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Healthcare Social Media and eProfessionalism Mayo Clinic Grand Rounds


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I gave Grand Rounds lecture to standing room only audience at Mayo Clinic Florida. I spoke about how the Social Media Three Shields (Facebook, Twitter and YouTube) can be used by hospitals and healthcare workers to advance the Mayo Clinic Three Shields (Patient Care, Research, Education). There were some humorous and inspiring social media case studies. The overwhelming response to this talk was such a surprise!

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Healthcare Social Media and eProfessionalism Mayo Clinic Grand Rounds

  1. 1. Social Media and e-Professionalism Vandana Y. Bhide, MD Vitamin Vee Blog @VeeMD VeeMD Channel Vandana Bhide
  2. 2. Disclosures• No relevant financial disclosures• Some lame jokes included• Lots of brands mentioned, no financial interest in any of them• Promise: No Kaplan-Meier Regression Curves ©2010 MFMER | slide-2
  3. 3. 1 min 39 second YouTube video abouthealthcare, e-patients and social media(used with permission from Akron Children’sHospital) ©2010 MFMER | slide-3
  4. 4. Why Be Online Anyway?• You consistently finish seeing patients early• All your patients’ lab values are normal, saving you enormous time on callbacks• You are so efficient at using the EMR that you have time for an extra cup of coffee• The insurance company said, “We were mistaken, your patient can get this brand name medication without an override.”• Sleep is a highly overrated commodity during residency• It’s 8 AM and you’ve already finished dispensing your patients’ 9 AM meds
  5. 5. Why be online?• Internet and Social Media are here to stay!• Dr. Sanjay Gupta has >1.3 million Twitter followers• Patients expect their physicians to be educated and involved online• e-patients are empowered/electronic/ engaged• Social Media is the new Word of Mouth ©2010 MFMER | slide-6
  6. 6. Mayo Brothers: The Original Social Network
  7. 7. Mayo Clinic Social Media Case Study• LA Dodgers outfielderJayson Werth--left wristfracture during spring training•Out for two months; afterone year had surgery byhand specialist--pain anddisability even worse•“Baseball’s over, I’m goingto be looking for a job, andI’ve done nothing but playbaseball my whole life.”
  8. 8. •Jayson sees Richard Berger,MD,PhD at Mayo Clinic
  9. 9. Ulnotriquetral Ligament Dr. Berger and orthopedic surgeons at Mayo Clinic were first to describe a “mysterious” condition in which a partial lengthwise tear of the UT ligament causes pain and weakness, but still holds bones in alignment ©2010 MFMER | slide-10
  10. 10. Dr. Berger’s Fovea sign—applying pressure on ulnar fovea reproduces patient’s pain ©2010 MFMER | slide-11
  11. 11. •Next day Jayson undergoes minimallyinvasive surgery for repair of partial tear ofthe UT ligament
  12. 12. •Jayson goes on to •Dr. Berger hostswin World Series ongoing twitterwith the Phillies chat for patients•Mayo Clinic records #wristpaina series ofinterviews withJayson Werth oninexpensive flipcamera•Posted onYouTube & SharingMayo Clinic Blog ©2010 MFMER | slide-13
  13. 13. •Werth signs 7-year/ $126million contract with theWashington Nationals•Credits Dr. Berger withsaving his career•Dr. Berger makesYouTube videos about UTligament tears for patients ©2010 MFMER | slide-14
  14. 14. Mayo Clinic Three Shields Patient Care Research Education ©2010 MFMER | slide-15
  15. 15. Mayo Clinic Channel Mayo Clinic Social Media Three Shields Channel #MayoClinicFL @MayoClinic
  16. 16. The Most Influential Physician in America?
  17. 17. FacebookLinksPatients toOrganDonationRegistries
  18. 18. ©2010 MFMER | slide-24
  19. 19. Infographicson Pinterest
  20. 20. Mayo Clinic Three Shields Patient Care ©2010 MFMER | slide-27
  21. 21. Patient Care• Studies show >75% of patients get health information on internet• How accurate is that information?• Healthcare professionals can provide accurate, evidence-based health information online• Information plus knowledge does not equal medical wisdom—patients need doctors— both in the office and online ©2010 MFMER | slide-28
  22. 22. ©2010 MFMER | slide-29
  23. 23. If Physicians Don’t Lead theConversation, Someone Else Will #pedchat Chris Carroll MD MS @ChrisCarrollMD @drflanders T1: Thats great! If were not leading the conversation, someone else will! 18 Nov 12 Reply Retweet Favorite ©2010 MFMER | slide-30
  24. 24. • On average, physician interrupts patient after just 18 seconds• Patients don’t remember what the doctor told them about their illness, especially with a new condition• Patients can get information in a non- threatening manner• Repetitive patient education topics such as pre-operative procedures, post-operative care, wound care, vaccine information, nutrition, weight loss strategies, medication side effects, disease specific information
  25. 25. PatientEducationfollowingBypassSurgery ©2010 MFMER | slide-34
  26. 26. • Information/Support for patients with chronic illnesses• Information/Support for patients with rare diseases• Information about any medical condition• Marketing/building medical practice• Medical Apps (including for physicians)• Online physician rating sites (Healthgrades)(Google your name to see what patients will see) ©2010 MFMER | slide-35
  27. 27. My Most-Viewed Blogpost Who would have guessed? ©2010 MFMER | slide-36
  28. 28. Mayo Clinic Use of Social Media• Mayo Clinic Center for Social Media• Mayo Clinic YouTube channel• Online health community • Patient forums/groups • Online Health tools• Sharing Mayo Clinic• Patient App• Twitter: #MayoClinicFL,@MayoClinic,@MCCSM• Mayo Clinic Podcasts• Mayo Clinic Facebook fan page• Discovery’s Edge online research magazine
  29. 29. Mayo Clinic YouTube Video: Know Your Numbers• Mayo Clinic - Know Your Numbers - YouTube ©2010 MFMER | slide-38
  30. 30. Mayo Clinic Three Shields Research ©2010 MFMER | slide-39
  31. 31. Social Media For Research• Dr. Anas Young, oncologist specializing in in lymphoma research, helped develop MD Anderson online magazine• Included YouTube video discussing Hodgkins lymphoma clinical trials• Enrollment of patients with relapsed Hodgkins lymphoma increased from 20 to 80 patients in one year
  32. 32. Social Media: Tool For Recruiting Patients for Studies• Patient with rare heart condition called spontaneous coronary artery dissection (SCAD) asked Dr. Sharonne Hayes, a Mayo Clinic cardiologist, to conduct a study.• Within one week, through the website, the full complement of 12 women for the study were recruited.
  33. 33. Mayo Clinic Researchers Join NBC Newsand Centers for Disease Control for Twitter Chat on Influenza/Pertussis
  34. 34. Mayo Clinic Three Shields Education ©2010 MFMER | slide-43
  35. 35. Medical Conferences• Mayo Clinic Individualizing Medicine Conference live streamed on YouTube• #tweetiatrician--American Academy of Pediatrics national conference 10/12• #MayoRagan—Mayo Clinic Center for Social Media residency• #UCSFMHP--Hospital Medicine Conference 10/12 University of California San Francisco by @Bob_Wachter
  36. 36. YouTube Videos in Medical/Nursing Education ©2010 MFMER | slide-45
  37. 37. “How do I “Now letfind time me getfor social thismedia straight…when I Youredon’t even telling mehave time I shouldto shave?” ask my kid how to tweet?”“My SocialMentionSentiment Scorejust wentdown…”
  38. 38. “Don’t let your fear of failing triumph over the joy of participating” ©2010 MFMER | slide-48
  39. 39. ©2010 MFMER | slide-49
  40. 40. What would youthink if you sawthis picture onFacebook…and realized hewas your doctor?Roger Collier Professionalism: SocialMedia Mishaps CMAJ, September 4,2012, 184(12)
  41. 41. Federation of State Medical Boards• Protect the Privacy and Confidentiality of their patients• Avoid requests for online medical advice• Act with professionalism• Be forthcoming about employment, credentials and conflicts of interest• Be aware that information posted online may be available to anyone, and could be misconstrued Rhyne JA et al Federation of State Medical Boards Model Policy Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice
  42. 42. Physician Obligations— Same in person and online• Privacy—to prevent unauthorized access to patient data and to ensure that “de-identified” data cannot be linked to the healthcare professional or patient Rhyne JA et al Federation of State Medical Boards Model Policy Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice• The Online Conversation is the same as the conversation in the Elevator or Hallway
  43. 43. Physicians should be cognizant of standards ofpatient privacy and confidentiality that must bemaintained in all environments, includingonline, and must refrain from postingidentifiable patient information online.AMA Policy: Professionalism in the Use of Social Media ©2010 MFMER | slide-53
  44. 44. Avoid Giving Advice Online• Disclaimers that what you are writing online does not constitute medical advice may not be judicially sound• It’s easy to develop a physician-patient relationship but hard to break it--Arthur R. Derse, MD, JD, Director of the Center for Bioethics and Medical Humanities, Medical College of Wisconsin• Ok to discuss health topic in a general way that would be applicable to a wide number of patients
  45. 45. Physician Blogs• Study of 271 medical blogs: three blogs showed recognizable photographic images of patients• 45 blogs included sufficient information for patients to identify their doctors or themselves• Healthcare products were promoted, either by images or description in 31 blogsLagu Tara et al Content of weblogs written by health professionals. J Gen Intern Med 23(10):1642-6 ©2010 MFMER | slide-55
  46. 46. Integrity—Information contained onPhysician websites should be truthful• Not misleading or deceptive• Accurate• Easy for patients to understand• Supported by current medical peer- reviewed literature• Should clearly indicate if information is based on scientific studies, expert consensus, professional experience or personal opinion Rhyne JA et al Federation of State Medical Boards Model Policy Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice
  47. 47. AMA Social Media Policy• If they interact with patients on the Internet, physicians must maintain appropriate boundaries of the patient- physician relationship• Physicians should consider separating personal and professional content onlineAMA Policy: Professionalism in the Use of Social Media
  48. 48. Physicians must recognize thatactions online and content postedmay negatively affect their reputationsamong patients and colleagues, mayhave consequences for their medicalcareers (particularly for physicians-in-training and medical students), andcan undermine public trust in themedical professionAMA Policy: Professionalism in the Use of Social Media ©2010 MFMER | slide-58
  49. 49. • The internet is like Vegas: What happens there stays there…• Forever• You can take it down but you can’t take it back
  50. 50. Mayo Clinic Employees Social Media Guidelines• Write in the first person…make it clear that you are speaking for yourself and not on behalf of Mayo Clinic• Include this disclaimer: “The views expressed on this [blog; website] are my own and do not reflect the views of my employer.”• Consider adding this language in an “About me” section of your blog or social media profile ©2010 MFMER | slide-60
  51. 51. Mayo Clinic Social Media Policy• Strongly discourages “friending” of patients on social media websites• Discourages staff in management/supervisory roles from initiating “friend” requests with employees they manage.• Managers/supervisors may accept friend requests if initiated by the employee• Does not endorse people, products, services and organizations.• On social media websites such as LinkedIn, where affiliation to Mayo Clinic is known, personal recommendations should not be given or requested
  52. 52. Mayo Clinic Center for Social Media 12-Word Social Media Policy• Don’t Lie, Don’t Pry• Don’t Cheat, Can’t Delete• Don’t Steal, Don’t RevealFarris Timimi, MD ©2010 MFMER | slide-62
  53. 53. “Disco Saves Lives” Youtube VideoOver 1,069,830 Views!
  54. 54. Social Media and e-Professionalism Vandana Y. Bhide, MD Vitamin Vee Blog @VeeMD VeeMD Channel Vandana Bhide