Social Media and Healthcare

Patients have come to expect unprecedented access to their physicians, especially through technology-based means; a large part of that is social media. However, many physicians are leery of wading into uncharted waters that have the potential to open them up to legal risk and possibly blemish their reputation. Yet refusing to embrace social media could ultimately harm your practice. Younger tech-savvy patients expect to see their physicians online. If they don't, they may choose to leave your practice for one that has a more robust online presence.

Pediatrician Wendy Sue Swanson, aka Seattle Mama Doc, started blogging for Seattle Children's Hospital five years ago in response to the media frenzy over the MMR vaccine. She realized that she had limited time in the exam room to educate her patients and their families. "To me it seemed that I was not going to be the pediatrician and advocate that I wanted to be if I continued to stay just in the exam room," says Swanson.

Through blogging, expanding her role on Facebook and Twitter (@SeattleMamaDoc), and utilizing other platforms like health advocacy and public speaking, Swanson now has 25,000 followers on Twitter. But she says that number is really not important. "You can have 24,000 followers or 24 followers, but if the 24 followers are the right followers — people who need your advice — then that's really good."

So take heart, you can begin with little steps. Here's what our experts say you should know about "getting social."

WHY SHOULD YOU USE SOCIAL MEDIA?

One of the best reasons for using social media is that you can reach your patients where they are increasingly active — online. Smartphones and other mobile devices are ubiquitous, and, in one sense, just a more sophisticated vehicle for word-of-mouth marketing. Patients continue to ask each other for the name of a good pediatrician or family doctor, but now they are doing that online.

Customer engagement is an important part of any business. Founder of practice-management consulting firm Physicians Practice Expert, Audrey "Christie" McLaughlin says practices that establish a presence on social media are connecting with their patients and the local community in ways that will position them as the go-to experts in the field. She adds this goes a long way to building the first steps to patient engagement: cultivating the "like, know, and trust factors" with a physician. 

Pediatrician Natasha Burgert makes liberal use of social media tools in her group practice, Pediatric Associates, a 13-provider medical practice in Kansas City, Mo. In addition to seeing patients full time, she is also the "social media community manager" for her practice. She says patients most often find out about her practice's social media accounts through word of mouth. "Moms talk to moms and they let [each other] know information is available. During the clinic visit I will tell them 'If you want to find out more, just follow us on Facebook, or you need to follow [my] blog,'" says Burgert.

Burgert says her patients' parents have come to trust the information they get from the practice's Facebook page or her personal blog, KCKidsDoc.com. In fact, the impetus for starting a practice social-media channel was the H1N1 epidemic in 2009. Burgert says her practice was being inundated with phone calls from panicked parents. They created a practice Facebook page where Burgert posted daily updates; when patients called, they were directed to Facebook.

SOCIAL MEDIA DO'S

Once you decide to plunge into social media, make sure you develop a plan. As with any worthwhile endeavor, it helps to have a playbook. Here are several factors you should consider first:

• Identify your goals. The first step to creating an online presence should be to define your social media goals as a practice. Julie Song, patient safety risk manager for medical malpractice insurer The Doctor's Company, says it is a mistake to lightly enter into the social media arena. She cautions against creating a Facebook or Twitter account because all the other groups in your community are doing so. "Determine what would be the best medium to portray your practice to the intended audience," Song says.

• Find your ideal patient. When working with practices, McLaughlin asks them to identify their "ideal" patient; the group of people your practice wants to speak to in its marketing and social media efforts. That has a lot to do with the type of social media channel that you choose. Burgert suggests that physicians register with Google+ and also create a profile on LinkedIn and Doximity. McLaughlin says Instagram and Pinterest are also good options for some practices.

• Make it fun. Make the learning process fun to remove some of the perceived drudgery of yet more administrative work. Swanson suggests starting a personal Facebook page around a hobby or family activity. She says using the social media tool in a "low-risk environment" will make it easier to learn the ropes, before you apply your new skills to your medical practice.

• Set a time commitment. Another hurdle that practices worry about is the time commitment they will have to make to their social media efforts. Busy physicians barely have time to see patients, let alone contribute to social media platforms on a regular basis. Burgert recommends finding that "one voice" to be responsible for posting to all social media platforms (with backup, of course, in the case of emergencies).

• Partner with staff. An acceptable alternative to doing it yourself is to identify that one staffer who has an interest and the skill set to represent your practice online. Swanson says she knows from personal experience how hard it is to treat patients full time and manage a social media presence. She says a physician can partner with staff members in the practice to share relevant, thought-provoking, or educational material that they can then disseminate to patients online.

• Decide how often you'll post. Burgert says she likes to post to Facebook at least twice a day. Twitter is much more "live-time, interactive," she says, so she posts when she is on the site, throughout the day. McLaughlin recommends practices post seven times to 10 times a week to Facebook, until they get a better idea of what their followers want and like. She suggests using Facebook Insights (a free data analytics tool) to dig into the data. That way you'll know when your people are online.

SOCIAL MEDIA DON'TS

Many physicians are unreasonably afraid of establishing a social media presence online, says McLaughlin: "Really, I think a lot of the fear is hyped up." As long as physicians keep common-sense tenets in mind, like not posting protected health information (PHI), she says they'll be fine.

However, there are a few social media pitfalls that physicians should be on the lookout for. Here are some things to be mindful of:

• Guard against HIPAA violations. It is important to protect your practice and patients against HIPAA violations. The best way to do this, says Song, is to have a HIPAA policy in place and to train your staff members on its execution. She advises that only HIPAA-trained staff members should engage with the public through social media. And to be thorough, your "office policy should dictate that staff are not to comment about patients or office-related matters on their personal social media accounts," says Song.

• Don't blur professional and personal profiles. Illinois-based healthcare attorney Ericka L. Adler says physicians should never combine personal and professional social media accounts. They should be kept strictly separate. She also advises against "friending" patients on a physician's personal Facebook page. "Patients don't need to see pictures of you partying to all hours of the night, or whatever it is," Adler says.

• Never give specific medical advice online. "I do not doctor online. I'm not sharing health information. I'm not sharing things that contain PHI without families' permission," says Burgert, of her social media platforms. She says only two of her patients have ever asked her personal health questions online. If they do, it is best to direct patients to call the office if they wish to speak with a physician.

• Don't acknowledge a physician-patient relationship. Another pitfall that physicians need to be aware of is acknowledging online that a person is their patient. Adler says that "simply acknowledging that somebody is your particular patient can create a HIPAA issue." If you are responding to a compliment about your practice, for instance, be neutral says Adler — you can say something like, "Thank you for your kind words."

In some cases, having a discussion with someone online could establish a patient-physician relationship where there is none, says Song. "Many practices do not realize that social media can create confusion about when the patient-physician relationship was established," she says.

Twitter is a widely used social medium. However, its application in promoting health behaviors is understudied.

In order to provide insights into designing health marketing interventions to promote physical activity on Twitter, this exploratory infodemiology study applied both social cognitive theory and the path model of online word of mouth to examine the distribution of different electronic word of mouth (eWOM) characteristics among personal tweets about physical activity in the United States.

This study used 113 keywords to retrieve 1 million public tweets about physical activity in the United States posted between January 1 and March 31, 2011. A total of 30,000 tweets were randomly selected and sorted based on numbers generated by a random number generator. Two coders scanned the first 16,100 tweets and yielded 4672 (29.02%) tweets that they both agreed to be about physical activity and were from personal accounts. Finally, 1500 tweets were randomly selected from the 4672 tweets (32.11%) for further coding. After intercoder reliability scores reached satisfactory levels in the pilot coding (100 tweets separate from the final 1500 tweets), 2 coders coded 750 tweets each. Descriptive analyses, Mann-Whitney U tests, and Fisher exact tests were performed.

Results: Tweets about physical activity were dominated by neutral sentiments (1270/1500, 84.67%). Providing opinions or information regarding physical activity (1464/1500, 97.60%) and chatting about physical activity (1354/1500, 90.27%) were found to be popular on Twitter.

Approximately 60% (905/1500, 60.33%) of the tweets demonstrated users’ past or current participation in physical activity or intentions to participate in physical activity. However, social support about physical activity was provided in less than 10% of the tweets (135/1500, 9.00%). Users with fewer people following their tweets (followers) (P=.02) and with fewer accounts that they followed (followings) (P=.04) were more likely to talk positively about physical activity on Twitter.

People with more followers were more likely to post neutral tweets about physical activity (P=.04). People with more followings were more likely to forward tweets (P=.04). People with larger differences between number of followers and followings were more likely to mention companionship support for physical activity on Twitter (P=.04).

Conclusions: Future health marketing interventions promoting physical activity should segment Twitter users based on their number of followers, followings, and gaps between the number of followers and followings.

The innovative application of both marketing and public health theory to examine tweets about physical activity could be extended to other infodemiology or infoveillance studies on other health behaviors (eg, vaccinations).

more at http://www.jmir.org/2013/11/e261/

Follower count is, unanimously, the biggest indicator of success on Twitter. Some people may contend with that statement. They may argue that quality of followers, quality of tweets, level of engagement, etc. are far more important success metrics.  

However, a lot of people are, without a doubt, influenced by the number of followers somebody has. Having a huge follower count is kind of a self-fulfilling prophecy. People see you have a lot of followers, assume your tweets must be extra-special or you must be extra-special and follow you, thus increasing your follower count further.  

So, what really gets you more followers? You will find articles aplenty online that tell you how to get more followers on Twitter. Why, I have written quite a few myself.   

But this post is different.  

This post does not rely on experience, observation, commonly held beliefs, guesswork or any other abstract factors to tell you where Twitter followers come from and how to get and keep them. This post is based entirely on scientific analysis and facts – numbers, stats, hard-to-refute conclusions. So, let’s get going.  

Scientifically, these are the factors that influence how many twitter followers a particular account can amass: