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The Virtual Team in the NICU: a Social
Media UpdateWorkshop on Perinatal Practice Strategies
Scottsdale, AZApril 15-17, 2011
CLARA SONG, MD, FAAPThe Children’s Hospital at OU Medical Center
The University of Oklahoma Health Sciences Center
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.
OBJECTIVES
• Understand the evolution of social media and its impact
on healthcare
• Classify the current available web-based tools in an
effort to facilitate collaboration between health
professionals
• Identify and prevent negative consequences associated
with social media use
Café Du Monde
100,489 fans + 324 fan photos
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
Saying it simply…
Many people are on the
web…
AND on the web to utilize
social media tools.
“Social media is NOT a fad…
“…it’s a fundamental shift in the way we
communicate.”Source: solcomhouse.com
Source: radarnetworks.com
Evolution of the Internet
Social Media
• Social media is a “group of Internet-
based applications…that build on the
foundations of Web 2.0, and that allow
the creation and exchange user-
generated content.”
• Social media uses Internet and web-
based technologies to transform
broadcast media monologues (one to
many) into social media dialogues (many
to many). It supports the
democratization of knowledge and
information, transforming people from
content consumers into content
producers.
1.Concept
2.Media
3.Social
interface
Source: http://en.wikipedia.org/wiki/Social_media
WEB 2.0Blogs
Photos
Videos
Audio
Social Networks
Event Networks
Interest
Networks
Wikis
Microblogs
Source: blog.milestoneinternet.com
Source: www.telegraph.co.uk
Reaching out and having a conversation.
Social Media is about….
• Facebook: over 3.5
million fans
• Twitter: over 60,000
followers
• YouTube: over 8.3
million uploads & 1.1
million views
• Hulu
• Blog
• Website
•2010:
•87 million
votes
•120,000
ideas
Health 2.0Information:
resources and
sharing
Medical education
Collaboration and
practice
Disease management
Research & data
sharing
Professional
Development &
NetworkingSource: 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
• 59% of ALL Americans adults (25%
Americans non-Internet users)Source: pewinternet.org/Reports/2011/HealthTopics.aspx
Social Media for Health Information
• 94% use Facebook
• 32% use YouTube
• 18% use MySpace or
• Average age: 41 yr
• Average income:
>$75K
National Research
Corporation Survey
23,000 Americans
41% use social
media
Source: CNN Health, thechart.blogs..cnn.com,3/4/2011
We are e-Patients
• “equipped, electronic, enabled, educated, empowered,
engaged, equals, emancipated…… expert??”
• Seek online guidance for their own conditions or for
their loved ones
• 2 effects “better health information and services and
different (but not always better) relationships with
their doctors”
Source: http://enwikipedia.org/wiki/E-Patient
SmartBlog on Social Media
• November, 12, 2010:
– Patients and their families benefit from
the community support by connecting
through social media before, during and
after a hospital stay
Source: sbne.ws/r/68Vj
We are e-Doctors• 99% of U.S. physicians are online
• 85% of offices have broadband
• 83% consider the Internet essential to their practice
• 91% use Google for medical and pharmaceutical queries
• The web and Blackberrys are replacing textbooks, drug references and
conferences.
• ….“e-Doctor”… all the “e’s” and then some (empathetic, eloquent,
encouraging,…..expert”
Source: pharma2blog.com/2008/07/03/taking-the-pulse of-the-physician
441 use social media
241 have Facebook pages
323 have Twitter accounts
213 have YouTube channels
Hospitals in the United States 2009
Source: Found In Cache, Social Media resources for healthcare professionals from Ed Bennett.
906 use social media
719 have Facebook pages
674 have Twitter accounts
448 have YouTube channels
Hospitals in the United States 2011
Source: Found In Cache, Social Media resources for healthcare professionals from Ed Bennett.
• Facebook: 535,391 followers + 19 other
Facebook pages
• YouTube: 238,325 views + 6 other YouTube
channels
• Twitter: 5,290 followers + 13 other Twitter pages
• 6 Blogs
• University of California, San Francisco
Medical Center used Twitter,
Facebook and Farmville to find new
donors and raise $1 million for the
new children’s hospital.Source: Modern Healthcare, March 14, 2011
HealthCare.gov
• “Take healthcare into your own hands…. Your
healthcare explained.”
• A federal government website managed by the US
Department of Health & Human Services
• “Stay Connected” email updates, twitter, Facebook,
YouTube, RSS
Electronic Health Record (EHR)
EMR Syste
m
Primary Physicia
n
Specialist
Network
Pharmacy
Laboratory/
Radiology
PatientInitiated and
maintained by an
institution
In an ideal world,
an national
EHR= PHR
(Personal Health
Record)
PHR Use Motivates Consumers
• 1 in 14 uses a PHR
• 56% learned more about their health
• 32% took specific action to improve their health
• 60% of low income & 40% of chronically ill felt more connected to
their physician
• 40% asked a question they otherwise wouldn’t have
• 58% would use PHR from PMD, 50% from insurer, 25% from private
tech company
• Increased interest in PHR use if their physician uses EHR (50% vs
41%)
• 68% concerned about privacySource: www.chcf.org/media
Personal Health Records (PHR)
Google Health
Microsoft Health
Vault
My Doclopedia
PHR
MediCompass
Medic Alert
Medsfile.com
WebMDImages: microsoftfeed.com, doclopedia.com, medfiles.eu, medicalert.co.za
Health 2.0 Information:
resources and
sharing
Medical education
Collaboration and
practice
Disease management
Research & data
sharing
Professional
Development &
Networking
Source: health20.org/wiki/ Health_2.0_Definition
What is your initial reaction when you hear “social media
tools”?
1.
2.
3.
4.
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
There are over 300 ways to bookmark and share information!
Source: Social Media Revolution from Socialnomics.net
Social Bookmarking and News Aggregates
Diigo
CiteULike
Connotea
Technorati
Google Chrome:
AddThis
SlashDot
StumbleUpon
DiggSource: 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
“Share what you know and write a knol.”
Knol= a unit of knowledge, “an authoritative article about a specific topic”
Google’s version of the online encyclopedia… but the authors provide credentials and elicit peer review
How do you feel about your Reader?
1. I love my Reader- we are in constant
contact.
2. We are casually dating- I visit my Reader
when I have time.
3. Thanks for reminding me! Better visit my
Reader before it bursts.
4. Who’s/What’s a Reader?
RSS= “Really Simple Syndication”
RSS is “a family of web
feed formats used to
publish frequently
updated works- such as
blog entries, news
headlines, audio, and
video- in a standardized
format.”
RSS feeds “benefit
readers who want to
subscribe to timely
updates from favored
websites or to
aggregate feeds from
many sites into one
place.”
Source: http://en.wikipedia.org/wiki/Rss
READER
Reader
NewsGator
My Yahoo!
FeedDemon
NetNewsWir
eSource: rssboard.org
RSS Feeds
• Sign up for your RSS feed Reader of choice
(Google, my Yahoo!, Shrook, etc.).
• Connect our websites to your Reader by
finding icons (RSS).
• “Subscribe now” or copy URL to add
subscriptions/feed onto your Reader.
• Watch out because here they’ll come!!
Trends, Tags, and Alerts in Medicine
• Google Alerts (Google Scholar)
• PubMed Save Search function
• PubMed Reader
• PeRSSonalized Medicine from Webicinia.com
• BioWizard
• AllTop
• WatchThatPage
• DailyMe
• TweepBeep
Have you participated in any of the following online
activities?1. Social networking (Facebook)
2. Interest-based networking (Ping,
Foursquare)
3. Blogging or MicroBlogging (Twitter)
4. I don’t know what you’re talking
about- that’s why I’m here.
Social networking
sites Image source: indiadailytimes.com
2010
… 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
Source: www.facebook.com/press/info.php?statistics
• More than 550 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)
• Median user age: 33
• Average user has 130 friends, creates 90 pieces of content/month
• Worldwide, more than 8 billion minutes a day spent on Facebook, yielding
over 60 million status updates each day
• Most popular site to share photos (comScore 2009)
• More than 100 million photos uploaded each day
• 3rd most popular site to view online video (Nielson VideoCensus, Nov 2009)
Fun, casual
Meet old friends,
make new friends
Join interest groups,
communities
Learn
Share stories
Make professional
connections
It’s a party! Source: facebook.com
But, not this kind of party…
Source: glamourvanity.com
Neonatologists on Facebook
Public pages/groups
Neonatology page
Neonatology group
Neonatology UK
Neonatology Review
AAP Perinatal FB Page
Private groups
AAP Perinatal FB Group
AAP Perinatal Trainees FB Group
Social= Share: Facebook Sign-up Tips
• “Show my FULL birthday in my profile.” is the
default.
• Connecting on Facebook: default is Everyone!
• Platform applications and websites ON is default
• Instant personalization “is allowed” is default
• Privacy settings: Photos you post, photos post and
“tag”, personal info…
Source: www.linkedstrategies.com/blog/tag/linkedin-statistics
• Global network with over 85 million experienced professional in 150
industries in over 200 countries
• Average age is 41 years
• Over 50% users have income >$100,000
• Over-representation of those who attended graduate school, compared to
all internet users
• 64% male
• 34% own a Smartphone/PDA
• 95% of companies use LinkedIn as their primary tool to find new
employees (80% of companies use social media for recruitment)
• Searchable by Google
LinkedIn: Business Lunch
• Neonatologists
on LinkedIn
– Neonatal-
Perinatal
Medicine Group
TwitterTwitter 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/
• unique visitors increased by 1,382% in a year
– 475,000 in Feb 2008 7 million in Feb 2009
• As of Feb 2010, largest Twitter group 35-44 year olds, 64% aged 35 or older,
& the median user age: 39
• Twitter.com primarily visited from work
– 62% assess from work only
– 35% assess from home only
• As of January 2011, 175 million registered users
• 55 millions tweets a day
• 600 million search queries a day via Twitter’s search engine
• 37% of active users are mobile
Coffee Talk
Tweets are short and sweet…..
Casual conversation, like at the water
cooler or coffee house
No one stays too long or says too much
If you don’t stop by, you’ll miss it
Image Source: nydailynews.com
Top Twitter Topics of 2010
• Gulf Oil Spill
• FIFA World Cup
• Inception
• Haiti
• VuvuzelaSource: visualnews.com Twitter's Top 10 Trending Topics for 2010
Top Twitter Topics of 2011
• Rebecca Black
• Full Moon
• H1N1
• UK Comic Relief
• KnutSource: www.mashable.com
HEALTHCARE on TWITTER • Healthcare
professionals
• AAP, Healthy Children,
AAP News, PediaLink,
AAP NCE
• AMA
• MDchat
• RNchat
• NICUchat
• Harvard Med, Harvard
Health, HarvardNeo
• HealthSocMed
• HHS gov, AIDS gov,
NIH Library
• Red Cross
• CDC, NIH
140 HEALTHCARE USES FOR TWITTER
• Tissue recruitment
• Epidemiological survey
• Disaster alerting and
response
• Supportive care for patients
and family members
• Diabetes management
• Alarming silent codes
(security incidents)
• Augmenting telemedicine
• Amber alerts
BY PHIL
BAUMANN,
“Health is
Social”
The Healthcare Hashtag Project
• ……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,
we hope to help new and
existing users alike to find the
conversations that are of
interest and importance …..Source: odomlewis.posterous.com
68%
8%
16%
4% 4%68% (17 votes) Yes, and active social media users
8% (2 votes) No, and active social media users
16% (4 votes) Work-ing on it, and active social media users
4% (1 vote) Yes, but not made it into the social world
4% (1 vote) No, but not make it into the social world
Does your organization/hospital have a social media policy?
Source: @reedsmith, Twtpoll Oct 2010
Does your institution have policy on employees’ use of
social media? 1. Yes, absolutely.
2. Yes, kind of, an unwritten
expectation.
3. No, not really.
4.
Twitter is not always reliable
Friday, April 2,2010:
Columbia University and MixedInk in New York
identified 52,000 Tweets mentioning antibiotics
during a 4 ½ month period in 2009.
Approximately 700 of those tweets included
incorrect information.
Source: www.healthday.com/Article.asp?AID=637674
Twitter 101
• What I’m doing… I’m thinking…
• Share information
• Join the conversation! (@songMD______)
• “Let others find me by email address”
• Tweet Location
• Tweet Media setting
• Twitter Privacy setting
Twitter AP • Share images/photos via Twitpic, Yfrog, GDZILA
• Share music via Tinysong
• Share videos via Twitvid
• Find information (#hashtag, www.search.twitter.com,
www.foxepractice.com/healthcare-hashtags)
• Update your all your social networks (ping.fm)
• Update all your social networks with media (pikchur)
• What’s going on in Twitter in a particular area (Twitte Local)
• TweetDeck for your desktop to organize and streamline
AAP in Social Media
• Website
• Twitter– AAPperinatal
• Facebook groups – AAP Perinatal – AAP Perinatal Trainees
• Facebook page– AAP Perinatal
• LinkedIn– Neonatal-Perinatal Medicine
Section
on
Perinatal
Pediatric
s
“Be who you are and say what you feel ….....
because those who matter don’t mind and those who mind don’t
matter.”
Dr. Seuss
Potential Risks
• 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.
SOCIAL MEDIA
Unveiling the
truth behind
the mystery
Source: pjvoice.com
Minimize Risks
• Use common sense.
– “The least common thing in the world is common sense.” –
overheard from Istvan Seri
• Review the terms of service of the online communities.
• Review your professional liability policy.
• Review your employment agreement.
• Be aware that you may not remain anonymous.
• Include a disclaimer.
• Review before you post. (Think, pause, then post.)
Source: Armon, Keller. Who is Dr. Wiki and Why You Need to Know. Unique Opportun. 2009.
Social Do’s and Don’t
• DO:
– Identify yourself with yourself employer if appropriate, but
emphasize that you do not represent your employer’s views
– Engage in discussion with your peers and colleagues
– Think, pause, then post.
• DON’T:
– Use for personal reasons during work time
– Post personal identifiable OR protected health information
– Use or post profane, defamatory, illegal language or material
How comfortable do you feel participating in social
networks with families of patients?1.
2.
3.
4.
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 paymentSource: HealthcareITnews.com, 3/24/2011
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
Effective
communication
More “expert-
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.”
“If you ask me anything I
don’t know…….
I’m not going to answer.”
- Yogi Berra
clara-
