Social Media and Healthcare: What is it, and why should I care?

VCU Internal Medicine Grand Rounds

Mark Ryan, MD, FAAFP

Assistant Clinical Professor, Department of Family Medicine and Population Health

Founding member of the External Advisory Board for the Mayo Clinic Center on Social Media

Objectives

1. Participants will be able to define social media.

2. Participants will identify five major social media tools, and discuss differences between them.

3. Participants will explain potential benefits and limits of social media use by healthcare professionals and students.

4. Participants will identify potential uses for social media in medical education.

During this talk:

Looking down at your smartphones is a compliment.

The clacking of phone and computer keyboards is the same as applause.

Isn’t social media just a way to get celebrity gossip and share funny cat pictures and photos of my dinner?

What is social media?

Defined by Merriam-Webster online as: “forms of electronic communication (as

Web sites for social networking and microblogging) through which users create online communities to share information, ideas, personal messages, and other content (as videos)”

What is social media?

Social media incorporates a set of online tools and websites that allow users to share ideas and user-generated content while engaging with individuals and networks without regard to distance or location

Context

E-patients: 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).

Context

Context

Context

"I don’t know, but I can try to find out" is the default setting for people with health questions.

"I know, and I want to share my knowledge" is the leading edge of health care. Pew Internet & American Life Project:

The Social Life of Health Information, 2011

Context

According to a Research Corp’s Ticker survey reported in Feb 2011: 20% used social network sites to find health

information—of these, 94% Facebook, 32% YouTube, 18% Twitter.

33% reported “high” or “very high” level of trust, 24% reported information on social media was “likely” or “very likely” to impact healthcare decisions.

Only 7.5% reported “very low” level of trust. Social media users tended to be young and

affluent.

Context

Context

Context

Health 1.0: Health care providers control medical information, provide information to patients, and direct treatment.

Health 2.0: Patients become increasingly involved in care, asking questions of their healthcare providers, collaborating in treatment.

Context

“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.”

Context

In health 2.0, communication crosses in all directions between patients, patient advocates, health care providers, 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 via participatory health care.

Context

The goals of empowering patients and developing collaborative relationships between patients and health care providers 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.”

Context

“patients who were more knowledgeable, skilled and confident about managing their day-to-day health and health care (also known as “patient activation,” measured by the Patient Activation Measure) had health care costs that were 8 percent lower in the base year and 21 percent lower in the next year compared to patients who lacked this type of confidence and skill. These savings held true even after adjusting for patient differences, such as demographic factors and the severity of illnesses.” Judith Hibbard and Jessica Green

Social media tools

Social media tools

Blogs The most “traditional” of social media

tools Online publications/diaries, whose

content varies on the author’s interests. Allow for long, detailed discussions, and

can include embedded pictures, videos, etc.

Dialogue/discussion via comments.

Social media tools

Facebook Largest social network: “where the eyes

are”. Allows individual and organizational or

professional accounts. Posted material can be public or private. Groups with specific areas of interest

can be formed and can be made public or private.

Social media tools

Twitter Very short (140-character) messages. Accounts can be public or private. Users identified by their “handle”. Posts (“tweets”) are shared among

account “followers”, and can be shared (“re-tweeted”, or “RT”) with other users.

Social media tools

Making sense of Twitter Hashtags (the # symbol, followed by

letters and numbers) help categorize tweets. They are searchable within Twitter, and allow users to follow specific topics.

Hashtags allow for shared, live discussion on these topics (e.g. TweetChat), and are catalogued at the Healthcare Hashtag Project.

User-defined lists help organize the stream.

Social media tools

YouTube Users can record videos on any topic and

upload them for viewing at any time. These videos can be collected under a

“channel” and could range from patient education information to medical education topics.

Can use to record and publish short video blogs, lectures or lessons, etc.

YouTube is part of Google = easily searchable.

Social media tools

Social media tools

Audio podcasts Users can record radio shows and

podcasts for listeners. Allows for live, interactive discussions

during the recording. Material can be available live, or

recorded and listened to on-demand.

Social media tools

Why should I care?

Professional benefits: Information gathering and sharing. Connections and collaborations: grants,

research projects, presentations, etc. Public outreach/public health. Promotion and tenure: online

engagement opens up new opportunities.

Twitter to Tenure: 7 ways social media advances my career

Why should I care?

Teaching: Many of our trainees are already on

social media, and we can (should?!) help them use social media professionally.

In 2009, JAMA reported “60% of medical schools surveyed reported incidents of students posting unprofessional content online”—including profanity, discriminatory language, and alcohol.

Why should I care?

Teaching: Address core competencies of residency education via social media engagement: Medical knowledge: Increased access to new sources

of information; opportunities to discuss information with multiple contacts.

Interpersonal and communication skills: as social media becomes more widely used, we need to teach learners these skills.

Professionalism: Accountability to society and the profession, and sensitivity to diverse populations.

Systems-based practice: Enhanced awareness of team-based care and the roles of other professionals and of patients.

Why should I care?

Teaching strategies and tools: Blogs:

Asynchronous teaching sessions Didactic review and teaching sessions: http:

//hcwetherell.blogspot.co.uk/ Teaching and study guides:

http://www.anatomyzone.com/

Why should I care?

Teaching strategies and tools: Facebook:

Share teaching ideas, curriculum development, and instructional approaches.

Can use private or public groups: “Social Media in Medical Education”

Facebook Group. Virtual journal club? Could post and share

articles, and allow for asynchronous discussion.

Virtual office hours? Discuss and clarify class material.

Why should I care?

Teaching strategies and tools: Twitter:

Cataloging information (#PM101). Augment PowerPoint presentations, and enhance Q&A. Encourage students to learn from patient experiences:

“I follow patients to understand…to avoid complacency…to maintain compassion.” – Danielle Jones,

Sharing information and support: #TwitterStudying Virtual case discussions: presentation, H&P, labs,

discussion of DDx, review of management, and discussion of key learning points: http://storify.com/GuerrillaMedEd/he-s-just-not-feeding

Cautions

Privacy. Remember what is visible by the public, and to be professional.

Cannot practice medicine in this setting.

Not reimbursed. Patient interactions: OK or not? Time constraints.

Cautions

No standards of use or official “best practices”. The AMA guidelines are not much help, and do not encourage use.

There is no definitive guide to best practices. Role is still developing, meaning that best practices, etc. are still unclear.

Conclusions

Physicians should be active participants in social media in order to liberate their expertise.

Patients are more likely to trust physicians they know, they can identify, and who are local.

Claim your “share of voice”. ROI: Risk of ignoring. Moral imperative?

Conclusions

Look for good contact points as you get started—resources and people you trust.

Start by watching, then commenting and interacting, and then creating your own content.

Look for experienced users, and ask for help. Trust the community!

My contact information:

mryan2@mcvh-vcu.edu

@RichmondDoc A Life in Underserved Medicine Social Media Healthcare Minutiae and Detritus