ALEXANDER M. DJURICICH, MD, FACP, FAAP

ASSOCIATE DEAN OF CMEPROGRAM DIRECTOR, MED-PEDS RESIDENCY

ASSOCIATE PROFESSOR OF CLINICAL PEDIATRICS AND CLINICAL MEDICINE

INDIANA UNIVERSITY SCHOOL OF MEDICINEST. VINCENT’S FALL PEDIATRIC CME CONFERENCE

OCTOBER 3 , 2012

Social Media in Medicine

My Social Media “Profiles”

Twitter: @MedPedsDoctorLinkedIn: Alex Djuricich

Alliance for Continuing Education in the Health Professions American College of Physicians Continuing Medical Education Indiana University School of Medicine

Doximity: Alexander M. Djuricich, MDGoogle+: Alexander DjuricichFacebook: choosing to waitBlog: http://alexdjuricich.blogspot.com

The idea for this slide comes from seeing a presentation by B McGowan, PhD, at ACEHP 2012

Disclosures

I have nothing to disclose

I receive no financial remuneration from any Social Media outlet, pharma company, or anyone except my employer

I am interested in emerging technology to improve education and patient care

Disclosures Part 2

I do not consider myself an expert in Social Media But I think social media is a cool niche

If you would have told me 1 year ago that I would be presenting a CME talk on Social Media, I would have said that you need your head examined

I enjoy finding and using ideal methods to teach doctors and doctors-in-training

http://www.ehow.com

http://www.ehow.com

Objectives

Clarify misconceptions surrounding use of social media in medicine/medical education

Describe opportunities in addition to unintended consequences resulting from health care professionals (HCPs) engaging in social media

Explore meaningful use of social media by physicians and other HCPs, hospitals and patients

Review opportunities social media can bring to medical education arena

Definition

SOCIAL MEDIA

“Internet-based applications which allow for the exchange of user-generated content; includes services such as social networking, professional online communities, wikis, blogs and microblogging”

Example Online Social Networks

Facebook 845 million users (December 2011)YouTube ~800 million usersTwitter ~500 million users (including

spammers)SlideShareDoximityLinkedIn

Infographics

Infographics

http://blog.bufferapp.com/the-5-funniest-twitter-infographics and http://imgur.com/f2iP4

Doximity

Physicians/Med Students only

Verification of credentials before allowing full access

HIPAA-compliant info with other physicians

Send fax via mobile/web to other docs or pharm

Social Media Myths

“Social media is only for young people”

“I don’t have time for social media” Doesn’t take long to read 140 characters Not obligated to read every tweet of those you follow

“I won’t get anything out of social media”

“People will think I am weird”

Arora V. blog: http://futuredocsblog.com/top-twitter-myths-tips/

So What is the Current State of Physician Usage of Social Media?

Physician “Use” of social networking sitesHave you ever used a social networking site?

N (All): 454 N (Physician): 137 N (Resident): 131 N (med student): 186

Bosslet GT, et al. The patient-doctor relationship and online social networks: results of a national survey. J Gen Intern Med 2011;26(10):1168-74.

All Physician Residents Med Students0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

74

42

79

94NoYes

Physician attitudes towards using social media

20%

22%

18%

47%

45%

49%

33%

33%

33%

0% 20% 40% 60% 80% 100%

All respondents

Oncologists

Primary Care Physicians

Waste of time Neutral Essential use of time

When sharing medical advances and knowledge with other physicians, using social media is _____________.

Note: Responses categorized as 1-3 waste of time, 4-7 neutral, 8-10 essential use of time

n= 479 Mean 6.0 St.dev. 2.5

n= 296Mean 6.2St.dev. 2.5

n= 183Mean 6.0St.dev. 2.6

Wasko M, et al. Physician adoption and use of Social Media to share medical knowledge with other physicians. Personal communication, used with permission from B McGowan, PhD , senior author,. J Med Internet Res 2012 (in press).

Use of Twitter

15% of online adults use Twitter

8% use it regularly (doubled since May 2011) Hypothesis: rise in smartphones and using Twitter on

such a device

http://pewinternet.org/Reports/2012/Twitter-Use-2012.aspx

Meaningful Use

Adapted from McGowan B. http://www.slideshare.net/cmeadvocate/medicine-2pt0-meaningful-use-of-so-me-by-physicians-final &Kind T, et al. Advantages and challenges of social media in pediatrics. Pediatr Ann 2011;40(9):430-4.

4 possible ways physicians could use social media

TREAT (engage directly with patients)

TEACH (provide credible information to other HCPs)

LEARN (share and retrieve medical information)

ADVOCATE (for profession, for societal good, for patients)

What Can Docs Do?

Comments by blogger Kevin Pho, MD, found on http://healthworkscollective.com/jamierauscher/26931/five-reasons-why-doctors-need-connect-patients-through-social-media

Provide Context [to new information]

Dispel Myths

Influence the health care debate

Connect with mainstream media [and each other]

Hear what patients have to say

Conference Blogging

Reinhardt W, et al. How people are using Twitter at conferences. Creativity & Innovation Competencies on the Web. 145-6.

Examples

IU Pediatric Grand Rounds: Tweeting since Jan 2012 #IUPedsGrRounds

AAMC Nov 2011 My tweets are my “notes” from meeting

ACEHP Jan 2012 Tweets about improving CME process

Example Tweets from AAMC Conference 11

Social Media in Medical Education

Medical Content spread to learners through Social Media channels

EXAMPLES“Influenza vaccine

shot does NOT cause the flu—it is not a live vaccine”

“Metoclopramide now has a black box warning for tardive dyskinesia”

Teach medical learners about Social Media

Teach actual ways to use different networks

Role model (“teach”) professionalism in context of social media

Social Media in Medical Education

http://thecourse.webicina.com/ (a free course for medical professionals in how to use social media)

Professionalism

Challenging to apply principles of professionalism to online environment

Physicians may not consider impact of online content on patients/profession

Momentary lapse in judgment by one can reflect poorly on entire profession

Consider one’s “digital footprint”

Greysen SR, et al. Online professionalism and the mirror of social media. J Gen Intern Med 2010;25(11):1227-9.

Professionalism – Cautious Optimism

Commentary

Reviewed positive and negative side to physician use of social media

Social Media guidelines/policies should be created and reviewed

Bosslet GT . Commentary: the good, the bad and the ugly of social media. Acad Emerg Med 2011;18(11):1221-2.

Are Physicians Unprofessional on Social Media?

Study of 260 physicians who use Twitter

Physician = self-identified by biographical sketch

Studied month of May, 2010

3% of Tweets by physicians were deemed unprofessional

Chretien KC, et al. Physicians on Twitter. JAMA 2011;305(6):566-7.

Professionalism

“Social networks may be considered the new millennium’s elevator.”

Mostaghimi A. Professionalism in the digital age. Ann Intern Med 2011;154:560.

Professionalism – The Positive

“We must go farther than curtailing unprofessional behavior online and embrace the positive potential for social media: physicians and health care organizations can and should utilize the power of social media to facilitate interactions with patients and the public that increase their confidence in the medical profession.”

Greysen SR, et al. Online professionalism and the mirror of social media. J Gen Intern Med 2010;25(11):1227-9.

Professionalism – The Positive

“We must go farther than curtailing unprofessional behavior online and embrace the positive potential for social media: physicians and health care organizations can and should utilize the power of social media to facilitate interactions with patients and the public that increase their confidence in the medical profession.”

Greysen SR, et al. Online professionalism and the mirror of social media. J Gen Intern Med 2010;25(11):1227-9.

Pediatrics

“Pediatricians can and will use [social networking] tools to promote the pediatric profession as a whole, as well as the health and well being of the children and families they serve.”

McKenna MP, et al. Social networks and the practice of medicine: harnessing powerful opportunities. J Pediatr 2011;158:1-2.

Pediatric Example

Wendy Sue Swanson, MD @SeattleMamaDoc

http://www.youtube.com/watch?v=BtmP5yWm7XA

Surgery

“[Social Media] is a major potential source of education for the surgical community, and, perhaps, more importantly, the patient population. The infrastructure is there—surgeons just need to learn to use it.”

Yamout SZ, et al. Using social media to enhance surgeon & patient education & communication. Bull Amer Coll Surg July 2011

Hospitals

Review of sites occurred in Feb-March, 201021% of hospitals utilize Social Media

Facebook Twitter YouTube

Motivations to use social media Target General Audience Provide content about organization Announce news and events Further public relations Promote health

Thaker SI, et al. How US hospitals use social media Ann Intern Med 2011;154(10):707-8,

http://ebennett.org/hsnl/

Hospitals part 2

Hospital Social Network List (October, 2011) 1229 Hospitals utilize Social Media (out of a total

6436) = approx. 19% Indiana

17 use Social media IU Health, IU Cancer Center, Riley Hospital were 3

separate hospitals in this study @_StVincentHealth is Twitter feed

How Can Patients Use Social Media?

http://pewinternet.org/Reports/2011/HealthTopics/aspx and www.patientslikeme.com

Pew Internet Research: 80% of internet users have accessed health information online

E-Patient

Kvedar JC, et al. E-patient connectivity and the near term future. J Gen Intern Med 2011;26 (Supple2):636-8.

Internet-savvy patient: uses internet to collect information about a medical condition of interest

Uses electronic communication tools

Equipped EnabledEmpoweredEngaged

Link between E-Patient and Participatory Medicine

How Can Caregivers Use Internet?

79% of caregivers have access to internet

Of those, 88% look online for health info

Caregivers are social Offline and online

http://pewinternet.org/Reports/2012/Caregivers-online/Summary-of-Findings.aspx

Population Health

Social Media allows public health researchers to monitor misinformation and public’s negative responses to health initiatives Trends in influenza vaccine comments on Twitter

Social media does NOT substitute for “old-fashioned” conversations

“Social media can be useful in monitoring and dispelling health misinformation and myths.”

http://www.livescience.com/19056-social-media-helps-health-myths-misinformation.html

Disaster Medicine

Michigan tornado March 17, 2012 Family members able to reach loved ones via social

media

Virginia earthquake, August 2011 Tweets arrived BEFORE shock waves in Ohio and New

York were felt

Facebook, Twitter become lifelines during Michigan tornadoes. Detroit Free Press, 3/17/12http://mashable.com/2011/08/23/virginia-earthquake/

Quotes

“[Social media in health care] isn’t an addition to your job. This is part of your job [as a physician].”

Farris Timimi, MD, Medical Director of the Center for Social Media at Mayo Clinic

http://newsblog.mayoclinic.org/2012/03/24/farris-timimi-m-d-discusses-the-role-and-use-of-social-media-in-healthcare/

Special Thanks

IUSM Division of CME http://cme.medicine.iu.edu

Nikki Stuckwisch, MD

Final thoughts

“Let’s meet our patients where they actually are, which is on social media.”

“Physicians have an obligation to society to disseminate clear, succinct and truthful health care messages to combat online misinformation that is unfortunately too common; what better way than to use social media to accomplish this.”

Djuricich AM. Social Media in Medicine. Fall CME Pediatric Conference. October 3, 2012. You heard it here!!

Links to Helpful Information

Guiding Principles for Social Media in Healthcare http://socialmedia.mayoclinic.org/2012/03/13/guiding-principles-for-physician-use-of-social-media/

140 Uses for Twitter in Healthcare http://philbaumann.com/2009/01/16/140-health-care-uses-for-twitter/

Twitter for Beginners: http://www.readwriteweb.com/enterprise/2012/01/a-beginners-guide-to-twitter.php

IUSM Social Media policy: http://msa.medicine.iu.edu/files/7113/2648/2858/OnlineProfessionalism.pdf

My blog: http://alexdjuricich.blogspot.com/

Take Home Summary

Comments by blogger Kevin Pho, MD, found on http://healthworkscollective.com/jamierauscher/26931/five-reasons-why-doctors-need-connect-patients-through-social-media

Provide Context [to new information]

Dispel Myths

Influence the health care debate [professionally]

Connect with mainstream media [and each other]

Hear what patients have to say

Questions?

Email: adjurici@iupui.eduTwitter: @MedPedsDoctorChat on medical educ topics: #MedEd Thur 9PM

ESTSoundMedicine podcast on “Social Media in

Medicine” : http://soundmedicine.iu.edu/segment/3202/social-media-for-physicians

Thank you so much for attending!