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Social Media and HealthcareReady or Not Here it ComesJoel Topf, MDAssistant Clinical Professor Oakland UniversityWilliam B...
Social Media and HealthcareReady or Not Here it ComesJoel Topf, MDAssistant Clinical Professor Oakland UniversityWilliam B...
Social media are web and mobile  based technologies which supportuser generated content, engagement, and collaboration amo...
Web 1.0          4
Web 1.0a few content creators       a whole bunch of consumers                                                          4
Web 1.0a few content creators       a whole bunch of consumers                                                          4
Web 1.0a few content creators       a whole bunch of consumers                                                          4
Web 1.0a few content creators       a whole bunch of consumers                                                          5
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Web 1.0a few content creators       a whole bunch of consumers                                                          7
Web 1.0a few content creators       a whole bunch of consumers                                                          7
Web 1.0a few content creators       a whole bunch of consumers     Getting everyone online                                ...
Web 2.0          8
Web 2.0a few professional      Consumers that comment, edit, tag, share, content creators           retweet, forward and l...
Web 2.0a few professional      Consumers that comment, edit, tag, share, content creators           retweet, forward and l...
Web 2.0a few professional      Consumers that comment, edit, tag, share, content creators           retweet, forward and l...
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nth                      1 ed its/mo h          itors with > edits/mont~6, 000 ed rs with > 5         dito~ 2,000 e       ...
nth                      1 ed its/mo h          itors with > edits/mont~6, 000 ed rs with > 5         dito~ 2,000 e       ...
nth                      1 ed its/mo h          itors with > edits/mont~6, 000 ed rs with > 5         dito~ 2,000 e       ...
How does Web 2.0 change healthcare                                     10
February 11, 2011: FDA approves Makena by KVPharmaceuticalMakena is 17-hydroxyprogesteronecaproate (17OHPC) for the preven...
Generic colchicine to FDA approved Colcrys                                             12
17-OHPC had been used off-label for   years at roughly $15 per dose.                                     13
KV Pharmaceutical chose to  charge $1,500 per dose                             13
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Why a Facebook page? Letsharness the power of socialmedia. Maybe if we standtogether and make astatement that this self-se...
Why a Facebook page? Letsharness the power of socialmedia. Maybe if we standtogether and make astatement that this self-se...
Why a Facebook page? Letsharness the power of socialmedia. Maybe if we standtogether and make astatement that this self-se...
Why a Facebook page? Lets    harness the power of social    media. Maybe if we stand    together and make a    statement t...
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FDA ApprovalFeb               16
Feb Mar          16
March of Dimes withdraws supportFeb Mar                                       16
FDA states no regulatory action for        compoundingFeb Mar Apr                                              16
Price reduced $690/doseFeb Mar Apr May                                     16
Price reduced $690/doseFeb Mar Apr May Jun Jul Aug Sep                                     16
Stock at $0.86 from $12                   at the time of approvalFeb Mar Apr May Jun Jul Aug Sep Oct                      ...
KV Pharma sued by investorsFeb Mar Apr May Jun Jul Aug Sep Oct Nov                                          16
KV Pharma sued by investors   Feb Mar Apr May Jun Jul Aug Sep Oct Nov DecJan Feb Mar Apr May Jun Jul                      ...
KV Pharma seeks                       bankruptcy protection   Feb Mar Apr May Jun Jul Aug Sep Oct Nov DecJan Feb Mar Apr M...
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http://www.webicina.com/blog/?postID=243                                           18
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Users (millions)                  0                      200                            400                               ...
Patient friend requestsPatient privacyPatient community                          22
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I log on to Facebook and find the friend request...                                                     23
I log on to Facebook and find the friend request...             ...from one of my patients.                                ...
Has this ever happened to you?                                 23
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c. If they interact with patients on the Internet,   physicians must maintain appropriate boundaries of   the patient-phys...
What do you do?                  25
What do you do?                  25
The rejection seems likea perfect solution untilthat awkward momentwhen the patient comesin for his next visit.           ...
Prior to rejecting the request use Facebook to sendthe patient a messageSorry Mr. Peterson, I reserve my Facebook for pers...
Instead of reject, redirectPrior to rejecting the request use Facebook to sendthe patient a messageSorry Mr. Peterson, I r...
Patient friend requestsPatient privacyPatient community                          28
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Nursing assistant Nai Mai Chao spent eight daysin jail, was banned from Facebook and othersocial networks, lost her job an...
Nursing assistant Nai Mai Chao spent eight daysin jail, was banned from Facebook and othersocial networks, lost her job an...
Nursing assistant Nai Mai Chao spent eight daysin jail, was banned from Facebook and othersocial networks, lost her job an...
Nursing assistant Nai Mai Chao spent eight daysin jail, was banned from Facebook and othersocial networks, lost her job an...
Alexandra Thran, hospital employedemergency doctor in Rhode Island,inadvertently violated confidentiality by revealingdetai...
Alexandra Thran, hospital employedemergency doctor in Rhode Island,inadvertently violated confidentiality by revealingdetai...
Alexandra Thran, hospital employedemergency doctor in Rhode Island,inadvertently violated confidentiality by revealingdetai...
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Patient friend requestsPatient privacyPatient community                          32
Gitelman’s syndrome• Hypokalemia• Hypomagnesemia• Metabolic alkalosis• Normal to low blood pressure• Intense salt cravings...
Gitelman’s syndrome• Hypokalemia• Hypomagnesemia• Metabolic alkalosis• Normal to low blood pressure• Intense salt cravings...
34
"I havent seen this before, but I have read about it."                                                          34
"The last time I saw this was during my fellowship"                                                      34
35
Should I get a port-a-cath? Should I get a picc line?                                                        35
Should I get a port-a-cath? Should I get a picc line?                                                        35
Should I get a port-a-cath? Should I get a picc line?       The pharmacy changed forms of       potassium. How can I get t...
Should I get a port-a-cath? Should I get a picc line?       The pharmacy changed forms of       potassium. How can I get t...
Should I get a port-a-cath? Should I get a picc line?       The pharmacy changed forms of       potassium. How can I get t...
Should I get a port-a-cath? Should I get a picc line?       The pharmacy changed forms of       potassium. How can I get t...
36
174 members              36
37
...helped me realize I wasn’t crazy and was not a      hypochondriac or just a drama queen.                               ...
...helped me feel part of the human race again.                                                  39
So having people here who understand and relate  has really allowed me to believe I can do this.                          ...
Citing many cases in the US finally helped mepersuade clinicians in the UK to allow me to try  this which has transformed m...
...you don’t have to explain yourself or try to make people understand because they already “get it.”                     ...
174 members              43
174 members              43
174 members              43
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Patient friend requestsPatient privacyPatient community                          45
...the other blue social network                                   46
few words, incalculable value                                46
Twitter is the second largestsocial network after Facebookthis is not a Coke vs Pepsi pairing,they are different animals   ...
Twitter is the second largestsocial network after Facebookthis is not a Coke vs Pepsi pairing,they are different animals   ...
Twitter is not Facebook• Facebook, friends are a mutual decision   • everyone you are friends with is simultaneously your ...
Twitter is not Facebook• Facebook, friends are a mutual decisionFacebook allows you to connect withpeople you already simu...
Twitter is not Facebook• Facebook, friends are a mutual decisionFacebook allows you tolie to people you                   ...
Best tutorial on how twitter works:http://www.momthisishowtwitterworks.com                                          49
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Three fundamental things to know about Twitter• Who to follow• What to do• What to say                                    ...
who to follow• be vicious with your follow list   • people who tweet their lunch   • people who suggest “earn great income...
ot   n followwho to• be vicious with your follow list   • people who tweet their lunch   • people who suggest “earn great ...
ot   n followwho to• be vicious with your follow list   • people who tweet their lunch   • people who suggest “earn great ...
who to follow: https://twitter.com/MGKatz036      Pt: "Im just here for a second opinion...           Already got my first ...
who to follow: https://twitter.com/precordialthump    4 medication classes linked to 67% of drug-    related hospitalizati...
who to follow: https://twitter.com/drves        What do people die of? Mortality rates         and data for every cause of...
who to follow: https://twitter.com/MedPedsDoctor        The biggest challenge in MedEd is to         demonstrate improved ...
who to follow: https://twitter.com/daniellenjones         If you havent found a Twitter friend/        colleague you want ...
who to follow: https://twitter.com/medicalaxioms       The job of the ER physician admitting a        medicine patient is ...
who to follow: https://twitter.com/zdoggmd        I shocked the sheriff...but they claim it            was asystole. #Medi...
http://zdoggmd.com/zdogg/http://www.youtube.com/watch?v=WNfFQI18ABI&feature=player_embedded                               ...
who to follow: https://twitter.com/Skepticscalpel       Correlation & causation went into a bar         The bartender asks...
The anonymous tweeterPhysicians who write anonymously online say it affordsthem the opportunity to vent their frustrations...
The anonymous tweeter"Doctors do need to vent," said Dr. Vartabedian, whoblogs and tweets under his own name. "I limit tha...
The mask will come off  and sometimes, not atthe time of your choosing                            63
Robert P. Lindeman, an Ivy League-educatedpediatrician sat on the stand in SuffolkSuperior Court, defending himself in ama...
Flea, was the screen name for a blogger whohad written about a trial remarkably similar tothe one happening at Suffolk Sup...
Lindeman admitted that hewas, in fact, Flea.The next morning, he settledfor what is described as asubstantial settlement. ...
•Tweet under your own name.•It will remind you that you arent scrawling graffiti behind the high school.•Sign your name and ...
Three fundamental things to know about Twitter• Who to follow• What to do• What to say                                    ...
What to do: Spread your own wisdom                                     69
What to do: Spread your own wisdom                                     69
What to do: Spread your own wisdom                                     69
What to do: Spread your own wisdom                                     69
What to do: Spread your own wisdom                                     69
What to do: Spread your own wisdom                                     69
What to do: Spread your own wisdom                                     69
What to do: Spread your own wisdom                                     69
What to do: Anatomy of a tweet                                 70
What to do: Anatomy of a tweet            Author: Deb            Screen name: @pingDeb            Picture                 ...
What to do: Anatomy of a tweet            Tweet text                                 70
What to do: Anatomy of a tweet            Hash Tag                                 70
What to do: Anatomy of a tweet            Retweeter                                 70
What to do: Anatomy of a tweet            Expand                                 71
What to do: Anatomy of a tweet            Expand                                 71
What to do: Anatomy of a tweet            Expand                                 Replies                                  ...
What to do: Anatomy of a tweet            Expand               your reply                                 Replies         ...
What to do: Anatomy of a tweet                                 72
What to do: Anatomy of a tweet            Reply: real interaction                                      72
What to do: Anatomy of a tweet            Reply: real interaction            Retweet: amplification                        ...
What to do: Anatomy of a tweet            Reply: real interaction            Retweet: amplification            Favorite: ho...
Reply: real interactionRetweet: amplificationFavorite: honor and collect                              73
Reply: real interaction Retweet: amplification Favorite: honor and collectAll of these are public                          ...
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The blood of Jesusagainst Obama history made 4 Nov 2008 aTaliban Muslim illegally   elected president     USA:Hussein.    ...
Three fundamental things to know about Twitter• Who to follow• What to do : Twitter Chats• What to say                    ...
Twitter Chats• Twitter Journal Club• MedEd Chat• HealthCare Social Media Chat• Symplur keeps a database of regular healthc...
#MedEd TweetChat Nov. 15: Academic Integrity• 3 questions for discussion  • Topic 1: How comfortable would you be with rep...
#MedEd TweetChat Nov. 15: Academic Integrity• 30 participants• 274 Tweets                                               78
suggest topics by DM or email #meded                                     Thu Nov 15 19:07:56 PST 2012                    m...
#KidneyWk12 The American Society of NephrologyAnnual Meeting                                                 79
#KidneyWk12 The American Society of NephrologyAnnual Meeting• 281 participants• 1,362 Tweets                              ...
#KidneyWk12 The American Society of NephrologyAnnual Meeting• 281 participants• 1,362 Tweets                              ...
ArborResHealth   Dr. Ramirez rcved a distinguished faculty invit to present Disease Management in                         ...
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TweetChat.com for chats or follow HashTags                                             81
TweetChat.com for chats or follow HashTags                                             81
TweetChat.com for chats or follow HashTags                                             81
Three fundamental things to know about Twitter• Who to follow• What to do• What to say                                    ...
•Find your own voice.•Everything you say is written in pen.•Staying quiet and watching is a good way to get started.•Find ...
Mayo Clinic has a twelve word social media policy:    Don’t Lie, Don’t Pry,  Don’t Cheat, Can’t Delete,   Don’t Steal, Don...
523 physicians found                                                                                        209 with < 500...
523 physicians found                                                                                        209 with < 500...
523 physicians found                                                                                        209 with < 500...
523 physicians found                                                                                        209 with < 500...
523 physicians found                                                                                        209 with < 500...
5,156 tweetsanalyzed and categorized   each circle represents 4 tweets                                     86
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144 of 5156 tweets wereconsidered unprofessional                            86
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38 potential privacy violations                                  87
38 potential privacy violations33 profanity                                  87
38 potential privacy violations33 profanity14 sexually explicit                                  87
38 potential privacy violations33 profanity14 sexually explicit4 discriminatory                                  87
38 potential privacy violations33 profanity14 sexually explicit4 discriminatory55 other unprofessional                    ...
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Ethical breaches and unprofessional contentwere rare but observed. Particularly concerningwas the presence of potential pa...
Ethical breaches and unprofessional contentwere rare but observed. Particularly concerningwas the presence of potential pa...
Ethical breaches and unprofessional contentwere rare but observed. Particularly concerningwas the presence of potential pa...
Representative?http://www.beevolve.com/twitter-statistics/#b1                                                 89
Representative?http://www.beevolve.com/twitter-statistics/#b1                                                 89
Representative?                                                 Average user has 208 followers                            ...
Representative?                                                 Average user has 208 followers                            ...
Representative? Nope.                                                 Average user has 208 followers                      ...
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Either you define yourselfonline, or someone willdefine you                            91
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b. Thus, physicians should routinely monitor their own   Internet presence to ensure that the personal and   professional ...
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Doctor        1   2   3   4   5   6   7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan   Dr. Topf                          ...
Doctor        1   2   3   4   5   6   7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan   Dr. Topf                          ...
Doctor        1   2   3   4   5   6   7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan   Dr. Topf                          ...
Doctor        1   2   3   4   5   6   7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan   Dr. Topf                          ...
Doctor        1   2   3   4   5   6   7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan   Dr. Topf                          ...
Doctor        1   2   3   4   5   6   7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan   Dr. Topf                          ...
Doctor        1   2   3   4   5   6   7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan   Dr. Topf                          ...
Doctor        1   2   3   4   5   6   7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan   Dr. Topf                          ...
Doctor        1   2   3   4   5   6   7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan   Dr. Topf                          ...
Doctor        1   2   3   4   5   6   7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan   Dr. Topf                          ...
Doctor        1   2   3   4   5   6   7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan   Dr. Topf                          ...
Implications of a lack of social media presence                                                  95
Following a bad experience people want tocomplain, share and be made whole.If you have a venue for this they can direct it...
Following a bad experience people want tocomplain, share and be made whole.If you have a venue for this they can direct it...
• Maritz Research surveyed an online panel of 1,298 US Consumers  • Twitter users who frequently tweet  • Have used Twitte...
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How satisfied were you with the company’s response?        Very Satisfied                                34.7%  Somewhat sa...
How satisfied were you with the company’s response?        Very Satisfied                                       34.7%  Some...
Summary• With everybody connected, social media is an unprecedented revolution in  communication• Numerous platforms but t...
Summary: Facebook• When patient friend requests you, redirect, don’t just  reject• Privacy  • Facebook is the new elevator...
Summary: Twitter• Asymmetric. People you follow may not be following  you. Vice-versa• http://www.MomThisIsHowTwitterworks...
Summary: Why• Define yourself or else• Provide a place for complaints                                   102
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Social Media in Health Care

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A presentation on some of the issues that are born from the intersection of healthcare and social media.

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Social Media in Health Care

  1. 1. 1
  2. 2. Social Media and HealthcareReady or Not Here it ComesJoel Topf, MDAssistant Clinical Professor Oakland UniversityWilliam Beaumont School of Medicine 2
  3. 3. Social Media and HealthcareReady or Not Here it ComesJoel Topf, MDAssistant Clinical Professor Oakland UniversityWilliam Beaumont School of MedicinePBFluids.com@kidney_boyhttps://www.facebook.com/StClairSpecialty http://bit.ly/SJHMCsmhc #SJHMCsmhc 2
  4. 4. Social media are web and mobile based technologies which supportuser generated content, engagement, and collaboration among individuals, companies and organizations. http://en.wikipedia.org/wiki/Social_media 3
  5. 5. Web 1.0 4
  6. 6. Web 1.0a few content creators a whole bunch of consumers 4
  7. 7. Web 1.0a few content creators a whole bunch of consumers 4
  8. 8. Web 1.0a few content creators a whole bunch of consumers 4
  9. 9. Web 1.0a few content creators a whole bunch of consumers 5
  10. 10. 6
  11. 11. 6
  12. 12. Web 1.0a few content creators a whole bunch of consumers 7
  13. 13. Web 1.0a few content creators a whole bunch of consumers 7
  14. 14. Web 1.0a few content creators a whole bunch of consumers Getting everyone online 7
  15. 15. Web 2.0 8
  16. 16. Web 2.0a few professional Consumers that comment, edit, tag, share, content creators retweet, forward and like content. 8
  17. 17. Web 2.0a few professional Consumers that comment, edit, tag, share, content creators retweet, forward and like content. 8
  18. 18. Web 2.0a few professional Consumers that comment, edit, tag, share, content creators retweet, forward and like content. 8
  19. 19. 9
  20. 20. nth 1 ed its/mo h itors with > edits/mont~6, 000 ed rs with > 5 dito~ 2,000 e 9
  21. 21. nth 1 ed its/mo h itors with > edits/mont~6, 000 ed rs with > 5 dito~ 2,000 e 9
  22. 22. nth 1 ed its/mo h itors with > edits/mont~6, 000 ed rs with > 5 dito~ 2,000 e 9
  23. 23. How does Web 2.0 change healthcare 10
  24. 24. February 11, 2011: FDA approves Makena by KVPharmaceuticalMakena is 17-hydroxyprogesteronecaproate (17OHPC) for the preventionof premature birth in women with asingle fetus of less than 37 weeksgestation who had at least one previouspreterm birth. 11
  25. 25. Generic colchicine to FDA approved Colcrys 12
  26. 26. 17-OHPC had been used off-label for years at roughly $15 per dose. 13
  27. 27. KV Pharmaceutical chose to charge $1,500 per dose 13
  28. 28. 14
  29. 29. 14
  30. 30. 15
  31. 31. Why a Facebook page? Letsharness the power of socialmedia. Maybe if we standtogether and make astatement that this self-servinggreed is exploiting families intheir darkest moments,perhaps someone will notice.Perhaps someone will care. Christine Hess OConnell 15
  32. 32. Why a Facebook page? Letsharness the power of socialmedia. Maybe if we standtogether and make astatement that this self-servinggreed is exploiting families intheir darkest moments,perhaps someone will notice.Perhaps someone will care. Christine Hess OConnell 15
  33. 33. Why a Facebook page? Letsharness the power of socialmedia. Maybe if we standtogether and make astatement that this self-servinggreed is exploiting families intheir darkest moments,perhaps someone will notice.Perhaps someone will care. Christine Hess OConnell 15
  34. 34. Why a Facebook page? Lets harness the power of social media. Maybe if we stand together and make a statement that this self-serving greed is exploiting families in their darkest moments, perhaps someone will notice. Perhaps someone will care. Christine Hess OConnellfounder of Shame on you KV Pharmaceutical and CEO Gregg Divis 15
  35. 35. 16
  36. 36. FDA ApprovalFeb 16
  37. 37. Feb Mar 16
  38. 38. March of Dimes withdraws supportFeb Mar 16
  39. 39. FDA states no regulatory action for compoundingFeb Mar Apr 16
  40. 40. Price reduced $690/doseFeb Mar Apr May 16
  41. 41. Price reduced $690/doseFeb Mar Apr May Jun Jul Aug Sep 16
  42. 42. Stock at $0.86 from $12 at the time of approvalFeb Mar Apr May Jun Jul Aug Sep Oct 16
  43. 43. KV Pharma sued by investorsFeb Mar Apr May Jun Jul Aug Sep Oct Nov 16
  44. 44. KV Pharma sued by investors Feb Mar Apr May Jun Jul Aug Sep Oct Nov DecJan Feb Mar Apr May Jun Jul 16
  45. 45. KV Pharma seeks bankruptcy protection Feb Mar Apr May Jun Jul Aug Sep Oct Nov DecJan Feb Mar Apr May Jun Jul Aug 16
  46. 46. 17
  47. 47. http://www.webicina.com/blog/?postID=243 18
  48. 48. 19
  49. 49. 20
  50. 50. Users (millions) 0 200 400 600 800 1,000 12 /2 004 4/ 20 0 7 1/ 20 0 9 9/ 20 0 9 Facebook Users 12 /2 010 3/ 20 1 221
  51. 51. Patient friend requestsPatient privacyPatient community 22
  52. 52. 23
  53. 53. I log on to Facebook and find the friend request... 23
  54. 54. I log on to Facebook and find the friend request... ...from one of my patients. 23
  55. 55. Has this ever happened to you? 23
  56. 56. 24
  57. 57. c. If they interact with patients on the Internet, physicians must maintain appropriate boundaries of the patient-physician relationship in accordance with professional ethical guidelines just, as they would in any other context.d. To maintain appropriate professional boundaries physicians should consider separating personal and professional content online. 24
  58. 58. What do you do? 25
  59. 59. What do you do? 25
  60. 60. The rejection seems likea perfect solution untilthat awkward momentwhen the patient comesin for his next visit. 26
  61. 61. Prior to rejecting the request use Facebook to sendthe patient a messageSorry Mr. Peterson, I reserve my Facebook for personalfriends and do not "friend" any patients or co-workers. Ido have a number of social media personas thatwelcome patients. You can find and interact with me at: @kidney_boy on twitter http://pbfluids.com on blogger http://facebook.com/scsp on facebook 27
  62. 62. Instead of reject, redirectPrior to rejecting the request use Facebook to sendthe patient a messageSorry Mr. Peterson, I reserve my Facebook for personalfriends and do not "friend" any patients or co-workers. Ido have a number of social media personas thatwelcome patients. You can find and interact with me at: @kidney_boy on twitter http://pbfluids.com on blogger http://facebook.com/scsp on facebook 27
  63. 63. Patient friend requestsPatient privacyPatient community 28
  64. 64. 29
  65. 65. Nursing assistant Nai Mai Chao spent eight daysin jail, was banned from Facebook and othersocial networks, lost her job and nursing license. 29
  66. 66. Nursing assistant Nai Mai Chao spent eight daysin jail, was banned from Facebook and othersocial networks, lost her job and nursing license. 29
  67. 67. Nursing assistant Nai Mai Chao spent eight daysin jail, was banned from Facebook and othersocial networks, lost her job and nursing license. 29
  68. 68. Nursing assistant Nai Mai Chao spent eight daysin jail, was banned from Facebook and othersocial networks, lost her job and nursing license.posting a photo of a dying patients buttocks 29
  69. 69. Alexandra Thran, hospital employedemergency doctor in Rhode Island,inadvertently violated confidentiality by revealingdetails of an injury that could reveal personallyidentifiable information on Facebook. 30
  70. 70. Alexandra Thran, hospital employedemergency doctor in Rhode Island,inadvertently violated confidentiality by revealingdetails of an injury that could reveal personallyidentifiable information on Facebook. She neverrevealed the patient’s name. 30
  71. 71. Alexandra Thran, hospital employedemergency doctor in Rhode Island,inadvertently violated confidentiality by revealingdetails of an injury that could reveal personallyidentifiable information on Facebook. She never Firedrevealed the patient’s name. Fined $500 Sent for re-education 30
  72. 72. 31
  73. 73. 31
  74. 74. Patient friend requestsPatient privacyPatient community 32
  75. 75. Gitelman’s syndrome• Hypokalemia• Hypomagnesemia• Metabolic alkalosis• Normal to low blood pressure• Intense salt cravings 33
  76. 76. Gitelman’s syndrome• Hypokalemia• Hypomagnesemia• Metabolic alkalosis• Normal to low blood pressure• Intense salt cravings Incidence is 1 in 40,000, most are undiagnosed 33
  77. 77. 34
  78. 78. "I havent seen this before, but I have read about it." 34
  79. 79. "The last time I saw this was during my fellowship" 34
  80. 80. 35
  81. 81. Should I get a port-a-cath? Should I get a picc line? 35
  82. 82. Should I get a port-a-cath? Should I get a picc line? 35
  83. 83. Should I get a port-a-cath? Should I get a picc line? The pharmacy changed forms of potassium. How can I get the old one? 35
  84. 84. Should I get a port-a-cath? Should I get a picc line? The pharmacy changed forms of potassium. How can I get the old one? Is liquid potassium better than pills? 35
  85. 85. Should I get a port-a-cath? Should I get a picc line? The pharmacy changed forms of potassium. How can I get the old one? Is liquid potassium better than pills? I get more muscle pain after IV potassium. Is that normal? 35
  86. 86. Should I get a port-a-cath? Should I get a picc line? The pharmacy changed forms of potassium. How can I get the old one? Is liquid potassium better than pills? I get more muscle pain after IV potassium. Is that normal? Is magnesium taurate okay? 35
  87. 87. 36
  88. 88. 174 members 36
  89. 89. 37
  90. 90. ...helped me realize I wasn’t crazy and was not a hypochondriac or just a drama queen. 38
  91. 91. ...helped me feel part of the human race again. 39
  92. 92. So having people here who understand and relate has really allowed me to believe I can do this. 40
  93. 93. Citing many cases in the US finally helped mepersuade clinicians in the UK to allow me to try this which has transformed my symptoms. 41
  94. 94. ...you don’t have to explain yourself or try to make people understand because they already “get it.” 42
  95. 95. 174 members 43
  96. 96. 174 members 43
  97. 97. 174 members 43
  98. 98. 44
  99. 99. 44
  100. 100. Patient friend requestsPatient privacyPatient community 45
  101. 101. ...the other blue social network 46
  102. 102. few words, incalculable value 46
  103. 103. Twitter is the second largestsocial network after Facebookthis is not a Coke vs Pepsi pairing,they are different animals 47
  104. 104. Twitter is the second largestsocial network after Facebookthis is not a Coke vs Pepsi pairing,they are different animals 47
  105. 105. Twitter is not Facebook• Facebook, friends are a mutual decision • everyone you are friends with is simultaneously your friend• Twitter is asymmetric • People you follow, do not necessarily follow you back 48
  106. 106. Twitter is not Facebook• Facebook, friends are a mutual decisionFacebook allows you to connect withpeople you already simultaneously your friend • everyone you are friends with is know.Twitter allows you to meet people you • Twitter is asymmetricwant to know.not • People you follow, do necessarily follow you back 48
  107. 107. Twitter is not Facebook• Facebook, friends are a mutual decisionFacebook allows you tolie to people you is where you connect withknow. you are friends with is know.people you already simultaneously your friend • everyoneTwitter allows you to meet people you is where youre honest with • Twitter is asymmetricstrangers. dowant to know.not • People you follow, necessarily follow you back 48
  108. 108. Best tutorial on how twitter works:http://www.momthisishowtwitterworks.com 49
  109. 109. 50
  110. 110. Three fundamental things to know about Twitter• Who to follow• What to do• What to say 51
  111. 111. who to follow• be vicious with your follow list • people who tweet their lunch • people who suggest “earn great income, work at home” • Anything by Zoey Deschanel 52
  112. 112. ot n followwho to• be vicious with your follow list • people who tweet their lunch • people who suggest “earn great income, work at home” • Anything by Zoey Deschanel 52
  113. 113. ot n followwho to• be vicious with your follow list • people who tweet their lunch • people who suggest “earn great income, work at home” • Anything by Zoey Deschanel 52
  114. 114. who to follow: https://twitter.com/MGKatz036 Pt: "Im just here for a second opinion... Already got my first one online." 53
  115. 115. who to follow: https://twitter.com/precordialthump 4 medication classes linked to 67% of drug- related hospitalizations http://t.co/ZR9CUszI Get these right: sugars and bleeding 54
  116. 116. who to follow: https://twitter.com/drves What do people die of? Mortality rates and data for every cause of death in 2011 visualized http:// bit.ly/RDXkVz 55
  117. 117. who to follow: https://twitter.com/MedPedsDoctor The biggest challenge in MedEd is to demonstrate improved pt outcomes from any education intervention, not just learner satisfaction 56
  118. 118. who to follow: https://twitter.com/daniellenjones If you havent found a Twitter friend/ colleague you want to chat with over coffee, youre advertising too much & interacting too little. 57
  119. 119. who to follow: https://twitter.com/medicalaxioms The job of the ER physician admitting a medicine patient is to tell you why the patient cant go home, not to tell you the diagnosis. 58
  120. 120. who to follow: https://twitter.com/zdoggmd I shocked the sheriff...but they claim it was asystole. #MedicalMarley 59
  121. 121. http://zdoggmd.com/zdogg/http://www.youtube.com/watch?v=WNfFQI18ABI&feature=player_embedded 60
  122. 122. who to follow: https://twitter.com/Skepticscalpel Correlation & causation went into a bar The bartender asks "Are you two related?" Correlation answers "Hey, what are you implying?" 61
  123. 123. The anonymous tweeterPhysicians who write anonymously online say it affordsthem the opportunity to vent their frustrations withpatients, colleagues, administrators and health plans withless fear of crossing legal and ethical lines. Kevin O’Reilly reporting for AMA News 62
  124. 124. The anonymous tweeter"Doctors do need to vent," said Dr. Vartabedian, whoblogs and tweets under his own name. "I limit that ventingof frustration to my immediate working staff and to myimmediate colleagues. I dont feel its appropriate for meto relate my frustrations with patients in a public placewhere everybody can see them." Dr. Vartabedian, @Doctor_V 62
  125. 125. The mask will come off and sometimes, not atthe time of your choosing 63
  126. 126. Robert P. Lindeman, an Ivy League-educatedpediatrician sat on the stand in SuffolkSuperior Court, defending himself in amalpractice suit involving the death of a 12-year-old patient.The opposing counsel startled him with aquestion. “Are you Flea?” 64
  127. 127. Flea, was the screen name for a blogger whohad written about a trial remarkably similar tothe one happening at Suffolk Superior Court.Flea had ridiculed the plaintiffs case and theplaintiffs lawyer.He had revealed the defense strategy.He had accused members of the jury of dozing. 65
  128. 128. Lindeman admitted that hewas, in fact, Flea.The next morning, he settledfor what is described as asubstantial settlement. 66
  129. 129. •Tweet under your own name.•It will remind you that you arent scrawling graffiti behind the high school.•Sign your name and you will be more careful with what you say.•You never are as anonymous as you think you are. 67
  130. 130. Three fundamental things to know about Twitter• Who to follow• What to do• What to say 68
  131. 131. What to do: Spread your own wisdom 69
  132. 132. What to do: Spread your own wisdom 69
  133. 133. What to do: Spread your own wisdom 69
  134. 134. What to do: Spread your own wisdom 69
  135. 135. What to do: Spread your own wisdom 69
  136. 136. What to do: Spread your own wisdom 69
  137. 137. What to do: Spread your own wisdom 69
  138. 138. What to do: Spread your own wisdom 69
  139. 139. What to do: Anatomy of a tweet 70
  140. 140. What to do: Anatomy of a tweet Author: Deb Screen name: @pingDeb Picture 70
  141. 141. What to do: Anatomy of a tweet Tweet text 70
  142. 142. What to do: Anatomy of a tweet Hash Tag 70
  143. 143. What to do: Anatomy of a tweet Retweeter 70
  144. 144. What to do: Anatomy of a tweet Expand 71
  145. 145. What to do: Anatomy of a tweet Expand 71
  146. 146. What to do: Anatomy of a tweet Expand Replies 71
  147. 147. What to do: Anatomy of a tweet Expand your reply Replies 71
  148. 148. What to do: Anatomy of a tweet 72
  149. 149. What to do: Anatomy of a tweet Reply: real interaction 72
  150. 150. What to do: Anatomy of a tweet Reply: real interaction Retweet: amplification 72
  151. 151. What to do: Anatomy of a tweet Reply: real interaction Retweet: amplification Favorite: honor and collect 72
  152. 152. Reply: real interactionRetweet: amplificationFavorite: honor and collect 73
  153. 153. Reply: real interaction Retweet: amplification Favorite: honor and collectAll of these are public 73
  154. 154. 74
  155. 155. The blood of Jesusagainst Obama history made 4 Nov 2008 aTaliban Muslim illegally elected president USA:Hussein. 74
  156. 156. Three fundamental things to know about Twitter• Who to follow• What to do : Twitter Chats• What to say 75
  157. 157. Twitter Chats• Twitter Journal Club• MedEd Chat• HealthCare Social Media Chat• Symplur keeps a database of regular healthcare twitter chats at: • http://www.symplur.com/healthcare-hashtags/tweet-chats/ 76
  158. 158. #MedEd TweetChat Nov. 15: Academic Integrity• 3 questions for discussion • Topic 1: How comfortable would you be with reporting someone for academic dishonesty? What if it were a close colleague? • Topic 2: What are the gray areas of academic dishonesty? What about overlooking a "minor" or 1st time occurrence? • Topic 3: How comfortable would you feel working with someone who had cheated in medical school? Should academic dishonesty be a career ender? 77
  159. 159. #MedEd TweetChat Nov. 15: Academic Integrity• 30 participants• 274 Tweets 78
  160. 160. suggest topics by DM or email #meded Thu Nov 15 19:07:56 PST 2012 mumbaiprepared RT @jvrbntz: Amen!!! RT @EMIMDoc: #meded For trainees to respect the system, the system must respect the trainees. Thu Nov 15 19:13:20 PST 2012#MedEd TweetChat Nov. 15: Academic Integrity• 30 participants• 274 Tweets 78
  161. 161. #KidneyWk12 The American Society of NephrologyAnnual Meeting 79
  162. 162. #KidneyWk12 The American Society of NephrologyAnnual Meeting• 281 participants• 1,362 Tweets 79
  163. 163. #KidneyWk12 The American Society of NephrologyAnnual Meeting• 281 participants• 1,362 Tweets 79
  164. 164. ArborResHealth Dr. Ramirez rcved a distinguished faculty invit to present Disease Management in #ESRD Pts at 6 pm, Rm 5 #kidneywk12 http://t.co/98a7gdkl Thu Nov 1 13:31:36 PDT 2012#KidneyWk12 The American Society of NephrologyAnnual Meeting• 281 participants• 1,362 Tweets 79
  165. 165. 80
  166. 166. 80
  167. 167. 80
  168. 168. TweetChat.com for chats or follow HashTags 81
  169. 169. TweetChat.com for chats or follow HashTags 81
  170. 170. TweetChat.com for chats or follow HashTags 81
  171. 171. Three fundamental things to know about Twitter• Who to follow• What to do• What to say 82
  172. 172. •Find your own voice.•Everything you say is written in pen.•Staying quiet and watching is a good way to get started.•Find people you respect and see how they interact on Twitter. 83
  173. 173. Mayo Clinic has a twelve word social media policy: Don’t Lie, Don’t Pry, Don’t Cheat, Can’t Delete, Don’t Steal, Don’t Reveal 84
  174. 174. 523 physicians found 209 with < 500 followers range: 500 to 1,910,700 314 with ≥ 500 followers followers (17,217) 54 excluded for other reasons • 9 non-English tweets • 8 not individuals 260 included in analysis • 7 no tweets in last 6 months • 7 private accounts • 5 deleted accounts 20 most recent tweets 5 users did not have 20 tweets analyzed 5,156 tweetsChretien KC, Azar J, Kind T.JAMA. 2011 Feb 9;305(6):566-8. 85
  175. 175. 523 physicians found 209 with < 500 followers range: 500 to 1,910,700 314 with ≥ 500 followers followers (17,217) 54 excluded for other reasons • 9 non-English tweets • 8 not individuals 260 included in analysis • 7 no tweets in last 6 months • 7 private accounts • 5 deleted accounts 20 most recent tweets 5 users did not have 20 tweets analyzed 5,156 tweetsChretien KC, Azar J, Kind T.JAMA. 2011 Feb 9;305(6):566-8. 85
  176. 176. 523 physicians found 209 with < 500 followers range: 500 to 1,910,700 314 with ≥ 500 followers followers (17,217) 54 excluded for other reasons • 9 non-English tweets • 8 not individuals 260 included in analysis • 7 no tweets in last 6 months • 7 private accounts • 5 deleted accounts 20 most recent tweets 5 users did not have 20 tweets analyzed 5,156 tweetsChretien KC, Azar J, Kind T.JAMA. 2011 Feb 9;305(6):566-8. 85
  177. 177. 523 physicians found 209 with < 500 followers range: 500 to 1,910,700 314 with ≥ 500 followers followers (17,217) 54 excluded for other reasons • 9 non-English tweets • 8 not individuals 260 included in analysis • 7 no tweets in last 6 months • 7 private accounts • 5 deleted accounts 20 most recent tweets 5 users did not have 20 tweets analyzed 5,156 tweetsChretien KC, Azar J, Kind T.JAMA. 2011 Feb 9;305(6):566-8. 85
  178. 178. 523 physicians found 209 with < 500 followers range: 500 to 1,910,700 314 with ≥ 500 followers followers (17,217) 54 excluded for other reasons • 9 non-English tweets • 8 not individuals 260 included in analysis • 7 no tweets in last 6 months • 7 private accounts • 5 deleted accounts 20 most recent tweets 5 users did not have 20 tweets analyzed 5,156 tweetsChretien KC, Azar J, Kind T.JAMA. 2011 Feb 9;305(6):566-8. 85
  179. 179. 5,156 tweetsanalyzed and categorized each circle represents 4 tweets 86
  180. 180. 86
  181. 181. 144 of 5156 tweets wereconsidered unprofessional 86
  182. 182. 87
  183. 183. 38 potential privacy violations 87
  184. 184. 38 potential privacy violations33 profanity 87
  185. 185. 38 potential privacy violations33 profanity14 sexually explicit 87
  186. 186. 38 potential privacy violations33 profanity14 sexually explicit4 discriminatory 87
  187. 187. 38 potential privacy violations33 profanity14 sexually explicit4 discriminatory55 other unprofessional 87
  188. 188. 88
  189. 189. Ethical breaches and unprofessional contentwere rare but observed. Particularly concerningwas the presence of potential patient privacyviolations and conflicts of interest. The studywas limited to established, self-identifiedphysician users of Twitter with the mostfollowers, a sample who may represent heavierusers. 88
  190. 190. Ethical breaches and unprofessional contentwere rare but observed. Particularly concerningwas the presence of potential patient privacyviolations and conflicts of interest. The studywas limited to established, self-identifiedphysician users of Twitter with the mostfollowers, a sample who may represent heavierusers. 88
  191. 191. Ethical breaches and unprofessional contentwere rare but observed. Particularly concerningwas the presence of potential patient privacyviolations and conflicts of interest. The studywas limited to established, self-identifiedphysician users of Twitter with the mostfollowers, a sample who may represent heavierusers. 88
  192. 192. Representative?http://www.beevolve.com/twitter-statistics/#b1 89
  193. 193. Representative?http://www.beevolve.com/twitter-statistics/#b1 89
  194. 194. Representative? Average user has 208 followers 6 of 10 users has no followershttp://www.beevolve.com/twitter-statistics/#b1 89
  195. 195. Representative? Average user has 208 followers 6 of 10 users has no followers Only 3.6% have >500http://www.beevolve.com/twitter-statistics/#b1 89
  196. 196. Representative? Nope. Average user has 208 followers 6 of 10 users has no followers Only 3.6% have >500http://www.beevolve.com/twitter-statistics/#b1 89
  197. 197. 90
  198. 198. Either you define yourselfonline, or someone willdefine you 91
  199. 199. 92
  200. 200. b. Thus, physicians should routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and, to the extent possible, content posted about them by others, is accurate and appropriate. 92
  201. 201. 93
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  208. 208. 94
  209. 209. Doctor 1 2 3 4 5 6 7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan Dr. Topf 94
  210. 210. Doctor 1 2 3 4 5 6 7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan Dr. Topf 94
  211. 211. Doctor 1 2 3 4 5 6 7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan Dr. Topf 94
  212. 212. Doctor 1 2 3 4 5 6 7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan Dr. Topf 94
  213. 213. Doctor 1 2 3 4 5 6 7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan Dr. Topf 94
  214. 214. Doctor 1 2 3 4 5 6 7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan Dr. Topf 94
  215. 215. Doctor 1 2 3 4 5 6 7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan Dr. Topf 94
  216. 216. Doctor 1 2 3 4 5 6 7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan Dr. Topf 94
  217. 217. Doctor 1 2 3 4 5 6 7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan Dr. Topf 94
  218. 218. Doctor 1 2 3 4 5 6 7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan Dr. Topf 94
  219. 219. Doctor 1 2 3 4 5 6 7Dr. Saravolatz Dr. GradyDr. LaLondeDr. Edhayan Dr. Topf 94
  220. 220. Implications of a lack of social media presence 95
  221. 221. Following a bad experience people want tocomplain, share and be made whole.If you have a venue for this they can direct it atyou.Without a venue the feedback will likely beanonymous, public and out of your control. 96
  222. 222. Following a bad experience people want tocomplain, share and be made whole.If you have a venue for this they can direct it atyou.Without a venue the feedback will likely beanonymous, public and out of your control. 96
  223. 223. • Maritz Research surveyed an online panel of 1,298 US Consumers • Twitter users who frequently tweet • Have used Twitter to complain about a specific product, service, brand, or company • At least 18 years of age Yes 376 No Yes 661 636 No 921 When you tweeted your complaint, did Has anyone from the company you expect the company to read it? contacted yo about your complaint? 97
  224. 224. 98
  225. 225. How satisfied were you with the company’s response? Very Satisfied 34.7% Somewhat satisfied 39.7% Neutral 9.9%Somewhat dissatisfied 10.1% Very dissatisfied 5.6% 0% 15% 30% 45% 60% 98
  226. 226. How satisfied were you with the company’s response? Very Satisfied 34.7% Somewhat satisfied 39.7% Neutral 9.9%Somewhat dissatisfied 10.1% Very dissatisfied 5.6% 0% 15% 30% 45% 60% How did you feel when the company contacted you regarding your complaint? I loved it 32% I liked it 51.5% Neutral 12.5% I didn’t like it 3.2% I hated it 0.8% 0% 15% 30% 45% 60% 98
  227. 227. Summary• With everybody connected, social media is an unprecedented revolution in communication• Numerous platforms but the two biggest are • Facebook • Twitter 99
  228. 228. Summary: Facebook• When patient friend requests you, redirect, don’t just reject• Privacy • Facebook is the new elevator conversation• Patient communities • Facebook has forever eliminated the friction keeping patients apart. 100
  229. 229. Summary: Twitter• Asymmetric. People you follow may not be following you. Vice-versa• http://www.MomThisIsHowTwitterworks.com• Ruthlessly prune your follower list• Use TweetChat.com to follow chats and conferences 101
  230. 230. Summary: Why• Define yourself or else• Provide a place for complaints 102
  231. 231. 103

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