Social Media in Health Care Case Study: FDA Removing Morphine Christian Sinclair, MD April 12, 2009
Background <ul><li>Morphine liquid at a concentration of 20mg/ml is an essential medication in hospice care </li></ul><ul>...
March 31st <ul><li>The FDA issues a memo notifying pharmaceutical manufacturers to stop making and dispensing a variety of...
 
On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along...
Late March 31st <ul><li>A nurse who I used to work with and is a Facebook friend posted a status update. </li></ul><ul><li...
 
On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along...
April 1st <ul><li>FDA memo mentioned by two people I follow (and trust) on Twitter </li></ul><ul><ul><li>@doclake </li></u...
First mention on Twitter
Re-tweeted in one hour
Re-tweeted again in few minutes
On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along...
April 1 st  – Late PM <ul><li>Sporadic emails to AAHPM/NHPCO likely throughout the day </li></ul><ul><li>Multiple discussi...
On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along...
April 2 nd   <ul><li>Comments on Pallimed post begin early in the AM and continue thru day </li></ul><ul><li>Commenters en...
On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along...
April 2 nd  late PM & 3rd <ul><li>NHPCO on 4/2 </li></ul><ul><ul><li>Announces on Website, ?Email </li></ul></ul><ul><li>A...
On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along...
April 4th-8th <ul><li>Multiple emails between major organizations detailing strategy </li></ul><ul><li>Official letter fro...
On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along...
Thursday, April 9th <ul><li>A Facebook group protesting the memo is formed the morning before the FDA teleconference </li>...
On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along...
Thursday, April 9 th  - PM <ul><li>FDA issues reversal of memo </li></ul><ul><li>Morphine 20mg/ml will not be removed from...
On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along...
Reversal Announced <ul><li>On many different platforms </li></ul><ul><ul><li>Individual emails </li></ul></ul><ul><ul><li>...
Lessons <ul><li>Develop your social networks across platforms for maximum effect </li></ul><ul><ul><li>You must contribute...
Lessons <ul><li>Redundancy is good </li></ul><ul><ul><li>If you find something important to you, pass it on, even if you t...
Lessons <ul><li>Be humble </li></ul><ul><ul><li>I cannot pretend to think posting about the FDA memo on Pallimed changed t...
Lessons <ul><li>Stickiness Matters </li></ul><ul><ul><li>No one will forward what you had for dinner </li></ul></ul><ul><u...
On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along...
Thanks to: <ul><li>Drew Rosielle, MD </li></ul><ul><ul><li>For creating Pallimed and letting me join </li></ul></ul><ul><l...
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Social Media In Health Care: FDA Limits Liquid Morphine

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A case study of how the hospice and palliative medicine field rallied to help overturn a FDA ruling that would have severely limited access to morphine, an essential medicine for pain control.

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Social Media In Health Care: FDA Limits Liquid Morphine

  1. 1. Social Media in Health Care Case Study: FDA Removing Morphine Christian Sinclair, MD April 12, 2009
  2. 2. Background <ul><li>Morphine liquid at a concentration of 20mg/ml is an essential medication in hospice care </li></ul><ul><li>It is currently ‘unapproved’ but allowed to be manufactured and distributed by the FDA </li></ul>
  3. 3. March 31st <ul><li>The FDA issues a memo notifying pharmaceutical manufacturers to stop making and dispensing a variety of opioid products that are unapproved within 90 days. </li></ul><ul><li>Morphine 20mg/ml is included in the list. </li></ul><ul><li>The memo is posted to the website, RSS feeds and fax. (?email?) </li></ul>On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  4. 5. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  5. 6. Late March 31st <ul><li>A nurse who I used to work with and is a Facebook friend posted a status update. </li></ul><ul><li>Notice the times: I did not see this until late on April 1. </li></ul>On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  6. 8. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  7. 9. April 1st <ul><li>FDA memo mentioned by two people I follow (and trust) on Twitter </li></ul><ul><ul><li>@doclake </li></ul></ul><ul><ul><li>@johnmulder </li></ul></ul><ul><li>Also hits newspapers </li></ul><ul><ul><li>Never saw the story in local paper </li></ul></ul><ul><ul><li>Or online news feeds </li></ul></ul>On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  8. 10. First mention on Twitter
  9. 11. Re-tweeted in one hour
  10. 12. Re-tweeted again in few minutes
  11. 13. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  12. 14. April 1 st – Late PM <ul><li>Sporadic emails to AAHPM/NHPCO likely throughout the day </li></ul><ul><li>Multiple discussions on local levels </li></ul><ul><li>FDA memo and unintended consequences posted to Pallimed around 11pm CST </li></ul><ul><li>Hits RSS and Twitter immediately (800+ subscribers) </li></ul><ul><li>Email subscriptions go out around 2am CST 4/2 (800+ add’l subscribers) </li></ul>On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  13. 15. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  14. 16. April 2 nd <ul><li>Comments on Pallimed post begin early in the AM and continue thru day </li></ul><ul><li>Commenters encouraged to contact NHPCO and AAHPM leadership </li></ul><ul><li>AAHPM source says emails between orgs did not start really going until April 2 nd </li></ul>On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  15. 17. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  16. 18. April 2 nd late PM & 3rd <ul><li>NHPCO on 4/2 </li></ul><ul><ul><li>Announces on Website, ?Email </li></ul></ul><ul><li>AAHPM on 4/3 </li></ul><ul><ul><li>Issues email alert </li></ul></ul><ul><li>Neither post to Twitter or Facebook at that time </li></ul><ul><li>Announces plan to write joint letter to FDA </li></ul>On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  17. 19. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  18. 20. April 4th-8th <ul><li>Multiple emails between major organizations detailing strategy </li></ul><ul><li>Official letter from orgs to FDA on 4/6 </li></ul><ul><li>Individual Letters/Emails to the FDA </li></ul><ul><li>Individual Letters/Emails to Congress </li></ul>On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  19. 21. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  20. 22. Thursday, April 9th <ul><li>A Facebook group protesting the memo is formed the morning before the FDA teleconference </li></ul><ul><li>FDA arranges teleconference </li></ul><ul><li>AAHPM gets the word out by email, Twitter and Facebook only minutes before teleconference (due to late arrangement) </li></ul><ul><li>Multiple listeners on conference call </li></ul><ul><ul><li>?numbers? </li></ul></ul>On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  21. 23. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  22. 24. Thursday, April 9 th - PM <ul><li>FDA issues reversal of memo </li></ul><ul><li>Morphine 20mg/ml will not be removed from the market at this time </li></ul><ul><li>Although regional shortages are still present </li></ul><ul><li>Announced by: </li></ul><ul><ul><li>Email, Facebook, Twitter, and Websites </li></ul></ul><ul><ul><li>By multiple individuals and organizations </li></ul></ul>On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  23. 25. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  24. 26. Reversal Announced <ul><li>On many different platforms </li></ul><ul><ul><li>Individual emails </li></ul></ul><ul><ul><li>Broadcast emails </li></ul></ul><ul><ul><li>Twitter (and re-tweeted a lot) </li></ul></ul><ul><ul><li>Facebook (in many different groups) </li></ul></ul><ul><ul><li>On websites (AAHPM, NHPCO, FDA) </li></ul></ul><ul><ul><li>On blogs (HFA, About.com, Pallimed) </li></ul></ul>On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  25. 27. Lessons <ul><li>Develop your social networks across platforms for maximum effect </li></ul><ul><ul><li>You must contribute to the social network or else you will not have the connections or social capital to move messages </li></ul></ul><ul><ul><li>Pallimed has built readership over 4 years but has never been part of an event like this </li></ul></ul><ul><ul><li>Our readers felt empowered by a shared narrative. What is your networks shared narrative? </li></ul></ul>
  26. 28. Lessons <ul><li>Redundancy is good </li></ul><ul><ul><li>If you find something important to you, pass it on, even if you think your friends & followers may have already heard it </li></ul></ul><ul><ul><li>I missed the FDA memo on Facebook and the News, before I saw it on Twitter </li></ul></ul><ul><ul><li>It is sometimes OK to repeat your message </li></ul></ul><ul><ul><li>It is better if other people do it for you </li></ul></ul>
  27. 29. Lessons <ul><li>Be humble </li></ul><ul><ul><li>I cannot pretend to think posting about the FDA memo on Pallimed changed the world </li></ul></ul><ul><ul><li>But it could have accelerated the change </li></ul></ul><ul><ul><li>If the Twitter/Facebook and other social networks you need are strong, you can move mountains </li></ul></ul><ul><ul><li>Or get the FDA to reverse a ruling in 9 days. </li></ul></ul>
  28. 30. Lessons <ul><li>Stickiness Matters </li></ul><ul><ul><li>No one will forward what you had for dinner </li></ul></ul><ul><ul><li>But if you put your concern in context for your reader/friend/follower, they will listen, and possibly interact, and possibly pass on your message </li></ul></ul>
  29. 31. On March 31 st , the FDA issued a memo effectively ending the production and distribution of morphine 20mg/ml liquid along with other opioids Thursday
  30. 32. Thanks to: <ul><li>Drew Rosielle, MD </li></ul><ul><ul><li>For creating Pallimed and letting me join </li></ul></ul><ul><li>My Twitter and Facebook networks </li></ul><ul><ul><li>For passing on the message because it meant something to you </li></ul></ul><ul><li>Email any questions/corrections to: </li></ul><ul><li>[email_address] </li></ul>

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