ou nnp.10.2011

The Virtual NICU Team: Using Social Media in

Medicine

CLARA SONG, MD, FAAP

Assistant Professor of Pediatrics

Section of Neonatal-Perinatal Medicine

DISCLOSURE

• SPEAKER: Clara Song, MD

• I have no relevant financial relationships with the

manufacturers of any commercial products and/or

provider of commercial services discussed in this CME

activity.

• I do not intend to discuss an unapproved or

investigative use of commercial products or devices.

The Truth and Nothing but…

• I am not a social media expert.

• There really are no social media experts.

There are only social media users (maybe

some are mega-users).

I am… • Pediatrician in a previous life

• Academic Neonatologist

• Social media user

– (@songMD, @AAPperinatal, @TECaN chat, @OU NICU

physician)

• A Journey fan

• Afraid of driving in the snow

From one perspective…

From another…

OBJECTIVES

• Define social media, the evolution to its current

state and its impact

• Navigate the various available web-based tools to

enhance daily practice, communication and

collaboration between healthcare communities

• Identify and prevent negative consequences

associated with social media use

Social Media Anxiety Disorder

• “Social Media” = Facebook and Twitter

• Rumor mill of unprofessional conduct on

Facebook and Twitter

• Unaware of closed Facebook account and

protected tweets

• Unaware of RSS, feed readers and other useful

applications of social media

Metha, N. "How physicians can overcome social media anxiety on Twitter." Technology in (Medical)

Education, blog. Aug 14, 2011.

Social media has taken over…

… porn as the #1 activity on

the web.

Source: Social Media Revolution from Socialnomics.net

Everyday…..

… approximately 2 Billion

Google searches occur.

Source: Social Media Revolution by Socialnomics.net

Interestingly…..

Facebook TOPS Google for

weekly traffic in the U.S.!

Source: Social Media Revolution 2 from Socialnomics.net

In 2010, social media use increased…

• Baby Boomers (46-65 yr): 54 76%

• Gen X (32-45 yr): 70 85%

• Millennials/Gen Y (13-31 yr): 84 91%

Source: PR Newswire, Nov 2010; Beyond.com Poll

Social networking – 51% of all adults

Groups in America • 40% church, spiritual groups

• 24% sports for self or children

• 24% consumer groups

• 22% charitable or volunteer orgs

• 20% professional or trade groups

• 19% neighborhood associations

• 18% illness groups or personal situation

• 17% hobby groups or clubs

• 15% national or local organizations

• 15% political parties

• 14% alumni associations

• 13% parent groups

• 11% literary, study groups

• 10% arts groups

• 9% are active in fan groups sports

• 9% are active in youth groups

• 8% labor unions

• 8% fraternal clubs, sororities/fraternities

• 7% environmental groups

• 7% sports fantasy leagues

• 7% veterans organizations

• 6% gaming communities

• 6% fan groups celebrities

• 5% ethnic or cultural groups

• 5% travel clubs

• 4% farm organizations

• 3% in fan groups for company/product

• 3% “other”

Source: Pew Internet Project Sept 2011

Social side of internet – participation in 27 kinds of groups

75% 80% 82% 85%

56%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

All adults Internet users Social network users

Twitter users Non-internet users

Participate in at least one group

Source: Pew Internet Project. Sept 2011.

Saying it simply…

Many people are on the web…

AND on the web to utilize social

media tools.

Social media impacts our lives

• Facebook Kawasaki diagnosis story

• President Obama’s townhall forum on

Facebook live

• Tweets from Egypt

Source: wired.com, Feb 2011

• $20 million for >1000 ideas

• 2,640,026 lives positively

affected

• Facebook:

– > 6 million fans

• Twitter:

– >142,000 followers

• YouTube:

– > 16.4 million uploads & 2.5

million views

•120,000 ideas

•>82 million

votes

“Social media is NOT a fad…

“…it’s a fundamental shift in the way we communicate.”

Source: solcomhouse.com

“I don’t care what people say… Facebook is here to stay.”

Source: radarnetworks.com

Evolution of the Internet

Social Media….

transforms broadcast

media monologues (one

to many) into social

media dialogues (many

to many).

1. Concept

2. Media

3. Social

interface

Source: http://en.wikipedia.org/wiki/Social_media

WEB 2.0 Blogs

Microblogs

Photos

Videos

Audio

Networks

Source: blog.milestoneinternet.com

Source: www.telegraph.co.uk

Reaching out and having a conversation.

Social Media is about….

Health 2.0

-Information: resources &

sharing

-Medical education

-Collaboration & practice

-Disease management &

patient education

-Research & data sharing

-Professional

Development &

Networking

Source: http://en.wikipedia.org.wiki/Health_2.0, health20.org/images/ c/c1/Virtuous_Cycle.png

3rd most prevalent activity

• Pew Research Center’s Internet & American

Life Project Feb 2011 report

• Survey of 3,001 American adults

• 8 in 10 Internet users search for health

information ONLINE

Source: pewinternet.org/Reports/2011/HealthTopics.aspx

Social Media for Health Information

• 94% use Facebook

• 32% use YouTube

• 18% use MySpace or

Twitter

National Research

Corporation Survey

• 23,000 Americans

• 41% use social

media

• Avg age: 41 yr

Source: CNN Health, thechart.blogs..cnn.com,3/4/2011

We are e-Patients

• Seek online guidance for their own conditions or for

loved ones

• “equipped, electronic, enabled, educated, empowered,

engaged, equals, emancipated……”

• ?expert- “I have an A.A.D degree (Almost A Doctor).”

• 2 effects “better health information/services and

different relationships with their doctors”

Source: http://enwikipedia.org/wiki/E-Patient

Social Media helps patients get through it…

• Patients and their families benefit from the community

support by connecting through social media before,

during and after a hospital stay

– SmartBlog on Social Media, Nov 2010

• 1 in 5 internet users are online searching for other e-

patients- “We can say things to each other we can’t say

to to others.”

– Pew Internet & American Life Project Feb 2011

• Facebook: 685,302 likes + 19 other Facebook pages

• YouTube: 411,936 views + 6 other YouTube channels

• Twitter: 8,210 followers + 13 other Twitter accounts

• 6 Blogs

Twitter and Facebook (Farmville)

was used to raise $1 million for the

new children’s hospital.

Source: Modern Healthcare, March 14, 2011

We are e-Clinicians

• 99% of U.S. physicians and clinicians are online

• 83% consider the Internet essential to their practice

• 91% use Google for medical/pharmaceutical queries

• Textbooks, conferences web, iPhones, Blackberrys

• ….“e-Provider” … all the “e’s” and then some

(empathetic, eloquent, encouraging,….. expert”

Source: pharma2blog.com/2008/07/03/taking-the-pulse of-the-physician

Clinician use of social media is UP

• February 2010: 41% practicing physicians

(N=141)

• August 2011: 87% practicing clinicians

(N=4033)

• “Connected Clinicians”

Bosslet et al, The Patient-Doctor Relationship and Online Social Networks, J Gen Intern Med, June

2011; QuantiaMD. Doctors, Patients, & Social Media, Sept 2011.

#1 reason for professional participation:

educational

61%

28%

31%

17%

- JOURNEY

Hang on, don’t you let go now.

You know, with every heartbeat, we love.

Nothing comes easy…

Hang on, ask the lonely.

Health 2.0

-Information:

resources & sharing

-Medical education

-Collaboration &

practice

-Disease management &

patient education

-Research & data

sharing

-Professional

Development &

Networking

Source: http://en.wikipedia.org.wiki/Health_2.0, health20.org/images/ c/c1/Virtuous_Cycle.png

How do you currently save your references and articles?

1. Print and file

2. Drag and drop onto a USB drive

3. Save and file into folders in Documents onto

My Computer

4. Bookmark reference onto a web account

Bookmark, Share & Save

Source: tootf.com

Source: geekestateblog.com

Social Bookmarking and News Aggregates

Diigo

Connotea

CiteULike

Google Chrome:

AddThis

Delicious

Technorati

Reddit

StumbleUpon

Digg

Source: doublejdesign.co.uk

Social bookmarking steps

• Choose a site

• Register

• Add button (optional, but recommended)

• Find references (websites, articles, etc.)

• “Add to …” with one-click

• Add “tags”

• Socialize and share

Slide Share

Google Docs

SlideBoom

SlideServe

Scribd

280 Slides

SlideRocket

Slide

Source: sethpickens.files.wordpress.com/2009/02/luke-yoda

SLIDE SHARING

“Try not. Do or do not. There is no try.” -Yoda

• Upload presentations, documents, video • Follow and be followed • Mark your “Favorites”

Health 2.0

-Information:

resources & sharing

-Medical education

-Collaboration & practice

-Disease management &

patient education

-Research & data sharing

-Professional

Development &

Networking

Source: http://en.wikipedia.org.wiki/Health_2.0, health20.org/images/ c/c1/Virtuous_Cycle.png

2010

Source: www.facebook.com/press/info.php?statistics, comScore 2009

• More than 750 million active users

• 50% of active users are logged on in any given day

• Fastest growing demographic is age 35 and older; second is 55-65 year

olds (Fastest growing segment is 55-65 year old females)

• More than 30 billion content pieces shared each month SEARCH

functionality

• Most popular site to share photos

• 3rd most popular site to view online video

Facebook

… it would be the 3rd largest in population.

If Facebook was a

country….

Source: Social Media Revolution 2 from Socialnomics.net

Image Source: flagspot.net, cia.gov, toddpaynefortennessee.com

FACEBOOK

Fun, casual

Meet old friends

Make new friends

Join interest groups

Learn

Share stories

Make professional

connections

Source: facebook.com

Facebook is casual, it’s fun!

It’s a party!

But, not this kind of party…

Meet old friends & make new ones

Learn and Share stories

Make professional connections

Join interest groups and communities

Create educational groups

- JOURNEY

It’s time to see how you imagine

your life…

You want to dream, anything is

possible.

Social= Share: Facebook Sign-up Tips

• Connecting on Facebook: default is Everyone!

• “Edit your profile” Customize

• “How Tags Work” OFF/ON for max sharing

• Public search ON

• “Secure browsing is currently disabled” is default

• Customize sharing (photos, tags, posts)

Source: www.linkedstrategies.com/blog/tag/linkedin-statistics, press.linked in.com

• > 120 million professionals in 150 industries in over 200

countries

• Average age is 41 years

• Over 50% users have income >$100,000

• Over-representation of graduate school-educated users

• 64% male

• 95% of companies use LinkedIn as their primary tool to find

new employees

• Searchable by Google

LinkedIn

LinkedIn: Conference • Neonatology on LinkedIn

– Neonatal-Perinatal

Medicine Group

– Neonatal/Pediatric Specialty

(RT)

– National Association of

Neonatal Nurses- NANN

– Neonatal Nurses

– NHS Neonatal and

Maternity Networking

Forum

– Preemie Purple Hearts Network

Health 2.0

-Information:

resources & sharing

-Medical education

-Collaboration & practice

-Disease management

& patient education

-Research & data

sharing

-Professional

Development &

Networking

Source: http://en.wikipedia.org.wiki/Health_2.0, health20.org/images/ c/c1/Virtuous_Cycle.png

HealthMap.org

Health 2.0

-Information: resources &

sharing

-Medical education

-Collaboration &

practice

-Disease management &

patient education

-Research & data sharing

-Professional

Development &

Networking

Source: http://en.wikipedia.org.wiki/Health_2.0, health20.org/images/ c/c1/Virtuous_Cycle.png

Health 2.0

-Information:

resources & sharing

-Medical education

-Collaboration &

practice

-Disease management

& patient education

-Research & data

sharing

-Professional

Development &

Networking

Source: http://en.wikipedia.org.wiki/Health_2.0, health20.org/images/ c/c1/Virtuous_Cycle.png

Twitter is a service for friends, family, and co-

workers to communicate and stay connected

through the exchange of quick frequent answers

to one simple question: What are you doing?

“Share and discover what’s happening

right now, anywhere in the world.”

Source: twitter.com

Source: http://blog.nielson.com/nielsonwire/online_mobile/twitters-tweet-smell-of-success/, denverpost.com/business,

marketinggum.com June 2011

Twitter

• 175 million registered users, as of January 2011

• 200 million tweets a day, as of June 2011

• Largest Twitter group 35-44 year olds, 64% >35 yr

• The median user age: 39

• 600 million search queries/day

• 37% of active users are mobile

Tweets are short and sweet….. Casual conversation, some chit-chat, some breaking news.. -Keep up-to-date: follow, search, engage -Push your cause: personal talk show -Create a presence: keep your finger on the public pulse

Image Source: nydailynews.com

• ……to make the use of

Twitter more accessible for

providers and the

healthcare community as a

whole… By lowering the

learning curve of Twitter

with a database of relevant

hashtags to follow…..

Source: odomlewis.posterous.com

• Tissue recruitment

• Disaster alerting/ response

• Amber alerts

• Tracking patient/disease trends

• Live-tweets: surgical

procedures, medical

conferences

• Publishing health-related news

• Clinical education coordination

Google +

Source: google.com

• Now Public! • Circles for sharing • Chat and follow • Hangout feature:

• Voice and video chat • Photos, videos, links • Search functionality

-JOURNEY

Be good to yourself when nobody else will.

Oh, be good to yourself.

You’re walkin’ a high wire, caught in a cross fire.

Oh, be good to yourself.

Lions and Tigers and Lawsuits, oh my!

• Social networking is online= Public domain, no longer

private

• Posting online is permanent; can be deleted, but may be

archived

• Professional liability risks (violations of medical code of

ethics, HIPAA, employer or medical staff policy)

• Anonymity cannot by guaranteed; privacy can be

violated

Source: Armon, Keller. Who is Dr. Wiki and Why You Need to Know. Unique Opportun. 2009.

Minimize Risks

• Use common sense.

– “The least common thing in the world is common sense.”

• Review the terms of service of the online communities.

• Review your professional liability policy.

• Review your employer’s social media policy.

• Include a disclaimer.

• Remember- anonymity cannot be guaranteed.

• Review before you post. (Think, pause, then post.)

Source: Armon, Keller. Who is Dr. Wiki and Why You Need to Know. Unique Opportun. 2009.

To Friend or Not to Friend

• “Please Don’t ‘Friend’ Your Patients”

• Violation of HIPAA by jeopardizing the

protection of individually identifiable health

information (IIHI)

Source: MDNews.com, 3/19/2011

Ignore…..

• 84% would NOT use social media to

communicate with their physician

• 72% would call nurse help line

• ~50% prefer email communication with

physician, online appointment setting, online

access to medical records , online bill payment

Source: HealthcareITnews.com, 3/24/2011

Social Do’s • Use common sense. Ask permission. Be the same courteous,

respectful person virtually that you are in the world everyday.

• Be transparent.

• Write what you know. (Share your e-xpert knowledge.)

• Aware of the perception you create. Virtual “perception is

Reality.”

• Engage in the conversation…. Add to it.

• Be a leader, an example- you represent us all!

• Admit your whoopsy… it’s human!

• Think, review and pause, then post.

Modified from: Social Media Policy for Physicians and Staff, foxepractice.com

AMA Policy: Professionalism

in the Use of Social Media

• Standards of patient privacy and confidentiality

• Privacy settings

• Appropriate boundaries of patient-physician relationship

• Professional boundaries

• Ethical responsibility to report unprofessionalism

• Possibility of negative consequences

Why bother??

Use web tools with

confidence to streamline

Enhanced education

Effective communication

More “expert-user-

generated” content

alongside user –generated

content

Ethical considerations?

“Social media is like voting…

You may not like the system, but unless

you vote, you don’t have a right to

complain about the outcome.”

Why not vote?

Still (social media) anxious?

-JOURNEY

Don’t stop believin’,

Hold onto that feelin’.

• For resources to help

with Social Media

Anxiety, contact:

• clara-

song@ouhsc.edu