1.
Social media “likes” healthcare
From marketing to social business
Health Research Institute
April 2012

2.
Table of contents
The heart of the matter 2
Liking, following, linking, tagging, stumbling:
social media is changing the nature of
health-related interactions
An in-depth discussion 4
Savvy adopters are tapping into social media
to foster new relationships
Executive summary 5
Social media is changing online dialogue from one-to-many to
many-to-many, at a phenomenal speed 7
Consumers are broadcasting their wants, needs, and preferences
through social media 8
• Social animals
• Social studies
• Social skills
• Social speed
• Social networks
• Social currency
How health organizations are evolving from social media marketing
to social business strategy 18
A future look: Data generated from individuals can help
complete the patient profile 27
What this means for your business 30
Social media enables organizations to expand
their role with customers
April 2012

3.
The heart of the matter
Liking, following,
linking, tagging,
stumbling: social
media is changing
the nature of
health-related
interactions

4.
When I was in the ER last night, I Savvy businesses know they must go hospitals, and health plans. HRI found
tweeted about the interminable wait. where the customers are. And in 2012, that one-third of consumers are using
It seemed as though people who weren’t a rapidly growing number are on social social media for health-related matters.
that sick got whisked in ahead of me! media, the space that enables instan- Most tellingly, they are choosing
Guess what? Someone from the hospital taneous self-expression and a shared “community” sites over industry-
heard me! They spotted my tweet and community experience — at any hour of sponsored sites. In a week’s snapshot of
responded. And even sent someone the day with someone in the house next several health-related companies and
down to talk to me in person. door or halfway across the globe. The consumer sites, HRI found that daily
rise of social media has been phenom- activity numbered in the thousands for
That’s what I love about social media. enal. Use of social networking sites has community sites versus in the hundreds
I can write what I want when I want, grown from 5% of all adults in 2005, on company sites.
and send it to all my friends, groups, to half of all adults (50%) in 2011.1 For
and followers in an instant. And, all of example, Facebook, which began with Early adopters in the health industry
them can send it to all of their friends, 5 million users in 2005, today has 845 tell PwC that despite concerns about
groups, and followers. It’s like million participants, more than the integrating social media into data
my personal electronic megaphone. entire population of Europe.2 Pinterest, analytics and measuring its effective-
a social image-sharing site using a ness, they are incorporating social
Ever since I found out I had diabetes, virtual “pinboard” interface, just hit media into their business strategy.
I’ve posted monthly on Facebook 11.7 million unique U.S. users, growing More than 1,200 hospitals participate
about my struggles managing my from 1.2 million only six months in 4,200 social networking sites.5
blood sugar and energy level, and earlier.3 Twitter has also shown tremen-
lots of people — some I don’t even dous growth, reporting 460,000 new With these new opportunities come
know — have swapped healthy recipes, accounts created on average per day.4 challenges and the likely threat of
sent me tips on where to buy test strips, agile new entrants into the market.
and even recommended doctors. Some While industries such as retail and With transparency, patient expecta-
even had links to YouTube videos. hospitality quickly saw the potential, tions rise. And as health organizations
the health sector has been slower collect more detailed information on
I feel like the healthcare industry is to move. According to a new survey its patients, proper safeguards will be
finally getting it. My hospital has a by PwC’s Health Research Institute needed to ensure privacy and security.
Facebook page where they post lifestyle (HRI), hospitals, insurers, and phar-
advice, the drug company shares newly maceutical manufacturers can benefit Not long ago, terms such as liking,
released treatment studies through its from this new form of interactive following, tagging, and stumbling all
Twitter account, and my insurer even communication. had very different meanings. But in
has these interactive games that help the era of social media, they provide
manage my diet and exercise. Best of With a single key stroke, individuals the clues that could lead to higher
all, I’ve joined a few patient commu- can broadcast their attitudes on physi- quality care, more loyal customers,
nities where I share how I’m doing cians, drugs, devices, treatments, efficiency, and even revenue growth.
on certain treatments and see how I
compare to others.
1 Madde, Mary. Zickuhr, Kathryn. 65% 2 Facebook, December 2011
of online adults use social networking 3 techcrunch.com/2012/02/07/pinterest-
sites. Pew Internet and American Life monthly-uniques/
Project, August 26, 2011, pewinternet.org/
Reports/2011/Social-Networking-Sites. 4 blog.twitter.com/2011/03/numbers.html
aspx, accessed on March 28, 2012. pg. 2 5 Ed Bennett, Found in Cache, ebennett.
org/hsnl/
The heart of the matter 3

5.
An in-depth discussion
Savvy adopters are
tapping into social
media to foster
new relationships

6.
Executive summary Willingness to share informa­ ‑
tion depends on trust. Sixty-one
percent of consumer respondents
According to PwC’s consumer survey are likely to trust information posted
of 1,060 U.S. adults, about one-third by providers, and 41% are likely to
of consumers are using the social share with providers via social media,
space as a natural habitat for health compared to 37% trusting informa-
discussions. Social media typically tion posted by a drug company, and
consists of four characteristics that 28% likely to share information with
have changed the nature of inter- a drug company.
actions among people and organi-
zations: user generated content, Age is the most influential factor
community, rapid distribution, and in engaging and sharing through
open, two-way dialogue. This report social media. More than 80% of
dives into the social world of the individuals ages 18–24 would be likely
health industry and provides insights to share health information through
into new and emerging relationships social media, while nearly 90% of
between consumers and the biggest individuals would engage in health
health companies that serve them. It activities or trust information found
examines how individuals think about via social media. Less than half (45%)
and use the social channel; how some of individuals ages 45–64 would be
providers, insurers, medical device, likely to share via social media, while
and pharmaceutical companies are 56% would be likely to engage in
responding; and discusses specific health activities.
implications for organizations to take
advantage of with this new view into Consumers are willing to have their
the 21st century patient. conversations monitored if they get
something in return. One-third of
consumers surveyed said they would
How consumers are be comfortable having their social
using social media media conversations monitored if that
Consumers are finding answers data could help them identify ways to
to their wants, needs and prefer‑ improve their health or better coordi-
ences. According to HRI’s survey, 42% nate care.
of consumers have used social media
to access health-related consumer A new expectation is being set on
reviews (e.g. of treatments or physi- response time. More than 75% of
cians). Nearly 30% have supported a consumers surveyed would expect
health cause, 25% have posted about healthcare companies to respond
their health experience, and 20% have within a day or less to appointment
joined a health forum or community. requests via social media, while nearly
half would expect a response within a
few hours.
An in-depth discussion 5

7.
Social media information is influ‑ Initiative (eHI), a national association therapeutics they’ve developed. But
encing decisions to seek care. For of health information and health tech- who has a full view of the individual?
example, 45% of consumers said infor- nology companies, reported that their Completing the patient profile is the
mation found via social media would social media efforts were decentral- likely next step in moving toward
affect their decisions to seek a second ized and managed by their marketing higher-quality outcomes-based care,
opinion. More than 40% of respon- and communications departments. IT although the prospect raises concerns
dents reported that information found departments and digital teams were about privacy protection and who
via social media would affect the way also identified as owning social media. owns and controls the information.
they coped with a chronic condition or Organizations that are strategic about Life activities and behaviors that indi-
their approach to diet and exercise. their use of social sites have differenti- viduals report in social networks open
ated between social media and social up a new view of patient health.
business. Social media was defined as
How organizations are the external-facing component that
using social media gives and receives customer input,
What this means for
Social media activity by industry and social business was defined as the health industry
organizations is dwarfed by the place where core operations, Business strategies that include social
consumer activity. Although eight like customer service, data analytics, media can help health industry compa-
in 10 companies evaluated by HRI and product development, could nies to take a more active, engaged
have some presence on various social use social data. role in managing individuals’ health.
media sites, the volume of activity for Social marketing can evolve into social
companies is in the hundreds versus Healthcare businesses started to business with the right leadership and
the thousands of posts, comments, and listen, but aren’t translating social investment of resources. Organizations
overall activity observed in commu- media conversations into practice. should coordinate internally to effec-
nity sites in a week’s snapshot analysis. One in two eHI members surveyed tively integrate information from the
In fact, community sites had 24 times worry about how to integrate social social media space and connect with
more social media activity on average media data into their businesses and their customers in more meaningful
than any of the health industry compa- how to connect social media efforts to ways that provide value and increase
nies over that one-week timeframe. a return on investment. Some organi- trust. Insights from social media also
Two out of three organizations in zations are capturing sentiment and offer instant feedback on products
the provider and insurer arena allow standard volume numbers on various or services, along with new ideas for
individuals to initiate posts on their sites, while others know that they innovation. Organizations that can
Facebook pages, known as “walls.” But need to go beyond capturing “likes” incorporate this information into their
fewer than one in three pharmaceu- and “followers” to collecting qualita- operations will be better positioned to
tical companies, which operate under tive engagement metrics. meet the needs of today’s consumers.
stricter regulations, have walls avail-
able for individuals to initiate posts. Data from interactions in social
media can complete the patient
Marketing/communications leaders profile. Patients know how they
tend to manage social media strate‑ feel, providers know how they treat,
gies. The majority of HRI interviewees insurers know what they cover, and
and members from the eHealth drug manufacturers know what
6 PwC Health Research Institute | Social media “likes” healthcare

8.
“ f you want to connect with people and be
I
part of their community, you need to go
where the community is.”
Ed Bennett, University of Maryland Medical Center
Social media changes achieve their goals.” For example, last
year Aetna partnered with a social
online dialogue
media company to offer members
from one-to-many to Life Game, an online social game to
many-to-many, at a help engage people to achieve their
phenomenal speed personal health and wellness goals.
In the past, a company would connect
The term “social media” is used with its customers via mail or a website,
widely, but remains ill-defined. but today’s dialogue has shifted to
This instantaneous communica- open, public forums that reach many
tion channel consists of four unique more individuals. Early adopters of
characteristics that have changed the social media in the health sector are
nature of interactions among people not waiting for customers to come to
and organizations: user generated them. “If you want to connect with
content, community, rapid distribu- people and be part of their community,
tion, and open, two-way dialogue. you need to go where the community
Common platforms are Facebook, is. You need to be connecting before
Twitter, and YouTube. In health, you are actually needed,” explained
examples of community sites include Ed Bennett, who oversees social media
Caring Bridge, Daily Strength, and efforts at the University of Maryland
BabyCenter. Medical Center.
The health industry has been slow to And social media is becoming a plat-
embrace social media, but is begin- form for internal discussions as well.
ning to see the benefits. In extensive “Our employees and physicians have
interviews with industry leaders, HRI had fruitful and provocative discus-
found many social media converts. sions using IdeaBook, our internal
Aetna, one of the nation’s largest social collaboration tool. The capacity
insurers, is among them. “Engagement for this candid internal collaboration is
is so important, but can be hard to crucial for our organization and essen-
achieve,” said Meg McCabe, Aetna’s tial to effectively running an organiza-
head of consumer solutions. “We’ve tion in the 21st century,” said Vince
been piloting several new social Golla, digital media and syndication
health platforms, and we’re seeing director, Kaiser Permanente.
that they can really make a difference.
Building connections among people
with similar health challenges gives
us a much better shot at helping them
An in-depth discussion 7

9.
Consumers are broadcast- information. “People like to access Social animals: Young invin-
ing and finding answers and connect with other people’s cibles are most willing to share,
to their wants, needs, stories, even if they’re unwilling to baby boomers are least likely
and preferences through share their own,” said Ellen Beckjord,
assistant professor at the University Based on age factor alone, the “young
social media
of Pittsburgh Medical Center and invincibles” ages 18–24 lead with the
Social media presents new opportu-
Hillman Cancer Institute, whose most social media activity, while the
nities for how individuals manage
research has focused on how making baby boomers ages 45–64 are least likely
their health, whether researching
health information available electron- to post or comment on any channel.
a particular illness or joining a
ically can affect disease management. More than 80% of individuals ages
support group to share experiences.
18–24 would be likely to share health
The virtual aspect of social media
HRI’s consumer survey found that information through social media, while
enhances communications by creating
Facebook and YouTube are the most nearly 90% of individuals would engage
a comfortable, often anonymous, envi-
commonly used social media channels in health activities or trust information
ronment for engaging and exchanging
for viewing health-related informa- found via social media. Less than half
tion. A 2011 National Research Corp. (45%) of individuals ages 45–64 would
6 National Research Corporation Ticker survey of approximately 23,000 be likely to share via social media, while
Survey: hcmg.nationalresearch.com/
public/News.aspx?ID=9 respondents produced similar results.6 56% would be likely to engage.
Figure 1: Impact of age level and health status on likelihood to engage, trust, and share about health using social media
6 National Research Corporation Ticker
Survey: http://hcmg.nationalresearch.
com/public/News.aspx?ID=9
Excellent health
Most likely Least likely
Trust Share
Share: How likely are you to share
health information through social
media with health-related
companies/individuals*?
15 18-24 30 35 40 45 50 55 60 65+ Trust: How likely are you to trust
Age health information posted online
through social media by health-
related companies/individuals?
Engage: Have you ever viewed health
related information or done health-
Engage Share Trust Engage
related activities using social media?
n = 1,060 * ealth-related companies/individuals include
H
hospitals, doctors, pharmacies, health insurers,
drug companies, etc.
Poor health
Source: PwC HRI Social Media
Consumer Survey, 2012
8 PwC Health Research Institute | Social media “likes” healthcare

10.
“Our patient support groups serve as a real-time referral network.”
Ryan Paul, Children’s Hospital Boston
When considering both age and health Figure 2: Percentage of consumers viewing health information through social media
status, respondents ages 18-24 in good
health were also more likely to share
via social media and trust information Health-related consumer reviews* Breakdown of consumer review types:
posted via social media (See Figure 1.) 42% = + + +
Alternatively, those ages 18-24 in poor 12% 11% 10% 9%
Friends’/family health experiences
health were most likely to engage. Medications Doctors Hospitals Health
32%
Respondents over age 65 in poor or treatments and other
medical
insurers
health were the least likely to trust, Other patients’ experiences with their disease facilities
29%
share, and engage using social media.
Health-related videos/images posted by patients
In addition, lower-income Medicaid 24%
beneficiaries were the most willing n = 1,060
to share at 64%, while individuals
with employer-based insurance were
*Consumer reviews of medications or treatments, hospitals and other medical facilities, doctors, health insurers
the least willing to share via social
Source: PwC HRI Social Media Consumer Survey, 2012
media at 51%. Those with individual
insurance and no insurance were also
among those who are most likely to
share and engage in health-related of quotes regarding our patient care,”
social media activities. said Ryan Paul, social media specialist
at the hospital. “This serves as the best
Social studies: Patients are type of validation for new patients
using social media to better looking for a hospital and for people
educate themselves to connect with others like them.”
When consumers are faced with a According to the HRI survey, 42%
health decision, social media can of consumers have used social media
provide a new avenue of information to access health-related consumer
and dialogue. Some may share a health reviews. (See Figure 2.) Thirty-two
goal to generate support or engage in percent of respondents have used
a patient community to interact with social media to view family/friend
other patients. At Children’s Hospital health experiences, and 29% have
Boston — which had nearly 700,000 sought information related to
Facebook “likes” as this report was other patients’ experiences with
released — prospective patients use their disease.
disease-specific support groups to learn
more about the hospital’s treatment or
clinical divisions from other patients.
“Our patient support groups serve as
a real-time referral network, which is
very different than giving people a list
An in-depth discussion 9

11.
Beyond viewing health-related inform- Research Branch. Social media also patient to evaluate and improve
tion through social media, nearly 30% helps satisfy a patient’s desire for self- his or her conditions as well as the
of respondents said they supported a service and access to information at system’s performance,” said Jamie
health-related cause or commented multiple touchpoints. Heywood, co-founder and chairman
on others’ health experiences. (See of PatientsLikeMe.
Figure 3.) Although some organiza- Social skills: Increased access
tions fear that creating a social media creates new expectations for The popular site tackles information
presence will open a flood of negative transparency and healing needs with peer care and
comments, individuals are more likely health data tools. “We’re capturing the
to share positive health-related experi- Social media has raised consumer relationship of caring for the individual
ences via social media than negative expectations. “As more people go by building a new kind of partnership
experiences. (See Figure 4.) HRI inter- online to interact with their banks and between the patient, their data, and
views also found that most consumer make purchases, they want to do this enterprises with the products that
comments online tend to be positive. with their doctors, health plans, and need to learn from them,” Heywood
condition and disease management said. Perhaps most significantly,
Although health activity on social as well. Social media has brought an PatientsLikeMe works with pharma-
media lags behind non-health related expectation for a different kind of ceutical companies to use patient-
activity, it’s expected to catch up in connection that already exists in their reported outcomes to inform the
the future. Twenty-seven percent of daily lives,” said Laura Clapper, MD, research and development processes.
consumers reported posting reviews chief medical officer of the online
of restaurants, hotels or products, community OneRecovery. (See more
while 17% said they posted reviews on OneRecovery in Case study 1.)
of doctors.
Several industry interviewees
The accessibility of social media pointed to social media sites such as
comes at an auspicious time for PatientsLikeMe, an eight-year-old
consumers who now pay significantly health data-sharing platform, which
higher portions of their care. With help patients connect with each other
insurance deductibles at an all-time and access relevant health informa-
high, consumers are more prone to tion. PatientsLikeMe connects more
shop around. “The democratization than 140,000 patients with others
of information through social media who have life changing conditions,
is shaping the clinical encounters and such as Parkinson’s and Lou Gehrig’s
the patient/provider relationship. disease. “Social networks will peel
It continues to bridge the informa- back every corner of the health system
tion divide,” said Wen-ying Sylvia and drive transparency on cost,
Chou, program director for the value, and outcomes. The information
National Cancer Institute’s Health asymmetry that patients experience
Communication and Informatics will be levelled, allowing the average
10 PwC Health Research Institute | Social media “likes” healthcare

12.
Figure 3: Percentage of consumers who use social media for health-related activities
Support health- Comment on Post about Join health Track and Post reviews Post reviews Share health- Post reviews
related cause others’ health health forum or share health of doctors of medications/ related videos/ of health
experiences experiences community symptoms/ treatments images insurers
behavior
28% 27% 24% 20% 18% 17% 16% 16% 15%
n = 1,060
Source: PwC HRI Social Media Consumer Survey, 2012
Figure 4: Likelihood of sharing positive and negative health experiences via social media*
Care Experience Specific Health Cost of Coverage Cost of care *Consumers responding likely or very likely
to share an experience using social media
received with doctor, insurer health by health at a hospital/
at hospital/ medication/ nurse, customer insurance insurer healthcare Source: PwC HRI Social Media
medical treatment healthcare service provider Consumer Survey, 2012
facility provider
44% 43% 42% 40% 37% 36% 36%
positive
negative
35% 37% 35% 34% 35%
40% 38%
n = 1,060
An in-depth discussion 11

13.
Case study 1
Recovering addicts get 24/7 support through social media start-up
Behavioral health is an area in which the round-the- How it works
clock support of social media fits well. “Substance abuse
• Members are invited by health plans, treatment
is one of those things that can negatively impact the
centers, or other members “in good standing.”
course of anything else you need to manage medically
The company has partnerships with five health plans
(e.g. diabetes can be complicated by an alcohol addic-
and numerous employers, treatment centers, and
tion),” noted Yan Chow, MD, director of Innovation and
other providers.
Advanced Technology at Kaiser Permanente. “Recurrent
cycles of cure and relapse make the management of other • Members can tap into various specialists and peer
conditions more challenging and expensive.” networks through their smartphones or computers.
And, they can aspire to help others as well. Members
More than 20 online sites such as In the Rooms, active for at least one year who have an established
Recovery Realm, and Addiction Tribe provide virtual reputation on the site can become senior peers,
tools to supplement treatment programs by connecting offering one-on-one support.
individuals to the support they need around the clock.
OneRecovery is an example of a company that has • Evidence-based clinical tools combined with interac-
created a consumer model that uses the mobile phone tive social and gaming technologies help members
to connect individuals with a community of people who manage their recovery. More than 80% of members
share their experiences. This type of program can scale use a tool called the “recovery clock”, which allows
up self care without necessarily scaling up traditional them to start their timekeeping from the beginning of
medical resources. recovery and alerts the network when someone needs
to “restart” their clock due to a relapse. Members can
Motivated by his own experience with addiction and check in with emoticons to inform others about how
recovery, David Metzler combined his expertise around they are feeling. This allows the members’ peers to
gaming and technology into OneRecovery, a “social intervene when there’s a “high risk” emoticon selected.
solutioning” company aimed at recovering addicts.”
OneRecovery is an invitation-only community of more
than 40,000 members. Unlike traditional treatment models OneRecovery’s Social Solutioning® Platform, 2012
in which health plans, physicians, or treatment providers
may call to “check in” on patients, through OneRecovery, “Effective”
“Members really are in control of how they share and Clinical principles reinforce and
extend the reach and impact of
participate. People can really feel like they own this the professional.
process,” said Laura Clapper, MD, chief medical officer.
Clinical
The model is changing how providers track patients’ Principles
progress. “OneRecovery provides a behavioral record
Structured
about how individuals and populations are doing peer support
post treatment,” said chief marketing officer Drew network
Paxton. “Organizations focused on quality and patient Social Game
Technology Mechanics
outcomes now have access to a new level of analytics.”
OneRecovery recently launched a platform which
allows connected health plans and providers to access
patients’ health reports (with the patients’ approval).
“Supportive” “Engaging”
Peer communities where
Leverages stickiness of game
Although a member may initially get referred for an members help peers manage science to drive behavior change.
chronic conditions.
addiction-related disorder, they can join additional
communities where they can get support for other
conditions, such as depression or anxiety. Source: OneRecovery, 2012
12 PwC Health Research Institute | Social media “likes” healthcare

14.
PatientsLikeMe demonstrates that HRI also found that about one-third Figure 5: Consumers’ feelings on doctors
despite privacy concerns, many of consumers would be comfortable going to online physician communities for
consumers are open to sharing infor- having their social media conversa- advice related to their health situation
mation via social media if it holds the tions monitored if it were to help
potential to improve their health. More improve their health, treatment,
than half of consumer survey respon- coordination of care, or management 54%
dents told HRI they would be comfort- of their chronic illnesses. Comfortable or
very comfortable
able with their doctor going to an online
physician community to seek advice if Social speed: Healthcare is on
the doctor were to gain information to a new response clockwatch
treat them better. (See Figure 5.) 17%
As consumers take advantage of social 9%
Online physician communities like media to instantly and publicly express
Sermo, a community of 130,000 their opinions, experiences, and reac- 14%
doctors, have realized the power of tions, they expect faster responsive-
sharing information. The site allows ness from healthcare organizations.
physicians to join free of charge and “Truly social brands will listen to what
is funded by companies interested in customers are saying and feeling and
surveying physicians for treatment or use that insight to adapt and create
23%
business research. “This is more than products and services,” said Kelly
networking — it’s collaboration and Colbert, director of strategic adver-
37%
interacting for learning and treatment tising at the insurer WellPoint.
purposes. Our physician members n = 1,060
share information with the end goal
of enabling better patient outcomes,”
said Richard Westelman, Sermo’s Very comfortable
chief operating officer. “The next Comfortable
evolution is how healthcare providers I don’t care
and patients start interacting with Uncomforable
each other. When, and in what setting, Very uncomfortable
will they come together?”
Source: PwC HRI Social Media Consumer Survey, 2012
An in-depth discussion 13

15.
More than 75% of consumers University Hospitals, was monitoring
surveyed would expect healthcare the Jefferson brand on Twitter and
companies to respond within a day saw that a patient in the Hospitals’
or less to a request for an appoint- Headache Center was complaining on
ment via social media, while nearly the social media site of his long wait.
half would expect a response within Goldstein, who was off campus, texted
a few hours. (See Figure 6.) In addi- the interactive marketing team to
tion, 70% of consumers would expect check out the waiting room and found
healthcare companies to respond that the patient had not signed in at
within a day to a request for informa- the computer kiosk. Within a matter
tion via social media, while just over of minutes, they were able to resolve
40% would expect a response within the matter. The incident highlighted
a few hours. Josh Goldstein, director the value of monitoring the Jefferson
of social media at Thomas Jefferson brand on social media channels.
Figure 6: Expectations for how quickly a healthcare company should respond when
contacted through social media
Request an appointment or Request information Post a complaint about a
follow up service, product, or experience
76%
70%
66%
49%
42%
39%
29%
23% 22%
1 3 6 9 12 18 24 1 3 6 9 12 18 24 1 3 6 9 12 18 24 hrs
n = 1,060
Within 1 hour Within a few hours Within a day or less
Source: PwC HRI Social Media Consumer Survey, 2012
14 PwC Health Research Institute | Social media “likes” healthcare

16.
45% of consumers said information from social
media would affect their decisions to seek a
second opinion.
Social networks: Information Figure 7: Likelihood of information found via
is influencing decisions about social media affecting health decisions
how and when to select treat-
ments and providers
Seeking second opinion from another doctor
45%
Consumers are increasingly using
information from social media to Coping with chronic condition or pain
assist in making healthcare choices. 42%
For example, 45% of consumers said Approach to diet, exercise, or stress management
it would affect their decision to seek a 42%
second opinion. (See Figure 7.) More
than 40% of respondents reported that Choosing specific hospital/medical facility
41%
information found via social media
would affect the way they coped with Choosing specific doctor
a chronic condition, their approach to 41%
diet and exercise, and even their selec-
Taking certain medication
tion of a specific doctor.
34%
Education levels may also play a Undergoing specific procedure or test
role in determining whether a facil- 33%
ity’s social media presence affects
Choosing health insurance plan
purchasing decisions. Individuals 32%
with lower education levels tended
n = 1,060
to be more influenced by a hospital’s
social media presence when making
treatment decisions than those with Source: PwC HRI Social Media Consumer Survey, 2012
higher education levels.
An in-depth discussion 15

17.
Across the health industry, consumers Figure 8: Percentage of respondents Figure 9: Percentage of respondents finding
seem to value information and services finding value in services offered by value in services offered by health insurers
that will help make their healthcare healthcare providers via social media and drug companies via social media media
easier to manage. More than 70% Percentage represents a response of Percentage represents a response of
of consumer survey respondents somewhat or very valuable somewhat or very valuable
would appreciate receiving assistance
from healthcare providers via social
Availability of doctor appointments Discounts or coupons
media with referrals and appoint-
72% 68%
ment scheduling, while 69% would
67%
value offers to save money and receive Appointment reminders
support post-discharge. (See Figure 71% Voice complaints/seek customer service
8.) Regarding the services offered by Referral to specialists 65%
insurers and drug companies via social 70% 67%
media, consumers find similar value,
Discounts or coupons for services Appointment reminders
with the most interest being ways to 69% 58%
save money and seek customer service.
Continued support post-treatment/discharge 67%
(See Figure 9.)
69%
Information to find cheapest medication
Voice complaints/seek customer service 65%
68% 67%
Patient reviews of doctors Treatment reminders
68%
60%
Treatment reminders 65%
68%
Support groups for similar patients
Current ER wait times 56%
65%
58%
n = 1,060
Share positive experiences with other patients
53%
Source: PwC HRI Social Media Consumer Survey, 2012
54%
Games/contests encouraging healthy behavior
42%
42%
n = 1,060
Drug company
Health Insurance
Source: PwC HRI Social Media Consumer Survey, 2012
16 PwC Health Research Institute | Social media “likes” healthcare

18.
Social currency: Providers have than an organization,” said Kathryn Mark Brooks, chief technology officer
the highest trust, drug compa- Armstrong, senior producer of web at Health Net, sees social media as
nies the lowest communications at Lehigh Valley a bridge: “In this business, we facili-
Health Network. While insurance and tate relationships, so we really think
Consumer survey respondents said drug companies might try to communi- about social media as not just a tech-
they would be most likely to trust cate with their customers through the nology and a process, but also as a
information posted via social media Internet or telephone, very few have capability that can help drive connec-
from providers (doctors, hospitals), direct, personal interactions with their tions in the value chain more effec-
and would be most likely to share customers. And while medical tech- tively.” As building these relationships
information with providers via social nology companies will disseminate becomes increasingly important to
media, over health insurance or drug information via their product sites, establishing trust and credibility with
companies. (See Figure 10.) very few have actually engaged with consumers, healthcare companies will
patients due to regulatory concerns.7 need to reconsider their approach to
Why do individuals trust their Healthcare providers have the ability these relationships.
doctors the most? Human relation- to form human relationships and
ships. “You want to trust and connect connections with their patients, which 7 PricewaterhouseCoopers Med Tech
with the people providing you the ultimately leads to increased trust. Focus: Social media opens new interaction
care. It’s easier to trust a person channel for medtech companies and
their customers, enhancing innovation
opportunities, 2011
7 PricewaterhouseCoopers Med Tech
Figure 10: Likelihood to trust or share informationFocus: Social media opens new
via social media
interaction channel for medtech
companies and their customers,
enhancing innovation opportunities, 2011
Doctor Hospital Health insurer Drug company
Likely
61% 55% 42% 37% to trust
information
Likely
41% 39% 34% 28% to share
information
n = 1,060
Source: PwC HRI Social Media Consumer Survey, 2012
An in-depth discussion 17

19.
Figure 11: Benefits of the digital social environment much more than media, it’s a social
strategy.” (See Figure 11 for indi-
vidual and company benefits of the
Individuals Healthcare companies digital social environment.)
–– View what others are experiencing in terms –– Demonstrate timely and thoughtful
of symptoms, reactions to treatments responses to problems Aetna is approaching social media in
–– Feel supported and not alone –– Understand in-between visit conversa- three ways, said McCabe: “Becoming
–– Research information to help ask better tions, behaviors, feelings a social business in how we leverage
questions to providers, insurers and others –– Reach a new audience for health social technologies to collaborate
education and service
–– Find real-time information and exchange within the organization, devel-
for a network of information –– Delegate spokespeople and lay
oping a social brand in the way we
referral agents
communicate and engage with our
Source: PwC Health Research Institute customers, and encouraging social
health within public or private
How health organiza- communities to empower others
to lead healthier lives.”
tions are evolving
from social media Another example of converting
marketing to social social media into business strategy
business strategy is Mercy’s experiment with the
customer referral concept. “We’re
Marketing typically owns social trying to capture the word-of-mouth
media in the beginning, but that referral patients use all the time and
soon evolves. In HRI’s survey of eHI make it easy to do via social media,”
members, 82% of respondents said said Brad Herrick, director of digital
their social media efforts are managed marketing at the 28-hospital system
by marketing/communications. in the Midwest. Mercy is creating
However, as an organization’s social an application that allows people to
media use grows, its purpose quickly “share” their doctors on Facebook,
morphs into customer service, inno- and the physician’s Mercy profile will
vation, and service/product devel- appear on an individual’s Facebook
opment. “As people go through life page. “Once our physicians agree
events and their health journey, they to have their Mercy profile shared,
have changing interests in health,” they don’t need to do anything
said Ann Sherry, senior director of else — this allows them to be some-
Kaiser Permanente’s Internet services. what social media savvy even if they
“They want and need different tools don’t have their own professional
and different interactions. To say Facebook page.”
we are going to have a social media
strategy would not be enough — it’s
18 PwC Health Research Institute | Social media “likes” healthcare

20.
Listen, participate knowing — it can involve looking at handle on negative chatter. On a posi-
and engage through company or brand sentiment, tracking tive note, companies that “listen” well
external forums touchpoints to various social media draw new ideas for services and use
Markets can shift quickly, and social sites, and analyzing comments and patient-reported health information to
media enables organizations to gauge discussions for qualitative patterns. inform the business.
the pulse of the public to diffuse a
problem or tap new opportunities. Here’s an example. Nurses within “No one has fully tapped into the
(See Figure 12.) a social network were discussing explosion of socially generated data
defects with a specific drug. The drug to understand what it means,” said
Listen maker’s executives had no knowl- Kevin Noble, director of interactive
edge of the defects — or the nurses’ marketing at Genentech. “My percep-
“One of the greatest risks of social discussions — until the chatter was tion is that the next level of intercon-
media is ignoring social media,” said discovered by regulatory authorities nectedness will be between pools of
Don Sinko, chief integrity officer of on one of the drug company’s social people who weren’t previously that
Cleveland Clinic. “It’s out there, and media sites. After this experience, close. Social media has the ability to
people are using it whether you like the company quickly established a pull together a fragmented industry,
it or not. You don’t know what you capability to mine information from with the patients and their informa-
don’t know.” “Listening” is the start to the social online community to get a tion in the center.”
Figure 12: Social media participation model for businesses
Listen Actively monitor and capture conversations to –– Company/brand
analyze and understand the meaning of what is sentiment
being said, the sentiment of the discussion, and –– New discoveries
what influence it has over audiences
–– Patient outcomes
Participate Proactively post and publish content on social –– Sponsor
media-enabled platforms to communicate a education
message to an audience, but not necessarily –– Corporate
engage them in a conversation messaging
Engage Actively interact in one-to-one, one-to-many –– Customer service
or many-to-many conversations within social –– Fundraising
media in order to freely exchange information
–– Champion a
and advance a discussion
health related
event or condition
Source: PwC Health Research Institute
An in-depth discussion 19

21.
Participate Engage Extend the customer
experience beyond a
Listening is just the first step for Engaging means having a mean- clinical encounter
healthcare businesses. As social media ingful, active presence in the social
use increases, new opportunities space. “That kind of relationship is In the retail world, good customer
for innovation emerge as consumer different than the old model of coming experience leads to retention and,
insights and ideas become more acces- in when the patient is sick. The new better yet, recommendation and
sible. Companies need to actively model is about connecting into the loyalty. Historically, the health
manage the data collected to capture member’s life decisions when they’re industry has not had to compete for
potential opportunities and respond healthy — about what food to buy customers in the same way, but the
appropriately. This may require taking or what type of physical activity to rising demand for value is forcing
action to remedy negative activity participate in,” said Chow of Kaiser companies to find different ways to
or information shared in the social Permanente. Before engaging, orga- get closer to their customers. (See
space. If there’s a negative post on nizations need to think about what Case study 2.) “Companies need to
any of Cleveland Clinic’s social media they’re looking for and why they want use health-oriented versus product-
forums, including Facebook, Twitter, to be there. Social media invites inter- oriented social media. They need to
and blogs, there’s a process to respond action, unlike a static webpage, where start communicating with the patient
both privately and publicly within a content can be developed once and need in mind,” said Greg Simon,
designated amount of time. revisited and refreshed later. former senior vice president of
patient engagement at Pfizer.
Even with the potential for negative “Facebook is turning into a behind-
publicity, Lee Aase, director of Mayo the-scenes customer service forum
Clinic’s Center for Social Media, for answering people’s questions,”
argues there can still be benefits to explained Paul of Children’s Hospital
engaging. “If you’re concerned about Boston. “When people have trouble
the ‘give and take’ aspect, then just finding what they need on our
‘give.’ This is half of it — you can use website (or sometimes they don’t
these tools to spread your message even check the website), they will
farther and at least start to create a come to Facebook and ask for help,
connection with your organization.” including how to change an appoint-
ment, how to find a certain doctor,
The response to negative feedback can etc.” Children’s encourages people to
carry equal or more weight than posi- participate in its various social media
tive consumer engagement programs. forums including Facebook, YouTube,
“Today, your organization’s digital Twitter, and its blogs, but warns them
identity is your identity,” said Mark against posting medical information
Langsfeld, co-founder of the social busi- and considering information posted as
ness intelligence company ListenLogic. medical advice. (See Figure 13: “Week
“The press is following what people do in the life of social health” for other
on the web. Before, the press is what ways organizations are engaging in
drove these insights, and now it’s flip- social media.)
flopped. Consumers are driving what
they want as a whole community.”
20 PwC Health Research Institute | Social media “likes” healthcare

22.
Case study 2
Health system internalizes social media to improve operations
What started as a social media experiment for Arlington, • Crowd-sourced problem solving: For example, when
Texas-based Texas Health Resources nearly three years there was an unexpected surge in emergency room
ago has resulted in a cultural transformation. Despite visits, the chief nursing officer reached out to the staff
initial reservations, Texas Health embraced the stra- to determine if additional support was needed.
tegic view that “social media reflects the kind of future
where healthcare is headed and can offer new ways and • Creating affinity groups: More than 100 “affinity”
delivery mechanisms to reach out to the community to groups have been formed, including ones around
encourage personal health responsibility,” said Edward weight loss, innovation, and sports. “We have formed
Marx, chief information officer for Texas Health and an a sports team where each member is from a different
active blogger and Twitter enthusiast. entity in our health system. Four out of the five team
members were picked up via the network,” said Marx.
But before Texas Health could be effective in engaging
customers externally, they wanted to develop an
Texas Health Resources social media model
internal culture of collaborating from operations issues
to customer service related issues. The effort started Cross-functional social media steering committee
with an interdisciplinary committee that developed a CIO Sr. VP Legal
CMIO Sr. VP Human REsources
simple social media policy based on trust of employees President Director of Marketing
with access to social media. “Once the gates were open, Sr. VP Marketing Communications Director of Communications
Sr. VP Compliance Director of Public Relations
people joined in. There was an untapped desire to do a
lot with social media,” said Marx. Internal social media External social media
Knowledge sharing Disease education and support
Social media has become a way of life for the multi- Innovation Community building
Communication and team building Employee recruitment
hospital system and is embedded in many aspects of
its business. (See Figure.) The system engages with
patients and community through Facebook, Twitter,
and blogs, connects with employees and physicians
through an internal social platform, and recruits Community Satellite
Existing
Potential
and potential
physicians sites employees
talent through LinkedIn. patients
Although internal social networking is voluntary, more
than 3,500 employees out of Texas Health’s 21,500
employees are active members. Following are ways it’s
Business
being used: partners
• Education and knowledge sharing: For example, the
Source: Texas Health Resources, 2012
chief medical information officer created a presenta-
tion on health information exchanges through input
given via the network.
An in-depth discussion 21

23.
Figure 13: A week in the life of social health
Over one week in February 2012, PwC’s Health Research there were lower overall membership counts among the
Institute tracked the social media activity of healthcare healthcare companies than communities, on average
companies (providers, insurers, pharma companies) more than 100 new members engaged with each company
and online consumer communities to create a “week in throughout the week. Further, the interactions that did
the life of social health” snapshot. The communities had take place were high-quality touchpoints between organi-
the largest membership and interaction — by both the zations and consumers, where they shared an educational
community moderators and the consumer members. resource or resolved a customer service issue. Despite
Community sites had 24 times more social media activity concerns by industry leaders that social media triggers
on average than any of the health industry companies — negative conversation, more than 80% of interactions
a single post in a community could generate several were neutral and only 5% were negative.
hundred comments. Communities remained active on
the weekends and were mostly driven by their consumer
members; whereas, provider, pharmaceutical, and insurer
groups had minimal activity on the weekends. Although
24x
Community sites had 24 times more social
media activity on average than any of the
health industry companies.
5%
Despite concerns that social media will solicit negative
conversations, the majority of mentions across all organization
types were neutral and only 5% were negative.
Average new likes, followers and views per organization Sentiment analysis*
Likes Followers Views Positive Neutral Negative
Provider 110 267 3,327 72 305 18
Pharma 148 109 17,119 110 681 50
Insurers 103 12 120 67 416 16
Communities 711 158 53,822 *Average sentiment in social media mentions per organization
Source: HRI Week in the Life Of Analysis, 2012
22 PwC Health Research Institute | Social media “likes” healthcare

24.
Consumer interactions with organizations via Facebook and Twitter
Activity measured in likes, shares, and comments
A community posted a question to members: “When did you
deliver your baby?—early, late, or on time?” and received:
61 likes Consumer
activity
766 comments
high:
6,778
low:
Communities 4,987
An insurer gained new members by hosting
A provider used quizzes to engage its a contest to reach its 15,000th page Like.
members. A quiz about Vitamin D had: The contest post received:
35 likes 321 likes
3 shares 5 shares Consumer
35 comments 16 comments activity
high:
633
low:
Provider 6
A pharma manufacturer alerted members
Pharma about a product recall which resulted in:
12 likes
Insurer 47 shares
12 comments
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Consumer Organization
Engagement with organizations’ Facebook sites Activity on their own Facebook sites
Consumers use provider sites to connect and share, but they treat Providers, insurers, pharma companies and communities use
insurer, pharma, and communities as a forum to give feedback. their sites to provide health information or answer questions.
Providers Pharma Insurers Communities Providers Pharma Insurers Communities
3% 5% 1% 1% 52% 35% 55% 88%
31% 48% 96% 69%
8%
18% 23%
5%
66% 47% 3% 30% 30% 57% 22% 7%
Asking questions Providing feedback Sharing and conversing Providing information Promoting Sharing and conversing
An in-depth discussion 23

25.
Tune up internal collabora- “There is this shift from hoarding Consider the privacy, security
tion processes to meet knowledge to sharing what you and other regulatory risks
external demands know as a way to both help others
and build your personal brand Privacy and security are top consumer
Health companies are responding to as an employee,” said Dee Anna concerns when sharing their health
employees’ needs to collaborate and McPherson, Yammer’s vice presi- information through social media.
connect through internal (enterprise) dent of marketing. “This knowledge Consumers are most concerned with
social media as well. Several organiza- can be used to enhance things like personal health information being
tions interviewed are using internal product development, customer shared in public (63%) and informa-
collaboration tools to connect on service, or on-boarding.” Several tion on social media being hacked or
personal interests and work-related interviewees said that personal leaked (57%). (See Figure 14.)
issues. For example, Mercy is using interest forums have led to work-
one such tool called Yammer to related communications such as
encourage and study collaboration collaboration drills on handling
for a medical home pilot. customer service inquiries that
require input from several depart-
Enterprise social network services are ments within an organization.
changing organizational culture and (See Case study 3 for more informa-
increasing employee engagement. tion on enterprise social media use.)
Figure 14: Consumer concerns of sharing health information through social media
Personal health Information Making a Health None of these Other
information being hacked decision based insurance
being shared or leaked on incorrect coverage being
in public information impacted due
to information
shared
63% 57% 52% 41% 20% 2%
n = 1,060
Source: PwC HRI Social Media Consumer Survey, 2012
24 PwC Health Research Institute | Social media “likes” healthcare

26.
Case study 3
Insurer extends customer experience capability through social media
Understanding that customers prefer to communicate Lessons learned:
and connect in different ways, Health Care Service
1. Consider the implications of a real-time communication
Corporation (HCSC), a four-state Blue Cross Blue Shield
channel. Responding thoughtfully and timely to
insurer, has used Facebook and Twitter to expand its
negative comments is just as important as offering
relationship with members. Its philosophy of offering
new services.
members their “channel of choice” prompted HCSC to
extend its one-to-one phone and web customer service 2. Educate departments so they’re prepared to
to a broader public forum. resolve issues.
Since HCSC began using social media for customer 3. Start small and ramp up strategically. As companies
service in 2008, its approach has evolved into a broader learn more about their audience and demand increases,
they need to be prepared to scale up services quickly.
strategy that provides information to raise health
literacy and improve disease prevention. “Health insur- 4. Build excitement within the organization about the
ance is something people don’t think about or don’t strategy, but make sure there’s an appreciation for
want to think about until something goes wrong,” said the amount of work that goes into managing a social
Lynde O’Brien, director of electronic media strategy. media channel.
“Connecting to members via social media before they
need care is a way to change that perception. We see 5. Look for opportunities to educate your customer
social media as a way to change the conversation and community about health benefits, processes, and
programs while being vigilant about protecting
establish a relationship with members in a way that’s
their privacy.
timely, relevant, and maybe even fun.”
6. Finally, O’Brien said the communications must be
For example, O’Brien tells of a young adult member who, “responsible and consistent. Members who decide to
after paying his first bill, tweeted negatively, saying on reach out via social media should get an experience
Jan. 26 at 7:27pm: “Just got my BCBSTX insurance card. consistent with other channels, such as a call center,
It’s confusing and I can’t afford it.” HCSC’s social media which offer an immediate response.”
community manager immediately contacted the customer
service team to coordinate a response. They invited the
unhappy customer to call so they could provide additional
information and support. The next day, the member
re-tweeted the entire exchange and the help HCSC had
provided to him. His final tweet a day later at 5:54pm
ended with “Great talking to you too! All my questions
were answered and my worries relieved.”
TWEET FROM: UPSET_MEMBER TWEET FROM: UPSET_MEMBER
Posted on: Jan 06, 2011 07:27 PM Posted on: Jan 07, 2011 05:54 PM
Just got my BCBSTX insurance card. It’s confusing and I can’t @BCBSTX Great talking to you, too! All my questions were
afford it. #mistake #swindled #PPO answered and my worries relieved.
Following: 38 | Followers: 66 | Updates: 1776 | Sentiment: Negative Following: 39 | Followers: 66 | Updates: 1798 | Sentiment: Positive
Source: Health Care Service Corporation
An in-depth discussion 25

27.
As healthcare companies and third Strategies should include a remedia- an area of excitement, but there’s little
parties start using social media- tion plan and training needs to be activity given the industry landscape,”
related information to inform busi- continual, detailing the consequences said Bob Rhatigan, senior vice presi-
ness, it’s important to be transparent of noncompliance on an individual dent of facial aesthetics at Allergan.
with consumers. Social media can and company level. Recent HRI “We can have a very controlled and
present risks such as information research showed that less than 40% regulated one-way dialogue, but to
being stolen through online fraud, of health industry organizations have a two-way dialogue in social
known as phishing, abbreviated URLs, surveyed have included social media media channels is very difficult. This is
data mining of information from in company privacy trainings.8 one of those mechanisms that cannot
social networking sites, employees be optimized to its full potential by
voluntarily disclosing critical busi- In the HRI survey, pharmaceutical/ pharmaceutical companies without
ness information, and data leakage life science companies were more further clarification and guidelines
violating confidentiality mandates. likely than providers and insurers to from the FDA.”
For more information on privacy and report social media as a top privacy/
security of health information, see security concern (35% compared 8 Old data learns new tricks: Managing
Old data learns new tricks: Managing to 27% and 21%, respectively). But patient privacy and security on
privacy and security on a new data- approximately 23% of drug makers a new data-sharing playground,
PricewaterhouseCoopers Health
sharing playground. said they have not begun to address Research Institute, 2011.
the privacy and security implications
Health industry organizations should of social media. Intense regulatory
have policies on business and personal scrutiny of marketing practices and
use of social media. For example, data stringent adverse-event reporting
should be classified so employees requirements have made the industry
understand what sensitive informa- reluctant to assume an active voice
tion is, how it can be used, and who is in the social media conversation.
authorized to access and share corpo- Although the industry is keenly aware
rate content. Company policies should of its obligations when sharing infor-
specify who owns relationships when mation about products, their uses, and
employees engage in social media side effects, industry regulators have
as representatives. For example, an yet to fully define the rules for social
employee working at a pharmaceutical media engagement. “Social media is
company develops a diabetes website.
The employee becomes “friends” with
doctors who are interested in hearing 8 Old data learns new tricks: Managing
about the latest technology. If the patient privacy and security on
a new data-sharing playground,
employee leaves the firm, who owns PricewaterhouseCoopers Health
the physician relationships? Research Institute, 2011.
26 PwC Health Research Institute | Social media “likes” healthcare