Trend: Social Media THE SURFACE IS BEING SCRATCHED

PROVIDERS ARE USING SOCIAL MEDIA TO ENGAGE PATIENTS, COLLABORATE WITH EACH OTHER BY GABRIEL PERNA

It's beginning to happen, slowly, but surely. Social media use in healthcare is beginning to scratch the surface.

The UCLA Health System live-tweets brain surgery, including short video clips to reduce future patients' fear of a procedure. Johns Hopkins uses Facebook to generate a 21-fold increase of people who registered themselves as an organ donor in a single day. Texas Health Resources in Arlington is using social media internally and externally, for knowledge-sharing, team building, education, and employee recruitment. Out of the organization's 21,500 employees, 3,500 are active social media users.

This is just a small sampling of how healthcare organizations, specifically leading providers, are beginning to embrace what many, and some likely still, dismiss as a passing fancy. For many, the use of social media is no longer just being passed off as a marketing effort. Leading providers are even integrating it into clinical operations and overall efforts to improve patient engagement. Others are using it to collaborate with others to better navigate the tricky, regulatory waters upon which IT leaders in healthcare are facing.

An April 2012 report from PricewaterhouseCoopers'(PwC) Health Research Institute (HRI) found that 60 percent of consumers would trust health information posted on social media by their doctors, 55 percent would trust a hospital, and 56 percent would trust a nurse. The same study found that one-third of all consumers use social media for healthcare information. Since then, social media in healthcare has only grown and many say it will continue to grow.

"[Social media] is too much of a natural process-because people use this stuff everyday in all aspects of their lives-it's only natural that it will [continue] to make the jump to healthcare itself. When you can order a plane ticket, order a pizza, and deposit your paycheck from a phone, you're going to want to access your health records, schedule a doctor visit, get your lab results, and you are going to want to ask a health question," says Jeff Livingston, M.D., a physician at MacArthur Obstetrics, Gynecology, and Infertility in Irving, Texas.

A PATIENT ENGAGEMENT TOOL

Livingston has spearheaded the organization's avid social media efforts, connecting with patients through these mediums, for approximately 10 years. This dates back to the days when he would go on MySpace and answer questions from his young patient demographic about their pregnancy concerns. One look on the MacArthur Ob/Gyn social networking sites and the fruits of his labor will be in clear viewnumerous likes, retweets, questions and comments, and overall, engaged patients.

His strategy differs from many larger organizations. Doctors, not the marketing people, are the ones using the networks. "Finding a doctor who likes a particular network is so important to success," Livingston says. Recently, one of Livingston's doctors took over the organization's Pinterest page and was able to gain more than 100 followers on the network overnight. "This is not about practice marketing. This is a tool to engage patients in their health."

MacArthur also focuses hyper-locally, looking to serve the patients of the Irving area and their concerns. To Livingston, this is how the organization can build effective, intimate relationships with their patients through social media.

For bigger hospital provider organizations, such as Mount Sinai Health System, a sevenhospital system based in New York City, the hyper-local concept might not fly as well when serving a city of eight million. Still, the organization, which has been recognized for being one of the friendliest hospitals for social media in the U.S., works to ensure there is a meaningful connection with patients.

To do this, John Ambrose, the social media director at Mount Sinai, says his team meets with physicians, nurses, and department heads multiple times per week. They're mining for information on what patients want to learn about and will create campaigns based on that research. In that vein, it promoted a free skin cancer screening on Facebook and had a line out the door at the dermatology department.

"It's really about word of mouth, speaking to the doctors, speaking to the nurses. These are the people who are sitting with the patients every single day and know what these patients need, and from that, we can create meaningful campaigns," Ambrose says. In addition to this, Mount Sinai has created 50 or so social media channels, many of which are specifically for a certain disease population.

CONCERNS WITH HIPAA

Many on the provider side have shied away from connecting from patients altogether, citing concerns with potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The Philadelphia-based American College of Physicians (ACP) has provided an official series of ethical guidelines for physicians using social media and other electronic means of communication. The guidelines advise them to keep a distance from patients on the networks and schedule an appointment if they are approached through electronic means for clinical advice.

"I encourage physicians to not even use Facebook and areas where they put personal content in there, because of the (potential) for miscommunication. We are observed and we have a certain standard to act professionally, and sometimes that filter is not there to enable us to do that appropriately," says David Fleming, M.D., the President-elect of the ACP, who served on ACP's Ethics, Professionalism and Human Rights Committee. "Sometimes things can slip out on a Facebook post, a tweet, a blog. Suddenly, you have private information from patients, it may have been put out there innocently or educationally...but there it is."

When it comes to interacting with patients digitally, Fleming advises providers to use a secure patient portal. He also says digital tools should be used to strengthen and enhance face-to-face relationships.

Ultimately, Fleming says providers need to establish guidelines for social media and other forms of digital communication with patients. Others in the industry are instead focusing social media efforts on provider-to-provider communications.

Drex DeFord, the one-time CIO of Steward Health Care, the Boston-based integrated health system and chairman of the board of the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME), shifted to the vendor side in 2013, accepting a job as CEO of the Seattle-based Next Wave Connect. Next Wave is a social media platform that allows healthcare professionals to collaborate internally and externally, in a private or open setting. It relies on advisory council experts, community advisors, and community managers to contribute to conversations and facilitate collaboration.

To DeFord, these elements are where the value of social networking for healthcare providers can come into play. "I think the ability to create real and persistent collaboration over time is a real opportunity for healthcare that isn't offered in any other way today," he says.

DeFord says there is a real opportunity for growth in social media for healthcare providers and patients, as soon as they recognize this collaborative potential, and not just see the medium as a "time waster." This includes, he says, taking patient-generated data from social apps and feeding it into clinical portals. "Figuring out ways to use social to make people healthier is really something that will become a reality, and is a reality today, but will come more commonplace in the coming years," he says.

WHEN YOU CAN ORDER A PLANE TICKET, ORDER A PIZZA, AND DEPOSIT YOUR PAYCHECK FROM A PHONE, YOU'RE GOING TO WANT TO ACCESS YOUR HEALTH RECORDS, SCHEDULE A DOCTOR VISIT, GET YOUR LAB RESULTS, AND YOU ARE GOING TO WANT TO ASK A HEALTH QUESTION. -JEFF LIVINGSTON, M.D.