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7/12/2012
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Healthcare Social Media: Time To Get On Board

Many hospitals and practices still hesitate to jump on board the social media bandwagon. Here's some practical advice to guide your organization through the decision process.




We humans are such social creatures. We band together to protect ourselves from a common enemy, we contribute food and clothing to the needy after a storm, and of course we tailgate to cheer on our favorite NFL team. Given this propensity to congregate, it comes as no surprise to see social media explode in the last several years.

By one estimate, 69% of active Web users--about 152 million people--visit Facebook at least once a month, and 62% of adult Internet users visit social networking sites of all sorts, according to Eliza, a healthcare communications vendor that specializes in patient engagement. Narrowing the figures down to health-related issues, Eliza says almost one out of every four social network users have followed their friends' personal health experiences or updates.

Obviously, social media is no passing fad, and healthcare providers who ignore this cultural phenomenon do so at their own peril, for at least two reasons: It's likely that the hospital or practice down the street is already working on a social media strategy, so you remain at a significant disadvantage if you keep your head in the sand. Equally important, several key federal IT regulations insist on more patient engagement--including the Centers for Medicare and Medicaid Services' Stage 2 Meaningful Use--and social media outlets are one of the best ways to engage patients.

But while some healthcare provider organizations have successfully navigated these waters, there are all sorts of undercurrents to watch out for.

Ernie Hood, senior director, research and insights for the Advisory Board Company, says that "usage issues" are more of a concern than direct technical problems. In a recent interview with InformationWeek Healthcare, Hood said potential stumbling blocks include understaffing of the social media effort; clumsy use, namely using the wrong social media tools; and not managing your message so that it's consistent across the organization.

Hood also had some good advice for CIOs: "We advise that they not try to lead the social media efforts but that they get in front by using it themselves and by encouraging others to leverage social media."

To help you through the decision-making process, our slideshow profiles how a major health system and a physician-practice are using social media. It also sums up advice from a HIMSS expert, a legal authority, and a nurse informatics specialist on the subject. And finally, we'll explore how two of the biggest social media networks designed for physicians are faring.




The MayoClinic has been in the forefront of social media ever since it began podcasting in 2005. It launched a Facebook page in 2007 and it has been on Twitter since 2008, the same year it began blogging.

It began using social media for media relations, according to Lee Asae, director of the Mayo Clinic Center for Social Media. "Social media has opened up communication and made communication flatter because people are able to communicate directly and to ask questions," Aase told InformationWeek Healthcare. "We are also able to share information on the Web that doesn't have to be on the Today Show or in the New York Times. It enables us to have much more in-depth information sharing and conversations with patients who may have an unusual condition that the mainstream media aren't going to cover, at least in any depth," Aase said. He added that through podcasts and YouTube videos, MayoClinic is able to make its expert researchers, scientists, and physicians available directly to people spread out around the country.

The MayoCinic recently finished its fourth installment of what it calls its social media residency, a day-and-a-half course that it provides for people working in healthcare. "It's a mix of internal MayoClinic people and external attendees. [During our last residency] we had 67 participants, a few doctors, some nurses, and people in various rolls throughout the organization," said Aase. He added that it's now becoming a basic requirement for hospitals to be involved in social media.

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Dr. Howard Luks's philosophy is pretty straightforward. "I firmly believe that physicians have a moral obligation to educate their patients." With that mantra in mind, Luks, chief of sports medicine at the N.Y. Medical College and Westchester Medical Center, has established a firm digital footprint. But he makes a distinction between a digital presence and a social media presence.

"You can root your digital presence in social media, but it doesn't have to be and the two aren't mutually exclusive," Luks told InformationWeek Healthcare." Luks created a website and became a very active user of Twitter in 2008 to interact with other physicians and urge them to share their experiences. He also has a Facebook page and is currently exploring Read List, a new platform where you can curate content in the form of a book. "For example, I can make a book about the knee or meniscus tears and I can include my own content as well as published articles or content from a government site or the MayoClinic and send a patient a link to that read list."

Luks said that a significant percentage of his patients are in his office because of his online presence. "Having a digital presence that's rooted in social media enables me to humanize myself and humanize my organization. To ignore your online presence or digital presence or practice website is to potentially ignore your own relevance as a practitioner over the next five to 10 years."

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By the end of 2011, one billion consumers were online using social media. But only 21% of hospitals were using social media in the United States, according to Brad Tritle, chair of social media work group, which is part of the HIMSS personal health IT task force. "Hospitals like to communicate but they weren't going where the people were, similar with physicians," Tritle told InformationWeek Healthcare. He said that most hospitals start using social media from a marketing standpoint. "But we're finding that those [hospitals] that are more effective and are attracting more people are doing more patient education, community education, and from that using customer relationship management (CRM) tools." He said that some hospitals are seeing a return on investment (ROI) for doing that kind of engagement.

Smith and White Hospital in Texas, for example, turned to Twitter and Facebook when the phone system went down during the Fort Hood shootings a few years ago. "Hospitals are using social media for marketing, patient education, and for disaster communications," according to Tritle, who also said that among the major barriers to social media adoption are concerns about privacy and security. He added that healthcare personnel need to know that there are boundaries. "These are tools that you can use and you should not, for example, share personal health information online," said Tritle. He adds that hospitals should lay out guidelines about how to correctly insert social media into existing standard employee agreements and HIPAA agreements.

Tritle's take home message: "Social media, when utilized appropriately, can be a great channel for communication and education. We encourage it, we think that it's going to benefit the HIMSS members by becoming active in social media."

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Social media can benefit healthcare providers, but there's also a dark side to be aware of. Frankly, it can ruin people's reputations, says John E. Steiner, Jr., chief compliance officer for Cancer Treatment Centers of America. Steiner points out that HIPAA has a criminal provision because people have been known to hurt other people by blasting libelous and defaming information on social media sites.

From a practical standpoint, Steiner said that a healthcare organization's legal exposure grows as the number of social media channels proliferate to include blogs, websites, emails, instant messaging, text messages, chat rooms, statements to the media, and any other forms of communication that may appear in the future.

He stressed the importance of having a social media policy in place so healthcare employees have some kind of guidance. When a hospital, for example, issues a PDA or a laptop to its employees, they are using property that's provided to them by the company and, as a result, they need to follow company policies when they are using that type of technology, Steiner said.

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As more healthcare organizations engage in social media, the ability to manage compliance with various state and federal laws becomes a real concern. With its SafeGuard offering, Charlottesville, Va.-based OpenQ, provides organizations with tools that enable social interaction while at the same time helping them address the issue of compliance.

According to Otavio Freire, OpenQ's chief technology officer, there's always risk with social media. "OpenQ allows you to look out for things that can create compliance issues and puts a safety net on that and unleashes social adoption."

Suppose a health care organization wants to engage in social business internally. For example, they want to have a Jive platform to share information back and forth to operate their business better, but they are concerned about the handling of personally identified information. By investing in Safeguard, the organization can listen to the interactions that are taking place and then, if appropriate, bring questionable information to the attention of a regulatory compliance officer, Zuffoletti said.

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Twelve years ago Eliza Corp. began pursuing a concept called health engagement management--using communication technology and behavioral analytics to keep people engaged about their health and health care. A dozen years later the notion of health engagement management has proven successful.

The Danvers, Mass.-based Company provides its health care customers--including large health plans, large health care systems, and disease management companies--with configurable programs that they can set up and then communicate with their patients or members about health related topics.

For example, one goal may be to extend the reach of a diabetes education program or the rate at which you can reach people who are pre-diabetic to delay the onset of the disease. "[We] use an analytics platform to present to customers what's working for whom, the channel of communication. Certain people respond more to an email versus a phone call, versus a text message," Lucas Merrow, Eliza CEO, told InformationWeek Healthcare

For example, Eliza does a lot of business during flu season making sure that senior citizens are aware that flu season is coming and recommending where they can get their vaccine.

As social media continues to explode within the healthcare sector, Eliza supports customer programs that support social media. "We're agnostic with respect to what channel we run the program. What we find is that if one channel works well, a combination of channels essentially always works better."

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When it comes to nursing and social media, you might say that Debra Wolf, PhD, RN, wrote the book. She did, literally. Wolf, an associate professor at Chatham University Department of Nursing, co-authored Social Media for Nursing, Educating Patients and Practitioners in a Networked World. Despite her enthusiasm for the subject, she says not all nursing professions are embracing social media to the point of where they use it to expand their services. "There's a lot of work out there right now in helping organizations extend their services through social media. Some of them are starting with physicians and with telehealth or telemedicine programs. But the push to have nurses utilize it is not occurring yet and that was one of the reasons for publishing the book.

"We need to help nurses understand social media and then to integrate it into their current practice," Wolf told InformationWeek Healthcare. One nurse who appreciates the value of social media, according to Wolf, is Renee Thompson, president and CEO of RTConnections. Thompson started the company because she believed that patients deserve to be cared for by competent, compassionate nurses and that nurses should believe they make a difference.

"To make that happen I offer keynote presentations that help nurses take ownership of their practice; seminars and workshops to improve clinical and professional practice; and consulting to help organizations create nurturing and supportive work environments for employees and the patients they serve," Thompson told InformationWeek Healthcare. "We use social media to socialize with other 'people' but not to engage in conversation as a profession. Nurses are way behind other professionals in getting involved in social media."

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According to Manhattan Research's Taking the Pulse v11.0, 2011 survey, 24% of U.S. physicians currently use or have expressed interest in using online communities or social networks created specifically for physicians. Sermo and QuantiaMD are two top-tier companies that are capitalizing on this interest.

"We call ourselves a physician community and not a network," Jon Michaeli, vice president of marketing and membership for Sermo, told InformationWeek Healthcare. Sermo insists on calling itself a community rather than a network because he said that a community evokes a sense of ownership and accountability to each other. He said that in medicine, when you're talking about clinical discussion and getting a colleague's input into real live patient cases, a community does that very well.

According to Michaeli, Sermo is the largest physician community, with almost 130,000 doctors. And that growth in membership is increasing Sermo's value. "It's the network effect. When more people use it, the value increases. It's efficient to do things on the Internet in a community like this that would be very difficult otherwise." For example, physicians in remote areas who aren't part of a large practice are isolated and often want to consult with their colleagues. With Sermo, they can do that and get responses within minutes. "At the end of the day, it gives them the opportunity to crowdsource, that's the key word," Michaeli said.

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If you want to be part of QuantiaMD, you better know what you're getting yourself into. Yes, it's a social network of physicians, but according to Eric Schultz, chairman and CEO, it's social in the sense that you interact with other physicians, but in a professional manner within a gated community--in other words, true peer-to-peer.

According to Schultz, only clinicians who pass a rigorous validation can participate. "People interact using their real names, it's a professional network and because they use their real name the behavior is very professional and the interaction is professionally focused," Schultz told InformationWeek Healthcare. QuantiaMD is free to participating doctors.

QuantiaMD offers interactive content and has a faculty of more than 540 experts who create interactive cases and short concise presentations where physicians can talk about the merits of a diagnosis or the availability of treatment methodologies.

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Tim Pacileo
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Tim Pacileo,
User Rank: Apprentice
7/18/2012 | 5:13:53 PM
re: Healthcare Social Media: Time To Get On Board
Social Media is a real game changer for most healthcare marketers, but not in the sense that many of us think of when it comes to social media benefits. Social Media actually impacts the cultural and lifestyle of the hospital marketer which in turn drives this reluctance to change.

Once a hospital goes live with social media it's no longer about pushing out messaging and developing campaigns in a 9-5 setting. When a hospital goes "live" with social media they can't turn it off, it runs 7 X 24 X 365 in real time. Someone needs to monitor the sites and be able to respond to inquires as the expectations from the users are to have quick responses to their messages. If there are negative comments on the social sites many of the hospitals have not even thought about how to respond. In fact I heard comments such that "If we don't go social then we don't have to worry about it". Clearly this is a flawed approach as we know people will post their comments on other sites and in most cases the hospital will not be aware of the comments, until the press or some other entity brings it to their attention. It's much better to have the sites up and listen then it is to get blindsided.

As for the security and HIPAA concerns, again I am not seeing many hospitals with social media policies in place and they need to have them even if they have not set up their corporate sites. Any hospital employee, nurse and/or physician that is active on a social media site should be following the guidelines and policies of the hospital, but if these don't exist they actually put the hospital at risk and in some cases the employee, nurse or physician are at risk as well both personally and professionally. In one quick example a nurse who was very active on her social media site had a patient who would not ask her for a data in person, found out on her Facebook page that she was single and asked her out on Facebook. Having the proper policies in place could have prevented this from occurring.

Nest we have an accountability concern because everything in the digital world can be managed, monitored and modified for ROI. It's not like in the good old days when one sent out thousands of postcards and hoped for a 2% response rate, or they ran an ad and if it didn't get the results they ran the same ad again. In the online world you can run an ad for a few days and if it's not working, you can change it on the fly to improve the results or re-target it to a different audience. There is much more flexibility tied to these solutions to drive better results and more impact for the brand and there also is more work because of it.

Today the online world of marketing is disrupting how many of the hospital leadership teams and supporting marketing teams promote their brand or services/specialties and they are not thoroughly convinced that online marketing will drive the benefits they seek, despite all the information and statistics to support this transition. There is also the concern of even more transparency and accountability and a new set of tools and solutions not just in social media but in digital marketing, mobile marketing and Big Data that all impact hospital marketing.

Social media and online marketing are gaining momentum and growing in importance to the healthcare marketer. It's not too late to get on the train and embrace the change, but you need to be able to move quickly as this change is accelerating.

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