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Humanising medicine through social media: Practical guidance for using social media in the Oncology practice
- 2. Don S. Dizon, MD Lifespan Cancer Institute, Rhode Island Hospital The Warren Alpert Medical School of Brown University Providence, RI HUMANISING MEDICINE THROUGH SOCIAL MEDIA: PRACTICAL GUIDANCE FOR USING SOCIAL MEDIA IN THE ONCOLOGY PRACTICE
- 3. • The digital age is upon us! • Conversations about cancer and about stakeholders are going online – with or without you • Patient-centred care relies on patients • Social media represents an opportunity to listen, learn, and engage SOCIAL MEDIA TAKE-HOME POINTS
- 4. SOCIAL MEDIA DEFINED Evolving technologies designed to facilitate ability to communicate • One-to-one • One-to-many Can help in developing online communities with shared interests
- 5. FACEBOOK Mesko B. Social media in clinical practice. London: Springer-Verlag; 2013. Kerpen D. Likeable social media. Chicago, IL: McGraw Hill; 2011. • www.facebook.com • Launched in 2004 • Currently over 1.86 billion users • Share photos, videos, status updates, and content links • No restriction on type of content • – Copyright monitoring automated • User communities: support groups (closed and open), institutions, organisations, non-profits
- 6. TWITTER • www.twitter.com • Launched in 2006 • Converse in 140 characters (a “tweet”) • Follow conversations by using their hashtags • #bcsm, #gyncsm, #some, #lcsm, #pallonc Mesko B. Social media in clinical practice. London: Springer-Verlag; 2013. Kerpen D. Likeable social media. Chicago, IL: McGraw Hill; 2011.
- 7. • www.linkedin.com • Launched in 2003 • 467 million+ users • Site for professional use • Profiles ─ Individual ─ Companies (including hospitals, professional organisations, schools, etc.) • Groups LINKEDIN Mesko B. Social media in clinical practice. London: Springer-Verlag; 2013. Kerpen D. Likeable social media. Chicago, IL: McGraw Hill; 2011.
- 8. • www.doximity.com • Physician-specific social media site ─ > 70% of US doctors as verified members • CME credit potential • User features: secure fax, confidential dialer • Partnership with Castle-Connolly*: ─ Top doctors ─ Best hospitals DOXIMITY Available from: https://www.doximity.com/about Accessed March 2017. *Available from: http://health.usnews.com/health-news/blogs/second-opinion/2014/01/10/doximity-begins- surveying-physicians-for-us-news-best-hospitals Accessed March 2017.
- 9. • A mobile-first company • Picture/video communication via “snaps” • Social media channel for millennials and high school age (and younger) ─ Snaps time-out (auto-delete), though possible for viewer to save! ─ Delineates user versus brand content SNAPCHAT http://support.snapchat.com/en-US
- 10. • www.youtube.com • Launched in 2005 • Acquired by Google in 2006 • Site on which users upload (and watch) videos • Largest video-sharing site in the world ─ The launch of the Internet star YOUTUBE Mesko B. Social media in clinical practice. London: Springer-Verlag; 2013. Kerpen D. Likeable social media. Chicago, IL: McGraw Hill; 2011.
- 11. • A web-based platform for expression of opinions and ideas through journal-type entries ─ Allows for multimedia content and sharing (via hyperlinks) BLOGS Available from: https://connection.asco.org/ Accessed March 2017. Available from: http://www.kevinmd.com/blog/ Accessed March 2017.
- 12. QUESTION: How much does the public trust health information from the following sources? HEALTH INFORMATION NATIONAL TRENDS SURVEY (NATIONAL CANCER INSTITUTE HINTS) Adapted from: https://hints.cancer.gov/_images/infographics/HINTS-TRUST-Infographic-Cancer-Sources_Facebook-Optimized.jpg Accessed March 2017. 92% Doctors 70% Government health agencies 66% Internet 55% Family and friends 55% Charitable organisations 42% Newspapers or magazines 36% Television 32% Religious organisations and leaders 25% Radio
- 13. QUESTION: Where does the public go first for health information? HEALTH INFORMATION NATIONAL TRENDS SURVEY (NATIONAL CANCER INSTITUTE HINTS) 2008 2015 61% 73% Americans who went to the internet FIRST to look for information about health or medical topics Adapted from: https://hints.cancer.gov/_images/infographics/HINTS-TRUST-Infographic-Cancer-Sources_Facebook-Optimized.jpg Accessed March 2017.
- 14. DESPITE THIS – DOCTORS REMAIN SCEPTICAL 61.4 23.4 66.8 18.5 68.2 18.9 0 10 20 30 40 50 60 70 80 Doctor or healthcare professional Internet 2002 2005 2008 Trust in source for cancer or health information Patients(%) Adapted from http://hints.cancer.gov/brief_16.aspx Accessed March 2017.
- 15. 40% of consumers say information from social media impacts how they deal with their health1 90% of 18–24 year olds trust health information shared on social media2 41% say social media can affect their choice of healthcare provider3 PATIENT INVOLVEMENT IN SOCIAL MEDIA 1. Available from: http://www.mediabistro.com/alltwitter/files/2012/12/social-media-healthcare.png Accessed March 2017. 2. Available from: http://www.pwc.com/us/en/health-industries/publications/health-care-social-media.jhtml Accessed March 2017. 3. Available from: http://thesparkreport.com/infographic-social-mobile-healthcare/ Accessed March 2017.
- 16. •Your patients are online •You are online as well (even if you aren’t) Two very simple reasons: WHY SHOULD YOU CARE ABOUT SOCIAL MEDIA?
- 17. WHY SHOULD YOU CARE ABOUT SOCIAL MEDIA? • Information is unfiltered: you have no direct control over what comes up and at what rank… • BUT! Digital engagement gives you the opportunity to contribute and potentially reorder what information filters to the top of search engines Do your own Google search and see how frequently your name comes up!
- 18. • The digital footprint ─ Online record of who you are and what you do online ─ Tracked by your IP address, name, institution • But whose footprint is it?? ─ Yours ─ Your institution ─ Organisations to which you belong ─ Feedback from others ─ Impostors? ─ ALL OF THE ABOVE DIGITAL FOOTPRINTS IP, Internet protocol.
- 19. Discovery Definition Dissemination Defence MANAGING YOUR ONLINE PRESENCE: THE “FOUR DS” http://www.onclive.com/publications/contemporary-oncology/2014/november- 2014/clinical-oncology-in-the-21st-century-reflections-on-how-healthcare-providers- should-manage-their-public-personas-on-social-media
- 20. • Google search your name and see what comes up DISCOVERY: FIND YOUR DIGITAL FOOTPRINT
- 21. • Find out: What is Internet saying about you? ─ Online search on your name ─ Search name + affiliations (practice, institution, city) ─ Also look on specific websites: • Healthcare rating systems • Society websites • Patient-related websites • Content-sharing sites DISCOVERY: THE PROFESSIONAL AUDIT
- 22. • Disseminate information in order to control what patients and peers learn about you: ─ GOAL: the information found first is the information you want found ─ Reality: very difficult to delete information from the web • “Once it’s out there, it is out there” • HOW? ─ Sign up for professional sites ─ Publish your CV in multiple places ─ Get involved in social media CONTROLLING GOOGLE: DEFINITION
- 23. Engagement = larger online presence Remember: assume you cannot remove content once posted; observe before participation • Copies live on a server somewhere Choose a medium that you are comfortable with Each platform has its own language and etiquette DISSEMINATION: RAISING YOUR PROFILE THROUGH ENGAGEMENT
- 24. TWITTER FACEBOOK INSTAGRAM SNAPCHAT Tweets Pages Pictures/video Snaps RT: Retweet MT: Modified Multimedia capability to communicate via posts Grams allow for posting of visual content with commentary Static or video – but not permanent HT: Hat-tip Allows for Likes Allows for Likes Streaks: ongoing conversation, captured within a 24-hour period without breaking Conversation tracking via hashtags Encourages conversations Comment feed availability Can be restricted or public pages Accounts can be closed or open DEFENCE: ACTIVE ENGAGEMENT, PROFESSIONALLY
- 25. • Inform others about new outcomes: ─ Comment on medical literature ─ Personal commentary at live meetings • Better inform patients and the public: ─ Identify reliable resources ─ Add voice to ongoing conversations and debates ─ Debunk unfounded treatments • Advocate special interests: ─ Clinical trials ─ Research initiatives PHYSICIAN INVOLVEMENT: WAYS WE INTERACT
- 26. • Aim to leverage professional connections while maintaining privacy in other settings • Example: ─ Use Twitter exclusively for professional means ─ Use Facebook exclusively for personal means • Separation is supported by the American Medical Association (Opinion 9.124)1 • IMPORTANT POINT: all social media posts should be considered public DUAL CITIZENSHIP 1. Mostaghimi A, et al. Ann Intern Med. 2011;154:560-2.
- 27. Clearly define a separation between work and personal life Conflicts of interests should be clearly disclosed Avoid using institutional graphics or logos “Friending” or “following” patients is controversial, and policies will vary PERSONAL VERSUS PROFESSIONAL
- 28. • PROS: ─ Allows for a private versus public persona ─ Minimises risk to patients, and others can contact you in a personal environment ─ “Being myself” versus “Being a doctor” • CONS: ─ “Robs” patients of the opportunity to see their clinicians as humans • The professional identity as constituted by the personal identity ─ Operationally impossible • Web searches can quickly connect the two CAN/SHOULD YOU HAVE DUAL IDENTITIES?? DeCamp M, et al. JAMA. 2013;310:581-2.
- 29. Acknowledge that social media is inherently public, no matter what the forum CAN/SHOULD YOU HAVE DUAL IDENTITIES?? DeCamp M, et al. JAMA 2013;310:2567-8.
- 30. There are no HIPAA compliant social media Physicians have been sanctioned for social media activity Any contact with patients should be initiated by them AREA OF RISK: PATIENT CONFIDENTIALITY HIPAA, Health Insurance Portability and Accountability Act.
- 31. • Social media is an intriguing way to publicise/recruit for studies, BUT: ─ It is considered as an advertisement ─ It requires IRB review (US Office of Inspector General determination) ─ Only limited information can be given clinicaltrials.gov benchmark • Always remember: patient confidentiality is paramount AREA OF RISK: CLINICAL RESEARCH IRB, institutional review board.
- 32. • As of 2012, 71% of US state boards had held disciplinary proceedings for inappropriate social media activity1 ─ 56% led to restriction, suspension, or revocation of licence • Activities agreed to be problematic include1,2: ─ Misinformation on website, including board certification or outcomes ─ Patient confidentiality ─ Inappropriate communications with patients SANCTIONS FOR INAPPROPRIATE ACTIVITY 1. Greysen S, et al. JAMA. 2012;307:1141-2. 2. Greysen S, et al. Ann Intern Med. 2013;158:124-30.
- 33. EXAMPLES OF US SANCTIONS Available from: http://newsok.com/oklahoma-doctor-disciplined-for-using-skype-to-treat-patients/article/3882187 Accessed March 2017. Skype
- 34. EXAMPLES OF US SANCTIONS Available from: http://archive.boston.com/lifestyle/health/articles/2011/04/20/for_doctors_social_media_a_tricky_case/?page=full Accessed March 2017. Facebook
- 35. Get involved Engage often Always identify yourself Protect patient confidentiality and privacy Contextualise your activities 1 2 3 4 5 Available from: http://www.asco.org/sites/www.asco.org/files/asco_socialmedia_card.pdf Accessed March 2017.
- 36. Avoid impropriety Give credit where credit is due Professionalism is critical Separate personal from professional Be aware of your institutional guidelines10 9 8 7 6 Available from: http://www.asco.org/sites/www.asco.org/files/asco_socialmedia_card.pdf Accessed March 2017.
- 37. You need an email address • If part of a larger institution, check institutional policies for ability to use work email for account setup • Institutions may require that social media accounts are subject to monitoring Establish a unique identifier • User name in most platforms Pick your forum and start lurking • Follow specific people • Follow conversations by #hashtag GETTING STARTED
- 38. HASHTAGS
- 39. • We are in a digital era of communication • Social media cannot be ignored • To learn: explore • Protect your identity • Engage to increase your visibility • Always remember that your reputation is at stake CONCLUSIONS So, come on in… The water is just fine!
- 40. QUESTIONS? DON S. DIZON, MD TWITTER: @DRDONSDIZON INSTAGRAM: DRDONSDIZON FACEBOOK: DON S DIZON