http://med20course.wordpress.com• Mayo Clinic Center for Social Media - http://socialmedia.mayoclinic.org• A twitter primer for physicians : http://www.kevinmd.com/blog/2012/06/started-twitter- primer-doctors.html• Community Sites for Scientists & Physicians - http://scienceroll.com/2008/05/24/community-sites-for-scientists-and-physicians-the- list/• Doctors on Twiitter - http://www.TwitterDoctors.net• European Docs on Twitter https://docs.google.com/spreadsheet/ccc?key=0Av- UbEbXL7m7dDhQQkdKUHJkcW5aLVFyWjRTUXNLRFE#gid=0• Dr Polaneczky’s Blogroll - http://www.tbtam.com/blogroll• 5 Best Blogging Platforms - http://lifehacker.com/5568092/five-best-blogging-platform• iMedical Apps – http://www.imedicalapps.com/s• Medgadget – http://medgadget.com weill.cornell.edu

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Social media & medicine 2012

by mpolanec on Jul 14, 2012

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