#eHealthPromotion, #SaluteSocial

Social media is here to stay. If you’re a business competing in the social area, it’s getting more and more difficult to stand out from the rest of the crowd. This holds especially true in medical marketing, and sometimes, medical practices find themselves getting online attention for all the wrong reasons.

In our latest video, CEO Ryan Miller discusses some of the bigger implications of social media and how it can positively (or negatively!) affect your online reputation. You’ll learn what has the potential to cross the line, and how to leverage social media best practices to help safeguard you and your medical practice.

Video Transcription

Hi again, it’s Ryan Miller with Etna Interactive and it’s good to be back with you today because we’re going to be talking about a somewhat serious and timely topic. We’re going to talk about the appropriate use of social media in the medical practice environment. By now, I think many of us are familiar with Dr. Windell Davis-Boutte, known as the “dancing doctor” in the popular media. Obviously, she was after her 15 minutes of fame when she began publishing videos of her singing and dancing while patients were anesthetized in her operating room, and has received a tremendous amount of criticism. Not only that, very recently she reached an agreement within her state which agreed to the suspension of her medical license for about 2.5 years.

Now, some of you are saying “Ah, you know, Ryan, that’s not me. I would never make such a huge mistake. I have much better judgment. Does this really apply?” And the answer is yes. Because if you joined us just a couple of months ago for our HIPAA webinar, you recall that there’s actually been a spate of similar disciplinary actions for things that were published on behalf of staff or on behalf of agencies that are working for medical practices. So we’re taking a broad look today at the appropriate use of social media for anyone that might be publishing on behalf of the practice because we have a couple of fairly existential questions that we have to be thinking about.

Where do you draw the line?

As marketing is moving from more traditional media or traditional online media towards social media, what do we have to do today to stand out? And it may be this question that’s driving people to ever more sensational postings. At the same time, we have to recognize that it may be your medical license that’s at risk, but the posts are very often today coming from members of your staff or agencies that you’ve hired. And I think on a much broader level, we have to step back and ask: What do we really feel is appropriate as it relates to social media postings from medical professionals, and do the postings of the few have a negative reflection on our medical specialties as a whole?

RealSelf Study

Now, why is it? What’s the drive that’s pushing us all towards social media? As far back as 2015, I think the data was fairly clear. RealSelf did a study and asked patients directly what were their preferences and their interests as it related to connecting with doctors on social media. Well the Huffington Post came out with this story titled, Nonsocial Doctors Are Terribly Outdated.

Now, where that was coming from really was inspired by these two data points: 95% of patients expected their physician to be at least somewhat active on social media. Although the majority, 66% said: “I’m not likely to actually connect with you”. We call this cyberstalking, right? The patients want to see what you’re doing. They’re interested in what’s happening in the practice and in order to fulfill that wish, to share with them what’s going on, we need to step back and we’re going to be taking a look at three things today.

Today’s presentation at a glance:

1. Common professional offenses on social media

2. Best practices for physicians

3. Steps to protect yourself and your practice

Now, let’s pause for a second here. We’re going to go a little bit longer than our typical newsletter distribution because our hope is that this is going to be a resource. A resource not only for your own edification but for training your existing staff. Perhaps for using this as you onboard new members of your team who will be active in social media on behalf of the practice. Now, let’s dive right in.

What could possibly go wrong?

Well, the research shows right now that infractions are abound, that we see more and more reports from both state medical licensing boards here in the United States and from the Royal Colleges up in Canada, that there is an increasing number of infractions that involved disciplinary action that relate directly to social media. So the problem is on the rise. The most common offenses that are reported that are resulting in disciplinary action are these:

• Inappropriate contact with patients (e.g., sexual misconduct)
• Inappropriate prescribing and inappropriate practice
• Misrepresentation of credentials or clinical outcomes
• Violations of patient confidentiality
• Defamatory language or profanity directed at a patient or coworker
• Depiction of inappropriate behaviors

Social media best practices for physicians.

Now, let’s pause here for a second again and think about the expansive nature of our advice. We’re not lawyers, so we’re not giving you legal advice, but this is applicable things that you’re doing on email, the content that you publish on your website, the text communications that you may be having today with patients, blogs that you publish, and of course, the broader and specific context that we’re talking about: the social networks.

Now, let’s go through some specific advice here:

1. Put your posts in context.

When we’re posting, we need to put our posts in context. If we have a bias, we need to share that bias inside the posts so that patients can understand how to interpret what they’re going to see as medical advice from you or from your practice. So if you have a financial, professional or personal conflict, be sure that you include it inside the post and be sure that you’re not representing your clinic, misrepresenting your clinical outcomes and overstating what you can realistically achieve.

2. Maintain your integrity.

We all need to be mindful of maintaining our integrity. I think the last thing we want is to be active on social media and have it undermine our own moral values. So, the basics of medical marketing are these: avoiding false, fraudulent and misleading statements are absolutely critical. Now, if you’re drawing upon scientific and clinical knowledge, we want to make sure that our content conforms to the standards of care, that we’re giving good medical advice.

Finally in this particular section, if we’re giving specific advice (which we generally recommend against), we need to be sure to indicate whether it’s based on scientific studies, expert consensus, or just your own personal and professional experience.

3. Protect patient privacy.

Now, a great example here of what can go wrong, especially when you’re sharing things without consent. This particular case, a story from the Tyler Morning Telegraph, about a plastic surgeon who shared some video of a patient without taking steps to protect that patient’s privacy.

Keeping in mind that the photos and videos that you publish on the web, things as subtle as the file names and metadata go out into the public web when you publish those assets. So if you have a picture of a patient that contains their last name and you publish that directly to Facebook, it’s not going to be de-identified. And you need to take the steps to do that yourself.

In addition to that, we always need to get express consent, specifically written consent, before we publish pictures or videos of our patients onto the web. Now, if your forms don’t expressly mention social media as one of the uses, it’s time to update those forms. Drop us a note, we’ll direct you to a great resource that’s provided by Medical Justice.

4. Avoid defamation.

Now, this is an actual post. It’s hard to believe, but this is a real post that appeared on social media and we see what’s happening as we kind of glance through the text here. We see one medical professional lambasting one of their colleagues for some decisions that were made, in this particular case, in the emergency room. Now, clearly bad idea in terms of both the defamatory nature of this post, but also the potential that this has for inciting a medical malpractice lawsuit. So we want to be careful that we’re avoiding defamation.

I think this hopefully goes without saying, but we don’t want to go after any of our colleagues. We don’t want to attack the reputation of a patient on the public web.

5. Be the professional.

Now, it’s not just an attack that might get us in trouble — complaining is a problem that’s fairly rampant as well.

In this example, also taken from the headlines, we see an OB-GYN complaining about a late patient. We see colleagues commiserating, all of them missing the fact that their discussion was visible on the public internet. There’s quite a backlash from the body of patients who had seen this practice. So those kinds of complaints we need to keep to ourselves and the basic advice there is simply to be professional. Act on social networks as you would in person and as if the people that we’re talking about are standing in the room with us.

Be sure that you set clear guidelines for yourself, that you’ve thought it through, and ideally that you’ve written guidelines as well for the members of your staff who will be participating on social media on behalf of the practice.

If you are publishing before and after photos or if you’re publishing videos of procedures, be sure that you’ve got some guidelines for you and for your team on how to de-identify that information so that we’re protecting patient privacy.

We have a specific recommendation for those doctors who have both personal social media profiles and professional profiles and that’s that you get used to politely declining social connections from patients on your personal profiles and that you can guide those people to connect with you on your professional social media accounts.

6. Maintain proper boundaries.

Maintaining boundaries is really just an extension of that same idea. Obviously, you should not be initiating a doctor-patient relationship with someone that you’ve never met. So don’t be practicing on strangers on social media.

Be mindful about the details of your own personal life, details as subtle as what’s contained in the photos that you place on your social media accounts. Be mindful about what you reveal there.

And of course, avoid any online relationships with current or former patients, right? Not a good idea to get too close personally on social media with someone that you’re also treating.

Protect your person and your practice.

Now, let’s talk about protecting, as we wrap up here, both your person and your practice.

Take care with privacy settings.

We’re recognizing that if you’re the Medical Director of a center, you’re responsible for everything that’s published in the name of that practice. So, let’s be sure and be aware that with privacy settings, they’re not as transparent as they should be despite what I think are the best efforts of the major social media players. It can be quite complex to control and clearly understand who’s seeing what you’re publishing. So, understand how you can configure privacy settings to protect your information and assume that everything that you share is going to become publicly available regardless of how you’ve set those privacy considerations.

Consider the destiny of your data.

Recognize as well that once it’s shared, it may be shared forever. Don’t plan on being able to delete anything that you publish online.

Now, for those of you, especially those of you that are either younger inside of a practice, or just getting started on professional careers and you aren’t your own boss: If you ever hope to be hired, it’s a good idea to assume that your future employer is likely to perform a background check of some kind. They’ll be taking a look at your activity online and they’ll be considering the quality of your posts and the style and types of the nature of the connections that you form on social media.

Assess yourself online.

To check yourself, we recommend you simply begin by Googling your full name. Look through all of your old social posts, look through your social connections in the groups to which you belong, and ask yourself, “Are my employers likely to object to anything that’s out there?” You may want to consider making edits or revisions to your public profile.

We do also recommend that practices consider formal policies. It’s important that you check here with human resources lawyers that you work with inside of your practice in your state because from one state and province to the next, the laws about what you can regulate for your employees different.

Consider formal policies.

We definitely recommend that every practice protect their passwords. Unfortunately, we’ve seen far too many cases where a practice separates from an employee only to find that the passwords and the user accounts for social media are attached to that departing employee who then has the control to edit or simply destroy the accounts that are built in the name of the practice. So, password protection is an important part of protecting your assets on social media.

Identify and articulate clearly to each member of your staff who’s actually allowed to participate on social media on behalf of the practice. Establish a clear HR policy that talks about what your expectations are and what the risks are surrounding their participation inside of social space. We also recommend for practices that have either staff or an agency publishing on their behalf that you have some clear protocols about when it’s required for members of your leadership team to approve text and content before it goes out.

Summary

Pulling all of those ideas together, we just need to recognize that disciplinary action for medical practice participation on social media — it’s on the rise. And it’s up to you to understand and adopt those best practices that are going to keep you safe.

In addition to just following best practices, some of those prophylactic actions that we recommended there that are intended to protect you and articulate in advance for the people who are participating on social media what they should and should not do, are really some of the best ways that you can protect yourself now and into the future.

And, of course, if you want to learn more, you can be sure that you’re subscribed to our newsletter so you receive our video broadcast each and every month. You can follow us on social media or maybe leave a review for the content on Facebook as well.

My name is Ryan Miller, and I welcome your questions directly at Ryan@etnainteractive.com. Thanks for tuning in today, we’ll look forward to seeing you next month.

Via Plus91

PURPOSE OF REVIEW:

The use of social media has now become a standard means of communication for many individuals worldwide. The use of one specific form of social media, Twitter, has increased among healthcare providers, both as a means of information gathering and as a conduit for original content creation. Recently, major efforts by users have been put forward to help streamline the unprecedented amount of information that can be found on Twitter. These efforts have led to the creation of diseasespecific hashtag (#) medical communities and have greatly enhanced the ability to understand and better categorize the available data on Twitter. Specifically, for those involved in rare cancer fields, adhering to organically designed and consistently used hashtags has led to the rapid, reliable dissemination of information and the ability to efficiently discuss and debate topics of interest in the field. For the field of myeloproliferative neoplasms (MPNs), the creation of #MPNSM (myeloproliferative neoplasms on social media) in 2015 has facilitated interactions among healthcare stakeholders from all over the world in the MPN field.

RECENT FINDINGS:

In order to better understand the trends and topics of interest to Twitter users of this novel medical community, we conducted the present analysis which focuses on Twitter analytics from the first two years of #MPNSM. In this analysis, we observed a sustained increase in the number of Twitter users, number of tweets, number of impressions, and number of retweets over time, demonstrating the feasibility of creating and maintaining a disease-specific hashtag for a rare cancer over time.

Via Plus91

Pharmaceutical companies are increasingly embracing social media as a forum for reaching patients. For example, 40% of adults use social media for health-related issues, such as connecting with patients with similar issues. Social forums allow pharmaceutical companies to not only engage with consumers or patients, but also hear what they have to say directly, rather than sifting through external forums to find out what patients are saying, for example, about side effects.

Disease awareness is a particularly popular use of social media for pharma companies. These forums are recognized by companies as good ways to improve knowledge about diseases and to encourage discussion about conditions. Examples include Above MS, which is supported by Biogen; Chron’s & Me, sponsored by UCB; Eczema Exposed supported by Sanofi US and Regeneron Pharmaceuticals; GSK’s Asthma.com; HIV information and support site Stop the Virus sponsored by Gilead; and Speak Your Migraine from Amgen and Novartis, among many others.

In addition, companies have begun supporting wellness sites, such as Merck Engage, to encourage consumers to make healthy choices.

With some diseases, particularly rare diseases, social platforms can prove valuable in connecting geographically dispersed patients and providing them with a voice. Social media groups can also be invaluable in providing patients with a forum for sharing concerns and information.

Overcoming Barriers

The industry has faced several constraints with regards to social media. One is certainly the lack of clear guidelines. While the FDA provided draft guidance on the use of social media, those guidelines haven’t been finalized. However, companies must ensure information about risks is made clear. For example, Duchesnay received a warning letter from the FDA after posts by Kim Kardashian promoting its morning sickness pill Diclegis didn’t mention side effects or risks.

Twitter is considered an excellent two-way communication forum, but again lack of guidance leaves companies uncertain as to how to embrace it, at least when it comes to speaking about their products.

In a conversation on this issue with Forbes, cardiologist and blogger Dr. Kevin Campbell warned that pharmaceutical companies would have to tread carefully when hosting any commercially driven discussion and be aware that during recalls or negative press, they could open themselves to legal issues.

The good news, however, is that as of mid-November 2017 the Office of Prescription Drug Promotion (OPDP) had issued only two enforcement letters on marketing communications, showing a marked drop in such activity from the regulators. While these letters aren’t specific to social media, they do indicate a positive trend generally.

Media forums themselves have sometimes created barriers for the industry. For example, in 2011 Facebook announced that all Facebook pages would have to allow comments. This resulted in companies removing many disease-state groups because they lacked the mechanisms and resources to handle comments and remain in compliance. Facebook later rescinded the requirement; however, pharmaceutical companies struggle to find a way to effectively communicate with patients in such forums.

Another barrier has been uncertainty over communicating directly with patients, and in particular, concerns over how those patients will react.

Best Foot Forward

Statistics show that pharma is tapping into social media, albeit more slowly than other industries. Research company eMarketer estimated that in 2016 pharma and healthcare marketers spent $1.64 billion on mobile and online advertising, but projected that would rise to $2.55 billion by 2019.

The social media companies themselves are looking at how to engage pharma companies from a commercial point of view. On June 6, 2017, Facebook hosted a Health Summit for pharmaceutical marketers, and the organization is looking at changes it needs to make to cater to pharmaceutical companies, which increasingly are moving ad budgets from television to digital media.

Google and Twitter have been tapping into the market for a while, hiring teams to focus on pharmaceutical ad campaigns.

Experts in social media advise pharma companies new to social media to take the plunge because patients and caregivers are eager to use these forums to engage. Those new to social platforms might be best advised to start with well-traveled forums such as Facebook and working closely with medical, legal, and regulatory teams to avoid any nasty surprises later. Another sound approach is to start in one disease area and learn as they go.

Companies are also advised to measure the effectiveness of their social media campaigns, especially when it comes to branded campaigns. To avoid falling foul of regulators, some experts recommend companies develop a controlled environment, such as a website for a product, to ensure information is accurate. But if companies provide a patient chat room they may face obligations to correct misinformation.

Social media market intelligence firm Unmetric assessed the metrics, content, and campaigns of 15 brands in terms of social media presence and found most brands put efforts into just a few channels, that fan base is less important than the ability to expand that base, and that reach and impressions don’t correlate with frequency of posting.

Leading the Way

Despite concerns, many pharma companies do recognize the value of social media as a way to reach patients whether in a non-branded way to open the conversation on disease states, or — though less so — from a more commercial perspective.

Some companies have appointed digital leads to advance their social positioning, including: Biogen, which has a head of digital strategy; Sanofi US, which has a head of digital intelligence and connected marketing; Boehringer Ingelheim, with a senior digital manager; and Takeda, with a head of digital acceleration, to name a few.

One of the most successful campaigns was Boehringer Ingelheim’s post during Brain Awareness Week in March 2016, which included a puzzle to highlight cognitive tasks. The post marked the company’s foray into the therapeutic area of CNS, including mental illness.

One strong proponent of social media is Ron Cohen, M.D., CEO of Acorda Therapeutics, who started a digital-innovation-and-strategy group at the company. This has led to several innovations, including a self-help application called MS self that lets users track metrics related to their health. The company is also using digital technology to recruit patients for clinical trials, using multichannel methods to find patients with a condition and inform them of the clinical trials, and providing click throughs so patients can find out more.

Another company looking at social networks for patient recruitment is Bioverativ, which has turned to MyHealthTeams to better understand the unmet needs of hemophilia patients and potentially get them into trials for an upcoming hemophilia drug. Once it gathered input, the company designed its trial to address unmet needs by gauging two key issues raised: continued pain and help with depression.

Companies must take a considered approach to their social media. Sandra Velez, content strategy leader at Merck, says companies must understand their customers’ needs, have two-way conversations with them, and be on channels that customers expect them to be on. She emphasizes the importance of creating a customer persona and understanding that their emotional needs will vary depending on their persona — patient, provider, or payer, for example.(PV)

Via Plus91, Lionel Reichardt / le Pharmageek

With the caveat in the section above–that we’re often doing a little of both–and some informal polling of many esteemed marketers I know, here is where I’ve landed on social marketing vs. content marketing.

 

Social marketing is a channel where we find potential customers by listening to earned conversations and analyzing our owned accounts. We then interact with those people to move them through the customer journey.

 

You can use various tactics to make that movement happen. Content marketing is a tactic. It’s a method of marketing that allows companies to add value for potential customers by creating and distributing (sometimes through social) collateral like blog posts, videos, and web pages.

 

These pieces of collateral entertain and educate your target audience about topics related to your product. They’re intended to generate interest in your offering by reinforcing relevant problems, challenges, misconceptions, and, finally, solutions....

Via Jeff Domansky