This document provides an overview of a presentation on social media, technology, and apps in patient care and engagement. It discusses how social media is relevant to healthcare providers, how to practice safe social media use professionally. It also discusses emerging technologies like Google Glass, medical tricorders, and "smart pills" as well as useful apps for patients and practitioners. The presentation encourages practitioners to incorporate smartphones and apps into clinical practice to improve efficiency and patient care.

1. S
Sociable! ‘Appy Hour:
Social Media, Technology & Apps in
Patient Care & Engagement
• Chris Ralph (Calgary, Canada)
• Clinical Pharmacist
• TBCC Cancer Centre
• CAPhO Communications Officer
#ROSS14

3. Disclosure
S No actual or potential conflicts of interest in relation to this
presentation.
Big Bang Theory

4. Objectives
S To provide an overview of social media and trends in patient care and
patient engagement.
S To provide an overview on just some of the advancing technologies
emerging in medicine and pharmacy and how they might impact pharmacy
practitioners.
S Describe how smartphone technology can been successfully
incorporated into clinical practice.*
S To provide practitioners with an overview of apps that could be of
great value in clinical practice and to keep abreast with current literature;
not all apps are accurate and reliable but will suggest some that are. *
S To provide practitioners with an overview of apps they can recommend
to patients.*

5. Outline
S Social Media (SM)
S Why is SM relevant to HCPs
S How to practice safe SM
S How to utilize professionally
S Technology
S The future is now…what’s next
S Mobile devices & Apps*

6. Please Turn ON Your
Smartphones!

7. Please Turn ON Your
Mobile Devices!

9. WHO – Definition of Health

10. Social Media - Definition
S Short Version:
S “Any tool or service that uses the Internet
to facilitate conversations”

11. Patients are Sociable
S 1/3 of adults say they are likely to share
information about their health on social
media sites with other patients.
S More than 40% of consumers say info
found via social media affects the way
they deal with their health.

12. SSocial media = Word of Mouth (WOM) in 21st century
Why Social Media?

13. SSocial media = World of Mouth (WOM) in 21st century
Why Social Media?

15. Patient Oriented Websites

16. Why Do Patients Use Social Media?
S Research tool
S Empowerment
S Giving advice to others
S Global community
S Advocacy
S Emotional support & motivation

17. Why Should HCPs* Utilize
Social Media?
S Keeping up-to-date by following peers
S Collaboration
S Networking: 1/3 HCPS now
S Source of reliable, real info for patients
S Act as filter for patients
S Promote and advance the profession
S Career opportunities

18. Why Should HCPs Utilize
Social Media?
S Only 0.04% of published medical research gets
mainstream attention.
S Social Media offers a platform to share research with:
S Colleagues
S Patients
S Caregivers
S Media
S Organizations
S Research funding opportunities

19. Social Media Networking Benefits

21. What if Dr. House
Used Twitter
S Dr. Bertalan (Berci) Meskò, Medical Futurist
S Identified gap between ePatients and
technology resistant Solution:
S Crowdsourcing to curate social media
S Webicina.com website
S Digital literacy must be in healthcare
professional curricula
S Social MEDia in Medicine online course

22. TMI: Too Much Information
S According to David Eddy, MD (1999), a leader in
the field of evidence-based medicine,
S“The complexity of modern medicine
exceeds the inherent limitations of the
unaided human mind.”

23. Let Community Filter News for You:
Keeping Up-to-date
S Build Twitter network of quality virtual colleagues (takes
time)
S Can create Lists in Twitter to track top Tweeps in areas of interest
S Check Twitter stream
S Check hashtags (#) of interest
S #breastcancer, #oncology, #BCSM, #Palliative
S Result: Quick, concise overview of most important, relevant
& interesting news
S No need to scroll over all of favourite sites.

24. S#ROSS14, #ISOPP14
S#Oncology, #Breastcancer
S#Palliative, #DigitalHealth
S#ChrisRalphIsBrilliant – Unused to date!
SFrom Twitter app or Twitter.com
Stry searching a hashtag above
SRT a tweet
SCreate a hashtag simply by using it in a tweet
S#BeautifulHalifax
Why Social Media #Hashtags?
- Enable easy gathering, especially around
an event or for a specific subject, e.g.:

25. Cancer Hashtags on Twitter

26. Crowdsourcing Medical Info
via Social Media
S What to do you if you have a specific question, but
do not know who might have the answer?
S You spend time & effort building a network and
build trust with this network.
S Drop the question in the network
S Generally, in a few minutes in an established
network, you can get your answer.

29. Medical Oncologists on Twitter

30. *Funding Research -
Crowdsourcing

31. #ISOPP14 Conference:
Twitter Buzz
#3 Top
Tweeps

32. Benefits of Twitter at a Conference
#ROSS14
S Discover who to follow in your specialty
S Explore the best from conferences in real-time or archived
S Share info learned – allow others to virtually be there
S Promoting your profession
S Networking
S Create a buzz about topics covered

33. #ROSS14

34. Practice Safe Social Media!
SSame rules apply for real life as for
internet
SCheck your work place policy
SASHP has statement on SM use

35. 12 Word Social Media Policy
SDon’t lie, don’t pry, don’t cheat,
SCan’t delete, don’t steal , don’t reveal
S -- via Farris Timimi, M.D., is medical director for the
S Mayo Clinic Center for Social Media

36. How to Tweet as a
Medical Professional
S Communicate just like in real life
S Be professional in all online interactions
S Adhere to ethical and professional standards guiding your
profession
S Patient information must always be kept confidential.
S Online interactions with patients should be straightforward.
S 3 Ps: plain language, professional tone & practical info

37. Remember
S Know when to take it offline.
S Adapted from ASHP SM statement:
S Recognize when a patient’s question is
better answered on the phone or in person
rather than through a Facebook post or in
the 140 characters afforded by Twitter.

38. Past/Present: “What happens in
Vegas stays in Vegas.”

39. Present/Future: What happens in
Vegas stays on:

40. Social Media Simulation*
You had a difficult run-in today
with a patient you just don’t like.
Which of the following Facebook/Twitter posts would be
appropriate?
A. Mr. Jones was here again today. What is his problem???
B. Sometimes, my job is a challenge.
C. We had a patient who screamed, got angry and also whined
whenever we tried to start his chemo today. Wuss!
*Adapted from Mayo Clinic CSM

41. Social Media Simulation:
Posting About a Patient #2
S You just saw a patient with the strangest symptoms you've
ever seen. You have a copy of the lab report detailing some
of the lab results. You whiteout the patient’s name and post
it on Facebook/Twitter to see if your colleagues can figure
out the case. Is this appropriate?
A. Yes, you've done enough to follow HIPAA/HIPA
guidelines.
B. No, it’s inappropriate to post patient information on social
media without explicit permission.

42. Social Media at
Meetings/Symposia
S ROSS hosts several fascinating and well-known speakers at their
symposia, and this year, you’re lucky enough to attend. You have
a personal Facebook and Twitter account, as well as a LinkedIn
account. Where is it OK to post photos, quotes, and commentary
about the symposium’s speakers?
S A. Facebook
S B. Twitter
S C. LinkedIn
S D. All three
#ROSS14

43. Social Media
Simulation: Disclaimers
You’re proud to work at H. Bliss Murphy, and you tell the world you
work here on your Twitter & Facebook profiles. You even include a
disclaimer stating that the opinions you share are your own and not
that of your employer’s. You’re having a fantastic time on spring
break in Cancun, and you post a photo of yourself drinking from a
beer funnel. Is this appropriate?
S A. Yes, you have a disclaimer
S B. No, if you identify yourself as an employee/student of your
workplace, you need to adhere to your workplace’s high standards
of professional conduct
S C. Maybe. It only matters if you are an MD.

44. Social Media Simulation:
Friending Patients
HCPs are strongly discouraged from friending their patients on SM,
whether the patient initiates the request or not. It may be acceptable
in some limited situations. Which of the following reasons would NOT be
an appropriate exception:
A. You don’t plan to see the patient as a patient again, but you would
like to pursue a romantic relationship
B. Your friendship with the patient predates the patient-provider
relationship
C. The patient has become a friend with whom you regularly stay in
touch outside of work

45. I’m just a pharmacist, why would
anyone care what I thought?
S “This one is easy. People care. But even if they didn’t, it is still
worth writing about that which intrigues you. For when you write,
you think, you organize, you learn more thoroughly. This is good
in and of itself. I have no data to support this thesis, but I
strongly believe that blogging [and tweeting] has made me a
better, more aware, more informed doctor. And this: the more
something intrigues you, the better will be the writing.”
S - JOHN MANDROLA, MD via DrJohnM.org

46. Focus on Twitter: Orientation

47. Twitter Versus Facebook
Facebook
S Primarily for
strengthening existing
connections or re-
establishing former
ones.
S For your friends
Twitter
S Enables you to connect
with people who have
common interests.
S For the friends you
don’t know yet.

48. SSign up for Twitter if you haven’t yet & set up
account.
SSuggested to “Follow”:
S @CAPhO_ACPhO
S@OncoPRN
SStart listening, following, re-tweeting and tweeting
SLet’s Tweet in touch!
Social Media Assignment

49. SIntroduce yourself with a tweet that includes your:
STitle, city and areas of interest, specialization
SInclude hashtag: #ROSS14
SYou can continue to tweet comments, highlights and
questions with respect to the conference using the same
hashtag. #ROSS14
Twitter Assignment #2:

50. Social Media - Conclusion
S Social media: game changer, powerful communication tool.
S It connects us, educates us.
S Allows us to share knowledge with the world around us
S Allows patients to access & share a wealth of info
S Ultimately what we write is both permanent and public.
S When engaging online remember we are professionals.
S Our patients would expect no less.
S Research is critical to develop safe, effective framework for
use in cancer care.

51. Let’s Tweet in Touch!

52. S
Onco Technology Update:
+ Mobile Device Apps
for the Patient and Pharmacy Practitioner

53. The Evolution
of Oncology
Pharmacy
How will technology
impact the future of
oncology pharmacy?

54. Think Outside the Box
Rethink Reinvent

56. AliveCor Heart Monitor

57. AliveCor Heart Monitor
S Record ECG using FDA cleared AliveCor System
S Attaches to smartphone
S Use AliveInsights™* analysis services to have a
cardiac technician or cardiologist review ECG
recording in as little as 30 minutes.

58. TMI: Too Much Information
S According to David Eddy, MD (1999), a leader in
the field of evidence-based medicine,
S“The complexity of modern medicine
exceeds the inherent limitations of the
unaided human mind.”

59. IBM Watson: From Jeopardy
Winner to Cancer Conqueror

60. Watson + MD Anderson:
Oncology Expert Advisor
(OAE)
S Artificial Intelligence (AI)
S Intelligence Augmentation (IA)
S *Understands 200 million digital papers & deliver an
answer in 3 seconds.

61. Watson + MD Anderson:
Oncology Expert Advisor
(OAE)
S System is a health monitor; keeps track of streams of info
about patients’ condition & alerts if something seems amiss.
S Match individual patients who have not responded to
conventional treatment to appropriate clinical trials.
S As HCPs interact @ Watson it learns & gets better at its job.
S In the future, Watson could help:
S Discover new & better treatments for specific genetic abnormalities
S Evaluate rare or complex patient conditions and identify drugs that
have already been approved for other uses that might also help

62. Google Glass

63. What is Google Glass?
Wirelessly connected hands-free
computer you wear like glasses.
S Heads-up style display uses a prism & sits just in front of
user’s eye.
S Interact through voice controls & touching frame of Glass
S Picture and video capture capabilities
S Current: efforts focused on Glass as a navigation tool, a
mechanism for social media notifications, and other
augmented reality functions.
S HCP Desirable: free up the user’s hands while still providing
functions similar to a smartphone and more…

64. Google Glass

65. Google Glass: Potential for
Pharmacy Practitioners
S Providing info during scanning & documenting verification process.
S Visual record creation to document preparation of IV meds
S Training & to investigate med misadventures.
S Medium to provide referential info, clinical decision support
S Connect with patient EMR to provide updated info

67. Medical Tricorder: Scanadu Scout
From Science Fiction To Science Reality

68. Medical Tricorder: Scanadu Scout
S A scanner packed with sensors that enables anyone to
conduct sophisticated physical exams — in a snap.
S Temperature
S Blood pressure, Pulse transit time
S Heart rate, Breathing rate
S Oximetry
S ECG
S Heart Rate Variability (HRV)
S Scanaflo™ measures twelve different signals in your urine
to help create your health map.

69. Proteus Digital Medicine:
“Smart Pill”
S Improve the effectiveness of existing pharmaceutical
treatments.
S Similar to pharmaceuticals available today, but each pill
will also contain a tiny sensor that can communicate,
via Proteus’ digital health feedback system, vital info
about med-taking behaviors & how body is responding.

71. Digital Medicine: Therapeutic
Targets; Example: Transplant
S Given the inherent risk in suppressing immune response,
tracking both adherence and basic health parameters may
have a significant impact on the success of organ
transplants, especially as an outpatient.

72. Oncology Pharmacist
App Starter Kit – “LEAD”
S Lexicomp
S Emesis iGuide, Evernote
S About Herbs (MSK)
S Docphin, Dropbox

73. Sn’App’ Shots: Other Useful Apps
– for Patients
S MyMedRec: Collaboration (CMA, CNA, CPhA,
ISMP, Rx&D) > adherence
S UMSkin: early detection (from Univ. of Michigan)
S Cancer.net (ASCO): info on >120 types of cancer
S ChemoCalendar: treatment focused
S Caring Bridges: support focused
S Alternative = PatientsLikeMe

74. Steve Jobs:
“Technology is nothing.
What’s important is that
you have a faith in
people, that they’re
basically good and smart,
and if you give them
tools, they’ll do wonderful
things with them.”

75. Contact Info
S Chris Ralph
S communications@capho.org or
christopher.ralph@albertahealthservices.ca or
chrisralph007@gmail.com
S Twitter:
S @OncoPRN
S LinkedIn:
S ca.linkedin.com/in/cral12/
S Websites:
S Onco-PRN: http://onco-prn.blogspot.com
S CAPhO: http://capho.org

77. Mobile Device Nostalgia
1997: Palm Pilot 2000: Compaq iPaq

78. Mobile
Multitasking
Specialists

79. The mHealth Era
S Of 1,063 clinicians who responded to a 2013
survey:
S 86% now use smartphones in their
professional activities; up from 78% in 2012.
S 53% use tablets at work, compared to 34%
last year.

80. Why use a mobile device clinically?
S Communication
S Drug Info
S Organization
S Decision support tools
S Literature
S Presentations
S Productivity
S Patient Care
S Education
S Portability

81. Integration of Smartphones Into
Clinical Pharmacy Practice:
An Evaluation of the Impact on Pharmacists’
Efficiency
S The Vancouver Island Health Authority
(VIHA) Experience

82. Study Design: Multicenter, Prospective,
Observational
P - 90 VIHA pharmacists
I - Corporate Smartphones (iPhone 4)
C - Current communication devices (pager)
O - Multiple outcomes
T - October 2012 to March 2013

83. Results of Time
Trial:
Smartphone use facilitated
a statistically significant
faster response time overall
(p=0.039)
Faster With Smartphone
Side Effects
Overdoses or poisoning
Precautions/contraindications
Pharmacokinetics
Compatibility/Stability
No Difference
In 10 types of drug therapy ?s
Slower With Smartphone
MOA
Drug of choice and alternatives
Available dosage forms
Therapeutic indications
ID drug by description

84. Results of Survey
- Smartphone Use
• 98% - Smartphones
are useful
• 87% - Smartphones
aids job performance
• 46% - increased
confidence and
competence in
resolving DRPs
Postive Aspects
Drug info accessibility
Rapid communication
Easier management of
emails & calendar
Negative Aspects
Small screen
Bad reception
Does not help with
tracking DRPs

85. Applicability to Practice
S Concluded:
S “Sufficient evidence to continue to support the use of smartphones
within VIHA’s pharmacy department.”
S As innovators, this project put pharmacy on the map
within VIHA.

86. Barriers to Integration
S Resistance to technology
S IT issues/infrastructure
S Lack of reliable Wifi/data connections
S Maintaining privacy
S Cost effectiveness
S Policies about use of mobile devices

88. Considerations Before Using An App
S Regularly updated?
S Authors listed?
S Properly referenced?
S Recommended by your mentor, university or
healthcare institution?
S Maintain privacy?

89. My Top 5 Suggested
Apps for Providers
Clinical Reference
Clinical Tools
Literature Curation
Productivity/Organization

91. Lexi-Comp:
Versatile Essential App
S Comprehensive drug reference
S Drug interaction checks
S Calculators, clinical tools, IV compatability
S Likes: aesthetically pleasing interface with descriptive
and easy to use, intuitive modules
S Not dependent on wifi/data
S Comprehensive; same info as website

97. Evernote: Non-medical Essential App
S Tremendous resource for keeping track of notes.
S Can add other users’ notes.
S Take pictures of handouts
S Helps you remember and act upon ideas, projects and
experiences across all the computers, phones and
tablets you use.

100. Dropbox: Non-medical Essential
S Store larger medical files:
S Powerpoint presentations
S Medical literature PDF files.

102. Docphin:
Medical Lit Curation App
S Help keep abreast of medical news & research
S Platform integrated with an institution’s library
S Journals sorted by medical specialties
S Oncology
S Hematology
S Pain

105. Memorial Sloan-Kettering's
About Herbs
S Compatible with iPad®, iPhone®, and iPod Touch®
S Web app version for all other mobile devices
S Under leadership of a pharmacist and botanicals
expert — provides comprehensive, objective
information about herbs, botanicals, supplements,
complementary therapies, and more.

107. Bonus: Oncology Specific:
Emesis iGuide
S Help facilitate decision making on the
antiemetic therapy to be administered to
patients undergoing a specific
chemotherapy (CT) regimen.
S Based on data from latest ASCO, ESMO,
MASCC, NCCN, and NCI guidelines
S Integrated with relevant evidences from
the international scientific literature.

109. Sn’App’ Shots: Other Useful Apps
S Medical Ref: Medscape, MedPage Today
S Alternative: UpToDate ($), Dynamed ($), STAT!Ref ($)
S Eponyms, InPractice Oncology, JCO, Skyscape
S Read by QxMD (Apple, coming soon for Android)
S Pub Med Mobile or Pubmed on Tap
S Drug Ref: Epocrates , Micromedex (Free, $), PEPID ($)
S Clinical Tools: MAT (MASCC), Calculate by QxMD
S NCCN Guidelines – tablets only
S CCO – Drug Formulary, Symptom Management
S Pharmacist’s Letter ($)
S Sanford ($)
S Heme Malignancy Assistant ($)

110. Sn’App’ Shots: Other Useful Apps
S Medical Ref: Medscape, MedPage Today
S Alternative: UpToDate ($), Dynamed ($), STAT!Ref ($)
S Eponyms, InPractice Oncology, JCO
S Read by QxMD (Apple, coming soon for Android)
S Pub Med Mobile or Pubmed on Tap
S Drug Ref: Epocrates , Micromedex (Free, $), PEPID ($)
S Clinical Tools: MAT (MASCC), Calculate by QxMD
S NCCN Guidelines – tablets only
S CCO – Drug Formulary, Symptom Management
S Pharmacist’s Letter ($)
S Sanford ($)
S Heme Malignancy Assistant ($)

111. Sn’App’ Shots: Other Useful Apps
S CE: Projects in Knowledge (Apple only), Smartest
Oncologist
S Feedly
S Google Drive
S Language Translator: MediBabble (Apple only)
S The Red Cross First Aid App (Canadian Red Cross)
S QR Code Reader
S PDF Annotations:
S Good Reader (Apple)
S iAnnotate PDF (Android)

112. Sn’App’ Shots: Other Useful Apps
S CE: Projects in Knowledge (Apple only), Smartest
Oncologist
S Feedly
S Google Drive
S Language Translator: MediBabble (Apple only)
S The Red Cross First Aid App (Canadian Red Cross)
S QR Code Reader
S PDF Annotations:
S Good Reader (Apple)
S iAnnotate PDF (Android)

113. Sn’App’ Shots: Other Useful Apps
– for Patients
S MyMedRec: Collaboration (CMA, CNA, CPhA,
ISMP, Rx&D) > adherence
S UMSkin: early detection (from Univ. of Michigan)
S Cancer.net (ASCO): info on >120 types of cancer
S ChemoCalendar: treatment focused
S Caring Bridges: support focused
S Alternative = PatientsLikeMe

114. Future of Healthcare/
Pharmacy Practice
S Episodic & Reactive
S Continuous & Proactive

115. How to Prepare for
Technology Advancement
S Whether as a patient or medical professional, follow main
trends and try to be up-to-date by using digital methods.
S Constantly look for solutions to improve your practice as a
medical professional or your health as a patient.
S Embrace digital in a comfortable way and use techniques
that make your life easier and your work more efficient.
S Look for examples and trends outside medicine as well.

116. How to Prepare for
Technology Advancement
S Evidence backed by extensive data is needed for any uses of
digital solutions in medicine/pharmacy.
S Hype in healthcare has never been our friend. Strategically
analyze trends & extrapolate to future in a meaningful way.
S Influence decision makers if your idea can make a change.
Be bold and use social media channels to spread the word.
S No matter how important role digital will play in our lives,
face-to-face interaction is and will always be the key in the
pharmacist-patient relationship.

117. Tech, Mobile Devices & Apps
Conclusion
S Technology in medicine/pharmacy is evolving rapidly – embrace
the changes & possibilities of enhancing our practice.
S Mobile devices & apps use in healthcare growing at a high rate.
S Apps for patients may assist: increasing adherence and educate
them.
S Mobile devices & apps can potentially improve oncology
pharmacists’ productivity if integrated in a systematic manner.

118. Adopted Medical Futurist Vision:
The PharmFuturist
S Develop stable relationship of mutual trust between pharmacists
& patients with SM resources filling void between patients &
HCPs prn.
S The practice of pharmacy must happen in real life. We have to
establish a relationship with the patient based on trust.
S But after that, technology & SM can strengthen this relationship.
S When designed properly & if used with strategy & design, social
media and technology can be of enormous benefit.
S With small steps & constant reevaluation using EBM.

119. Future Directions
S Research mobile devices & other technologies in the
oncology setting
S Develop good quality oncology specific apps
S The ultimate oncology supportive care app?
S Secure apps to track patient care, interventions,
outcomes
S App with chemo regimens and dose adjustments

120. Come Monday...

122. Steve Jobs:
“Technology is nothing.
What’s important is that
you have a faith in
people, that they’re
basically good and smart,
and if you give them
tools, they’ll do wonderful
things with them.”

123. Contact Info
S Chris Ralph
S communications@capho.org or
christopher.ralph@albertahealthservices.ca or
chrisralph007@gmail.com
S Twitter:
S @OncoPRN
S LinkedIn:
S ca.linkedin.com/in/cral12/
S Websites:
S Onco-PRN: http://onco-prn.blogspot.com
S CAPhO: http://capho.org

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126. Daniel Kraft
(Oncologist)
“We’re moving to this
integration of
biomedicine, information
technology, wireless and
mobile now — an era of
digital medicine. Even
my stethoscope is now
digital. And of course,
there’s an app for
that.”

127. 1. Staff can access social media on personal devices.
2. Access is a management decision, not just one by IT or HR.
3. Create social media polices and guidelines, then enforce them.
4. Provide training about social media risks and opportunities.
5. Social media sites are web sites, so virus and malware risks are
similar and can be managed.
6. Even if you block social media, staff can and will visit other
sites.
7. Educate users about managing security risks (e.g., creating
passwords, recognizing suspicious emails, messages, links, etc.)
Answers to Common
Social Media Objections