Slides based on a presentation I gave at the Satzburg Medical Seminars July 3, 2012.

1. Social Media & Medicine 2012
A Primer for Docs
MARGARET POLANECZKY, MD
Associate Professor
Obstetrics & Gynecology
weill.cornell.edu

2. Social Media & Medicine 2012
• Social Media Primer
• Patients & Social Media
• Doctors & Social Media
• Rules for Engagement
• How to get started (or not)
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3. Social media is user generated content that is shared
over the internet via technologies that promote
engagement, sharing and collaboration.*
* Definition from The Social Media Guide.com
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4. Percent of population
55
The
65
Internet
46
Revolution
21.9
24.9
9.6
http://www.itu.int/ITU-D/ict/statistics/at_glance/keytelecom.html
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5. Social media is the second Internet revolution.
Used w/ permissions GNU License
http://en.wikiversity.org/wiki/File:Web_2.0_elements.png http://en.wikiversity.org/wiki/File:Web_1.0_elements.png
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6. Healthcare 1.0
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7. Health Care 2.0
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8. The Long Tail
Healthcare 1.0 Healthcare 2.0
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9. Social networking – 50% of all US adults
% of internet users
Pew Internet Project
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10. PATIENTS are using social media
The search for health information online its usually triggered by health
concerns of the patient or their family member.
*Survey, Rich Meyer, Pharmaforum.com
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11. YOUR PATIENTS Are Using Social Media
•Source - Pew Internet project
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12. 60% of patients say
Information found online
affected a decision
about how to treat an
illness or condition
Source - Pew Internet Project
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13. E-PATIENTS engage in communities online to share their stories,
disease & treatment information, referrals and support
Social media sites have 24 TIMES the activity of healthcare sites
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14. E-PATIENTS crowd source
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16. HOSPITALS are using Social Media
http://ebennett.org/hsnl/
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17. Hospital-Sponsored Patient Communities
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18. Mayo Clinic E-Visits – 2 year pilot study
• 4,282 patients registered
– 2,531 online visits
– Billings ($35) were made for 1,159 patients.
• E-visits used primarily by women during working hours
• E visits nvolved 294 different conditions.
– 2% included uploaded photographs
– 16% replaced telephone protocols with billable encounters.
• Office visits unnecessary in 1012 cases (40%)
• In 324 cases (13%), the patient was asked to schedule an
appointment for a face-to-face encounter.
Mayo Clin Proc. 2010 August; 85(8): 704–7.
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19. E-Medicine Practices Mobile patient platform
Jay Parkinson, MD
Video Visits, Instant message visits
• Online communication - patients can upload
BP, blood sugars, weight data for review online
• Online appointment scheduling, refills
• Patients pay an annual fee + low costs per visit
• No insurance
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20. Online, your patients TRUST YOU the most
Likely to trust
online information
from…
Likely to share
online information
from…..
Source: PwC Health Research Institute: Social Media “Likes” healthcare Chart pack
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21. Physicians & Social Media Use
Blogs
Source - http://www.quantiamd.com
Percent
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22. Why Don’t Docs Engage in Social Media?
Source - http://www.quantiamd.com/q-qcp/DoctorsPatientSocialMedia.pdf
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23. Whether you know it or not -
Whether you like it or not - You are Online
 Information in the public domain
 Insurer’s databases
 Physician review sites
 Pharmacy databases
 Patient websites
 Social networking sites
Don’t believe me?
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24. Will YOU engage in Social Media?
YES NO
• Authority • Lack of personal privacy
• Influence • Liability concerns
• Reputation • Patient privacy risks
• Marketing of practice • No way to get paid for it
• Patient education • Takes time
• Share medical knowledge • Employment Insecurity
• Crowd-sourcing • Being marketed to
• Expressing yourself • Being asked for advice online
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25. SOCIAL MEDIA - GETTING STARTED
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26. Physician Online Communities
You don’t get something for nothing
•Provide Doctors with a protected community for
sharing clinical information and advice
•Provide Pharma an opportunity to observe and
engage with physicians
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27. SOCIAL MEDIA – GETTING STARTED
• PRACTICE WEBSITE
– Professional, clean design with simple interface, Dynamic updates, RSS Feed
– ? Patient portal (appointment, refill requests),? Online EMR, ? Patient community
• TWITTER
– Each doc has their own twitter page (? + practice twitter for larger practices)
– Broadcast health news, commentary & messages
– Engagement with colleagues ,Crowd sourcing medical dilemmas
– Avoid direct patient interactions
• LINKED IN
– Professional network, useful for job networking
• FACEBOOK
– Keep practice page and personal pages separate
• YOUTUBE
– Patient education videos , medical education
• BLOG
– Can be part of practice website or separate
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28. Your patients are not your friends
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29. vs.
IDENTITY ANONYMITY
 Authority  Privacy
 Reputation Control  Freedom
 Enhanced practice  Employment security
 Employment security  ?Increases risky online behavior
 Engagement
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30. ANONYMITY IS NOT INVISIBILTY
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31. WHAT ABOUT PATIENT PRIVACY?
• If the information that is shared is
generic enough that nobody can
identify a patient in the course of
reading, (Berkman, Mass Med law
report, Social net- working 101 for
Physicians, 2009) the post is
permitted and is a valuable tool for
physicians to share information and
skills with other physicians faster
than ever before.
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33. 98% of US state medical boards report online
violations by physicians
JAMA. 2012;307(11):1141-1142. doi:10.1001/jama.2012.330
Copyright © 2012 American Medical
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Association. All rights reserved.

34. • Posts limited to 140 characters
• Can have private account or public account
• Users follow other users
– Can block followers or be private and only permit certain followers.
– You don’t have to follow everyone who follows you
• Post tweets, comment on other’s tweets, send private messages
• Hashtags (#) allow for grouping of related posts
– Conferences, breaking news, topics of interest, Twitter chats
• WHO TO FOLLOW?
– Experts in your field
– Reporters who report in your areas of interest
– Medical journalists
– Colleagues
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35. Doctors on Twitter
Nature of tweets
49% Health or medical related
21% Personal
12% Self-promotional
1% Medical education
1 % Recommended medical product
2158 tweets
from 260 twitter 148 Tweets (3%) were Unprofessional
users with >500 33 (0.6%) Contained profanity
followers 38 (0.7%) Potential patient privacy violations
14(0.3%) Contained sexually explicit material
4 (0.1%) Discriminatory statements
JAMA, February 9, 2011—Vol 305, No. 6 567
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36. Twitter Smarts Twitter Not-so-Smarts
(@DrWes ) @mommy_doctor )
1. Follow smart people doing work that is
relevant to yours. Trash most others.
2. Post relevant, valuable content of
interest to your followers.
3. Watch your time on Twitter. At most, I
spend 20 minutes a day on Twitter, and I
think it would take me far more time
offline to gain and share the same
information.
4. Do not EVER post patient information
– Tweets are public and searchable on
Google.
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37. The Eleven Commandments of Social Media Engagement
1. Observe, Listen & Think Before Engaging What are your goals with this tweet/post/comment? Is this
the best platform?
2. Add Value. Be relevant. Be Accurate. Research & attribute your sources.
3. Maintain patient privacy – Don’t post anything about a patient that he/she would recognize themselves.
Go beyond HIPAA. Stay away from patient-specific dialogue.
4. Be Respectful. Keep it Civil. Keep it Clean. Don't post material that is profane, libelous, obscene,
threatening, abusive, harassing, hateful, defamatory or embarrassing to anyone.
5. Abide by the law. Don't post content that violates any state or federal laws. Get permission to use or
reproduce copyrighted content.
6. Be Transparent. Disclose affiliations and conflicts. Clearly identify any advertising as such.
7. Remember - What happens on the Web stays on the Web. Forever. Even if you delete it.
8. Engage with others. Social media is not a place for you to talk without listening, commenting and
responding to the conversations around you.
9. Don’t give individual medical advice online
10. Patients are not your friends. Keep your individual Facebook page private.
11. Be yourself. That’s what social media is all about. Show your personality.
Modified from Vanderbuilt University Med Center Social Media Toolkit
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38. HON Code of Conduct for Medical and Health Web Sites
1. Authoritative. Indicate the qualifications of the authors. Any medical or health advice provided will
only be given by medically trained & qualified professionals unless a clear statement is made that it is
from a non-medically qualified individual or organization.
2. Complimentarity. Information should support, not replace, the doctor-patient relationship.
3. Privacy. Respect the privacy and confidentiality of personal data submitted to the site by the visitor.
The Web site owners undertake to honour or exceed the legal requirements of medical/health
information privacy that apply in the country and state where the Web site and mirror sites are
located.
4. Attribution. Cite source(s) of published information, with specific HTML links page. Clearly display
date when a medical page was last updated.
5. Justifiability. Any claims relating to the benefits/performance of a specific treatment, commercial
product or service will be supported by appropriate, balanced evidence in the manner outlined above
in Principle 4.
6. Transparency. Accessible presentation, accurate email contact.
7. Financial disclosure. Clearly identify funding sources, including the identities of commercial and
non-commercial organizations that have contributed funding, services or material for the site.
8. Advertising Policy. Clearly distinguish advertising from editorial content. If advertising is a source of
funding it will be clearly stated.
http://www.hon.ch/HONcode/Pro/Conduct.html
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39. Sample Website Disclaimer
The opinions expressed in this blog are strictly my own, and should not be construed as
the opinion or policy of my employer, XXX Medical Center.
Material on this blog is provided for informational purposes only. It is general
information that may not apply to you as an individual, and is not a substitute for your
own doctor’s medical care or advice.
Reading this blog should be construed to mean that you and I have a patient-physician
relationship. Therefore, I ask that you not ask me for medical advice, either in the
comments or by email. I may delete such comments and accept no responsibility to
respond to unsolicited email.
The inclusion of any link does not imply my endorsement of the linked site or its
affiliates, or any information, content, products, services, advertising or other materials
presented on or through such web sites. I am not responsible for the availability,
accuracy, or any information, content, products or services accessible from such sites.
NEVER DISREGARD MEDICAL ADVICE OR DELAY SEEKING MEDICAL CARE BECAUSE OF SOMETHING
YOU HAVE READ ON OR ACCESSED THROUGH THIS WEB SITE.
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40. SOCIAL MEDIA RESOURCES
• Ten Best Practices for Social Media
http://asne.org/portals/0/publications/public/10_best_practices_for_social_media.pdf
• Social Networking 101 for Physicians -
http://www.massmed.org/Content/NavigationMenu2/ContinuingEducationEvents/New
Courses/SocialNetworking101forPhysicians/Social_Networking_.htm
• Healthcare Blogger Code of Ethics - http://medbloggercode.com
• The Social MEDia Course - http://med20course.wordpress.com
• Mayo Clinic Center for Social Media - http://socialmedia.mayoclinic.org
• A twitter primer for physicians : http://www.kevinmd.com/blog/2012/06/started-twitter-
primer-doctors.html
• Community Sites for Scientists & Physicians -
http://scienceroll.com/2008/05/24/community-sites-for-scientists-and-physicians-the-
list/
• Doctors on Twiitter - http://www.TwitterDoctors.net
• European Docs on Twitter https://docs.google.com/spreadsheet/ccc?key=0Av-
UbEbXL7m7dDhQQkdKUHJkcW5aLVFyWjRTUXNLRFE#gid=0
• Dr Polaneczky’s Blogroll - http://www.tbtam.com/blogroll
• 5 Best Blogging Platforms - http://lifehacker.com/5568092/five-best-blogging-platform
• iMedical Apps – http://www.imedicalapps.com/s
• Medgadget – http://medgadget.com
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