A talk given at a conference for neonatal nurse practitioners.

1. The Virtual NICU Team:
Using Social Media in
Medicine
CLARA SONG, MD, FAAP
Assistant Professor of Pediatrics
Section of Neonatal-Perinatal Medicine

2. DISCLOSURE
• SPEAKER: Clara Song, MD
• I have no relevant financial relationships with the
manufacturers of any commercial products and/or
provider of commercial services discussed in this CME
activity.
• I do not intend to discuss an unapproved or
investigative use of commercial products or devices.

3. The Truth and Nothing but…
• I am not a social media expert.
• There really are no social media experts.
There are only social media users (maybe
some are mega-users).

4. I am…
• Pediatrician in a previous life
• Academic Neonatologist
• Social media user
– (@songMD, @AAPperinatal, @TECaN chat, @OU NICU
physician)
• A Journey fan
• Afraid of driving in the snow

5. From one perspective…

6. From another…

7. OBJECTIVES
• Define social media, the evolution to its current
state and its impact
• Navigate the various available web-based tools to
enhance daily practice, communication and
collaboration between healthcare communities
• Identify and prevent negative consequences
associated with social media use

8. Social Media Anxiety Disorder
• “Social Media” = Facebook and Twitter
• Rumor mill of unprofessional conduct on
Facebook and Twitter
• Unaware of closed Facebook account and
protected tweets
• Unaware of RSS, feed readers and other useful
applications of social media
Metha, N. "How physicians can overcome social media anxiety on Twitter." Technology in (Medical)
Education, blog. Aug 14, 2011.

9. Social media has
taken over…
… porn as the #1 activity on
the web.
Source: Social Media Revolution from Socialnomics.net

10. Everyday…..
… approximately 2 Billion
Google searches occur.
Source: Social Media Revolution by Socialnomics.net

11. Interestingly…..
Facebook TOPS Google for
weekly traffic in the U.S.!
Source: Social Media Revolution 2 from Socialnomics.net

12. In 2010, social media
use increased…
• Baby Boomers (46-65 yr): 54 76%
• Gen X (32-45 yr): 70 85%
• Millennials/Gen Y (13-31 yr): 84 91%
Source: PR Newswire, Nov 2010; Beyond.com Poll

13. Social networking – 51% of all adults

14. Groups in America
• 40% church, spiritual groups
• 24% sports for self or children
• 24% consumer groups
• 22% charitable or volunteer orgs
• 20% professional or trade groups
• 19% neighborhood associations
• 18% illness groups or personal situation
• 17% hobby groups or clubs
• 15% national or local organizations
• 15% political parties
• 14% alumni associations
• 13% parent groups
• 11% literary, study groups
• 10% arts groups
• 9% are active in fan groups sports
• 9% are active in youth groups
• 8% labor unions
• 8% fraternal clubs, sororities/fraternities
• 7% environmental groups
• 7% sports fantasy leagues
• 7% veterans organizations
• 6% gaming communities
• 6% fan groups celebrities
• 5% ethnic or cultural groups
• 5% travel clubs
• 4% farm organizations
• 3% in fan groups for company/product
• 3% “other”
Source: Pew Internet Project Sept 2011

15. Social side of internet – participation in 27
kinds of groups
75%
80% 82% 85%
56%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
All adults Internet users Social network
users
Twitter users Non-internet users
Participate in at least one group
Source: Pew Internet Project. Sept 2011.

16. Saying it simply…
Many people are on the web…
AND on the web to utilize social
media tools.

17. Social media impacts our lives
• Facebook Kawasaki diagnosis story
• President Obama’s townhall forum on
Facebook live
• Tweets from Egypt

20. Source: wired.com, Feb 2011

21. • $20 million for >1000 ideas
• 2,640,026 lives positively
affected
• Facebook:
– > 6 million fans
• Twitter:
– >142,000 followers
• YouTube:
– > 16.4 million uploads & 2.5
million views
•120,000 ideas
•>82 million
votes

22. “Social media is NOT a fad…
“…it’s a fundamental shift in the way we communicate.”
Source: solcomhouse.com

23. “I don’t care what people say…
Facebook is here to stay.”

24. Source: radarnetworks.com
Evolution of the Internet

25. Social
Media…. transforms broadcast
media monologues (one
to many) into social
media dialogues (many
to many).
1. Concept
2.Media
3.Social
interface
Source: http://en.wikipedia.org/wiki/Social_media

26. WEB 2.0
Blogs
Microblogs
Photos
Videos
Audio
Networks
Source: blog.milestoneinternet.com

27. Source: www.telegraph.co.uk
Reaching out and having a
conversation.
Social Media is about….

28. Health 2.0
-Information: resources &
sharing
-Medical education
-Collaboration & practice
-Disease management &
patient education
-Research & data sharing
-Professional
Development &
Networking
Source: http://en.wikipedia.org.wiki/Health_2.0, health20.org/images/ c/c1/Virtuous_Cycle.png

29. 3rd most prevalent activity
• Pew Research Center’s Internet & American
Life Project Feb 2011 report
• Survey of 3,001 American adults
• 8 in 10 Internet users search for health
informationONLINE
Source: pewinternet.org/Reports/2011/HealthTopics.aspx

30. Social Media for Health
Information
• 94% use Facebook
• 32% useYouTube
• 18% use MySpace or
Twitter
National Research
Corporation Survey
• 23,000 Americans
• 41% use social
media
• Avg age: 41 yr
Source: CNN Health, thechart.blogs..cnn.com,3/4/2011

31. We are e-Patients
• Seek online guidance for their own conditions or for
loved ones
• “equipped, electronic, enabled, educated, empowered,
engaged, equals, emancipated……”
• ?expert- “I have an A.A.D degree (Almost A Doctor).”
• 2 effects “better health information/services and
different relationships with their doctors”
Source: http://enwikipedia.org/wiki/E-Patient

32. Social Media helps patients get through it…
• Patients and their families benefit from the community
support by connecting through social media before,
during and after a hospital stay
– SmartBlog on Social Media, Nov 2010
• 1 in 5 internet users are online searching for other e-
patients- “We can say things to each other we can’t say
to to others.”
– Pew Internet & American Life Project Feb 2011

34. • Facebook: 685,302 likes + 19 other Facebook pages
• YouTube: 411,936 views + 6 otherYouTube channels
• Twitter: 8,210 followers + 13 otherTwitter accounts
• 6 Blogs

35. Twitter and Facebook (Farmville)
was used to raise $1 million for the
new children’s hospital.
Source: Modern Healthcare, March 14, 2011

36. We are e-Clinicians
• 99% of U.S. physicians and clinicians are online
• 83% consider the Internet essential to their practice
• 91% use Google for medical/pharmaceutical queries
• Textbooks, conferences web, iPhones, Blackberrys
• ….“e-Provider” … all the “e’s” and then some
(empathetic, eloquent, encouraging,….. expert”
Source: pharma2blog.com/2008/07/03/taking-the-pulse of-the-physician

37. Clinician use of social
media is UP
• February 2010: 41% practicing physicians
(N=141)
• August 2011: 87% practicing clinicians
(N=4033)
• “ConnectedClinicians”
Bosslet et al, The Patient-Doctor Relationship and Online Social Networks, J Gen Intern Med, June
2011; QuantiaMD. Doctors, Patients, & Social Media, Sept 2011.

38. #1 reason for professional participation:
educational

39. 61%
28%
31%
17%

40. - JOURNEY
Hang on, don’t you let go now.
You know, with every heartbeat, we love.
Nothing comes easy…
Hang on, ask the lonely.

41. Health 2.0-Information:
resources & sharing
-Medical education
-Collaboration &
practice
-Disease management &
patient education
-Research & data
sharing
-Professional
Development &
Networking
Source: http://en.wikipedia.org.wiki/Health_2.0, health20.org/images/ c/c1/Virtuous_Cycle.png

42. How do you currently save your
references and articles?
1. Print and file
2. Drag and drop onto a USB drive
3. Save and file into folders in Documents onto
My Computer
4. Bookmark reference onto a web account

43. Bookmark, Share & Save
Source: tootf.com

44. Source: geekestateblog.com

45. Social Bookmarking
and News Aggregates
Diigo
Connotea
CiteULike
Google Chrome:
AddThis
Delicious
Technorati
Reddit
StumbleUpon
Digg
Source: doublejdesign.co.uk

47. Social bookmarking steps
• Choose a site
• Register
• Add button (optional, but recommended)
• Find references (websites, articles, etc.)
• “Add to …” with one-click
• Add “tags”
• Socialize and share

48. Slide Share
Google Docs
SlideBoom
SlideServe
Scribd
280 Slides
SlideRocket
Slide
Source: sethpickens.files.wordpress.com/2009/02/luke-yoda
SLIDE SHARING
“Try not. Do or do not. There is no try.”
-Yoda

49. • Upload presentations, documents, video
• Follow and be followed
• Mark your “Favorites”

50. Health 2.0
-Information:
resources & sharing
-Medical education
-Collaboration & practice
-Disease management &
patient education
-Research & data sharing
-Professional
Development &
Networking
Source: http://en.wikipedia.org.wiki/Health_2.0, health20.org/images/ c/c1/Virtuous_Cycle.png

51. 2010

52. Source: www.facebook.com/press/info.php?statistics, comScore 2009
• More than 750 million active users
• 50% of active users are logged on in any given day
• Fastest growing demographic is age 35 and older; second is 55-65 year
olds (Fastest growing segment is 55-65 year old females)
• More than 30 billion content pieces shared each month SEARCH
functionality
• Most popular site to share photos
• 3rd most popular site to view online video
Facebook

53. … it would be the 3rd largest in
population.
If Facebook was a
country….
Source: Social Media Revolution 2 from Socialnomics.net

54. Image Source: flagspot.net, cia.gov, toddpaynefortennessee.com

55. FACEBOOK
Fun, casual
Meet old friends
Make new friends
Join interest groups
Learn
Share stories
Make professional
connections
Source: facebook.com

56. Facebook is casual, it’s fun!

57. It’s a party!

58. But, not this kind of party…

59. Meet old friends & make new
ones

60. Learn and Share stories

61. Make professional connections

62. Join interest groups and
communities

63. Create educational groups

64. - JOURNEY
It’s time to see how you imagine
your life…
You want to dream, anything is
possible.

65. Social= Share:
Facebook Sign-up Tips
• Connecting on Facebook: default is Everyone!
• “Edit your profile” Customize
• “How Tags Work” OFF/ON for max sharing
• Public search ON
• “Secure browsing is currently disabled” is default
• Customize sharing (photos, tags, posts)

66. Source: www.linkedstrategies.com/blog/tag/linkedin-statistics, press.linked in.com
• > 120 million professionals in 150 industries in over 200
countries
• Average age is 41 years
• Over 50% users have income >$100,000
• Over-representation of graduate school-educated users
• 64% male
• 95% of companies use LinkedIn as their primary tool to find
new employees
• Searchable by Google
LinkedIn

67. LinkedIn: Conference
• Neonatology on LinkedIn
– Neonatal-Perinatal
Medicine Group
– Neonatal/Pediatric Specialty
(RT)
– National Association of
Neonatal Nurses- NANN
– Neonatal Nurses
– NHS Neonatal and
Maternity Networking
Forum
– Preemie Purple Hearts Network

68. Health 2.0-Information:
resources & sharing
-Medical education
-Collaboration & practice
-Disease management
& patient education
-Research & data
sharing
-Professional
Development &
Networking
Source: http://en.wikipedia.org.wiki/Health_2.0, health20.org/images/ c/c1/Virtuous_Cycle.png

69. HealthMap.org

70. Health 2.0-Information: resources &
sharing
-Medical education
-Collaboration &
practice
-Disease management &
patient education
-Research & data sharing
-Professional
Development &
Networking
Source: http://en.wikipedia.org.wiki/Health_2.0, health20.org/images/ c/c1/Virtuous_Cycle.png

72. Health 2.0-Information:
resources & sharing
-Medical education
-Collaboration &
practice
-Disease management
& patient education
-Research & data
sharing
-Professional
Development &
Networking
Source: http://en.wikipedia.org.wiki/Health_2.0, health20.org/images/ c/c1/Virtuous_Cycle.png

73. Twitter is a service for friends, family, and co-
workers to communicate and stay connected
through the exchange of quick frequent answers
to one simple question: What are you doing?
“Share and discover what’s happening
right now, anywhere in the world.”
Source: twitter.com

75. Source: http://blog.nielson.com/nielsonwire/online_mobile/twitters-tweet-smell-of-success/, denverpost.com/business,
marketinggum.com June 2011
Twitter
• 175 million registered users, as of January 2011
• 200 million tweets a day, as of June 2011
• Largest Twitter group 35-44 year olds, 64% >35 yr
• The median user age: 39
• 600 million search queries/day
• 37% of active users are mobile

76. Tweets are short and sweet…..
Casual conversation, some chit-
chat, some breaking news..
-Keep up-to-date: follow, search,
engage
-Push your cause: personal talk
show
-Create a presence: keep your
finger on the public pulse
Image Source: nydailynews.com

77. • ……to make the use of
Twitter more accessible for
providers and the
healthcare community as a
whole… By lowering the
learning curve ofTwitter
with a database of relevant
hashtags to follow…..
Source: odomlewis.posterous.com

84. • Tissue recruitment
• Disaster alerting/ response
• Amber alerts
• Tracking patient/disease trends
• Live-tweets: surgical
procedures, medical
conferences
• Publishing health-related news
• Clinical education coordination

85. Google +
Source: google.com
• Now Public!
• Circles for sharing
• Chat and follow
• Hangout feature:
• Voice and video chat
• Photos, videos, links
• Search functionality

88. -JOURNEY
Be good to yourself when nobody else will.
Oh, be good to yourself.
You’re walkin’ a high wire, caught in a cross fire.
Oh, be good to yourself.

89. Lions and Tigers and Lawsuits,
oh my!
• Social networking is online= Public domain, no longer
private
• Posting online is permanent; can be deleted, but may be
archived
• Professional liability risks (violations of medical code of
ethics, HIPAA, employer or medical staff policy)
• Anonymity cannot by guaranteed; privacy can be
violated
Source: Armon, Keller. Who is Dr. Wiki and Why You Need to Know. Unique Opportun. 2009.

92. Minimize Risks
• Use common sense.
– “The least common thing in the world is common sense.”
• Review the terms of service of the online communities.
• Review your professional liability policy.
• Review your employer’s social media policy.
• Include a disclaimer.
• Remember- anonymity cannot be guaranteed.
• Review before you post. (Think, pause, then post.)
Source: Armon, Keller. Who is Dr. Wiki and Why You Need to Know. Unique Opportun. 2009.

93. To Friend or Not to Friend
• “Please Don’t ‘Friend’Your Patients”
• Violation of HIPAA by jeopardizing the
protection of individually identifiable health
information (IIHI)
Source: MDNews.com, 3/19/2011

94. Ignore…..
• 84% would NOT use social media to
communicate with their physician
• 72% would call nurse help line
• ~50% prefer email communication with
physician, online appointment setting, online
access to medical records , online bill payment
Source: HealthcareITnews.com, 3/24/2011

95. Social Do’s
• Use common sense. Ask permission. Be the same courteous,
respectful person virtually that you are in the world everyday.
• Be transparent.
• Write what you know. (Share your e-xpert knowledge.)
• Aware of the perception you create. Virtual “perception is
Reality.”
• Engage in the conversation…. Add to it.
• Be a leader, an example- you represent us all!
• Admit your whoopsy… it’s human!
• Think, review and pause, then post.
Modified from: Social Media Policy for Physicians and Staff, foxepractice.com

96. AMA Policy: Professionalism
in the Use of Social Media
• Standards of patient privacy and confidentiality
• Privacy settings
• Appropriate boundaries of patient-physician relationship
• Professional boundaries
• Ethical responsibility to report unprofessionalism
• Possibility of negative consequences

97. Why bother??
Use web tools with
confidence to streamline
Enhanced education
Effective communication
More “expert-user-
generated” content
alongside user –generated
content
Ethical considerations?

98. “Social media is like
voting…
You may not like the system, but unless
you vote, you don’t have a right to
complain about the outcome.”

99. Why not vote?

100. Still (social media)
anxious?

101. -JOURNEY
Don’t stop believin’,
Hold onto that feelin’.

102. • For resources to help
with Social Media
Anxiety, contact:
• clara-
song@ouhsc.edu