#msk_hcsm14

Connectivity, Collaboration, and Disruption:
Social Media and the Oncologist
Solid Tumor Conference
Memorial ...
#msk_hcsm14

Disclosures
No relevant financial relationships to disclose
Non-FDA approved uses of drugs or products
discus...
#msk_hcsm14

Does social media matter in
health care?
#msk_hcsm14
#msk_hcsm14

Wireless Sensors	

Genomics	


Creative
Destruction	


New Medicine	


Mobile Technology and Bandwidth	

Inte...
#msk_hcsm14

Social	
  media	
  is	
  user	
  generated	
  content	
  that	
  is	
  shared	
  over	
  the	
  

internet	
 ...
Social	
  media	
  is	
  the	
  second	
  Internet	
  revolu8on.	
  	
  

#msk_hcsm14

Used	
  w/	
  permissions	
  GNU	
 ...
#msk_hcsm14

http://www.flickr.com/photos/interactegypt/6882960792
Attribution-NonCommercial-ShareAlike 2.0 Generic (CC BY...
#msk_hcsm14

“Facebook hits milestone of 1 billion users”!
--Washington Post 10/4/12

(CC) JD Lasica, socialmedia.biz
Attr...
#msk_hcsm14
#msk_hcsm14
#msk_hcsm14
#msk_hcsm14
#msk_hcsm14

Social media categories & applications
—  Blogging – WordPress, Blogger (Google)
—  Microblogging – Twitter...
#msk_hcsm14

http://instagr.am/p/nm695 via @DouglasWRay
#msk_hcsm14

“Why would any physician bother
with this stuff?”
“Isn’t it risky and a total waste of
time?”
“I don’t get Tw...
#msk_hcsm14

Our patients are online, and they
expect us to be there, too…
#msk_hcsm14

Patient engagement and
empowerment - trends
1.  The rise of the e-patient

--democratization of medical infor...
#msk_hcsm14

http://www.pewinternet.org/~/media//Files/Presentations/2012/Sept/FoxMed2Panel_PDF.pdf
#msk_hcsm14

U.S.: Different sources for different information

http://www.pewinternet.org/Presentations/2013/Jul/Epatient...
#msk_hcsm14

Mobile health
—  91% of U.S. adults own cell phones
—  56% of U.S. adults own smartphones
—  19% of smartp...
#msk_hcsm14

http://www.jmir.org/2013/12/e287

1.  295 unique apps
2.  Purpose: raise awareness (32%), educational
info ab...
#msk_hcsm14

Data ≠ Information ≠ Knowledge
#msk_hcsm14

Our institutions are online…
#msk_hcsm14

3	
  ways	
  physicians	
  might	
  use	
  social	
  media
	
  
1.  To	
  treat	
  –	
  engaging	
  directly	...
#msk_hcsm14

Bucket	
  1	
  

Bucket	
  2	
  

Bucket	
  3	
  

Care	
  

Info	
  

Info	
  
#msk_hcsm14

The	
  “Meaningful	
  Use”	
  of	
  	
  
Social	
  Media	
  by	
  Physicians	
  
Brian	
  S.	
  McGowan,	
  P...
#msk_hcsm14

Defining	
  ‘Sharing	
  Medical	
  Informa8on’
	
  
•  Sharing	
  medical	
  knowledge	
  is	
  
defined	
  as	...
#msk_hcsm14

Adopters	
  versus	
  Adamant	
  Non-­‐Adopters
	
  
%	
  of	
  Physicians	
  
80	
  

71	
  

70	
  
60	
  
...
#msk_hcsm14

http://www.jmir.org/2012/5/e117

•  24% use SM daily to explore/share medical
information; 14% use SM daily t...
#msk_hcsm14

January 2010
January 2014

#msk_hcsm14
Academic oncologists on Twitter
— 

Sunil Patel (MDACC)

— 

Mark Lewis (MDACC)

— 

Julie Gralow (Univ of WA)

— 

Wa...
http://rsm2800.blogspot.com
http://jop.ascopubs.org/site/podcasts/index.xhtml
#msk_hcsm14

Why I like Twitter
—  Low barrier to entry
—  Platform agnostic
—  Minimal requirements for content produc...
#msk_hcsm14
#msk_hcsm14

Diagram of a Tweet

“@” + username
calls that user’s
attention to
message

“shortened”
link

Actions you can
...
#msk_hcsm14

#Tweetchats
—  Virtual meetings usually held on a repeating basis

organized around a specific topic and has...
#msk_hcsm14
#msk_hcsm14

Je n’ai fait celle-ci plus longue que
parce que je n’ai pas eu le loisir de la
faire plus courte.
--Blaise Pa...
#msk_hcsm14

How I use Twitter - outbound
#msk_hcsm14

1/25/14 – 1/31/14:
•  44 mentions/RTs
•  8 favorites
#msk_hcsm14

How I use Twitter - inbound
—  Twitter accounts I follow:
§  Oncologists & other MD’s
§  Thought leaders i...
#msk_hcsm14

How can there possibly be
enough time to do this?
#msk_hcsm14

Consider the value:
—  Unexpected connections & networking
—  Crowdsourcing questions
—  Establishing own ...
PLoS Biol. 2013 April; 11(4): e1001535

“ In the age of the internet, social media tools
offer a powerful way for scientis...
How and why to use social media as
a scientist
—  Online tools improve research efficiency
§  Keeping up with new develo...
Use of Twitter at medical conferences
#msk_hcsm14

Twitter usage at ASCO Annual Meeting
—  #ASCO10: 684 users, 4456 tweets (14 MD’s=979 tweets)

#ASCO11: 1537 ...
San	
  Antonio	
  Breast	
  Cancer	
  Symposium	
  
12/10/13-­‐12/14/13	
  
YouTube	
  
PromoDng	
  clinical	
  trials	
  
PromoDng	
  ParDcipaDon	
  in	
  Clinical	
  Trials	
  
Providing	
  links	
  to	
  Clinicaltrials.gov	
  
SWOG.org	
  1/20/14	
  
#msk_hcsm14

Social media & clinical trials
—  Engage your institution’s media department and the

sponsor before creatin...
#msk_hcsm14

http://33charts.com/2011/12/physicians-risk-opportunity-social-media.html
#msk_hcsm14

Professionalism in the Use of Social Media
(AMA Policy 11/8/10)

—  Always maintain patient privacy/confiden...
#msk_hcsm14

http://jop.ascopubs.org/content/8/5/e114.long

http://annals.org/article.aspx?articleid=1675927
#msk_hcsm14

Potential problem areas
—  Establishing a patient-physician relationship via social

media
—  Communicating...
#msk_hcsm14

Ten tips from ASCO (Tips 1-5)
1.  Get involved
2.  Engage often
3.  Always identify yourself
4.  Protect pati...
#msk_hcsm14

Ten Tips….
6.  Avoid impropriety
7.  Give credit where credit is due
7.  Professionalism is critical
8.  Sepa...
#msk_hcsm14

Mayo Clinic
12 Word Social Media Policy
—  Don’t Lie, Don’t Pry
—  Don’t Cheat, Can’t Delete
—  Don’t Stea...
#msk_hcsm14

My version…
—  Don’t be anonymous
—  Don’t be stupid
—  Remember everyone’s watching
—  Developing trust ...
#msk_hcsm14
#msk_hcsm14

How to get started
—  Be a lurker first
§  Read blogs, listen to podcasts, learn how to use RSS feeds for j...
Public network skills every physician
should have --Bryan Vartabedian, MD (33 charts
blog)
1.  The ability to confidently ...
New physician literacies in the digital
age --Bryan Vartabedian, MD (33 charts blog)
1.  Network Awareness/Collaboration
-...
#msk_hcsm14

Conclusions
—  The Internet has democratized information and

eliminated traditional filters constraining ac...
#msk_hcsm14

Conclusions (cont.)
—  Concerns about patient privacy, liability, and time

commitment do not negate the val...
Track this talk on Twitter
#msk_hcsm14
Follow me on Twitter:
@rsm2800
Read my blog:
rsm2800.blogspot.com
Connectivity, Collaboration, and Disruption: Social Media and the Oncologist
Connectivity, Collaboration, and Disruption: Social Media and the Oncologist
Connectivity, Collaboration, and Disruption: Social Media and the Oncologist
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Connectivity, Collaboration, and Disruption: Social Media and the Oncologist

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On 2/4/14, I presented a talk at Memorial Sloan-Kettering Cancer Center "Connectivity, Collaboration, and Disruption: Social Media and the Oncologist." I created a special hashtag - #msk_hcsm14 and used it to schedule a series of tweets to go out during the talk with some of my references.

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Connectivity, Collaboration, and Disruption: Social Media and the Oncologist

  1. 1. #msk_hcsm14 Connectivity, Collaboration, and Disruption: Social Media and the Oncologist Solid Tumor Conference Memorial Sloan-Kettering Cancer Center February 4, 2014 Robert S. Miller, MD, FACP, FASCO Clinical Associate, Breast Cancer Program Johns Hopkins University School of Medicine Oncology Medical Information Officer Sidney Kimmel Comprehensive Cancer Center
  2. 2. #msk_hcsm14 Disclosures No relevant financial relationships to disclose Non-FDA approved uses of drugs or products discussed - None
  3. 3. #msk_hcsm14 Does social media matter in health care?
  4. 4. #msk_hcsm14
  5. 5. #msk_hcsm14 Wireless Sensors Genomics Creative Destruction New Medicine Mobile Technology and Bandwidth Internet SUPER CONVERGENCE Imaging Social Networking Computing Power + Data Universe Information systems Old Medicine
  6. 6. #msk_hcsm14 Social  media  is  user  generated  content  that  is  shared  over  the   internet  via  technologies  that  promote  engagement,  sharing  and  collabora8on.*   *  Defini(on  from  The  Social  Media  Guide.com   weill.cornell.edu  
  7. 7. Social  media  is  the  second  Internet  revolu8on.     #msk_hcsm14 Used  w/  permissions  GNU  License   h;p://en.wikiversity.org/wiki/File:Web_2.0_elements.png   h;p://en.wikiversity.org/wiki/File:Web_1.0_elements.png   weill.cornell.edu  
  8. 8. #msk_hcsm14 http://www.flickr.com/photos/interactegypt/6882960792 Attribution-NonCommercial-ShareAlike 2.0 Generic (CC BY-NC-SA 2.0)
  9. 9. #msk_hcsm14 “Facebook hits milestone of 1 billion users”! --Washington Post 10/4/12 (CC) JD Lasica, socialmedia.biz Attribution-NonCommercial 2.0 Generic (CC BY-NC 2.0)
  10. 10. #msk_hcsm14
  11. 11. #msk_hcsm14
  12. 12. #msk_hcsm14
  13. 13. #msk_hcsm14
  14. 14. #msk_hcsm14 Social media categories & applications —  Blogging – WordPress, Blogger (Google) —  Microblogging – Twitter, Tumblr —  Social networking – Facebook, Google+, LinkedIn —  Collaborating – wiki’s, Google Docs —  Multimedia content sharing – YouTube, Flickr, podcasts, Instagram, Pinterest, Prezi, Slideshare —  Social bookmarking – Diigo, Delicious, CiteULike —  Rating/reviewing – Yelp, Epinions —  Location-based social networking – Foursquare
  15. 15. #msk_hcsm14 http://instagr.am/p/nm695 via @DouglasWRay
  16. 16. #msk_hcsm14 “Why would any physician bother with this stuff?” “Isn’t it risky and a total waste of time?” “I don’t get Twitter.”
  17. 17. #msk_hcsm14 Our patients are online, and they expect us to be there, too…
  18. 18. #msk_hcsm14 Patient engagement and empowerment - trends 1.  The rise of the e-patient --democratization of medical information 2.  Patient portals/online access to medical records = part of Meaningful Use 3.  Patients online and engaged in social media (long before physicians) 4.  Peer-to-peer healthcare
  19. 19. #msk_hcsm14 http://www.pewinternet.org/~/media//Files/Presentations/2012/Sept/FoxMed2Panel_PDF.pdf
  20. 20. #msk_hcsm14 U.S.: Different sources for different information http://www.pewinternet.org/Presentations/2013/Jul/Epatients-and-their-hunt-for-health-information.aspx
  21. 21. #msk_hcsm14 Mobile health —  91% of U.S. adults own cell phones —  56% of U.S. adults own smartphones —  19% of smartphone owners use health apps — Self-tracking/“Quantified self ” — Exercise, fitness, pedometer, pulse monitoring, BP, diet, food/calories, blood sugar, mood, sleep
  22. 22. #msk_hcsm14 http://www.jmir.org/2013/12/e287 1.  295 unique apps 2.  Purpose: raise awareness (32%), educational info about cancer (29%), early detection (12%), fundraising (10%), support disease management (4%), prevention (2%) 3.  Few apps took advantage of smartphone capabilities (no mobile sensing, limited communication w/ medical team, other pts) 4.  0/594 articles w/evaluation of cancer app
  23. 23. #msk_hcsm14 Data ≠ Information ≠ Knowledge
  24. 24. #msk_hcsm14 Our institutions are online…
  25. 25. #msk_hcsm14 3  ways  physicians  might  use  social  media   1.  To  treat  –  engaging  directly  w/  pa8ents  about  care   2.  To  teach  –  providing  8mely  &  credible  educa8on   3.  To  learn  –  sharing  of  medical  informa8on/knowledge     Bucket  1   Bucket  2   Bucket  3  
  26. 26. #msk_hcsm14 Bucket  1   Bucket  2   Bucket  3   Care   Info   Info  
  27. 27. #msk_hcsm14 The  “Meaningful  Use”  of     Social  Media  by  Physicians   Brian  S.  McGowan,  Ph.D.     Senior  Director,  Oncology;     Medical  EducaDon  Group,  Pfizer  Inc   Chair,  Commi;ee  on  Emerging  Technologies  in  Educa8on   Alliance  for  Con8nuing  Medical  Educa8on   Consult  Columnist,  Social  Media  Connec(ons   Medical  Mee8ngs,  A  Mee8ngsNet  Magazine   Presented  at  “Medicine  2.0”  September,  2011,  Stanford,  CA  
  28. 28. #msk_hcsm14 Defining  ‘Sharing  Medical  Informa8on’   •  Sharing  medical  knowledge  is   defined  as  the  exchange  of   informa(on,  advice,  ideas,   reports  and  scien(fic   discoveries  with  other   physicians  in  the  medical   community.           Bucket  3  
  29. 29. #msk_hcsm14 Adopters  versus  Adamant  Non-­‐Adopters   %  of  Physicians   80   71   70   60   52   50   40   33   30   20   10   13   6   40   36   27   26   25   23   21   19   19   21   18   16   16   13   11   11   9   7   0   Will  Never  Use   Current  user   9   5   1  
  30. 30. #msk_hcsm14 http://www.jmir.org/2012/5/e117 •  24% use SM daily to explore/share medical information; 14% use SM daily to contribute •  60% say SM improves quality of pt care •  Oncologists more likely to use SM due to “personal innovativeness” •  PCP’s more likely to use SM to have access to peers
  31. 31. #msk_hcsm14 January 2010
  32. 32. January 2014 #msk_hcsm14
  33. 33. Academic oncologists on Twitter —  Sunil Patel (MDACC) —  Mark Lewis (MDACC) —  Julie Gralow (Univ of WA) —  Wafik El-Deiry (Penn State) —  Ray Dubois (ASU) —  Larry Norton (MSKCC) —  Anas Younes (MSKCC) —  David Johnson (UT-Southwestern) —  Naoto Ueno (MDACC) —  Michael Fisch (MDACC) —  Lee Ellis (MDACC) —  John Sweetenham (Huntsman) —  Charles Blanke (OHSU) —  Rich Schilsky (ASCO) —  Yousuf Zafar (Duke) —  Tom Beer (OHSU) —  Nathan Pennell (Cleveland Clinic) —  Don Dizon (MGH) —  Mark Robson (MSKCC) —  Miguel Perales (MSKCC) —  Robert Orlowski (MDACC) —  Antonio Wolff (Hopkins) —  Evan Lipson (Hopkins)
  34. 34. http://rsm2800.blogspot.com
  35. 35. http://jop.ascopubs.org/site/podcasts/index.xhtml
  36. 36. #msk_hcsm14 Why I like Twitter —  Low barrier to entry —  Platform agnostic —  Minimal requirements for content production (140- character tweets vs. 500-word blog posts) —  Emphasis on frequency, breadth not depth —  Asymmetric (“following” does not require reciprocation) —  Ability to embed shortened links —  #hashtags = metadata —  Instantaneous dissemination of information
  37. 37. #msk_hcsm14
  38. 38. #msk_hcsm14 Diagram of a Tweet “@” + username calls that user’s attention to message “shortened” link Actions you can take after posting Science at the heart of medicine # Hashtags = easier way to find groups of tweets | 39
  39. 39. #msk_hcsm14 #Tweetchats —  Virtual meetings usually held on a repeating basis organized around a specific topic and hashtag —  Healthcare Hashtag Project - http://www.symplur.com/healthcare-hashtags —  #BCSM = Breast Cancer Social Media (Mon 9 pm ET) —  Moderated by 2 breast cancer advocates @jodyms & @stales and an LA breast surgeon @DrAttai
  40. 40. #msk_hcsm14
  41. 41. #msk_hcsm14 Je n’ai fait celle-ci plus longue que parce que je n’ai pas eu le loisir de la faire plus courte. --Blaise Pascal, Lettres Provinciales (1657) “I would have written a shorter letter, but I did not have the time.”
  42. 42. #msk_hcsm14 How I use Twitter - outbound
  43. 43. #msk_hcsm14 1/25/14 – 1/31/14: •  44 mentions/RTs •  8 favorites
  44. 44. #msk_hcsm14 How I use Twitter - inbound —  Twitter accounts I follow: §  Oncologists & other MD’s §  Thought leaders in organized medicine & IT §  Journalists, bloggers, patient advocates, public figures §  Professional societies, institutions §  Not necessarily everyone who follows me —  New insights – patient empowerment, patient-centered health IT, safety/quality —  New professional opportunities (but not academic advancement…yet)
  45. 45. #msk_hcsm14 How can there possibly be enough time to do this?
  46. 46. #msk_hcsm14 Consider the value: —  Unexpected connections & networking —  Crowdsourcing questions —  Establishing own digital footprint/reputation management —  Promote your science
  47. 47. PLoS Biol. 2013 April; 11(4): e1001535 “ In the age of the internet, social media tools offer a powerful way for scientists to boost their professional profile and act as a public voice for science.” “[I]n today’s technology-driven world, lack of an online presence can severely limit a researcher’s visibility, and runs the risk that undesirable search results appear before desirable ones…”
  48. 48. How and why to use social media as a scientist —  Online tools improve research efficiency §  Keeping up with new developments via Twitter §  Online communities for niche topics §  Blogs as medium for extended scientific conversations —  An active online presence may enhance credentials measured through traditional metrics —  Social media enhances professional networking —  Communicating science to the general public §  To patients/lay audience – teach, translate §  Combat pseudoscience (vaccine/autism example) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3635859
  49. 49. Use of Twitter at medical conferences
  50. 50. #msk_hcsm14 Twitter usage at ASCO Annual Meeting —  #ASCO10: 684 users, 4456 tweets (14 MD’s=979 tweets) #ASCO11: 1537 users, 8188 tweets (34 MD’s=1477 tweets) Chaudhry A, Glode LM, Gillman M, Miller RS (2012). Trends in Twitter use by physicians at the American Society of Clinical Oncology Annual Meeting, 2010 and 2011. J Oncol Pract 8:173-178. http://jop.ascopubs.org/content/8/3/173.full
  51. 51. San  Antonio  Breast  Cancer  Symposium   12/10/13-­‐12/14/13  
  52. 52. YouTube   PromoDng  clinical  trials  
  53. 53. PromoDng  ParDcipaDon  in  Clinical  Trials   Providing  links  to  Clinicaltrials.gov  
  54. 54. SWOG.org  1/20/14  
  55. 55. #msk_hcsm14 Social media & clinical trials —  Engage your institution’s media department and the sponsor before creating Facebook page/Twitter account —  Determine if IRB review required —  No proprietary information —  Avoid claims about efficacy or discussion about side effects —  No disclosure of trial results —  Monitor posts to avoid HIPAA violations —  No screening of subjects via social media —  Link only to sites for more info (e.g., clinicaltrials.gov) —  No blogging about conduct of study (can be viewed as advertising) Adapted from Table 3 in Dizon DS et al J Oncol Pract Sep 1, 2012:e114-e124
  56. 56. #msk_hcsm14 http://33charts.com/2011/12/physicians-risk-opportunity-social-media.html
  57. 57. #msk_hcsm14 Professionalism in the Use of Social Media (AMA Policy 11/8/10) —  Always maintain patient privacy/confidentiality. —  Monitor own Internet presence/use privacy settings on SM (know they are not absolute). —  Maintain boundaries when interacting with patients online. —  Consider separating personal & professional online accounts. —  Police colleagues’ online behavior. —  Online behavior can affect reputation & undermine trust in the medical profession. http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medicalethics/opinion9124.page
  58. 58. #msk_hcsm14 http://jop.ascopubs.org/content/8/5/e114.long http://annals.org/article.aspx?articleid=1675927
  59. 59. #msk_hcsm14 Potential problem areas —  Establishing a patient-physician relationship via social media —  Communicating directly with existing patients via social media/online friendships and connections —  Writing about patients on social media —  Googling patients —  Product endorsements and advertisements Chretien K, Kind T. Social media and clinical care: Ethical, professional, and social implications. Circulation 2013; 127:1413-1421 http://circ.ahajournals.org/content/127/13/1413
  60. 60. #msk_hcsm14 Ten tips from ASCO (Tips 1-5) 1.  Get involved 2.  Engage often 3.  Always identify yourself 4.  Protect patient confidentiality and privacy 5.  Contextualize your activities
  61. 61. #msk_hcsm14 Ten Tips…. 6.  Avoid impropriety 7.  Give credit where credit is due 7.  Professionalism is critical 8.  Separate the personal from professional 9.  Be aware of your institutional guidelines http://www.asco.org/about-asco/social-media
  62. 62. #msk_hcsm14 Mayo Clinic 12 Word Social Media Policy —  Don’t Lie, Don’t Pry —  Don’t Cheat, Can’t Delete —  Don’t Steal, Don’t Reveal --Farris Timimi, M.D., Medical Director, Mayo Clinic Center for Social Media http://socialmedia.mayoclinic.org/2012/04/05/a-twelve-word-social-media-policy
  63. 63. #msk_hcsm14 My version… —  Don’t be anonymous —  Don’t be stupid —  Remember everyone’s watching —  Developing trust in your online community takes time – maintain a healthy skepticism
  64. 64. #msk_hcsm14
  65. 65. #msk_hcsm14 How to get started —  Be a lurker first §  Read blogs, listen to podcasts, learn how to use RSS feeds for journals & news sites —  Join Twitter §  Pick a short, descriptive handle, use a real photo as an avatar §  “Who to follow” Twitter suggestions, follow people others follow §  Give it time to grow —  Share content – links to articles and stories that interest you —  Create content – blog —  Cultivate your network – RT’s, #FF, @replies
  66. 66. Public network skills every physician should have --Bryan Vartabedian, MD (33 charts blog) 1.  The ability to confidently shape and compose an idea 2.  3.  4.  5.  or opinion in under 500 words The ability to summarize and share an idea in a few hundred characters The ability to shape an idea and put it on a short video clip Understanding of the limitations of patient-specific dialog in public networks Understanding of how to manage input and consumption of information http://33charts.com/2013/09/public-network-skills-physicians.html
  67. 67. New physician literacies in the digital age --Bryan Vartabedian, MD (33 charts blog) 1.  Network Awareness/Collaboration -Physicians no longer control information 2.  Input management -Too much to know (balancing information, attention, and filters) 3.  Creation/Translation -Moving online from observationàconversationàcurationàcontent creation 4.  Mindfulness -Balancing technology with attention to patients http://33charts.com/2012/09/new-physician-literacies.html
  68. 68. #msk_hcsm14 Conclusions —  The Internet has democratized information and eliminated traditional filters constraining access to medical knowledge; social media (SM) is the communication channel resulting from this change in paradigm. —  SM provides an unparalleled opportunity for the authoritative voice of the physician to be heard in patient education & health messaging. —  Physicians can effectively use SM for connection and networking with other physicians and scientists both inside of and outside of traditional spheres of influence.
  69. 69. #msk_hcsm14 Conclusions (cont.) —  Concerns about patient privacy, liability, and time commitment do not negate the value of participation in SM. —  Physician professionalism and patient-centered focus trump all other considerations.
  70. 70. Track this talk on Twitter #msk_hcsm14 Follow me on Twitter: @rsm2800 Read my blog: rsm2800.blogspot.com

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