Social networking platforms Social media refers to the means of - - PDF document

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@Seth Bokser, MD, MPH Associate Clinical Professor, UCSF Medical School Medical Director for IT , UCSF Benioff Children’s Hospital

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a)I don’t really know what Social Media means b) None (but I know what Social Media means) c) 1 Social Media Network d) 2 Social Media Networks e) 3 or more Social Media Networks

• Bosslet GT

, et. al. The Patient–Doctor Relationship and Online Social Networks: Results of a National Survey. J Gen Intern

• Med. 2011 October; 26(10): 1168–1174
• Marcio von Muhlen, Lucila Ohno-Machado Brief communication: Reviewing social media use by clinicians J Am Med Inform

Assoc 2012;19:5 777-781 Published Online First: 3 July 2012doi:10.1136/amiajnl-2012-000990

• What is Social Media?
• Learn how Social Media is being applied

in healthcare today

• Connect:

Consider the Opportunities and Challenges

• Privacy
• Professionalism
• Accuracy of health information

Social media refers to the means of

interactions among people in which they create, share, and exchange information and ideas in virtual communities and networks.

Social networking platforms

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Blogs and Wikis

Today, I find t hat more people know me from my blog writ ings t han from my 200 peer-reviewed art icles and six books, and t hat I receive more direct feedback about my blog post s t han about virt ually any of my writ ings in more t radit ional

• media. -Bob Wachter, MD

Micro-blogging (Twitter)

≤ 140 character “tweets” (blurbs) commonly with links to other sites Users include Hashtags (# signs) in tweets about a particular topic so users can more easily find them and follow topics. A method of categorization. What’s trending? Users include @ signs followed by usernames to mention or reply to other users

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a) 0-20% b) 21-40% c) 41-60% d) 61-80% e) 81-100%

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Web 1.0 Web 2.0

• 72% of internet users say they looked
• nline for health information of one

kind or another within the past year.

• 35% of U.S. Adults “Online Diagnosers”

I sort of look up t o t hem and say ‘ If t hey can do it , maybe I can do it ’ .

• Teenager in Ontario Hospital speaking of finding other

teenage hockey players with his diagnosis Hmm somet imes we do, like about doct ors and st uff like he has a funny hairdo or like medicat ion or st uff like t hat like we compare you know oh did you t ake like what happened when you did t hat . We kind of compare but apart from t hat we don't say like oh yeah I am going for surgery for nanana, it is not like professional, it is j ust for fun.

• Hospitalized teenager in Ontario Hospital speaking of how

pediatric inpatients interact on Facebook

Van der Velden M, El Emam K. “ Not all my friends need t o know” : a qualitative study of teenage patients, privacy, and social media. J Am Med Inform Assoc 2013;20:16-24 doi:10.1136/amiajnl- 2012-000949

Connect Engage patients where they live Leverage the masses to empower, educate, and problem solve Maintain professionalism and trust Respect patients’ privacy Protect patients from inaccurate, anxiety provoking, and dangerous health info online

Opportunities Challenges

*Gartner Research. Forecast: Social Media Revenue, Worldwide, 2011-2016 http://www.gartner.com/newsroom/id/2092217. Accessed March 25, 2013

Connect

Maintain professionalism and trust

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A) I use at least one social platform, and I

have received a friend or “connection”

request from a patient. B) I use at least one social platform, and I

have not received a friend request from a

patient.

Bosslet GT , et. al. The Patient–Doctor Relationship and Online Social Networks: Results of a National Survey. J Gen Intern Med. 2011 October; 26(10): 1168–1174

* Garner J, O'Sullivan H. Facebook and the professional behaviours of undergraduate medical students. ClinTeach 2010;7:112–15 **JAMA. 2009;302(12):1309-1315. doi:10.1001/jama.2009.1387

• 96% percent of medical students used Facebook*
• 19% accepted friend requests from people they did not

know*

• 52% admitted that there were photos of themselves on

Facebook that they found “embarrassing.*”

• 60% (47/78) of U.S. medical schools reported incidents
• f students posting unprofessional online content**

0% 10% 20% 30% 40% 50% 60%

US Medical Schools Reporting Unprofessional Content Posted by Students using Social Media

• JAMA. 2009;302(12):1309-1315. doi:10.1001/jama.2009.1387

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Engage patients where they live

Respect patients’ privacy

• Protected Health Information (PHI): 18 unique patient data

elements

• “All elements of dates”
• “Any unique identifying number, characteristic or code”
• Covered Entities = All healthcare providers and employees
• Treatment, Payment, or Authorization. Any other use requires

the express permission of the patient.

1996 2009 2013 1996 2009 2013

• Patients must separately authorize release of PHI for

marketing purposes

• Business Associate (BA) = one who on behalf of a covered

entity, creates, receives, maintains or transmits PHI on behalf

• f the covered entity
• BAs are regulated directly under HIPAA and the BA Agreement

with the covered entity

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Recent ly, we suspended a user who regist ered as a pat ient in t he Mood communit y. This user was not a pat ient , but rat her a comput er program t hat scrapes (i.e. reads and st ores) forum informat ion. Our syst em, which alert s us when an account has looked at t oo many post s or t oo many pat ient profiles wit hin a specified t ime int erval, det ect ed t he user. We have verified t he account was linked t o a maj or media monit oring company, and we have since sent a cease and desist let t er t o it s execut ives. http://blog.patientslikeme.com/2010/05/20/bentransparencymessage/

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http://www.aap.org/en-us/my-aap/Documents/SocialMedia_guidelines.pdf “ S

• cial media comes down t o t his Golden Rule: If it applies t o t radit ional

media or t he Int ernet , it probably applies t o most public social media plat forms t oo”

• Separate personal and professional personas
• Do not use text messaging for medical interaction
• Establish a professional online profile so that it

appear first in Google search

• Develop educational programs to prevent trainees

from harming their future careers

JM Farnan, et al. Online Medical Professionalism: Patient and Public Relationships: Policy Statement From the American College of Physicians and the Federation of State Medical Boards. Annals of Internal Medicine. 2013 Apr;158(8):620-627.

• Set personal account privacy settings

to High

• Do not discuss specific patients in

social media forums

• Avoid: “I saw a patient today with

DKA”

• Okay: “Children with DKA

typically present with nausea. . .”

Empowering, Educating, Crowd Sourcing Validity of Health Information

*Brabham, Daren (2008), "Crowdsourcing as a Model for Problem Solving: An Introduction and Cases", Convergence: The Int ernat ional Journal of Research int o New Media Technologies 14 (1): 75–90

The practice of obtaining needed services, ideas, or content by soliciting contributions from a large group of people, and especially from an online community, rather than from traditional employees or suppliers. Scientific/Healthcare Context = Crowdsourcing is an online, distributed problem-solving and production model.* Crowd + Outsourcing = Crowdsourcing

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#Pro-ana #Pro-mia #Thinspiration

“ I was a few pounds overweight and needed support . I found a great sit e where everyone gave each ot her weight -loss t ips.” “ I shared a phot o of myself and got 47 comment s most ly saying how fat I was.” “ It really mot ivat ed me. I lost 3 st one wit h t he help of t hat sit e.”

• 14-year-old female with anorexia

http://www.huffingtonpost.co.uk/2012/10/12/social-media-anorexia-bulimia-young-people_n_1962730.html San Francisco, CA

20th Century 21st Century

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