1) A longitudinal study analyzed the use of social media by hospitals in 12 Western European countries over three time periods from 2009 to 2011. 2) The study found that hospitals' use of social media, especially YouTube, Twitter, and blogs, increased significantly over time. However, there were significant differences between countries. 3) Hospitals seemed to use social media primarily for promotional and recruitment purposes as opposed to direct engagement with patients. The study concluded that more research is needed on how social media can improve healthcare.