Social media and online tools are empowering patients and enabling new forms of participatory healthcare known as Health 2.0. Patients are increasingly educated online and use social platforms like Facebook, Twitter, blogs and YouTube to find health information and connect with providers. While this presents challenges around privacy and professional standards, it also offers opportunities if used strategically. Social media could help disseminate public health updates, answer general questions, send reminders, and help patients access resources and care. Early evidence suggests some providers are seeing new patients and income from their online presence.

1. Why add *another* task to a busy day? Social Media and Health Care

2. 2011 Virginia Telehealth Summit

5. E-patient: not an abbreviation for “electronic patient”. Equipped, enabled, empowered, engaged, equals, emancipated and experts. E-patients use internet resources and social media to educate themselves and others and to enhance health care for patients (and for providers). Why this matters

6. The goals of empowering patients, developing collaborative relationships between pts and HCPs align with the concept of the patient-centered medical home (PCMH): “ Enhanced access to care is available through systems such as open scheduling, expanded hours and new options for communication between patients, their personal physician, and practice staff . ” Why this matters

7. Increasingly, patients and the public will look for physicians who are willing and able to interact with them via social media. Even the Healthy People 2020 goals reflect this shift, and recognize the value of social media. Pew Internet project shows some vulnerable communities with higher-than-average use of Twitter. Why this matters

8. According to National Research Corp’s Ticker survey reported in Feb 2011: 1/5 Americans use social network sites to find health information—94% Facebook, 32% YouTube, 18% Twitter. 1/4 reported this info was “likely” or “very likely” to impact health care decisions. 1/3 reported “high” or “very high” level of trust; only 7.5% reported “very low” level of trust. Why this matters

9. Health 1.0: Health care providers (HCPs) control medical information, provide information to pts, and direct treatment. Health 2.0: Pts become increasingly involved in care, asking questions of HCPs, collaborating in treatment. Why this matters

10. “ A concise definition of Health 2.0 is the use of a specific set of Web tools (blogs, Podcasts, tagging, search, wikis, etc) by actors in health care including doctors, patients, and scientists, using principles of open source and generation of content by users, and the power of networks in order to personalize health care, collaborate, and promote health education. ” Why this matters

11. In other words, in health 2.0 communication crosses in all directions between patients, patient advocates, HCPs, etc. This communication includes user generated content in which individuals produce the material being distributed. The goal is to enhance individuals’ health and health care. Participatory health care. Why this matters

13. Blogs The most traditional of social media tools. Online publications/diaries. Content varies on the author ’ s interests. Can include embedded pictures, videos, etc. Dialogue/discussion via comments. Social Media Tools

14. Kevin MD 33 Charts Seattle Mama Doc Social Medial Healthcare: Community of Practice Social Media Tools

16. Facebook Allows for private messages, public comments and discussion, and information sharing among a network of interested people. For patient interaction, it is likely safest to have a professional Facebook page separate from your private Facebook page. For professional pages, determine how much interaction you will allow. Social Media Tools

17. Facebook I recommend using tight privacy settings on private Facebook pages. There is debate about whether to “ friend ” patients on Facebook. I choose not to. Social Media Tools

18. Dominican Aid Society of Virginia group page Una Vida Sana group page Social Media Tools

20. Twitter Characterized by very short messages (140 characters). Posts (tweets) are distributed among your “followers”. Tweets are public unless you choose to protect them, in which case you must accept followers requests. Social Media Tools

21. Some jargon: All Twitter usernames (handles) start with the “ @ ” Retweet (RT): one user re-posts another’s post. This allows sharing of information and can help start conversations. Replies start with another’s user name (@); this notifies the other user you are speaking to them. Direct message (DM): only viewed by recipient, not the public. Social Media Tools

22. Jargon (cont) Hashtag (#): topics of interest can be tagged with a #. For example, any post focused on health care reform can be tagged “#HCR”. This allows you to search for any recent posts that incorporate that tag. “ What the Hashtag” is a website that defines as many #s as possible. #s allow for Twitter-based conversations (#hcsm, #MDChat). Social Media Tools

23. My Twitter feed My Twitter profile Social Media Tools

24. Best practices for Twitter: Find resources worth following. Interact with people. Be a resource to the community. Develop lists to filter out the stream. Use tools (TweetDeck) to simplify use. Social Media tools

25. Health 1.0: VCU Facebook VCU Twitter Examples

26. Health 2.0 (good) Bon Secours Facebook Bon Secours Twitter Examples

27. Health 2.0 (better) MacArthur Ob/GYN Facebook MacArthur Ob/GYN Twitter Examples

28. Privacy (yours and the patient’s). Remember what is visible by the public. Cannot practice medicine in this setting. Not reimbursed. No standards of use or official “ best practices ” . The AMA guidelines are not much help, and do not encourage use. Role is still developing: wider use within patient communities, variable interest for provider/patient communication. Cautions

29. Envision how social media could change health care delivery: Broadcast important public health information. Answer general medical questions and be a resource to the community for general topics. Advocacy. Potential

30. Envision how social media could change health care delivery: Send disease-specific reminders (Have you checked your blood sugar? Have you taken your medicine?); patients can choose to receive Tweets or Facebook updates as text messages. Some evidence that text message reminders can improve adherence and patient satisfaction. Potential

31. Envision how social media could change health care delivery: Use Facebook or Twitter DMs to ask patients to contact the office. If/when secure portals enter wider use, can refer patients directly into care via E-visits or other portal-based services. Connecting social media into personal communication (SMS/text messages and portals) will maximize potential. Potential

32. Help patients find necessary resources, including free clinic services, health fairs, and dental screenings. Can have a personal Twitter account and a professional/practice Twitter account, and use them for different purposes. Potential

33. Personal and professional benefits: I submitted two abstracts for talks (one PCMH, one STFM) with someone from Colorado I have had not actually met at that time; both were accepted. I collaborate on a blog with 2 people I have not met in person; the blog has 6,507 page views since we started last August. I have made connections across the US and met Twitter acquaintances in real life. I learn something new and interesting most every day. Potential

34. Practice income: One orthopedist noted 14 patients in one month who found him via his web presence. This could easily represent $2,100 in charges. This could help convince health systems of the value of social media engagement. Potential

35. I think that social media communication tools will continue to impact how doctors and patients communicate with each other. We are early in the process of determining the best use, but I think health care providers need to be engaged in the process because social media will become increasingly important. Conclusion

36. Thank you for your attention. [email_address] http://socialmedia.mayoclinic.org/